Why Hospital Medicine Must Be Community-Based: A Thread. Today, an elder woman from the Latinx community is hospitalized, unable to make medical decisions. She has no family. She only remembers the name of one dear friend who she trusts but does not know how to reach her. 1/n

Due to lack of competency, the hospital team was moving her towards conservatorship, which would have appointed a stranger by the court to look over her care. While this system can help protect many, it can be severe to others, 2/n

who have their agency and their cultural perspectives subsumed under court-appointed people who wield major decision-making power. Instead, I texted a dear friend in the Latinx community who knows everyone. Or knows everyone who knows everyone. 3/n

Through a combination of playing music in the Mission for years, working with artists at MCCLA, organizing with Brown and Black activists in SF and working at a free clinic for undocumented folks, I have become a part of an amazing community of highly interconnected folks. 4/n

This is part of how I view medicine. This is one way we can become highly effective in our work in the hospitals, by connecting directly with the people we serve. within a few hours I was connected to the patient's dear friend. 5/n

The friend happily agreed to act as the surrogate decision maker. The patient is reconnected to her community. The hospital saved thousands of dollars which is what the conservatorship process costs. Hospital medicine must always be community-based. It's good medicine. FIN n/n