#MedicineForward - User contributions [en]

Curated Articles

2025-05-03T15:50:33Z

Sumukh: Transferred over the old Curated_Articles page

= Library 📚 =
The voices for change can be found across time and across mediums. Medicine Forward has gathered a reference library that gives perspective and hope to fuel our shared transformation agenda.

== Physician Perspectives ==
Why Doctors Should Organize, New Yorker, Aug 5, 2019, Eric Topol, MD

* https://www.newyorker.com/culture/annals-of-inquiry/why-doctors-should-organize

Doctors Aren’t Burned Out from Overwork. We’re Demoralized by Our Health System, Feb 5 2023, The New York Times, Eric Reinhart

* https://www.nytimes.com/2023/02/05/opinion/doctors-universal-health-care.html

The Disillusionment of a Rikers Island Doctor, The New Yorker, March 24, 2022, Rachael Bedard

* https://www.newyorker.com/news/essay/the-disillusionment-of-a-rikers-island-doctor

Physician Burnout Has Reached Distressing Levels, New Research Finds, The New York Times, Oliver Whang, Sept 29, 2022

* https://www.nytimes.com/2022/09/29/health/doctor-burnout-pandemic.html

== Physician Burnout ==
New Survey Reveals 55% of Physicians Know a Physician Who Considered, Attempted or Died by Suicide, Aug 5 2021, The Physicians Foundation

* https://physiciansfoundation.org/press-releases/new-survey-reveals-55-of-physicians-know-a-physician-who-considered-attempted-or-died-by-suicide/

What COVID Hospitalization Numbers Are Missing, The Atlantic, May 28, 2022, Ed Yong

* https://www.theatlantic.com/health/archive/2022/05/hospitalization-covid-healthcare-burnout/629892/

Physicians spend an average of 16 minutes and 14 seconds per encounter using EHRs

* https://annals.org/aim/article-abstract/2758843/physician-time-spent-using-electronic-health-record-during-outpatient-encounters

== Healthcare Crisis in the United States ==
Potentially Preventable Deaths from Five Leading Causes of Death – United States 2008-2010, Medscape, 2014

* https://www.medscape.com/viewarticle/824495_2

Improving the prognosis of health care in the USA, The Lancet, Feb 15, 2020

* https://www.thelancet.com/article/S0140-6736(19)33019-3/fulltext

Inequality and the health-care system in the USA, The Lancet, April 8, 2017

* https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(17)30398-7/fulltext

Profits Over Patients: They Were Entitled to Free Care. Hospitals Hounded Them to Pay, The New York Times, Sept 2022, Jessica Silver-Greenberg and Katie Thomas

* https://www.nytimes.com/2022/09/24/business/nonprofit-hospitals-poor-patients.html

Profits Over Patients: How a Sprawling Hospital Chain Ignited Its Own Staffing Crisis, The New York Times, Dec 15, 2022, Rebecca Robbins, Katie Thomas, Jessica Silver-Greenberg

* https://www.nytimes.com/2022/12/15/business/hospital-staffing-ascension.html

Fixing Prior Authorization: Twitter. October 25, 2022. Political Science professor and author of US health policy book, Coverage Denied, which looks at health and economic impacts of insurers' denial of prescribed care including via prior authorization.

* [https://x.com/i/spaces/1DXxyvPVgqLKM/peek?s=20 Twitter Spaces interview with Miranda Yaver, PhD]

== Shortage of Healthcare Workers ==
Why Health-care Workers are Quitting in Droves, November 16, 2021, The Atlantic, Ed Yong,

* https://www.theatlantic.com/health/archive/2021/11/the-mass-exodus-of-americas-health-care-workers/620713/

‘I Am Worth It”: Why Thousands of Doctors in America Can’t Get a Job, The New York Times, Feb 19, 2021, Emma Goldberg

* https://www.nytimes.com/2021/02/19/health/medical-school-residency-doctors.html

Addressing the Health Care Staffing Shortage, Definitive Healthcare, Oct 2022

* https://www.definitivehc.com/sites/default/files/resources/pdfs/Addressing-the-healthcare-staffing-shortage.pdf

Pushed to Their Limit, 1 in 5 Physicians Intends to Leave Practice, JAMA Network, March 30, 2022, Jennifer Abbasi

* [https://jamanetwork.com/journals/jama/fullarticle/2790791#:~:text=Pushed%20to%20Their%20Limits%2C%201%20in%205%20Physicians%20Intends%20to%20Leave%20Practice,-Jennifer%20Abbasi&text=On%20the%20same%20day,effects%20on%20primary%20care%20practices https://jamanetwork.com/journals/jama/fullarticle/2790791]

== History of Our Current System ==
A critique of clinical economy: reassessing value and care during covid-19, BMJ, July 2020, Eric Reinhart and Daniel Brauner

* https://www.bmj.com/content/370/bmj.m2878

Health Rights Are Civil Rights: Peace and Justice Activism in Los Angeles, 1963-1978, Minnesota Press, 2014, Jenna Lloyd

* https://www.upress.umn.edu/book-division/books/health-rights-are-civil-rights

Ronald Regan radio address on socialized medicine

* https://www.americanrhetoric.com/speeches/ronaldreagansocializedmedicine.htm

Inside the American Medical Association’s Fight Over Single-Payer Health Care, The New Yorker, Feb 22, 2022, Clifford Marks

* https://www.newyorker.com/science/annals-of-medicine/the-fight-within-the-american-medical-association

The Blind Spot in Medicare for All, The Nation, May 12, 2022, Eric Reinhart

* https://www.thenation.com/article/economy/fee-health-care-ama/

== Path of Transformation ==
The Hippocratic Underground: Civil Disobedience and Health Care Reform, The Hastings Center Report, Jan-Feb 2005, Robert Macauley

* https://www.jstor.org/stable/3528215?origin=crossref

Structural medicine: towards and economy of care, The Lancet, April 20, 2021, Eric Reinhart, Daniel Dawes, Aletha Maybank

* https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(21)00937-5/fulltext

How Doctors Care Use Medical Billing to Sabotage Abortion Bans, Slate, Aug 16, 2022, Eric Reinhart

* https://slate.com/news-and-politics/2022/08/doctors-defy-abortion-bans-medical-billing.html

More physicians unionize in the face of burnout, consolidation, Axios, Nov 7, 2022, Arielle Dreher

* https://www.axios.com/2022/11/07/more-physicians-join-unions

Fixing Prior Authorization: Twitter. September 22, 2022. Vice president for digital health at UCSF talks fixing prior authorization by focusing on audits and outliers instead of roadblocks for everyone — and putting data to work.

* [https://x.com/i/spaces/1OdJrzrkzoeJX/peek?s=20 Twitter Spaces interview with Aaron Neinstein, MD]

501c3 FAQ

2025-05-02T23:22:46Z

Sumukh: Transferred over the old 501c3 FAQ page

= FAQ Simple Guide: Sponsorship vs. Advertising for Non-profits (DRAFT v0.11) =
Thinking about getting corporate sponsors? This <abbr>FAQ</abbr> breaks down '''what counts as a sponsorship (tax-free money)''' and '''what counts as advertising (which is taxed)'''—all based on IRS rules. We’ll keep it simple so you know what’s okay, what’s not, and how to stay compliant.

''(Based on IRS guidelines under <abbr>IRC</abbr> Section 513(i))''

== 1. What is a Qualified Sponsorship Payment? ==
A '''qualified sponsorship payment''' is money, property, or services provided by a business to a non-profit '''without expecting a substantial return benefit'''.

'''Key Features of Qualified Sponsorship Payments''':

* The sponsor can be acknowledged (e.g., name, logo, or slogan) but '''not promoted'''.
* No advertising, endorsements, or inducements to purchase the sponsor’s products or services.

== 2. What is Advertising? ==
'''Advertising''' includes messages that:

* Use comparative or qualitative language (e.g., “best coffee in town”).
* Include pricing or discounts (e.g., “20% off our products”).
* Endorse or encourage people to buy, sell, or use the sponsor's products or services.

'''Advertising is considered unrelated business income''' and is taxable.

== 3. What are Qualified Sponsorships ==
{| class="wikitable"
|+
!Example
!Reasoning
|-
|✅ Displaying a sponsor's logo or slogan on event materials without promoting their products or services.
|Acknowledgement only; no advertising.
|-
|✅ Listing the sponsor’s name, logo, and location (e.g., “Sponsored by ABC Co., 123 Main St”).
|Value-neutral recognition without endorsement.
|-
|✅ Saying “Thank you to XYZ Corp for their generous support” on a banner or website.
|Simple acknowledgement of sponsorship.
|-
|✅ Displaying a sponsor's product at an event (e.g., free water bottles with their logo).
|Value-neutral and does not encourage sales.
|-
|❌ “Visit ABC Co. for the best deals in town!”
|Contains qualitative language (“best deals”).
|-
|❌ “Shop at XYZ Store and get 10% off your purchase today!”
|Includes pricing and promotional language.
|-
|❌ “Our event is proudly brought to you by ABC Co., the leader in home appliances.”
|Promotional and endorses the sponsor’s business.
|-
|❌ Exclusive provider agreements where only the sponsor's product can be sold at the event.
|Substantial return benefit for the sponsor.
|}

== 4. What is a Substantial Return Benefit? ==
A '''substantial return benefit''' occurs when the sponsor receives more than just an acknowledgment, such as:

* Advertising (as defined above).
* Exclusive provider agreements (e.g., only the sponsor’s brand is sold at the event).
* Use of non-profit trademarks or other intangible assets.
* Goods, services, or privileges that exceed 2% of the sponsorship payment's value.

== 5. How Can Non-profits Ensure Payments Stay Qualified? ==

* '''Avoid advertising:''' Stick to acknowledgements only (e.g., sponsor’s name, logo, slogan, or address).
* '''Avoid exclusivity:''' Do not allow sponsors to limit competitors at events unless it’s an exclusive sponsorship (not exclusive provider).
* '''Be transparent:''' Clearly outline sponsor benefits in contracts and ensure they align with IRS rules.

== 6. What Happens If Payments Include Advertising? ==
If part of the payment involves advertising, the '''advertising portion becomes taxable''' as unrelated business income. The non-profit must document the fair market value of the advertising to calculate the taxable amount.

== 7. Need Help? / Links: ==
If you’re unsure whether a sponsorship agreement meets IRS guidelines, consult a tax professional or refer to IRS Treasury Regulation 1.513-4 for detailed guidance.

* https://www.irs.gov/charities-non-profits/advertising-or-qualified-sponsorship-payments

Selling Products

* https://www.501c3.org/kb/selling-products-unrelated-business-income/

Decision Making

2025-05-02T21:37:06Z

Sumukh: Transferred over the old Wiki decision making page

= Decision-Making Policy for Medicine Forward (DRAFT v0.2) =
Our goal is that at Medicine Forward '''any person who feels strongly about an issue or a possibility has the power to do something about it'''. And, every decision is informed by collective intelligence. This decision-making policy empowers individuals while ensuring alignment with the organization’s purpose through clear processes and distributed authority. It emphasizes '''1) autonomy, 2) decentralization, and 3) efficiency''', prioritizing the Advice Process and consent-based decision-making while clarifying the role of individual decision-making.

== Core Principles ==

# '''Autonomy''' Empower individuals to make decisions independently within their roles and responsibilities.
## ''Accountability'': Ensure individuals are responsible for their decisions and their outcomes.
## ''Invitation'': Foster a culture of voluntary participation, encouraging people to step forward based on interest and expertise.
# '''Decentralization''' Distribute authority to enable decision-making at all levels, minimizing reliance on hierarchical structures.
#* ''Inclusivity'': Ensure decision-making includes input from those affected and individuals with relevant expertise to leverage collective intelligence.
#* ''Transparency'': Make relevant information accessible to members to enhance trust and clarity.
# '''Efficiency''' Streamline decision-making processes to avoid unnecessary delays and ensure timely action.
# '''Purpose-Driven''' Align all decisions with the organization’s overarching purpose to ensure focus and coherence

== Decision-Making Methods ==

=== 1. Individual Decision-Making ===

* '''When to Use:''' For decisions with minimal risk and short-term impact.
* '''Process:'''
** Individuals make decisions independently within their domain of expertise.
** They assume full responsibility for the decision and its outcomes.
* '''Examples:''' Selecting vendors for office supplies or scheduling team meetings.

=== 2. The Advice Process ===

* '''When to Use:''' For decisions affecting multiple people or requiring specialized knowledge.
* '''Process:'''
** The decision-maker consults those affected and individuals with relevant expertise.
** Advice is considered but not mandatory to follow.
** The decision-maker assumes accountability for the final decision and its consequences.
* '''Examples:''' Initiating new projects, modifying work processes, or approving significant expenditures.
* '''Pitfalls to Avoid:''' Overlooking advice, failing to seek diverse perspectives, or bypassing consultations with key stakeholders.

=== 3. Consent-Based Decision-Making ===

* '''When to Use:''' For decisions requiring collective input and agreement, especially those with significant organizational implications.
* '''Process:'''
** A facilitator is appointed to guide the process.
** A proposal is presented, followed by clarifying questions.
** Participants share reactions to the proposal without interruption.
** Objections are raised if the proposal is seen as risky or regressive. Without valid objections, the proposal is approved.
** If objections arise, the proposal is revised collaboratively.
** Visual confirmation is used to approve a proposal.
* '''Accountability:''' The group collectively shares responsibility for the decision.
* '''Examples:''' Creating new policies, restructuring, or making strategic decisions.
* '''Pitfalls to Avoid:''' Prioritizing personal preferences over organizational goals, allowing dominant voices to overshadow others, or dismissing valid objections.

=== 4. Consensus Decision-Making (in progress…) ===

== Decision-Making Authority ==

* '''General Principle:''' Anyone can initiate a decision using an appropriate method.
* '''No Hierarchical Overrides:''' Decisions made through the Advice Process or consent-based methods cannot be overridden by higher authority figures.
* '''Stewardship:''' Individuals serve as stewards of their roles, focusing on fulfilling the role’s purpose rather than asserting ownership.
* '''Autonomy:''' People have the freedom to make decisions within their roles without unnecessary consultations.
* '''Decentralization:''' Authority is distributed to empower decision-making at every level, fostering agility and inclusivity.

== Implementation Guidelines ==

* '''Training:''' Provide education on decision-making processes, with emphasis on the Advice Process and consent-based methods.
* '''Transparency:''' Document all decisions and make them accessible to members.
* '''Conflict Resolution:''' Establish a process for addressing disagreements constructively.
* '''Regular Review:''' Periodically evaluate the policy to ensure effectiveness and relevance.
* '''Emphasis on Invitation:''' Shift towards inviting participation rather than mandating it.
* '''Metrics:''' Develop co-created metrics to evaluate decision-making effectiveness.
* '''Embrace Learning:''' Treat mistakes and decisions as opportunities for growth and improvement.
* '''Proposals:''' Foster an environment where everyone feels empowered to suggest improvements.
* '''Documentation:''' Maintain clear records of decisions, rationales, and action items.
* '''Communication:''' Ensure consistent and clear dissemination of decisions to all relevant parties.

== Pitfalls to Avoid ==

* '''Relying Solely on Consensus:''' Avoid inefficiency by seeking consensus only when appropriate.
* '''Ignoring Diverse Perspectives:''' Actively include varied viewpoints to enhance decision quality.
* '''Confusing Personal Preferences with Organizational Needs:''' Focus decisions on what benefits the organization as a whole.
* '''Failing to Document Decisions:''' Ensure all decisions are clearly recorded with rationales and outcomes.
* '''Neglecting Ownership:''' Assign clear responsibility for each decision’s execution.
* '''Dominating Decision-Making:''' Encourage balanced participation and rotation of facilitation roles.
* '''Hierarchical Bias:''' Avoid defaulting to traditional top-down authority structures.
* '''Fear of Conflict:''' View conflict as a growth opportunity, and have mechanisms in place to address it.
* '''Avoiding Responsibility:''' Ensure individuals take ownership of their actions and decisions.

== References: ==
Laloux, Frederic. ''Reinventing Organizations: A Guide to Creating Organizations Inspired by the Next Stage of Human Consciousness.'' Nelson Parker, 2014.

Robertson, Brian J. ''Holacracy: The New Management System for a Rapidly Changing World.'' Henry Holt, 2015.

Slade, Samantha. ''Going Horizontal: Creating a Non-Hierarchical Organization, One Practice at a Time.'' Berrett-Koehler Publishers, 2018.

Spending Policy

2025-05-02T21:15:55Z

Sumukh: Transferred overthe old Wiki spending policy to the new web page

= Spending Policy for Medicine Forward (v.1) =

===== Objective =====
To establish clear guidelines for how Medicine Forward’s funds are allocated, ensuring transparency, fairness, and alignment with organizational priorities.

== Spending Guidelines ==

==== Executive Team Spending Authority ====

* The Executive Team has the authority to spend up to '''$1,000''' on a single expense without consulting other stakeholders.
* Individual Executive Team members can approve expenses up to '''$250''' without additional approval. This includes regular operational costs such as:
** Software subscriptions (e.g., Squarespace, Zoom, Mighty Networks, Acuity Scheduling).
** Administrative tools and services directly supporting Medicine Forward’s operations

==== Project-Specific Funds ====

* Funds raised for specific projects, such as the '''NYC Burnout Symposium Workshop''', will be used to support the goals and needs of that project.
* The primary aim is to maximize impact and ensure fairness in how the funds are used.
* Before completion of the project, project-specific funds should not be redirected to other Medicine Forward initiatives unless they directly contribute to the success of the funded project.
* Any remaining funds or additional contributions may be used for unexpected expenses related to the project or allocated to future projects that align directly with Medicine Forward's mission.

===== Spending Over $1,000 =====

* For expenses exceeding '''$1,000''', a written proposal must be created either by the Executive Team or a designated member.
* The proposal should outline:
** The purpose and justification for the expenditure.
** Expected benefits and alignment with Medicine Forward’s goals.
* This proposal will first be reviewed internally by the Executive Team.
* After internal review, the proposal will be shared with the 501c3 Board for transparency and consultative feedback.
* Final decisions will rest with the Executive Team, incorporating feedback from the relevant stakeholders when possible.

== Transparency & Constraints ==

==== Transparency ====

* Spending will be tracked and available for auditing and creating financial reports. Audits and reports can be requested by anyone on the 501c3 Board.
* The 501c3 Board should be notified of new purchases, especially new recurring subscriptions like Acuity, at the next available team meeting.

==== Constraints ====

* No deficit spending. Verify funds are available and within budget before spending.

== The Advice Process ==
In line with practices from ''Reinventing Organizations'', Medicine Forward will utilize the '''advice process''' for key spending decisions:

* '''Definition''': The advice process is a decision-making approach where individuals or teams seek input from those who will be affected by the decision or who hold expertise in the relevant area before making a final decision.
* '''Application''': When spending decisions require broader consideration (e.g., expenses above '''$1,000''' or complex resource allocation), the Executive Team will consult with both the 501c3 Board and other relevant stakeholders through this process. This ensures that decisions are well-informed and reflective of diverse perspectives.

<u>Last accepted by Traction Team 10/21/24 version 1.0</u>