Enriching Spiritual Care in Medical Residents Through Cultural Humility and Courage.

Introduction: While many patients desire spiritual care, it is infrequently provided by physicians. When a model of cultural humility and courage is employed, resident physicians can be introduced to the spiritual care of patients.

Methods: We developed this 90-minute, onetime session to speak directly to resident physicians about the relationships between medicine and spirituality and the nature of spiritual care.

Implementation of dedicated social worker coaching for emergency medicine residents - Lessons learned.

Emergency medicine training is associated with high levels of stress and burnout, which were exacerbated by the COVID-19 pandemic. The pandemic further exposed a mismatch between trainees' mental health needs and timely support services; therefore, the objective of our innovation was to create an opportunity for residents to access a social worker who could provide consistent coaching. The residency leadership team partnered with our graduate medical education (GME) office to identify a clinical social worker and professionally-trained coach to lead sessions.

Health Equity Is No Spectator Sport: The Radical Rooting of a Post-Pandemic Bioethics.

The relationship between equality and equity has been theorized and described in many ways. Recently, this relationship has been popularly illustrated via a meme depicting three people watching a baseball game while standing on boxes. The meme's analogy, that achieving health equity is the ability to view a spectator sport, is a neoliberal account of health.

The Wayback Machine.

We suffer from a radical autonomy which too often collapses the therapeutic alliance between patient and physician into a health-care transaction between consumer and provider, a fee-for-service exchange for something far short of true health. Some ethicists and physicians are seeking a better way, by employing a virtue ethics approach in which health is seen as a distinct good and the proper end of a medical encounter. Curlin and Tollefsen's The Way of Medicine (2021) synthesizes this material into a heuristic contrasting what they characterize as the Provider Services Model and the Way of Medicine.

The triple helix of clinical, research, and education missions in academic health centers: A qualitative study of diverse stakeholder perspectives.

Introduction: Academic health centers are poised to improve health through their clinical, education, and research missions. However, these missions often operate in silos. The authors explored stakeholder perspectives at diverse institutions to understand challenges and identify alignment strategies.

Combating Contagion and Injustice: The Shared Work for Public Health and Faith Communities During COVID-19.

Faith communities are uniquely positioned for essential public health work to combat the COVID-19 pandemic and address the chronic pre-existing health disparities that have been exacerbated by COVID-19. Specifically, faith communities can (1) dialogue with public health communities, developing internal policies and meeting guidelines consistent with evidence-based recommendations and their own faith traditions, (2) bolster religious daycare and parochial school immunization policies, and (3) partner with faith-based organizations through financial support and volunteer hours. This essential work will complement governmental public health approaches and ensure faith communities can assist with future pandemics.

Questionable Agreement: The Experience of Depression and DSM-5 Major Depressive Disorder Criteria.

Immediately before the release of DSM-5, a group of psychiatric thought leaders published the results of field tests of DSM-5 diagnostic criteria. They characterized the interrater reliability for diagnosing major depressive disorder by two trained mental health practitioners as of "questionable agreement." These field tests confirmed an open secret among psychiatrists that our current diagnostic criteria for diagnosing major depressive disorder are unreliable and neglect essential experiences of persons in depressive episodes.

What You Need to Know About Cannabis: An Evidence-Based Crash Course for Mental Health Trainees.

Introduction: Although increasing numbers of states are legalizing cannabis for both medical and recreational purposes, health care providers and students report low comfort levels and limited knowledge regarding cannabis, highlighting current deficits in medical training.

Methods: We developed a structured cannabis curriculum for a general psychiatry residency program at the University of Colorado. In constructing our curriculum, we initially surveyed advanced psychiatry residents and attending psychiatrists in the university outpatient clinic regarding attitudes and approaches to psychiatric patients using cannabis.

Held Against Our Wills: Reimagining Involuntary Commitment.

Involuntary psychiatric treatment for people with serious mental illness should focus on returning to health instead of reducing danger.

Alternatives to War Within Medicine: .

When we figure medical practice as warfare, an individual clinician may be either a dutiful combatant or a conscientious objector. The rhetorical structure of this choice means that clinicians may exercise their consciences by loyally joining or disloyally exiting the medical ranks' battle against disease. But there are alternatives to loyalty and exit, and within psychiatry, these alternatives have transformed clinical services.

The worthless remains of a physician's calling: Max Weber, William Osler, and the last virtue of physicians.

On the centenary of Max Weber's "Science as a Vocation," his essay still performs interpretative work. In it, Weber argues that the vocation of a scientist is to produce specialized, rationalized knowledge that will be superseded. Weber says this vocation is a rationalized version of the Protestant conception of calling or vocation (Beruf), tragically disenchanting the world and leaving the idea of calling as a worthless remains (caput mortuum).

Review of serum prolactin levels as an antipsychotic-response biomarker.

Antipsychotics acting as antagonists at dopamine D2 receptors concentrated in the striatum are the cornerstone of effective treatment of psychosis. Substantial progress in treating persons with schizophrenia could be achieved by the identification of biomarkers which reliably determine the lowest efficacious dose of antipsychotics. Prolactin levels have been considered a promising treatment-response biomarker due to dopamine's regulation of serum prolactin levels through D2 receptors in the hypothalamic-pituitary pathway.

The association of cannabis use on inpatient psychiatric hospital outcomes.

Background: The associations between cannabis use and psychosis are well documented in numerous studies. There is a need to evaluate the impact of cannabis use on inpatient psychiatric utilization and outcomes.

Objectives: To evaluate the impact of cannabis use on psychiatric hospital outcomes.

"I am the Author and Must Take Full Responsibility": Abraham Verghese, Physicians as the Storytellers of the Body, and the Renewal of Medicine.

Abraham Verghese proposes to renew medicine by training physicians to read the right texts-literary fiction and patients' bodies-with skilled attention. Analyzing Verghese's proposal with reference to Foucault's idea of the "clinical gaze," I find that Verghese conceives of patients as texts that only physicians can read, meaning that physicians become the storytellers of the bodies, lives, and deaths of the people they meet as patients. I conclude that Verghese's project is unsustainable and alternatively propose thinking analogically of physicians as ship captains who maintain therapeutic distance to reopen interpretative spaces for communities outside of medicine.

Risk Factors for Readmission on an Adult Inpatient Psychiatric Unit.

Objective: Readmission rates have been proposed as a possible quality metric for inpatient psychiatry. Little is known about predicting readmissions and identifying modifiable factors that may reduce early readmissions in these settings.

Methods: We reviewed 693 medical records from our adult inpatient psychiatric unit to identify factors associated with patients' readmission within 90 days of discharge.

Trains Departing from Different Stations: Being Mortal and Dying in the 21st Century.

While physician-writers and medical humanists both characterize contemporary deaths as train wrecks, they sometimes disagree about what causes such consistent wreckage. In Being Mortal (2014), the surgeon-writer Atul Gawande attributes the wreckage to forces that so reduce aging and dying persons' autonomy that they prevent those persons from being themselves. For the leading medical humanists in Dying in the Twenty-First Century (2015), edited by Lydia Dugdale, it is our emphasis on autonomy over interdependence that causes contemporary death and dying to go off the rails.

Use and diversion of medical marijuana among adults admitted to inpatient psychiatry.

Background: Marijuana use is associated with anxiety, depressive, psychotic, neurocognitive, and substance use disorders. Many US states are legalizing marijuana for medical uses.

Objective: To determine the prevalence of medical marijuana use and diversion among psychiatric inpatients in Colorado.