#JHMChat Transcript

Healthcare social media transcript of the #JHMChat hashtag.
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See #JHMChat Influencers/Analytics.

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Society of Hospital Medicine @SocietyHospMed
⏰ 🔟 minutes until this month’s #JHMChat! 🩺 Tonight’s facilitator and guests: @michellebr00ks as @JHospMedicine, @tony_breu, and @DocLennyF Don’t forget to use #JHMChat in all tweets! Need a refresher on how to join? 👀👇 https://t.co/ivHhIPERG8 https://t.co/PJIa2EDoiQ
Journal of Hospital Medicine @JHospMedicine
🔟 MINUTES LEFT UNTIL #JHMChat! Last chance to fill your #myJHMmug! ☕ PC: @freckledpedidoc (P.S. we are jealous of those marshmallows!!) https://t.co/8cSniyqGPR
Anika Kumar, MD (she/her) @freckledpedidoc
RT @JHospMedicine: 🔟 MINUTES LEFT UNTIL #JHMChat! Last chance to fill your #myJHMmug! ☕ PC: @freckledpedidoc (P.S. we are jealous of those marshmallows!!) https://t.co/8cSniyqGPR
Society of Hospital Medicine @SocietyHospMed
RT @JHospMedicine: 🔟 MINUTES LEFT UNTIL #JHMChat! Last chance to fill your #myJHMmug! ☕ PC: @freckledpedidoc (P.S. we are jealous of those marshmallows!!) https://t.co/8cSniyqGPR
Dhruv Srinivasachar MD (he/el/ele.) @TheRealDSrini
@JHospMedicine @freckledpedidoc Unfortunately don't have mine tonight #myJHMmug #JHMChat https://t.co/JtbbCFmoQk
Journal of Hospital Medicine @JHospMedicine
RT @TheRealDSrini: @JHospMedicine @freckledpedidoc Unfortunately don't have mine tonight #myJHMmug #JHMChat https://t.co/JtbbCFmoQk
Michelle Brooks, MD @michellebr00ks
RT @JHospMedicine: 🔟 MINUTES LEFT UNTIL #JHMChat! Last chance to fill your #myJHMmug! ☕ PC: @freckledpedidoc (P.S. we are jealous of those marshmallows!!) https://t.co/8cSniyqGPR
Mohamad Arif Ali @mhealth1
RT @SocietyHospMed: ⏰ 🔟 minutes until this month’s #JHMChat! 🩺 Tonight’s facilitator and guests: @michellebr00ks as @JHospMedicine, @tony_breu, and @DocLennyF Don’t forget to use #JHMChat in all tweets! Need a refresher on how to join? 👀👇 https://t.co/ivHhIPERG8 https://t.co/PJIa2EDoiQ
Samir S. Shah @SamirShahMD
RT @JHospMedicine: 🔟 MINUTES LEFT UNTIL #JHMChat! Last chance to fill your #myJHMmug! ☕ PC: @freckledpedidoc (P.S. we are jealous of those marshmallows!!) https://t.co/8cSniyqGPR
Society of Hospital Medicine @SocietyHospMed
@TheRealDSrini @JHospMedicine @freckledpedidoc Any mug will do, but we love the photo! #JHMChat
Journal of Hospital Medicine @JHospMedicine
RT @SocietyHospMed: ⏰ 🔟 minutes until this month’s #JHMChat! 🩺 Tonight’s facilitator and guests: @michellebr00ks as @JHospMedicine, @tony_breu, and @DocLennyF Don’t forget to use #JHMChat in all tweets! Need a refresher on how to join? 👀👇 https://t.co/ivHhIPERG8 https://t.co/PJIa2EDoiQ
Dhruv Srinivasachar MD (he/el/ele.) @TheRealDSrini
2 Minutes left! Reminder for those who want to join! @gradydoctor @jenreadlynn #JHMChat
Journal of Hospital Medicine @JHospMedicine
Hello! I'm @michellebr00ks, your moderator for tonight's #JHMChat, coming at you from San Antonio, TX. 🤠 🤝 Go ahead and introduce yourself while we wait for people to join.
Jen Readlynn, MD, FHM (she/her) @jenreadlynn
#JHMChat, #KetanjiBrownJacksonHearing , & #MomMilestones by @gracefarris! Great day! https://t.co/JgejyzpgJs
Society of Hospital Medicine @SocietyHospMed
RT @JHospMedicine: Hello! I'm @michellebr00ks, your moderator for tonight's #JHMChat, coming at you from San Antonio, TX. 🤠 🤝 Go ahead and introduce yourself while we wait for people to join.
Society of Hospital Medicine @SocietyHospMed
🏥 Welcome to this month’s #JHMChat. We’re excited for a great discussion! 🔥 📢 Use #JHMChat on all replies. 📢 Introduce yourself and where you’re from. 📢 Engage with the prompts and each other. 📢 Refresh the latest tweets with the hashtag to stay up to date.
Journal of Hospital Medicine @JHospMedicine
We would like to thank our special guests @tony_breu @DocLennyF for joining us tonight for a #JHMChat focused on our #TWDFNR series. This sort of feels like a warm-up for #SHMConverge! BTW, have you registered yet? https://t.co/jpypOF8zJJ https://t.co/QuvS1T1QFh
Anika Kumar, MD (she/her) @freckledpedidoc
@JHospMedicine @michellebr00ks 👋 Anika Kumar, Pediatric Hospitalist in Cleveland #JHMChat
Tony Breu @tony_breu
I'm excited to be back for #JHMChat. It's been too long. I blame DST for my absence.
One Week Bot @OneWeekBot
🎶 Gotta get in tune with Sailor Moon 🎶 #oneweek https://t.co/ESgdIGiNCL
Annie Massart @Annie_Massart_
@JHospMedicine @michellebr00ks Hello! I'm Annie Massart, an academic hospitalist in Atlanta. Looking forward to chatting with y'all! #JHMChat
Leonard Feldman @DocLennyF
#JHMChat. Lenny Feldman in the house.
Journal of Hospital Medicine @JHospMedicine
@jenreadlynn @gracefarris So glad you're here! And not jealous at all of your book. #JHMChat https://t.co/upSzVqko2d
Society of Hospital Medicine @SocietyHospMed
@Annie_Massart_ @JHospMedicine @michellebr00ks Welcome! Glad you made it. #JHMChat
Charlie M. Wray, DO, MS @WrayCharles
@JHospMedicine @michellebr00ks Hey there #JHMChat community. I'm @WrayCharles - hospitalist in SF. Looking forward to tonight's chat w/@tony_breu & @DocLennyF - w/moderator @michellebr00ks
Trushar M. Dungarani @DrT_Dungarani
#JHMChat Trushar Dungarani, adult hospitalist @HopkinsMedicine
Society of Hospital Medicine @SocietyHospMed
@tony_breu Welcome! Glad to have you with us. #JHMChat
Jen Readlynn, MD, FHM (she/her) @jenreadlynn
@SocietyHospMed I'm Jen Readlynn, academic hospitalist in Rochester, NY and big fan of #TWDFNR! #JHMChat
Journal of Hospital Medicine @JHospMedicine
@Annie_Massart_ @michellebr00ks Welcome! You've had a busy day! #JHMChat
Society of Hospital Medicine @SocietyHospMed
RT @JHospMedicine: We would like to thank our special guests @tony_breu @DocLennyF for joining us tonight for a #JHMChat focused on our #TWDFNR series. This sort of feels like a warm-up for #SHMConverge! BTW, have you registered yet? https://t.co/jpypOF8zJJ https://t.co/QuvS1T1QFh
Lanna Felde @LannaFelde
Lanna Felde here coming at you from @UTSWHospitalMed. Excited to be here! #JHMChat
Dhruv Srinivasachar MD (he/el/ele.) @TheRealDSrini
@JHospMedicine @michellebr00ks Dhruv Srinivasachar, PGY-1 Med-Peds @WMUMedicine , thinking combined hospitalist. Hoping for good discussion on #TWDFNR #JHMChat
Journal of Hospital Medicine @JHospMedicine
You also may see some of our authors pop in to #JHMChat! We ❤️ highlighting your #TWDFNR work! @DrSamanthaWang @Payalia320 @DanielRicottaMD @DavidACohen_MD @ChristleNwora https://t.co/2rkJ83e1Uu
Ndidi Unaka MD, MEd @NdidiUnaka
@JHospMedicine @michellebr00ks Hi! I'm Ndidi, peds hospitalist in Cincinnati :) #JHMChat
Journal of Hospital Medicine @JHospMedicine
@tony_breu Same. #JHMChat https://t.co/d4JlqNTNMZ
Charlie M. Wray, DO, MS @WrayCharles
@tony_breu It's nice to see some of the OG #JHMChat crew. Hey @FutureDocs - look who showed up! (Can't wait to catch up in Nashville)
Payal Parikh, MD, FACP @Payalia320
@JHospMedicine @michellebr00ks hi all! Im Payal Parikh, academic hospitalist, Vice Chair of Quality and Safety Robert Wood Johnson Medical School (NJ), also co-author of the #TWDFNR metformin publication! So excited for today! #JHMChat
Journal of Hospital Medicine @JHospMedicine
@freckledpedidoc @michellebr00ks Hi! Still jealous of your marshmallows. #JHMChat
Society of Hospital Medicine @SocietyHospMed
@jenreadlynn We all love #TWDFNR! This is gonna be a great discussion! #JHMChat
Prabi Rajbhandari @prabimd
@JHospMedicine @michellebr00ks Prabi Rajbhandari, pediatric hospitalist , Akron childrens #JHMChat
Journal of Hospital Medicine @JHospMedicine
FYI - #JHMChat has 3️⃣ topics tonight, centered around 3️⃣ #TWDFNR articles. A 🔗 link to the article and the #VisualAbstract will be posted just prior to each #JHMChat question.
Ndidi Unaka MD, MEd @NdidiUnaka
RT @WrayCharles: @JHospMedicine @michellebr00ks Hey there #JHMChat community. I'm @WrayCharles - hospitalist in SF. Looking forward to tonight's chat w/@tony_breu & @DocLennyF - w/moderator @michellebr00ks
Annie Massart @Annie_Massart_
@JHospMedicine @michellebr00ks Grateful for all the virtual connections happening today! #JHMChat
Journal of Hospital Medicine @JHospMedicine
@LannaFelde @UTSWHospitalMed Hope you're staying safe and away from any severe weather up there! #JHMChat
Society of Hospital Medicine @SocietyHospMed
@Payalia320 @JHospMedicine @michellebr00ks Yay! Glad you're here! #JHMChat
Reshon Hadmon, MD 🩺 @HadmonReshon
@SocietyHospMed Hi I am Reshon Hadmon from Guyana. I am currently a Faculty with a love for clinical reasoning. #JHMChat
Samantha Wang @DrSamanthaWang
@JHospMedicine @Payalia320 @DanielRicottaMD @DavidACohen_MD @ChristleNwora Excited to be part of the #JHMChat tonight with my colleague and co-author @juliablumcaton!
Journal of Hospital Medicine @JHospMedicine
@TheRealDSrini @michellebr00ks @WMUMedicine Welcome back! #JHMChat
Tony Breu @tony_breu
@WrayCharles @FutureDocs I'm excited to catch up too. #JHMChat
Dhruv Srinivasachar MD (he/el/ele.) @TheRealDSrini
@JHospMedicine @freckledpedidoc @michellebr00ks Same! #JHMChat
Journal of Hospital Medicine @JHospMedicine
@NdidiUnaka @michellebr00ks Thank you for being here! #JHMChat
Society of Hospital Medicine @SocietyHospMed
@DrSamanthaWang @JHospMedicine @Payalia320 @DanielRicottaMD @DavidACohen_MD @ChristleNwora @juliablumcaton Welcome! Glad you're here for this conversation! #JHMChat
Journal of Hospital Medicine @JHospMedicine
Q1: What's your approach to the use of metformin in hospitalized patients? How has this #TWDFNR article impacted your practice? #JHMChat https://t.co/AcTv8ZcaI0
Journal of Hospital Medicine @JHospMedicine
Topic 1️⃣: Holding Metformin in Hospitalized Patients 🔗 Article Link: https://t.co/j86y6Vuclu 👀 Awesome #VisualAbstract by @LannaFelde #JHMChat https://t.co/jbJN76mXro
Ndidi Unaka MD, MEd @NdidiUnaka
RT @JHospMedicine: We would like to thank our special guests @tony_breu @DocLennyF for joining us tonight for a #JHMChat focused on our #TWDFNR series. This sort of feels like a warm-up for #SHMConverge! BTW, have you registered yet? https://t.co/jpypOF8zJJ https://t.co/QuvS1T1QFh
Mark Shapiro, MD @ETSshow
@WrayCharles @JHospMedicine @michellebr00ks @tony_breu @DocLennyF Evening all! Mark Shapiro here, Hospitalist & host of Explore The Space Podcast Delighted to be virtually near to @tony_breu Hopefully you’ll be at SHM Annual Meeting & I can conjure you out of thin air again like in 2019! #JHMChat https://t.co/aDBqXow5NQ
Yichi Zhang (张一弛) @YichiZzzzz
@SocietyHospMed Hey everyone, it's Yichi again! High winds today and wifi went down but that's not stopping me from being here! #JHMChat #TWDFNR https://t.co/GYL3K4HTa3
Tony Breu @tony_breu
@DrSamanthaWang @JHospMedicine @Payalia320 @DanielRicottaMD @DavidACohen_MD @ChristleNwora @juliablumcaton It's great to have you here Samantha! #JHMChat
Journal of Hospital Medicine @JHospMedicine
@DrSamanthaWang @Payalia320 @DanielRicottaMD @DavidACohen_MD @ChristleNwora @juliablumcaton We're so excited to highlight your #TWDFNR work! #JHMChat
Society of Hospital Medicine @SocietyHospMed
RT @ETSshow: @WrayCharles @JHospMedicine @michellebr00ks @tony_breu @DocLennyF Evening all! Mark Shapiro here, Hospitalist & host of Explore The Space Podcast Delighted to be virtually near to @tony_breu Hopefully you’ll be at SHM Annual Meeting & I can conjure you out of thin air again like in 2019! #JHMChat https://t.co/aDBqXow5NQ
Dhruv Srinivasachar MD (he/el/ele.) @TheRealDSrini
@JHospMedicine @michellebr00ks @WMUMedicine Currently on nights but hoping for no admits or calls! 🤞🤞🤞#JHMChat
Society of Hospital Medicine @SocietyHospMed
RT @JHospMedicine: Topic 1️⃣: Topic 1️⃣: Holding Metformin in Hospitalized Patients 🔗 Article Link: https://t.co/j86y6Vuclu 👀 Awesome #VisualAbstract by @LannaFelde #JHMChat https://t.co/jbJN76mXro
Society of Hospital Medicine @SocietyHospMed
RT @JHospMedicine: Q1: Q1: What's your approach to the use of metformin in hospitalized patients? How has this #TWDFNR article impacted your practice? #JHMChat https://t.co/AcTv8ZcaI0
Leonard Feldman @DocLennyF
@DrSamanthaWang @JHospMedicine @Payalia320 @DanielRicottaMD @DavidACohen_MD @ChristleNwora @juliablumcaton #JHMChat Glad you’re here!
Lanna Felde @LannaFelde
Woooo pumped to learn some nuggets of wisdom from the #TWDFNR that @michellebr00ks is about to drop 💣 #JHMChat
Journal of Hospital Medicine @JHospMedicine
@prabimd @michellebr00ks Thanks for being here! Hope to highlight more pediatric #TWDFNR in the future! #JHMChat
Society of Hospital Medicine @SocietyHospMed
@YichiZTulane LOVE your perseverence. Welcome! #JHMChat
Journal of Hospital Medicine @JHospMedicine
@Payalia320 @michellebr00ks Thank you for being here! Excited to highlight your work! #JHMChat
Payal Parikh, MD, FACP @Payalia320
@JHospMedicine @DrSamanthaWang @DanielRicottaMD @DavidACohen_MD @ChristleNwora excited to join this evening! #JHMChat
Charlie M. Wray, DO, MS @WrayCharles
@YichiZTulane @SocietyHospMed Good to see you back, Yichi #JHMChat
Ammar @AmmarSaati
RT @JHospMedicine: Topic 1️⃣: Topic 1️⃣: Holding Metformin in Hospitalized Patients 🔗 Article Link: https://t.co/j86y6Vuclu 👀 Awesome #VisualAbstract by @LannaFelde #JHMChat https://t.co/jbJN76mXro
Lanna Felde @LannaFelde
@TheRealDSrini @JHospMedicine @michellebr00ks @WMUMedicine way to multitask! #jhmchat
Julia Caton @juliablumcaton
@DrSamanthaWang @JHospMedicine @Payalia320 @DanielRicottaMD @DavidACohen_MD @ChristleNwora thanks @DrSamanthaWang - excited to be here! #JHMChat
Elise Peterson Lu, MD, PhD @elibrilu
Elise Lu here! I'm the side-kick to Lenny and Tony, repping for the tiny humans. Pediatric Hospitalist at Children's Hospital of Pittsburgh, mom to Lizzie (4.5) and Maggie (11mo). #JHMChat
Society of Hospital Medicine @SocietyHospMed
@elibrilu Welcome! We love a representation for the tiny humans! #JHMChat
Dhruv Srinivasachar MD (he/el/ele.) @TheRealDSrini
@elibrilu Wondering if @esharpmd is going to join us? #JHMChat
Journal of Hospital Medicine @JHospMedicine
Awwww...we hope y'all can recreate this picture in Nashville! #JHMChat
Mark Shapiro, MD @ETSshow
@JHospMedicine A1: I do not use metformin in hospitalized patients ever Prepared for your slings & arrows #JHMChat
Charlie M. Wray, DO, MS @WrayCharles
@JHospMedicine I've been dancing with the idea of continuing metformin in hospitalized patients for several years. This article really helped me solidify that desire. Funny, how something just needs to be written down to justify my doctoring #JHMChat
Lanna Felde @LannaFelde
@YichiZTulane @SocietyHospMed Same here - just got done sheltering with my family in the bathroom for a half hour waiting for the tornado sirens to stop🙃. Excited to be here! #JHMChat
Satyendra Dhar, MD FHM @DharSaty
I’m Satyendra Dhar, #Hospitalist at University of Michigan Health system. Always enjoy #JHMChat
Journal of Hospital Medicine @JHospMedicine
So glad you're on the #TWDFNR team! #JHMChat
Tony Breu @tony_breu
For topic 1, I also wonder how quickly people "add it back" if an admitting doctor stopped it. #JHMChat
Anika Kumar, MD (she/her) @freckledpedidoc
@elibrilu Yay for Tiny Humans! #JHMChat https://t.co/1RDgC0tcdR
Trushar M. Dungarani @DrT_Dungarani
#JHMChat often our admitters and night time team hold metformin with uncertainty of renal fxn the next day. Day time team forget or not interested in restarting.
Jen Readlynn, MD, FHM (she/her) @jenreadlynn
@JHospMedicine This article combined with @COREIMpodcast on oral meds in the hospital have definitely given me the confidence to continue or resume home metformin in hospitalized patients. We're discussing as a division on 3/30 (@UR_HMD) and getting some endo tips as well. #JHMChat
Journal of Hospital Medicine @JHospMedicine
RT @jenreadlynn: @JHospMedicine This article combined with @COREIMpodcast on oral meds in the hospital have definitely given me the confidence to continue or resume home metformin in hospitalized patients. We're discussing as a division on 3/30 (@UR_HMD) and getting some endo tips as well. #JHMChat
Mark Shapiro, MD @ETSshow
RT @JHospMedicine: Awwww...we hope y'all can recreate this picture in Nashville! #JHMChat
Charlie M. Wray, DO, MS @WrayCharles
@DrSamanthaWang @JHospMedicine @Payalia320 @DanielRicottaMD @DavidACohen_MD @ChristleNwora @juliablumcaton Good to see you here, Samantha! #JHMChat
Journal of Hospital Medicine @JHospMedicine
RT @DrT_Dungarani: #JHMChat often our admitters and night time team hold metformin with uncertainty of renal fxn the next day. Day time team forget or not interested in restarting.
Leonard Feldman @DocLennyF
@elibrilu #JHMChat And we are developing some great peds TWDFNR content!
Society of Hospital Medicine @SocietyHospMed
@DharSaty Thanks for joining! #JHMChat
Tony Breu @tony_breu
Mark - do you do this because it's the simplest route or because of a fear of LA? #JHMChat
Journal of Hospital Medicine @JHospMedicine
RT @WrayCharles: @JHospMedicine I've been dancing with the idea of continuing metformin in hospitalized patients for several years. This article really helped me solidify that desire. Funny, how something just needs to be written down to justify my doctoring #JHMChat
Mark Shapiro, MD @ETSshow
RT @JHospMedicine: Topic 1️⃣: Topic 1️⃣: Holding Metformin in Hospitalized Patients 🔗 Article Link: https://t.co/j86y6Vuclu 👀 Awesome #VisualAbstract by @LannaFelde #JHMChat https://t.co/jbJN76mXro
Journal of Hospital Medicine @JHospMedicine
RT @ETSshow: @JHospMedicine A1: @JHospMedicine A1: I do not use metformin in hospitalized patients ever Prepared for your slings & arrows #JHMChat
Tony Breu @tony_breu
@DrT_Dungarani The resonates with me #JHMChat
Mark Shapiro, MD @ETSshow
@JHospMedicine @NdidiUnaka @michellebr00ks Time for my requisite reply to my friend @NdidiUnaka… Go Bruins! #JHMChat https://t.co/TXKup6UFTP
Prabi Rajbhandari @prabimd
@freckledpedidoc @elibrilu Peds hospitalists watching the adults hash out metformin debacle #JHMChat https://t.co/EOYkn13XEw
Charlie M. Wray, DO, MS @WrayCharles
@tony_breu Exactly, Tony. I don't mind if held on day 1 and 2 - but once I start to see clinically stability, I'm pushing myself and team to think about getting back on board #JHMChat
Samantha Wang @DrSamanthaWang
@JHospMedicine If patient is admitted without acute renal injury or increased risk for renal injury, I continue metformin! I find it achieves better glucose control than transitioning to basal/sliding scale insulin. #JHMChat
Jen Readlynn, MD, FHM (she/her) @jenreadlynn
@tony_breu Definitely try to add it back when approaching discharge. Have started doing earlier if taking good PO. Often makes insulin management much easier and allows us to space BG checks too. #JHMChat
Anika Kumar, MD (she/her) @freckledpedidoc
@ETSshow @JHospMedicine I have not used Metformin in Hospitalized Patients since I was a medical student and took care of patients older than me. #JHMChat
Journal of Hospital Medicine @JHospMedicine
This is an excellent question. Do we develop therapeutic inertia? #JHMChat
Society of Hospital Medicine @SocietyHospMed
RT @DrSamanthaWang: @JHospMedicine If patient is admitted without acute renal injury or increased risk for renal injury, I continue metformin! I find it achieves better glucose control than transitioning to basal/sliding scale insulin. #JHMChat
Leonard Feldman @DocLennyF
@WrayCharles @tony_breu #JHMChat what about in PERIOPERATIVE patients?
Society of Hospital Medicine @SocietyHospMed
RT @JHospMedicine: This is an excellent question. Do we develop therapeutic inertia? #JHMChat
Jen Readlynn, MD, FHM (she/her) @jenreadlynn
@ETSshow @JHospMedicine But why? #JHMChat
Mark Shapiro, MD @ETSshow
@tony_breu Honestly, I had an attending absolutely blow me out of the water for prescribing it back in the day. I’ve also seen so many patients experience new nausea w/o other clear cause too #JHMChat
Mark Shapiro, MD @ETSshow
RT @tony_breu: Mark - do you do this because it's the simplest route or because of a fear of LA? #JHMChat
Charlie M. Wray, DO, MS @WrayCharles
We have a front-runner for tonight's best #JHMChat Tweet
Jeffrey Jaeger, MD @jjaeger3
RT @JHospMedicine: Topic 1️⃣: Topic 1️⃣: Holding Metformin in Hospitalized Patients 🔗 Article Link: https://t.co/j86y6Vuclu 👀 Awesome #VisualAbstract by @LannaFelde #JHMChat https://t.co/jbJN76mXro
Ndidi Unaka MD, MEd @NdidiUnaka
@ETSshow @JHospMedicine I can count on one hand the number of times I have taken care of a hospitalized peds patient on metformin. So I would love to learn more about what informs your practice #JHMChat
Journal of Hospital Medicine @JHospMedicine
@freckledpedidoc @ETSshow Appreciate the honesty! #JHMChat https://t.co/6bdI6cGoN0
Dhruv Srinivasachar MD (he/el/ele.) @TheRealDSrini
@JHospMedicine A1: on the pediatric side we heavily rely on our endocrine colleagues, but on the adult side, we routinely hold it. Just seems to be a whole bunch of inertia even if it's a #TWDFNR. #JHMChat
Payal Parikh, MD, FACP @Payalia320
@ETSshow @JHospMedicine that was my teaching as well, but working on this paper with @DavidACohen_MD and @DanielRicottaMD helped me to really change my own practice, especially in the right patient population that does not have any reason to have significant AKI. now I teach my residents! #JHMChat
Melissa Plesac @MelissaPlesacMD
@JHospMedicine @michellebr00ks Melissa Plesac from University of Minnesota joining a few minutes late! #JHMChat
Tony Breu @tony_breu
@JHospMedicine I certainly experience this inertia. With complex patients, this is often not item #1 for discussion. #JHMChat
Leonard Feldman @DocLennyF
@ETSshow @tony_breu #JHMChat Nausea in pts who regularly take met?
Journal of Hospital Medicine @JHospMedicine
This has to be my favorite part about the #phm folks being in this chat! #JHMChat
Averi Wilson-Raya, MD @AveriWilsonMD
RT @JHospMedicine: Topic 1️⃣: Topic 1️⃣: Holding Metformin in Hospitalized Patients 🔗 Article Link: https://t.co/j86y6Vuclu 👀 Awesome #VisualAbstract by @LannaFelde #JHMChat https://t.co/jbJN76mXro
Mark Shapiro, MD @ETSshow
@NdidiUnaka @JHospMedicine #JHMChat
Karyn Baum (she/her) @karynbaum
@JHospMedicine A1 I used to hold it all the time. Now I only hold if the renal function is off, sepsis, decompensated CHF or liver ds. Tell me if I'm an idiot though since all I do now is admitting shifts! #JHMChat
Ndidi Unaka MD, MEd @NdidiUnaka
RT @JHospMedicine: This is an excellent question. Do we develop therapeutic inertia? #JHMChat
Journal of Hospital Medicine @JHospMedicine
@WrayCharles Hard co-sign @ETSshow #JHMChat
Mark Shapiro, MD @ETSshow
@jenreadlynn @JHospMedicine #JHMChat
Payal Parikh, MD, FACP @Payalia320
@WrayCharles @JHospMedicine Agreed! working on this paper with @DavidACohen_MD and @DanielRicottaMD helped me to really change my own practice and made me comfortable to continue the metformin, now I teach my residents! #JHMChat
Trushar M. Dungarani @DrT_Dungarani
Also Irrational fear of diarrhea and subsequent c diff ordering #JHMChat
Tony Breu @tony_breu
@ETSshow It's remarkable how that attending experience imprinted a sustained practice. #JHMChat
Mark Shapiro, MD @ETSshow
@DocLennyF @tony_breu It’s been a minute but yes #JHMChat
Doctivist 🏳️‍🌈 🇺🇸 @jbcowartmd
@JHospMedicine @michellebr00ks Howdy! Jennifer Cowart, academic hospitalist in Florida, here as longtime #TWDFNR fan! #jhmchat
Reshon Hadmon, MD 🩺 @HadmonReshon
@JHospMedicine @SocietyHospMed The article identified a interesting criteria with Covid infection #JHMChat
Journal of Hospital Medicine @JHospMedicine
Adds another whole dimension! Surgeons can blame the metformin for the elevated lactate and AKI? @aoglasser #JHMChat
Payal Parikh, MD, FACP @Payalia320
@DharSaty @jenreadlynn @JHospMedicine @COREIMpodcast @UR_HMD that is eactly the basis of our paper! throwing in also advance heart failure and any reason to believe a patient will likely go into AKI! #JHMChat
Society of Hospital Medicine @SocietyHospMed
@jbcowartmd @JHospMedicine @michellebr00ks Welcome to the #JHMChat! Happy you're here!
Mark Shapiro, MD @ETSshow
@tony_breu My admiration for you grows. I appreciate this #JHMChat
Mark Shapiro, MD @ETSshow
RT @tony_breu: @ETSshow It's remarkable how that attending experience imprinted a sustained practice. #JHMChat
Journal of Hospital Medicine @JHospMedicine
RT @DrSamanthaWang: @JHospMedicine If patient is admitted without acute renal injury or increased risk for renal injury, I continue metformin! I find it achieves better glucose control than transitioning to basal/sliding scale insulin. #JHMChat
Society of Hospital Medicine @SocietyHospMed
📟 Our #JHMChat is happening NOW with guests @tony_breu and @DocLennyF. We’re talking Things We Do For No Reason™️ 👀 Pros 🆚 Cons. Unnecessary 🆚 Necessary Don’t miss the chance to share your stance! 💪 @JHospMedicine @michellebr00ks
Dhruv Srinivasachar MD (he/el/ele.) @TheRealDSrini
@prabimd @freckledpedidoc @elibrilu 🤣🤣🤣🤣🤣 Combined resident half laughing and half engaged in the argument...#JHMChat
Journal of Hospital Medicine @JHospMedicine
RT @WrayCharles: @tony_breu Exactly, Tony. I don't mind if held on day 1 and 2 - but once I start to see clinically stability, I'm pushing myself and team to think about getting back on board #JHMChat
Mark Shapiro, MD @ETSshow
RT @Payalia320: @ETSshow @JHospMedicine that was my teaching as well, but working on this paper with @DavidACohen_MD and @DanielRicottaMD helped me to really change my own practice, especially in the right patient population that does not have any reason to have significant AKI. now I teach my residents! #JHMChat
Charlie M. Wray, DO, MS @WrayCharles
The cool thing about #JHMChat is that it brings back a lot of our past JHM Editorial Fellows, like @MelissaPlesacMD & @DrSamanthaWang
Mark Shapiro, MD @ETSshow
@Payalia320 @JHospMedicine @DavidACohen_MD @DanielRicottaMD I really appreciate this. Thank you! #JHMChat
David A. Cohen @DavidACohen_MD
@jenreadlynn @tony_breu @AmDiabetesAssn And it’s isn’t a point that is unique to #diabetes — so many home regimens get changed while a patient is admitted and not restarted on discharge. Leads to difficulty with transitions of care and readmissions. #JHMChat
Samantha Wang @DrSamanthaWang
@Payalia320 @WrayCharles @JHospMedicine @DavidACohen_MD @DanielRicottaMD I once had a patient with solitary kidney and diabetes (on Metformin) who developed oliguric AKI. Nephrologist did ask to trend lactates overnight. He did not develop lactic acidosis (though we did hold his metformin in that case). #JHMChat
Payal Parikh, MD, FACP @Payalia320
@DrSamanthaWang @JHospMedicine agreed completely! less fluctuations in blood glucose, and thereby possibly less days in hospital because less hypoglycemic/hyperglycemic events! #JHMChat
Ndidi Unaka MD, MEd @NdidiUnaka
RT @tony_breu: @ETSshow It's remarkable how that attending experience imprinted a sustained practice. #JHMChat
Anika Kumar, MD (she/her) @freckledpedidoc
@prabimd @elibrilu I’m just over here enjoying my marshmallows… #JHMChat https://t.co/gktD3NPtPY
Melissa Plesac @MelissaPlesacMD
@jenreadlynn @tony_breu Same! I am driven by my love for having the active med list the day prior to discharge being as close to the discharging med list as possible! #JHMChat
Journal of Hospital Medicine @JHospMedicine
RT @DavidACohen_MD: @jenreadlynn @tony_breu @AmDiabetesAssn And it’s isn’t a point that is unique to #diabetes — so many home regimens get changed while a patient is admitted and not restarted on discharge. Leads to difficulty with transitions of care and readmissions. #JHMChat
Mark Shapiro, MD @ETSshow
RT @JHospMedicine: @WrayCharles Hard co-sign @ETSshow #JHMChat
Journal of Hospital Medicine @JHospMedicine
RT @jenreadlynn: @tony_breu Definitely try to add it back when approaching discharge. Have started doing earlier if taking good PO. Often makes insulin management much easier and allows us to space BG checks too. #JHMChat
Jen Readlynn, MD, FHM (she/her) @jenreadlynn
@DocLennyF @WrayCharles @tony_breu Luckily I have colleagues like @JennyShenMD who deal much more w/ periop. If it hasn't been restarted, I would probably wait until after surgery "just in case" but if they're already on &stable I don't see a reason to stop unless concerned for kidney injury in surgery. #JHMChat
Leonard Feldman @DocLennyF
@ETSshow @tony_breu #JHMChat hard not to remember the time an attending ripped you. I still recall when I got yelled at for not doing a testicular exam on a pt with a new DVT.
Journal of Hospital Medicine @JHospMedicine
RT @NdidiUnaka: @ETSshow @JHospMedicine I can count on one hand the number of times I have taken care of a hospitalized peds patient on metformin. So I would love to learn more about what informs your practice #JHMChat
Doctivist 🏳️‍🌈 🇺🇸 @jbcowartmd
RT @JHospMedicine: Topic 1️⃣: Topic 1️⃣: Holding Metformin in Hospitalized Patients 🔗 Article Link: https://t.co/j86y6Vuclu 👀 Awesome #VisualAbstract by @LannaFelde #JHMChat https://t.co/jbJN76mXro
Journal of Hospital Medicine @JHospMedicine
RT @Payalia320: @ETSshow @JHospMedicine that was my teaching as well, but working on this paper with @DavidACohen_MD and @DanielRicottaMD helped me to really change my own practice, especially in the right patient population that does not have any reason to have significant AKI. now I teach my residents! #JHMChat
Anika Kumar, MD (she/her) @freckledpedidoc
RT @SocietyHospMed: 📟 Our #JHMChat is happening NOW with guests @tony_breu and @DocLennyF. We’re talking Things We Do For No Reason™️ 👀 Pros 🆚 Cons. Unnecessary 🆚 Necessary Don’t miss the chance to share your stance! 💪 @JHospMedicine @michellebr00ks
Journal of Hospital Medicine @JHospMedicine
@MelissaPlesacMD @michellebr00ks So glad you're here! #JHMChat
David A. Cohen @DavidACohen_MD
@MelissaPlesacMD @jenreadlynn @tony_breu Yes!!! So important for transitions of care!! #JHMChat https://t.co/NcSwslNyxD
Payal Parikh, MD, FACP @Payalia320
@karynbaum @JHospMedicine agreed! I used to hold it all the time too! working on this #TWDFNR with @DavidACohen_MD and @DanielRicottaMD helped me to really change my own practice and made me comfortable to continue the metformin and really only hold if potential for AKI! #JHMChat
Mark Shapiro, MD @ETSshow
@DocLennyF @tony_breu We all have stories sadly I would have enjoyed having you both as attendings #JHMChat
Charlie M. Wray, DO, MS @WrayCharles
@DocLennyF @tony_breu Making it more difficult for us now, Lenny! For me, it's held periop. If anticipate quick DC home (ie. pt on a CoM service) will just advise to restart at home (1-2 days later) #JHMChat
Jen Readlynn, MD, FHM (she/her) @jenreadlynn
@tony_breu @JHospMedicine For sure. I always tell new hospitalists or even residents that unless they're admitted for a blood sugar issue, we're going to pay more attention to that on day 2 and deal with other acute issues on day 1. We'll have a plan but take a closer look later. #JHMChat
Journal of Hospital Medicine @JHospMedicine
#JHMChat https://t.co/EozoCFCNJL
Ndidi Unaka MD, MEd @NdidiUnaka
RT @SocietyHospMed: 📟 Our #JHMChat is happening NOW with guests @tony_breu and @DocLennyF. We’re talking Things We Do For No Reason™️ 👀 Pros 🆚 Cons. Unnecessary 🆚 Necessary Don’t miss the chance to share your stance! 💪 @JHospMedicine @michellebr00ks
Journal of Hospital Medicine @JHospMedicine
This has been so interesting to hear how practices differ. Topic 2️⃣ is coming up soon... #JHMChat
Journal of Hospital Medicine @JHospMedicine
@jbcowartmd @michellebr00ks So glad you made it! #JHMChat
Trushar M. Dungarani @DrT_Dungarani
Hope you did your fecal occult test too! #twdfnr #JHMChat
Tony Breu @tony_breu
I do want to go on the record as saying that I believe metformin associated lactic acidosis exists. #JHMChat
Mark Shapiro, MD @ETSshow
@WrayCharles @DocLennyF @tony_breu Our patterns are similar here @WrayCharles #JHMChat
Journal of Hospital Medicine @JHospMedicine
RT @SocietyHospMed: 📟 Our #JHMChat is happening NOW with guests @tony_breu and @DocLennyF. We’re talking Things We Do For No Reason™️ 👀 Pros 🆚 Cons. Unnecessary 🆚 Necessary Don’t miss the chance to share your stance! 💪 @JHospMedicine @michellebr00ks
Lanna Felde @LannaFelde
@MelissaPlesacMD @jenreadlynn @tony_breu Agree, this is part of good discharge planning 💪#jhmchat
Joseph “Dr. Joe” Thomas, MD @DocWithBowtie
@JHospMedicine #JHMChat A1: I’m in the same camp as @ETSshow, I always hold it. Even after the “looser control 120-180” proved less difficult, and seeing through the “people don’t eat as much, so we just hold all the meds”, it’s just ingrained to switch to insulin control. This is a good topic.
Society of Hospital Medicine @SocietyHospMed
RT @tony_breu: I do want to go on the record as saying that I believe metformin associated lactic acidosis exists. #JHMChat
Journal of Hospital Medicine @JHospMedicine
RT @Payalia320: @DrSamanthaWang @JHospMedicine agreed completely! less fluctuations in blood glucose, and thereby possibly less days in hospital because less hypoglycemic/hyperglycemic events! #JHMChat
Doctivist 🏳️‍🌈 🇺🇸 @jbcowartmd
Hidden curriculum strikes again.
Eileen Barrett MD MPH (she/her) @EileenBarrettNM
@JHospMedicine A. would like to add it back to my practice, after reading this article. But anticipating the texts and panic about it from colleagues makes me tired already! It will be important for there to be a lot of peer education #JHMChat
Mark Shapiro, MD @ETSshow
RT @DocWithBowtie: @JHospMedicine #JHMChat A1: @JHospMedicine #JHMChat A1: I’m in the same camp as @ETSshow, I always hold it. Even after the “looser control 120-180” proved less difficult, and seeing through the “people don’t eat as much, so we just hold all the meds”, it’s just ingrained to switch to insulin control. This is a good topic.
Society of Hospital Medicine @SocietyHospMed
RT @EileenBarrettNM: @JHospMedicine A. would like to add it back to my practice, after reading this article. But anticipating the texts and panic about it from colleagues makes me tired already! It will be important for there to be a lot of peer education #JHMChat
Journal of Hospital Medicine @JHospMedicine
@freckledpedidoc @prabimd @elibrilu Is this you? #JHMChat https://t.co/danVzLvQyO
Anika Kumar, MD (she/her) @freckledpedidoc
@NdidiUnaka @JHospMedicine @ETSshow You have more experience than me Dr. Unaka… learning so much from our Adult Hospitalist colleagues #JHMChat https://t.co/wKVuniaomN
Journal of Hospital Medicine @JHospMedicine
Topic 2️⃣: Routine Inclusion of Race in the HPI 🔗 Article Link: https://t.co/2SbJf9IcV1 👀 #VisualAbstract by @michellebr00ks #JHMChat https://t.co/wR7OjiMeiF
Journal of Hospital Medicine @JHospMedicine
RT @EileenBarrettNM: @JHospMedicine A. would like to add it back to my practice, after reading this article. But anticipating the texts and panic about it from colleagues makes me tired already! It will be important for there to be a lot of peer education #JHMChat
Charlie M. Wray, DO, MS @WrayCharles
@tony_breu Honest question...have you ever (knowingly) seen it? #JHMChat
Society of Hospital Medicine @SocietyHospMed
RT @JHospMedicine: Topic 2️⃣: Topic 2️⃣: Routine Inclusion of Race in the HPI 🔗 Article Link: https://t.co/2SbJf9IcV1 👀 #VisualAbstract by @michellebr00ks #JHMChat https://t.co/wR7OjiMeiF
Yichi Zhang (张一弛) @YichiZzzzz
@jenreadlynn @JHospMedicine @COREIMpodcast @UR_HMD Speaking of the wonderful @COREIMpodcast and inpatient diabetes mgmt, I'm working to produce a graphic byte about Basal-Bolus > SSI. And a major limitation of previous studies is the discontinuation of oral antidiabetic agents. Future studies should really address this! #JHMChat
Tony Breu @tony_breu
It's just very rare and requires pretty bad AKI and continuation of metformin. #JHMChat
Lanna Felde @LannaFelde
@EileenBarrettNM @JHospMedicine So true. Inertia is so powerful. #JHMChat
Anika Kumar, MD (she/her) @freckledpedidoc
@JHospMedicine @prabimd @elibrilu #JHMChat https://t.co/avWx3I2lA0
Journal of Hospital Medicine @JHospMedicine
Does anyone want to talk about the other biguanide in the article? #JHMChat https://t.co/un4XFZWoYo
Leonard Feldman @DocLennyF
@EileenBarrettNM @JHospMedicine #JHMChat it is a bit like swimming upstream. https://t.co/PfrCuGjerP
Ndidi Unaka MD, MEd @NdidiUnaka
RT @JHospMedicine: Topic 2️⃣: Topic 2️⃣: Routine Inclusion of Race in the HPI 🔗 Article Link: https://t.co/2SbJf9IcV1 👀 #VisualAbstract by @michellebr00ks #JHMChat https://t.co/wR7OjiMeiF
Tony Breu @tony_breu
@WrayCharles I have. It wasn't subtle. Cr 9. LA >10. #JHMChat
Maha @Arhait
@JHospMedicine Q1 I would say at least continue metformin for observation patients #JHMChat
Dhruv Srinivasachar MD (he/el/ele.) @TheRealDSrini
@JHospMedicine Since when do people use Phenformin anymore?! #JHMChat
Journal of Hospital Medicine @JHospMedicine
@DrT_Dungarani #JHMChat https://t.co/jBSfwePbLs
David A. Cohen @DavidACohen_MD
@NdidiUnaka @ETSshow @JHospMedicine Thanks @NdidiUnaka — I’m on our endo consult service right now & it’ll take my 2 hands plus 1 of yours to count the patients we have on metformin. Without contraindications (hypoxia, sepsis, AKI) it is very effective to help lower glucose levels without hypoglycemia. #JHMChat
Journal of Hospital Medicine @JHospMedicine
RT @jenreadlynn: @tony_breu @JHospMedicine For sure. I always tell new hospitalists or even residents that unless they're admitted for a blood sugar issue, we're going to pay more attention to that on day 2 and deal with other acute issues on day 1. We'll have a plan but take a closer look later. #JHMChat
Jen Readlynn, MD, FHM (she/her) @jenreadlynn
@EileenBarrettNM @JHospMedicine My colleague (Dr. Meghan Train) and I help run our high value care series for our HMD faculty development. We use these articles as the blueprint and bring in local experts to discuss practices. It's really fun and informative! #JHMChat
Journal of Hospital Medicine @JHospMedicine
RT @Payalia320: @karynbaum @JHospMedicine agreed! I used to hold it all the time too! working on this #TWDFNR with @DavidACohen_MD and @DanielRicottaMD helped me to really change my own practice and made me comfortable to continue the metformin and really only hold if potential for AKI! #JHMChat
Journal of Hospital Medicine @JHospMedicine
RT @DavidACohen_MD: @MelissaPlesacMD @jenreadlynn @tony_breu Yes!!! So important for transitions of care!! #JHMChat https://t.co/NcSwslNyxD
Society of Hospital Medicine @SocietyHospMed
RT @jenreadlynn: @EileenBarrettNM @JHospMedicine My colleague (Dr. Meghan Train) and I help run our high value care series for our HMD faculty development. We use these articles as the blueprint and bring in local experts to discuss practices. It's really fun and informative! #JHMChat
Mark Shapiro, MD @ETSshow
RT @jenreadlynn: #JHMChat, #KetanjiBrownJacksonHearing , & #MomMilestones by @gracefarris! Great day! https://t.co/JgejyzpgJs
Ndidi Unaka MD, MEd @NdidiUnaka
RT @DavidACohen_MD: @NdidiUnaka @ETSshow @JHospMedicine Thanks @NdidiUnaka — I’m on our endo consult service right now & it’ll take my 2 hands plus 1 of yours to count the patients we have on metformin. Without contraindications (hypoxia, sepsis, AKI) it is very effective to help lower glucose levels without hypoglycemia. #JHMChat
Anika Kumar, MD (she/her) @freckledpedidoc
@jenreadlynn @EileenBarrettNM @JHospMedicine That’s a wonderful idea @jenreadlynn!! #JHMChat
Journal of Hospital Medicine @JHospMedicine
Is there a zoom link? Asking for our friend @michellebr00ks. #JHMChat
Jenny Y Shen, MD, FHM @JennyShenMD
@jenreadlynn @DocLennyF @WrayCharles @tony_breu Metformin periop I tend to hold until clinical stability. Post op AKI no joke and common. I usually hold Metformin on admission since people show up with AKI or need contrast study. #JHMChat
Journal of Hospital Medicine @JHospMedicine
Q2: How do you address and/or teach about the use of race in an HPI? How has this #TWDFNR article impacted your practice? #JHMChat https://t.co/MavwL5QakO
Society of Hospital Medicine @SocietyHospMed
RT @JHospMedicine: Q2: Q2: How do you address and/or teach about the use of race in an HPI? How has this #TWDFNR article impacted your practice? #JHMChat https://t.co/MavwL5QakO
Payal Parikh, MD, FACP @Payalia320
@tony_breu I did see a case of it as an intern @The_BMC! it does exist!! patient had a glucose of 5! AG 30, corrected in 24 hrs, patient walked out!! #JHMChat
Ndidi Unaka MD, MEd @NdidiUnaka
RT @JHospMedicine: Q2: Q2: How do you address and/or teach about the use of race in an HPI? How has this #TWDFNR article impacted your practice? #JHMChat https://t.co/MavwL5QakO
Jen Readlynn, MD, FHM (she/her) @jenreadlynn
RT @YichiZTulane: @jenreadlynn @JHospMedicine @COREIMpodcast @UR_HMD Speaking of the wonderful @COREIMpodcast and inpatient diabetes mgmt, I'm working to produce a graphic byte about Basal-Bolus > SSI. And a major limitation of previous studies is the discontinuation of oral antidiabetic agents. Future studies should really address this! #JHMChat
David A. Cohen @DavidACohen_MD
@TheRealDSrini @JHospMedicine I use it right in between leaches for bloodletting and eye of newt. #JHMChat
Journal of Hospital Medicine @JHospMedicine
RT @YichiZTulane: @jenreadlynn @JHospMedicine @COREIMpodcast @UR_HMD Speaking of the wonderful @COREIMpodcast and inpatient diabetes mgmt, I'm working to produce a graphic byte about Basal-Bolus > SSI. And a major limitation of previous studies is the discontinuation of oral antidiabetic agents. Future studies should really address this! #JHMChat
Melissa Plesac @MelissaPlesacMD
@tony_breu Have only seen it when patient with new renal failure gets sent out with it restarted as a home med on accident #obsessedwithmedrecs #JHMChat
Leonard Feldman @DocLennyF
@DavidACohen_MD @NdidiUnaka @ETSshow @JHospMedicine #JHMChat Obs pts are definitely low hanging fruit. https://t.co/GhHtv5dGCP
Payal Parikh, MD, FACP @Payalia320
@WrayCharles @tony_breu I did see a case of it as an intern @The_BMC ! it does exist!! patient had a glucose of 5! AG 30, corrected in 24 hrs, patient walked out!! #JHMChat
Charlie M. Wray, DO, MS @WrayCharles
@DocLennyF @EileenBarrettNM @JHospMedicine You should come more often, Lenny. You eventually get used to it #JHMChat
Journal of Hospital Medicine @JHospMedicine
@DavidACohen_MD @TheRealDSrini Only took a few minutes to get to bloodletting! #JHMChat
Yichi Zhang (张一弛) @YichiZzzzz
@JHospMedicine @michellebr00ks A2: I think the focus here should really be educational programs aimed at recognizing and mitigating #implicitbias. Because whether race is included in HPI or not, some clinicians will still choose different treatments based on race if they are not well-informed. #JHMChat
Journal of Hospital Medicine @JHospMedicine
RT @JennyShenMD: @jenreadlynn @DocLennyF @WrayCharles @tony_breu Metformin periop I tend to hold until clinical stability. Post op AKI no joke and common. I usually hold Metformin on admission since people show up with AKI or need contrast study. #JHMChat
Society of Hospital Medicine @SocietyHospMed
RT @YichiZTulane: @JHospMedicine @michellebr00ks A2: @JHospMedicine @michellebr00ks A2: I think the focus here should really be educational programs aimed at recognizing and mitigating #implicitbias. Because whether race is included in HPI or not, some clinicians will still choose different treatments based on race if they are not well-informed. #JHMChat
Charlie M. Wray, DO, MS @WrayCharles
RT @JHospMedicine: Q2: Q2: How do you address and/or teach about the use of race in an HPI? How has this #TWDFNR article impacted your practice? #JHMChat https://t.co/MavwL5QakO
Journal of Hospital Medicine @JHospMedicine
Really well said @YichiZTulane. #JHMChat
Beatriz Rivera Rodriguez @Bea_riverar
RT @JHospMedicine: Topic 2️⃣: Topic 2️⃣: Routine Inclusion of Race in the HPI 🔗 Article Link: https://t.co/2SbJf9IcV1 👀 #VisualAbstract by @michellebr00ks #JHMChat https://t.co/wR7OjiMeiF
David A. Cohen @DavidACohen_MD
@JennyShenMD @jenreadlynn @DocLennyF @WrayCharles @tony_breu Yes about holding with AKI & contrast. But IV contrast with normal renal function + metformin is totally OK! And actually good… #JHMChat
Jen Readlynn, MD, FHM (she/her) @jenreadlynn
@JHospMedicine @michellebr00ks I can make it happen as long as @UR_HMD and @ValerieLangMD agree to share! #JHMChat
Karyn Baum (she/her) @karynbaum
@JHospMedicine @michellebr00ks A2 Used to include it until a couple of years ago. Don't anymore. Goes in social if anywhere at all. Otherwise, into the EHR so we can measure how we are doing with closing disparity gap (hint: not great). Honestly, how many of us have been trained how to ask anyway? #jhmchat
Melissa Plesac @MelissaPlesacMD
@karynbaum @EileenBarrettNM @JHospMedicine Haha makes me think how many times I have had to explain to a Minnesotan patient why I have held their Metformin! I miss you Dr. Baum!!!! #JHMChat
Leonard Feldman @DocLennyF
@YichiZTulane @JHospMedicine @michellebr00ks #JHMchat Social determinants of health are so often overlooked!
Prabi Rajbhandari @prabimd
A2: not in HPI but in social history, after one has asked and verified appropriately , often people assume the race based on how they look which is wrong #JHMChat
Elise Peterson Lu, MD, PhD @elibrilu
A2: I haven't actually used race in an HPI since medical school (full disclosure, graduated in 2015). It was not standard at Children's due to intentional changes by our faculty. But I've definitely had to address it with students on rounds or in documentation. #JHMChat
Tony Breu @tony_breu
One of the most interesting quotes from the paper. "In a recent study, clinicians documented race in the HPI for 33% of Black patients compared with 16% of White patients, and White clinicians were twice as likely to document race as Black physicians." #JHMChat
Melissa Plesac @MelissaPlesacMD
RT @YichiZTulane: @JHospMedicine @michellebr00ks A2: @JHospMedicine @michellebr00ks A2: I think the focus here should really be educational programs aimed at recognizing and mitigating #implicitbias. Because whether race is included in HPI or not, some clinicians will still choose different treatments based on race if they are not well-informed. #JHMChat
Society of Hospital Medicine @SocietyHospMed
RT @tony_breu: One of the most interesting quotes from the paper. "In a recent study, clinicians documented race in the HPI for 33% of Black patients compared with 16% of White patients, and White clinicians were twice as likely to document race as Black physicians." #JHMChat
Ammar @AmmarSaati
RT @JHospMedicine: Topic 2️⃣: Topic 2️⃣: Routine Inclusion of Race in the HPI 🔗 Article Link: https://t.co/2SbJf9IcV1 👀 #VisualAbstract by @michellebr00ks #JHMChat https://t.co/wR7OjiMeiF
Dhruv Srinivasachar MD (he/el/ele.) @TheRealDSrini
@JHospMedicine A2: I have consciously avoided putting race in the HPI. My question is how do we incorporate SES/effects of systemic racism into the Social Hx (likely the best place)? #JHMChat
Leonard Feldman @DocLennyF
@prabimd #jhmchat. How does it add to the social history?
Joseph “Dr. Joe” Thomas, MD @DocWithBowtie
@JHospMedicine #JHMChat A2: YES I LOVE THIS ONE. This is actually something I did all through residency and then becoming active on #MedTwitter and seeing people discuss the exact points of this #TWDFNR made me realize how unnecessary it was as a routine one-liner component.
David A. Cohen @DavidACohen_MD
RT @Payalia320: @karynbaum @JHospMedicine agreed! I used to hold it all the time too! working on this #TWDFNR with @DavidACohen_MD and @DanielRicottaMD helped me to really change my own practice and made me comfortable to continue the metformin and really only hold if potential for AKI! #JHMChat
Jen Readlynn, MD, FHM (she/her) @jenreadlynn
@JHospMedicine T2: I'm grateful that I haven't encountered a lot of use of race in HPI as a learner or an educator. However, we have only recently started addressing social determinants of health in the medical record and we could do better w/ actions & resources. #JHMChat
Lanna Felde @LannaFelde
@elibrilu Agree. But I find it challenging to correct trainees. Do you take time out to explain to your team why they shouldn't include it? #jhmchat
Ndidi Unaka MD, MEd @NdidiUnaka
@JHospMedicine A1: I honestly never document race in my notes. There is more than enough bias in our system...we do not need to create more. I am so glad that the students and trainees I have worked with share this same approach #JHMChat
Society of Hospital Medicine @SocietyHospMed
RT @DocWithBowtie: @JHospMedicine #JHMChat A2: @JHospMedicine #JHMChat A2: YES I LOVE THIS ONE. This is actually something I did all through residency and then becoming active on #MedTwitter and seeing people discuss the exact points of this #TWDFNR made me realize how unnecessary it was as a routine one-liner component.
David A. Cohen @DavidACohen_MD
RT @Payalia320: @WrayCharles @JHospMedicine Agreed! working on this paper with @DavidACohen_MD and @DanielRicottaMD helped me to really change my own practice and made me comfortable to continue the metformin, now I teach my residents! #JHMChat
Annie Massart @Annie_Massart_
@JHospMedicine A2.Someone taught me why this is a TWDFNR a few years back. Since then,I realized most of my learners were ahead of the curve and they don't use race in the HPI. When I see it in notes, it's always written by faculty. Takes us older folks longer to change our ways! #JHMChat
Journal of Hospital Medicine @JHospMedicine
RT @DocWithBowtie: @JHospMedicine #JHMChat A2: @JHospMedicine #JHMChat A2: YES I LOVE THIS ONE. This is actually something I did all through residency and then becoming active on #MedTwitter and seeing people discuss the exact points of this #TWDFNR made me realize how unnecessary it was as a routine one-liner component.
Joseph “Dr. Joe” Thomas, MD @DocWithBowtie
@JHospMedicine #JHMChat A2.2 It’s been difficult to find opportunities to discuss and change this practice among others, outside of directly precepting residents, which I don’t do as regularly. Usually bc the days are busy and I feel like it’s seen as trivial among my mostly White colleagues.
Society of Hospital Medicine @SocietyHospMed
RT @NdidiUnaka: @JHospMedicine A1: @JHospMedicine A1: I honestly never document race in my notes. There is more than enough bias in our system...we do not need to create more. I am so glad that the students and trainees I have worked with share this same approach #JHMChat
Anika Kumar, MD (she/her) @freckledpedidoc
@JHospMedicine A2. The #TWDFNR article didn’t impact my practice of documenting race. In my Pediatrics residency, we were taught not to include it. Since then I’ve always questioned it. The article made it easier to teach trainees not to document race. #JHMChat
Tony Breu @tony_breu
@TheRealDSrini @JHospMedicine I do a poor job of assessing for these factors myself which limits my ability to incorporate them. #JHMChat
Journal of Hospital Medicine @JHospMedicine
RT @tony_breu: One of the most interesting quotes from the paper. "In a recent study, clinicians documented race in the HPI for 33% of Black patients compared with 16% of White patients, and White clinicians were twice as likely to document race as Black physicians." #JHMChat
Anika Kumar, MD (she/her) @freckledpedidoc
RT @YichiZTulane: @JHospMedicine @michellebr00ks A2: @JHospMedicine @michellebr00ks A2: I think the focus here should really be educational programs aimed at recognizing and mitigating #implicitbias. Because whether race is included in HPI or not, some clinicians will still choose different treatments based on race if they are not well-informed. #JHMChat
Journal of Hospital Medicine @JHospMedicine
RT @elibrilu: A2: A2: I haven't actually used race in an HPI since medical school (full disclosure, graduated in 2015). It was not standard at Children's due to intentional changes by our faculty. But I've definitely had to address it with students on rounds or in documentation. #JHMChat
Lonika *abortion is health care* @sood_lonika
Lurking from Spokane… #JHMChat
Samantha Wang @DrSamanthaWang
A2: I think we've failed in medicine in perpetuating the fallacy that race is biologic and inclusion of it into the PMH is somehow significant in its association with chief compliant, disease, or treatment. Instead, focus should be on structural factors affecting health #JHMChat
Journal of Hospital Medicine @JHospMedicine
RT @karynbaum: @JHospMedicine @michellebr00ks A2 Used to include it until a couple of years ago. Don't anymore. Goes in social if anywhere at all. Otherwise, into the EHR so we can measure how we are doing with closing disparity gap (hint: not great). Honestly, how many of us have been trained how to ask anyway? #jhmchat
Joseph “Dr. Joe” Thomas, MD @DocWithBowtie
@JHospMedicine #JHMChat A2.3: This is inspiring to include this in one of our upcoming team-wide e-mails, though.
Reshon Hadmon, MD 🩺 @HadmonReshon
@JHospMedicine @SocietyHospMed This is a topic that’s has been trending for a while. Some students might find this beneficial because it gives hints to answer, but I agree with the visual abstract with skin tone instead of race. The use of race can lead to some instances of negligence in management. #JHMChat
Society of Hospital Medicine @SocietyHospMed
⏲️ This #JHMChat is 🔥! ✅ Connect with your hospitalist community ✅ Share advice ✅ Learn tips Use #JHMChat on all replies to be part of the conversation!
Vinny Arora MD MAPP @FutureDocs
RT @JHospMedicine: Topic 2️⃣: Topic 2️⃣: Routine Inclusion of Race in the HPI 🔗 Article Link: https://t.co/2SbJf9IcV1 👀 #VisualAbstract by @michellebr00ks #JHMChat https://t.co/wR7OjiMeiF
Journal of Hospital Medicine @JHospMedicine
RT @HadmonReshon: @JHospMedicine @SocietyHospMed This is a topic that’s has been trending for a while. Some students might find this beneficial because it gives hints to answer, but I agree with the visual abstract with skin tone instead of race. The use of race can lead to some instances of negligence in management. #JHMChat
Society of Hospital Medicine @SocietyHospMed
RT @DrSamanthaWang: A2: A2: I think we've failed in medicine in perpetuating the fallacy that race is biologic and inclusion of it into the PMH is somehow significant in its association with chief compliant, disease, or treatment. Instead, focus should be on structural factors affecting health #JHMChat
Anika Kumar, MD (she/her) @freckledpedidoc
RT @NdidiUnaka: @JHospMedicine A1: @JHospMedicine A1: I honestly never document race in my notes. There is more than enough bias in our system...we do not need to create more. I am so glad that the students and trainees I have worked with share this same approach #JHMChat
Payal Parikh, MD, FACP @Payalia320
@JHospMedicine @michellebr00ks A2: I agree with the authors. Including in the social Hx. #SDOH are 📈important. Also would add, better to ask and not assume! do need a standard way to capture in EMR #jhmchat
Journal of Hospital Medicine @JHospMedicine
RT @SocietyHospMed: ⏲️ This #JHMChat is 🔥! ✅ Connect with your hospitalist community ✅ Share advice ✅ Learn tips Use #JHMChat on all replies to be part of the conversation!
Jen Readlynn, MD, FHM (she/her) @jenreadlynn
@MelissaPlesacMD @tony_breu I have to say that I love and appreciate your obsession with med recs! #JHMChat https://t.co/j1LowI5ZHB
Lonika *abortion is health care* @sood_lonika
@JHospMedicine T2: learnt in residency to use it… but #MedTwitter has helped to change my approach… I don’t use it anymore #jhmchat
Tony Breu @tony_breu
@Annie_Massart_ @JHospMedicine Yes, I have noticed this as well. #JHMChat
Christle Nwora, MD @ChristleNwora
RT @JHospMedicine: Q2: Q2: How do you address and/or teach about the use of race in an HPI? How has this #TWDFNR article impacted your practice? #JHMChat https://t.co/MavwL5QakO
Journal of Hospital Medicine @JHospMedicine
Another hard co-sign. #JHMChat
Caregiver ✝️💞⚔️🛡️ @stevecripe57
RT @JennyShenMD: @jenreadlynn @DocLennyF @WrayCharles @tony_breu Metformin periop I tend to hold until clinical stability. Post op AKI no joke and common. I usually hold Metformin on admission since people show up with AKI or need contrast study. #JHMChat
Anika Kumar, MD (she/her) @freckledpedidoc
@prabimd Curious Prabi, why you add it to social history? #JHMChat
Journal of Hospital Medicine @JHospMedicine
RT @freckledpedidoc: @JHospMedicine A2. The #TWDFNR article didn’t impact my practice of documenting race. In my Pediatrics residency, we were taught not to include it. Since then I’ve always questioned it. The article made it easier to teach trainees not to document race. #JHMChat
Charlie M. Wray, DO, MS @WrayCharles
Nailed it! #JHMChat 👇👇👇
Ndidi Unaka MD, MEd @NdidiUnaka
The data speaks for itself #JHMCha
Jen Readlynn, MD, FHM (she/her) @jenreadlynn
@NdidiUnaka @JHospMedicine Totally agree. Now trying to work on bias associated with mental health disorders and substance use and how that gets discussed in the medical record! #JHMChat
Journal of Hospital Medicine @JHospMedicine
@Annie_Massart_ #JHMChat https://t.co/nujxB3t146
Vinny Arora MD MAPP @FutureDocs
@JHospMedicine @michellebr00ks This is one where I WAS taught to include race as a student so had to honestly learn not to as a practicing physician. Grateful for the grace and time to make this change and a key example of why faculty need to be taught too. #jhmchat
Lanna Felde @LannaFelde
@sood_lonika Welcome lurker! #jhmchat
Ndidi Unaka MD, MEd @NdidiUnaka
RT @DrSamanthaWang: A2: A2: I think we've failed in medicine in perpetuating the fallacy that race is biologic and inclusion of it into the PMH is somehow significant in its association with chief compliant, disease, or treatment. Instead, focus should be on structural factors affecting health #JHMChat
Journal of Hospital Medicine @JHospMedicine
RT @NdidiUnaka: @JHospMedicine A1: @JHospMedicine A1: I honestly never document race in my notes. There is more than enough bias in our system...we do not need to create more. I am so glad that the students and trainees I have worked with share this same approach #JHMChat
Joseph “Dr. Joe” Thomas, MD @DocWithBowtie
RT @DrSamanthaWang: A2: A2: I think we've failed in medicine in perpetuating the fallacy that race is biologic and inclusion of it into the PMH is somehow significant in its association with chief compliant, disease, or treatment. Instead, focus should be on structural factors affecting health #JHMChat
Leonard Feldman @DocLennyF
#JHMChat Should OUD, AUD, or tobacco use be in the social history? Aren’t they medical problems, not social problems?
Satyendra Dhar, MD FHM @DharSaty
@JHospMedicine I guess I have to change my practice! I believed the HPI should include every detail with well known diseases common in certain races. Thank you for article #NEJM . #JHMChat
Journal of Hospital Medicine @JHospMedicine
@sood_lonika #JHMChat https://t.co/wjmca0dAz9
Karyn Baum (she/her) @karynbaum
@Payalia320 @JHospMedicine @michellebr00ks We train registration folks how to ask this often sensitive question. If we are going to document, shouldn't we get the same training? #JHMChat
Ndidi Unaka MD, MEd @NdidiUnaka
@jenreadlynn @JHospMedicine I could not agree more! #JHMChat
Vinny Arora MD MAPP @FutureDocs
RT @tony_breu: One of the most interesting quotes from the paper. "In a recent study, clinicians documented race in the HPI for 33% of Black patients compared with 16% of White patients, and White clinicians were twice as likely to document race as Black physicians." #JHMChat
Journal of Hospital Medicine @JHospMedicine
What do y'all think? #JHMChat
Lonika *abortion is health care* @sood_lonika
@jenreadlynn @EileenBarrettNM @JHospMedicine Imma gonna chat with you about that #jhmchat
Inas Abuali, MD @inas_md
RT @DrSamanthaWang: A2: A2: I think we've failed in medicine in perpetuating the fallacy that race is biologic and inclusion of it into the PMH is somehow significant in its association with chief compliant, disease, or treatment. Instead, focus should be on structural factors affecting health #JHMChat
Journal of Hospital Medicine @JHospMedicine
RT @FutureDocs: @JHospMedicine @michellebr00ks This is one where I WAS taught to include race as a student so had to honestly learn not to as a practicing physician. Grateful for the grace and time to make this change and a key example of why faculty need to be taught too. #jhmchat
Melissa Plesac @MelissaPlesacMD
RT @DrSamanthaWang: A2: A2: I think we've failed in medicine in perpetuating the fallacy that race is biologic and inclusion of it into the PMH is somehow significant in its association with chief compliant, disease, or treatment. Instead, focus should be on structural factors affecting health #JHMChat
Andrew Zimolzak @AndrewZimolzak
RT @tony_breu: One of the most interesting quotes from the paper. "In a recent study, clinicians documented race in the HPI for 33% of Black patients compared with 16% of White patients, and White clinicians were twice as likely to document race as Black physicians." #JHMChat
Journal of Hospital Medicine @JHospMedicine
RT @jenreadlynn: @NdidiUnaka @JHospMedicine Totally agree. Now trying to work on bias associated with mental health disorders and substance use and how that gets discussed in the medical record! #JHMChat
Lanna Felde @LannaFelde
@NdidiUnaka @jenreadlynn @JHospMedicine great points! #jhmchat
Jen Readlynn, MD, FHM (she/her) @jenreadlynn
@TheRealDSrini @JHospMedicine I find it hard to do an assessment of these areas w/o having resources or solutions. Talking about these things can be traumatizing so I let them initiate. Probably not the best approach &am definitely missing things but want to help where I can & not cause harm. #JHMChat
Dhruv Srinivasachar MD (he/el/ele.) @TheRealDSrini
@DocLennyF Interesting thought! Especially if patients are on medical treatment for it! #JHMChat
Reshon Hadmon, MD 🩺 @HadmonReshon
@JHospMedicine @SocietyHospMed Also a great example which can be a teaching point is describing tone instead of race. Pigmented skin can affect the production of Vit D which is a risk factor for many pathologies. So the terminology has to change and also describe the pathological process.#JHMChat
Vinny Arora MD MAPP @FutureDocs
@JHospMedicine @michellebr00ks And yes I’m that old 😂 #jhmchat
Yichi Zhang (张一弛) @YichiZzzzz
@tony_breu I wonder what if this trend still holds true at our hospital, which serves a minority-majority community (60% African Americans), and the clinical faculty also tends to be more diverse. #JHMChat
Doctor Fingerguns @docfingerguns
98% of the time the inclusion of race in the HPI has no clinical relevance. Stop including it unless it is directly pertinent to the disease State going on (which it ALMOST never is)
Maha @Arhait
@JHospMedicine A2. During the covid crisis, race in the chart was like a hint of how complicated this encounter will be (implicit bias trap) #JHMChat
Journal of Hospital Medicine @JHospMedicine
⚡ As always...this #JHMChat is going by so quickly! #TWDFNR Topic 3️⃣ is up next..
Karyn Baum (she/her) @karynbaum
@DocLennyF They end up on many problem lists now. But a more standard approach would be helpful. #JHMChat
Trushar M. Dungarani @DrT_Dungarani
#JHMChat race and gender attempt to paint a human picture of our patients but lacks the consistency that is needed to avoid micro aggressions. We do need a solution to humanize the people we take care of.
Payal Parikh, MD, FACP @Payalia320
@karynbaum @JHospMedicine @michellebr00ks yes agreed! need to all be comfortable and use the same approach! so often it is "someone else's job" and tied to chart completion; but really should be everyone's job and tied to health care improvement! #JHMCHAT
Vinny Arora MD MAPP @FutureDocs
@DocLennyF I actually think no TED is the worst social history. I want to know what does this person live with? What do they do/did? How do they support themselves or how do they need support? What are they motivated or inspired by? #jhmchat
Lanna Felde @LannaFelde
@DocLennyF #jhmchat https://t.co/zM3mADdn4h
Leonard Feldman @DocLennyF
@Arhait @JHospMedicine #jhmchat definitely have used race as a proxy for socioeconomic status. Just as problematic as proxy for genetics. Can’t assume anyone’s experience.
Melissa Plesac @MelissaPlesacMD
@DocLennyF My biggest worry about this is that these Dx often incorrect, or based on false information/assumptions/bias, and then in the world of copy forward they exist forever. Try only to include if relevant to admission and I confirmed myself #JHMChat
Charlie M. Wray, DO, MS @WrayCharles
@Annie_Massart_ @JHospMedicine Totally agree, Annie. Rarely see trainees doing this anymore, usually a vestige of older attendings #JHMCHat
Journal of Hospital Medicine @JHospMedicine
RT @DocLennyF: @Arhait @JHospMedicine #jhmchat definitely have used race as a proxy for socioeconomic status. Just as problematic as proxy for genetics. Can’t assume anyone’s experience.
Journal of Hospital Medicine @JHospMedicine
Topic 3️⃣: Fluid Restriction for the Management of Acute Decompensated Heart Failure in Patients with Reduced EF 🔗 Article Link: https://t.co/XMGR3qnqMl 👀 #VisualAbstract by @michellebr00ks #JHMChat https://t.co/KYs8jx37Ne
Journal of Hospital Medicine @JHospMedicine
RT @MelissaPlesacMD: @DocLennyF My biggest worry about this is that these Dx often incorrect, or based on false information/assumptions/bias, and then in the world of copy forward they exist forever. Try only to include if relevant to admission and I confirmed myself #JHMChat
Doctivist 🏳️‍🌈 🇺🇸 @jbcowartmd
@JHospMedicine Also, let’s be honest, in EHR the social hx is useless. All the good clinical info is in HPI. #jhmchat https://t.co/nX4ot8VInc
Prabi Rajbhandari @prabimd
@freckledpedidoc Social history reflects a persons social circumstance which is defined by a lot of factors of which race is 1 #JHMchat
Journal of Hospital Medicine @JHospMedicine
RT @FutureDocs: @DocLennyF I actually think no TED is the worst social history. I want to know what does this person live with? What do they do/did? How do they support themselves or how do they need support? What are they motivated or inspired by? #jhmchat
Society of Hospital Medicine @SocietyHospMed
RT @JHospMedicine: Topic 3️⃣: Topic 3️⃣: Fluid Restriction for the Management of Acute Decompensated Heart Failure in Patients with Reduced EF 🔗 Article Link: https://t.co/XMGR3qnqMl 👀 #VisualAbstract by @michellebr00ks #JHMChat https://t.co/KYs8jx37Ne
Elise Peterson Lu, MD, PhD @elibrilu
@DocLennyF #JHMChat I generally include alcohol, tobacco, and drug use in the social history but maybe that's because we don't think of them as medical disorders in peds? Binge drinking as bad behavior rather than disease?
Yichi Zhang (张一弛) @YichiZzzzz
@tony_breu Hmm... I do recall that several times on surgery rotation, this was left for the #PCP to do after discharge... 😅#JHMChat
Elise Peterson Lu, MD, PhD @elibrilu
@DocLennyF #JHMChat We also have the issue of open notes vs patient confidentiality. I'm often writing a separate confidential note for social history, and it feels safer to document drug, alcohol, and tobacco use there to protect a teen's privacy.
Journal of Hospital Medicine @JHospMedicine
Q3: What's your approach to fluid restriction in patients with heart failure? How has this #TWDFNR article impacted your practice? #JHMChat https://t.co/zyiqzJtUkI
Ndidi Unaka MD, MEd @NdidiUnaka
@jenreadlynn @TheRealDSrini @JHospMedicine Yep, I totally get this. Asking questions about social risk and not having processes and resources to address patient and family needs negatively impacts our quest to build trust and strong therapeutic alliances #JHMChat
Society of Hospital Medicine @SocietyHospMed
RT @JHospMedicine: Q3: Q3: What's your approach to fluid restriction in patients with heart failure? How has this #TWDFNR article impacted your practice? #JHMChat https://t.co/zyiqzJtUkI
Lonika *abortion is health care* @sood_lonika
@JHospMedicine I almost always stop it…#jhmchat
Anika Kumar, MD (she/her) @freckledpedidoc
@LannaFelde @NdidiUnaka @jenreadlynn @JHospMedicine They should be entered into the PMH or Problem List like any other diagnosis. Some #SDoH can be entered into the Problem List too I enter food insecurity into my problem list WAY too often #JHMChat
Prabi Rajbhandari @prabimd
#jhmchat
Melissa Plesac @MelissaPlesacMD
RT @FutureDocs: @DocLennyF I actually think no TED is the worst social history. I want to know what does this person live with? What do they do/did? How do they support themselves or how do they need support? What are they motivated or inspired by? #jhmchat
Payal Parikh, MD, FACP @Payalia320
@jenreadlynn @EileenBarrettNM @JHospMedicine that is a great idea! #JHMChat
Society of Hospital Medicine @SocietyHospMed
RT @freckledpedidoc: @LannaFelde @NdidiUnaka @jenreadlynn @JHospMedicine They should be entered into the PMH or Problem List like any other diagnosis. Some #SDoH can be entered into the Problem List too I enter food insecurity into my problem list WAY too often #JHMChat
Journal of Hospital Medicine @JHospMedicine
I think that @PaulNWilliamz was talking about this earlier...screening without a solution.
Joseph “Dr. Joe” Thomas, MD @DocWithBowtie
@WrayCharles @Annie_Massart_ @JHospMedicine Some of my NPs and PAs are also still doing it fresh out of school, need to extend this discussion to their schools/training as well, and find the opportunity to discuss at work, too (I work with a lot). #JHMChat
Journal of Hospital Medicine @JHospMedicine
I think that @PaulNWilliamz was talking about this earlier on Twitter...screening without a solution. #JHMChat
Ravi Singh @rav7ks
@jenreadlynn @NdidiUnaka @JHospMedicine Absolutely a great point. One of my interests is the removal of labels than can be disparaging and can introduce bias subconsciously during our interactions. Respect is required in both our interactions as well as the medical record. #jhmchat
Lonika *abortion is health care* @sood_lonika
@JHospMedicine T3: the older I get the less restrictive I am…except maybe for refractory hyponatremia or chf #jhmchat
Annie Massart @Annie_Massart_
@JHospMedicine A3. I'm so glad to change this practice. I've always felt bad restricting fluids, especially in patients with heart failure who so often have dry mouth. Glad to have data tell me it's not necessary! #JHMChat
Doctivist 🏳️‍🌈 🇺🇸 @jbcowartmd
@JHospMedicine @michellebr00ks Ooh a juicy one! Definitely struggling to implement this—people look at me like I have horns. Don’t even mention 3% saline infusion. #jhmchat #twdfnr https://t.co/BfVz8o7nnN
Journal of Hospital Medicine @JHospMedicine
RT @Annie_Massart_: @JHospMedicine A3. I'm so glad to change this practice. I've always felt bad restricting fluids, especially in patients with heart failure who so often have dry mouth. Glad to have data tell me it's not necessary! #JHMChat
Trushar M. Dungarani @DrT_Dungarani
RT @JHospMedicine: Topic 3️⃣: Topic 3️⃣: Fluid Restriction for the Management of Acute Decompensated Heart Failure in Patients with Reduced EF 🔗 Article Link: https://t.co/XMGR3qnqMl 👀 #VisualAbstract by @michellebr00ks #JHMChat https://t.co/KYs8jx37Ne
Journal of Hospital Medicine @JHospMedicine
RT @jbcowartmd: @JHospMedicine @michellebr00ks Ooh a juicy one! Definitely struggling to implement this—people look at me like I have horns. Don’t even mention 3% saline infusion. #jhmchat #twdfnr https://t.co/BfVz8o7nnN
Leonard Feldman @DocLennyF
#JHMChat have you ever restricted to < 1L routinely?
Doctivist 🏳️‍🌈 🇺🇸 @jbcowartmd
@JHospMedicine A3: shamefully I have to admit I have not been successful in adopting fluids to thirst. #jhmchat #twdfnr https://t.co/bP4QkVUou4
Jen Readlynn, MD, FHM (she/her) @jenreadlynn
@JHospMedicine A3: Hate it. Will only do it if really having a hard time diuresing/bad hyponatremia or if cardiology is following and insists on it. I also try not to put people on low Na or diabetic diets unless they want to be. I would be so thirsty. #JHMChat https://t.co/gCr0vO6seG
Karyn Baum (she/her) @karynbaum
@JHospMedicine A3 less restrictions than I used to use. Hint: the nurses always knew this was crap. And they have to be the enforcers, which is awful for them. #JHMChat
Tony Breu @tony_breu
Talk about inertia. The one is harder to reverse than holding metformin #JHMChat
Lanna Felde @LannaFelde
A3. Much like holding metformin, it's the inertia! It's so reflective and I feel like if I don't fluid restrict I will have to explain to every other person in the hospital. #JHMChat
Charlie M. Wray, DO, MS @WrayCharles
@NdidiUnaka @jenreadlynn @TheRealDSrini @JHospMedicine This is good learning for me. I often probe on these issues as it helps me understand my patients and their situations better. I'm often advocating for them with SW/CM, DC planners, etc - that having such data points allows me to be an advocate and "tell their story" #JHMChat
Journal of Hospital Medicine @JHospMedicine
That just seems mean. #JHMChat https://t.co/90cbU9e2fy
Dhruv Srinivasachar MD (he/el/ele.) @TheRealDSrini
@JHospMedicine A3: On the adult side, just general 2-3L fluid goal+diuretics as appropriate for net loss. In peds, esp. w/congenital heart disease, w/o GDMT, & w/need for growth (i.e. formula/breastmilk), diuretics w/o fluid goal. But again, cards drives the ship in peds. #JHMChat
Payal Parikh, MD, FACP @Payalia320
RT @SocietyHospMed: ⏲️ This #JHMChat is 🔥! ✅ Connect with your hospitalist community ✅ Share advice ✅ Learn tips Use #JHMChat on all replies to be part of the conversation!
Charlie M. Wray, DO, MS @WrayCharles
@DocLennyF Ugh, that's just torture, Lenny! #JHMChat
Annie Massart @Annie_Massart_
@JHospMedicine Also, I drink so much Coke Zero. Telling someone to back off on fluids is really hypocritical. #JHMChat https://t.co/YIiTni7aXP
Leonard Feldman @DocLennyF
#JHMChat how much does the avg HFrEF pt drink in the hospital/day?
Lonika *abortion is health care* @sood_lonika
#jhmchat tonight is… On fire 🔥 Peds Hospitalists are teaching the Medicine Hospitalists A-LOT 🤯
Journal of Hospital Medicine @JHospMedicine
RT @karynbaum: @JHospMedicine A3 less restrictions than I used to use. Hint: @JHospMedicine A3 less restrictions than I used to use. Hint: the nurses always knew this was crap. And they have to be the enforcers, which is awful for them. #JHMChat
Melissa Plesac @MelissaPlesacMD
@JHospMedicine A3: I try really hard not to do this unless i am at a total brick wall with diuresis. I try not to do things in the hospital that aren’t reasonably replicable at home #JHMChat
Dhruv Srinivasachar MD (he/el/ele.) @TheRealDSrini
@WrayCharles @NdidiUnaka @jenreadlynn @JHospMedicine Agreed. And it also allows us to figure out what is needed, and if not there, advocate for such services #JHMChat.
Journal of Hospital Medicine @JHospMedicine
RT @MelissaPlesacMD: @JHospMedicine A3: @JHospMedicine A3: I try really hard not to do this unless i am at a total brick wall with diuresis. I try not to do things in the hospital that aren’t reasonably replicable at home #JHMChat
Satyendra Dhar, MD FHM @DharSaty
@JHospMedicine I usually go for 1200-1500 ml fluid restriction, funny that, I have been ignoring previous articles which say 30 ml/kg bw is reasonable. #JHMchat https://t.co/VnfgpF7Xxi
Society of Hospital Medicine @SocietyHospMed
RT @MelissaPlesacMD: @JHospMedicine A3: @JHospMedicine A3: I try really hard not to do this unless i am at a total brick wall with diuresis. I try not to do things in the hospital that aren’t reasonably replicable at home #JHMChat
Kimberly D. Manning, MD @gradydoctor
😭😭😭
Tony Breu @tony_breu
And I feel that a culture change is required for this TWDFNR. Patients will lose trust if they hear the mixed messages ("my last team said I could drink when thirsty...") #JHMChat
Prabi Rajbhandari @prabimd
A3: Phone call to a friendly peds cardiologist #JHMChat https://t.co/ngeGP48anX
Journal of Hospital Medicine @JHospMedicine
What's the most you've seen someone drink in a day? Maybe that person should be restricted and everyone else we can just trust to drink to thirst. #JHMChat
Ndidi Unaka MD, MEd @NdidiUnaka
RT @WrayCharles: @NdidiUnaka @jenreadlynn @TheRealDSrini @JHospMedicine This is good learning for me. I often probe on these issues as it helps me understand my patients and their situations better. I'm often advocating for them with SW/CM, DC planners, etc - that having such data points allows me to be an advocate and "tell their story" #JHMChat
Journal of Hospital Medicine @JHospMedicine
RT @Annie_Massart_: @JHospMedicine Also, I drink so much Coke Zero. Telling someone to back off on fluids is really hypocritical. #JHMChat https://t.co/YIiTni7aXP
Jen Readlynn, MD, FHM (she/her) @jenreadlynn
@DocLennyF No. Have done it rarely but not routinely. It sounds awful. #JHMChat https://t.co/kmwqjtQbz2
Anika Kumar, MD (she/her) @freckledpedidoc
@elibrilu @DocLennyF Interesting… I personally do not diagnose a lot of Alcohol, Tobacco or Drug Use Disorders as a Pediatric Hospitalist so I think that’s why I place it in the social history. Perhaps documenting Use in Social History is a #TWDFNR in PHM? 🤔 #JHMChat
Society of Hospital Medicine @SocietyHospMed
RT @tony_breu: And I feel that a culture change is required for this TWDFNR. Patients will lose trust if they hear the mixed messages ("my last team said I could drink when thirsty...") #JHMChat
Lanna Felde @LannaFelde
@tony_breu Argh that's such a great point and so disheartening! #jhmchat
Journal of Hospital Medicine @JHospMedicine
RT @tony_breu: And I feel that a culture change is required for this TWDFNR. Patients will lose trust if they hear the mixed messages ("my last team said I could drink when thirsty...") #JHMChat
Charlie M. Wray, DO, MS @WrayCharles
@LannaFelde Totally understand this rationale, Lanna. Often when I do something like this, I'll actually print out the #TWDFNR article, bring it on rounds, hand it out then make a big deal about it so that no one asks again. Seems to work - and drill it into learners #JHMChat
Trushar M. Dungarani @DrT_Dungarani
Depends how many techs are on the floor #jhmchat
Yichi Zhang (张一弛) @YichiZzzzz
@JHospMedicine A3: This is why I'm super appreciative of the nursing staff who perform diligent #dailyweights. It would give me more confidence to have patients take sips if weights and lytes were both reassuring! #JHMChat Then, the patients also have more energy to tell me stories! #Winwin
Charlie M. Wray, DO, MS @WrayCharles
@tony_breu I recall you presenting this topic topic at #SHMConverge 3-4 years ago, Tony #JHMChat
Samantha Wang @DrSamanthaWang
@JHospMedicine A3: I trained and practice at an institution where fluid restriction is not part of #EminenceBasedMedicine. So we let most of our ADHF patients #QuenchThatThirst #JHMChat
Elise Peterson Lu, MD, PhD @elibrilu
@JHospMedicine #JHMChat Peds folks looking at all these fluid numbers thinking: "but what is it per kilo?!" https://t.co/LsAJKPBwiK
Journal of Hospital Medicine @JHospMedicine
@WrayCharles @LannaFelde *actual footage of @WrayCharles on rounds. #JHMChat https://t.co/1AJ87EeRPi
Joseph “Dr. Joe” Thomas, MD @DocWithBowtie
@JHospMedicine #JHMChat A3: I have definitely loosened restrictions, strengthened by a COREIM (or Curbsiders?) heart failure ep which discussed how terrible anything less than 2L water and 2g sodium was. This is an interesting read! Makes sense to consider in hyponatremia.
Vinny Arora MD MAPP @FutureDocs
@JHospMedicine @WrayCharles @LannaFelde No one rounds with me anymore. Charlie what’s your secret??? #jhmchat
Tony Breu @tony_breu
@WrayCharles I sure did. I do think that avoiding sodium restriction is just as important. #jhmchat
Journal of Hospital Medicine @JHospMedicine
Perhaps another nomination for tweet of the night? #JHMChat
Prabi Rajbhandari @prabimd
RT @elibrilu: @JHospMedicine #JHMChat Peds folks looking at all these fluid numbers thinking: @JHospMedicine #JHMChat Peds folks looking at all these fluid numbers thinking: "but what is it per kilo?!" https://t.co/LsAJKPBwiK
Charlie M. Wray, DO, MS @WrayCharles
@elibrilu @JHospMedicine You all are too smart for us internists with all your equations and conversions #JHMChat
Payal Parikh, MD, FACP @Payalia320
@JHospMedicine A3: I have begun to do this recently, probably bc I am now one of the "older attendings" 😂 - fluids to thirst is my motto to train residents, and patients. (assuming not decompensated CHF where I would be chasing my tail when INs>>>Outs !) #jhmchat https://t.co/wgjPEZoFOY
Joseph “Dr. Joe” Thomas, MD @DocWithBowtie
@JHospMedicine #JHMChat A3.B: It’s also interesting to see how people will judge patients for drinking a lot while hospitalized with heart failure when we ought to be considering how thirsty they are and maybe that our diuresis efforts aren’t enough.
Melissa Plesac @MelissaPlesacMD
@WrayCharles @LannaFelde Sooo @WrayCharles when can we do a distance virtual peer observation …. #JHMChat
Ndidi Unaka MD, MEd @NdidiUnaka
@elibrilu @JHospMedicine LOL!!! Yes! #JHMChat
Jen Readlynn, MD, FHM (she/her) @jenreadlynn
This gets back to questions about social history in T2 of #JHMChat. We have to find out what patients and families can do at home and not assume! Treatments that only work in the hospital are a recipe for readmission!
Journal of Hospital Medicine @JHospMedicine
But what happens if you *don't* order a low sodium diet? Does the hospital revoke your hospitalist card? #JHMChat
Lonika *abortion is health care* @sood_lonika
@JHospMedicine #metricsystemwins #jhmchat
Society of Hospital Medicine @SocietyHospMed
@gradydoctor We've missed you! Hope you can catch up on the great pearls of wisdom! #JHMChat
Yichi Zhang (张一弛) @YichiZzzzz
@tony_breu A super cool trick I learned on IM rotation! When we are the primary team, we sometimes leave sticky notes for our dear consultants by the bedside! Sometimes more effective than merely noting it in the progress note in EHR. #JHMChat And always with a smiley face ofc :)
Anika Kumar, MD (she/her) @freckledpedidoc
@WrayCharles @LannaFelde I did that with the NPO after Midnight before Sedation #TWDFNR article. My trainees loved it and it wasn’t even Pediatric!! #JHMChat https://t.co/SorYdhNu1n
Jen Readlynn, MD, FHM (she/her) @jenreadlynn
@WrayCharles @elibrilu @JHospMedicine So grateful to not use a calculator most days! #JHMChat
Charlie M. Wray, DO, MS @WrayCharles
@FutureDocs @JHospMedicine @LannaFelde Ha! This GIF implies that that lead duck knows where it's going. I just start walking the halls until someone tells me to stop. I've become that attending. #JHMChat
Reshon Hadmon, MD 🩺 @HadmonReshon
@DharSaty @JHospMedicine Good article and a point which was made “to increase adherence, education, support and planned evaluations.”#JHMChat
Society of Hospital Medicine @SocietyHospMed
RT @YichiZTulane: @tony_breu A super cool trick I learned on IM rotation! When we are the primary team, we sometimes leave sticky notes for our dear consultants by the bedside! Sometimes more effective than merely noting it in the progress note in EHR. #JHMChat And always with a smiley face ofc :)
Tony Breu @tony_breu
The authors (including @DrSamanthaWang) make the point that thirst may be related to elevated ATII. This is not what we want in our heart failure patients. #jhmchat
Payal Parikh, MD, FACP @Payalia320
@tony_breu this 👆 mixed messaging is so detrimental to our profession!! how can we change this culture faster? almost like we need #TWDFNR PSAs (Physician/clinician service announcements)! #jhmchat
Olgert Bardhi @OlgertBardhi
RT @JHospMedicine: Topic 2️⃣: Topic 2️⃣: Routine Inclusion of Race in the HPI 🔗 Article Link: https://t.co/2SbJf9IcV1 👀 #VisualAbstract by @michellebr00ks #JHMChat https://t.co/wR7OjiMeiF
Ravi Singh @rav7ks
@JHospMedicine It looks good on core measures and discharge paperwork but pretty much accomplishes nothing. Na restriction is also not accomplishing much but possibly preventing adequate caloric intake leading to nutritional deficiencies. #jhmchat
Journal of Hospital Medicine @JHospMedicine
Did you see the pediatric QI study? #JHMChat #VisualAbstract by @LannaFelde https://t.co/aqfuZnqQ02
Elise Peterson Lu, MD, PhD @elibrilu
@freckledpedidoc @WrayCharles @LannaFelde #JHMChat Here is a shameless plug for the slide decks that now accompany TWDFNR articles published since 2018. Quick powerpoints (usually 5-6 slides) with distilled information for teaching.
Lanna Felde @LannaFelde
@Payalia320 @tony_breu this #JHMChat is the PSA 😂
Dhruv Srinivasachar MD (he/el/ele.) @TheRealDSrini
@jenreadlynn @WrayCharles @elibrilu @JHospMedicine #JHMChat https://t.co/te3g0vDlt0
Society of Hospital Medicine @SocietyHospMed
Thank you for being a part of this #JHMChat. 🙏 As we wind down, please take some time to fill out our brief feedback form. 📝 We want to 👂 from you on what you want to see from #JHMChat! 👀 https://t.co/k9nukaNq1d
Journal of Hospital Medicine @JHospMedicine
📘 Just enough time for any closing thoughts! Also - if you have any recent JHM articles or topics you want to see discussed for a future #JHMChat, drop them below!
Leonard Feldman @DocLennyF
@Payalia320 @tony_breu #jhmchat we have started ‘financial Fridays’ to review a TWDFNR with all our resident teams weekly.
Journal of Hospital Medicine @JHospMedicine
BRB downloading all of these RIGHT NOW! #JHMChat
Ndidi Unaka MD, MEd @NdidiUnaka
RT @JHospMedicine: Did you see the pediatric QI study? #JHMChat #VisualAbstract by @LannaFelde https://t.co/aqfuZnqQ02
Charlie M. Wray, DO, MS @WrayCharles
@jenreadlynn Completely agree, Jen. They are a captive audience, then we send back out into the wild to do what they want. Never understood our rationale when it came to these barbaric (yeah, I said it) treatments. PS. I also don't believe in a cardiac diet for this reason #JHMChat
Charlie M. Wray, DO, MS @WrayCharles
RT @JHospMedicine: BRB downloading all of these RIGHT NOW! #JHMChat
Leonard Feldman @DocLennyF
RT @elibrilu: @freckledpedidoc @WrayCharles @LannaFelde #JHMChat Here is a shameless plug for the slide decks that now accompany TWDFNR articles published since 2018. Quick powerpoints (usually 5-6 slides) with distilled information for teaching.
Journal of Hospital Medicine @JHospMedicine
#JHMChat #TWDFNR PSA!! https://t.co/V94furyzNT
Jen Readlynn, MD, FHM (she/her) @jenreadlynn
@WrayCharles @LannaFelde I've also worked with our IT folks to allow @JHospMedicine links in our notes so I can link a #TWDFNR article in my note and allow others to read if they have questions too. #JHMChat
Charlie M. Wray, DO, MS @WrayCharles
For those of you in the back who missed this... Great resource put together by former @JHospMedicine Editorial Fellow and now Associate Editor @elibrilu
Ndidi Unaka MD, MEd @NdidiUnaka
@JHospMedicine @LannaFelde Such a great QI project! #JHMChat
Journal of Hospital Medicine @JHospMedicine
Everyone else is in 2022, and @jenreadlynn is in 3022. #JHMChat
Ndidi Unaka MD, MEd @NdidiUnaka
RT @SocietyHospMed: Thank you for being a part of this #JHMChat. 🙏 As we wind down, please take some time to fill out our brief feedback form. 📝 We want to 👂 from you on what you want to see from #JHMChat! 👀 https://t.co/k9nukaNq1d
Leonard Feldman @DocLennyF
@jenreadlynn @WrayCharles @LannaFelde @JHospMedicine #jhmchat that’s amazing!!!
Samantha Wang @DrSamanthaWang
@tony_breu As @juliablumcaton knows, this could drive worsening renal function. But the data is still so sparse on a practice that is so ubiquitous! #JHMChat
Reshon Hadmon, MD 🩺 @HadmonReshon
@DharSaty @JHospMedicine I always recall in the past trying to restrict fluid but my patient was hiding extra salt for his meal. More education and support was needed. #JHMChat
Anika Kumar, MD (she/her) @freckledpedidoc
@jenreadlynn As a patient, I’ve been there. My doctors have asked me to do things to care for myself that they’ve said they wouldn’t be able to do themselves… #JHMChat. https://t.co/pLlYnI3owR
Annie Massart @Annie_Massart_
@jenreadlynn @WrayCharles @LannaFelde @JHospMedicine We couldn't get our IT folks to add a fishbone for labs to notes. Very impressed by your success! #JHMChat
Joseph “Dr. Joe” Thomas, MD @DocWithBowtie
@JHospMedicine #JHMChat A3C: I also find that some of my patients know these “tricks” but have seen them as punishments because previous docs haven’t partnered with them as well, so when I admit I get the “and don’t put me on that low sodium crap, I hate that.” Mismanaged expectations.
Anika Kumar, MD (she/her) @freckledpedidoc
@sood_lonika @JHospMedicine We ❤️ the Metric System in Peds #JHMChat
Payal Parikh, MD, FACP @Payalia320
@LannaFelde @tony_breu true! #jhmchat
Andrew Zimolzak @AndrewZimolzak
RT @JHospMedicine: BRB downloading all of these RIGHT NOW! #JHMChat
Ndidi Unaka MD, MEd @NdidiUnaka
RT @elibrilu: @freckledpedidoc @WrayCharles @LannaFelde #JHMChat Here is a shameless plug for the slide decks that now accompany TWDFNR articles published since 2018. Quick powerpoints (usually 5-6 slides) with distilled information for teaching.
Payal Parikh, MD, FACP @Payalia320
RT @JHospMedicine: Topic 1️⃣: Topic 1️⃣: Holding Metformin in Hospitalized Patients 🔗 Article Link: https://t.co/j86y6Vuclu 👀 Awesome #VisualAbstract by @LannaFelde #JHMChat https://t.co/jbJN76mXro
Elise Peterson Lu, MD, PhD @elibrilu
@freckledpedidoc @DocLennyF #JHMChat Such a tough topic. The first time I cared for a patient with OUD with an overdose, I felt powerless because I was unfamiliar with OUD and at a loss for how to best help them. It's blessedly rare in Peds. I just hope that doesn't mean kids get worse care for these issues
Society of Hospital Medicine @SocietyHospMed
RT @JHospMedicine: Everyone else is in 2022, and @jenreadlynn is in 3022. #JHMChat
Jen Readlynn, MD, FHM (she/her) @jenreadlynn
@elibrilu @freckledpedidoc @WrayCharles @LannaFelde Did not know this! This will be so helpful! #JHMChat https://t.co/XUdvTHTeYV
Doctivist 🏳️‍🌈 🇺🇸 @jbcowartmd
@DocWithBowtie @JHospMedicine If we restrict the diet to unsustainable levels inpatient, we cannot titrate therapy to what the patient’s normal intake is like outpatient. I incorporate education and some restrictions but try to partner on what patients can sustain after dc. #jhmchat
Anika Kumar, MD (she/her) @freckledpedidoc
RT @elibrilu: @freckledpedidoc @WrayCharles @LannaFelde #JHMChat Here is a shameless plug for the slide decks that now accompany TWDFNR articles published since 2018. Quick powerpoints (usually 5-6 slides) with distilled information for teaching.
Vinny Arora MD MAPP @FutureDocs
@WrayCharles @JHospMedicine @LannaFelde Congratulations you’re ready to get promoted now! #jhmchat
Journal of Hospital Medicine @JHospMedicine
That's a wrap! We had so much fun with y'all tonight. Can't wait to see you in Nashville! 🤠 Be on the lookout for our #JHMChat recap on The Hospital leader Blog. https://t.co/vEL1hAsLE3 https://t.co/2q56VD8O7P
Joseph “Dr. Joe” Thomas, MD @DocWithBowtie
@HadmonReshon @DharSaty @JHospMedicine Yes! Gotta manage expectations and partner with the patient.
Leonard Feldman @DocLennyF
#JHMChat. Many more TWDFNR in the pipeline. Keep submitting your great ideas and watch Tony B and John S present TWDFNR at Converge.
Vinny Arora MD MAPP @FutureDocs
RT @elibrilu: @freckledpedidoc @WrayCharles @LannaFelde #JHMChat Here is a shameless plug for the slide decks that now accompany TWDFNR articles published since 2018. Quick powerpoints (usually 5-6 slides) with distilled information for teaching.
Tony Breu @tony_breu
@JHospMedicine Thanks for the great #JHMChat. Hopefully, I'll see everyone in Nashville.
Journal of Hospital Medicine @JHospMedicine
RT @DocLennyF: #JHMChat. Many more TWDFNR in the pipeline. Keep submitting your great ideas and watch Tony B and John S present TWDFNR at Converge.
Society of Hospital Medicine @SocietyHospMed
RT @JHospMedicine: That's a wrap! We had so much fun with y'all tonight. Can't wait to see you in Nashville! 🤠 Be on the lookout for our #JHMChat recap on The Hospital leader Blog. https://t.co/vEL1hAsLE3 https://t.co/2q56VD8O7P
Society of Hospital Medicine @SocietyHospMed
That’s a wrap on March’s #JHMChat with @tony_breu and @DocLennyF. Our hat tips to them for this engaging and lively discussion. 🙌 🎉 Shout out to @michellebr00ks for facilitating as @JHospMedicine. See you all next month!
Yichi Zhang (张一弛) @YichiZzzzz
@JHospMedicine Would love to see grand rounds based on these decks being given to us MS3 students starting IM rotations! This way we can start doing it the right way from the get-go! #JHMChat
Society of Hospital Medicine @SocietyHospMed
RT @DocLennyF: #JHMChat. Many more TWDFNR in the pipeline. Keep submitting your great ideas and watch Tony B and John S present TWDFNR at Converge.
Journal of Hospital Medicine @JHospMedicine
RT @tony_breu: @JHospMedicine Thanks for the great #JHMChat. Hopefully, I'll see everyone in Nashville.
Journal of Hospital Medicine @JHospMedicine
RT @SocietyHospMed: That’s a wrap on March’s #JHMChat with @tony_breu and @DocLennyF. Our hat tips to them for this engaging and lively discussion. 🙌 🎉 Shout out to @michellebr00ks for facilitating as @JHospMedicine. See you all next month!
Melissa Plesac @MelissaPlesacMD
Well @jenreadlynn this is the coolest and I would like this function immediately! Such an awesome opportunity for learning and teaching! Imagining all the #MedEd possibilities! You all are so cool and smart 👏🏻👏🏻👏🏻 #JHMChat
Payal Parikh, MD, FACP @Payalia320
@JHospMedicine Thank you for a great #Jhmchat! #practice changing! See you all there!
Charlie M. Wray, DO, MS @WrayCharles
@FutureDocs @JHospMedicine @LannaFelde Is that all it takes? The brass just check in periodically to see how you round? Once you get to "wandering the hall status" you can become Associate? What does it take become Full Professor? #JHMChat
Jen Readlynn, MD, FHM (she/her) @jenreadlynn
@Annie_Massart_ @WrayCharles @LannaFelde @JHospMedicine Hyperlink tool was available but putting in an external link always ended up blocked. I've started to learn through QI work that if I just ask, we can usually find a way to make it happen. #JHMChat
Charlie M. Wray, DO, MS @WrayCharles
RT @DocLennyF: #JHMChat. Many more TWDFNR in the pipeline. Keep submitting your great ideas and watch Tony B and John S present TWDFNR at Converge.
Journal of Hospital Medicine @JHospMedicine
RT @jenreadlynn: This gets back to questions about social history in T2 of #JHMChat. We have to find out what patients and families can do at home and not assume! Treatments that only work in the hospital are a recipe for readmission!
Melissa Plesac @MelissaPlesacMD
RT @elibrilu: @freckledpedidoc @WrayCharles @LannaFelde #JHMChat Here is a shameless plug for the slide decks that now accompany TWDFNR articles published since 2018. Quick powerpoints (usually 5-6 slides) with distilled information for teaching.
Eileen Barrett MD MPH (she/her) @EileenBarrettNM
@JHospMedicine Great work and thank you for this #JHMChat!
Logan Lawson @LoganDLawson
RT @DrSamanthaWang: A2: A2: I think we've failed in medicine in perpetuating the fallacy that race is biologic and inclusion of it into the PMH is somehow significant in its association with chief compliant, disease, or treatment. Instead, focus should be on structural factors affecting health #JHMChat
Charlie M. Wray, DO, MS @WrayCharles
@YichiZTulane @JHospMedicine Can't wait for you to become a hospitalist, Yichi #JHMChat
Joseph “Dr. Joe” Thomas, MD @DocWithBowtie
@jbcowartmd @JHospMedicine Couldn’t agree more. If they can’t/won’t (for whatever reason) do it when they go back to their own life, it’s not an effective discharge med regimen. #JHMChat
Anika Kumar, MD (she/her) @freckledpedidoc
@elibrilu @DocLennyF I often find these are the best times for me to ask my #medpeds or Adolescent Medicine colleagues for advice. I’m very fortunate to work with a great group. #JHMChat
Yichi Zhang (张一弛) @YichiZzzzz
@SocietyHospMed @tony_breu @DocLennyF @michellebr00ks @JHospMedicine Thank you @michellebr00ks @tony_breu @DocLennyF and everyone who chimed in! Can't wait for the #TWDFNR discussion at #SHMConverge Another inspirational #JHMChat for the books~
Charlie M. Wray, DO, MS @WrayCharles
@JHospMedicine Can't end a #JHMChat without a salute to @michellebr00ks for putting this all together and making things happen https://t.co/B6xPMDN2jN
Lanna Felde @LannaFelde
Strong work by our host @michellebr00ks #JHMChat https://t.co/5i7aQAmrl9
Michelle Brooks, MD @michellebr00ks
Y’all are the best. #JHMchat always flies by, and now I have to wait for the next one!! 😔
Anika Kumar, MD (she/her) @freckledpedidoc
@WrayCharles @FutureDocs @JHospMedicine @LannaFelde Seriously⁉️ I was wondering the halls 2️⃣ years into being an Assistant‼️ 🤔 Maybe I have a poor sense of direction… #JHMChat
Michelle Brooks, MD @michellebr00ks
Are we making our own gif of this at #SHMConverge @LannaFelde? #JHMChat
Michelle Brooks, MD @michellebr00ks
#JHMChat!
Elise Peterson Lu, MD, PhD @elibrilu
@freckledpedidoc @DocLennyF #JHMChat Adolescent Medicine is such an amazing and invaluable specialty. They have become our go-to folks for these kids. I had initially expected it to be Toxicology or Behavioral Health. 🤷‍♀️
Anika Kumar, MD (she/her) @freckledpedidoc
@JHospMedicine Thanks #JHMChat Crew & @michellebr00ks for an Awesome #TwitterChat See you in Nashville, IRL‼️
jyeh29 @jyeh29
RT @JHospMedicine: Topic 2️⃣: Topic 2️⃣: Routine Inclusion of Race in the HPI 🔗 Article Link: https://t.co/2SbJf9IcV1 👀 #VisualAbstract by @michellebr00ks #JHMChat https://t.co/wR7OjiMeiF
CORE IM @COREIMpodcast
RT @jenreadlynn: @JHospMedicine This article combined with @COREIMpodcast on oral meds in the hospital have definitely given me the confidence to continue or resume home metformin in hospitalized patients. We're discussing as a division on 3/30 (@UR_HMD) and getting some endo tips as well. #JHMChat
Margaret Russell, MD, MA, AAHIVS @Margaret1473
RT @DrSamanthaWang: A2: A2: I think we've failed in medicine in perpetuating the fallacy that race is biologic and inclusion of it into the PMH is somehow significant in its association with chief compliant, disease, or treatment. Instead, focus should be on structural factors affecting health #JHMChat
Pallavi Rohela, MBBS, MPH @Experiential_Dr
Missed attending the #JHMChat Thank the Twitter Gods for hashtags and the ability to have asynchronous conversations. Following up now ..
#JHMChat content from Twitter.