Well, seeing some Twitter chatter and following, when lo and behold this comes across (about an hour ago):
Tweeted by Matthew Bowdish, MD of California
@MatthewBowdish
QuoteSicherer: Not every family needs a 504 plan - mainly for kids who are not getting what they need from the school
#AAAI17
So, just want to say "thank you" to Dr. Sicherer for giving the refuse-meaningful-504-schools and districts this century's version of FAAN's old "false sense of security" . . . .
grrrrrrr . . . . . . . .
How hard do we have to continue to work on this to get medical profession to GET IT too?? (Or to at least get them to NOT make a blanket statement that is not based in study data or law???)
Is there link to video of conference?
Is there possible transcript of presentations?
Has Sicherer been quoted as saying this same thing previously?
I'm pretty sure the legal minds would take issue with statement.
http://www.wrightslaw.com/blog/tag/food-allergies/ (http://www.wrightslaw.com/blog/tag/food-allergies/)
http://allergylawproject.com/ (http://allergylawproject.com/)
To include those attorneys at OCR who have been overwhelmed with work and take on NEW student food allergy discrimination cases DAILY. Those same, lovely OCR attorneys who issue marvellous letters to schools in order to get the schools to comply with the LAW:
OCR Ruling on 504 Ineligibility--Gloucester (http://foodallergysupport.olicentral.com/index.php/topic,6929.0.html)
GLOUCESTER - OCR Case: *** Section 504 Plan *** (http://foodallergysupport.olicentral.com/index.php/topic,1138.0.html)
OCR Union County, NORTH CAROLINA Documents (ajasfolks2) (http://foodallergysupport.olicentral.com/index.php/topic,985.0.html)
OCR - Virginia Beach City Schools 2012 (http://foodallergysupport.olicentral.com/index.php/topic,7656.0.html)
(Just to post a few links)
And currently, from the Dept of Ed:
Dept Ed Updated 504 Guide (http://foodallergysupport.olicentral.com/index.php/topic,11499.0.html)
Hashtagged medicine in 140 characters does not help actual patients. Even if Sicherer released an official statement correcting the position it won't outpace the speed of retweeting grossly ignorant or inaccurate statements.
Wow. I'm too tired to deal with this.
QuoteSicherer: will sometimes put food in some child's hand in clinic to demonstrate to pt & parents that they can live around allergen
Yeah, saw that and literally shouted WTF in my kitchen.
So, cannot wait for this to become new "standard practice"
What the ever loving _____ ??!!!
[spoiler]Just wait 'til schools decide this needs to be done as part of "proving" the anaphylaxis and granting accommodations.[/spoiler]
I listened to a radio interview with him once... year or two ago.... something...
... and I was not impressed... at least with his handling of how the information he was saying could be twisted to fit another agenda.
I think it is possible to be factually correct, completely logical, but miss the actual problem with stating things in a certain way... because... yes..... school districts that suck tend to use that against you.
Technical accuracy shouldn't be used to negate actual necessity. Like, yes, you can hold a peanut in your hand but that doesn't mean you don't need a 504.
Lacking external validity is a legitimate challenge. Problem is from highly cited subject matter expert to layperson ears (or eyes) in the public. We can't let our own allergists do the driving if the rest are shouting over them in a bid for global dominance or final words.
I'm in transit from a education and disability law conference. Good year at the appellate level for sped case law; unfortunately that doesn't do much to prevent drama at the classroom level. I do wish doctors would stop trying to practice medicine and law on Twitter.
I do wish doctors would stop trying to practice medicine and law on Twitter.
:yes:
Please note the following is in no way legal advice. It part personal opinion, part administrative analysis. The Schools subforum has plenty of existing resources to advocate for your child's educational and disability rights for whosoever should want them. I would point towards Wrightslaw as the best single starting point.
Students with disability who qualify for protections under IDEA, 504, and ADA do not lose those rights simply because a doctor tweets his personal belief. Rather, to do so may constitute discrimination by stating a class of protected persons based solely on their disability should be treated DIFFERENTLY than any other student with disability eligible for the same protections. Replace anaphylaxis with HIV or diabetes and it will become more obvious how contrary to nondiscrimination such gross statements are.
Whether that individual should hypothetically be held accountable through a wide variety of accountability mechanisms will be up to: if those accountability mechanisms are brought into play; by whom; and if implemented in an effective manner (i.e., not malicious). Accountability mechanisms could be employer policies or administration, state law, city ordinance, federal law, agency regulation, ethics committee, hospital or city ADA coordinator, professional nongovernmental oversight (such as bar association or state licensure), or private right of action under 504 or ADA for damages.
There may have to be a course correction implemented by large hospitals to hold their physicians accountable for statements that may cause harms, especially when they violate institution nondiscrimination policies, or constitute unauthorized practice of law. I can't imagine many medical schools attached to state or publicly funded institutions having risk management departments that would not be sensitive to such events once they are made aware of them.
One should be aware of the caveats in seeking accountability of persons in high profile professions. Expect an institution to circle wagons over liability concerns for its employee and potential law suits (even where there is no litigious intent whatsoever), retaliation and character assassination of the person filing the complaint ("you are a dumb Facebook mom/anxious/hysterical/helicopter parent", ad infinitum), rationalization or justification for the person's actions or statements ("I'm only trying to help, why do you hate kids/facts/reason."), and to get blocked by administration.
A reasonable expectation in this hypothesis is some internal institutional corrective action in exchange for your individual humiliation getting dragged by their social network including sycophants, perhaps with a hint or so of sexism by resolution phase. No one will ever admit any wrongdoing even when it does truly amount to simple error in judgment.
In closing I'd like to remind all readers here and whoever may have seen statements attributed to Sicherer on Twitter, it is my opinion that is not remotely enough evidence of what he may have actually said. Until then it seems like someone trying to instigate drama using 140 characters. No offense to Twitter but you have to own what you put out there. And right now, that isn't Sicherer doing it.
It was an MD who tweeted abt Sicherer . . . . likely as the talk was happening?
Treating this as a hypothetical:
I understand Dr. Bowdish made the decision to issue his own proxy he attributed to Dr. Sicherer via social media. However, before I would even begin to think (again, as a hypothetical academic exercise) of holding any other person accountable for a potentially discriminatory, harmful, or reckless statement, I need a much more conclusive set of demonstrable facts forming a pattern that supports or suggests it deserves attention or intervention from the state or nongovernmental organization with jurisdiction.
Take the Tweet at face value. These aren't lawyers or K12 educators who would use this area of administrative law in their profession. They are laypersons when it comes to education and civil rights protections. Viewed in the best possible light, the statement attributed to Sicherer in short form might relay Sicherer's anecdotal experience viewed through a layperson's lens. He may not be aware that nondiscrimination laws in education are in effect whether or not a written 504 is in place. He is likely unaware that child find is a mandate under law that is the K12 educational institution's responsibility, not the parents' or student's.
It would be a rather reckless statement with great potential for harm, and I'd be curious what the liability is for institutions whose spokespersons make such statements that result in harms regardless if they have policies in place or valid nondiscrimination statements. Remember when everyone thought the EpiPen 4 Schools was a great program? Anyone questioning Mylan sponsorship was a witch hunter? Here we are a few antitrust suits, a Congressional and Medicare investigation later.
I think, ajas, there's some value in seeing where this is all going as well. What is the agenda of both individuals and organizations? How are US allergists intending to respond to those who point out replication of hypotheses that are largely US-centric do not enjoy validity outside the region? How are the studies funded? Do they intentionally ignore well structured, rigorous studies that challenge their findings? Do they keep themselves in an echo chamber?
Sources I've made passing reference to with regard to global consensus and unintended consequences since this is an AAAAI thread.
LEAPing forward with new guidelines (http://www.jacionline.org/article/S0091-6749(16)31368-9/fulltext)
Allergy and infant feeding guidelines in the context of resource-constrained settings (http://www.jacionline.org/article/S0091-6749(16)31287-8/abstract)
https://www.cdc.gov/healthyyouth/foodallergies/pdf/13_243135_a_food_allergy_web_508.pdf (https://www.cdc.gov/healthyyouth/foodallergies/pdf/13_243135_a_food_allergy_web_508.pdf)
Just as a point of interest, and relevant only as interest possibly to me..... given note to special acknowledgements and whether or not individuals have an awareness of issues raised.
Doh! Took me a minute to get you gvmom -- yes I see his name pg 6 now.
Hmmmmm . . . . . that makes what he may have said (if he said it the way portrayed on Twitter) even more aggravating.
Maybe I need to send him a copy -- highlighted - of that .pdf!
How many times does 504 appear in it? Need to go count.
55 times in 108 pages!!!
Seriously considering sending with a note.
:evil:
Doh! Took me a minute to get you gvmom
;)
I also think that I would wait to hear the full conversation to judge that. It is unfortunate that this out of context sentence was released onto twitter. I agree with Mr. Barlow about this. Things that could sound very bad out of context often have quite a different meaning that is obvious to those present.
People get misquoted all the time.
If he did say and mean what the twitter post implies, that's really surprising. He seems to be the type of person who if emailed politely, would be open to learning. He seems like a nice, caring doctor.
From what I could figure out .... or it appears to be..... is that the tweeting guy/doctor/allergist is just tweeting along during a sort of meeting where topics are discussed. Like a monthly meeting of allergists that belong to some medical group and they get various people, including allergists, to talk about different topics.
These days, anything can be lifted from anywhere to sound like anything. Even something that is actually factual, but without context, can be used or twisted, including in ways against parents working to get 504's.
The argument about whether or not an expert is aware of the issues can be possibly be understood if you find things that they've been involved in, cited in, or acknowledged in as a large contributor.
I don't doubt someone being an expert and being a great doctor based on one lifted tweet. It is concerning that when you have people who seem to be very much aware of the 504 process, and very likely why parents go that route, and likely understands their role as expert, they aren't parsing their words closer.
And, it is likely that things have changed since we were in the 504 world ..... but ..... there were at that time, doctors that you did use specifically as expert sources for documentation to prove you weren't some lunatic that made up food allergies. If any of those experts you are using then have statements that could be used to refute the need for a 504, you are SOL, because then you are put in the position of having to undermine your own cited expert source.
I mean, these days, is the 504 process any less antagonistic?
Section 504 and IDEA are the proper statutory mechanisms. Not screaming, crying, cutting deals, or any other arbitrary derailment from the rules. You all know this, and I know you know this.
This is all they are. The antagonism comes from administration ignoring compliance, capacity building, and performance. You have to look at motivation from white collar professionals to enable "traditions" that are for all intents and purposes come from individual emotions like nostalgia, wanting to be liked or popular, or unsure how to effectively lead through social discomfort. Rationalization is a powerful psychological driver of bad behavior from good people.
Christiakis's Op Ed was damaging, as was Stein's use of Christiakis' journal op ed. Up until now there has been little accountability for such reckless and harmful statements that only have THAT level of punch because it is said by individuals banking on not only their personal credentials, but as spokespersons of large, well-funded institutions with good reputation. That's an immense amount of social capital that when used thoughtlessly out of emotion rather than competence, is at the least unethical.
My question is to you all: Are you ready to do what is necessary to hold such persons accountable? It would not be for the meek. It can, and arguably should, be done. Is that what you want to do?
In terms of the 504 comment attributed to Sicherer, I'd sure like some video of audio of the conference presentation to verify . . . . or perhaps first step is to try to reach out to Sicherer on this and ask him directly if that IS what he said ad what he MEANT.
As to the put peanut into had comment, I'll let that be somebody else's battle.
Quote from: lakeswimr on March 10, 2017, 04:51:29 AM
I also think that I would wait to hear the full conversation to judge that. It is unfortunate that this out of context sentence was released onto twitter. I agree with Mr. Barlow about this. Things that could sound very bad out of context often have quite a different meaning that is obvious to those present.
People get misquoted all the time.
If he did say and mean what the twitter post implies, that's really surprising. He seems to be the type of person who if emailed politely, would be open to learning. He seems like a nice, caring doctor.
I agree broadly, but would like to point out the nuance in which I have answered thus far. I do not disagree with the crux of gvmom's argument. I do not misunderstand her point(s). What I (and we) must do is follow process, and these are governed by rules with agreed upon thresholds for resolution--or punishment.
Personality is not at issue, nor are the roots of ignorance or justifications to continue in ignorance. It is action(s) taken and the results of such action(s) if they cause harm to others by subverting the intent of legal protections by clearly operating outside of professional scope in a multitude of what are now very indelible ways.
Quote from: ajasfolks2 on March 08, 2017, 07:57:23 PM
Seriously considering sending with a note.
:evil:
May I please request don't? At least not to him in your singular name. Gather enough to demonstrate a clear, factual pattern that accurately narrates the impact of statements on an entire class of protected persons within the context of federal, NYS disability law, and NYC nondiscrimination ordinances. The city and state government of NY are robust compared to other states with enforcement equally robust if a report is written in a professional manner.
Ideally this has multiple signatories sent in to the institution's ADA coordinator with the risk department, ethics committee, NYSBA, NY SEA, education chancellor, and Disability Rights NY office copied.
As an academic exercise in the theory of accountability...
Here is the Sinai nondiscrimination statement. To my knowledge it is compliant, which is good. A compliant nondiscrimination statement is prominently placed, widely published, and has verbiage "we do not discriminate..." Nondiscrimination absolutely intends to not treat differently on the basis of disability. It is not limited to openly hostile statements.
By the way, this is only a template using Sinai as an example. The same goes for institutions within scope.
QuoteThe Mount Sinai Health System complies with applicable Federal civil rights laws and does not discriminate, exclude, or treat people differently on the basis of race, color, national origin, age, religion, disability, sex, sexual orientation, gender identity, or gender expression.
We can always hope someone stealth emails or tweets this thread until it makes rounds. There is a distinct reason I'm keeping my language fit for institutional reception. By all means any allergists, nurses, or public administrators reading this, do check with your agency's attorneys, Title II directors, or risk departments. I encourage it.
P.S. Read, then reread, your organization's policies on social media use and ethics. I know a few of you out there have strayed, to put it euphemistically. Your institutions have terrific compliant ethics reporting inputs. Oh, and the terms of malpractice insurance policies. Don't want to forget those!
My question is to you all: Are you ready to do what is necessary to hold such persons accountable? It would not be for the meek. It can, and arguably should, be done. Is that what you want to do?
I'm not sure how to word what I'm thinking, but I'll give it a go.
Do you think that there are those of us who haven't tried to hold people accountable?
Section 504 and IDEA are the proper statutory mechanisms. Not screaming, crying, cutting deals, or any other arbitrary derailment from the rules. You all know this, and I know you know this.
If you know that we all know the above, and you add this:
This is all they are. The antagonism comes from administration ignoring compliance, capacity building, and performance. You have to look at motivation from white collar professionals to enable "traditions" that are for all intents and purposes come from individual emotions like nostalgia, wanting to be liked or popular, or unsure how to effectively lead through social discomfort. Rationalization is a powerful psychological driver of bad behavior from good people.
.... then add in, the years, as parents we that go through meetings, gather documentation, and build a case like you are headed to the supreme court.... go up food chains in school districts, consult with disability attorneys, and file OCR complaints.....
I'm not sure what all else you are thinking of.
Frankly, I just wish we pulled our kids from public school sooner. Plain and simple. I think, that when you go into a 504 meeting it should be like when you call the OCR .... which for me, the first time, I nearly started crying, but really just had my breath taken away and sat in disbelief for a few moments because I actually didn't have to sit and go through everything I prepared to first of all prove to the woman I was speaking to that LTFA's was a hidden disability and qualified my son for a 504. I sat there listening to her tell me that before I even could gather myself back together.
Until schools really are about children, completely, then you aren't going to be able to escape the politics, money, posturing, social dynamics, etc., that infiltrate and corrupt things meant to help every child truly have a free and appropriate public education.
Isolated to previously defined scope: allergists issuing blanket statements that may be discriminatory and/or attempt to give legal advice and/or medical advice about individuals who are not their patients resulting in harms to those individuals or as a class.
Not beyond that.
Edited to add different agency jurisdiction. HHS OCR, not DOE if the federal funds flow through HHS and it probably does. Nothing that can't be cleared up with a FOIA request.
Filing a Civil Rights Complaint
If you believe that you have been discriminated against because of your race, color, national origin, disability, age, sex (including sex stereotyping and gender identity), or religion in programs or activities that HHS directly operates or to which HHS provides federal financial assistance, you may file a complaint with OCR. You may file a complaint for yourself or for someone else.
If you believe that you have been discriminated against because of your disability by a State or local government health care or social services agency, you may file a complaint with the OCR. You may file a complaint for yourself or for someone else.
Sorry for the multiple posts. I was mobile.
There shouldn't be any "we" in your 504/IEP or mine. That relationship should be limited to persons knowledgeable about the student with disability. To ensure that process is safeguarded there may be need to coordinate against events or instances that violate policies, regulations, or ethics in a manner that broadly affects us as a group or class.
This, however, isn't about the 504 process itself. It's about actions, poor decisions, and behavior by professionals contrary to their own institution policy, professional organizations, ethics, law or regulations that intend to negatively* affect parent advocacy for 504 due to reasons outside the scope of their licensure.
For example: I'm not asking Sicherer's legal opinion on 504. I'm not even asking my allergist's legal opinion on 504. The only question for our allergist is does this condition substantially limit a major life activity when acute? The rest is governed by rules that don't involve him.
I also wouldn't be asking any physician to opine if he or she personally or professionally believes adult employees with a specific qualifying condition should or should not be able to seek disability protections in their place of work.
The question about physician accountability in media remains. You will be highly criticized for doing so, possibly socially ostracized. This isn't meant as discouragement but more to encourage a thoughtful process.
*intend to negatively affect in my lay expression here refers to assume he or she knows more than you as the parent and your child based on the absence of relative facts
Okay, well I'm still confused.
You put:
My question is to you all: Are you ready to do what is necessary to hold such persons accountable? It would not be for the meek. It can, and arguably should, be done. Is that what you want to do?
I ask:
I'm not sure what all else you are thinking of.
Then you clarify:
Isolated to previously defined scope: allergists issuing blanket statements that may be discriminatory and/or attempt to give legal advice and/or medical advice about individuals who are not their patients resulting in harms to those individuals or as a class.
Not beyond that.
I must be missing something. I have a whole lot of other stuff swirling in my head about everything else you put, but, getting down to just the essentials, without being mired in all of the extraneous stuff you've got there, I am still wondering where you are headed?
You ask a question that seems to suggest that you are asking a group, or, maybe a collective that might be able to do something, or do you think an individual is going to tackle something to somehow do something, which I have no idea what that would be, though you suggest that whatever it is "would not be for the meek", which suggests you have an idea about what to do, about the scope you state.
Or are you just asking a question to ask it? It would be helpful to know.
For some reason, I've been thinking about this thread. I got a funny thing (to me) that ran through my head.
Picture doctor guy in white lab coat walking down the hall in medical building. Sort of the character of Scott Lang. Jogging up beside him, another doctor guy, white lab coat, Tony Stark-ish. He comes up saying to first doc, "Hey Scott-y..... " with a slap on the back.... continues ... "Matt-y's been tweeting you out of context again..... "
1st guy... stops and sighs... says "I've talked to him about this......."
3rd guy comes walking up .... sort of Luis character .... from right side, up from another hall, intercepts others....
Scott looks at 3rd guy and says, "Have you been tweeting me out of context again? You know how much trouble that gets me in from those moms on the internet!"
3rd guy looks right into the camera and says, "I say..... yes...." with big smile....
Okay..... anyway..... that sort of really has no point, except maybe I was sort of imagining maybe an exchange by doctors in a hallway somehow .... given the world of tweeting, etc.