RHODE ISLAND M EDICAL J OURNAL The Aronson Tree SEptember 2018 VOLUME 101 • NUMBER 7 ISSN 2327-2228 STAY FOCUSED AMONG THE DISTRACTIONS. Minimize the things that get in the way of why you’re in healthcare to begin with. A focus on reducing lawsuits is just one way we do this. MEDICAL PROFESSIONAL LIABILITY INSURANCE ANALYTICS RISK MANAGEMENT EDUCATION Insurance products issued by: ProSelect Insurance Company® coverys.com RHODE ISLAND M EDICAL J OURNAL 7 COMMENTARY Sotto voce JOSEPH H. FRIEDMAN, MD The Aronson Tree and the Roots of Brown’s Medical School SUTCHIN R. PATEL, MD ANTHONY A. CALDAMONE, MD Eliminating parental consent for adolescents receiving human papillomavirus vaccination NICHOLA HADDAD, BA REBECCA H. ALLEN, MD, MPH DARIA SZKWARKO, DO, MPH MICHELLE FORCIER, MD, MPH CHERIE PAQUETTE, MD, MS 15 RIMJ AROUND THE WORLD Barcelona, Spain 53 RIMS NEWS Are you reading RIMS Notes? Working for You Annual Membership CONVIVIUM and Awards Dinner Convivi um T RAN G NORM 3 RHODE ISLAND M EDICAL J OURNAL IN THE NEWS RHODE ISLAND HOSPitaL 59 61 WOMEN & INfaNTS receives $11.8M to establish introduces new technology Center of Biomedical Research to guide breast surgeries Excellence on Opioids and Overdose 63 PartNERS HEALTHCARE, CARE NEW ENGLAND, BROWN VAMC CARDIOPULMONARY RESEARCH 60 negotiate partnership Center of Excellence $10M grant renewed 64 CARE NEW ENGLAND FENtaNYL TEST STRIPS 61 releases FY 2018 Q3 results distributed on Overdose Awareness Day PEOPLE/PLACES RHODE ISLAND 66 68 BARBARA FLETCHER, RN a national leader in named hospice volunteer immunizations for adolescents coordinator at VNA of CNE SOUTH COUNTY HOSPitaL 66 69 LISA RAMEAKA, MD among 2018–19 Best Hospitals appointed VP of Medical Affairs, by U.S. News & World Report CMO at South County SOUTHCOAST HEALTH 66 69 ERIKA WERNER, MD named among region’s best named Director of Division by U.S. News & World Report of Maternal-Fetal Medicine Paari GOPALAKRISHNAN, MD 68 70 OBITUARIES named Chief Medical Officer Yalakki Gowda, MD at Kent Hospital Adib M. Mechrefe, MD 4 SEptember 2018 VOLUME 101 • NUMBER 7 RHODE ISLAND Rhode Island Medical Society R I Med J (2013) M EDICAL J OURNAL PUBLISHER 2327-2228 RHODE ISLAND MEDICAL SOCIETY 101 PRESIDENT BRADLEY J. COLLINS, MD 7 PRESIDENT-ELECT 2018 PETER A. HOLLMANN, MD VICE PRESIDENT September NORMAN M. GORDON, MD CONTRIBUTIONS Secretary 17 Newborn Screening for Hemoglobinopathies in Rhode Island, 2017 CHRISTINE BROUSSEAU, MD 4 PHILIPPA SPRINZ, MD, MSc; KAREN LEMKE, BSN, RN; TREASURER JAMES PADBURY, MD; CHRISTELLE FARROW, MPH CATHERINE A. CUMMINGS, MD IMMEDiate past PRESIDENT 21 Evaluation of Orthopaedic Interest Groups SARAH J. FESSLER, MD in American Medical Schools EXECUTIVE DIRECTOR NEWELL E. WARDE, PhD NATHAN V. DOREMUS, MS; ANDREW D. SOBEL, MD; JOSEPH A. GIL, MD; MARY K. MULCAHEY, MD EDITOR-IN-CHIEF JOSEPH H. FRIEDMAN, MD 25 State Unintentional Drug Overdose Reporting Surveillance: Associate EDITOR Opioid Overdose Deaths and Characteristics in Rhode Island KENNETH S. KORR, MD YONGWEN JIANG, PhD; JAMES MCDONALD, MD, MPH; ARIEL GOLDSCHMIDT, MD; JENNIFER KOZIOL, MPH; PUBLication StaFF MEGHAN MCCORMICK, MPH; SAMARA VINER-BROWN, MS; MANAGING EDITOR NICOLE ALEXANDER-SCOTT, MD, MPH MARY KORR [email protected] 31 Food Insecurity and Child Maltreatment: GRAPHIC DESIGNER A Quality Improvement Project MARIANNE MIGLIORI RACHEL SILLIMAN COHEN, MD, FAAP; JESSICA L. MOORE, BA; ADvertisinG ADministrator CHRISTINE E. BARRON, MD, FAAP SARAH BROOKE STEVENS [email protected] 35 Engaging College-Level Baccalaureate-MD Students in Clinical Research ELAINE M. TRAN, BS; JULIANNE IP, MD PAUL B. GREENBERG, MD, MPH 39 Use of Language Services for Telephone Advice by Limited English Proficiency Families in a Pediatric Primary Care Setting DELMA-JEAN WATTS, MD; NIZAR DOWLA, MD; PRIYA HIRWAY, ScM; MAURICE HAJJAR; SHUBA KAMATH, MD, MPH 43 Comparing HbA1C by POC and HPLC SUNGEETA AGRAWAL, MD; STEVEN E. REINERT, MS; GRAYSON L. BAIRD, PhD; JOSE BERNARDO QUINTOS, MD PUBLIC HEALTH RHODE ISLAND MEDICAL JOURNAL 47 HEALTH BY NUMBERS (USPS 464-820), a monthly publication, is owned and published by the Rhode Island Risky Motor Vehicle Behaviors among Medical Society, 405 Promenade Street, Suite Rhode Island High School Students A, Providence RI 02908, 401-331-3207. All rights reserved. ISSN 2327-2228. Published TRACY L. JACKSON, PhD, MPH articles represent opinions of the authors and TARA COOPER, MPH do not necessarily reflect the official policy of the Rhode Island Medical Society, unless clearly specified. Advertisements do not im- ply sponsorship or endorsement by the Rhode 51 Vital Statistics Island Medical Society. ROSEANN GIORGIANNI DEPUTY STATE REGISTRAR © COPYRIGHT 2013–2018, RHODE ISLAND MEDICAL SOCIETY, ALL RIGHTS RESERVED. 5 Your records are secure. Until they’re not. Data theft can happen to anyone, anytime. A misplaced mobile device can compromise your personal or patient records. RIMS IBC can get you the cyber liability insurance you need to protect yourself and your patients. Call us. 401-272-1050 IN COOPERATION WITH RIMS IBC RIMS INSURANCE BROKERAGE CORPORATION 405 PROMENADE STREET, SUITE B, PROVIDENCE RI 02908-4811 MEDICAL PROFESSIONAL/ CYBER LIABILITY PROPERTY/ CASUALTY LIFE/HEALTH/ DISABILITY Commentary Sotto voce JOSEPH H. FRIEDMAN, MD [email protected] 7 8 EN IT IS NEVER A GOOD IDEA if the next patient arrives to patients. Many years ago I realized for a doctor to get angry at on time, I might have to that when I became short with some a patient or family. I am cut short the visit. But annoying patients, I became a bit louder sure it happens to all of I apologize for this, as than usual. I’m sure many of us do that, us, even the most saintly. if this is my own fault, but I realized that this was always a Nothing upsets me more although I don’t really bad way to interact. I also sometimes than a patient who shows mean it that way. cut them off, although ever mindful up late and then insists I was stunned recently of the famous study that reported that on taking time to describe to receive a copy of an American doctors, on average, allow trivial problems or simply office note from a primary their patients to speak for 17 seconds to socialize, completely care doctor describing an before interrupting. While I abhor the unconcerned about the interaction with our notion that I might be included in that patients waiting to be seen. I ask a ques- mutual patient, who is, to be honest, statistic, I do sometimes fantasize that tion and get a tangential response, with sometimes rather demanding, hence, I could emulate it, but there is always the spouse adding an even more mini- annoying. The PCP actually charted a power differential between the doctor mally related observation, or perhaps his loss of savoir faire. The patient, and the patient, whether the doctor per- even a theory as to why the fried chicken probably for the tenth time, including a ceives it or not, and that it should never was the real culprit. few phone calls, asked why he was not be abused. I made a decision to try to I will admit that I have a problem responding to a medication I, not the always lower my voice when annoyed. with running late. I hate to keep people PCP, had given him, and the PCP, obvi- I figured that was the easiest way to keep waiting. It runs in my family. We are ously a bit beyond the end of his tether, myself from showing anger. I might almost never late for anything. I often said, “I’m not your f___ing neurologist. have to repeat a question or a request, feel miserable excoriating Mr. Jones in Go ask him!” The next note records the and, if the patient was deaf, I could shout my mind when a secretary asks if I’ll apology the doctor made to the patient. anyway without appearing to express still see him, as he is 10 minutes late His inclusion of the interaction, with annoyance. I don’t think that any of the and that’s the upper limit we use in my quotes, was, on the one hand, honest, many medical observers, house staff and clinic. I agree, as I always do, and in brave and appropriately apologetic, students, have ever remarked on my totters an incredibly frail, elderly man while on the other, illuminating on the occasional soft voice. I, of course, find with his equally frail and elderly wife difficult interactions these two have the use of the soft voice pretty obvious, apologizing for one of them having to had. Having shared many patients with and I have noticed that I often adopt the stop in a bathroom, and for the accident this doctor, I have never heard any voice before I am consciously aware that on Route 95 which stopped traffic and complaints about him, and certainly I am annoyed. When I’m really angry, which they had nothing to do with. I am never had cause to wonder if he had a I think of gangster movies where the bad a sinner, and know it. I think that I cover behavioral abnormality. guy makes his most serious threats in an up pretty well, but who knows? When a That office note made me reflect on almost whispered voice. “When I asked patient arrives late, without an apology, my own sub-optimal patient interac- you when the tremor began, I really or an excuse, I try not to ask what held tions. Like most doctors, I spend a lot meant, when did the tremor begin. them up, although I may tell them that of time every day returning phone calls I didn’t ask what you were eating when RIMJ ARCHIVES | SEPTEMBER ISSUE WEBPAGE | RIMS SEPTEMBER 2018 RHODE ISLAND MEDICAL JOURNAL 7 Commentary you first noticed it.