Month: February 2021

Vaccine Hesitancy and Allyship with Aysha Khoury, MD, MPH

In 2019, Dr. Aysha (i-sha) Khoury (koo-ree) was recruited to become founding faculty at Kaiser Permanente Bernard J Tyson School of Medicine. She developed case-based curricula, implementing flipped classroom and active learning pedagogies. She served as a small group facilitator and Equity, Inclusion, and Diversity Champion and Workgroup member. On August 28, 2020, within hours of engaging her small group in a critical discussion on bias and racism in medicine, she was targeted, suspended, and ultimately terminated without transparency or due process. We begin the interview by discussing her termination, what she felt led to it, although with the lack of transparency, she still hasn’t been informed. We use this as a jumping off point to discuss allyship, or in her situation, lack thereof.

We then move on to why there is medical mistrust among minoritized communities, including a discussion on why we now use words like minoritized and enslaved. We finish with a discussion on how to address SARS-Co-V-2 vaccine hesitancy in the setting of justifiable medical mistrust. Her argument is that there is less hesitancy in the older population, so if we address the inequities in vaccination access, the older population will be able to influence the hesitations of the younger population.

Dr. Khoury grew up in Atlanta, GA and completed her medical degree there at Morehouse School of Medicine. After completing an internal medicine residency and working as a primary care physician, she returned to Morehouse School of Medicine to complete training in public health and preventive medicine and earned a Master of Public Health.  After this, Dr. Khoury returned to the Southeastern Permanenete Medical Group and pioneered a new role there as a Clinical Decision Unit Internist. This encompassed work in quality management, process improvement, and evaluation of treatment outcomes. Committed to education and advocacy early in her career, she served as an adjunct clinical assistant professor and Admissions Committee Member at Morehouse School of Medicine, where she was later inducted in the White Coat Society for demonstrating compassionate care and community service.

Motivational Interviewing for Addressing Vaccine Hesitancy with Joseph Weiner, MD, PhD

Dr. Joseph Weiner is an Associate Professor of Clinical Psychiatry, Medicine and Science Education at the Zucker School of Medicine at Hofstra/Northwell, where he co-directs the four-year curriculum in Physician-Patient Communication and Interpersonal Skills. Thinking and writing about how patients and clinicians communicate with each other has been a major interest in his career.

He teaches us today about something I’ve been wanting to learn about for a long time. The tagline of this show is “everything we should have been learning while we were memorizing Kreb’s cycle.” This doesn’t hold true for this episode because Dr. Weiner teaches motivational interviewing to medical students; it just wasn’t being taught when I was there. We go over the basics of motivational interviewing, its origins, the spirit of it, how to go about it and then we discuss how it can be used to have a productive conversation about the SARS-CoV-2 vaccine. I haven’t had training in it, but I’ve used it already and it WORKS! You can’t use it to get someone to do something they don’t already want to do, but it helps them clarify their thoughts and hesitations and, using BJ Fogg’s language, either get closer to or over the action line.

Dr. Weiner received his M.D. and his Ph.D. in Physiology and Biophysics from New York University. He did residency training in psychiatry at NYU/Bellevue and a fellowship in public psychiatry at Columbia College of Physicians and Surgeons. In addition, he pursued advanced psychotherapy training at the American Institute of Psychoanalysis.

Dr. Weiner has received national and regional awards for his work as a clinician and educator. One he is particularly proud of was the 2015 Teacher of the Year Award from the Zucker School of Medicine at Hofstra/Northwell for the first 100 weeks of medical school. Dr. Weiner’s career interest in communication has expanded to the written medical narrative. He is writing a book about lessons learned from his late wife’s battle with cancer and is currently an MFA student in Creative Writing and Literature at Stony Brook Southampton.

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How Do People Make Decisions about Vaccinations with Reyaneh Maktoufi, PhD

Dr. Reyhaneh Maktoufi has recently defended her Ph.D. in Media, Technology, and Society at Northwestern University. She is a Rita Allen Foundation Civic Science Fellow at WGBH/NOVA. Her main fields of interest are science communication, misinformation, curiosity, public engagement with scientists, and science communication in media. She is a health communications expert turned science communication expert, so we are bringing her back into health communication with another discussion on addressing vaccine hesitancy.

When approaching patients with vaccine hesitancy, it is important recognizing that we make many decisions with emotions, not with facts. Fighting misinformation with information probably won’t. The key is trust. Find out the source of their hesitation and never ever dismiss it. Trust starts with relationship building and the conversation ends with addressing concerns. We also discuss how we can build trust in patients from communities that have justifiable mistrust of the medical establishment. And never bring up misinformation with your patients because it actually plants the seed of it possibly being true.

Before starting a Ph.D., Rey has been working as a health communication facilitator and cancer preventive/palliative care campaign manager in Tehran, Iran. She was a visiting researcher at the Adler Planetarium, where she studied science communication and facilitated workshops on communication skills and she’s also a producer at The Story Collider podcast. Rey currently enjoys working with different nonprofits such as the Communicating Science Conference (ComSciCon).

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Science Communication: SARS-CoV-2 Vaccine Edition, with Matthew Facciani, PhD

Matthew Facciani, PhD, is a postdoctoral researcher at Vanderbilt University in the Medicine, Health, and Society Department. His research interests include LGBTQ health, social networks, political polarization, and misinformation. We discuss science communication and how to find ways to make complicated science easier to understand. This is particularly relevant because of the SARS-CoV-2 vaccine, so we need to be sure we can effectively communicate how it works and any potential risks. We even get into how to effectively conceptualize and communicate risk. I fumbled during the interview to think of a quote from Neil deGrasse Tyson, which is “The good thing about science is that it’s true whether or not you believe in it,” but Dr. Facciani makes the point that even science is not without politics, so we discuss this and how because of politics, the traditional antivaxxer isn’t the same as the SARS-CoV-2 antivaxxer.

Dr. Facciani received a BA in Psychology from Westminster College and MA and PhD in Sociology from The University of South Carolina. Facciani’s writing and research has appeared in The Conversation, Snopes, Salon, Mother Jones, and other outlets. Facciani has also given talks about his research to audiences around the country and has provided scientific testimony to policy makers.  Find him at MatthewFacciani.com and his podcast Social Science Hour.

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Consent-Driven Care with Dr. Crystal Beal

Dr. Crystal Beal is a non-binary femme physician, who provides high-quality, expert, and individualized queer and #genderaffirming medical care through QueerDoc.com. QueerDoc’s mission is to raise the bar and lower the barriers to accessing #genderaffirmingcare. Dr. Beal discusses just how frequent trauma is and how what they call “consent-driven care” is an extension of #traumainformedcare. For more on trauma-informed care, see my episode with Dr. Megan Gerber.

As #physicians, we shouldn’t just assume that we have permission to touch our #patients in a way that we deem appropriate. We may assume that it is implied that if they are in the office for a thyroid exam, we can just examine their neck, but keep in mind, there may be a #traumahistory. They teach us at what point during the visit we should be asking for consent for parts of the #physicalexam and even the way we ask some parts of the history. This can help us #buildtrust with patients who may have had experiences with the #healthcaresystem that has given them cause for mistrust. We also discuss when it is necessary to have a chaperone.

Dr. Beal attended Florida State University College of Medicine. They completed their training at Valley #FamilyMedicine #Residency achieving Board Certification in Family Medicine. Continuing to see gaps in care for their #LGBTQ+community, Dr. Beal sought extensive additional training in #sexualhealth, #queerhealth, and gender affirming care including self-study, continuing medical education trainings, and shadowing experts at Seattle Children’s #GenderClinic.

While starting QueerDoc, Dr. Beal supported their #privatepractice through work providing care for people with #substanceusedisorder. Working in this field has continued to ignite Dr. Beal’s passion for #equityinhealthcare and advocacy for vulnerable populations. Now board-eligible in #AddictionMedicine, Dr. Beal plans to sit for the exams in 2021.

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