#JHMChat Transcript

Healthcare social media transcript of the #JHMChat hashtag.
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J Hospital Medicine @JHospMedicine
Thx for being here @KFowler_PSEP! #jhmchat starts NOW! https://t.co/haaKJiugro
J Hospital Medicine @JHospMedicine
RT @vineet_chopra: Vineet Chopra clocking in #JHMChat
Society of Hospital Medicine @SHMLive
#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
J 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
J Hospital Medicine @JHospMedicine
Welcome to #JHMChat, I am your moderator @FutureDocs please introduce yourself. T1 up in a moment...
J Hospital Medicine @JHospMedicine
Tonight's #visualabstract for #JHMChat brought to you by @WrayCharles https://t.co/NjBGiNlt4L
J 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
J 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 m…
J Hospital Medicine @JHospMedicine
RT @SHMLive: #JHMChat begins NOW! Join the conversation on lawsuits, defensive #medicine and resources utilization, then claim #CME: https:…
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 m…
Vinny Arora MD MAPP @FutureDocs
RT @SHMLive: #JHMChat begins NOW! Join the conversation on lawsuits, defensive #medicine and resources utilization, then claim #CME: https:…
Rebecca Jaffe @RJmdphilly
@tony_breu that is very precise to the hour calculation... #JHMChat
J 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
J Hospital Medicine @JHospMedicine
Thank you for doing another #JHMChat @sanjaysaint ! https://t.co/9iJ6eXqZZt
Grace Farris MD @gracefarris
Grace Farris in NYC #JHMChat https://t.co/wcMuFmIfSd
Grace Farris MD @gracefarris
RT @JHospMedicine: Thank you for doing another #JHMChat @sanjaysaint ! https://t.co/9iJ6eXqZZt
J 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
J Hospital Medicine @JHospMedicine
So lucky to have @gracefarris in the #JHMChat room again! https://t.co/T2vxkDNpZJ
Rebecca Jaffe @RJmdphilly
I can't match @tony_breu 's entrance. Rebecca Jaffe from Philly. #nomorebabies #JHMChat
Allen Kachalia @allenkachalia
Happy to join right now! #jhmchat
J Hospital Medicine @JHospMedicine
We still welcome you as a loyal participant #JHMChat !@RJmdphilly https://t.co/bkTOdedjWF
Lonika Sood, MD, MHPE @sood_lonika
lonika sood from green bay, wi #jhmchat
J 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
Grace Farris MD @gracefarris
@RJmdphilly @tony_breu 😂 #JHMChat
Rebecca Jaffe @RJmdphilly
RT @JHospMedicine: T1 The authors discovered that hospitalists perceived 37.5% of healthcare costs are due to defensive medicine, which is…
Lonika Sood, MD, MHPE @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…
Vinny Arora MD MAPP @FutureDocs
RT @sood_lonika: @JHospMedicine A1: misperceptions of what providers are sued for, bad experiences that are heard from colleagues, stories.…
Grace Farris MD @gracefarris
Agree #JHMChat https://t.co/alm5tlsiLI
J Hospital Medicine @JHospMedicine
RT @sood_lonika: @JHospMedicine A1: misperceptions of what providers are sued for, bad experiences that are heard from colleagues, stories.…
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
J 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/…
Vineet Chopra @vineet_chopra
A1 Also fear of being wrong. “What if I miss that dx? What if I get sued?” #jhmchat
Grace Farris MD @gracefarris
Also thinking addl testing gives more answers #JHMChat https://t.co/wE53KtDEm5
Lonika Sood, MD, MHPE @sood_lonika
T1: discomfort with wait and watch; shorter LOS; metrics #jhmchat
J Hospital Medicine @JHospMedicine
@sood_lonika Welcome to #JHMChat!
Society of Hospital Medicine @SHMLive
T1 is live! Join in for tonight's #JHMChat https://t.co/zb8sTtyVcY
Benjamin P. Geisler @ben_geisler
Ben Geisler from Boston #jhmchat
J 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…
J 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 @SHMLive
Don't forget to claim #CME after tonight's #JHMChat: https://t.co/1tAKL3PWln
Benjamin P. Geisler @ben_geisler
RT @gracefarris: Grace Farris in NYC #JHMChat https://t.co/wcMuFmIfSd
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
J 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: https://t.co/1tAKL3PWln
J Hospital Medicine @JHospMedicine
RT @SHMLive: Don't forget to claim #CME after tonight's #JHMChat: https://t.co/1tAKL3PWln
Charlie M. Wray @WrayCharles
Checking in for tonight’s #jhmchat (while I attempt to corral and feed 2 toddlers). I’m definitely practicing defensive parenting tonight...
J Hospital Medicine @JHospMedicine
@ben_geisler Great to have you at #jhmchat
Rebecca Jaffe @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 @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 opposi…
J Hospital Medicine @JHospMedicine
@tony_breu I like it - super powers on #JHMChat
Nonie S. Arora @nonie_arora
RT @JHospMedicine: T1 The authors discovered that hospitalists perceived 37.5% of healthcare costs are due to defensive medicine, which is…
J 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 opposi…
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
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
J Hospital Medicine @JHospMedicine
RT @RJmdphilly: Definition of "defensive"? Defensive in legal context (preventing litigation) or defensive in a clinical context (fear of b…
J 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…
mithil @drmithil1
RT @RJmdphilly: Definition of "defensive"? Defensive in legal context (preventing litigation) or defensive in a clinical context (fear of b…
J Hospital Medicine @JHospMedicine
RT @tony_breu: @RJmdphilly Study uses: "when doctors order tests, procedures, or visits, or avoid certain high-risk patients or procedures,…
Lonika Sood, MD, MHPE @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…
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…
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…
Rebecca Jaffe @RJmdphilly
RT @sanjaysaint: T1 Likely this is - in part - overestimation by the physicians but it also reflects they feel the medical care provided is…
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
J 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. A…
Benjamin P. Geisler @ben_geisler
A1: training determines high cost/low value vs low/cost/high value behavior, at least in the first decade. being risk-averse might play a role/anchoring? #JHMChat
Lonika Sood, MD, MHPE @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. A…
J 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. A…
Rebecca Jaffe @RJmdphilly
@tony_breu oops forgot to tag #JHMChat
Grace Farris MD @gracefarris
This. #JHMChat https://t.co/dxjHCU6Yq7
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 !
Grace Farris MD @gracefarris
What! #JHMChat 🙏 https://t.co/v8ft0jyj6p
Benjamin P. Geisler @ben_geisler
@tony_breu consults is an important point: who else gets large laundry list of tests from newly minted subspecialty fellows? #JHMChat
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, MD, MHPE @sood_lonika
@tony_breu @RJmdphilly or offence :( #JHMChat
Grace Farris MD @gracefarris
Yes #JHMChat https://t.co/cRnQzZf0yv
J 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…
J Hospital Medicine @JHospMedicine
RT @sood_lonika: @tony_breu @RJmdphilly extra consults=extra tests=extra procedures.... #JHMChat
J 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
Grace Farris MD @gracefarris
Thanks, PESIT #JHMChat https://t.co/giBU4kyrRC
Chris Petrilli @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
J Hospital Medicine @JHospMedicine
T2 up in a moment #JHMchat
Lonika Sood, MD, MHPE @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…
Rebecca Jaffe @RJmdphilly
RT @tony_breu: @ben_geisler And I often feel uncomfortable not adhering to recommendations. This is often where defense comes in. "Dr. Br…
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. Br…
Grace Farris MD @gracefarris
A1. Hard to explain this concept #JHMChat https://t.co/eof6oPTQrd
Lonika Sood, MD, MHPE @sood_lonika
@tony_breu @ben_geisler because they came in with a GI bleed!!! and have had that headache for 5 months!! 😬 #JHMChat
Benjamin P. Geisler @ben_geisler
except they might not be a specialist yet.. #JHMChat https://t.co/ODRIfYjPI6
J 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
Grace Farris MD @gracefarris
RT @tony_breu: @ben_geisler And I often feel uncomfortable not adhering to recommendations. This is often where defense comes in. "Dr. Br…
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 @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 reso…
Grace Farris MD @gracefarris
@tony_breu @ben_geisler Neuro asking for folate and ammonia levels 🙄 #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
Rebecca Jaffe @RJmdphilly
@gracefarris tell that to your LOS #JHMChat
Lonika Sood, MD, MHPE @sood_lonika
@gracefarris cost for 24 hours hospitalisation >>> that additional test to rule out zebra? #JHMChat
Benjamin P. Geisler @ben_geisler
#JHMChat: is "shotgun testing" always less costly compared to sequential testing though? depending on the case, the length of stay might be shorter.
Andrew Admon @ajadmon
RT @PetrilliMD: T1 - @Pahwa @HiValueCarolina i think defensive isn’t always “inappropriate”. Wells score can be 1.5 or 4.5 depending on “j…
Tony Breu @tony_breu
@gracefarris @ben_geisler Paging @ebtapper #JHMChat
Charlie M. Wray @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…
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
Grace Farris MD @gracefarris
They don’t involve an atomizer #JHMChat https://t.co/gApaIlXF5E
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 reso…
Rebecca Jaffe @RJmdphilly
RT @JHospMedicine: T2 Being a VA doctor, more years in practice AND being a non-Hispanic white male were associated lower estimates of reso…
Vinny Arora MD MAPP @FutureDocs
RT @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…
Michael Sinha MD, JD, MPH @DrSinhaEsq
RT @JHospMedicine: Tonight's #visualabstract for #JHMChat brought to you by @WrayCharles https://t.co/NjBGiNlt4L
Grace Farris MD @gracefarris
😹 #JHMChat https://t.co/PH1X4iEcx5
J Hospital Medicine @JHospMedicine
RT @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…
Rebecca Jaffe @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
J Hospital Medicine @JHospMedicine
RT @sood_lonika: @gracefarris cost for 24 hours hospitalisation >>> that additional test to rule out zebra? #JHMChat
Michael Sinha MD, JD, MPH @DrSinhaEsq
RT @gracefarris: Grace Farris in NYC #JHMChat https://t.co/wcMuFmIfSd
Benjamin P. Geisler @ben_geisler
z-pack for viral URI #JHMChat https://t.co/5AyeVjgriM
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 ni…
Society of Hospital Medicine @SHMLive
RT @JHospMedicine: T2 Being a VA doctor, more years in practice AND being a non-Hispanic white male were associated lower estimates of reso…
Lonika Sood, MD, MHPE @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 @RJmdphilly
@sanjaysaint or a rec to check a UA and replete K and magically everything will get better #delirium #JHMChat
J Hospital Medicine @JHospMedicine
Brilliant #JHMChat @costsofcare @ABIMFoundation @WolfsonD https://t.co/zGL5N3iJIS
J Hospital Medicine @JHospMedicine
RT @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…
Vineet Chopra @vineet_chopra
RT @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…
J 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 ni…
Vinny Arora MD MAPP @FutureDocs
RT @JHospMedicine: Brilliant #JHMChat @costsofcare @ABIMFoundation @WolfsonD https://t.co/zGL5N3iJIS
Michael Sinha MD, JD, MPH @DrSinhaEsq
RT @gracefarris: A1. Hard to explain this concept #JHMChat https://t.co/eof6oPTQrd
Grace Farris MD @gracefarris
Sigh. #JHMChat https://t.co/7NShJLO9U4
Patient Safety Enhancement Program (UMVA) @PSEPUMVA
RT @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…
Rebecca Jaffe @RJmdphilly
RT @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…
Karen Fowler @kfowler_psep
@JHospMedicine T2: Part of the VA piece is the population. Veterans are very loyal. #JHMChat
Benjamin P. Geisler @ben_geisler
A2: VA most def. For the other result: no Bonferroni correction??? #JHMChat https://t.co/SuWBCJbkpj
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 @TChanMD
RT @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…
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
Grace Farris MD @gracefarris
Not sure can someone mansplain this? Maybe there could be a #manel on it? #JHMChat https://t.co/utiPovtvME
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, MD, MHPE @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…
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 @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/rh2…
Daniel Wolfson @WolfsonD
#JHMChat https://t.co/7XNmeVYv0h
J 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
J Hospital Medicine @JHospMedicine
RT @WolfsonD: #JHMChat https://t.co/7XNmeVYv0h
J Hospital Medicine @JHospMedicine
RT @sanjaysaint: T2 VA affiliation may reduce perceived risk because VA environments tend to be less litigious. A patient population that i…
J 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, l…
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 i…
Rebecca Jaffe @RJmdphilly
@FutureDocs now that's just irony #JHMChat
Michael Sinha MD, JD, MPH @DrSinhaEsq
RT @gracefarris: Not sure can someone mansplain this? Maybe there could be a #manel on it? #JHMChat https://t.co/utiPovtvME
Grace Farris MD @gracefarris
RT @WolfsonD: #JHMChat https://t.co/7XNmeVYv0h
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/rh2…
Chris Petrilli @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
J 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…
Lonika Sood, MD, MHPE @sood_lonika
@JHospMedicine yet we seem to feel more strongly about cost of care than specialists (have not heard other specialties discuss HVC) #JHMChat
J Hospital Medicine @JHospMedicine
RT @KFowler_PSEP: @JHospMedicine T2: Part of the VA piece is the population. Veterans are very loyal. #JHMChat
Rebecca Jaffe @RJmdphilly
@tony_breu though is that a cumulative rate/ Risk per year likely the same? #JHMChat
Rebecca Jaffe @RJmdphilly
RT @gracefarris: Not sure can someone mansplain this? Maybe there could be a #manel on it? #JHMChat https://t.co/utiPovtvME
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…
Ranjeet Sinha @sinhachild
RT @JHospMedicine: Brilliant #JHMChat @costsofcare @ABIMFoundation @WolfsonD https://t.co/zGL5N3iJIS
Grace Farris MD @gracefarris
Yes. Also a lot of pressure from hosp staff (CM, admin) to follow specialist recs, esp if you are a youngish woman in medicine #JHMChat https://t.co/yOJGDLSiGt
Faysal 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…
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…
Rebecca Jaffe @RJmdphilly
RT @WolfsonD: #JHMChat https://t.co/7XNmeVYv0h
Vinny Arora MD MAPP @FutureDocs
RT @gracefarris: Yes. Also a lot of pressure from hosp staff (CM, admin) to follow specialist recs, esp if you are a youngish woman in medi…
Michael Sinha MD, JD, MPH @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 al…
Vinny Arora MD MAPP @FutureDocs
RT @PetrilliMD: T2: VA docs may feel less “waste” because of essential single payer system for large majority of patients so “inpatient exp…
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
J 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…
J Hospital Medicine @JHospMedicine
RT @gracefarris: Yes. Also a lot of pressure from hosp staff (CM, admin) to follow specialist recs, esp if you are a youngish woman in medi…
J Hospital Medicine @JHospMedicine
RT @PetrilliMD: T2: VA docs may feel less “waste” because of essential single payer system for large majority of patients so “inpatient exp…
J Hospital Medicine @JHospMedicine
RT @WolfsonD: #JHMChat Payment mechanisms overstated influence - as much overuse at KP. Imprinting behaviors in medical school & residency…
Ranjeet Sinha @sinhachild
RT @PetrilliMD: T2: VA docs may feel less “waste” because of essential single payer system for large majority of patients so “inpatient exp…
Karen Fowler @kfowler_psep
@ben_geisler The P-Values are from a multivariable regression so no Bonferroni correction needed.#JHMChat
J Hospital Medicine @JHospMedicine
T3 up in a minute ...#JHMChat welcome to those just joining!
Rebecca Jaffe @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
Doctivist @jbcowartmd
RT @sanjaysaint: T1 Case report to get a #neuro consult without a recommendation of at least of the following tests: MRI, LP, EEG, or EMG/N…
J Hospital Medicine @JHospMedicine
Thx for clarification #JHMChat https://t.co/t9J9cXeNpm
J 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?
J 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
J 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…
Chris Petrilli @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 @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 unc…
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: nurses, docs, food servi…
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…
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 @RJmdphilly
RT @FutureDocs: So...The opposite of imposter syndrome #jhmchat https://t.co/BhARc8eDGF
Chris Petrilli @PetrilliMD
RT @sanjaysaint: T2 The other aspect of being at the #VA is the clear sense of a shared mission for the employees: nurses, docs, food servi…
Allen Kachalia @allenkachalia
A3: Well, one great way to reduce risk is to improve quality and safety of care. #jhmchat
Benjamin P. Geisler @ben_geisler
so much agree with @Wolfson's #JHMChat answer. there was this study that looked at high cost/low value-region graduates moving to low cost/high value regions... https://t.co/RxFwK3L3CS
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: nurses, docs, food servi…
Vinny Arora MD MAPP @FutureDocs
RT @allenkachalia: A3: Well, one great way to reduce risk is to improve quality and safety of care. #jhmchat
Rebecca Jaffe @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
J Hospital Medicine @JHospMedicine
RT @ben_geisler: so much agree with @Wolfson's #JHMChat answer. there was this study that looked at high cost/low value-region graduates mo…
J Hospital Medicine @JHospMedicine
RT @allenkachalia: A3: Well, one great way to reduce risk is to improve quality and safety of care. #jhmchat
Benjamin P. Geisler @ben_geisler
that is terrible #JHMChat https://t.co/OprQzcro9T
Allen Kachalia @allenkachalia
A3: And when harm does occur, we're increasingly seeing how open and honest communication is the way to go #jhmchat
Doctivist @jbcowartmd
RT @sanjaysaint: T2 The other aspect of being at the #VA is the clear sense of a shared mission for the employees: nurses, docs, food servi…
Benjamin P. Geisler @ben_geisler
haha.. plenty of IP PET scans in civilian hospitals #JHMChat https://t.co/DMCH4Pw1Tr
J 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: And when harm does occur, we're increasingly seeing how open and honest communication is the way to go #jhmchat
J 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: nurses, docs, food servi…
Rebecca Jaffe @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: nurses, docs, food servi…
J Hospital Medicine @JHospMedicine
RT @allenkachalia: 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
Benjamin P. Geisler @ben_geisler
an outpatient procedure (say, a nuke) might still be low-value test, depending on if there's no good indication #JHMChat https://t.co/QzJ2V4zM8z
Mary Drago @mkgdaz
RT @JHospMedicine: T1 The authors discovered that hospitalists perceived 37.5% of healthcare costs are due to defensive medicine, which is…
J Hospital Medicine @JHospMedicine
Thx for joining #JHMChat @karynbaum https://t.co/vVGakmBlYq
Lonika Sood, MD, MHPE @sood_lonika
T3: support a thorough mentoring process... have risk/legal talk to staff on several occasions to advise processes #jhmchat
Rebecca Jaffe @RJmdphilly
RT @JHospMedicine: T3 #JHMChat Over a quarter of hospitalists reported having been sued at least once for medical malpractice. For those in…
Grace Farris MD @gracefarris
Sorry, late w T2 #JHMChat https://t.co/aC5Rbmogvz
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 MD, JD, MPH @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 MD, JD, MPH @DrSinhaEsq
RT @JHospMedicine: T3 #JHMChat Over a quarter of hospitalists reported having been sued at least once for medical malpractice. For those in…
Grace Farris MD @gracefarris
Same #JHMChat https://t.co/vPPpOPzQLJ
Michael Sinha MD, JD, MPH @DrSinhaEsq
RT @gracefarris: Sorry, late w T2 #JHMChat https://t.co/aC5Rbmogvz
Vinny Arora MD MAPP @FutureDocs
@sood_lonika So meta i love it #jhmchat
Lonika Sood, MD, MHPE @sood_lonika
@RJmdphilly @FutureDocs @PamelaJohnsonMD absolutely... these are so much more appreciated .. #JHMChat
Grace Farris MD @gracefarris
RT @WolfsonD: #JHMChat Payment mechanisms overstated influence - as much overuse at KP. Imprinting behaviors in medical school & residency…
Vinny Arora MD MAPP @FutureDocs
RT @gracefarris: Sorry, late w T2 #JHMChat https://t.co/aC5Rbmogvz
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
J Hospital Medicine @JHospMedicine
RT @sanjaysaint: 1/ Invest in systems approaches to reduce error 2/ Lower the power distance (hierarchy) so people feel comfortable speakin…
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 speakin…
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 @RJmdphilly
@ben_geisler literally never been allowed to no matter how hard I have tried. (for good reasons I swear!) #JHMChat
J Hospital Medicine @JHospMedicine
RT @WolfsonD: #JHMChat The antidote of defensive medicine is partnerships with patients, active listening, defined options & trusting relat…
Vineet Chopra @vineet_chopra
Nice overview of some of the work done by our chief legal officer https://t.co/Fkb0Cuqz59 #JHMChat
Benjamin P. Geisler @ben_geisler
agree! also, non-disclosure of errors (either driven by hospital policy or personal misjudgement) and lack of apologies might drive up (non-normally distributed?) litigation rates #JHMchat https://t.co/QH2TupPhMz
Allen Kachalia @allenkachalia
@DrSinhaEsq That's spot on! #JHMChat
J Hospital Medicine @JHospMedicine
RT @DrSinhaEsq: A3: To err is human, but communication is KEY. Patients often sue to get information about what happened! Go to the bedside…
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
J 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 m…
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
J 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/qU…
Doctivist @jbcowartmd
RT @sanjaysaint: 1/ Invest in systems approaches to reduce error 2/ Lower the power distance (hierarchy) so people feel comfortable speakin…
J Hospital Medicine @JHospMedicine
RT @ben_geisler: agree! also, non-disclosure of errors (either driven by hospital policy or personal misjudgement) and lack of apologies mi…
Doctivist @jbcowartmd
RT @DrSinhaEsq: A3: To err is human, but communication is KEY. Patients often sue to get information about what happened! Go to the bedside…
Rebecca Jaffe @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
J Hospital Medicine @JHospMedicine
RT @vineet_chopra: Nice overview of some of the work done by our chief legal officer https://t.co/Fkb0Cuqz59 #JHMChat
J Hospital Medicine @JHospMedicine
RT @allenkachalia: @vineet_chopra @tony_breu Yes, this program worked well at Michigan from a claims perspective...Others have implemented…
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
J 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 MD, JD, MPH @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 |…
Benjamin P. Geisler @ben_geisler
that one caught my eye as well! #JHMChat https://t.co/DTsZF7A4ZE
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 repor…
Vinny Arora MD MAPP @FutureDocs
RT @vineet_chopra: @allenkachalia @DrSinhaEsq Worth mentioning that this runs counter to almost every instinct when something goes wrong. T…
Vinny Arora MD MAPP @FutureDocs
RT @tony_breu: 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 relat…
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
Doctivist @jbcowartmd
RT @JHospMedicine: T4 The discussion states "Reducing defensive medicine requires decreasing physician fears of liability and related repor…
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 a…
Michael Sinha MD, JD, MPH @DrSinhaEsq
Communicate early and often. Be candid. #JHMChat https://t.co/HlcK75HbB3
Society of Hospital Medicine @SHMLive
RT @JHospMedicine: T4 The discussion states "Reducing defensive medicine requires decreasing physician fears of liability and related repor…
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 a…
Lonika Sood, MD, MHPE @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
J Hospital Medicine @JHospMedicine
RT @DrSinhaEsq: Communicate early and often. Be candid. #JHMChat https://t.co/HlcK75HbB3
Michael Sinha MD, JD, MPH @DrSinhaEsq
RT @vineet_chopra: @allenkachalia @DrSinhaEsq Worth mentioning that this runs counter to almost every instinct when something goes wrong. T…
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 @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
Tina Hilmas @tina_hilmas
RT @sanjaysaint: 1/ Invest in systems approaches to reduce error 2/ Lower the power distance (hierarchy) so people feel comfortable speakin…
Rebecca Jaffe @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 MD, JD, MPH @DrSinhaEsq
RT @tony_breu: I'm going to flip these and put #4 first: Listen to what the nurses are saying! #JHMChat https://t.co/UlA3AlBXdZ
Doctivist @jbcowartmd
T4 We just started a QI-focused M&M conference aimed at discussing issues openly among the hospitalists and residents. I think teaching systems issues is a place to start. Rather than one person being personally liable, it is encouraging team thinking. #JHMChat
J Hospital Medicine @JHospMedicine
RT @RJmdphilly: @JHospMedicine would follow T3 and all the excellent responses with - how can hospitalist groups work with their administra…
Doctivist @jbcowartmd
RT @DrSinhaEsq: Communicate early and often. Be candid. #JHMChat https://t.co/HlcK75HbB3
Doctivist @jbcowartmd
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;…
J Hospital Medicine @JHospMedicine
RT @allenkachalia: @vineet_chopra @DrSinhaEsq Yup--That is why we recommend hospitals set up programs to help clinicians and patients throu…
J 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;…
J 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 a…
J Hospital Medicine @JHospMedicine
RT @ben_geisler: that one caught my eye as well! #JHMChat https://t.co/DTsZF7A4ZE
J Hospital Medicine @JHospMedicine
RT @DrSinhaEsq: Bingo. #JHMChat https://t.co/eimFs3U0nG
J Hospital Medicine @JHospMedicine
RT @sanjaysaint: T3 #JHMChat Liability Claims and Costs Before and After Implementation of a Medical Error Disc... | Ann Intern Med | ACP |…
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
J Hospital Medicine @JHospMedicine
RT @vineet_chopra: @allenkachalia @DrSinhaEsq Worth mentioning that this runs counter to almost every instinct when something goes wrong. T…
J 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 experience…
Grace Farris MD @gracefarris
T4 is mindfulnessa panacea? #JHMChat https://t.co/oPHlOs52gI
J Hospital Medicine @JHospMedicine
RT @jbcowartmd: T4 We just started a QI-focused M&M conference aimed at discussing issues openly among the hospitalists and residents. I th…
Karyn Baum (feeling boring today) @karynbaum
@jbcowartmd Do you invite the other professions by any chance? #JHMChat
Grace Farris MD @gracefarris
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 experience…
Vinny Arora MD MAPP @FutureDocs
RT @gracefarris: T4 is mindfulnessa panacea? #JHMChat https://t.co/oPHlOs52gI
Michael Sinha MD, JD, MPH @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 experience…
Vinny Arora MD MAPP @FutureDocs
RT @jbcowartmd: T4 We just started a QI-focused M&M conference aimed at discussing issues openly among the hospitalists and residents. I th…
Vinny Arora MD MAPP @FutureDocs
RT @allenkachalia: @FutureDocs A4: Great question, Vinny. Because it's hard to measure defensive medicine, it's hard to determine if tort…
Sanjay Saint @sanjaysaint
Error is inevitable in a field premised on the art of balancing probabilities. #JHMChat
J Hospital Medicine @JHospMedicine
RT @allenkachalia: @FutureDocs A4: Great question, Vinny. Because it's hard to measure defensive medicine, it's hard to determine if tort…
J Hospital Medicine @JHospMedicine
RT @DrSinhaEsq: See article by @MichelleM_Mello @allenkachalia & Dave Studdert in @nejm: https://t.co/pMNCM3N1mu #JHMChat https://t.co/V0eg…
J Hospital Medicine @JHospMedicine
RT @gracefarris: T4 is mindfulnessa panacea? #JHMChat https://t.co/oPHlOs52gI
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 MD, JD, MPH @DrSinhaEsq
RT @sanjaysaint: Error is inevitable in a field premised on the art of balancing probabilities. #JHMChat
Charlie M. Wray @WrayCharles
RT @sanjaysaint: Error is inevitable in a field premised on the art of balancing probabilities. #JHMChat
J Hospital Medicine @JHospMedicine
RT @sanjaysaint: Error is inevitable in a field premised on the art of balancing probabilities. #JHMChat
J 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.…
Vineet Chopra @vineet_chopra
RT @jbcowartmd: T4 We just started a QI-focused M&M conference aimed at discussing issues openly among the hospitalists and residents. I th…
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 experience…
Rebecca Jaffe @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 b…
Guilherme Barcellos @brhospitalist
RT @WrayCharles: Looking to join #JHMChat this Monday 2/26 at 9PM EST? Here's my quick take on the paper: https://t.co/YXYawQNlRG via @SHML
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: Great question, Vinny. Because it's hard to measure defensive medicine, it's hard to determine if tort…
Vineet Chopra @vineet_chopra
RT @sanjaysaint: Error is inevitable in a field premised on the art of balancing probabilities. #JHMChat
Society of Hospital Medicine @SHMLive
Special thank you tonight's guest experts and our partners @ABIMFoundation & @CostsofCare! #JHMChat
J 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
J 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 @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
Tina Hilmas @tina_hilmas
RT @sanjaysaint: Error is inevitable in a field premised on the art of balancing probabilities. #JHMChat
Charlie M. Wray @WrayCharles
RT @JHospMedicine: You def don’t need to say sorry for this one:) #JHMChat brilliance from our resident artist @gracefarris https://t.co/qU…
J 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 h…
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…
Vinny Arora MD MAPP @FutureDocs
RT @SHMLive: Special thank you tonight's guest experts and our partners @ABIMFoundation & @CostsofCare! #JHMChat
Doctivist @jbcowartmd
RT @sanjaysaint: Error is inevitable in a field premised on the art of balancing probabilities. #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.…
Vinny Arora MD MAPP @FutureDocs
RT @sanjaysaint: Error is inevitable in a field premised on the art of balancing probabilities. #JHMChat
Doctivist @jbcowartmd
RT @DrSinhaEsq: See article by @MichelleM_Mello @allenkachalia & Dave Studdert in @nejm: https://t.co/pMNCM3N1mu #JHMChat https://t.co/V0eg…
Doctivist @jbcowartmd
RT @vineet_chopra: Instructive to see what happens in the airline industry when an error occurs. Thorough review by a non biased party. Det…
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. Det…
Sanjay Saint @sanjaysaint
CT If sued, speak to your clinical mentor. S/he has very likely been there before. #JHMChat https://t.co/Dqm7blADf2
Grace Farris MD @gracefarris
RT @tony_breu: @RJmdphilly But, just acknowledging to others (including junior hospitalists) that a great doctor might go through - and get…
Doctivist @jbcowartmd
RT @SHMLive: Special thank you tonight's guest experts and our partners @ABIMFoundation & @CostsofCare! #JHMChat
J 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, MD, MHPE @sood_lonika
also need to be responsive to burn out and perception of legal action #jhmchat
Rebecca Jaffe @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). Bu…
J 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). Bu…
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
Doctivist @jbcowartmd
RT @sanjaysaint: CT If sued, speak to your clinical mentor. S/he has very likely been there before. #JHMChat https://t.co/Dqm7blADf2
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
J Hospital Medicine @JHospMedicine
RT @tony_breu: @RJmdphilly But, just acknowledging to others (including junior hospitalists) that a great doctor might go through - and get…
J 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. Det…
Michael Sinha MD, JD, MPH @DrSinhaEsq
Who is "they" in this scenario? The lawyers? #JHMChat https://t.co/g5urP70gQ1
Lonika Sood, MD, MHPE @sood_lonika
thank you for a great chat!! #jhmchat
J 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
Doctivist @jbcowartmd
CT: sometimes the standard of care is blurry. In that setting, easier to “just order the test.” It is ok to stop and think first. #JHMChat
J Hospital Medicine @JHospMedicine
RT @sood_lonika: thank you for a great chat!! #jhmchat
Michael Sinha MD, JD, MPH @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). Bu…
Doctivist @jbcowartmd
RT @sood_lonika: also need to be responsive to burn out and perception of legal action #jhmchat
J Hospital Medicine @JHospMedicine
RT @jbcowartmd: CT: sometimes the standard of care is blurry. In that setting, easier to “just order the test.” It is ok to stop and think…
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…
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…
Grace Farris MD @gracefarris
Thanks for hosting another fun chat @FutureDocs @WrayCharles @CostsofCare @JHospMedicine #JHMChat
J Hospital Medicine @JHospMedicine
Dont forget to claim your #CME here after #JHMChat https://t.co/ZuELpIwwXO
J Hospital Medicine @JHospMedicine
Thank you to our partners @SHMLive @CostsofCare and @ABIMFoundation for supporting #JHMChat!
J 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
J 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 #J
Rebecca Jaffe @RJmdphilly
RT @gracefarris: Thanks for hosting another fun chat @FutureDocs @WrayCharles @CostsofCare @JHospMedicine #JHMChat
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
J 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...
Benjamin P. Geisler @ben_geisler
Again, a wonderful #jhmchat. I believe, defensive medicine can be an excuse and is often more the result of what region you trained in (or if you practice at the VA!).
Chris Petrilli @PetrilliMD
RT @sanjaysaint: Error is inevitable in a field premised on the art of balancing probabilities. #JHMChat
J Hospital Medicine @JHospMedicine
RT @vineet_chopra: @JHospMedicine That’ll need a #JHMChat all to itself...
Chris Petrilli @PetrilliMD
RT @sanjaysaint: 1/ Invest in systems approaches to reduce error 2/ Lower the power distance (hierarchy) so people feel comfortable speakin…
Michael Sinha MD, JD, MPH @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
Grace Farris MD @gracefarris
RT @JHospMedicine: @gracefarris @FutureDocs @WrayCharles @CostsofCare Thx for all the art and your thoughts #JHMChat
Doctivist @jbcowartmd
RT @ben_geisler: Again, a wonderful #jhmchat. I believe, defensive medicine can be an excuse and is often more the result of what region yo…
Doctivist @jbcowartmd
RT @WolfsonD: #JHMChat Suspect self-reporting of defensive medicine by physicians- term is not as useful as what underlies the term. Better…
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 #J
Benjamin P. Geisler @ben_geisler
RT @gracefarris: T4 is mindfulnessa panacea? #JHMChat https://t.co/oPHlOs52gI
Grace Farris MD @gracefarris
Anytime! #JHMChat https://t.co/2pwOXQy9EM
Vinny Arora MD MAPP @FutureDocs
RT @JHospMedicine: Dont forget to claim your #CME here after #JHMChat https://t.co/ZuELpIwwXO
Vinny Arora MD MAPP @FutureDocs
RT @gracefarris: Thanks for hosting another fun chat @FutureDocs @WrayCharles @CostsofCare @JHospMedicine #JHMChat
Benjamin P. Geisler @ben_geisler
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 experience…
Patient Safety Enhancement Program (UMVA) @PSEPUMVA
RT @JHospMedicine: Dont forget to claim your #CME here after #JHMChat https://t.co/ZuELpIwwXO
Doctivist @jbcowartmd
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…
Doctivist @jbcowartmd
RT @JHospMedicine: We didn’t even have time to do burnout second victim discussion. Alas #jhmchat is sometimes too short! https://t.co/RFBv…
Doctivist @jbcowartmd
RT @vineet_chopra: One of my favorite teachers used to say “It’s not if, but when you get named...” #JHMChat https://t.co/jDxYE1mHec
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: Again, a wonderful #jhmchat. I believe, defensive medicine can be an excuse and is often more the result of what region yo…
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
J Hospital Medicine @JHospMedicine
RT @ben_geisler: Again, a wonderful #jhmchat. I believe, defensive medicine can be an excuse and is often more the result of what region yo…
John Rother @jrother47
RT @WolfsonD: #JHMChat Payment mechanisms overstated influence - as much overuse at KP. Imprinting behaviors in medical school & residency…
J Hospital Medicine @JHospMedicine
RT @JHospMedicine: Special thanks to our authors for their expertise on perceptions of resource use related to defensive medicine during #J
J Hospital Medicine @JHospMedicine
RT @JHospMedicine: Thank you to our partners @SHMLive @CostsofCare and @ABIMFoundation for supporting #JHMChat!
J Hospital Medicine @JHospMedicine
RT @JHospMedicine: Dont forget to claim your #CME here after #JHMChat https://t.co/ZuELpIwwXO
Rebecca Jaffe @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
J Hospital Medicine @JHospMedicine
RT @gracefarris: Thanks for hosting another fun chat @FutureDocs @WrayCharles @CostsofCare @JHospMedicine #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…
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! htt…
Michael Sinha MD, JD, MPH @DrSinhaEsq
RT @allenkachalia: @vineet_chopra @DrSinhaEsq Yup--That is why we recommend hospitals set up programs to help clinicians and patients throu…
Gretchen Diemer @gretchendiemer
RT @sanjaysaint: Error is inevitable in a field premised on the art of balancing probabilities. #JHMChat
Shannon McNamara, MD @ShannonOMac
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 experience…
Doctivist @jbcowartmd
RT @PSEPUMVA: Great #JHMChat tonight! Be sure to follow that hashtag to see the details. Let us be your source for #ptsafety papers! htt…
Doctivist @jbcowartmd
RT @RJmdphilly: Late CT 1) there is a difference btwn defensive (law suit) & defensive (clinical reasoning) 2) we should all be so lucky as…
Shannon McNamara, MD @ShannonOMac
RT @sanjaysaint: Error is inevitable in a field premised on the art of balancing probabilities. #JHMChat
Shannon McNamara, MD @ShannonOMac
RT @jbcowartmd: T4 We just started a QI-focused M&M conference aimed at discussing issues openly among the hospitalists and residents. I th…
#JHMChat content from Twitter.