#JHMChat Transcript
Healthcare social media transcript of the #JHMChat hashtag.
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| Profile | Tweet |
|---|---|
 | J Hospital Medicine @JHospMedicine Greetings, I am @FutureDocs your moderator for tonight's #JHMChat. Please introduce yourself. T1 up in a moment... |
 | Society of Hospital Medicine @SHMLive #JHMChat w/ @JHospMedicine @FutureDocs & @PetrilliMD begins NOW! Use the hashtag & claim #CME here: https://t.co/O8U9kzyAOS |
| J Hospital Medicine @JHospMedicine RT @SHMLive: #JHMChat w/ @JHospMedicine @FutureDocs & @PetrilliMD begins NOW! Use the hashtag & claim #CME here: https://t.co/O8U9kzyAOS |
 | Vinny Arora MD MAPP @FutureDocs RT @SHMLive: #JHMChat w/ @JHospMedicine @FutureDocs & @PetrilliMD begins NOW! Use the hashtag & claim #CME here: https://t.co/O8U9kzyAOS |
| Vinny Arora MD MAPP @FutureDocs RT @JHospMedicine: Greetings, I am @FutureDocs your moderator for tonight's #JHMChat. Please introduce yourself. T1 up in a moment... |
 | Shoshana Herzig @ShaniHerzig Greetings from snowy Boston #jhmchat |
| J Hospital Medicine @JHospMedicine welcome author @PetrilliMD author of Things We Do For No Reason: inpatient hypercoag testing #JHMChat https://t.co/6zo5FtmhBi |
| Society of Hospital Medicine @SHMLive RT @JHospMedicine: Greetings, I am @FutureDocs your moderator for tonight's #JHMChat. Please introduce yourself. T1 up in a moment... |
 | Tony Breu @tony_breu @JHospMedicine @FutureDocs Tony Breu here from VA Boston. #jhmchat |
| J Hospital Medicine @JHospMedicine Just remember to tag #jhmchat in all tweets tonight;) https://t.co/u7HRZ0Qk0V |
 | Irsk Anderson @ijanders1 #jhmchat Irsk Anderson Univ of Chicago |
 | Chris Petrilli @PetrilliMD @JHospMedicine #JHMChat Great to be here. Thank you to all non 'Bama / Clemson fans who could join us tonight! |
| Society of Hospital Medicine @SHMLive RT @JHospMedicine: welcome author @PetrilliMD author of Things We Do For No Reason: inpatient hypercoag testing #JHMChat https://t.co/6zo5F… |
 | ABIM Foundation @ABIMFoundation RT @SHMLive: #JHMChat w/ @JHospMedicine @FutureDocs & @PetrilliMD begins NOW! Use the hashtag & claim #CME here: https://t.co/O8U9kzyAOS |
 | Nate Houchens @nate_houchens New to hashtags. Not new to @PetrilliMD. Glad I can be here to learn from the masters! #jhmchat |
| J Hospital Medicine @JHospMedicine Special thanks to our partners @SHMLive @CostsofCare @ABIMFoundation for bringing you #JHMChat tonight - #CME edition! |
 | Shannon K. Martin @shannonmartinmd Hi, Shannon Martin from Chicago here #jhmchat |
| Chris Petrilli @PetrilliMD RT @JHospMedicine: Just remember to tag #jhmchat in all tweets tonight;) https://t.co/u7HRZ0Qk0V |
| J Hospital Medicine @JHospMedicine Dont forget to register for #CME for participation in tonight's #JHMChat - sign up here! https://t.co/dbOp3pOMLp |
 | Charlie M. Wray @WrayCharles Howdy from the soggy, SF Bay area! #JHMChat |
| Society of Hospital Medicine @SHMLive RT @JHospMedicine: Just remember to tag #jhmchat in all tweets tonight;) https://t.co/u7HRZ0Qk0V |
 | Nancy H Stewart DO, MS @nvhstewart Hi @FutureDocs! Nancy here- I'm on nights, so may need to sign off early. Happy to join this time! #jhmchat #meded |
| J Hospital Medicine @JHospMedicine @ShaniHerzig glad @futuredocs made it out otherwise #JHMChat would have been Boston based! |
| Society of Hospital Medicine @SHMLive RT @JHospMedicine: Dont forget to register for #CME for participation in tonight's #JHMChat - sign up here! https://t.co/dbOp3pOMLp |
| Society of Hospital Medicine @SHMLive RT @JHospMedicine: Special thanks to our partners @SHMLive @CostsofCare @ABIMFoundation for bringing you #JHMChat tonight - #CME edition! |
| J Hospital Medicine @JHospMedicine @nvhs0401 @FutureDocs thanks for joining #JHMChat and retweeting Nancy! you can check out the transcript tomorrow:) |
| J Hospital Medicine @JHospMedicine ICYMI Tonight's #JHMChat article on ordering inpt inherited thrombophilia testing by @PetrilliMD @vineet_chopra https://t.co/6zo5FtmhBi |
| Chris Petrilli @PetrilliMD RT @nate_houchens: New to hashtags. Not new to @PetrilliMD. Glad I can be here to learn from the masters! #jhmchat |
| J Hospital Medicine @JHospMedicine T1: In @PetrilliMD et al, inpt inherited thrombophilia tests NOT recommended. Are these recs followed? why/why not? #JHMChat |
| Shoshana Herzig @ShaniHerzig @JHospMedicine @FutureDocs we'd have been happy to keep her! #jhmchat |
| Society of Hospital Medicine @SHMLive RT @JHospMedicine: ICYMI Tonight's #JHMChat article on ordering inpt inherited thrombophilia testing by @PetrilliMD @vineet_chopra https://… |
| Chris Petrilli @PetrilliMD RT @JHospMedicine: T1: In @PetrilliMD et al, inpt inherited thrombophilia tests NOT recommended. Are these recs followed? why/why not? #JH… |
| Vinny Arora MD MAPP @FutureDocs RT @JHospMedicine: T1: In @PetrilliMD et al, inpt inherited thrombophilia tests NOT recommended. Are these recs followed? why/why not? #JH… |
| Vinny Arora MD MAPP @FutureDocs RT @JHospMedicine: ICYMI Tonight's #JHMChat article on ordering inpt inherited thrombophilia testing by @PetrilliMD @vineet_chopra https://… |
| Society of Hospital Medicine @SHMLive Join us on #JHMChat - happening now through 10 p.m. EST! T1 is live! https://t.co/dPuNZASum9 |
| ABIM Foundation @ABIMFoundation RT @JHospMedicine: ICYMI Tonight's #JHMChat article on ordering inpt inherited thrombophilia testing by @PetrilliMD @vineet_chopra https://… |
 | Malvinder Parmar @wittykidney Malvinder Parmar, a nephtwitron, no COI #JHMChat |
| J Hospital Medicine @JHospMedicine glad you are here as well - just tag all your tweets #JHMchat and you are all set! https://t.co/5zCBU7oz5M |
| J Hospital Medicine @JHospMedicine @ShaniHerzig @FutureDocs glad to know! #jhmchat |
| Tony Breu @tony_breu NOT followed. 1 reason: people assume identifying one will change long-term management. #jhmchat https://t.co/x1Uar2Vk9c |
 | Michelle Brooks, MD, FACP, FHM @michellebr00ks I think the residents I work with want to make a diagnosis. Maybe we're taught to diagnose before we manage? #JHMChat |
| Irsk Anderson @ijanders1 @JHospMedicine @PetrilliMD T1 #jhmchat not always. See sent from ED. Inpt feels may change Rx. |
| J Hospital Medicine @JHospMedicine @wittykidney you will like next month's chat -stay tuned towards end! #jhmchat |
| J Hospital Medicine @JHospMedicine RT @SHMLive: Join us on #JHMChat - happening now through 10 p.m. EST! T1 is live! https://t.co/dPuNZASum9 |
| Malvinder Parmar @wittykidney @JHospMedicine @PetrilliMD these tests are not recommended in ER or inpt but often done by many, docs need to do something #JHMChat |
| J Hospital Medicine @JHospMedicine RT @tony_breu: NOT followed. 1 reason: people assume identifying one will change long-term management. #jhmchat https://t.co/x1Uar2Vk9c |
| Chris Petrilli @PetrilliMD I'd say when they aren't followed - main reason is to satisfy physician and patient curiousity @FutureDocs @JHospMedicine #jhmchat |
| Chris Petrilli @PetrilliMD #JHMChat Even if that were true - most of those tests dont even come back before discharge...@JHospMedicine @FutureDocs @UM_IHPI https://t.co/0z0L96lIwE |
 | Sanjay Saint @sanjaysaint Glad to join and learn from @PetrilliMD and others! #jhmchat |
| Nancy H Stewart DO, MS @nvhstewart RT @JHospMedicine: T1: In @PetrilliMD et al, inpt inherited thrombophilia tests NOT recommended. Are these recs followed? why/why not? #JH… |
| Tony Breu @tony_breu Another reason may be order sets. Too easy! #jhmchat https://t.co/x1Uar2Vk9c |
| J Hospital Medicine @JHospMedicine great observation from our guest author @PetrilliMD on #jhmchat https://t.co/CVVnOU9U2a |
| Malvinder Parmar @wittykidney The problem is many doesn't know when and in whom to do such work-up #JHMChat |
| Nancy H Stewart DO, MS @nvhstewart RT @tony_breu: NOT followed. 1 reason: people assume identifying one will change long-term management. #jhmchat https://t.co/x1Uar2Vk9c |
| J Hospital Medicine @JHospMedicine RT @wittykidney: @JHospMedicine @PetrilliMD these tests are not recommended in ER or inpt but often done by many, docs need to do something… |
| J Hospital Medicine @JHospMedicine RT @ijanders1: @JHospMedicine @PetrilliMD T1 #jhmchat not always. See sent from ED. Inpt feels may change Rx. |
| Chris Petrilli @PetrilliMD @michellebr00ks I think that's a huge part of the "problem" but when they have the answer what does it do? #anxiety #increasedcost #JHMChat |
| Shoshana Herzig @ShaniHerzig T1: still some testing, but seems much less frequent than 10 years ago. #progress #jhmchat |
| Nancy H Stewart DO, MS @nvhstewart RT @wittykidney: @JHospMedicine @PetrilliMD these tests are not recommended in ER or inpt but often done by many, docs need to do something… |
| Nancy H Stewart DO, MS @nvhstewart RT @PetrilliMD: I'd say when they aren't followed - main reason is to satisfy physician and patient curiousity @FutureDocs @JHospMedicine #… |
| Vinny Arora MD MAPP @FutureDocs RT @tony_breu: NOT followed. 1 reason: people assume identifying one will change long-term management. #jhmchat https://t.co/x1Uar2Vk9c |
| Vinny Arora MD MAPP @FutureDocs RT @PetrilliMD: #JHMChat Even if that were true - most of those tests dont even come back before discharge...@JHospMedicine… |
| Nancy H Stewart DO, MS @nvhstewart #jhmchat this is so true!! https://t.co/gEk7PHpcpA |
| Charlie M. Wray @WrayCharles T1: I've definitely seen young trainees order. likely to feel obliged to order - shows they were thinking about it. #jhmchat @JHospMedicine |
| Vinny Arora MD MAPP @FutureDocs RT @tony_breu: Another reason may be order sets. Too easy! #jhmchat https://t.co/x1Uar2Vk9c |
| Vinny Arora MD MAPP @FutureDocs RT @JHospMedicine: great observation from our guest author @PetrilliMD on #jhmchat https://t.co/CVVnOU9U2a |
| Sanjay Saint @sanjaysaint RT @JHospMedicine: T1: In @PetrilliMD et al, inpt inherited thrombophilia tests NOT recommended. Are these recs followed? why/why not? #JH… |
| Irsk Anderson @ijanders1 #jhmchat stem from old practice? APLA INR 2.5-3.5? Unprov VTE w finite Rx? |
| Society of Hospital Medicine @SHMLive RT @JHospMedicine: great observation from our guest author @PetrilliMD on #jhmchat https://t.co/CVVnOU9U2a |
| Chris Petrilli @PetrilliMD @wittykidney #JHMChat and now they have a wonderfully written (and edited) reference @JHospMedicine @TWDFNR https://t.co/C1rriHo7yr |
| Vinny Arora MD MAPP @FutureDocs I also think there is a knowledge gap #jhmchat https://t.co/kRBrvstbw5 |
| Michelle Brooks, MD, FACP, FHM @michellebr00ks I never order anymore, and I cringe when the residents do it (inwardly), and then we talk about cost conscious care. #teachingopp #JHMChat |
| J Hospital Medicine @JHospMedicine RT @WrayCharles: T1: I've definitely seen young trainees order. likely to feel obliged to order - shows they were thinking about it. #jhmc… |
| Tony Breu @tony_breu @ShaniHerzig Agreed. I do think these tests are sent less often. The message may be getting out. #jhmchat |
| Irsk Anderson @ijanders1 @ShaniHerzig agree T1 #jhmchat |
 | Kim Tartaglia, MD @KimTartaglia @JHospMedicine @PetrilliMD I seem to recall a certain online text recommending doing limited work-up for unprovoked DVT in pts <35 #jhmchat |
| J Hospital Medicine @JHospMedicine great observation - reminder to tag #jhmchat in your tweets @wittykidney so they are seen by the group. https://t.co/Qlud6UhfXN |
| Charlie M. Wray @WrayCharles This is so true! And then the question is who follows up...(and likely misinterprets due to complexity of IP scene) #jhmchat https://t.co/fl8Up2YgRd |
 | Timothy Craig Allen @timallenmdjd #PathologistsCanHelp https://t.co/9uEhBnE0aL |
| Nancy H Stewart DO, MS @nvhstewart T1: part of it may be trainee "sleuthing" for the zebra #jhmchat |
| Chris Petrilli @PetrilliMD @JRKnightMD re: c - Agreed! the circumstances are so rare...but patients need to be counseled first before testing #alsorare #JHMChat |
| Chris Petrilli @PetrilliMD RT @FutureDocs: I also think there is a knowledge gap #jhmchat https://t.co/kRBrvstbw5 |
| Sanjay Saint @sanjaysaint Not consistently. Docs often order these tests as part of the hypercoag "grope-a-gram" https://t.co/80jiws8m5b |
| Nancy H Stewart DO, MS @nvhstewart Yes! Absolutely!! https://t.co/D4wYROMTyE |
| J Hospital Medicine @JHospMedicine full text available for 24h because of #JHMChat https://t.co/K3iY3iSXXr |
| Irsk Anderson @ijanders1 @WrayCharles Anticoagulation Clinic:)! #jhmchat |
| Society of Hospital Medicine @SHMLive RT @JHospMedicine: great observation - reminder to tag #jhmchat in your tweets @wittykidney so they are seen by the group. https://t.co/Qlu… |
 | NationalQualityForum @natqualityforum RT @SHMLive: Join us on #JHMChat - happening now through 10 p.m. EST! T1 is live! https://t.co/dPuNZASum9 |
| Chris Petrilli @PetrilliMD @tony_breu @ShaniHerzig @TWDFNR I hope so! #UnderRatedImpactFactor #JHMChat @JHospMedicine |
| J Hospital Medicine @JHospMedicine RT @nvhs0401: T1: part of it may be trainee "sleuthing" for the zebra #jhmchat |
| Vinny Arora MD MAPP @FutureDocs RT @PetrilliMD: I'd say when they aren't followed - main reason is to satisfy physician and patient curiousity @FutureDocs @JHospMedicine #… |
| Society of Hospital Medicine @SHMLive RT @JHospMedicine: full text available for 24h because of #JHMChat https://t.co/K3iY3iSXXr |
| Sanjay Saint @sanjaysaint Not consistently. Docs often order these tests as part of the hypercoag "grope-a-gram" #jhmchat https://t.co/80jiws8m5b |
| Charlie M. Wray @WrayCharles RT @JHospMedicine: full text available for 24h because of #JHMChat https://t.co/K3iY3iSXXr |
| Chris Petrilli @PetrilliMD RT @JHospMedicine: full text available for 24h because of #JHMChat https://t.co/K3iY3iSXXr |
| Vinny Arora MD MAPP @FutureDocs Spoken like one who runs an Anticoag clinic ) #jhmchat https://t.co/dJAH8PsBFc |
| Vinny Arora MD MAPP @FutureDocs RT @JHospMedicine: full text available for 24h because of #JHMChat https://t.co/K3iY3iSXXr |
 | Amit Kumar Pahwa @pahwa amit pahwa from @HopkinsMedicine trying to #jhmchat and watch championship game and edit grant #multitasking |
| Vinny Arora MD MAPP @FutureDocs I feel dirty almost retweeting this #jhmchat https://t.co/Ko2rwHJPJh |
| Amit Kumar Pahwa @pahwa we teach our third years not to do big workup through modules - https://t.co/FBndjZbfLq - need to add @PetrilliMD as reference #jhmchat |
| Chris Petrilli @PetrilliMD #JHMChat - agree re: APS - we deliberately focused on inherited thrombophilia (there's about 10-12 common tests) #SoManyTestsSoLittleValue https://t.co/LhHbugtIZc |
| J Hospital Medicine @JHospMedicine @Pahwa @HopkinsMedicine thanks for joining! we knew it would be a #multitasking night @PetrilliMD #jhmchat |
| ABIM Foundation @ABIMFoundation RT @JHospMedicine: full text available for 24h because of #JHMChat https://t.co/K3iY3iSXXr |
| J Hospital Medicine @JHospMedicine RT @sanjaysaint: Not consistently. Docs often order these tests as part of the hypercoag "grope-a-gram" #jhmchat https://t.co/80jiws8m5b |
| Chris Petrilli @PetrilliMD RT @sanjaysaint: Not consistently. Docs often order these tests as part of the hypercoag "grope-a-gram" #jhmchat https://t.co/80jiws8m5b |
| J Hospital Medicine @JHospMedicine T2 coming up in a moment...#jhmchat |
| Irsk Anderson @ijanders1 RT @Pahwa: we teach our third years not to do big workup through modules - https://t.co/FBndjZbfLq - need to add @PetrilliMD as reference #… |
| Michelle Brooks, MD, FACP, FHM @michellebr00ks Do we glorify the "sleuthing for the zebra" a little too much? Maybe why the residents look for them. h/t @nvhs0401 #JHMChat |
| Vinny Arora MD MAPP @FutureDocs RT @michellebr00ks: Do we glorify the "sleuthing for the zebra" a little too much? Maybe why the residents look for them. h/t @nvhs0401 #J… |
| Society of Hospital Medicine @SHMLive Don't miss out on #JHMChat - happening now! Don't forget to use the hashtag to index your tweets! https://t.co/us1Z5F1Y3d |
| Michelle Brooks, MD, FACP, FHM @michellebr00ks very cool! @Pahwa #JHMchat https://t.co/qA139fE0Lg |
| Irsk Anderson @ijanders1 @JRKnightMD @PetrilliMD Poss most important point of T1 (in addition to pt anxiety) #jhmchat |
| Malvinder Parmar @wittykidney @sanjaysaint @JHospMedicine @PetrilliMD patient asks why I had blood clot? Rather than explaining order tests - not required? #jhmchat |
| Tony Breu @tony_breu Yes, we do. In #AMreport and elsewhere. #jhmchat @VA_Boston_CMRs https://t.co/hP5T18GLlF |
| J Hospital Medicine @JHospMedicine T2 Given uncertainty of inpt inherited thrombophilia labs in @PetrilliMD, what DO/SHOULD you do if you suspect it? #JHMChat #CME |
| Charlie M. Wray @WrayCharles we speak about financial costs, but consider the emotional costs to "you may have an inherited blood clotting d/o.." then test neg. #jhmchat |
| Kim Tartaglia, MD @KimTartaglia @Pahwa Greetings Amit. Think I still owe you an email. grant writing is not as fun as folding laundry during #jhmchat ! |
| Nancy H Stewart DO, MS @nvhstewart I think we do!! I try to teach that "it's a zebra for a reason" and "treat the obvious, as we lookout for the zebra" #jhmchat https://t.co/LumqHw38a5 |
| J Hospital Medicine @JHospMedicine RT @wittykidney: @sanjaysaint @JHospMedicine @PetrilliMD patient asks why I had blood clot? Rather than explaining order tests - not requir… |
| Society of Hospital Medicine @SHMLive Be sure to incorporate the #JHMChat hashtag in your tweets so other participants are able to see your comments! |
| Vinny Arora MD MAPP @FutureDocs RT @tony_breu: Yes, we do. In #AMreport and elsewhere. #jhmchat @VA_Boston_CMRs https://t.co/hP5T18GLlF |
 | Chris Moriates, MD @ChrisMoriates Hey guys - late to the #jhmchat because i had to be a parent and its bedtime around here... |
| Vinny Arora MD MAPP @FutureDocs RT @JHospMedicine: T2 Given uncertainty of inpt inherited thrombophilia labs in @PetrilliMD, what DO/SHOULD you do if you suspect it? #JHMC… |
| Chris Petrilli @PetrilliMD @Pahwa @HopkinsMedicine #JHMChat https://t.co/kAe4S8EN6S (Role of Thrombophilia testing in sports - #NextChat?) :) |
| Irsk Anderson @ijanders1 @WrayCharles #jhmchat $2-3K later:) |
| Vinny Arora MD MAPP @FutureDocs RT @WrayCharles: we speak about financial costs, but consider the emotional costs to "you may have an inherited blood clotting d/o.." then… |
 | VA Joint Chiefs @bostonchiefs @tony_breu not always at #AMreport at @VA_Boston_CMRs though! #jhmchat |
| Chris Petrilli @PetrilliMD @Pahwa #JHMChat Always happy to consult! |
| Vinny Arora MD MAPP @FutureDocs The epitome of #multitasking #toddlerlife #jhmchat https://t.co/pgcKYCEVGc |
 | Eric Strong @drericstrong @michellebr00ks Desire to diagnose zebras should be considered a form of cognitive bias - one driven by zebras in morning reports. #JHMChat |
| Society of Hospital Medicine @SHMLive RT @JHospMedicine: T2 Given uncertainty of inpt inherited thrombophilia labs in @PetrilliMD, what DO/SHOULD you do if you suspect it? #JHMC… |
| Charlie M. Wray @WrayCharles Absolutely! On my service, it usually can't be a zebra until the 3rd day of stay & still no answer #jhmchat https://t.co/rDC8oDMyoH |
 | Harper @harperstia https://t.co/Bumig6P1R8 RT https://t.co/hqfnKRT1vS |
| Chris Petrilli @PetrilliMD RT @FutureDocs: The epitome of #multitasking #toddlerlife #jhmchat https://t.co/pgcKYCEVGc |
| J Hospital Medicine @JHospMedicine @ChrisMoriates thanks for joining #jhmchat |
| J Hospital Medicine @JHospMedicine RT @nvhs0401: I think we do!! I try to teach that "it's a zebra for a reason" and "treat the obvious, as we lookout for the zebra… |
| Michelle Brooks, MD, FACP, FHM @michellebr00ks RT @DrEricStrong: @michellebr00ks Desire to diagnose zebras should be considered a form of cognitive bias - one driven by zebras in morning… |
| J Hospital Medicine @JHospMedicine RT @WrayCharles: we speak about financial costs, but consider the emotional costs to "you may have an inherited blood clotting d/o.." then… |
| Kim Tartaglia, MD @KimTartaglia @PetrilliMD tells me I should consult my friend hematologist if concerned, before sending a bunch of labs. #jhmchat https://t.co/ci6Xpxnrcc |
| Chris Petrilli @PetrilliMD re: T2 - If you suspect it...then you can tell your friends...risk of recurrence unchanged in thrombophilia or not...@JHospMedicine #jhmchat |
| Chris Petrilli @PetrilliMD RT @WrayCharles: Absolutely! On my service, it usually can't be a zebra until the 3rd day of stay & still no answer #jhmchat https://t.co/r… |
| J Hospital Medicine @JHospMedicine For those just joining #JHMChat, welcome T2 is LIVE! https://t.co/OQKtuwOfH4 |
| Irsk Anderson @ijanders1 @WrayCharles Great approach! #jhmchat |
| Nancy H Stewart DO, MS @nvhstewart My everyday life at home!! #jhmchat #worklifebalancesomehow https://t.co/gZaseKkFiW |
| Nancy H Stewart DO, MS @nvhstewart I like this rule!! https://t.co/rrjB9aHmKu |
| Tony Breu @tony_breu @michellebr00ks @nvhs0401 I’d be lying if I said I didn’t enjoy the pursuit. #jhmchat |
| Nancy H Stewart DO, MS @nvhstewart RT @JHospMedicine: T2 Given uncertainty of inpt inherited thrombophilia labs in @PetrilliMD, what DO/SHOULD you do if you suspect it? #JHMC… |
| Amit Kumar Pahwa @pahwa T1: most people unsure of pretest probability and don't think will it change management #JHMChat |
| Society of Hospital Medicine @SHMLive RT @JHospMedicine: For those just joining #JHMChat, welcome T2 is LIVE! https://t.co/OQKtuwOfH4 |
| J Hospital Medicine @JHospMedicine great insight from our guest author @PetrilliMD tonight #JHMChat https://t.co/dA0pMpm5uY |
| J Hospital Medicine @JHospMedicine RT @WrayCharles: Absolutely! On my service, it usually can't be a zebra until the 3rd day of stay & still no answer #jhmchat https://t.co/r… |
| J Hospital Medicine @JHospMedicine RT @DrEricStrong: @michellebr00ks Desire to diagnose zebras should be considered a form of cognitive bias - one driven by zebras in morning… |
| Michelle Brooks, MD, FACP, FHM @michellebr00ks RT @PetrilliMD: re: T2 - If you suspect it...then you can tell your friends...risk of recurrence unchanged in thrombophilia or not...@JHosp… |
| Chris Petrilli @PetrilliMD @KimTartaglia #JHMChat - actually, no ... They dont need to see these pts either! Mgmt doesnt change. 2nd clot just as likely &= lifelong tx |
| J Hospital Medicine @JHospMedicine RT @SHMLive: Be sure to incorporate the #JHMChat hashtag in your tweets so other participants are able to see your comments! |
| Shoshana Herzig @ShaniHerzig T2 @PetrilliMD do you suggest consideration of heme referral (to PCP) for all unprovoked VTE, or just with 1st degree relative? #jhmchat |
| Michelle Brooks, MD, FACP, FHM @michellebr00ks T2: As a hospitalist, it's gotta be just conversations about the possibility, the fact it won't change management... #JHMChat |
| ABIM Foundation @ABIMFoundation RT @JHospMedicine: For those just joining #JHMChat, welcome T2 is LIVE! https://t.co/OQKtuwOfH4 |
| Michelle Brooks, MD, FACP, FHM @michellebr00ks T2:...and maybe being transparent with the patient about the costs of testing? #JHMChat |
| Malvinder Parmar @wittykidney @JHospMedicine @PetrilliMD explain to patient. Protein C & S levels may be falsely low during acute stage ➡️false diagnosis #jhmchat |
| Irsk Anderson @ijanders1 Agree. Consider delaying to outpatient (heme, anticoag clinic etc). Tests often invalid given heparin/warfarin/acute VTE anyway #jhmchat https://t.co/rDuzg8Fqp2 |
| Charlie M. Wray @WrayCharles I might disagree, Amit. I think a lot of people assume it WILL change management #jhmchat https://t.co/AauwasY7iZ |
| Chris Petrilli @PetrilliMD RT @PetrilliMD: #JHMChat - agree re: APS - we deliberately focused on inherited thrombophilia (there's about 10-12 common tests)… |
| Society of Hospital Medicine @SHMLive We're #JHMChat-ting. Why aren't you? Join in to discuss #hypercoag workups with @JHospMedicine @FutureDocs & @PetrilliMD! https://t.co/0nAtJPSeso |
| J Hospital Medicine @JHospMedicine RT @wittykidney: @JHospMedicine @PetrilliMD explain to patient. Protein C & S levels may be falsely low during acute stage ➡️false diagnosi… |
| Nancy H Stewart DO, MS @nvhstewart RT @wittykidney: @JHospMedicine @PetrilliMD explain to patient. Protein C & S levels may be falsely low during acute stage ➡️false diagnosi… |
 | Aaron Hunter @aaron_hunter Dr. Skye reporting for tonight's #jhmchat! https://t.co/J6k83Ln1rd |
| Nancy H Stewart DO, MS @nvhstewart RT @ijanders1: Agree. Consider delaying to outpatient (heme, anticoag clinic etc). Tests often invalid given heparin/warfarin/ac… |
| Chris Petrilli @PetrilliMD RT @JHospMedicine: great insight from our guest author @PetrilliMD tonight #JHMChat https://t.co/dA0pMpm5uY |
| Irsk Anderson @ijanders1 @ShaniHerzig @PetrilliMD personally would do 4 1st degree relative, esp if young @ dx #jhmchat |
| Tony Breu @tony_breu I agree with @WrayCharles I suspect most see that it’ll increase the need for lifelong anticoagulant. #jhmchat https://t.co/JkKzqrH9nd |
 | Jigar Contractor @jigsymd @WrayCharles Interesting approach to balance promoting curiosity needed to be good physicians and going on a safari everytime #jhmchat |
| Sanjay Saint @sanjaysaint Yes, we do glorify finding zebras. There are 3 chances for greatness as a resident and one is diagnosing a rare disease. #jhmchat https://t.co/SKJP0Tiv6F |
| Chris Petrilli @PetrilliMD @JHospMedicine #JHMChat Thank you! I've had amazing teachers and mentors! @sanjaysaint @vineet_chopra |
| J Hospital Medicine @JHospMedicine just joining #JHMChat? quick summary of tonights article by @PetrilliMD, we present the #VisualAbstract in #Gif thx @WrayCharles! https://t.co/VgvlhonIXE |
| J Hospital Medicine @JHospMedicine just joining #JHMChat? quick summary of tonights article by @PetrilliMD, we present the #VisualAbstract in #Gif... https://t.co/ZfrCkhEwTB |
| Michelle Brooks, MD, FACP, FHM @michellebr00ks @aaron_hunter This is the BEST! #JHMChat |
| Charlie M. Wray @WrayCharles I fall back onto this rational a lot, @ijanders1 #jhmchat. Even it disease is there, it's clouded over by everything else going on https://t.co/PbzUfYVjIU |
| J Hospital Medicine @JHospMedicine and the other 2 are...? #JHMChat https://t.co/mPQndmcFnL |
| Society of Hospital Medicine @SHMLive RT @JHospMedicine: just joining #JHMChat? quick summary of tonights article by @PetrilliMD, we present the #VisualAbstract in #Gif thx… |
| Nancy H Stewart DO, MS @nvhstewart RT @JHospMedicine: just joining #JHMChat? quick summary of tonights article by @PetrilliMD, we present the #VisualAbstract in #Gif thx… |
| J Hospital Medicine @JHospMedicine RT @sanjaysaint: Yes, we do glorify finding zebras. There are 3 chances for greatness as a resident and one is diagnosing a rare dis… |
| J Hospital Medicine @JHospMedicine and the other 2 are...? #JHMChat https://t.co/mPQndmcFnL https://t.co/fE2GCLrPt6 |
| Michelle Brooks, MD, FACP, FHM @michellebr00ks @sanjaysaint What are the other two? #jhmchat |
| Tony Breu @tony_breu @PetrilliMD Based on my read of your review, it does seem to increase the risk somewhat. Is that not true? #jhmchat https://t.co/cbvBrcjJOY |
| Irsk Anderson @ijanders1 RT @michellebr00ks: @aaron_hunter This is the BEST! #JHMChat |
| J Hospital Medicine @JHospMedicine RT @JigsyMD: @WrayCharles Interesting approach to balance promoting curiosity needed to be good physicians and going on a safari everytime… |
| Michelle Brooks, MD, FACP, FHM @michellebr00ks RT @JHospMedicine: just joining #JHMChat? quick summary of tonights article by @PetrilliMD, we present the #VisualAbstract in #Gif thx… |
| Irsk Anderson @ijanders1 RT @JHospMedicine: just joining #JHMChat? quick summary of tonights article by @PetrilliMD, we present the #VisualAbstract in #Gif thx… |
| J Hospital Medicine @JHospMedicine RT @tony_breu: I agree with @WrayCharles I suspect most see that it’ll increase the need for lifelong anticoagulant. #jhmchat https://t.co/… |
| Chris Petrilli @PetrilliMD @ShaniHerzig what would a heme referral do? Unless c/f APLS, plans to start hormone therapy, etc - no need, mgmt wont change #JHMChat |
| J Hospital Medicine @JHospMedicine RT @JHospMedicine: just joining #JHMChat? quick summary of tonights article by @PetrilliMD, we present the #VisualAbstract in #Gif thx… |
| Malvinder Parmar @wittykidney @JHospMedicine @PetrilliMD in fact I saw a pt, who had these levels done during acute phase, levels low ➡️false diagnosis, OAC 5y #JHMChat |
| Charlie M. Wray @WrayCharles don't leave us hanging, @sanjaysaint...what are the other 2!? #jhmchat https://t.co/DU4gvU4DRM |
| Irsk Anderson @ijanders1 @JHospMedicine Yes, please tell! #jhmchat |
| Nancy H Stewart DO, MS @nvhstewart Yes, I'm all ears... what are the other 2 @sanjaysaint #jhmchat https://t.co/1XxYdj4g1Y |
| Vinny Arora MD MAPP @FutureDocs RT @SHMLive: We're #JHMChat-ting. Why aren't you? Join in to discuss #hypercoag workups with @JHospMedicine @FutureDocs &… |
| Vinny Arora MD MAPP @FutureDocs RT @WrayCharles: don't leave us hanging, @sanjaysaint...what are the other 2!? #jhmchat https://t.co/DU4gvU4DRM |
| Chris Petrilli @PetrilliMD @ijanders1 Even if it was valid - #JHMChat do any hematologists "manage" FVL? The tx plan doesnt change, lifelong anticoag is only after 2 |
| Chris Petrilli @PetrilliMD RT @SHMLive: We're #JHMChat-ting. Why aren't you? Join in to discuss #hypercoag workups with @JHospMedicine @FutureDocs &… |
| Amit Kumar Pahwa @pahwa I agree! We had a hematologist while developing modules and he said just don't do it #jhmchat https://t.co/6wuTHYHx0Y |
| Vinny Arora MD MAPP @FutureDocs Good question #jhmchat https://t.co/Ag0Pka9Yct |
| Chris Petrilli @PetrilliMD @ijanders1 @ShaniHerzig #JHMChat - then would you put them on lifelong anticoagulation after the first clot? Our heme wouldnt @JHospMedicine |
| Michelle Brooks, MD, FACP, FHM @michellebr00ks Should we be like the ABIM and throw in a fertile female who wants testing and counseling on this as well? #laughsmenacingly #JHMChat |
| Society of Hospital Medicine @SHMLive RT @WrayCharles: don't leave us hanging, @sanjaysaint...what are the other 2!? #jhmchat https://t.co/DU4gvU4DRM |
| Chris Moriates, MD @ChrisMoriates This is cool! #jhmchat https://t.co/DIAeOU1Eqj |
| Nancy H Stewart DO, MS @nvhstewart 😱 but I guess this shouldn't be too surprising in the litigious society that we practice in #jhmchat https://t.co/j4H3llSew3 |
| Chris Petrilli @PetrilliMD RT @sanjaysaint: Yes, we do glorify finding zebras. There are 3 chances for greatness as a resident and one is diagnosing a rare dis… |
| Vinny Arora MD MAPP @FutureDocs RT @JHospMedicine: just joining #JHMChat? quick summary of tonights article by @PetrilliMD, we present the #VisualAbstract in #Gif thx… |
| Malvinder Parmar @wittykidney @WrayCharles @ijanders1 need to consider populations as well #JHMChat |
| Chris Petrilli @PetrilliMD RT @JHospMedicine: just joining #JHMChat? quick summary of tonights article by @PetrilliMD, we present the #VisualAbstract in #Gif thx… |
| Chris Petrilli @PetrilliMD RT @JHospMedicine: and the other 2 are...? #JHMChat https://t.co/mPQndmcFnL https://t.co/fE2GCLrPt6 |
| Kim Tartaglia, MD @KimTartaglia @PetrilliMD Misunderstood "Patients at risk should meet with an outpatient hematologist or a genetic counselor" Thx for clarifying!#jhmchat |
 | Daniel Wolfson @WolfsonD RT @PetrilliMD: I'd say when they aren't followed - main reason is to satisfy physician and patient curiousity @FutureDocs @JHospMedicine #… |
| Irsk Anderson @ijanders1 @PetrilliMD @ShaniHerzig @JHospMedicine If unproved VTE by ACCP should be anyway #jhmchat |
| Chris Petrilli @PetrilliMD @tony_breu #JHMChat - statistically yes, but not enough clinically to change management unless plans for hormone therapy, etc... |
| Daniel Wolfson @WolfsonD RT @WrayCharles: we speak about financial costs, but consider the emotional costs to "you may have an inherited blood clotting d/o.." then… |
| Daniel Wolfson @WolfsonD #JHMChat Enjoying the conversation & thanks to @JHospMedicine @SHMLive #choosingwisely @PetrilliMD @WrayCharles |
| J Hospital Medicine @JHospMedicine thanks! idea originates with @AndrewMIbrahim and brought to you for tonights #JHMChat by @WrayCharles ! https://t.co/MFNXSZ2ggy |
| Chris Petrilli @PetrilliMD RT @WrayCharles: don't leave us hanging, @sanjaysaint...what are the other 2!? #jhmchat https://t.co/DU4gvU4DRM |
| Shannon K. Martin @shannonmartinmd Interesting- agree but have often received answer when asking trainees why they order hypercoag workup is "because heme rec'd it"! #jhmchat https://t.co/6PgTqlImPU |
| Tony Breu @tony_breu And while I don’t often send these tests, I’d also be lying if I said I wouldn’t be interested in sending them on me if I had a VTE #jhmchat https://t.co/5l0DKy2kAS |
 | Geoff Barnes @gbarnesmd @PetrilliMD @ijanders1 We are using more indefinite #cvCoag even for 1st unprovoked #VTE, esp with new drugs and less bleed risk #jhmchat |
| Chris Petrilli @PetrilliMD RT @ChrisMoriates: This is cool! #jhmchat https://t.co/DIAeOU1Eqj |
| J Hospital Medicine @JHospMedicine great clarification on when to refer (not inpt heme consult) #JHMChat by @PetrilliMD https://t.co/EHE13Nb5RY |
| Malvinder Parmar @wittykidney @nvhs0401 @JHospMedicine @PetrilliMD that's why order tests only when clinically necessary. #JHMChat |
| Tony Breu @tony_breu @PetrilliMD That’s helpful. And if you have a young patient (e.g. 45) who is not sure they want lifelong anticoag? #jhmchat |
| Irsk Anderson @ijanders1 @GBarnesMD @PetrilliMD agreed #jhmchat |
| Kim Tartaglia, MD @KimTartaglia @JHospMedicine @PetrilliMD @WrayCharles Great image. Would we also add "doesn't change management" #jhmchat |
| Malvinder Parmar @wittykidney @nvhs0401 @JHospMedicine @PetrilliMD Ordering tests at inappropriate times results often in inappropriate actions #JHMChat |
| Society of Hospital Medicine @SHMLive Claim your #CME after tonight's #JHMChat here: https://t.co/ZcpQuplJPT Eval is available until 11pm EST! |
| Chris Moriates, MD @ChrisMoriates I move that we pause #jhmchat until @sanjaysaint tells us the 3 chances for greatness as a resident... https://t.co/LvtddsmrNk |
| J Hospital Medicine @JHospMedicine great lesson re @CostsofCare #choosingwisely on #JHMChat https://t.co/zQfVIocLp5 |
| Michelle Brooks, MD, FACP, FHM @michellebr00ks @tony_breu I had a VTE! Got all of them done. This was about 7 years ago. I was the fertile female in question. #JHMChat |
| Jigar Contractor @jigsymd @PetrilliMD @tony_breu What about a woman that is planning on becoming pregnant? #jhmchat |
| J Hospital Medicine @JHospMedicine RT @KimTartaglia: @JHospMedicine @PetrilliMD @WrayCharles Great image. Would we also add "doesn't change management" #jhmchat |
| J Hospital Medicine @JHospMedicine great lesson re @CostsofCare #choosingwisely on #JHMChat https://t.co/zQfVIocLp5 https://t.co/EmQVctqXBR |
| Daniel Wolfson @WolfsonD RT @JHospMedicine: just joining #JHMChat? quick summary of tonights article by @PetrilliMD, we present the #VisualAbstract in #Gif thx… |
| J Hospital Medicine @JHospMedicine thanks for joining @TWDFNR ! remember to tag #JHMChat - we love the #visualabstract #gif too! https://t.co/Uk7glikdwR |
| Chris Petrilli @PetrilliMD @GBarnesMD @ijanders1 #JHMChat - These new drugs must be pretty cheap! Great to have you here, Geoff! @FutureDocs @JHospMedicine |
| Society of Hospital Medicine @SHMLive RT @JHospMedicine: great clarification on when to refer (not inpt heme consult) #JHMChat by @PetrilliMD https://t.co/EHE13Nb5RY |
| Kim Tartaglia, MD @KimTartaglia RT @JHospMedicine: just joining #JHMChat? quick summary of tonights article by @PetrilliMD, we present the #VisualAbstract in #Gif thx… |
| Society of Hospital Medicine @SHMLive RT @JHospMedicine: great lesson re @CostsofCare #choosingwisely on #JHMChat https://t.co/zQfVIocLp5 https://t.co/EmQVctqXBR |
| Nancy H Stewart DO, MS @nvhstewart Yes, but I find it's still hard to teach this to trainees due to the "glory" of sleuthing for the "zebra" https://t.co/ak8sLRns92 |
| Michelle Brooks, MD, FACP, FHM @michellebr00ks Interestingly enough, I eventually got diagnosed with nephrotic syndrome. #zebraindahouse #jhmchat |
| Chris Petrilli @PetrilliMD RT @WolfsonD: #JHMChat Enjoying the conversation & thanks to @JHospMedicine @SHMLive #choosingwisely @PetrilliMD @WrayCharles |
| Sanjay Saint @sanjaysaint The 3 chances for resident greatness: 1/ find a zebra 2/ NEVER argue about an admission 3/ ALWAYS be kind to nurses #JHMChat https://t.co/VRXGiaeGTF |
| Irsk Anderson @ijanders1 @ChrisMoriates @sanjaysaint still curious too! #jhmchat |
| J Hospital Medicine @JHospMedicine keep the discussion going on #JHMChat! T3 up in a moment... |
| Michelle Brooks, MD, FACP, FHM @michellebr00ks Second this! https://t.co/OxCOAQLxvL |
| Nancy H Stewart DO, MS @nvhstewart RT @JHospMedicine: great lesson re @CostsofCare #choosingwisely on #JHMChat https://t.co/zQfVIocLp5 https://t.co/EmQVctqXBR |
| Society of Hospital Medicine @SHMLive RT @JHospMedicine: thanks for joining @TWDFNR ! remember to tag #JHMChat - we love the #visualabstract #gif too! https://t.co/Uk7glikdwR |
| Vinny Arora MD MAPP @FutureDocs RT @michellebr00ks: Second this! https://t.co/OxCOAQLxvL |
| Michelle Brooks, MD, FACP, FHM @michellebr00ks Phew! I was holding my breath! #JHMChat https://t.co/uYlKX12AUM |
| Nancy H Stewart DO, MS @nvhstewart RT @sanjaysaint: The 3 chances for resident greatness: 1/ find a zebra 2/ NEVER argue about an admission 3/ ALWAYS be kind to nurses… |
| Malvinder Parmar @wittykidney @GBarnesMD @PetrilliMD @ijanders1 in addition despite studies showing low risk of underlying malignancy, many undergo screening #JHMChat |
| Vinny Arora MD MAPP @FutureDocs Wow thx for sharing on #jhmchat from a patient perspective! https://t.co/goHgTtxTIp |
| Shannon K. Martin @shannonmartinmd RT @sanjaysaint: The 3 chances for resident greatness: 1/ find a zebra 2/ NEVER argue about an admission 3/ ALWAYS be kind to nurses… |
| Chris Petrilli @PetrilliMD RT @ChrisMoriates: I move that we pause #jhmchat until @sanjaysaint tells us the 3 chances for greatness as a resident... https://t.co/Lvtd… |
| Society of Hospital Medicine @SHMLive RT @JHospMedicine: keep the discussion going on #JHMChat! T3 up in a moment... |
| Vinny Arora MD MAPP @FutureDocs RT @sanjaysaint: The 3 chances for resident greatness: 1/ find a zebra 2/ NEVER argue about an admission 3/ ALWAYS be kind to nurses… |
 | Clinical Pearl @clinicalpearl RT @sanjaysaint: The 3 chances for resident greatness: 1/ find a zebra 2/ NEVER argue about an admission 3/ ALWAYS be kind to nurses… |
 | Ji Baang @jbaang RT @sanjaysaint: The 3 chances for resident greatness: 1/ find a zebra 2/ NEVER argue about an admission 3/ ALWAYS be kind to nurses… |
| Sanjay Saint @sanjaysaint @ChrisMoriates Sorry - watching the #nationalchampionship game while tweeting #badidea #jhmchat |
 | Things We Do For No Reason @TWDFNR @ChrisMoriates @sanjaysaint Has he revealed the other 2 yet? #jhmchat |
| Chris Petrilli @PetrilliMD RT @sanjaysaint: The 3 chances for resident greatness: 1/ find a zebra 2/ NEVER argue about an admission 3/ ALWAYS be kind to nurses… |
 | JedGonzalo @jed_gonzalo15 #psusync #psumeded https://t.co/e8Ob9MfRdL |
 | The Pediatric MD @thepediatricmd RT @sanjaysaint: The 3 chances for resident greatness: 1/ find a zebra 2/ NEVER argue about an admission 3/ ALWAYS be kind to nurses… |
| Ji Baang @jbaang So true... https://t.co/TQNzuXx0l6 |
| Vinny Arora MD MAPP @FutureDocs RT @JHospMedicine: keep the discussion going on #JHMChat! T3 up in a moment... |
| Society of Hospital Medicine @SHMLive RT @FutureDocs: Wow thx for sharing on #jhmchat from a patient perspective! https://t.co/goHgTtxTIp |
| Vinny Arora MD MAPP @FutureDocs RT @wittykidney: @nvhs0401 @JHospMedicine @PetrilliMD Ordering tests at inappropriate times results often in inappropriate actions #JHMChat |
| Vinny Arora MD MAPP @FutureDocs RT @SHMLive: Claim your #CME after tonight's #JHMChat here: https://t.co/ZcpQuplJPT Eval is available until 11pm EST! |
| Michelle Brooks, MD, FACP, FHM @michellebr00ks Sorry - should have clarified - got all the testing, after completing 6 months anticoagulation (not inpatient) #jhmchat |
| Tony Breu @tony_breu @GBarnesMD @JigsyMD @PetrilliMD Thanks! #jhmchat |
| Vinny Arora MD MAPP @FutureDocs RT @WolfsonD: #JHMChat Enjoying the conversation & thanks to @JHospMedicine @SHMLive #choosingwisely @PetrilliMD @WrayCharles |
| Jigar Contractor @jigsymd @GBarnesMD @PetrilliMD @tony_breu Wonder if these can be done inpatient during an event or if better served as an outpt heme f/u #jhmchat |
| Vinny Arora MD MAPP @FutureDocs RT @ChrisMoriates: This is cool! #jhmchat https://t.co/DIAeOU1Eqj |
| Ji Baang @jbaang Truth https://t.co/TQNzuXx0l6 |
| Geoff Barnes @gbarnesmd RT @sanjaysaint: The 3 chances for resident greatness: 1/ find a zebra 2/ NEVER argue about an admission 3/ ALWAYS be kind to nurses… |
 | 👩🏻⚕️Doctor Organa @c_diazepine RT @sanjaysaint: The 3 chances for resident greatness: 1/ find a zebra 2/ NEVER argue about an admission 3/ ALWAYS be kind to nurses… |
| Chris Moriates, MD @ChrisMoriates RT @sanjaysaint: The 3 chances for resident greatness: 1/ find a zebra 2/ NEVER argue about an admission 3/ ALWAYS be kind to nurses… |
| J Hospital Medicine @JHospMedicine tagging #JHMChat https://t.co/SCm4pXTk8d |
| Malvinder Parmar @wittykidney @michellebr00ks a simple urine test, and history of edema, anasarca might have been the clue, not a zebra #JHMChat |
| Nancy H Stewart DO, MS @nvhstewart Yes- the other 2 were 1) always be nice to nurses 2) never refuse an admit. I know I broke #2, but hopefully never broke #1 #jhmchat https://t.co/00rSWP1nfw |
| Things We Do For No Reason @TWDFNR @michellebr00ks did you want the testing? #jhmchat |
| Irsk Anderson @ijanders1 @michellebr00ks T2: This is what we see/do. Just did on patient. Was able to d/c warfarin. Felt good! #jhmchat |
| Daniel Wolfson @WolfsonD #jhmchat What system approaches have been instituted to avoid this in-patient service. Has education been sufficient? CDS? Peer comparison? |
| Geoff Barnes @gbarnesmd @wittykidney @PetrilliMD @ijanders1 RCT data argues against body CT screening. I only advocate age-appropriate screening #jhmchat |
 | Margaret Fleming @mlsfleming2 RT @wittykidney: @nvhs0401 @JHospMedicine @PetrilliMD Ordering tests at inappropriate times results often in inappropriate actions #JHMChat |
 | Megan P. Williams @meganpwilliams Thanks @sanjaysaint for shining the spotlight on nurses! https://t.co/IsfSqzF8e5 |
| J Hospital Medicine @JHospMedicine T3 Given @CostsofCare = $1100-$2400 per thrombophilia panel in @PetrilliMD et al, how can we reduce inpatient testing? #JHMChat |
| Irsk Anderson @ijanders1 RT @JHospMedicine: tagging #JHMChat https://t.co/SCm4pXTk8d |
| Vinny Arora MD MAPP @FutureDocs RT @JHospMedicine: T3 Given @CostsofCare = $1100-$2400 per thrombophilia panel in @PetrilliMD et al, how can we reduce inpatient testing? #… |
| Chris Petrilli @PetrilliMD @JigsyMD @GBarnesMD @tony_breu #JHMChat - Actually I think Geoff's pt was if unprovoked consider lifelong w/ new agent #GeoffIsWickedSmart |
 | Rich Duszak, MD @RichDuszak RT @sanjaysaint: The 3 chances for resident greatness: 1/ find a zebra 2/ NEVER argue about an admission 3/ ALWAYS be kind to nurses… |
 | Gretchen Diemer @gretchendiemer RT @michellebr00ks: Do we glorify the "sleuthing for the zebra" a little too much? Maybe why the residents look for them. h/t @nvhs0401 #J… |
| J Hospital Medicine @JHospMedicine RT @sanjaysaint: The 3 chances for resident greatness: 1/ find a zebra 2/ NEVER argue about an admission 3/ ALWAYS be kind to nurses… |
| J Hospital Medicine @JHospMedicine RT @PetrilliMD: I'd say when they aren't followed - main reason is to satisfy physician and patient curiousity @FutureDocs @JHospMedicine #… |
| Chris Moriates, MD @ChrisMoriates RT @WolfsonD: #jhmchat What system approaches have been instituted to avoid this in-patient service. Has education been sufficient? CDS? Pe… |
| J Hospital Medicine @JHospMedicine RT @michellebr00ks: Do we glorify the "sleuthing for the zebra" a little too much? Maybe why the residents look for them. h/t @nvhs0401 #J… |
| Michelle Brooks, MD, FACP, FHM @michellebr00ks @TWDFNR I didn't know - just wanted to know if I could get pregnant or if I should be on anticoag during pregnancy - #JHMChat |
| Charlie M. Wray @WrayCharles @WolfsonD great question! How do we protect ourselves/patients from ourselves #jhmchat |
| Society of Hospital Medicine @SHMLive T3 is up and ready for you on #JHMChat! Jump in now! https://t.co/DFtLfb7SRp |
| Irsk Anderson @ijanders1 @JHospMedicine @CostsofCare @PetrilliMD best practice alerts, unbundle orders, require heme input? Just thoughts...#jhmchat |
| J Hospital Medicine @JHospMedicine Great ideas for T3 which is live! how can we reduce inpt inherited thrombophilia testing? #JHMChat others? https://t.co/kkTgf9WGiZ |
| Tony Breu @tony_breu T3: You can make the case that it is NEVER required inpatient. The patient is getting at least 3m no matter the results. #jhmchat https://t.co/LDF15v1MYu |
| Things We Do For No Reason @TWDFNR @WolfsonD Barry Meisenberg in Maryland at AAMC just doesn't let the tests be ordered on inpts. Solved the problem. #jhmchat |
 | Phoenix Rising @azneighboraz #jhmchat Why are hospitals treating legit chronic pain patients who take opioids responsibly like addicts and refusing to treat their pain? |
| Amit Kumar Pahwa @pahwa forgot to tage #jhmchat https://t.co/iPMJ8y5Md2 |
| Geoff Barnes @gbarnesmd @JigsyMD @PetrilliMD @tony_breu Prob best to defer to outpt setting, less acute thromb effects. Identify follow up responsibility #jhmchat |
| Malvinder Parmar @wittykidney @PetrilliMD @JigsyMD @GBarnesMD @tony_breu that wouldn't be right, irrespective of new or old agent #JHMChat |
| Vinny Arora MD MAPP @FutureDocs Education (don't tell anyone I said this) is not enough to change practice. Need to change system too. #jhmchat https://t.co/xSjpScx4eN |
| Michelle Brooks, MD, FACP, FHM @michellebr00ks @wittykidney agreed - but the VTE preceded the edema/anasarca by about a year. #JHMChat |
| J Hospital Medicine @JHospMedicine RT @tony_breu: T3: You can make the case that it is NEVER required inpatient. The patient is getting at least 3m no matter the res… |
| Chris Petrilli @PetrilliMD @JHospMedicine @CostsofCare @UM_IHPI @UMich #JHMChat remove FVL, PT20210, MTHFR ordering from IP and include POC education #UMSolutions |
| J Hospital Medicine @JHospMedicine RT @ijanders1: @JHospMedicine @CostsofCare @PetrilliMD best practice alerts, unbundle orders, require heme input? Just thoughts...#jhmchat |
| J Hospital Medicine @JHospMedicine RT @SHMLive: T3 is up and ready for you on #JHMChat! Jump in now! https://t.co/DFtLfb7SRp |
| Gretchen Diemer @gretchendiemer RT @sanjaysaint: The 3 chances for resident greatness: 1/ find a zebra 2/ NEVER argue about an admission 3/ ALWAYS be kind to nurses… |
| Chris Petrilli @PetrilliMD RT @TWDFNR: @WolfsonD Barry Meisenberg in Maryland at AAMC just doesn't let the tests be ordered on inpts. Solved the problem. #jhmchat |
| Malvinder Parmar @wittykidney @WrayCharles @WolfsonD need to the prevalence of these in different populations, #JHMChat |
| Charlie M. Wray @WrayCharles T3: My new theory. electronic soft/hard stops don't work! This is test in which phonecall/more effort wld need 2 b made to get test #jhmchat https://t.co/Z073bFYrdt |
| Society of Hospital Medicine @SHMLive RT @FutureDocs: Education (don't tell anyone I said this) is not enough to change practice. Need to change system too. #jhmchat https://t.c… |
| Irsk Anderson @ijanders1 RT @FutureDocs: Education (don't tell anyone I said this) is not enough to change practice. Need to change system too. #jhmchat https://t.c… |
| Society of Hospital Medicine @SHMLive RT @JHospMedicine: Great ideas for T3 which is live! how can we reduce inpt inherited thrombophilia testing? #JHMChat others? https://t.co/… |
| Shannon K. Martin @shannonmartinmd Spouse of pt perspective - exasperated when he showed me heterozygous FVL result from 23&Me with no h/o clot/risk factors :) #jhmchat https://t.co/G2Rjda38AK |
| Michelle Brooks, MD, FACP, FHM @michellebr00ks T3 - the article makes the case that this is NOT an inpatient test. Make the order only outpatient. #JHMChat https://t.co/qt3R7URvcL |
| J Hospital Medicine @JHospMedicine ha ha! we welcome more pieces #JHMChat https://t.co/52pYRSe0H8 |
| Chris Moriates, MD @ChrisMoriates Your secret is safe with us... ;-) #jhmchat https://t.co/MXHR5uWUDD |
| Irsk Anderson @ijanders1 @WrayCharles Yes! make work hard 4 it! I like it! #jhmchat T3 |
| Chris Petrilli @PetrilliMD @wittykidney @JigsyMD @GBarnesMD @tony_breu #JHMChat - If recurrence is essentially the same, why would mgmt change? #GBarnes2036 |
| Chris Petrilli @PetrilliMD RT @FutureDocs: Education (don't tell anyone I said this) is not enough to change practice. Need to change system too. #jhmchat https://t.c… |
| Gretchen Diemer @gretchendiemer Order sets are low hanging fruit. #jhmchat https://t.co/XR5lWN4cxp |
| Nancy H Stewart DO, MS @nvhstewart This is so true. #jhmchat https://t.co/vgHCW2qWdx |
| Malvinder Parmar @wittykidney @WrayCharles Factor V Leiden or prothrombin 20210 mutations common in Caucasians, while prevalence of protein C&S def is 0.3% #JHMChat |
| J Hospital Medicine @JHospMedicine RT @PetrilliMD: @JHospMedicine @CostsofCare @UM_IHPI @UMich #JHMChat remove FVL, PT20210, MTHFR ordering from IP and include POC education… |
| Tony Breu @tony_breu @WrayCharles Or just make them unavailable as @PetrilliMD suggest. #jhmchat |
| J Hospital Medicine @JHospMedicine RT @FutureDocs: Education (don't tell anyone I said this) is not enough to change practice. Need to change system too. #jhmchat https://t.c… |
| Nancy H Stewart DO, MS @nvhstewart RT @JHospMedicine: T3 Given @CostsofCare = $1100-$2400 per thrombophilia panel in @PetrilliMD et al, how can we reduce inpatient testing? #… |
| Things We Do For No Reason @TWDFNR @WrayCharles totally agree. make folks call the lab and let the lab decide if the test can be sent. Save ourselves from ourselves #jhmchat |
 | Kyle Glienke @glienkekyle RT @JHospMedicine: T3 Given @CostsofCare = $1100-$2400 per thrombophilia panel in @PetrilliMD et al, how can we reduce inpatient testing? #… |
| Geoff Barnes @gbarnesmd @JHospMedicine @CostsofCare @PetrilliMD Some centers (e.g. Mark Crowther's) don't offer as inpatient, or require heme approval #jhmchat |
| J Hospital Medicine @JHospMedicine RT @TWDFNR: @WolfsonD Barry Meisenberg in Maryland at AAMC just doesn't let the tests be ordered on inpts. Solved the problem. #jhmchat |
 | Andrew M. Ibrahim MD @AndrewMIbrahim Loving the use of #VisualAbstract to set up journal clubs / chats . Nice work @WrayCharles ! https://t.co/eknb8nwYaJ |
| Chris Petrilli @PetrilliMD @ChrisMoriates @FutureDocs #JHMChat - sorry, I already tweeted it out.... |
 | Gene Hobbs @gene_hobbs RT @FutureDocs: Education (don't tell anyone I said this) is not enough to change practice. Need to change system too. #jhmchat https://t.c… |
| J Hospital Medicine @JHospMedicine RT @ShannonMartinMD: Spouse of pt perspective - exasperated when he showed me heterozygous FVL result from 23&Me with no h/o clot/risk f… |
 | Madhu S. MD @thinkalot RT @sanjaysaint: The 3 chances for resident greatness: 1/ find a zebra 2/ NEVER argue about an admission 3/ ALWAYS be kind to nurses… |
| Nancy H Stewart DO, MS @nvhstewart RT @wittykidney: @WrayCharles Factor V Leiden or prothrombin 20210 mutations common in Caucasians, while prevalence of protein C&S def is 0… |
| Nancy H Stewart DO, MS @nvhstewart RT @TWDFNR: @WrayCharles totally agree. make folks call the lab and let the lab decide if the test can be sent. Save ourselves from ourselv… |
| Chris Petrilli @PetrilliMD #JHMChat I agree with Tony! https://t.co/Ifseb7BBKL |
 | Priya Radhakrishnan @docphx RT @JHospMedicine: just joining #JHMChat? quick summary of tonights article by @PetrilliMD, we present the #VisualAbstract in #Gif thx… |
| Malvinder Parmar @wittykidney @WrayCharles @WolfsonD proteinC and s issues are common in AA. These studies should not be done during acute phase - consumption #JHMChat |
| Chris Moriates, MD @ChrisMoriates Sometimes this really is the best intervention. I agree that this is one of those times. #jhmchat https://t.co/mSjfBEsqmJ |
| Geoff Barnes @gbarnesmd @wittykidney @PetrilliMD @JigsyMD @tony_breu Testing for pre-pregnancy prophy is different than testing to determine #VTE tx length #jhmchat |
| J Hospital Medicine @JHospMedicine we like to be forward thinking here at #JHMChat:) REMINDER to register for #CME here https://t.co/dbOp3pOMLp https://t.co/ZgplrxsDAq |
| Geoff Barnes @gbarnesmd RT @FutureDocs: Education (don't tell anyone I said this) is not enough to change practice. Need to change system too. #jhmchat https://t.c… |
| Kim Tartaglia, MD @KimTartaglia Agreed! I don't think we have thrombophilia testing in admission panels for VTE so it's harder to do wrong thing. This makes it impossible. https://t.co/Gab1DRxaf1 |
| Vinny Arora MD MAPP @FutureDocs I know! My poor #meded colleagues #jhmchat https://t.co/2ZsaDu6Nmb |
| Society of Hospital Medicine @SHMLive RT @JHospMedicine: we like to be forward thinking here at #JHMChat:) REMINDER to register for #CME here https://t.co/dbOp3pOMLp https://t.c… |
| Michelle Brooks, MD, FACP, FHM @michellebr00ks #JHMChat https://t.co/no3LVhUosi |
| Vinny Arora MD MAPP @FutureDocs RT @JHospMedicine: we like to be forward thinking here at #JHMChat:) REMINDER to register for #CME here https://t.co/dbOp3pOMLp https://t.c… |
| Geoff Barnes @gbarnesmd @ShannonMartinMD @FutureDocs Great insight! Danger of genetic testing without informed counseling #jhmchat |
| Society of Hospital Medicine @SHMLive RT @ChrisMoriates: Sometimes this really is the best intervention. I agree that this is one of those times. #jhmchat https://t.co/mSjfBEsqmJ |
 | Kim de la Cruz @aortasurg RT @sanjaysaint: The 3 chances for resident greatness: 1/ find a zebra 2/ NEVER argue about an admission 3/ ALWAYS be kind to nurses… |
| Charlie M. Wray @WrayCharles RT @AndrewMIbrahim: Loving the use of #VisualAbstract to set up journal clubs / chats . Nice work @WrayCharles ! https://t.co/eknb8nwYaJ |
| Vinny Arora MD MAPP @FutureDocs RT @ChrisMoriates: Sometimes this really is the best intervention. I agree that this is one of those times. #jhmchat https://t.co/mSjfBEsqmJ |
| J Hospital Medicine @JHospMedicine RT @ChrisMoriates: Sometimes this really is the best intervention. I agree that this is one of those times. #jhmchat https://t.co/mSjfBEsqmJ |
| Chris Petrilli @PetrilliMD @ChrisMoriates #JHMChat - but then you put extra work on the lab (or heme consult services)...need to just STOP-IT (tm) @UM_IHPI @UMHS_PRO |
| Kim Tartaglia, MD @KimTartaglia #jhmchat. Also think education is only useful if it builds relevance on how and why it doesn't change management. https://t.co/dW3jPiDP7I |
| Chris Petrilli @PetrilliMD RT @JHospMedicine: we like to be forward thinking here at #JHMChat:) REMINDER to register for #CME here https://t.co/dbOp3pOMLp https://t.c… |
 | Seth Trueger @MDaware RT @sanjaysaint: The 3 chances for resident greatness: 1/ find a zebra 2/ NEVER argue about an admission 3/ ALWAYS be kind to nurses… |
| Irsk Anderson @ijanders1 @michellebr00ks This just made excellent chat even better! #jhmchat |
| Michelle Brooks, MD, FACP, FHM @michellebr00ks RT @nvhs0401: This is so true. #jhmchat https://t.co/vgHCW2qWdx |
| Chris Petrilli @PetrilliMD @GBarnesMD @wittykidney @JigsyMD @tony_breu #JHMChat - absolutely...pregnancy is def one of the exceptions we mentioned in the article... |
| Vinny Arora MD MAPP @FutureDocs T3 any ways to engage #patients to reduce testing? #jhmchat would be great partners https://t.co/hxKz3mlTvQ |
| Chris Petrilli @PetrilliMD RT @GBarnesMD: @ShannonMartinMD @FutureDocs Great insight! Danger of genetic testing without informed counseling #jhmchat |
| J Hospital Medicine @JHospMedicine RT @KimTartaglia: #jhmchat. Also think education is only useful if it builds relevance on how and why it doesn't change management. https:/… |
| Irsk Anderson @ijanders1 @PetrilliMD @ChrisMoriates @UM_IHPI @UMHS_PRO agree & lab doesn't have all clinical info. Like rads saying "clin corr rec"! #jhmchat |
| J Hospital Medicine @JHospMedicine RT @michellebr00ks: #JHMChat https://t.co/no3LVhUosi |
| Seth Trueger @MDaware @FutureDocs #jhmchat explain that if management won't change either way, what's the point of the test? |
| Vinny Arora MD MAPP @FutureDocs RT @michellebr00ks: #JHMChat https://t.co/no3LVhUosi |
| Margaret Fleming @mlsfleming2 RT @FutureDocs: T3 any ways to engage #patients to reduce testing? #jhmchat would be great partners https://t.co/hxKz3mlTvQ |
| J Hospital Medicine @JHospMedicine RT @michellebr00ks: T3 - the article makes the case that this is NOT an inpatient test. Make the order only outpatient. #JHMChat https://… |
| Seth Trueger @MDaware RT @FutureDocs: Education (don't tell anyone I said this) is not enough to change practice. Need to change system too. #jhmchat https://t.c… |
| Society of Hospital Medicine @SHMLive RT @FutureDocs: T3 any ways to engage #patients to reduce testing? #jhmchat would be great partners https://t.co/hxKz3mlTvQ |
| J Hospital Medicine @JHospMedicine RT @FutureDocs: T3 any ways to engage #patients to reduce testing? #jhmchat would be great partners https://t.co/hxKz3mlTvQ |
| Malvinder Parmar @wittykidney @GBarnesMD @ShannonMartinMD @FutureDocs postive test = ⬆️propensity, but != disease #jhmchat |
| J Hospital Medicine @JHospMedicine RT @PetrilliMD: @GBarnesMD @wittykidney @JigsyMD @tony_breu #JHMChat - absolutely...pregnancy is def one of the exceptions we mentioned in… |
| Chris Moriates, MD @ChrisMoriates I can't pass up opportunity, w/ all my friends here, to plug @CostsofCare Creating Value Challenge.15d left https://t.co/mh99QRaKtW #jhmchat |
| Chris Petrilli @PetrilliMD @FutureDocs #JHMChat - with HIV testing you used to need pt consent. Given potential for anxiety, etc - could consider this b4 ordering |
| Chris Petrilli @PetrilliMD RT @ijanders1: @PetrilliMD @ChrisMoriates @UM_IHPI @UMHS_PRO agree & lab doesn't have all clinical info. Like rads saying "clin corr rec"!… |
| J Hospital Medicine @JHospMedicine RT @GBarnesMD: @wittykidney @PetrilliMD @JigsyMD @tony_breu Testing for pre-pregnancy prophy is different than testing to determine #VTE tx… |
| Amit Kumar Pahwa @pahwa @FutureDocs 3 words - shared decision making #jhmchat |
| Chris Petrilli @PetrilliMD RT @ChrisMoriates: I can't pass up opportunity, w/ all my friends here, to plug @CostsofCare Creating Value Challenge.15d left https://t.co… |
| Sanjay Saint @sanjaysaint Word. #jhmchat https://t.co/jYQc4b5NEQ |
| Shannon K. Martin @shannonmartinmd RT @PetrilliMD: @FutureDocs #JHMChat - with HIV testing you used to need pt consent. Given potential for anxiety, etc - could consider this… |
| Irsk Anderson @ijanders1 RT @ChrisMoriates: I can't pass up opportunity, w/ all my friends here, to plug @CostsofCare Creating Value Challenge.15d left https://t.co… |
 | Armand Krikorian @endouno @PetrilliMD @FutureDocs Important perspective reminding us that often less is more in medicine #jhmchat |
| Tony Breu @tony_breu @Pahwa @FutureDocs I loved shared decision making, but this is a tough one for even us providers to understand! #jhmchat |
| J Hospital Medicine @JHospMedicine Wow time is FLYING tonight on #JHMChat -5 minutes left to share your closing thoughts on reducing inpt inherited thrombophilia testing! |
| Society of Hospital Medicine @SHMLive RT @ChrisMoriates: I can't pass up opportunity, w/ all my friends here, to plug @CostsofCare Creating Value Challenge.15d left https://t.co… |
| Michelle Brooks, MD, FACP, FHM @michellebr00ks RT @ChrisMoriates: I can't pass up opportunity, w/ all my friends here, to plug @CostsofCare Creating Value Challenge.15d left https://t.co… |
 | David Rosenthal MD @davidrosenthal RT @sanjaysaint: The 3 chances for resident greatness: 1/ find a zebra 2/ NEVER argue about an admission 3/ ALWAYS be kind to nurses… |
| Nancy H Stewart DO, MS @nvhstewart RT @PetrilliMD: @FutureDocs #JHMChat - with HIV testing you used to need pt consent. Given potential for anxiety, etc - could consider this… |
| Armand Krikorian @endouno What about when we will have entire human genome sequenced with home kits? #jhmchat https://t.co/yFCJCah8H2 |
| Daniel Wolfson @WolfsonD RT @ChrisMoriates: I can't pass up opportunity, w/ all my friends here, to plug @CostsofCare Creating Value Challenge.15d left https://t.co… |
 | DWK Fraser @dwkf RT @FutureDocs: Education (don't tell anyone I said this) is not enough to change practice. Need to change system too. #jhmchat https://t.c… |
| J Hospital Medicine @JHospMedicine Get #CME for participation in tonight's #JHMChat - sign up here! https://t.co/dbOp3pOMLp |
| J Hospital Medicine @JHospMedicine RT @ENDOUNO: @PetrilliMD @FutureDocs Important perspective reminding us that often less is more in medicine #jhmchat |
| Irsk Anderson @ijanders1 @JHospMedicine Thx 2 all! As primarily outpt MD, was excellent! #jhmchat |
| J Hospital Medicine @JHospMedicine RT @Pahwa: @FutureDocs 3 words - shared decision making #jhmchat |
| Society of Hospital Medicine @SHMLive RT @JHospMedicine: Wow time is FLYING tonight on #JHMChat -5 minutes left to share your closing thoughts on reducing inpt inherited thrombo… |
| J Hospital Medicine @JHospMedicine RT @ChrisMoriates: I can't pass up opportunity, w/ all my friends here, to plug @CostsofCare Creating Value Challenge.15d left https://t.co… |
| Society of Hospital Medicine @SHMLive RT @JHospMedicine: Get #CME for participation in tonight's #JHMChat - sign up here! https://t.co/dbOp3pOMLp |
| Michelle Brooks, MD, FACP, FHM @michellebr00ks CT: I think the gif said it best...really no reason to order inherited thrombophilia testing as an inpatient. #jhmchat |
 | Michael Sinha MD, JD, MPH @DrSinhaEsq RT @FutureDocs: Education (don't tell anyone I said this) is not enough to change practice. Need to change system too. #jhmchat https://t.c… |
| Nancy H Stewart DO, MS @nvhstewart RT @michellebr00ks: CT: I think the gif said it best...really no reason to order inherited thrombophilia testing as an inpatient. #jhmchat |
| J Hospital Medicine @JHospMedicine Special thanks to our partners @SHMLive @CostsofCare @ABIMFoundation & guest author @PetrilliMD for great #JHMChat tonight! |
| Irsk Anderson @ijanders1 RT @michellebr00ks: CT: I think the gif said it best...really no reason to order inherited thrombophilia testing as an inpatient. #jhmchat |
| Malvinder Parmar @wittykidney @JHospMedicine I often can't get that, seems like one has to SHM membership #JHMChat |
| Jigar Contractor @jigsymd @FutureDocs Cost transparency would go along way in these discussions. Most MDs don't know how much their hospital is charging #jhmchat |
| Chris Petrilli @PetrilliMD Competing with the #TheBachelor and #nationalchampionship - This has been very impressive #jhmchat @JHospMedicine @FutureDocs @UM_IHPI |
| J Hospital Medicine @JHospMedicine Tune in 4 next #JHMChat Mon Feb 6th 2017 9p ET on @CostsofCare of acute #kidney injury w/ @WrayCharles @kidney_boy #choosingwisely |
| Chris Petrilli @PetrilliMD RT @michellebr00ks: CT: I think the gif said it best...really no reason to order inherited thrombophilia testing as an inpatient. #jhmchat |
| Tony Breu @tony_breu Thank you @PetrilliMD @FutureDocs @JHospMedicine for another amazing #jhmchat !!! https://t.co/uPF9fGz1Tr |
| Chris Petrilli @PetrilliMD RT @JHospMedicine: Get #CME for participation in tonight's #JHMChat - sign up here! https://t.co/dbOp3pOMLp |
| Vinny Arora MD MAPP @FutureDocs I do think we held our own #jhmchat! thank you!!! https://t.co/nE606BOZgO |
| Michelle Brooks, MD, FACP, FHM @michellebr00ks RT @JHospMedicine: Tune in 4 next #JHMChat Mon Feb 6th 2017 9p ET on @CostsofCare of acute #kidney injury w/ @WrayCharles @kidney_boy #choo… |
| Chris Petrilli @PetrilliMD RT @sanjaysaint: Word. #jhmchat https://t.co/jYQc4b5NEQ |
| Vinny Arora MD MAPP @FutureDocs RT @tony_breu: Thank you @PetrilliMD @FutureDocs @JHospMedicine for another amazing #jhmchat !!! https://t.co/uPF9fGz1Tr |
| Vinny Arora MD MAPP @FutureDocs RT @JHospMedicine: Tune in 4 next #JHMChat Mon Feb 6th 2017 9p ET on @CostsofCare of acute #kidney injury w/ @WrayCharles @kidney_boy #choo… |
| Society of Hospital Medicine @SHMLive RT @JHospMedicine: Tune in 4 next #JHMChat Mon Feb 6th 2017 9p ET on @CostsofCare of acute #kidney injury w/ @WrayCharles @kidney_boy #choo… |
| Charlie M. Wray @WrayCharles RT @JHospMedicine: Tune in 4 next #JHMChat Mon Feb 6th 2017 9p ET on @CostsofCare of acute #kidney injury w/ @WrayCharles @kidney_boy #choo… |
 | Joel Topf, MD FACP @kidney_boy RT @JHospMedicine: Tune in 4 next #JHMChat Mon Feb 6th 2017 9p ET on @CostsofCare of acute #kidney injury w/ @WrayCharles @kidney_boy #choo… |
| Chris Petrilli @PetrilliMD RT @JHospMedicine: Tune in 4 next #JHMChat Mon Feb 6th 2017 9p ET on @CostsofCare of acute #kidney injury w/ @WrayCharles @kidney_boy #choo… |
| Vinny Arora MD MAPP @FutureDocs . @SHMLive may be able to help you #jhmchat https://t.co/QykxCsGmej |
 | Manas Kaushik MD @manas8u .@sanjaysaint demolishes myth that residents can be good at value based care (#2) saving admits=saving $ not ¢ @JHospMedicine 😟#JHMchat |
| Sanjay Saint @sanjaysaint "Shared decision-making" usually means: we make the decision and then share it with our patients. Agree important to do it right. #jhmchat https://t.co/hoKr8Jrtas |
 | Healthcare discovery @HealthTypes RT @sanjaysaint: The 3 chances for resident greatness: 1/ find a zebra 2/ NEVER argue about an admission 3/ ALWAYS be kind to nurses… |
| Healthcare discovery @HealthTypes RT @JHospMedicine: just joining #JHMChat? quick summary of tonights article by @PetrilliMD, we present the #VisualAbstract in #Gif thx… |
| Society of Hospital Medicine @SHMLive RT @FutureDocs: I do think we held our own #jhmchat! thank you!!! https://t.co/nE606BOZgO |
 | Greg Gramelspacher @ggramels RT @sanjaysaint: The 3 chances for resident greatness: 1/ find a zebra 2/ NEVER argue about an admission 3/ ALWAYS be kind to nurses… |
| Michelle Brooks, MD, FACP, FHM @michellebr00ks @PetrilliMD ...I mean...obviously the article said it best....#blushing #JHMchat https://t.co/JxCEW7477v |
| Shannon K. Martin @shannonmartinmd Thanks for a great #jhmchat tonight, looking forward to next month! https://t.co/9D4nZGmQEZ |
 | Sumant Ranji @sumantranji @FutureDocs @WolfsonD one needed system change: partnerships between generalists and specialists to ID/eliminate #twdfnr #jhmchat |
| Joel Topf, MD FACP @kidney_boy this is very cool #YouUppedTheAnte https://t.co/eocOmKEz05 |
| Society of Hospital Medicine @SHMLive Thanks to partners @ABIMFoundation & @CostsofCare for helping to spread the word and for participating in #JHMChat! |
| Society of Hospital Medicine @SHMLive Thank you @JHospMedicine @FutureDocs @PetrilliMD for another great #JHMChat! Don't forget to claim #CME here: https://t.co/mMElHgWZBt |
| Chris Petrilli @PetrilliMD @MANas8U @sanjaysaint @JHospMedicine @UM_IHPI - #JHMChat his former resident was the 1st author of this paper - Taught me everything I know! |
| J Hospital Medicine @JHospMedicine RT @SHMLive: Thank you @JHospMedicine @FutureDocs @PetrilliMD for another great #JHMChat! Don't forget to claim #CME here: https://t.co/mME… |
| Chris Petrilli @PetrilliMD RT @sanjaysaint: "Shared decision-making" usually means: we make the decision and then share it with our patients. Agree important t… |
| Vinny Arora MD MAPP @FutureDocs RT @SHMLive: Thank you @JHospMedicine @FutureDocs @PetrilliMD for another great #JHMChat! Don't forget to claim #CME here: https://t.co/mME… |
| Vinny Arora MD MAPP @FutureDocs RT @sumantranji: @FutureDocs @WolfsonD one needed system change: partnerships between generalists and specialists to ID/eliminate #twdfnr #… |
 | Irfan Dhalla @irfandhalla #4, at least when I'm attending: know the patients' life stories https://t.co/igodUYcgzJ |
| Chris Moriates, MD @ChrisMoriates RT @sumantranji: @FutureDocs @WolfsonD one needed system change: partnerships between generalists and specialists to ID/eliminate #twdfnr #… |
 | Kristina Dzara, PhD, MMSc @kristinadzara #hmieduators https://t.co/ef6V4Nl9VR |
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