Discover and read the best of Twitter Threads about #twitternists

Most recents (5)

@MParshleyMD @adamIMdoc @InduPartha @primarycarechat @ACPinternists Urgent need to provide MORE time for ambulatory visits. Us ambulatory specialists have all felt the time crunch of seeing complex patient w/ 5-10 issues (or more) in 15-20 minutes. NOT good #PatientCare. NOT #PatientSafety. Thread đŸ§” 1 @ACPinternists #IMProud
@MParshleyMD @adamIMdoc @InduPartha @primarycarechat @ACPinternists We need major payment reform so reimbursements & physician “productivity” is NOT volume-centered based on number of visit encounters. THAT drives ambulatory schedules to have visits that are far too short to maximize numbers of visits. Thread đŸ§” 2 @ACPinternists #IMProud
@MParshleyMD @adamIMdoc @InduPartha @primarycarechat @ACPinternists Focus on value of care, NOT number of visits. Have flexibility of visit lengths based on appropriateness for care complexity. Get rid of “one size fits all” 15-20 minute visits. Simple 1 issue visit ok for that. Complex multi-problems-NOT ok w/ that. Threads đŸ§” 3 @ACPinternists
Read 6 tweets
1/Many of my colleagues and I have not been redeployed to the hospital during the #COVID pandemic. We have been doing the ambulatory care of pre/non hospitalized patients, helped w admitted pts and starting to see post discharge pts.

Many thoughts/advice points:

A đŸ§”THREAD
2/ First our #primarycare triage function in this process is crucial.

Workflows/teamwork/infrastructure have to be worked out and optimized.

An updated list of daily follow up #telehealth covid pts must be kept. Day of illness, daily update notes and tracking has to happen
3/ Key points:

Age, comorbidities matter. And yet, there are those healthier patients that get sicker, hypoxemic/stormy as well

Don’t completely know (like so much in this illness) the grouped likelihood ratios for the following but these are things to ask to be complete ..
Read 20 tweets
1/ Hey #medtwitter #proudtobeGIM

cc @mmteacherdoc @templeratcliffe @tony_breu @meggerber @laurelfick @adamcifu @DrSinhaEsq @SusanHingle

Received a text this AM from division’s admin coordinator

‘What a beautiful day it would have been for opening day - Let’s Go Mets ..’
->
2/ 2which my Chief of DGIM responded:

The one constant through all the years, Ray, has been baseball.

America has rolled by like an army of steamrollers. It's been erased like a blackboard, rebuilt, and erased again. But baseball has marked the time.

This field, this game->
3/ it’s part of our past, Ray. It reminds us of all that was once good, and what could be again.

Ohhh, people will come Ray. They most definitely come

To which I responded ->
Read 5 tweets
1/
“The Erythemas” – A #dermatology #meded #FOAMEd #tweetorial. pc:@dermnetnz

Ever get all the different #dermatologic terms jumbled up? Was it erythema nodosum, erythema migrans, or erythema multiforme?

Honest poll – Ever write “rash” b/c you couldn’t remember the diagnosis?
2/
All kidding aside, these terms can get confusing. Remember though, derm terms are usually just descriptors of what you see. The name tells you all you need to know.

For example: Acute Generalized Exanthematous Pustulosis (AGEP) = pustules suddenly appeared everywhere!
3/
So, the “erythemas.” First off, what does “erythema” actually mean? Well, according to my Google machine, it's from the Greek root “eruthros” meaning “red.” So "erythema" doesn’t add much to our knowledge of what the rash looks like other than it’s red, and so, likely inflamed
Read 15 tweets
1/ #medtwitter #twitternists #proudtobeGIM

I've been sitting on a @SocietyGIM #sgim19 debrief #medthread since the meeting, and thought I might finally take a swing at it - here goes ..

I am considering whether I can do more division/systems leadership in coming years .. ->
2/ Theme of the conference was 'Courage to Lead', and single best workshop for me was :

Leading Change: Tools/Tips for Change Management

Crediting Alfred Burger, Emily Fondahn, Brent Petty, Nathan Spell, Dan Steinberg - can't find them on Twitter, so giving proper 🗣🗣.
3/ would like to share key concepts for all of us trying to lead in academic medicine or in #advocacy spaces.

First key Slide/thoughts:

The hard stuff - barriers to change .. ->
Read 16 tweets

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