The practice of urine drug testing during pregnancy and then often reporting positive results to Child Protective Services triggers a cascade that can result in separation of mother and newborn, with devastating consequence for both. These practices are more common when patients come from marginalized communities even when baseline substance use rates are the same. As our guest -- obstetrician/gynecologist and addiction medicine expert Mishka Terplan MD, MPH -- points out, illicit substances are not teratogens in comparison to, say, alcohol, tobacco or lead exposure. So why do we order these tests? He also discusses how talking with patients about substance use behaviors, especially with the help of screening instruments, is the only way to characterize substance use behaviors and formulate treatment strategies.
This is the third episode in which we learn of common clinician practices in which clinicians are co-opted into punitive and even carceral systems of oppression.
“Tough Love” is Not the Answer: A critique of NEJM reporting on student/trainee grievances and educator discontent
What a James Baldwin story can teach doctors and patients about care amidst suffering
How confronting racist ideas I didn’t realize I had is shaping me as a physician and a person
About me being racist: A conversation that follows an apology
How effects of racism were mistaken for “race” in clinical algorithms: What clinicians should know
Directly and Covertly Observing Care: How it Can Transform Medical Education and Improve Clinical Practice
"Dire Consequences": When students do not receive appropriate accommodations on the USMLE examinations
Why it's time to remove time limits on tests, like the USMLE exams
Running the Gauntlet: My Journey into Medicine with a Learning Disability
Why are doctors turning to ChatGPT for help relating to patients?
Prescription Opioid Reductions and Suicide: What Should Caring Physicians Do in the Face of Uncertainty?
My patient’s in shackles: Can we take these off?
From medical student mistreatment to burnout: How can we change the culture?
Medical Student Mistreatment: A Wicked Problem
Uncommon wisdom from a family physician and medical educator
Challenging Questions to Help Physicians Reflect, Grow, and Find More Joy Practicing Medicine
Organic Chemistry and the Questionable Ways We Select and Train Physicians
Contextualizing Care in a Nutshell (and a New Study)
Medical Gaslighting: Why Are We A--holes?
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