Democratizing the Conversation for Greater Good: Social Media Usage at Academic Conferences

By Chris Morley, PhD, Ben Miller, PsyD,  and Mark Ryan, MD

Recently, there has been some discussion about whether the sharing of information presented during academic conferences via social media is appropriate, taking form in both peer-reviewed literature1–4 and in online blogs5 and social media, with a particular focus on Twitter.

Predictably, there are arguments presented against the sharing of material via social media that frequently center on the protection of copyrights, patents, intellectual property, or simply ideas-in-formation. Other arguments tend to fret over whether the sharing of a table, figure, or text, presented in a conference, may somehow represent prior publication that might interfere with the ability to later incorporate the same text into a formal journal publication. The crux of either argument tends to be that the presenter has shared information in one form, but that any sharing of that information beyond that context without the presenter’s express permission infringes upon intellectual property rights and/or future publication possibilities.

This antiquated view of information sharing is in need of disruption. Academia, of all, should learn a thing or two about the need to stay relevant in a day and age where people learn of their news from Twitter. It really puts things in perspective when one considers that most academicians wait 8–12 months (or longer!) for a peer-review process to be complete to allow them to share their findings. Conferences have long been one of the best ways to allow for academicians to share their findings with a broader audience while waiting on the laborious and lengthy peer-review process to complete.

However, should we take it as far as to tell people to not tweet what they hear or see at a conference?

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LGBT Health Is More Than HIV and STIs

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Adam Lake, MD

When it comes to LGBTQ+ health, the first topic that I often see is related to HIV and STIs.

While this is certainly one of many health disparities that emerge when comparing the LGBTQ+ population to the population as a whole, overdoing the focus on this topic can be divisive. The health disparities extend to mental health, cardiovascular risk, and use of preventative care.

As a family doctor and HIV care provider, I see this bias leading to an earlier diagnosis in a young gay man who had a sore throat that wouldn’t quit, but missed completely in the straight married woman with unexplained low cell counts despite extensive testing and multiple subspecialist referrals. This pattern is borne out in many, many, many studies.

True, sexual (and/or romantic) identity is what can be used to define the LGB population, though same-sex sexual activity is not always the defining factor for self-identification. As a juxtaposition, Trans*, queer, and gender non-conforming populations generally are defined by their non-cis gender identity and not sexual identity. The impact we have on Trans* patients seeking health care is especially striking with 28% putting off care due to discrimination and disrespect even when sick or injured.

The challenge here is deeper than where we may immediately recognize. The hard part is not seeing the nuance in the population prevalence: this is about being a safe space for all patients.

As teaching family doctors, we have a great opportunity to demonstrate empathy and to teach appropriate care for all. I encourage my learners to find a way to add sexual history inquiries into standard questions and to create a safe space to have candid dialog between provider and patient.

I will never forget a true conversation I had with a 60-year-old man in our more rural practice:

Me: Do you smoke cigarettes?

Patient: Nah, quit that years ago.

Me: Any alcohol?

Patient: Here and there, you know, nothing on a regular basis.

Me: Any other drugs?

Patient: Nope.

Me: Are you currently sexually active?

Patient: Yep.

Me: With men, women, or both?

Patient: Both, but I generally only have sex with guys when my wife and I are doing coke…

As you can imagine, more questions followed. While this patient identified as straight, I have found again and again that simply asking about sex will often lead to more accurate histories from patients in other domains of information. Questions about this have helped me break down my own preconceived notions of sexuality, especially when encountering unexpected answers in patients who challenge our assumptions.

To change the health care system as a whole is not within the power of a single one of us, but affecting that which is within our influence is possible. You may have the ability to affect curricular development or develop community educational activities. Or you may have the ability to personally open the eyes of your students, residents, or colleagues.  Whatever your power may be, go out and make the change.
We owe it to all our patients. For patients invisibly attracted to those on the same side of the gender spectrum who have never revealed that to a provider. For the transwoman who just wants to talk to you about her shoulder pain and not her genitals. For the straight woman with the sore throat that won’t go away. For the queer teen who just can’t take it anymore. I want our patients to know that we care.

Taking the Time to Learn About Transgender Health Care

Rebecca Bak_Photoweb

Rebecca Bak, MD, MPH

A few weeks after I met a young transgender woman in our urgent care and had offered to become her primary care doctor, she sent me an email with a link to a small study in which only 41% of endocrinologists felt competent to provide transgender care. In her email, she thanked me for being the first doctor to ask about her chosen gender pronouns and for taking the time to learn about transgender health care.

I am a family doctor working in rural New Mexico, 2 years out of residency. I still often feel like I am working just outside my comfort zone—when I’m reducing a dislocated shoulder, managing a retained placenta, or caring for a young patient who had ingested a liquid poison. I’ve learned to rely on my colleagues, consult specialists when needed, and read—a lot. At the end of residency, I still didn’t feel comfortable with interpreting complicated EKGs, so I set up a rotation with a cardiologist and went through page after page of EKGs. I still don’t feel completely comfortable providing rheumatologic medications to patients (and my patient population has a large number with rheumatoid arthritis), so I read up and call the specialists.

Family doctors, whether working rurally or urban, are often expected to work just outside their comfort zone. I did my residency in Rhode Island and, though the nearest city with the preeminent hospital was 15 minutes away, many patients with complicated illnesses chose to continue care with us because they felt more comfortable with their family doctors, they couldn’t afford bus fare, or they were caregivers to others and wanted to stay close to home.

We, family doctors, should be at the forefront of providing medical care, including hormone therapy, to our transgender patients. We are present for our patients from birth to death, during severe medical illnesses, at moments of depression and anxiety, and also during moments of joy. It is a statement of acceptance to continue caring for our patients who are making the momentous decision to transition to a body that feels right to them.

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