#JHMChat Transcript
Healthcare social media transcript of the #JHMChat hashtag.
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See #JHMChat Influencers/Analytics.
| Profile | Tweet |
|---|---|
 | Journal of Hospital Medicine @JHospMedicine Thx for being here @KFowler_PSEP! #jhmchat starts NOW! https://t.co/haaKJiugro |
| Journal of Hospital Medicine @JHospMedicine RT @vineet_chopra: Vineet Chopra clocking in #JHMChat |
 | Society of Hospital Medicine @SocietyHospMed #JHMChat begins NOW! Join the conversation on lawsuits, defensive #medicine and resources utilization, then claim #CME: https://t.co/iYEYzaBa06 @JHospMedicine @ABIMFoundation @CostsofCare https://t.co/IS8scho5Fx |
| Journal of Hospital Medicine @JHospMedicine Tonight's #visualabstract for #JHMChat brought to you by @WrayCharles https://t.co/NjBGiNlt4L |
| Journal of Hospital Medicine @JHospMedicine Welcome to #JHMChat, I am your moderator @FutureDocs please introduce yourself. T1 up in a moment... |
| Journal of Hospital Medicine @JHospMedicine tonight on #JHMChat we are pleased to welcome the authors of this paper on perceptions of resources spent on defensive medicine & history of being sued https://t.co/zsJRrX3HYe @sanjaysaint @vineet_chopra @KFowler_PSEP and @allenkachalia |
| Journal of Hospital Medicine @JHospMedicine tonight on #JHMChat we are pleased to welcome the authors of this paper on perceptions of resources spent on... https://t.co/LTDj4FDJ58 |
| Journal of Hospital Medicine @JHospMedicine @vineet_chopra Thx for being here and promo @vineet_chopra #JHMChat |
 | Patient Safety Enhancement Program (UMVA) @PSEPUMVA RT @JHospMedicine: tonight on #JHMChat we are pleased to welcome the authors of this paper on perceptions of resources spent on defensive medicine & history of being sued https://t.co/zsJRrX3HYe @sanjaysaint @vineet_chopra @KFowler_PSEP and @allenkachalia |
| Journal of Hospital Medicine @JHospMedicine RT @SHMLive: #JHMChat begins NOW! Join the conversation on lawsuits, defensive #medicine and resources utilization, then claim #CME: #JHMChat begins NOW! Join the conversation on lawsuits, defensive #medicine and resources utilization, then claim #CME: https://t.co/iYEYzaBa06 @JHospMedicine @ABIMFoundation @CostsofCare https://t.co/IS8scho5Fx |
 | Vineet Chopra @vineet_chopra RT @JHospMedicine: Welcome to #JHMChat, I am your moderator @FutureDocs please introduce yourself. T1 up in a moment... |
 | Vinny Arora MD MAPP @FutureDocs RT @JHospMedicine: Welcome to #JHMChat, I am your moderator @FutureDocs please introduce yourself. T1 up in a moment... |
 | Sanjay Saint @sanjaysaint Looking forward to #JHMChat tonight! |
 | Tony Breu @tony_breu Tony Breu here from VA Boston. Wife at 40.17 weeks so if I leave abruptly, you'll know why... #soontobedadagain #JHMChat |
| Vinny Arora MD MAPP @FutureDocs RT @JHospMedicine: Tonight's #visualabstract for #JHMChat brought to you by @WrayCharles https://t.co/NjBGiNlt4L |
| Vinny Arora MD MAPP @FutureDocs RT @JHospMedicine: tonight on #JHMChat we are pleased to welcome the authors of this paper on perceptions of resources spent on defensive medicine & history of being sued https://t.co/zsJRrX3HYe @sanjaysaint @vineet_chopra @KFowler_PSEP and @allenkachalia |
| Vinny Arora MD MAPP @FutureDocs RT @SHMLive: #JHMChat begins NOW! Join the conversation on lawsuits, defensive #medicine and resources utilization, then claim #CME: #JHMChat begins NOW! Join the conversation on lawsuits, defensive #medicine and resources utilization, then claim #CME: https://t.co/iYEYzaBa06 @JHospMedicine @ABIMFoundation @CostsofCare https://t.co/IS8scho5Fx |
 | Rebecca Jaffe, MD @RJmdphilly @tony_breu that is very precise to the hour calculation... #JHMChat |
| Journal of Hospital Medicine @JHospMedicine Congrats to one of our loyal #JHMChat participants @tony_breu https://t.co/QODpbRfvNA |
| Tony Breu @tony_breu @RJmdphilly Yeah, once you're past the due date, the clock really starts running #JHMChat |
| Journal of Hospital Medicine @JHospMedicine Thank you for doing another #JHMChat @sanjaysaint ! https://t.co/9iJ6eXqZZt |
| Journal of Hospital Medicine @JHospMedicine T1 The authors discovered that hospitalists perceived 37.5% of healthcare costs are due to defensive medicine, which is much higher than previous estimates ~2% of all healthcare spending. What is driving the difference btwn perception & reality? #JHMChat |
| Journal of Hospital Medicine @JHospMedicine So lucky to have @gracefarris in the #JHMChat room again! https://t.co/T2vxkDNpZJ |
| Rebecca Jaffe, MD @RJmdphilly I can't match @tony_breu 's entrance. Rebecca Jaffe from Philly. #nomorebabies #JHMChat |
 | Allen Kachalia @allenkachalia Happy to join right now! #jhmchat |
| Journal of Hospital Medicine @JHospMedicine We still welcome you as a loyal participant #JHMChat !@RJmdphilly https://t.co/bkTOdedjWF |
 | Lonika Sood @sood_lonika lonika sood from green bay, wi #jhmchat |
| Journal of Hospital Medicine @JHospMedicine Thanks for joining #JHMChat @allenkachalia as an author expert- looking forward to discussion! https://t.co/RR7y3YZMGB |
| Tony Breu @tony_breu It's not just about being sued. It's about looking "bad" in front of patients, colleagues, the world. #JHMChat https://t.co/NiPdRH1nxC |
| Rebecca Jaffe, MD @RJmdphilly RT @JHospMedicine: T1 The authors discovered that hospitalists perceived 37.5% of healthcare costs are due to defensive medicine, which is much higher than previous estimates ~2% of all healthcare spending. What is driving the difference btwn perception & reality? #JHMChat |
| Lonika Sood @sood_lonika @JHospMedicine A1: misperceptions of what providers are sued for, bad experiences that are heard from colleagues, stories... #JHMChat |
| Vinny Arora MD MAPP @FutureDocs RT @RJmdphilly: I can't match @tony_breu 's entrance. Rebecca Jaffe from Philly. #nomorebabies #JHMChat |
| Vinny Arora MD MAPP @FutureDocs RT @JHospMedicine: T1 The authors discovered that hospitalists perceived 37.5% of healthcare costs are due to defensive medicine, which is much higher than previous estimates ~2% of all healthcare spending. What is driving the difference btwn perception & reality? #JHMChat |
| Vinny Arora MD MAPP @FutureDocs RT @sood_lonika: @JHospMedicine A1: @JHospMedicine A1: misperceptions of what providers are sued for, bad experiences that are heard from colleagues, stories... #JHMChat |
| Journal of Hospital Medicine @JHospMedicine RT @sood_lonika: @JHospMedicine A1: @JHospMedicine A1: misperceptions of what providers are sued for, bad experiences that are heard from colleagues, stories... #JHMChat |
| Tony Breu @tony_breu Even though I'm a VA employee - and therefore "less at risk", I practice similarly to when I was at two non-VA hospitals. #JHMChat |
| Journal of Hospital Medicine @JHospMedicine RT @tony_breu: It's not just about being sued. It's about looking "bad" in front of patients, colleagues, the world. #JHMChat https://t.co/NiPdRH1nxC |
| Vineet Chopra @vineet_chopra A1 Also fear of being wrong. “What if I miss that dx? What if I get sued?” #jhmchat |
| Lonika Sood @sood_lonika T1: discomfort with wait and watch; shorter LOS; metrics #jhmchat |
| Journal of Hospital Medicine @JHospMedicine @sood_lonika Welcome to #JHMChat! |
| Society of Hospital Medicine @SocietyHospMed T1 is live! Join in for tonight's #JHMChat https://t.co/zb8sTtyVcY |
| Journal of Hospital Medicine @JHospMedicine RT @SHMLive: T1 is live! Join in for tonight's #JHMChat https://t.co/zb8sTtyVcY |
| Patient Safety Enhancement Program (UMVA) @PSEPUMVA RT @JHospMedicine: T1 The authors discovered that hospitalists perceived 37.5% of healthcare costs are due to defensive medicine, which is much higher than previous estimates ~2% of all healthcare spending. What is driving the difference btwn perception & reality? #JHMChat |
| Journal of Hospital Medicine @JHospMedicine RT @vineet_chopra: A1 Also fear of being wrong. “What if I miss that dx? What if I get sued?” #jhmchat |
| Tony Breu @tony_breu @gracefarris True. I am defensive against uncertainty. #JHMChat |
| Society of Hospital Medicine @SocietyHospMed Don't forget to claim #CME after tonight's #JHMChat: https://t.co/1tAKL3PWln |
| Patient Safety Enhancement Program (UMVA) @PSEPUMVA RT @vineet_chopra: A1 Also fear of being wrong. “What if I miss that dx? What if I get sued?” #jhmchat |
| Journal of Hospital Medicine @JHospMedicine Foreshadow to T2 #jhmchat https://t.co/CMIQfpX2AV |
| Patient Safety Enhancement Program (UMVA) @PSEPUMVA RT @SHMLive: Don't forget to claim #CME after tonight's #JHMChat: Don't forget to claim #CME after tonight's #JHMChat: https://t.co/1tAKL3PWln |
| Journal of Hospital Medicine @JHospMedicine RT @SHMLive: Don't forget to claim #CME after tonight's #JHMChat: Don't forget to claim #CME after tonight's #JHMChat: https://t.co/1tAKL3PWln |
 | Charlie M. Wray, DO, MS @WrayCharles Checking in for tonight’s #jhmchat (while I attempt to corral and feed 2 toddlers). I’m definitely practicing defensive parenting tonight... |
| Journal of Hospital Medicine @JHospMedicine @ben_geisler Great to have you at #jhmchat |
| Rebecca Jaffe, MD @RJmdphilly Definition of "defensive"? Defensive in legal context (preventing litigation) or defensive in a clinical context (fear of being wrong, missing zebra, missing badness). #JHMChat https://t.co/8utLidNhJ3 |
| Tony Breu @tony_breu @JHospMedicine Well, we're now at 40.21 weeks so I may jump ahead at times. #JHMChat |
| Vineet Chopra @vineet_chopra A1 What about payouts? Often, patients equate testing and probing with higher quality of care. Lack of same - the opposite. #jhmchat |
| Rebecca Jaffe, MD @RJmdphilly @gracefarris fear of ambiguity #JHMChat |
| Vineet Chopra @vineet_chopra RT @tony_breu: @gracefarris True. I am defensive against uncertainty. #JHMChat |
| Patient Safety Enhancement Program (UMVA) @PSEPUMVA RT @vineet_chopra: A1 What about payouts? Often, patients equate testing and probing with higher quality of care. Lack of same - the opposite. #jhmchat |
| Journal of Hospital Medicine @JHospMedicine @tony_breu I like it - super powers on #JHMChat |
 | Nonie S. Arora, MD MBA @nonie_arora RT @JHospMedicine: T1 The authors discovered that hospitalists perceived 37.5% of healthcare costs are due to defensive medicine, which is much higher than previous estimates ~2% of all healthcare spending. What is driving the difference btwn perception & reality? #JHMChat |
| Sanjay Saint @sanjaysaint T1 Likely this is - in part - overestimation by the physicians but it also reflects they feel the medical care provided is unnecessary #JHMChat https://t.co/8PCJCwvnDN |
| Journal of Hospital Medicine @JHospMedicine RT @vineet_chopra: A1 What about payouts? Often, patients equate testing and probing with higher quality of care. Lack of same - the opposite. #jhmchat |
| Tony Breu @tony_breu @RJmdphilly Study uses: "when doctors order tests, procedures, or visits, or avoid certain high-risk patients or procedures, primarily (but not necessarily) because of concern about malpractice liability.” #JHMChat |
| Vineet Chopra @vineet_chopra @RJmdphilly All of the above. #JHMChat |
| Journal of Hospital Medicine @JHospMedicine RT @RJmdphilly: Definition of "defensive"? Defensive in legal context (preventing litigation) or defensive in a clinical context (fear of being wrong, missing zebra, missing badness). #JHMChat https://t.co/8utLidNhJ3 |
 | burnt.eth @drmithil1 RT @RJmdphilly: Definition of "defensive"? Defensive in legal context (preventing litigation) or defensive in a clinical context (fear of being wrong, missing zebra, missing badness). #JHMChat https://t.co/8utLidNhJ3 |
| Journal of Hospital Medicine @JHospMedicine RT @sanjaysaint: T1 Likely this is - in part - overestimation by the physicians but it also reflects they feel the medical care provided is unnecessary #JHMChat https://t.co/8PCJCwvnDN |
| Journal of Hospital Medicine @JHospMedicine RT @tony_breu: @RJmdphilly Study uses: @RJmdphilly Study uses: "when doctors order tests, procedures, or visits, or avoid certain high-risk patients or procedures, primarily (but not necessarily) because of concern about malpractice liability.” #JHMChat |
| Lonika Sood @sood_lonika @vineet_chopra A!: i think expectations are also fed in my the healthcare system/ social media... case in point- resuscitation = good care; not resuscitating=suboptimal care #JHMChat |
| Patient Safety Enhancement Program (UMVA) @PSEPUMVA RT @sanjaysaint: T1 Likely this is - in part - overestimation by the physicians but it also reflects they feel the medical care provided is unnecessary #JHMChat https://t.co/8PCJCwvnDN |
 | Elliot Tapper @ebtapper RT @sanjaysaint: T1 Likely this is - in part - overestimation by the physicians but it also reflects they feel the medical care provided is unnecessary #JHMChat https://t.co/8PCJCwvnDN |
| Vinny Arora MD MAPP @FutureDocs RT @sanjaysaint: T1 Likely this is - in part - overestimation by the physicians but it also reflects they feel the medical care provided is unnecessary #JHMChat https://t.co/8PCJCwvnDN |
| Rebecca Jaffe, MD @RJmdphilly RT @sanjaysaint: T1 Likely this is - in part - overestimation by the physicians but it also reflects they feel the medical care provided is unnecessary #JHMChat https://t.co/8PCJCwvnDN |
| Vinny Arora MD MAPP @FutureDocs I think it’s a combo of both that feeds each other #JHMChat https://t.co/Ew0NBXuYZ0 |
| Vineet Chopra @vineet_chopra For many patients, tests are reassuring. Lack of tests are unnerving. #jhmchat |
| Vinny Arora MD MAPP @FutureDocs @WrayCharles -Miracle my daughter is asleep but running #JHMChat from rocking chair (quietly) https://t.co/Hu8doMfOm1 |
| Tony Breu @tony_breu @RJmdphilly Of these, I'd rank my own types as: 1. Order extra tests 2. Order extra consults 3. Order extra procedures 4. Avoid high risk procedures 5. Avoid high risk patients (can't really do this at VA). #JHMChat |
| Journal of Hospital Medicine @JHospMedicine RT @vineet_chopra: For many patients, tests are reassuring. Lack of tests are unnerving. #jhmchat |
| Vineet Chopra @vineet_chopra RT @tony_breu: @RJmdphilly Of these, I'd rank my own types as: 1. Order extra tests 2. Order extra consults 3. Order extra procedures 4. Avoid high risk procedures 5. Avoid high risk patients (can't really do this at VA). #JHMChat |
| Lonika Sood @sood_lonika @tony_breu @RJmdphilly extra consults=extra tests=extra procedures.... #JHMChat |
| Patient Safety Enhancement Program (UMVA) @PSEPUMVA RT @tony_breu: @RJmdphilly Of these, I'd rank my own types as: 1. Order extra tests 2. Order extra consults 3. Order extra procedures 4. Avoid high risk procedures 5. Avoid high risk patients (can't really do this at VA). #JHMChat |
| Journal of Hospital Medicine @JHospMedicine RT @tony_breu: @RJmdphilly Of these, I'd rank my own types as: 1. Order extra tests 2. Order extra consults 3. Order extra procedures 4. Avoid high risk procedures 5. Avoid high risk patients (can't really do this at VA). #JHMChat |
| Rebecca Jaffe, MD @RJmdphilly @tony_breu oops forgot to tag #JHMChat |
| Tony Breu @tony_breu @sood_lonika @RJmdphilly Very true. Often that first "extra" (consult) leads to a lot of downstream defense. #JHMChat |
| Vinny Arora MD MAPP @FutureDocs @WrayCharles Fortunately #JHMChat is not a video chat ! |
| Sanjay Saint @sanjaysaint T1 I also think the #chagrin factor plays a role. There is more 'chagrin' for not doing something (e.g., CT to r/o PE) and we miss something like a PE compared to doing something unnecessary (e.g., CT example above) and pt develops AKI from contrast #JHMChat https://t.co/8PCJCwvnDN |
| Lonika Sood @sood_lonika @tony_breu @RJmdphilly or offence :( #JHMChat |
| Journal of Hospital Medicine @JHospMedicine RT @sanjaysaint: T1 I also think the #chagrin factor plays a role. There is more 'chagrin' for not doing something (e.g., CT to r/o PE) and we miss something like a PE compared to doing something unnecessary (e.g., CT example above) and pt develops AKI from contrast #JHMChat https://t.co/8PCJCwvnDN |
| Journal of Hospital Medicine @JHospMedicine RT @sood_lonika: @tony_breu @RJmdphilly extra consults=extra tests=extra procedures.... #JHMChat |
| Journal of Hospital Medicine @JHospMedicine RT @tony_breu: @sood_lonika @RJmdphilly Very true. Often that first "extra" (consult) leads to a lot of downstream defense. #JHMChat |
| Tony Breu @tony_breu @ben_geisler And I often feel uncomfortable not adhering to recommendations. This is often where defense comes in. "Dr. Breu, can you explain why you didn't get the MRI when Dr. Smith - A SPECIALIST - recommended one?" #JHMChat |
 | Chris Petrilli, MD, SFHM @PetrilliMD T1 - @Pahwa @HiValueCarolina i think defensive isn’t always “inappropriate”. Wells score can be 1.5 or 4.5 depending on “judgment” so they might interpret that as defensive when that’s how score was designed = more CTs #jhmchat |
| Journal of Hospital Medicine @JHospMedicine T2 up in a moment #JHMchat |
| Lonika Sood @sood_lonika @ben_geisler @tony_breu same with seasoned attendings... inpatient PET scans, gastric emptying studies 🙄 #JHMChat |
| Patient Safety Enhancement Program (UMVA) @PSEPUMVA RT @sanjaysaint: T1 I also think the #chagrin factor plays a role. There is more 'chagrin' for not doing something (e.g., CT to r/o PE) and we miss something like a PE compared to doing something unnecessary (e.g., CT example above) and pt develops AKI from contrast #JHMChat https://t.co/8PCJCwvnDN |
| Rebecca Jaffe, MD @RJmdphilly RT @tony_breu: @ben_geisler And I often feel uncomfortable not adhering to recommendations. This is often where defense comes in. "Dr. Breu, can you explain why you didn't get the MRI when Dr. Smith - A SPECIALIST - recommended one?" #JHMChat |
| Vineet Chopra @vineet_chopra RT @tony_breu: @ben_geisler And I often feel uncomfortable not adhering to recommendations. This is often where defense comes in. "Dr. Breu, can you explain why you didn't get the MRI when Dr. Smith - A SPECIALIST - recommended one?" #JHMChat |
| Lonika Sood @sood_lonika @tony_breu @ben_geisler because they came in with a GI bleed!!! and have had that headache for 5 months!! 😬 #JHMChat |
| Journal of Hospital Medicine @JHospMedicine T2 Being a VA doctor, more years in practice AND being a non-Hispanic white male were associated lower estimates of resources spent on defensive medicine. What are some explanations for these findings? #JHMChat |
| Tony Breu @tony_breu @gracefarris I thought z-packs were the oldest treatment on the books... #JHMChat |
| Vineet Chopra @vineet_chopra @sood_lonika @ben_geisler @tony_breu While the opiates flow, of course. #JHMChat |
| Rebecca Jaffe, MD @RJmdphilly @sood_lonika @ben_geisler @tony_breu agree - I don't think it is a youth thing. Different lesions perhaps in fellow over ordering and attending over ordering. #JHMChat |
| Patient Safety Enhancement Program (UMVA) @PSEPUMVA RT @JHospMedicine: T2 Being a VA doctor, more years in practice AND being a non-Hispanic white male were associated lower estimates of resources spent on defensive medicine. What are some explanations for these findings? #JHMChat |
| Sanjay Saint @sanjaysaint T1 Case report to get a #neuro consult without a recommendation of at least of the following tests: MRI, LP, EEG, or EMG/NCS :-) #JHMChat https://t.co/9aLgKu4FD9 |
| Lonika Sood @sood_lonika @gracefarris cost for 24 hours hospitalisation >>> that additional test to rule out zebra? #JHMChat |
| Rebecca Jaffe, MD @RJmdphilly @gracefarris tell that to your LOS #JHMChat |
| Tony Breu @tony_breu @gracefarris @ben_geisler Paging @ebtapper #JHMChat |
| Charlie M. Wray, DO, MS @WrayCharles RT @sanjaysaint: T1 I also think the #chagrin factor plays a role. There is more 'chagrin' for not doing something (e.g., CT to r/o PE) and we miss something like a PE compared to doing something unnecessary (e.g., CT example above) and pt develops AKI from contrast #JHMChat https://t.co/8PCJCwvnDN |
| Vineet Chopra @vineet_chopra A2 That’s easy: wisdom. Wisdom to choose the VA (where no one wants to sue the federal government) and wisdom from being more comfortable in practice. #JHMChat |
| Vinny Arora MD MAPP @FutureDocs RT @JHospMedicine: T2 Being a VA doctor, more years in practice AND being a non-Hispanic white male were associated lower estimates of resources spent on defensive medicine. What are some explanations for these findings? #JHMChat |
| Rebecca Jaffe, MD @RJmdphilly RT @JHospMedicine: T2 Being a VA doctor, more years in practice AND being a non-Hispanic white male were associated lower estimates of resources spent on defensive medicine. What are some explanations for these findings? #JHMChat |
| Vinny Arora MD MAPP @FutureDocs RT @vineet_chopra: A2 That’s easy: A2 That’s easy: wisdom. Wisdom to choose the VA (where no one wants to sue the federal government) and wisdom from being more comfortable in practice. #JHMChat |
 | Michael Sinha @DrSinhaEsq RT @JHospMedicine: Tonight's #visualabstract for #JHMChat brought to you by @WrayCharles https://t.co/NjBGiNlt4L |
| Journal of Hospital Medicine @JHospMedicine RT @vineet_chopra: A2 That’s easy: A2 That’s easy: wisdom. Wisdom to choose the VA (where no one wants to sue the federal government) and wisdom from being more comfortable in practice. #JHMChat |
| Rebecca Jaffe, MD @RJmdphilly @gracefarris @tony_breu @ben_geisler #twdfnr @TWDFNR #JHMChat |
| Tony Breu @tony_breu YES. Best decision I've made in my clinical career was joining VA. Not just about federal tort claims act, but it's still nice. #JHMChat https://t.co/06wTRz7xr3 |
| Journal of Hospital Medicine @JHospMedicine RT @sood_lonika: @gracefarris cost for 24 hours hospitalisation >>> that additional test to rule out zebra? #JHMChat |
| Vineet Chopra @vineet_chopra RT @tony_breu: YES. Best decision I've made in my clinical career was joining VA. Not just about federal tort claims act, but it's still nice. #JHMChat https://t.co/06wTRz7xr3 |
| Society of Hospital Medicine @SocietyHospMed RT @JHospMedicine: T2 Being a VA doctor, more years in practice AND being a non-Hispanic white male were associated lower estimates of resources spent on defensive medicine. What are some explanations for these findings? #JHMChat |
| Lonika Sood @sood_lonika A2: white males because of perception that they are more trusted?? I am a non hispanic non white non male, and it takes me a while to build trust with patients c/w my white male colleagues.. #jhmchat |
| Rebecca Jaffe, MD @RJmdphilly @sanjaysaint or a rec to check a UA and replete K and magically everything will get better #delirium #JHMChat |
| Journal of Hospital Medicine @JHospMedicine Brilliant #JHMChat @costsofcare @ABIMFoundation @WolfsonD https://t.co/zGL5N3iJIS |
| Journal of Hospital Medicine @JHospMedicine RT @sood_lonika: A2: A2: white males because of perception that they are more trusted?? I am a non hispanic non white non male, and it takes me a while to build trust with patients c/w my white male colleagues.. #jhmchat |
| Vineet Chopra @vineet_chopra RT @sood_lonika: A2: A2: white males because of perception that they are more trusted?? I am a non hispanic non white non male, and it takes me a while to build trust with patients c/w my white male colleagues.. #jhmchat |
| Journal of Hospital Medicine @JHospMedicine RT @tony_breu: YES. Best decision I've made in my clinical career was joining VA. Not just about federal tort claims act, but it's still nice. #JHMChat https://t.co/06wTRz7xr3 |
| Vinny Arora MD MAPP @FutureDocs RT @JHospMedicine: Brilliant #JHMChat @costsofcare @ABIMFoundation @WolfsonD https://t.co/zGL5N3iJIS |
| Patient Safety Enhancement Program (UMVA) @PSEPUMVA RT @sood_lonika: A2: A2: white males because of perception that they are more trusted?? I am a non hispanic non white non male, and it takes me a while to build trust with patients c/w my white male colleagues.. #jhmchat |
| Rebecca Jaffe, MD @RJmdphilly RT @sood_lonika: A2: A2: white males because of perception that they are more trusted?? I am a non hispanic non white non male, and it takes me a while to build trust with patients c/w my white male colleagues.. #jhmchat |
 | Karen Fowler @KFowler_PSEP @JHospMedicine T2: Part of the VA piece is the population. Veterans are very loyal. #JHMChat |
| Vineet Chopra @vineet_chopra A2 When I practiced in the South, being a non white non Hispanic male and being a physician was seen as a huge asset. In the words of a kind Arkansan, “You must’ve overdone all kinds of odds to practice” Indeed. #JHMChat |
 | Teresa Chan | 陳敏怡 @TChanMD RT @sood_lonika: A2: A2: white males because of perception that they are more trusted?? I am a non hispanic non white non male, and it takes me a while to build trust with patients c/w my white male colleagues.. #jhmchat |
| Vinny Arora MD MAPP @FutureDocs Yet found the white male paradox in this article fascinating bc males were more likely to be sued #JHMChat https://t.co/rh2RRPrMu2 |
| Tony Breu @tony_breu I was surprised that more years in practice was associated with LESS defense, given the clear increase in risk of prior lawsuit with years in practice. #JHMChat https://t.co/PbRm675U0r |
| Elliot Tapper @ebtapper @gracefarris @tony_breu @ben_geisler It is universal. Where did the laundry lists of “non directed” tests come from? Neuro, liver, rheum, ID.... has anyone been sued for not ordering an ANA in a hospitalized patient? A ceruloplasmin in an 80 with ischemic hepatitis? #jhmchat |
| Lonika Sood @sood_lonika @FutureDocs i misunderstood then... 😬 #JHMChat |
| Patient Safety Enhancement Program (UMVA) @PSEPUMVA RT @vineet_chopra: A2 When I practiced in the South, being a non white non Hispanic male and being a physician was seen as a huge asset. In the words of a kind Arkansan, “You must’ve overdone all kinds of odds to practice” Indeed. #JHMChat |
| Sanjay Saint @sanjaysaint T2 VA affiliation may reduce perceived risk because VA environments tend to be less litigious. A patient population that is poorer, older, sicker, and with more mental illness may also contribute. VA’s form of enterprise liability shelters its physicians too #JHMChat https://t.co/13lY0YpKy6 |
| Rebecca Jaffe, MD @RJmdphilly this i think it runs deeper too. If non-hispanic white males self report less defensive medicine, it feels like it isn't all about patient trust, but self trust. Cultural permission to have self confidence? #JHMChat https://t.co/8y5wY6WuZj |
| Patient Safety Enhancement Program (UMVA) @PSEPUMVA RT @FutureDocs: Yet found the white male paradox in this article fascinating bc males were more likely to be sued #JHMChat https://t.co/rh2RRPrMu2 |
 | Daniel Wolfson @WolfsonD #JHMChat https://t.co/7XNmeVYv0h |
| Journal of Hospital Medicine @JHospMedicine Seems like an issue for Hospitalists vs specialists. Thoughts? #JHMChat https://t.co/vSOyRdKnkh |
| Sanjay Saint @sanjaysaint T2 The “white male effect” is likely at work in reducing those hospitalists’ perception of risk, though it is particularly interesting in this case, since that group is 2.5 times more likely to report having been sued! #JHMChat https://t.co/13lY0YpKy6 |
| Journal of Hospital Medicine @JHospMedicine RT @WolfsonD: #JHMChat https://t.co/7XNmeVYv0h |
| Journal of Hospital Medicine @JHospMedicine RT @sanjaysaint: T2 VA affiliation may reduce perceived risk because VA environments tend to be less litigious. A patient population that is poorer, older, sicker, and with more mental illness may also contribute. VA’s form of enterprise liability shelters its physicians too #JHMChat https://t.co/13lY0YpKy6 |
| Journal of Hospital Medicine @JHospMedicine RT @ebtapper: @gracefarris @tony_breu @ben_geisler It is universal. Where did the laundry lists of “non directed” tests come from? Neuro, liver, rheum, ID.... has anyone been sued for not ordering an ANA in a hospitalized patient? A ceruloplasmin in an 80 with ischemic hepatitis? #jhmchat |
| Patient Safety Enhancement Program (UMVA) @PSEPUMVA RT @sanjaysaint: T2 VA affiliation may reduce perceived risk because VA environments tend to be less litigious. A patient population that is poorer, older, sicker, and with more mental illness may also contribute. VA’s form of enterprise liability shelters its physicians too #JHMChat https://t.co/13lY0YpKy6 |
| Rebecca Jaffe, MD @RJmdphilly @FutureDocs now that's just irony #JHMChat |
| Vineet Chopra @vineet_chopra @JHospMedicine With the lawyers in the middle of course. #JHMChat |
| Tony Breu @tony_breu RT @FutureDocs: Yet found the white male paradox in this article fascinating bc males were more likely to be sued #JHMChat https://t.co/rh2RRPrMu2 |
| Chris Petrilli, MD, SFHM @PetrilliMD T2: VA docs may feel less “waste” because of essential single payer system for large majority of patients so “inpatient expedited workups” not otherwise indicated are accepted. #jhmchat |
| Journal of Hospital Medicine @JHospMedicine RT @sanjaysaint: T2 The “white male effect” is likely at work in reducing those hospitalists’ perception of risk, though it is particularly interesting in this case, since that group is 2.5 times more likely to report having been sued! #JHMChat https://t.co/13lY0YpKy6 |
| Lonika Sood @sood_lonika @JHospMedicine yet we seem to feel more strongly about cost of care than specialists (have not heard other specialties discuss HVC) #JHMChat |
| Journal of Hospital Medicine @JHospMedicine RT @KFowler_PSEP: @JHospMedicine T2: @JHospMedicine T2: Part of the VA piece is the population. Veterans are very loyal. #JHMChat |
| Rebecca Jaffe, MD @RJmdphilly @tony_breu though is that a cumulative rate/ Risk per year likely the same? #JHMChat |
| Tony Breu @tony_breu @PetrilliMD This is a good point. I've order inpatient PET scans, something I could never do in civilian hospital. Not for defense, but instead to save someone from an 8 hour drive. #JHMChat |
| Patient Safety Enhancement Program (UMVA) @PSEPUMVA RT @sanjaysaint: T2 The “white male effect” is likely at work in reducing those hospitalists’ perception of risk, though it is particularly interesting in this case, since that group is 2.5 times more likely to report having been sued! #JHMChat https://t.co/13lY0YpKy6 |
 | Ranjeet Sinha @sinhachild RT @JHospMedicine: Brilliant #JHMChat @costsofcare @ABIMFoundation @WolfsonD https://t.co/zGL5N3iJIS |
 | Faycal Tahiri M.D @FaycalTahiriMD2 RT @JHospMedicine: T1 The authors discovered that hospitalists perceived 37.5% of healthcare costs are due to defensive medicine, which is much higher than previous estimates ~2% of all healthcare spending. What is driving the difference btwn perception & reality? #JHMChat |
| Vineet Chopra @vineet_chopra At #VA, its about mission. Not margin. Doing the right thing - even if the right thing is to do nothing - understood as good practice. Not sure this translates outside #VHA. #JHMChat |
| Vinny Arora MD MAPP @FutureDocs I have seen radiology take up appropriateness @PamelaJohnsonMD #JHMChat and many others in #choosingwisely but something different about consults https://t.co/quuPP9yv7W |
| Patient Safety Enhancement Program (UMVA) @PSEPUMVA RT @vineet_chopra: At #VA, its about mission. Not margin. Doing the right thing - even if the right thing is to do nothing - understood as good practice. Not sure this translates outside #VHA. #JHMChat |
| Rebecca Jaffe, MD @RJmdphilly RT @WolfsonD: #JHMChat https://t.co/7XNmeVYv0h |
| Michael Sinha @DrSinhaEsq RT @RJmdphilly: this i think it runs deeper too. If non-hispanic white males self report less defensive medicine, it feels like it isn't all about patient trust, but self trust. Cultural permission to have self confidence? #JHMChat https://t.co/8y5wY6WuZj |
| Vinny Arora MD MAPP @FutureDocs RT @PetrilliMD: T2: T2: VA docs may feel less “waste” because of essential single payer system for large majority of patients so “inpatient expedited workups” not otherwise indicated are accepted. #jhmchat |
| Vinny Arora MD MAPP @FutureDocs RT @WolfsonD: #JHMChat https://t.co/7XNmeVYv0h |
| Daniel Wolfson @WolfsonD #JHMChat Payment mechanisms overstated influence - as much overuse at KP. Imprinting behaviors in medical school & residency - long-lasting effects. Read Blind Spots to learn about imprinting at young ages. https://t.co/T5p020vMta |
| Journal of Hospital Medicine @JHospMedicine RT @vineet_chopra: At #VA, its about mission. Not margin. Doing the right thing - even if the right thing is to do nothing - understood as good practice. Not sure this translates outside #VHA. #JHMChat |
| Journal of Hospital Medicine @JHospMedicine RT @PetrilliMD: T2: T2: VA docs may feel less “waste” because of essential single payer system for large majority of patients so “inpatient expedited workups” not otherwise indicated are accepted. #jhmchat |
| Journal of Hospital Medicine @JHospMedicine RT @WolfsonD: #JHMChat Payment mechanisms overstated influence - as much overuse at KP. Imprinting behaviors in medical school & residency - long-lasting effects. Read Blind Spots to learn about imprinting at young ages. https://t.co/T5p020vMta |
| Ranjeet Sinha @sinhachild RT @PetrilliMD: T2: T2: VA docs may feel less “waste” because of essential single payer system for large majority of patients so “inpatient expedited workups” not otherwise indicated are accepted. #jhmchat |
| Karen Fowler @KFowler_PSEP @ben_geisler The P-Values are from a multivariable regression so no Bonferroni correction needed.#JHMChat |
| Journal of Hospital Medicine @JHospMedicine T3 up in a minute ...#JHMChat welcome to those just joining! |
| Rebecca Jaffe, MD @RJmdphilly @tony_breu @PetrilliMD complex. we get asked to do same by consultants, but no easy way to do so quickly, so it adds to LOS and cost eaten depending on patient's coverage. So even if it isn't defensive, a lot harder to do this workup inpatient in non-VA systems. #JHMChat |
| Journal of Hospital Medicine @JHospMedicine Thx for clarification #JHMChat https://t.co/t9J9cXeNpm |
| Journal of Hospital Medicine @JHospMedicine T3 #JHMChat Over a quarter of hospitalists reported having been sued at least once for medical malpractice. For those in practice for at least 20 years, more than half (55%) had been sued at least once. How can we reduce this risk? |
| Journal of Hospital Medicine @JHospMedicine T3 #JHMChat Over a quarter of hospitalists reported having been sued at least once for medical malpractice. For... https://t.co/r6pa1xPZ2m |
| Journal of Hospital Medicine @JHospMedicine Thx for clarification #JHMChat https://t.co/t9J9cXeNpm https://t.co/Wv0ddxpq4z |
| Patient Safety Enhancement Program (UMVA) @PSEPUMVA RT @JHospMedicine: T3 #JHMChat Over a quarter of hospitalists reported having been sued at least once for medical malpractice. For those in practice for at least 20 years, more than half (55%) had been sued at least once. How can we reduce this risk? |
| Chris Petrilli, MD, SFHM @PetrilliMD @WolfsonD #JHMChat. Well in the VA these are just perceptions. The VA is one of the most efficient systems in the US. #mostVAnewsisfakenews |
| Rebecca Jaffe, MD @RJmdphilly @vineet_chopra feeling a lot of #FOMO about working at the VA right now. Trying to remember the forlorn feeling of 2am uncrustables so I don't get ahead of myself. #JHMChat |
| Sanjay Saint @sanjaysaint T2 The other aspect of being at the #VA is the clear sense of a shared mission for the employees: nurses, docs, food services, etc. People don't generally work at the VA for the money or prestige. It is the sense of giving back to those who risked their lives for us. #JHMChat https://t.co/13lY0YpKy6 |
| Vinny Arora MD MAPP @FutureDocs So...The opposite of imposter syndrome #jhmchat https://t.co/BhARc8eDGF |
| Vinny Arora MD MAPP @FutureDocs RT @RJmdphilly: @vineet_chopra feeling a lot of #FOMO about working at the VA right now. Trying to remember the forlorn feeling of 2am uncrustables so I don't get ahead of myself. #JHMChat |
| Patient Safety Enhancement Program (UMVA) @PSEPUMVA RT @sanjaysaint: T2 The other aspect of being at the #VA is the clear sense of a shared mission for the employees: T2 The other aspect of being at the #VA is the clear sense of a shared mission for the employees: nurses, docs, food services, etc. People don't generally work at the VA for the money or prestige. It is the sense of giving back to those who risked their lives for us. #JHMChat https://t.co/13lY0YpKy6 |
| Vinny Arora MD MAPP @FutureDocs RT @JHospMedicine: T3 #JHMChat Over a quarter of hospitalists reported having been sued at least once for medical malpractice. For those in practice for at least 20 years, more than half (55%) had been sued at least once. How can we reduce this risk? |
| Tony Breu @tony_breu I wonder if anyone in the chat has any experience with apology and resolution programs. These seem like a good model. #JHMChat https://t.co/RPEjeA9iN8 |
| Rebecca Jaffe, MD @RJmdphilly RT @FutureDocs: So...The opposite of imposter syndrome #jhmchat https://t.co/BhARc8eDGF |
| Chris Petrilli, MD, SFHM @PetrilliMD RT @sanjaysaint: T2 The other aspect of being at the #VA is the clear sense of a shared mission for the employees: T2 The other aspect of being at the #VA is the clear sense of a shared mission for the employees: nurses, docs, food services, etc. People don't generally work at the VA for the money or prestige. It is the sense of giving back to those who risked their lives for us. #JHMChat https://t.co/13lY0YpKy6 |
| Allen Kachalia @allenkachalia A3: Well, one great way to reduce risk is to improve quality and safety of care. #jhmchat |
| Tony Breu @tony_breu RT @sanjaysaint: T2 The other aspect of being at the #VA is the clear sense of a shared mission for the employees: T2 The other aspect of being at the #VA is the clear sense of a shared mission for the employees: nurses, docs, food services, etc. People don't generally work at the VA for the money or prestige. It is the sense of giving back to those who risked their lives for us. #JHMChat https://t.co/13lY0YpKy6 |
| Vinny Arora MD MAPP @FutureDocs RT @allenkachalia: A3: A3: Well, one great way to reduce risk is to improve quality and safety of care. #jhmchat |
| Rebecca Jaffe, MD @RJmdphilly @FutureDocs @PamelaJohnsonMD not sure I agree completely - GI recs for out patient c scopes, Cards attending saying "if healthy enough for a stress it can be outpatient." #GoodApples in all fields #JHMChat |
| Journal of Hospital Medicine @JHospMedicine RT @ben_geisler: |
| Journal of Hospital Medicine @JHospMedicine RT @allenkachalia: A3: A3: Well, one great way to reduce risk is to improve quality and safety of care. #jhmchat |
| Allen Kachalia @allenkachalia A3: And when harm does occur, we're increasingly seeing how open and honest communication is the way to go #jhmchat |
| Journal of Hospital Medicine @JHospMedicine Any of our authors comment ? #jhmchat @allenkachalia @KFowler_PSEP @vineet_chopra @sanjaysaint https://t.co/2XMpgCC8YI |
| Patient Safety Enhancement Program (UMVA) @PSEPUMVA RT @allenkachalia: A3: A3: And when harm does occur, we're increasingly seeing how open and honest communication is the way to go #jhmchat |
| Journal of Hospital Medicine @JHospMedicine RT @sanjaysaint: T2 The other aspect of being at the #VA is the clear sense of a shared mission for the employees: T2 The other aspect of being at the #VA is the clear sense of a shared mission for the employees: nurses, docs, food services, etc. People don't generally work at the VA for the money or prestige. It is the sense of giving back to those who risked their lives for us. #JHMChat https://t.co/13lY0YpKy6 |
| Rebecca Jaffe, MD @RJmdphilly @WolfsonD Great David Asch paper on this #JHMChat. |
| Tony Breu @tony_breu And it "works", right? #JHMChat https://t.co/cuoCGpVc9q |
| Daniel Wolfson @WolfsonD RT @sanjaysaint: T2 The other aspect of being at the #VA is the clear sense of a shared mission for the employees: T2 The other aspect of being at the #VA is the clear sense of a shared mission for the employees: nurses, docs, food services, etc. People don't generally work at the VA for the money or prestige. It is the sense of giving back to those who risked their lives for us. #JHMChat https://t.co/13lY0YpKy6 |
| Journal of Hospital Medicine @JHospMedicine RT @allenkachalia: A3: A3: And when harm does occur, we're increasingly seeing how open and honest communication is the way to go #jhmchat |
| Tony Breu @tony_breu @ben_geisler Not where I worked. #JHMChat |
 | Mary Kelsey Drago, PhD @MkgdAZ RT @JHospMedicine: T1 The authors discovered that hospitalists perceived 37.5% of healthcare costs are due to defensive medicine, which is much higher than previous estimates ~2% of all healthcare spending. What is driving the difference btwn perception & reality? #JHMChat |
| Journal of Hospital Medicine @JHospMedicine Thx for joining #JHMChat @karynbaum https://t.co/vVGakmBlYq |
| Lonika Sood @sood_lonika T3: support a thorough mentoring process... have risk/legal talk to staff on several occasions to advise processes #jhmchat |
| Rebecca Jaffe, MD @RJmdphilly RT @JHospMedicine: T3 #JHMChat Over a quarter of hospitalists reported having been sued at least once for medical malpractice. For those in practice for at least 20 years, more than half (55%) had been sued at least once. How can we reduce this risk? |
| Vineet Chopra @vineet_chopra @tony_breu Indeed. @allenkachalia was involved with the original work and can also speak to this. But overall, reduced malpractice allegations and claims over time. Also empowered docs to focus on doing the right thing. And saying sorry when it didn’t go as planned. #JHMChat |
| Michael Sinha @DrSinhaEsq A3: To err is human, but communication is KEY. Patients often sue to get information about what happened! Go to the bedside and be honest. If you are still compiling the facts, investigate and REPORT BACK to the patient or the family! #JHMChat https://t.co/5orybjaqP2 |
| Michael Sinha @DrSinhaEsq RT @JHospMedicine: T3 #JHMChat Over a quarter of hospitalists reported having been sued at least once for medical malpractice. For those in practice for at least 20 years, more than half (55%) had been sued at least once. How can we reduce this risk? |
| Vinny Arora MD MAPP @FutureDocs @sood_lonika So meta i love it #jhmchat |
| Lonika Sood @sood_lonika @RJmdphilly @FutureDocs @PamelaJohnsonMD absolutely... these are so much more appreciated .. #JHMChat |
| Sanjay Saint @sanjaysaint 1/ Invest in systems approaches to reduce error 2/ Lower the power distance (hierarchy) so people feel comfortable speaking up when things are wrong 3/ Explain things well to pts & families (and do so while being at eye level) 4/ Listen to what the nurses are saying #JHMChat https://t.co/mLJLLQz5zh |
| Daniel Wolfson @WolfsonD #JHMChat The antidote of defensive medicine is partnerships with patients, active listening, defined options & trusting relationships- I am always here for you. https://t.co/uH7HY4hwLl |
| Journal of Hospital Medicine @JHospMedicine RT @sanjaysaint: 1/ Invest in systems approaches to reduce error 2/ Lower the power distance (hierarchy) so people feel comfortable speaking up when things are wrong 3/ Explain things well to pts & families (and do so while being at eye level) 4/ Listen to what the nurses are saying #JHMChat https://t.co/mLJLLQz5zh |
| Patient Safety Enhancement Program (UMVA) @PSEPUMVA RT @sanjaysaint: 1/ Invest in systems approaches to reduce error 2/ Lower the power distance (hierarchy) so people feel comfortable speaking up when things are wrong 3/ Explain things well to pts & families (and do so while being at eye level) 4/ Listen to what the nurses are saying #JHMChat https://t.co/mLJLLQz5zh |
| Allen Kachalia @allenkachalia @vineet_chopra @tony_breu Yes, this program worked well at Michigan from a claims perspective...Others have implemented programs like this (now called Communication and Resolution Programs). #JHMChat |
| Rebecca Jaffe, MD @RJmdphilly @ben_geisler literally never been allowed to no matter how hard I have tried. (for good reasons I swear!) #JHMChat |
| Journal of Hospital Medicine @JHospMedicine RT @WolfsonD: #JHMChat The antidote of defensive medicine is partnerships with patients, active listening, defined options & trusting relationships- I am always here for you. https://t.co/uH7HY4hwLl |
| Vineet Chopra @vineet_chopra Nice overview of some of the work done by our chief legal officer https://t.co/Fkb0Cuqz59 #JHMChat |
| Allen Kachalia @allenkachalia @DrSinhaEsq That's spot on! #JHMChat |
| Journal of Hospital Medicine @JHospMedicine RT @DrSinhaEsq: A3: A3: To err is human, but communication is KEY. Patients often sue to get information about what happened! Go to the bedside and be honest. If you are still compiling the facts, investigate and REPORT BACK to the patient or the family! #JHMChat https://t.co/5orybjaqP2 |
| Patient Safety Enhancement Program (UMVA) @PSEPUMVA RT @vineet_chopra: Nice overview of some of the work done by our chief legal officer https://t.co/Fkb0Cuqz59 #JHMChat |
| Journal of Hospital Medicine @JHospMedicine RT @vineet_chopra: @tony_breu Indeed. @allenkachalia was involved with the original work and can also speak to this. But overall, reduced malpractice allegations and claims over time. Also empowered docs to focus on doing the right thing. And saying sorry when it didn’t go as planned. #JHMChat |
| Tony Breu @tony_breu I'm going to flip these and put #4 first: Listen to what the nurses are saying! #JHMChat https://t.co/UlA3AlBXdZ |
| Journal of Hospital Medicine @JHospMedicine You def don’t need to say sorry for this one:) #JHMChat brilliance from our resident artist @gracefarris https://t.co/qU33DdxNyN |
| Patient Safety Enhancement Program (UMVA) @PSEPUMVA RT @JHospMedicine: You def don’t need to say sorry for this one:) #JHMChat brilliance from our resident artist @gracefarris https://t.co/qU33DdxNyN |
| Journal of Hospital Medicine @JHospMedicine RT @ben_geisler: |
| Rebecca Jaffe, MD @RJmdphilly @ben_geisler Sure, everything can be useless sometimes. But many things are more useless, or harmful to individuals or systems, if done at the wrong time. #JHMChat |
| Journal of Hospital Medicine @JHospMedicine RT @vineet_chopra: Nice overview of some of the work done by our chief legal officer https://t.co/Fkb0Cuqz59 #JHMChat |
| Journal of Hospital Medicine @JHospMedicine RT @allenkachalia: @vineet_chopra @tony_breu Yes, this program worked well at Michigan from a claims perspective...Others have implemented programs like this (now called Communication and Resolution Programs). #JHMChat |
| Vineet Chopra @vineet_chopra @allenkachalia @DrSinhaEsq Worth mentioning that this runs counter to almost every instinct when something goes wrong. Takes a moment of #mindfulness and #presence within a system of support to get it right. #JHMChat |
| Journal of Hospital Medicine @JHospMedicine T4 The discussion states "Reducing defensive medicine requires decreasing physician fears of liability and related reporting." How can we reduce fear among physicians? #JHMChat |
| Sanjay Saint @sanjaysaint T3 #JHMChat Liability Claims and Costs Before and After Implementation of a Medical Error Disc... | Ann Intern Med | ACP | https://t.co/Qo8IDgLrgN |
| Michael Sinha @DrSinhaEsq Bingo. #JHMChat https://t.co/eimFs3U0nG |
| Patient Safety Enhancement Program (UMVA) @PSEPUMVA RT @sanjaysaint: T3 #JHMChat Liability Claims and Costs Before and After Implementation of a Medical Error Disc... | Ann Intern Med | ACP | https://t.co/Qo8IDgLrgN |
| Vinny Arora MD MAPP @FutureDocs RT @DrSinhaEsq: Bingo. #JHMChat https://t.co/eimFs3U0nG |
| Vinny Arora MD MAPP @FutureDocs RT @JHospMedicine: T4 The discussion states "Reducing defensive medicine requires decreasing physician fears of liability and related reporting." How can we reduce fear among physicians? #JHMChat |
| Vinny Arora MD MAPP @FutureDocs RT @vineet_chopra: @allenkachalia @DrSinhaEsq Worth mentioning that this runs counter to almost every instinct when something goes wrong. Takes a moment of #mindfulness and #presence within a system of support to get it right. #JHMChat |
| Vinny Arora MD MAPP @FutureDocs RT @tony_breu: I'm going to flip these and put #4 first: I'm going to flip these and put #4 first: Listen to what the nurses are saying! #JHMChat https://t.co/UlA3AlBXdZ |
| Vinny Arora MD MAPP @FutureDocs RT @WolfsonD: #JHMChat The antidote of defensive medicine is partnerships with patients, active listening, defined options & trusting relationships- I am always here for you. https://t.co/uH7HY4hwLl |
| Allen Kachalia @allenkachalia @vineet_chopra Rick has done incredible work in not only building the program at Michigan, but also in teaching others around the world the best model! #JHMChat |
| Michael Sinha @DrSinhaEsq Communicate early and often. Be candid. #JHMChat https://t.co/HlcK75HbB3 |
| Vineet Chopra @vineet_chopra RT @allenkachalia: @vineet_chopra Rick has done incredible work in not only building the program at Michigan, but also in teaching others around the world the best model! #JHMChat |
| Society of Hospital Medicine @SocietyHospMed RT @JHospMedicine: T4 The discussion states "Reducing defensive medicine requires decreasing physician fears of liability and related reporting." How can we reduce fear among physicians? #JHMChat |
| Patient Safety Enhancement Program (UMVA) @PSEPUMVA RT @allenkachalia: @vineet_chopra Rick has done incredible work in not only building the program at Michigan, but also in teaching others around the world the best model! #JHMChat |
| Lonika Sood @sood_lonika T4:having a legal mock m&m to discuss what is actually high risk and low risk.. stories carry forward much more than fact; talk to patients and nurses and staff #jhmchat |
| Michael Sinha @DrSinhaEsq RT @vineet_chopra: @allenkachalia @DrSinhaEsq Worth mentioning that this runs counter to almost every instinct when something goes wrong. Takes a moment of #mindfulness and #presence within a system of support to get it right. #JHMChat |
| Journal of Hospital Medicine @JHospMedicine RT @DrSinhaEsq: Communicate early and often. Be candid. #JHMChat https://t.co/HlcK75HbB3 |
| Allen Kachalia @allenkachalia @vineet_chopra @DrSinhaEsq Yup--That is why we recommend hospitals set up programs to help clinicians and patients through the events. #JHMChat |
| Rebecca Jaffe, MD @RJmdphilly @JHospMedicine would follow T3 and all the excellent responses with - how can hospitalist groups work with their administrations to create these programs, or change culture towards transparency, etc? #AskingForPhiladelphia #JHMChat |
| Rebecca Jaffe, MD @RJmdphilly @sood_lonika @FutureDocs Imposter syndrome in precontemplation phase #JHMChat |
| Vinny Arora MD MAPP @FutureDocs T4 key question: whether tort reform can reduce fear defensive Medicine? #JHMChat cc @allenkachalia |
| Michael Sinha @DrSinhaEsq RT @tony_breu: I'm going to flip these and put #4 first: I'm going to flip these and put #4 first: Listen to what the nurses are saying! #JHMChat https://t.co/UlA3AlBXdZ |
| Journal of Hospital Medicine @JHospMedicine RT @RJmdphilly: @JHospMedicine would follow T3 and all the excellent responses with - how can hospitalist groups work with their administrations to create these programs, or change culture towards transparency, etc? #AskingForPhiladelphia #JHMChat |
| Journal of Hospital Medicine @JHospMedicine RT @allenkachalia: @vineet_chopra @DrSinhaEsq Yup--That is why we recommend hospitals set up programs to help clinicians and patients through the events. #JHMChat |
| Journal of Hospital Medicine @JHospMedicine RT @sood_lonika: T4:having a legal mock m&m to discuss what is actually high risk and low risk.. stories carry forward much more than fact; talk to patients and nurses and staff #jhmchat |
| Journal of Hospital Medicine @JHospMedicine RT @allenkachalia: @vineet_chopra Rick has done incredible work in not only building the program at Michigan, but also in teaching others around the world the best model! #JHMChat |
| Journal of Hospital Medicine @JHospMedicine RT @ben_geisler: |
| Journal of Hospital Medicine @JHospMedicine RT @DrSinhaEsq: Bingo. #JHMChat https://t.co/eimFs3U0nG |
| Journal of Hospital Medicine @JHospMedicine RT @sanjaysaint: T3 #JHMChat Liability Claims and Costs Before and After Implementation of a Medical Error Disc... | Ann Intern Med | ACP | https://t.co/Qo8IDgLrgN |
| Tony Breu @tony_breu There are a lot of things I fear about getting sued, but shame is at the top. Getting people to talk openly their experiences will help others cope with the possibility. #JHMChat https://t.co/tgvzFinrNF |
| Journal of Hospital Medicine @JHospMedicine RT @vineet_chopra: @allenkachalia @DrSinhaEsq Worth mentioning that this runs counter to almost every instinct when something goes wrong. Takes a moment of #mindfulness and #presence within a system of support to get it right. #JHMChat |
| Journal of Hospital Medicine @JHospMedicine RT @tony_breu: There are a lot of things I fear about getting sued, but shame is at the top. Getting people to talk openly their experiences will help others cope with the possibility. #JHMChat https://t.co/tgvzFinrNF |
 | @KarynDoc@mstdn.party @karynbaum @jbcowartmd Do you invite the other professions by any chance? #JHMChat |
| Michael Sinha @DrSinhaEsq See article by @MichelleM_Mello @allenkachalia & Dave Studdert in @nejm: https://t.co/pMNCM3N1mu #JHMChat https://t.co/V0egkj4x0F |
| Allen Kachalia @allenkachalia @FutureDocs A4: Great question, Vinny. Because it's hard to measure defensive medicine, it's hard to determine if tort reform has helped. That said, there is some data suggesting that caps can lower some types of defensive medicine. #JHMChat |
| Vinny Arora MD MAPP @FutureDocs RT @tony_breu: There are a lot of things I fear about getting sued, but shame is at the top. Getting people to talk openly their experiences will help others cope with the possibility. #JHMChat https://t.co/tgvzFinrNF |
| Vinny Arora MD MAPP @FutureDocs RT @allenkachalia: @FutureDocs A4: @FutureDocs A4: Great question, Vinny. Because it's hard to measure defensive medicine, it's hard to determine if tort reform has helped. That said, there is some data suggesting that caps can lower some types of defensive medicine. #JHMChat |
| Sanjay Saint @sanjaysaint Error is inevitable in a field premised on the art of balancing probabilities. #JHMChat |
| Journal of Hospital Medicine @JHospMedicine RT @allenkachalia: @FutureDocs A4: @FutureDocs A4: Great question, Vinny. Because it's hard to measure defensive medicine, it's hard to determine if tort reform has helped. That said, there is some data suggesting that caps can lower some types of defensive medicine. #JHMChat |
| Journal of Hospital Medicine @JHospMedicine RT @DrSinhaEsq: See article by @MichelleM_Mello @allenkachalia & Dave Studdert in @nejm: See article by @MichelleM_Mello @allenkachalia & Dave Studdert in @nejm: https://t.co/pMNCM3N1mu #JHMChat https://t.co/V0egkj4x0F |
| Allen Kachalia @allenkachalia @jbcowartmd Yup--The challenge is that our legal system does not always approach errors they way we do in safety today. #JHMChat |
| Michael Sinha @DrSinhaEsq RT @sanjaysaint: Error is inevitable in a field premised on the art of balancing probabilities. #JHMChat |
| Charlie M. Wray, DO, MS @WrayCharles RT @sanjaysaint: Error is inevitable in a field premised on the art of balancing probabilities. #JHMChat |
| Journal of Hospital Medicine @JHospMedicine RT @sanjaysaint: Error is inevitable in a field premised on the art of balancing probabilities. #JHMChat |
| Journal of Hospital Medicine @JHospMedicine RT @allenkachalia: @jbcowartmd Yup--The challenge is that our legal system does not always approach errors they way we do in safety today. #JHMChat |
| Vineet Chopra @vineet_chopra RT @tony_breu: There are a lot of things I fear about getting sued, but shame is at the top. Getting people to talk openly their experiences will help others cope with the possibility. #JHMChat https://t.co/tgvzFinrNF |
| Rebecca Jaffe, MD @RJmdphilly @FutureDocs @allenkachalia that was where my mind went too #JHMChat |
| Patient Safety Enhancement Program (UMVA) @PSEPUMVA RT @sanjaysaint: Error is inevitable in a field premised on the art of balancing probabilities. #JHMChat |
 | Guilherme Barcellos @brhospitalist RT @RJmdphilly: Definition of "defensive"? Defensive in legal context (preventing litigation) or defensive in a clinical context (fear of being wrong, missing zebra, missing badness). #JHMChat https://t.co/8utLidNhJ3 |
| Guilherme Barcellos @brhospitalist RT @WrayCharles: Looking to join #JHMChat this Monday 2/26 at 9PM EST? Here's my quick take on the paper: Looking to join #JHMChat this Monday 2/26 at 9PM EST? Here's my quick take on the paper: https://t.co/YXYawQNlRG via @SHMLive. Join @FutureDocs, @sanjaysaint, @vineet_chopra, & @allenkachalia as they discuss the role of Defensive Medicine in Resource Utilization in Hospital Med |
 | Pranjal Singh @pranjsingh RT @sanjaysaint: Error is inevitable in a field premised on the art of balancing probabilities. #JHMChat |
| Vineet Chopra @vineet_chopra RT @allenkachalia: @FutureDocs A4: @FutureDocs A4: Great question, Vinny. Because it's hard to measure defensive medicine, it's hard to determine if tort reform has helped. That said, there is some data suggesting that caps can lower some types of defensive medicine. #JHMChat |
| Vineet Chopra @vineet_chopra RT @sanjaysaint: Error is inevitable in a field premised on the art of balancing probabilities. #JHMChat |
| Society of Hospital Medicine @SocietyHospMed Special thank you tonight's guest experts and our partners @ABIMFoundation & @CostsofCare! #JHMChat |
| Journal of Hospital Medicine @JHospMedicine CT #JHMChat Please add closing thoughts on Perception Of Resources Spent On Defensive Medicine And History Of Being Sued Among Hospitalists https://t.co/zsJRrX3HYe |
| Journal of Hospital Medicine @JHospMedicine CT #JHMChat Please add closing thoughts on Perception Of Resources Spent On Defensive Medicine And History Of... https://t.co/Zzp2xjEo5X |
| Rebecca Jaffe, MD @RJmdphilly @tony_breu Hard to do! Whenever you are involved in a suit the first thing they say is Don't Talk to Anyone! And then you have to list all the people you ever talked to. that's pretty hard to circumvent #JHMChat |
| Charlie M. Wray, DO, MS @WrayCharles RT @JHospMedicine: You def don’t need to say sorry for this one:) #JHMChat brilliance from our resident artist @gracefarris https://t.co/qU33DdxNyN |
| Journal of Hospital Medicine @JHospMedicine RT @SHMLive: Special thank you tonight's guest experts and our partners @ABIMFoundation & @CostsofCare! #JHMChat |
 | Jack Iwashyna🫁 @iwashyna RT @sanjaysaint: Error is inevitable in a field premised on the art of balancing probabilities. #JHMChat |
| Vinny Arora MD MAPP @FutureDocs RT @RJmdphilly: @tony_breu Hard to do! Whenever you are involved in a suit the first thing they say is Don't Talk to Anyone! And then you have to list all the people you ever talked to. that's pretty hard to circumvent #JHMChat |
| Vineet Chopra @vineet_chopra Instructive to see what happens in the airline industry when an error occurs. Thorough review by a non biased party. Determination of System vs Human origin. And a fix to make sure it never happens again. I tire of #avaiationanalogies but this.... #JHMChat |
| Vinny Arora MD MAPP @FutureDocs RT @JHospMedicine: CT #JHMChat Please add closing thoughts on Perception Of Resources Spent On Defensive Medicine And History Of Being Sued Among Hospitalists https://t.co/zsJRrX3HYe |
| Vinny Arora MD MAPP @FutureDocs RT @SHMLive: Special thank you tonight's guest experts and our partners @ABIMFoundation & @CostsofCare! #JHMChat |
| Vinny Arora MD MAPP @FutureDocs RT @allenkachalia: @jbcowartmd Yup--The challenge is that our legal system does not always approach errors they way we do in safety today. #JHMChat |
| Vinny Arora MD MAPP @FutureDocs RT @sanjaysaint: Error is inevitable in a field premised on the art of balancing probabilities. #JHMChat |
| Tony Breu @tony_breu @RJmdphilly But, just acknowledging to others (including junior hospitalists) that a great doctor might go through - and get out the other side - is important. Don't need specifics of the case. #JHMChat |
| Vineet Chopra @vineet_chopra Not so at #Michigan. One of the first things we do here is talk to family. Very hard to do so (esp if you messed up). But powerful and cathartic to say “I’m Sorry.” #JHMChat https://t.co/cVig5yejlF |
| Vinny Arora MD MAPP @FutureDocs RT @vineet_chopra: Instructive to see what happens in the airline industry when an error occurs. Thorough review by a non biased party. Determination of System vs Human origin. And a fix to make sure it never happens again. I tire of #avaiationanalogies but this.... #JHMChat |
| Sanjay Saint @sanjaysaint CT If sued, speak to your clinical mentor. S/he has very likely been there before. #JHMChat https://t.co/Dqm7blADf2 |
| Journal of Hospital Medicine @JHospMedicine RT @sanjaysaint: CT If sued, speak to your clinical mentor. S/he has very likely been there before. #JHMChat https://t.co/Dqm7blADf2 |
| Lonika Sood @sood_lonika also need to be responsive to burn out and perception of legal action #jhmchat |
| Rebecca Jaffe, MD @RJmdphilly RT @sanjaysaint: Error is inevitable in a field premised on the art of balancing probabilities. #JHMChat |
| Patient Safety Enhancement Program (UMVA) @PSEPUMVA RT @vineet_chopra: Not so at #Michigan. One of the first things we do here is talk to family. Very hard to do so (esp if you messed up). But powerful and cathartic to say “I’m Sorry.” #JHMChat https://t.co/cVig5yejlF |
| Journal of Hospital Medicine @JHospMedicine RT @vineet_chopra: Not so at #Michigan. One of the first things we do here is talk to family. Very hard to do so (esp if you messed up). But powerful and cathartic to say “I’m Sorry.” #JHMChat https://t.co/cVig5yejlF |
| Vineet Chopra @vineet_chopra One of my favorite teachers used to say “It’s not if, but when you get named...” #JHMChat https://t.co/jDxYE1mHec |
| Patient Safety Enhancement Program (UMVA) @PSEPUMVA RT @sanjaysaint: CT If sued, speak to your clinical mentor. S/he has very likely been there before. #JHMChat https://t.co/Dqm7blADf2 |
| Journal of Hospital Medicine @JHospMedicine RT @tony_breu: @RJmdphilly But, just acknowledging to others (including junior hospitalists) that a great doctor might go through - and get out the other side - is important. Don't need specifics of the case. #JHMChat |
| Journal of Hospital Medicine @JHospMedicine RT @vineet_chopra: Instructive to see what happens in the airline industry when an error occurs. Thorough review by a non biased party. Determination of System vs Human origin. And a fix to make sure it never happens again. I tire of #avaiationanalogies but this.... #JHMChat |
| Michael Sinha @DrSinhaEsq Who is "they" in this scenario? The lawyers? #JHMChat https://t.co/g5urP70gQ1 |
| Lonika Sood @sood_lonika thank you for a great chat!! #jhmchat |
| Journal of Hospital Medicine @JHospMedicine We didn’t even have time to do burnout second victim discussion. Alas #jhmchat is sometimes too short! https://t.co/RFBvPvoRYb |
| Journal of Hospital Medicine @JHospMedicine RT @sood_lonika: thank you for a great chat!! #jhmchat |
| Michael Sinha @DrSinhaEsq RT @vineet_chopra: Not so at #Michigan. One of the first things we do here is talk to family. Very hard to do so (esp if you messed up). But powerful and cathartic to say “I’m Sorry.” #JHMChat https://t.co/cVig5yejlF |
| Vineet Chopra @vineet_chopra CT If you’re named in a claim, remember you’re not alone. You’re also no worse a physician. Get help / many others have been there before you. #JHMChat |
| Tony Breu @tony_breu RT @vineet_chopra: CT If you’re named in a claim, remember you’re not alone. You’re also no worse a physician. Get help / many others have been there before you. #JHMChat |
| Patient Safety Enhancement Program (UMVA) @PSEPUMVA RT @vineet_chopra: CT If you’re named in a claim, remember you’re not alone. You’re also no worse a physician. Get help / many others have been there before you. #JHMChat |
| Journal of Hospital Medicine @JHospMedicine Thank you to our partners @SHMLive @CostsofCare and @ABIMFoundation for supporting #JHMChat! |
| Journal of Hospital Medicine @JHospMedicine Dont forget to claim your #CME here after #JHMChat https://t.co/ZuELpIwwXO |
| Journal of Hospital Medicine @JHospMedicine Special thanks to our authors for their expertise on perceptions of resource use related to defensive medicine during #JHMChat @sanjaysaint @allenkachalia @KFowler_PSEP @vineet_chopra |
| Journal of Hospital Medicine @JHospMedicine Dont forget to claim your #CME here after #JHMChat https://t.co/ZuELpIwwXO https://t.co/TAf1dY0uTe |
| Patient Safety Enhancement Program (UMVA) @PSEPUMVA RT @JHospMedicine: Special thanks to our authors for their expertise on perceptions of resource use related to defensive medicine during #JHMChat @sanjaysaint @allenkachalia @KFowler_PSEP @vineet_chopra |
| Daniel Wolfson @WolfsonD #JHMChat Suspect self-reporting of defensive medicine by physicians- term is not as useful as what underlies the term. Better communication, better trusting relationships, better partnerships, tolerance of uncertainty, https://t.co/9W4mP0qNCW |
| Journal of Hospital Medicine @JHospMedicine @gracefarris @FutureDocs @WrayCharles @CostsofCare Thx for all the art and your thoughts #JHMChat |
| Vineet Chopra @vineet_chopra @JHospMedicine That’ll need a #JHMChat all to itself... |
| Chris Petrilli, MD, SFHM @PetrilliMD RT @sanjaysaint: Error is inevitable in a field premised on the art of balancing probabilities. #JHMChat |
| Journal of Hospital Medicine @JHospMedicine RT @vineet_chopra: @JHospMedicine That’ll need a #JHMChat all to itself... |
| Chris Petrilli, MD, SFHM @PetrilliMD RT @sanjaysaint: 1/ Invest in systems approaches to reduce error 2/ Lower the power distance (hierarchy) so people feel comfortable speaking up when things are wrong 3/ Explain things well to pts & families (and do so while being at eye level) 4/ Listen to what the nurses are saying #JHMChat https://t.co/mLJLLQz5zh |
| Michael Sinha @DrSinhaEsq @gracefarris @FutureDocs @WrayCharles @CostsofCare @JHospMedicine Thanks for the great illustrations, @gracefarris! #JHMChat |
| Patient Safety Enhancement Program (UMVA) @PSEPUMVA RT @DrSinhaEsq: @gracefarris @FutureDocs @WrayCharles @CostsofCare @JHospMedicine Thanks for the great illustrations, @gracefarris! #JHMChat |
| Vinny Arora MD MAPP @FutureDocs RT @JHospMedicine: Special thanks to our authors for their expertise on perceptions of resource use related to defensive medicine during #JHMChat @sanjaysaint @allenkachalia @KFowler_PSEP @vineet_chopra |
| Vinny Arora MD MAPP @FutureDocs RT @JHospMedicine: Dont forget to claim your #CME here after #JHMChat https://t.co/ZuELpIwwXO |
| Patient Safety Enhancement Program (UMVA) @PSEPUMVA RT @JHospMedicine: Dont forget to claim your #CME here after #JHMChat https://t.co/ZuELpIwwXO |
| Vinny Arora MD MAPP @FutureDocs I gotta say I do feel better right after this #JHMChat thx everyone! |
| Vinny Arora MD MAPP @FutureDocs RT @ben_geisler: |
| Patient Safety Enhancement Program (UMVA) @PSEPUMVA Great #JHMChat tonight! Be sure to follow that hashtag to see the details. Come visit us, too, for many your source for #ptsafety papers! https://t.co/CKuwyVmv8h |
| Journal of Hospital Medicine @JHospMedicine RT @ben_geisler: |
| Journal of Hospital Medicine @JHospMedicine RT @JHospMedicine: Special thanks to our authors for their expertise on perceptions of resource use related to defensive medicine during #JHMChat @sanjaysaint @allenkachalia @KFowler_PSEP @vineet_chopra |
| Journal of Hospital Medicine @JHospMedicine RT @JHospMedicine: Thank you to our partners @SHMLive @CostsofCare and @ABIMFoundation for supporting #JHMChat! |
| Journal of Hospital Medicine @JHospMedicine RT @JHospMedicine: Dont forget to claim your #CME here after #JHMChat https://t.co/ZuELpIwwXO |
| Rebecca Jaffe, MD @RJmdphilly Late CT 1) there is a difference btwn defensive (law suit) & defensive (clinical reasoning) 2) we should all be so lucky as to work in VA, 3) constructive relationship w consults might dec overuse, 4) preventing litigation requires teamwork w admin/risk & policy advocacy #JHMChat |
| Vinny Arora MD MAPP @FutureDocs RT @RJmdphilly: Late CT 1) there is a difference btwn defensive (law suit) & defensive (clinical reasoning) 2) we should all be so lucky as to work in VA, 3) constructive relationship w consults might dec overuse, 4) preventing litigation requires teamwork w admin/risk & policy advocacy #JHMChat |
| Patient Safety Enhancement Program (UMVA) @PSEPUMVA Great #JHMChat tonight! Be sure to follow that hashtag to see the details. Let us be your source for #ptsafety papers! https://t.co/CKuwyVmv8h |
| Vineet Chopra @vineet_chopra RT @PSEPUMVA: Great #JHMChat tonight! Be sure to follow that hashtag to see the details. Let us be your source for #ptsafety papers! https://t.co/CKuwyVmv8h |
| Michael Sinha @DrSinhaEsq RT @allenkachalia: @vineet_chopra @DrSinhaEsq Yup--That is why we recommend hospitals set up programs to help clinicians and patients through the events. #JHMChat |
 | Gretchen Diemer @gretchendiemer RT @sanjaysaint: Error is inevitable in a field premised on the art of balancing probabilities. #JHMChat |
#JHMChat content from Twitter.