Discover and read the best of Twitter Threads about #Primarycare
Most recents (24)
1a) Welcome to a 🆕#accredited #tweetorial on the importance of time in range #TIR in #diabetes . . . with additional emphases on #primarycare and on practice in 🇨🇦.
#FOAMed #endotwitter #MedEd @MedTweetorials #nephtwitter #cardiotwitter
#FOAMed #endotwitter #MedEd @MedTweetorials #nephtwitter #cardiotwitter
1b) Hence we welcome2⃣ expert faculty from Canada: Ilana Halperin @ilanajhalperin, academic endocrinologist at @Sunnybrook and @uoftmedicine, and Noah Ivers @NoahIvers, #familydoc & researcher at Women's College Hospital @UofT 
2) Earn 0.75hr 🆓CE/#CME by following this🧵! This program is supported by an unrestricted educational grant from Sanofi Canada and is intended for #HCPs. Statement of accreditation & faculty disclosures at cardiometabolic-ce.com/disclosures/.
And so we begin . . .
And so we begin . . .
A 44-yo♂️, HIV +, CD4 cell count of 86/mL, viral load of 35,900 copies/mL: a 1-month history of fevers and pruritic blackish-brown lamellated plaques on the limbs and scalp.
¼
👇
DOI: 10.1056/NEJMicm2213894
#IDtwitter #dermatology
¼
👇
DOI: 10.1056/NEJMicm2213894
#IDtwitter #dermatology
A RPR titer of 1:32.
A Treponema pallidum particle agglutination: ➕.
A skin-biopsy of the left forearm 🔬: diffuse dermal lymphocytes and histiocytes admixed with a plasma-cell infiltrate.
MALIGNANT SYPHILIS
2/4
#microbiology #dermpath #RareInfection
A Treponema pallidum particle agglutination: ➕.
A skin-biopsy of the left forearm 🔬: diffuse dermal lymphocytes and histiocytes admixed with a plasma-cell infiltrate.
MALIGNANT SYPHILIS
2/4
#microbiology #dermpath #RareInfection
Malignant #syphilis:
- uncommon form of secondary syphilis
- primarily affects immunocompromised persons.
-skin manifestations are varied, ranging from ulceronodular lesions to oyster shell–like crusts
3/4
#primarycare #MedTwitter #Awareness
- uncommon form of secondary syphilis
- primarily affects immunocompromised persons.
-skin manifestations are varied, ranging from ulceronodular lesions to oyster shell–like crusts
3/4
#primarycare #MedTwitter #Awareness
As I wrap up my 5th year of #primarycare practice, I can't help but reflect on the TEN "sparks" trainees may miss out on during residency that make this work so rewarding.
A 🧵of #gratitude...
@CLOSLER @primarycarechat @InduPartha @adamcifu @gabrieldane @GIMaPreceptor
0/11
A 🧵of #gratitude...
@CLOSLER @primarycarechat @InduPartha @adamcifu @gabrieldane @GIMaPreceptor
0/11
1) Spending the majority of time in an office visit talking about kids, grandkids, sports, golf league, and fears for the future.
Very few people get to be a sounding board in the lives of others.
Very few people get to be a sounding board in the lives of others.
2) Knowing your patients without having to look anything up. What would take another provider 45 minutes to orient to, you can address in 2 minutes or less.
#knowyourworth
#knowyourworth
#Antivax #vaccineswork #primarycare If you have read the book Turtles all the way down, by an anonymous author, and edited by @ChildrensHD attorney Mary Holland, you have been deliberately, and systematically lied to. A small sampling of the antivax strategies used:
1. Claim that nobody knows how to read scientific studies except for them. If you intentionally misinterpret studies on traditional vaccines, you can literally come up with any conclusion you want.
2. Using deliberately hostile language in reference to the men and women who spent their professional careers working on immunizations. Much of what @ChildrensHD does is to create imaginary hostility to spread their message.
Hey #medtwitter #meded
Dear #healthcare employers, academic medical centers/institutional structures
#primarycare is the foundation of care in a large system. It is not treated as such
Metrics rating us and attracting scrutiny include
1/? -> …
Dear #healthcare employers, academic medical centers/institutional structures
#primarycare is the foundation of care in a large system. It is not treated as such
Metrics rating us and attracting scrutiny include
1/? -> …
2/
% A1C > 9
blood pressure <140/90 at last touch across board,
w/o regard to age/context
% mammo (w many outside your system and clicks to result burdensome)
% colon screening
% flu or pnvx
% PHQ screened
average # patients seen / exam room / day
90% RVU target->
% A1C > 9
blood pressure <140/90 at last touch across board,
w/o regard to age/context
% mammo (w many outside your system and clicks to result burdensome)
% colon screening
% flu or pnvx
% PHQ screened
average # patients seen / exam room / day
90% RVU target->
3/
These metrics are from CMS menus, or from finance, etc
EMRs don’t always generate panel wide data well, don’t always define or find panels well. #primarycare metric measurement workarounds then have to be created repeatedly
#primarycare docs/teams can be penalized, 😡->
These metrics are from CMS menus, or from finance, etc
EMRs don’t always generate panel wide data well, don’t always define or find panels well. #primarycare metric measurement workarounds then have to be created repeatedly
#primarycare docs/teams can be penalized, 😡->
An 85-YO in rural Mississippi: months of tender, erythematous plaques & edema on bilateral hands extending to the elbows & on feet extending below the knees with significant pain
🔬skin granulomatous inflammation & numerous AFB
Mycobacterial🧫:➖
1/19
#IDtwitter #dermatology
🔬skin granulomatous inflammation & numerous AFB
Mycobacterial🧫:➖
1/19
#IDtwitter #dermatology
A repeat skin extensive granulomatous inflammation (A), with Ziehl-Neelsen stain clusters of acid-fast bacilli throughout the dermis (B).
Kinyoun stain >9 AFB/high-power field (C & D).
2/19
DOI: doi.org/10.1128/jcm.00…
#dermpath #microbiology
Kinyoun stain >9 AFB/high-power field (C & D).
2/19
DOI: doi.org/10.1128/jcm.00…
#dermpath #microbiology
Molecular identification: 100% identity to multiple Mycobacterium leprae
BORDERLINE LEPROMATOUS LEPROSY WITH REVERSAL REACTION
3/19
#MedTwitter #MolBiol
BORDERLINE LEPROMATOUS LEPROSY WITH REVERSAL REACTION
3/19
#MedTwitter #MolBiol
A 44-YO♂️, stayed in a rural cottage of France 2 weeks previously: cramping upper abdominal pain with watery diarrhea.
He had passed what he thought were worms in his feces
Eosinophilia
1/6
doi.org/10.1093/cid/ci…
#GITwitter #IDtwitter #microbiology
He had passed what he thought were worms in his feces
Eosinophilia
1/6
doi.org/10.1093/cid/ci…
#GITwitter #IDtwitter #microbiology
The specimens: identified as the larvae of the drone fly, Eristalis tenax
These larvae are 2.5–3 cm in length; the posterior tube gives them the name of “rat-tailed maggots”
INTESTINAL MYASIS CAUSED BY ERISTALIS TENAX LARVA
2/6
doi.org/10.1093/cid/ci…
#parasites #GIPath #Doctor
These larvae are 2.5–3 cm in length; the posterior tube gives them the name of “rat-tailed maggots”
INTESTINAL MYASIS CAUSED BY ERISTALIS TENAX LARVA
2/6
doi.org/10.1093/cid/ci…
#parasites #GIPath #Doctor
Myiasis caused by E. tenax:
✔️rare but have been
✔️reported from various countries including Europe
✔️most often intestinal myiasis, but cases of infestation of the nasal cavity, urinary tract, and vagina have been described.
3/6
#Doctor #MedStudentTwitter
✔️rare but have been
✔️reported from various countries including Europe
✔️most often intestinal myiasis, but cases of infestation of the nasal cavity, urinary tract, and vagina have been described.
3/6
#Doctor #MedStudentTwitter
A 26-YO♂️ no #sexual contacts other than with his male partner: 6-day of fever, malaise, a swollen parotid gland, & ulcerative lesion on the ipsilateral lower lip.
Mild lymphopenia
⬆️GGT & CRP
1/6
doi.org/10.1016/S0140-…
#IDtwitter #dermatology #EarNoseThroat
Mild lymphopenia
⬆️GGT & CRP
1/6
doi.org/10.1016/S0140-…
#IDtwitter #dermatology #EarNoseThroat
PCRs on the throat & ulcer swabs:➕for human #monkeypox (hMPX)
Genomic sequencing: clade IIb variant clustering within the current international mpox virus outbreak
PAROTIDITIS CAUSED BY hMPX virus
2/6
#sexually #maxillofacial #microbiology
Genomic sequencing: clade IIb variant clustering within the current international mpox virus outbreak
PAROTIDITIS CAUSED BY hMPX virus
2/6
#sexually #maxillofacial #microbiology
7 days after initial presentation, his clinical condition had improved together with a decrease in the parotid swelling and the size of the ulcer.
3/6
#MedTwitter #Doctor #MedStudentTwitter
3/6
#MedTwitter #Doctor #MedStudentTwitter
A 58-YO♂️, DM, fever & L lower quadrant abdominal pain 2 months prior: acute R-sided back pain, & 3/6 diastolic murmur at R upper sternal border.
CT: a R renal infarction & splenic embolism
MR: multiple infarctions
1/7
doi.org/10.1016/j.idcr…
#Cardiology #medicine #cardiologia
CT: a R renal infarction & splenic embolism
MR: multiple infarctions
1/7
doi.org/10.1016/j.idcr…
#Cardiology #medicine #cardiologia
Transesophageal echocardiography: a vegetation and severe aortic regurgitation.
Blood 🧫: Cardiobacterium hominis
CARDIOBACTERIUM HOMINIS ENDOCARDITIS ASSOCIATED WITH CEREBRAL, RENAL, AND SPLENIC INFARCTIONS
2/7
#IDtwitter #microbiology
Blood 🧫: Cardiobacterium hominis
CARDIOBACTERIUM HOMINIS ENDOCARDITIS ASSOCIATED WITH CEREBRAL, RENAL, AND SPLENIC INFARCTIONS
2/7
#IDtwitter #microbiology
The patient received antibiotic therapy and surgical aortic valve replacement, and he was doing well without major complications.
3/7
#infecciosas #MedTwitter #Doctor
3/7
#infecciosas #MedTwitter #Doctor
A 50-YO ♀️ bitten by her pet rat: fever, myalgia, sore throat, headaches a nonpruritic rash on extremities including palms & soles, arthralgias, knees arthritis.
A punctate wound with central necrosis on L palm, & her R thumb.
1/9
#rheumatology #internalmedicine #dermatology
A punctate wound with central necrosis on L palm, & her R thumb.
1/9
#rheumatology #internalmedicine #dermatology
Leukocytosis with neutrophilia
ESR & PCR:⬆️
Purulent R knee synovial fluid:
✔️46 000 cells/mL (88% neutrophils).
✔️Gram stain: scant pleomorphic gram-negative bacilli in chains with lateral bulbar swellings
2/9
doi.org/10.1093/cid/ci…
#microbiology #rheumatologist
ESR & PCR:⬆️
Purulent R knee synovial fluid:
✔️46 000 cells/mL (88% neutrophils).
✔️Gram stain: scant pleomorphic gram-negative bacilli in chains with lateral bulbar swellings
2/9
doi.org/10.1093/cid/ci…
#microbiology #rheumatologist
Synovial fluid 🧫culture: Streptobacillus moniliformis identified by biochemical testing & confirmed by MALDI-TOF.
RAT BITE FEVER (RBF) WITH SEPTIC ARTHRITIS DUE STREPTOBACILLUS MONILIFORMIS
3/9
#bacteriology #IDtwitter #microbiología
RAT BITE FEVER (RBF) WITH SEPTIC ARTHRITIS DUE STREPTOBACILLUS MONILIFORMIS
3/9
#bacteriology #IDtwitter #microbiología
Today we’ll hear the draft recommendations from a group of 36 everyday Ontarians about how to make the #primarycare system better
They were randomly selected from 1250 who volunteered
They’ve spent 40+ hrs learning from experts and each other
What’s been in the curriculum?
They were randomly selected from 1250 who volunteered
They’ve spent 40+ hrs learning from experts and each other
What’s been in the curriculum?
We started virtually with talks from
@ElizabethMuggah on primary care in ON
@AndrewDPinto @snewbery1 @DrFitzsimon and F Garwe on equitable access
And myself on models of care from other countries
Talks all available here: OurCare.ca/Ontario
@ElizabethMuggah on primary care in ON
@AndrewDPinto @snewbery1 @DrFitzsimon and F Garwe on equitable access
And myself on models of care from other countries
Talks all available here: OurCare.ca/Ontario
On Thursday eve, we gathered everyone in person here in Toronto
People came in from all corners of Ontario (and even directly from a hospital discharge!) #Commitment
After dinner, I walked folks through the result of our national survey
Data.OurCare.ca
People came in from all corners of Ontario (and even directly from a hospital discharge!) #Commitment
After dinner, I walked folks through the result of our national survey
Data.OurCare.ca
A 17-YO♀️, unprotected #sexual intercourse with multiple male partners: a 1-month history of pruritic genital lesions, multiple smooth, grayish-white papules & plaques were noted on the vulva & upper inner thighs.
1/5
DOI: 10.1056/NEJMicm2207538
#gynecology #womenshealth
1/5
DOI: 10.1056/NEJMicm2207538
#gynecology #womenshealth
A Treponema pallidum particle agglutination assay:➕
Rapid plasma reagin titer: ➕1:16.
CONDYLOMA LATA OF SECONDARY SYPHILIS
2/5
#microbiology #gynecologist #primarycare
Rapid plasma reagin titer: ➕1:16.
CONDYLOMA LATA OF SECONDARY SYPHILIS
2/5
#microbiology #gynecologist #primarycare
✔️Testing for other sexually transmitted infections, including HIV infection: ➖
✔️Counseling on the importance of condom use
✔️IM penicillin G benzathine
At the 1-month follow-up visit, the lesions had resolved, and the RPR was 1:8.
3/5
#dermtwitter #IDtwitter #MedTwitter
✔️Counseling on the importance of condom use
✔️IM penicillin G benzathine
At the 1-month follow-up visit, the lesions had resolved, and the RPR was 1:8.
3/5
#dermtwitter #IDtwitter #MedTwitter
A 29-YO♂️, 6 months before, HIV + & non–drug-resistant pulmonary tuberculosis, antiretroviral & 4-drug antituberculous therapy initiated but soon reduced to rifampin & isoniazid only: abdominal pain on the L side
CT: ?
1/5
DOI: 10.1056/NEJMicm2206174
#radiologist #GITwitter
CT: ?
1/5
DOI: 10.1056/NEJMicm2206174
#radiologist #GITwitter
CT: an enlarged spleen with numerous hypodense lesions (A).
CD4 cell count: 119/mm3
VIH viral load: 1778 copies/mm3
A splenectomy was performed to evaluate for cancer:
numerous necrotic nodules with purulent discharge (B).
2/5
#microbiology #gastroenterology #IDtwitter
CD4 cell count: 119/mm3
VIH viral load: 1778 copies/mm3
A splenectomy was performed to evaluate for cancer:
numerous necrotic nodules with purulent discharge (B).
2/5
#microbiology #gastroenterology #IDtwitter
🔬granulomatous inflammation with caseous necrosis (C) and acid-fast bacilli (D, arrowheads).
A tissue🧫: ➖
PCR: ➕for Mycobacterium tuberculosis
SPLENIC TUBERCULOSIS
3/5
#bacteriology #MedTwitter #GIPath
A tissue🧫: ➖
PCR: ➕for Mycobacterium tuberculosis
SPLENIC TUBERCULOSIS
3/5
#bacteriology #MedTwitter #GIPath
A 31-YO ♂️, sex with men, HIV treatment, HCV: in 2022, fever, cervical lymph nodes & erythemato-squamous papules, with umbilications & ulcerations, vesicles & pustules, & honey-colored crusts on the face, trunk & limbs including his palms & soles
1/7
#IDtwitter #primarycare
1/7
#IDtwitter #primarycare
PCR: ➕for MPXVirus.
#HIV viral load of < 40 copies/mL and a CD4 + count of 167 cells/mm3
#MPOX (MONKEYPOX)
2/7
#healthcare #internalmedicine #microbiology
doi.org/10.1016/j.idcr…
#HIV viral load of < 40 copies/mL and a CD4 + count of 167 cells/mm3
#MPOX (MONKEYPOX)
2/7
#healthcare #internalmedicine #microbiology
doi.org/10.1016/j.idcr…
Supportive care of Mpox was provided, namely,
✔️beta-lactams due to bacterial superinfection of the lesions,
✔️in addition to analgesia, which was initially administered with NSAIDs and then escalated to opioids.
3/7
#MedTwitter #MedStudentTwitter #dermtwitter
✔️beta-lactams due to bacterial superinfection of the lesions,
✔️in addition to analgesia, which was initially administered with NSAIDs and then escalated to opioids.
3/7
#MedTwitter #MedStudentTwitter #dermtwitter
A 32-YO ♂️ sex worker, sex with men unprotected, HIV under treatment: 20 lesions scattered throughout the body of umbilicated, erythematous, violaceous papules with central ulcerations & pustules, fevers, cervical & axillary lymph nodes
1/5
#IDtwitter #primarycare #healthcare
1/5
#IDtwitter #primarycare #healthcare
HIV viral load of 1577 copies/mL and a CD4 + count of 932 cells/mm3
PCR: ➕ for Mpox virus
MPOX (MONKEYPOX)
2/5
#internalmedicine #microbiology doi.org/10.1016/j.idcr…
PCR: ➕ for Mpox virus
MPOX (MONKEYPOX)
2/5
#internalmedicine #microbiology doi.org/10.1016/j.idcr…
Mpox had been a neglected disease until May, 2022, and since then, there has been a notorious increase in the number of human monkeypox cases in non-endemic areas
3/5
#MedTwitter #MedStudentTwitter #dermtwitter
3/5
#MedTwitter #MedStudentTwitter #dermtwitter
An 86-YO ♂️, injury on his L leg 47 years prior, several debridements, skin grafts, & vein stripping procedures: chronic bilateral leg progressive ulcers.
Superficial🧫: multiple organisms including E. coli & coagulase➖Staphylococcus.
1/6
#internalmedicine #IDtwitter
Superficial🧫: multiple organisms including E. coli & coagulase➖Staphylococcus.
1/6
#internalmedicine #IDtwitter
Skin biopsy🔬: bilateral invasive squamous cell carcinomas.
BILATERAL INVASIVE SQUAMOUS CELL CARCINOMAS (MARJOLIN ULCERS)
2/6
#dermatology #dermpath
doi.org/10.1093/cid/ci…
BILATERAL INVASIVE SQUAMOUS CELL CARCINOMAS (MARJOLIN ULCERS)
2/6
#dermatology #dermpath
doi.org/10.1093/cid/ci…
The mean time period between development of a wound to malignancy is 30–35 years.
The most common malignancies seen in Marjolin ulcers are squamous cell carcinomas, but basal cell carcinomas and melanomas have been reported.
3/6
#Doctor #healthcare #MedStudentTwitter
The most common malignancies seen in Marjolin ulcers are squamous cell carcinomas, but basal cell carcinomas and melanomas have been reported.
3/6
#Doctor #healthcare #MedStudentTwitter
A 64-YO ♂️ from a rural community: pain, itching, bleeding in the L ear, & mobile larvae occluding the L external auditory canal
1/4
DOI: 10.1056/NEJMicm2005407
#primarycare #Otolaryngologist
1/4
DOI: 10.1056/NEJMicm2005407
#primarycare #Otolaryngologist
AURAL MYASIS
An ear aspirator, forceps, and irrigation with sterile water were used to remove the larvae
Perforation of the tympanic membrane was identified.
2/4
DOI: 10.1056/NEJMicm2005407
#healthcare #parasitology
An ear aspirator, forceps, and irrigation with sterile water were used to remove the larvae
Perforation of the tympanic membrane was identified.
2/4
DOI: 10.1056/NEJMicm2005407
#healthcare #parasitology
Aural myiasis:
📌infestation of the middle or external ear
📌by fly larvae of the order Diptera.
Risk factors:
✔️chronic otitis media,
✔️diabetes mellitus, and
✔️impaired hygiene.
3/4
DOI: 10.1056/NEJMicm2005407
#Otolaryngology #parasites
📌infestation of the middle or external ear
📌by fly larvae of the order Diptera.
Risk factors:
✔️chronic otitis media,
✔️diabetes mellitus, and
✔️impaired hygiene.
3/4
DOI: 10.1056/NEJMicm2005407
#Otolaryngology #parasites
A 20-YO ♀️, college wrestling, Mexico: itching in the past 2 months, erythematous & fine-scaling papules with annular plaques having a raised border affecting the face, neck, & torso.
1/6
doi: 10.18502/cmm.6.4.5439
#dermatology #primarycare #MedTwitter
1/6
doi: 10.18502/cmm.6.4.5439
#dermatology #primarycare #MedTwitter
KOH: multiple thin & septate hyphae.
🧫, MALDI-TOF-MS: Trichophyton tonsurans
T. tonsurans was isolated in 4 cases belonging to the school fighting team & from one of the training mats
TINEA GLADIATORUM DUE TO TRICHOPHYTON TONSURANS IN A SCHOLL WRESTLING TEAN
2/6
#mycology
🧫, MALDI-TOF-MS: Trichophyton tonsurans
T. tonsurans was isolated in 4 cases belonging to the school fighting team & from one of the training mats
TINEA GLADIATORUM DUE TO TRICHOPHYTON TONSURANS IN A SCHOLL WRESTLING TEAN
2/6
#mycology
Oral terbinafine for 3 weeks: clinical & mycological cure.
Tinea gladiatorum is a type of dermatophytosis that occurs in combat athletes, such as wrestlers and judo fighters, as a result of Trichophyton species.
3/6
doi: 10.18502/cmm.6.4.5439
#IDtwitter #microbiology #Doctor
Tinea gladiatorum is a type of dermatophytosis that occurs in combat athletes, such as wrestlers and judo fighters, as a result of Trichophyton species.
3/6
doi: 10.18502/cmm.6.4.5439
#IDtwitter #microbiology #Doctor
A 38-YO♂️, #HIV➕: asthenia, fever, & generalized & confluent maculopapular rash predominantly on the back, cervical & inguinal lymphadenopathies, & stippled petechial hemorrhages in the soft palate (Forchheimer’s spots)
Subsequently, pustules appeared
1/5
#emergency #IDtwitter
Subsequently, pustules appeared
1/5
#emergency #IDtwitter
Classic Mpox pustules appeared
PCR:
✔️for measles & rubella➖
✔️for Mpox➕
HUMAN Mpox, although confluent maculopapular rash & Forchheimer’s spots have been reported as classic signs of rubella or measles infections
2/5
DOI: doi.org/10.4269/ajtmh.…
#microbiology #MedTwitter
PCR:
✔️for measles & rubella➖
✔️for Mpox➕
HUMAN Mpox, although confluent maculopapular rash & Forchheimer’s spots have been reported as classic signs of rubella or measles infections
2/5
DOI: doi.org/10.4269/ajtmh.…
#microbiology #MedTwitter
Forchheimer spots, a type of enanthem:
📌sometimes precede the skin rash of rubella.
📌tiny red spots on the soft palate in rubella, measles and scarlet fever.
3/5
#dermatology #internalmedicine #primarycare
📌sometimes precede the skin rash of rubella.
📌tiny red spots on the soft palate in rubella, measles and scarlet fever.
3/5
#dermatology #internalmedicine #primarycare
@writenrun @TimHoustonNS @CH_ABeswick @NS_Justice @nspc I recently heard @CTVSteveMurphy tell @TVeinotteShow that Tim Houston is a lot more like Stephen McNeil than most people realize.
In other words, they're both "my way or the highway" kinda' guys. #WhiteMalePrivilege
In other words, they're both "my way or the highway" kinda' guys. #WhiteMalePrivilege
@writenrun @TimHoustonNS @CH_ABeswick @NS_Justice @nspc @CTVSteveMurphy @TVeinotteShow @skimber The new Tim Houston has morphed into the old Stephen McNeill: arrogant, angry, self-righteous. (paywalled) #nspoli #nspc halifaxexaminer.ca/commentary/hou…
@writenrun @TimHoustonNS @CH_ABeswick @NS_Justice @nspc @CTVSteveMurphy @TVeinotteShow @skimber Last week, @MLABarbAdams announced plans to build 600 new #LTC beds, doubling the number under development.
Good news, but… Is it playing politics to note that most of those beds will not open until 2025, the year the Tim Houston govt. is scheduled to seek a new mandate?
Good news, but… Is it playing politics to note that most of those beds will not open until 2025, the year the Tim Houston govt. is scheduled to seek a new mandate?
The media is putting more focus on #NHSCrisis
You see reports from wards, hospitals, Emergency Departments, Ambulances of the immense pressures faced by my colleagues in secondary care
But what does this crisis look like in #primarycare?
A thread 🧵...
You see reports from wards, hospitals, Emergency Departments, Ambulances of the immense pressures faced by my colleagues in secondary care
But what does this crisis look like in #primarycare?
A thread 🧵...
I've been a GP for 15 years
GP + #primarycare has always been busy
Balancing access, demand + capacity has always been a challenge
But honestly, things are different now.
We don't have trollies in corridors or ambulances queuing outside.
But this doesn't mean there's no #GPCrisis
GP + #primarycare has always been busy
Balancing access, demand + capacity has always been a challenge
But honestly, things are different now.
We don't have trollies in corridors or ambulances queuing outside.
But this doesn't mean there's no #GPCrisis
This is not something that has happened overnight
The current "perfect storm" of flu, covid, respiratory illness and lack of social care has exposed and exacerbated long term cracks that have become gaping holes in the system...
So what are the issues in GP?
The current "perfect storm" of flu, covid, respiratory illness and lack of social care has exposed and exacerbated long term cracks that have become gaping holes in the system...
So what are the issues in GP?
🧵 1/5
Will "time modifiers"
added to family doctors fees
help more people in BC
access primary care?
🩺❤️🩹Probably not
2006-14, BC spent a BILLION $$ (!!)
with incentive fees family doctors for work that typically takes more time (e.g. mental health)
#bcpoli #primarycare
Will "time modifiers"
added to family doctors fees
help more people in BC
access primary care?
🩺❤️🩹Probably not
2006-14, BC spent a BILLION $$ (!!)
with incentive fees family doctors for work that typically takes more time (e.g. mental health)
#bcpoli #primarycare
2/5
The new fees were "on top" of the usual "fee-for-service"
The stated aim:
💥to encourage family doctors to return to a traditional model of "full-service family practice"💥
And acknowledged that some work was taking doctors MORE TIME⌚️
@globeandmail
theglobeandmail.com/opinion/was-bc…
The new fees were "on top" of the usual "fee-for-service"
The stated aim:
💥to encourage family doctors to return to a traditional model of "full-service family practice"💥
And acknowledged that some work was taking doctors MORE TIME⌚️
@globeandmail
theglobeandmail.com/opinion/was-bc…
3/5
The result?😢
-family doctors got paid more
-family doctors saw fewer patients
⁉️But maybe patient outcomes like hospitalizations improved, she types hopefully (see next tweet...)
ref: longwoods.com/content/23782/…
The result?😢
-family doctors got paid more
-family doctors saw fewer patients
⁉️But maybe patient outcomes like hospitalizations improved, she types hopefully (see next tweet...)
ref: longwoods.com/content/23782/…
28-AUG-2022 UPDATE
1/23
Incidence of #COVID19 in 🇺🇸 kids increased 10% during the week ending 26-AUG-2022. More than 17,000 new cases every day; ADIR = 21.8/100,000.
#epitwitter #PedsICU #LongCovidKids
covkidproject.org
1/23
Incidence of #COVID19 in 🇺🇸 kids increased 10% during the week ending 26-AUG-2022. More than 17,000 new cases every day; ADIR = 21.8/100,000.
#epitwitter #PedsICU #LongCovidKids
covkidproject.org
28-AUG-2022 UPDATE
2/23
The highest #COVID19 new daily incidence rates for kids are concentrated in the #Southeast.
covkidproject.org/hot-spots
2/23
The highest #COVID19 new daily incidence rates for kids are concentrated in the #Southeast.
covkidproject.org/hot-spots
28-AUG-2022 UPDATE
3/23
States with adverse trends ( ⬆️ incidence) of #COVID19 in kids for the week ending 26-AUG-22 are red/orange on the map.
covkidproject.org/hot-spots
3/23
States with adverse trends ( ⬆️ incidence) of #COVID19 in kids for the week ending 26-AUG-22 are red/orange on the map.
covkidproject.org/hot-spots
26-AUG-22 UPDATE
1/25
In this 🧵, we update #COVID19 incidence, hospitalizations, deaths, and disparities for 🇺🇸 children and adolescents.
Please share this 🧵 #epitwitter #PedsICU #tweetiatrician #SARSCoV2 #Omicron #LongCovidKids
covkidproject.org
1/25
In this 🧵, we update #COVID19 incidence, hospitalizations, deaths, and disparities for 🇺🇸 children and adolescents.
Please share this 🧵 #epitwitter #PedsICU #tweetiatrician #SARSCoV2 #Omicron #LongCovidKids
covkidproject.org
