REGISTER NOW FOR MAY 18th ANNUAL MEETING

the benefit of its customers (patients). Lean is a system that produces quality products, recognizes employees as the organization’s greatest asset, and constantly pursues perfection in everything that the organization does. (Zidel, “Lean Done Right”, 2012) While I will not get into all the details of Lean in this article, suffice it to say that it represents a great process improvement tool that many healthcare systems have used to improve patient care outcomes and to attempt to achieve zero patient harm. As physicians, we may all be able to relate to incidents either in our training or in our practice where a bad patient outcome may have been prevented if a mistake were caught earlier or avoided. According to a recent article, studies of medical errors have estimated errors may account for as many as 251,000 deaths annually in the United States, making medical errors the third leading cause of death. (Anderson & Abrahamson, Stud Health Technology Informatics, 2017) Statistics like this are scary and should be motivation for all physicians to seek ways to improve the processes of our institutions in ways that lead to better outcomes for all patients. In our current healthcare environment, process improvement can be applied to many areas including ways to efficiently distribute the COVID-19 vaccine, ways to improve efficiency in the operating room, and ways to deliver high quality care at lower costs, just to name a few. The more we as physicians begin to speak about ways to improve the healthcare systems in which we work, the more our healthcare systems and our communities will benefit.

REGISTER NOW! The SCMS ANNUAL MEMBERSHIP

MEETING and the SCMS FOUNDATION ANNUAL MEETING will be held concurrently via Zoom on Tuesday, May 18, 2021, at 7 p.m. Please register online at

https://www.surveymonkey.com/r/SCMSAnnualMtg

The Zoom link will be emailed to all of those who register.

The following, and more, will be on the Agenda:

• The Slate of Nominees for 2021-22 will be voted on at the meeting and via electronic vote prior to the meeting. (see below) • Approval of updated and amended Foundation Bylaws. In 2019, the Foundation Bylaws were reviewed and revised to not only bring them up-to date as they were written over 50 years ago, but also to increase the size of the Board of Directors. The proposed Bylaws will be voted on at the meeting and via electronic vote prior to the meeting. o View the original 1968 Bylaws by clicking HERE. o View the proposed Bylaws by clicking HERE. o The Bylaws are also available on the SCMS

website under the FOUNDATION tab www. SaginawCountyMS.com

• Update on the CMU College of Medicine. Contingent on pandemic conditions, we tentatively hope to have in-person meetings on Tuesday, September 21 and Tuesday, October 19. Keep an eye on your inbox and The Bulletin for details when available. Questions? Contact Joan Cramer at jmcramer@sbcglobal. net (preferred method) or (989) 284-8884 (please leave message if I’m unable to answer).

SCMS SLATE OF NOMINEES FOR 2021-22

The following Slate of Nominees for 2021-22 was approved by the SCMS Board of Directors on Tuesday, April 20, 2021. The Slate will be voted on by the membership at the virtual Annual Membership Meeting on Tuesday, May 18, 2021.

President Anthony M. Zacharek MD President-Elect Tiffany K. Kim MD

Past President Mildred J. Willy MD Secretary Caroline G.M. Scott MD Treasurer Miriam T. Schteingart MD Board of Directors (Three year in line for presidency) Mark G. Greenwell MD Elizabeth A. Paulus MD Furhut R. Janssen DO

MSMS Delegates

Elvira M. Dawis MD Julia M. Walter MD Mildred J. Willy MD Anthony M. Zacharek MD

MSMS Alternate Delegates

Caroline G.M. Scott MD Waheed Akbar MD Mohammad Yahya Khan MD Steven J. Vance MD Christopher J. Allen MD Miriam T. Schteingart MD Kala K. Ramasamy MD Jennifer M. Romeu MD

Karensa L. Franklin MD Judy V. Blebea MD Elizabeth M. Marshall MD Nicholas E. Haddad MD

James R. Hines MD

Board of Directors (One year) Harvey K. Yee MD Mary J. McKuen MD Kai Anderson MD

Peer Review Ethics Committee

Waheed Akbar MD Chair Caroline G.M. Scott MD

Sisters

By Louis L. Constan, MD

Last month, we celebrated Women’s History Month. My own family, which includes six sisters; a remarkable wife and daughter; many granddaughters, great nieces, and female cousins, is especially blessed to have the contributions of its female members. I applaud them all. I applaud my woman practice-partner and my two women mid-levels. I applaud the contributions, as I endeavored to be your Editor of this publication, of another woman, Joan Cramer, the real brains behind “The Bulletin,” and everything else that goes on with the Saginaw County Medical Society.1 The contribution of women to my life personally and professionally, over the years, has been immense. Now is high time we honor them. In our larger society, women have made their mark everywhere. Up to and including the Vice-Presidency of our nation. It seems somehow surreal, therefore, that you hear so much about women being mistreated by men. Our own governor was once raped. Secretaries are groped. Prominent celebrities come forward daily with stories of sexual misconduct, belittlement, discrimination, abuse. Women fighting for our country are raped by their very commanding officers. Our own Underground Railroad is full of women fleeing abuse by their significant others, the fathers of their children. Shame on the men who perpetrate these injustices! Though I’d like to think that male physicians are not among those who harm and denigrate, certain inconvenient stories keep popping up of which we should be aware. Female doctorsin-training (medical students and residents) being subjected to “locker room” talk, lewd remarks, solicitations, unequal treatment compared to male trainees, and missed chances for advancement. Even more subtle sexist treatment, women colleagues say, can be demoralizing, and its day-in, dayout quality can damage promising careers. I would like to think that I myself have always treated men and women colleagues equally at all times, but I have to admit that I may not have always done so. Apologies are in order. Nevertheless, could it be that the stories you hear about sexual misconduct, discrimination, etc., are just isolated incidents, the exceptions that prove the rule? Could it be that, overall, the physician community customarily does treat men and women alike? As Benjamin Franklin would say, the proof is in the pudding. In other words, we must look at how exactly the house of Medicine is constructed in actuality… then decide if, indeed, women are treated as well as their men colleagues. First, distribution within specialty organizations. Are women represented in equal numbers within the more rarified, prestigious, difficult-to-getinto and more well-paying surgical specialties? If our profession were gender neutral, if we treated women equally and fairly, we would have equal numbers of women in each and every specialty organization, wouldn’t we? But, that’s clearly not the case. The less lucrative specialties are where the women are: Family practice, pediatrics and obstetrics. The better paid specialties are populated by men. The proof is in the pudding. So: inequality. Second, teachers in our medical schools and residencies at all levels up to Deans and Directors of Residency programs. These are important positions. Not only because of prestige, but because they influence the next generation of physicians and are well compensated. If the House of Medicine practiced gender equality, these positions would be close to 50/50 men/women. Not the case in Michigan medical schools. Inequality.

continued on page 7

I applaud the contributions, as I endeavored to be your Editor of this publication, of another woman, Joan Cramer, the real brains behind “The Bulletin,” and everything else that goes on with the Saginaw County Medical Society.1

continued from page 6

Third, physician administrators in hospitals, health care organizations and insurance companies. These positions are not always filled by physicians, but when they are, the physician is usually a male. These positions are well paid, which is always important and a fairness issue; but, perhaps more important, these doctors actually make policy decisions that affect the practice situations of myriad other physicians. The majority of these administrators are men, and we might question if they can reasonably represent the interests of half of the physician population which is female. If they are mostly men, then is there not some bias somewhere in the system? Again, inequality. Fourth, physician-scientists, scientific research company directors and administrators. Again, these are corporate jobs and carry high salaries (the fairness issue), but also have influence over the larger way physicians practice medicine. These male doctors set the research agenda for the country and may be the reason why women are underrepresented in double-blind research studies; as well as, the dearth of studies on traditional women’s issues such as contraception and abortion. Further inequality. Fifth, and perhaps most important. The biggest influencers in our society are politicians. The United States Congress currently has 15 physician members, who certainly have an outsized influence when said Congress considers health legislation (1/5th of our economy and always on the docket). And how many of those physicians are women? Zero. The ultimate inequality! Let’s MAKE history and actually encourage and support women physicians in all these roles! For regular readers of this column: You may enjoy “Two Minds, Your Body,” which contains some of my favorite articles. You can get it by typing “Louis Constan Book” into any search engine.

1 It’s important to point out the SCMS has a rich history of involvement by women physicians in leadership roles.

www.SaginawCountyMS.com

All statements or comments in The Bulletin are those of the writer, and not necessarily the opinion of the Saginaw County Medical Society.

If you find it difficult to communicate with your doctor; if you find it hard to get personal attention from an 'impersonal healthcare industry'; if you don't understand all those insurance-company rules; if you don't know how to change your bad health habits; if you think you may be on unnecessary medications; if you are perplexed by those annoying health-product advertisements; and if you'd like to know which are your greatest health risks - you'll appreciate this Family Doctor's advice, gleaned from 44 years of practice. 1 Each chapter is illustrated with real-life examples from his and other doctors' practices. Each chapter ends with 'bonus' essays written by the author and published in newspapers and magazines giving the doctor's viewpoint. This will give you a unique perspective and allow you to 'get into the mind' of a doctor. Sweet! Available on Kindle (different cover but same book) and paperback.

Available on Amazon by clicking HERE

Michigan Suicide Prevention Commission Report Makes Lowering Suicide Rate a Priority, Offers Recommendations

Someone dies by suicide every six hours in the state

With someone dying by suicide every six hours in the state, the Michigan Department of Health and Human Services (MDHHS) released a report that makes recommendations on how to reduce the suicide rate. The Michigan Suicide Prevention Commission Initial Report is from a group appointed by Gov. Gretchen Whitmer in March 2020 which includes Barb Smith. “In Michigan, anyone who needs help should be able to get it,” said Gov. Whitmer. “This task force will do critical work to collect data, expand resources, and implement best practices so we can save lives. We must work together to reduce suicide rates in Michigan and make sure that everyone knows that it’s OK to not be OK and help is always here.” The recommendations address the Commission priorities of: • Minimizing risk for suicidal behavior by promoting safe environments, resiliency and connectedness. • Increasing and expanding access to care to support Michiganders who are at-risk. • Improving suicide prevention training and education. • Implementing best practices in suicide prevention for health care systems. • Enhancing suicide-specific data collection and systems. The Commission has been charged to work with state departments, nonprofit organizations and universities to research the causes and possible underlying factors of suicide in the state. Provisional 2020 data for Michigan shows 1,282 suicide deaths. That number is expected to increase as more suicide reports are finalized. In 2019, there were 1,471 suicides in Michigan. Suicide is the 10th leading cause of death in

Michigan. In 2017, more than four times as many people died by suicide in Michigan than by alcohol-related motor vehicle accidents.

The report notes that MDHHS has taken steps to address mental health issues that could be worsened by the COVID-19 pandemic. This has included providing mental health and substance use services, as well as, emotional support resources. These resources can be found at michigan.gov/StayWell.

Anyone who needs help can call the National Suicide Prevention Lifeline 24 hours a day, seven days a week, at 1-800273-8255 or 1-800-273-TALK. Press 1 for the Veterans Crisis Line. Anyone under age 21 can ask to talk to a peer at Teen Link, 1-866-833-6546. TTY users can use their preferred relay services or dial 711 then 1-800-273-8255.

Are you in a crisis? Call 800-273-8255 or text TALK to 741741