Virtual Care: Choosing the Right Tool, at the Right Time
07/2021
When the immediate threat of COVID-19 subsides, the future of health care will involve more virtual care. Before the pandemic, patient choice rather than clinician guidance determined which medium (telephone visits, video visits, electronic messaging) was used to receive care. Two media synchronicity theory principles—conveyance and convergence—can create a framework for determining how to choose the right medium of care for the patient…
One Year Later: Delayed care, missed visits put crushing demands on doctors
3/15/21
COVID-19 doesn’t evoke the same fear in me as it did a year ago. Now it merely makes me impatient, restless, and often just weary. Let’s get this over with. It is a feeling one can experience only from a place of privilege in a pandemic — protected by a well-oiled health care institution with command centers, drive-through testing, PPE protocols, and policies 2.0, 3.0 and 4.0.
An institution that kept its promise of no layoffs and offered work-from-home accommodations for those of us providing virtual care.
But even here, we in primary care are exhausted. I know I am.
Equity in COVID-19 vaccine: What’s our next step?
January 2021
In contrast, when PICAWA led vaccination efforts with healthcare organizations, they “walk the message,” which translates to walking and delivering the vaccines to community elders who are most vulnerable. He summarized, “There’s not a vaccine hesitancy problem. There’s a problem with white supremacy. If community members lead vaccination efforts, they’ll be vaccinated. We’ll do what’s best for our communities.” It’s not about the message, it’s about the messenger.
Virtual medical care leads to suffering for patients on the wrong side of the digital divide
August 2020
“With the rapid expansion of telehealth, smartphones, tablets, and laptops aren’t luxuries — they are requisite for high-quality medical care…Until we find a way to get health care leaders or policymakers to take responsibility for closing the digital divide, patients of color, poor patients, and those with limited English will suffer unnecessarily.”
A Patient With COVID-19 Is Left Behind As Care Goes Virtual
August 2020
“It’s time to build relationships and strategize to ensure that all information that’s created about COVID-19 is offered in multiple languages, technological solutions are designed for universal accessibility, information is disseminated through trusted venues, and collaboration with community-based organizations is prioritized as part of any initiative. We will get through this together, and we will have a story to tell. I hope it’s not just a story of persistence and survival but also a story of unity.”
Choose Your Battles
2019
Sundar KR. Choose Your Battles. Fam Med. 2019;51(3):282-283. https://doi.org/10.22454/FamMed.2019.237126.
“I wish I could change culture and processes quickly as evidence mounts and practice evolves. I didn’t want to “choose my battles.” At the same time, I realized how poorly I had managed my interaction with the nurse, who was concerned for the safety of our patient, due to my stress…it seemed deciding on when to challenge colleagues or staff involves answering these questions for myself: (1) Do I believe this change is important for patient safety? (2) Is this the right time to address this issue? (3) Is my relationship with this person strong enough to withstand this conflict? (4) Am I putting my emotions, fear of conflict or desire to be right, above the patient’s well-being?”
A Doctor’s Moral Obligation to March and Roar for Justice
UNE 15, 2020
Published on KevinMD.com and Doximity
“The consequences and risks of staying silent are too large. I have a duty to wield my power and a moral obligation as a doctor to roar and march for justice. Taking the risk to march once during a pandemic is worth fighting against the threat of losing black lives indefinitely due to systemic racism. I will not stay silent”
Why this physician marched during a pandemic
JUNE 15, 2020
Published on KevinMD.com and Doximity
“The consequences and risks of staying silent are too large. I have a duty to wield my power and a moral obligation as a doctor to roar and march for justice. Taking the risk to march once during a pandemic is worth fighting against the threat of losing black lives indefinitely due to systemic racism. I will not stay silent”
The Gift of Empanelment in a “Clinic First” Residency
November 2018
Sundar KR. The Gift of Empanelment in a “Clinic First” Residency. Ann Fam Med. 2018 Nov;16(6):563-565. doi: 10.1370/afm.2307. PMID: 30420375; PMCID: PMC6231938.
“Empanelment in a “clinic first” residency has helped me develop competency in medicine and understand the value of primary care. …To build the primary care workforce of the future, I have no doubt every resident needs to have this type of rewarding experience in their clinics.”
The Best Year of Angela’s Life
October 1, 2018
Sundar KR. The Best Year of Angela’s Life. Perm J. 2018;22:18-076. doi: 10.7812/TPP/18-076. PMID: 30285919; PMCID: PMC6172032.
“Using a patient story, this narrative demonstrates why health care organizations, specifically primary care clinics, should strive to identify and to address social needs. This story demonstrates how Kaiser Permanente Washington, by using community resource specialists, has empowered primary care clinics to address social needs in a health care setting to improve patient care and experience.”
Universal Screening for Social Needs in a Primary Care Clinic: A Quality Improvement Approach Using the Your Current Life Situation Survey
Sundar KR. Universal Screening for Social Needs in a Primary Care Clinic: A Quality Improvement Approach Using the Your Current Life Situation Survey. Perm J. 2018;22:18-089. doi: 10.7812/TPP/18-089. PMID: 30296397; PMCID: PMC6175598.
“By using a frontline improvement approach, I could answer questions and address concerns most important to local operational stakeholders when implementing screening for social needs. When practitioners conduct universal social needs screening and more fully understand social needs prevalence in a primary care clinic, resources can be tailored more effectively to accommodate patient needs”
No Parachutes 