Green spaces not only slow global warming, but reduce crime and improve learning

The DTSR took note of a recent study by the University of Illinois at Urbana-Champaign, which showed that leafy green spaces can reduce domestic violence rates, relieve ADHD symptoms, and reduce crime. In fact, city buildings with high levels of greenery had 48% fewer property crimes and 56% fewer violent crimes. City kids with bedroom views of greenery had higher test scores than kids that just looked at pavement.

The same group also believes that people who live in green communities tend to procrastinate less. We’ll get around to investigating this further. Maybe tomorrow.

Source: Keep America Beautiful




The latest on condoning homophobia at BIDMC

For those who aren't keeping up with the comments thread over at Paul Levy's blog, here's a quick summary of where the discussion has gone thus far.

He is now blaming the victims. People are posting about how it's the hospital's responsibility to address the issue with the physician, because there is no way for a patient to know whether a physician declined to run tests or declined to take complaints seriously based on sexual orientation or perceived sexual orientation. Paul Levy maintains that it is the patient's duty to complain if there is incompetence on the physician's part. But see, the patient isn't the one who reviews the physician's work and asks why certain decisions were or were not made.

He also insists that there cannot be rules about what is allowed to be said in a workplace, because this would be "thought policing" (his words). No, it wouldn't be thought policing, because no one is asking you to read people's thoughts. We're asking you to take action based on the fact that this physician wrote a letter, full of medically incorrect information, stating that GLBT folks are inherently bad. According to the BIDMC human resources website, there are rules prohibiting written or spoken speech that is discriminatory. There are also rules requiring doctors to keep abreast of medical research. There absolutely can be rules about what can be said in a workplace, and there are. Would he use the same excuse if someone circulated a letter saying a coworker had nice tits?

If you haven't already, please write to BIDMC and tell them how dangerous and irresponsible this is.


BIDMC CEO receives communication from a BIDMC physician representing an anti-GLBT hate group, blogs it, takes no real action

Paul Levy, the CEO of Beth Israel Deaconess Medical Center, posts a letter on his blog that he received, which states that the author is opposed to BIDMC validating the GLBT community, because the committee feels that "homosexuality is immoral, ungodly, unnatural, and of course unhealthy." The letter further states that "the health risks of homosexual behavior are well known and incontrovertible," and "It is all together inappropriate for BIDMC to endorse, affirm, or encourage these behaviors."

The letter orginated from a physician at the institution and is written in the first-person plural, claiming to be from "The Committee to Restore Sensible Values and Perspective."

While I enjoy reading Mr. Levy's blog and very much respect him, I find his lack of action on this letter quite disturbing, especially given that the letter is now available to staff and patients by virtue of being posted on his blog.

If you read the comments thread, you'll see Mr. Levy's descriptions of the action he has taken in response to the letter. He describes having done the following:
  • Wrote back to the physician, assuring him/her that BIDMC is somewhere where all values can be expressed and respected (we'll get to how the BIDMC anti-discrimination policy doesn't necessarily agree in a moment)
  • Asked the physician to consider whether s/he is able to separate these beliefs from his/her work with patients (the physician reportedly ensured Mr. Levy that s/he is able to)

  • Mentioned the letter to the physician's supervisor (the supervisor reportedly assured Mr. Levy that "there had been no indication of improper behavior by this doctor in the presence of patients")

I appreciate that he spoke to the person in question and posted on his blog expressing his disagreement. This is appropriate. What's troublesome is all of the actions he hasn't taken, and which he defends throughout the comments thread. He seems to be focused on how he can't discipline someone or take away privileges when the person has not given evidence of harming patients. This is correct, of course, and we don't want to ruin a good cause by violating this physician's rights in the process. We also don't want to overlook that the individual who signed the letter has some basic medical facts wrong, which is grounds for taking many actions that don't necessarily involve removing privileges.

Why this lack of action troubles me:

  • This physician has some medical facts wrong regarding STD risk, the idea that GLBT identity is inherently unhealthy, and the idea that GLBT identity should not be affirmed or encouraged (the AMA has released position statements regarding the harm caused by encouraging people to deny or change their sexual orientation). This physician took it upon him/herself to alert Mr. Levy to this lack of education. Mr. Levy should thank him/her for being so upfront in disclosing these deficits in this matter and see to it that s/he receive appropriate training. (Which, in the healthcare field, involves being observed by another provider to ensure that the skills are being applied appropriately.)
  • Disparities in healthcare between GLBT individuals and non-GLBT individuals are not generally caused by outright "mistreatment" by providers, but rather by providers whose own biases prevent them from taking accurate sexual histories, from encouraging patients to be open and honest about their lives and behavior, and from accurately assessing the mental and emotional health of patients. A physician with good boundaries between personal beliefs and professional practice would not typically take the time to state, in writing, at his/her workplace, that s/he believes GLBT individuals are immoral and unhealthy. This letter is evidence of a serious potential to harm patients. "No evidence of improper behavior" is not a sufficient indication that this person can really work effectively with GLBT individuals. At every one of the GLBT healthcare trainings I do, I hear from dozens of people who have encountered homophobia in healthcare but did not complain.

  • Remember, this wasn't just a comment that this doctor muttered after seeing an announcement. This was a letter the doctor has written every year, while purporting to be part of a committee. The AMA has made statements that GLBT identity must be affirmed and disparities must be addressed, yet this physician clearly feels differently. It is important that all staff at the institution are working from the same standards, and if an alleged committee is advocating for different practices from the standard ones, an appropriate response is either to take action to ask that s/he stop, or to make the committee's statement available for all staff to discuss in order to arrive at an official hospital policy.
  • The Beth Israel Deaconess Medical Center Policy on Harassment and Discrimination states that inappropriate behavior includes unsolicited remarks, gestures, or physical contact, display, or circulation of written materials or pictures which has the purpose or effect of creating an environment which is hostile, offensive, coercive, or humiliating based on race, color, religion, national origin, age, sex, sexual orientation (gay, lesbian, bisexual, or heterosexual), disability, or veteran status. This individual clearly circulated written materials that are offensive to GLB individuals. [Notice that their policies don't cover trans folks, even though the City of Boston Municipal Code covers gender identity and gender expression]. Thanks to Mr. Levy's blog, this material has now been circulated to all staff, patients, and community members who come across the letter. Additionally, the letter does not purport to be the opinion of one person, but rather, of a committee operating within the hospital.

  • I find it hard to believe that this doesn't violate some sort of policies regarding organizing (or using company time, or using company computers...) for purposes that are not directly related to their mission. At my workplace, which is quite progressive, there would be consequences for forming a committee inside the workplace without clearing it with administration, regardless of the message of the committee. This is mostly just for reasons of practicality, but also to ensure that staff are not sending messages that go against the mission of the company.

What I'm doing to address this:

  • Writing to everyone I can at BIDMC (patientrelations@bidmc.harvard.edu or conduct_c@bidmc.harvard.edu seem like good places to start) to tell them how I feel. I'm expressing that as a patient, I feel scared and threatened that this letter was circulated at the hospital with no consequences, and I'm letting them know that I am not comfortable returning to a hospital that tolerates such things. I'm outlining how the letter seems to violate their harassment policy (especially since it is in the hands of staff and patients) and explaining why I believe additional action needs to be taken to truly assess this person's professional boundaries and skills.
  • I'm encouraging everyone we know who works at BIDMC to take action if they feel the letter affects them as an employee there.
  • I'm writing to Fenway Community Health Center, where my PCP is, explaining to them that I feel uncomfortable that they typically refer patients to BIDMC for specialty care, given that BIDMC is allowing physicians to spread anti-GLBT sentiments throughout the hospital (and now into the community) with little consequence. I am asking them if they plan to give any sort of statement in response to the letter.
  • I plan to conduct more GLBT healthcare trainings this year than I had previously planned to, and to offer these to agencies at a reduced rate. I am also looking into writing articles that I had not previously planned to write.

If the events that have taken place ad BIDMC are bothersome to you as well, please consider sending a few e-mails.



If you're concerned about the health of yourself and of animals, then stop making choices to the contrary

I just got an e-mail alert linking to this petition:

When you grab a latte from Starbucks, do you know what's in the milk? Unfortunately, probably more than you bargained for. Starbucks uses milk from cows that are injected with a genetically engineered, artificial hormone called recombinant bovine growth hormone, also known as rBGH or rBST. The problem is, this hormone is known to cause harm to cows and may pose harm to humans.

Sure, being concerned about artificial hormones and the risks they pose to humans and animals is a legitimate issue. But it's not like the genetically modified cow's milk is the only option at Starbucks. The headline of the petition is particularly ironic: Tell Starbucks to Buy Safer Milk!

Uh, people? They already do. Starbucks offers soy milk. They have had it for at least the past 15 years. If they didn't offer soy milk, these people might have a point, but a better point would be to ask them to offer soy milk. Don't get me wrong; it's admirable that people are concerned about health, but avoiding dairy products all together is better for the animal's health and the people's health. If they're really concerned about either, why are they consuming dairy products in the first place? I consume dairy products from time to time, but I do so with full knowledge that they're cruel to animals, bad for my health, and bad for the environment.

If you're choosing dairy products, particularly at a location that has soy milk and other beverage options, don't blame the dining establishment or society at large for the animal cruelty and human health risks involved. Take responsibility for your choices instead of creating petitions blaming others for the purchases you've decided to make.


I've found out how seriously the MBTA takes customer comments

I sent a complaint this morning using the form on the webpage. Apparently it's going to a dead mailbox, because I received this reply:

from: Mailer-Daemon@charlie.mbta.com

The message that you sent was undeliverable to the following:mbta-fb (UNUSED)


When Massholes eat salads

A customer in front of me in the line at Au Bon Pain today placed a bottle of juice and a plastic container of "Riviera Salad" on the counter and stated "I got this juice heah anda Reveah salad."

Clerk did the right thing and just rang it up without, um, pronouncing it.


Who's rewriting history now?

When I read this letter in the Metro this morning, the ignorance just shocked me. I don’t recall seeing the original letter, and I don’t feel a need to go digging for it, but even without seeing it, I don’t think it’s a difficult concept that our country was clearly founded by illegal immigration. (Whether that issue needs to play into today’s immigration debate is a separate issue).

This land was taken from its original inhabitants without respect for the laws that were already in effect on the land. Does the writer of said letter really not realize this? Apparently not, since she believes that there were not immigration laws in place at the time of the founding of our country. Assuming she’s referring to the founding of the United States of America, rather than the nations that were here previously, then yes, there absolutely were laws present on this land prohibiting such things. While most of the Native nations did not have a concept of land ownership until contact with Anglos, they have certainly always had laws addressing torture and killing people and destroying their homes.

The writer talks about how her family members came here “legally,” presumably following the Anglo laws regarding such things. Yes, I recognize that pretty much every piece of land on the planet has changed owners several times, usually forcefully, and that governments change. But still, how can this person have so little grasp of history to think that the English-speaking democratic society on this piece of land was created by people who came here and followed the laws? The part about “people rewriting history to fit their own agenda” was particularly disturbing coming from someone whose grasp of history apparently leaves out the original inhabitants of this land and the laws that were established long before any of my people or her people arrived here.

If she wanted to truly honor her ancestors, she could acknowledge that they were following the laws in place when they arrived, while still acknowledging that said laws did in fact originate illegally.


Attention passengers: The next orange line train to glory is now arriving

Announcement on the T this morning:

"When exiting MBTA vehicles or stations, please remember to take all of your belongings."

Hello? Dan Grabauskas? There's all these UHauls parked all over the platform...


An interesting HIPAA question

A colleague and I were discussing the seeming disparity between HIPAA and the employment laws regarding doctor's notes. I know that employers are permitted to ask for doctor's notes verifying that an employee was sick or was attending an appointment. Thanks to the ADA and other fair employment laws, they are only allowed to require the relevant information regarding the dates the person was legitimately out of work; they can't ask the employee or the provider about the nature of the medical condition.

At a hospital or large clinic, one can obtain a doctor's note from the front desk person, just stating that [name] was seen on [date] at [facility].

But what happens if someone is seeing, say, an infectious diseases specialist in private practice? Or what if someone is seeing, say, me in private practice? I have no way of having anyone else write the letter. Even though I wouldn't say why the person was seeing me, I'd need to sign the letter with my credentials, which would then inform the person's employer that the person saw a mental health clinician. If the employer is irrational and paranoid anyway, they're not going to stop and think that most people see clinicians for regular-old life issues and aren't dangerous or confused or untrustworthy. Or what if the employer just fires anyone who might possibly present any liability, and they toss out anyone who sees a physical therapist, thinking they're going to cause workplace accidents? It's very hard to prove employment discrimination when there was never any harassment or violation of policies.

At some workplaces, there is a human resources department who the employee could ask to screen the letter, verify that the absence was excused, and inform the supervisor that the absence is excused. But many places aren't large enough to have a human resources department. Does this mean that the employer is essentially allowed to require that the employees disclose their personal health information and their disability if applicable?


I'm about to start Awareness Awareness Month

From an e-mail I just got at work:

National Parity Day (May 2) - Call your representative
National Anxiety Disorders Screening Day (May 2)
Children’s Mental Health Week (May 6-12)
Childhood Depression Awareness Day (May 8)
National Anxiety and Depression Awareness Week (May 6-12)
National Mental Health Counseling Week (May 6-12)

Older Americans’ Mental Health Week (May 20-26)

These are all great things to be aware of, but good lord. There's an awareness day/week/month/arbitrarytimeframe for just about everything. How do people notice any of these awareness campaigns when the calendar is so saturated? And do people really need a designated timeframe to distribute information about important issues? Is it not acceptable to just be like, "hey, I was reading some articles on depression, and found a lot of information that could be helpful, so I thought I'd pass out some info at staff meeting and my neighborhood group and my religious community," without rationalizing this with any corresponding awareness campaign?