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Sleeping by Example: Interview with Leading Researcher and Hopkins Professor of Neurology, Dr. Rachel Salas

3/24/2013

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One of the first lifestyle behaviors that clinicians and students sacrifice during their training is their sleep. This can have both personal and professional consequences. A recent Huffington Post article entitled "Doctors are Human; They Need Sleep" cites evidence that surgical residents are 22% more likely to commit preventable medical errors when fatigued due to sleep-deprivation. Sleep is so important that it was named one of the "20 Great Challenges" in medicine by TEDMED.


Dr. Rachel Salas is an Assistant Professor Neurology and sleep specialist at Johns Hopkins who has made it her mission to improve sleep quality in her patients and the medical students and residents whom she trains. She also is a supporter and signer of The Patient Promise. We had the opportunity to interview her about her background, how she became interested in sleep, and what The Patient Promise means to her.


Can you describe your current role, and the journey you took to get there? 

As the oldest of four and now, the mother of two, I have always been in position as a role model, whether I realized it or not. As a physician, this is also the case, not only for my patients, but for my students and trainees.  My medical career began while I attended Health Careers High School in San Antonio, Texas at which time I confirmed that I wanted to be a doctor. From there, I went to St. Mary's University to stay close to home. I went on to medical school at the University of Texas Medical Branch at Galveston where I stayed to also complete my internship in internal medicine and neurology residency. I was also selected to be the chief resident my last year of neurology residency. I then came to Johns Hopkins to complete a 2-year fellowship in Sleep Medicine.

While my plans were to return to Texas after fellowship (everyone always goes back to Texas), the department of Neurology, and in particular my mentors, inspired me to start my academic career here at Johns Hopkins.  I have been interested in being an academic physician since medical school. I believe that physicians should be teachers and researchers who strive to provide better care for our patients. Currently, I am an assistant professor in the department of neurology at Johns Hopkins. I am also the Co-director for the JH SOM Neurology Clerkship.  

As my career has evolved, I wear different hats depending on the day you catch me on.  One thing that stays constant, however, is that I am a teacher and a learner.  From my experience, I have really held on to the mantra "see one, do one, and teach one," which we are all taught in medical school.  While most may look at this as more of a clinical procedural activity (i.e., performing a lumbar puncture), I believe it extends to all aspects of being a health care provider.  

In my practice of being an academic physician, I have extended "the see one, do one, teach one" approach to patient care, where I have modified it to "Learn one, Practice one, and Teach one".  This has been a valuable "golden rule" for me, as a physician, as a mother, as a peer, as a teacher, as a friend, as a sister, as daughter.  I am not perfect and it has been a slow process, but I have started with what I know...and that is sleep. Sleep is integral to many other facets of life and it is something that many people do have power to improve. So I have started here. It is my mission to teach my students, menthes, trainees, and peers about so that they can improve their sleep quality. I believe that if I can improve their sleep quality, then they can ask their patients about sleep and so on.  Perhaps, a "pay it forward" on sleep...


What motivated you to sign The Patient Promise and practice what you preach?

I believe Health care providers should practice what we preach--it sets us up for providing better patient care--studies show this. 


How are you living one or more of the tenets of The Patient Promise?

I am spreading the word to others--I practice sleep wellness and have implemented several of the strategies I teach to students and patients about sleep. I am not perfect, but I have started on things I know (i.e., sleep) and plan to work on other areas of my health. My promise today is to practice healthy sleep habits and to teach these practices to others.


Have you discussed your commitment with any of your patients?

Not yet, however, I am spreading the word about The Patient Promise in my sleep health workshop to students. My hope is to teach students about sleep health earlier in medical school so that they begin to see the importance of sleep and that they do have control in improving their sleep. My hope is that experiential learning will get them to learn about their own sleep practices and improve these. Then, as studies show, if they have good sleep practices, they will be more comfortable to talk to their patients about sleep.  Over 60 million people meet the criteria for a sleep disorder, but most do not realize that there is something that can be done or that they may actually have a serious sleep disorder that is affecting their morbidity.


Has The Patient Promise influenced the frequency with which you discuss healthy lifestyle behaviors with your patients?

Yes, I think patients hear their doctor better--when their doctor says "it worked for me or I practice this too". Many people know that physicians, in particular, often are "the worst patients" and often "don't practice what they preach". This needs to change.


Do you feel like practicing healthy behaviors helps you partner with patients in their own journey?

Absolutely!


Do you have any advice for clinicians who may be considering signing The Patient Promise?

Start one step at a time. So with what you know. Learn about it first..."Learn one, Practice One, Then Teach One".  For me, it was "Learn about Sleep Health, Practice Sleep Health, Then Teach Sleep Health". It is a process...I am on step three now.

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Do you have any questions, comments? Leave them below, or e-mail [email protected]. 



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Watch ESCAPE FIRE on CNN on March 16th and Earn CMEs! 

3/15/2013

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The award-winning Sundance documentary ESCAPE FIRE: The Fight to Rescue American Healthcare, directed by Matthew Heineman and Oscar-Nominee Susan Froemke, tackles one of the most pressing issues of our time: what can be done to save our broken medical system? ESCAPE FIRE will be broadcast on Saturday, March 16th at 8pm & 11pm ET on CNN. Pledge to watch the film at EscapeFireMovie.com/CNN  

In an unprecedented professional education opportunity, watching the film will qualify for two (2) Prescribed CME credits from the American Academy of Family Physicians (AAFP), which can translate via reciprocity into American Medical Association (AMA) Category 1 credits. This is a unique chance for healthcare providers from around the country to join the millions tuning in to elevate and deepen the national dialogue about our healthcare system and our role in leading it out of crisis. A 1/2 hour roundtable discussion led by Dr. Sanjay Gupta, centered around the main themes in the film, will start immediately following the film’s broadcast.  Learn more at EscapeFireMovie.com/CME. You can view the film's trailer here. 
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