#JHMChat Transcript
Healthcare social media transcript of the #JHMChat hashtag.
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See #JHMChat Influencers/Analytics.
| Profile | Tweet |
|---|---|
 | Society of Hospital Medicine @SocietyHospMed #JHMChat with @JHospMedicine @WrayCharles @DKorenstein starts NOW! Claim #CME after the discussion here: https://t.co/JJDy0rvjGh https://t.co/KOFLtENk75 |
 | Journal of Hospital Medicine @JHospMedicine Howdy, I'm @WrayCharles your moderator for tonight's #JHMChat. Go ahead and introduce yourself while we wait for people to join |
 | Vinny Arora MD MAPP @FutureDocs RT @SHMLive: #JHMChat with @JHospMedicine @WrayCharles @DKorenstein starts NOW! Claim #CME after the discussion here: https://t.co/JJDy0rvjGh https://t.co/KOFLtENk75 |
 | Tony Breu @tony_breu Tony Breu here from VA Boston. #JHMChat |
 | Michelle Brooks, MD, SFHM @michellebr00ks Michelle Brooks - hospitalist at @VCUHealth in Richmond, Virginia, and $100 down from Vegas (#hospmed17). #JHMchat |
| Vinny Arora MD MAPP @FutureDocs Thx for leading #jhmchat tonight @WrayCharles! still negotiating bedtime here #ToddlerLife #sleep is #priceless https://t.co/62SYhJ0H7V |
| Vinny Arora MD MAPP @FutureDocs @michellebr00ks @VCUHealth not so high value #jhmchat |
| Vinny Arora MD MAPP @FutureDocs Always great to have an author on #jhmchat! Thx https://t.co/Ha0uao3adj |
| Journal of Hospital Medicine @JHospMedicine FYI. 4 topics tonight! Don't forget to tag your tweets with #JHMChat. T1 up in a moment… |
 | Joshua Allen-Dicker MD MPH @DrJoshuaAD Josh Allen-Dicker, hospitalist in Boston, excited to discuss this paper #JHMChat |
| Journal of Hospital Medicine @JHospMedicine Want to welcome @DKorenstein as an author on tonight's article exploring and understanding medical overuse https://t.co/mmfeJ0dRQ5 #jhmchat https://t.co/Aj3nGHknGz |
 | Guilherme Barcellos @brhospitalist Guilherme from Brazil #ABMH #BrazilChapterSHM #jhmchat |
| Vinny Arora MD MAPP @FutureDocs RT @JHospMedicine: FYI. 4 topics tonight! Don't forget to tag your tweets with #JHMChat. T1 up in a moment… |
| Vinny Arora MD MAPP @FutureDocs RT @JHospMedicine: Want to welcome @DKorenstein as an author on tonight's article exploring and understanding medical overuse https://t.co/mmfeJ0dRQ5 #jhmchat https://t.co/Aj3nGHknGz |
 | Daniel Wolfson @WolfsonD Real pioneers in addressing overuse #JHMchat https://t.co/Qj778ZsqzA |
| Journal of Hospital Medicine @JHospMedicine Be sure to register for #CME for participation in tonight's #JHMChat - sign up here!--> https://t.co/eF9tllkDbU |
| Journal of Hospital Medicine @JHospMedicine Be sure to register for #CME for participation in tonight's #JHMChat - sign up here!--> https://t.co/eF9tllkDbU https://t.co/39iiqPCPVv |
 | Rebecca Jaffe, MD @RJmdphilly Rebecca Jaffe from philly - currently suffering sticker shock from 3 weeks on service. Ready for some #JHMChat |
| Journal of Hospital Medicine @JHospMedicine Welcome, Guilherme! Glad you could make it to #jhmchat https://t.co/vwGc0A1Ho3 |
| Journal of Hospital Medicine @JHospMedicine Special thanks to our partners @SHMLive @Costsofcare @ABIMFoundation 4 bringing you #JHMChat tonight - #CME edition! |
| Guilherme Barcellos @brhospitalist Guilherme from Brazil #ABMH #BrazilChapterSHM #ChoosingWiseliBrazil #jhmchat |
| Journal of Hospital Medicine @JHospMedicine T1: In your experiences, why has decreasing medical overuse been so difficult? #JHMChat |
 | Nancy H. Stewart, DO, MS (she/her) @nvhstewart Excited for the #JHMChat tonight w @WrayCharles -- Nancy Stewart here, @creightonpccm fellow in #omaha |
| Society of Hospital Medicine @SocietyHospMed RT @JHospMedicine: Special thanks to our partners @SHMLive @Costsofcare @ABIMFoundation 4 bringing you #JHMChat tonight - #CME edition! |
| Journal of Hospital Medicine @JHospMedicine RT @WolfsonD: Real pioneers in addressing overuse #JHMchat https://t.co/Qj778ZsqzA |
| Nancy H. Stewart, DO, MS (she/her) @nvhstewart RT @JHospMedicine: Want to welcome @DKorenstein as an author on tonight's article exploring and understanding medical overuse https://t.co/mmfeJ0dRQ5 #jhmchat https://t.co/Aj3nGHknGz |
| Rebecca Jaffe, MD @RJmdphilly Must tag @gretchendiemer for T1. She would say uncertainty is driver. #jhmchat |
| Tony Breu @tony_breu @JHospMedicine I agree with @DKorenstein that "Practice norms within the group” have a high magnitude of effect. #JHMChat |
 | Costs of Care @CostsofCare RT @JHospMedicine: Special thanks to our partners @SHMLive @Costsofcare @ABIMFoundation 4 bringing you #JHMChat tonight - #CME edition! |
| Society of Hospital Medicine @SocietyHospMed T1 is live - Join in the #JHMChat discussion on understanding and reducing #medicaloveruse! https://t.co/mh0N4rOazE |
| Journal of Hospital Medicine @JHospMedicine Can you tell us more about what you mean, when you say "culture", Deb? #jhmchat https://t.co/6cEkdM8m5V |
| Journal of Hospital Medicine @JHospMedicine @ben_geisler Welcome, Ben. Glad you could join us! #jhmchat |
| Nancy H. Stewart, DO, MS (she/her) @nvhstewart T1: I think one thing driving overuse is medical #uncertainty #JHMChat |
| Michelle Brooks, MD, SFHM @michellebr00ks T1: diagnostic uncertainty, patient expectations, provider misunderstanding test characteristics...agree with the article #JHMChat |
| Tony Breu @tony_breu @nvhs0401 Yes, and the (often false) belief that more tests will relieve us of the uncertainty. #JHMChat |
| Journal of Hospital Medicine @JHospMedicine RT @tony_breu: @JHospMedicine I agree with @DKorenstein that "Practice norms within the group” have a high magnitude of effect. #JHMChat |
| Journal of Hospital Medicine @JHospMedicine Can you give us an example, Nancy? #jhmchat https://t.co/KiwMR0kEvo |
| Daniel Wolfson @WolfsonD #JHMChat Both physicians & patients are well trained in overuse. |
| Journal of Hospital Medicine @JHospMedicine RT @michellebr00ks: T1: T1: diagnostic uncertainty, patient expectations, provider misunderstanding test characteristics...agree with the article #JHMChat |
| Journal of Hospital Medicine @JHospMedicine RT @nvhs0401: T1: T1: I think one thing driving overuse is medical #uncertainty #JHMChat |
| Vinny Arora MD MAPP @FutureDocs Very true cc @jeannemfarnan #jhmchat https://t.co/YVrd5Vk3CK |
| Michelle Brooks, MD, SFHM @michellebr00ks T1: cognitive biases - commission bias - the need to do something rather than just sit there. #JHMChat |
| Vinny Arora MD MAPP @FutureDocs RT @michellebr00ks: T1: T1: diagnostic uncertainty, patient expectations, provider misunderstanding test characteristics...agree with the article #JHMChat |
| Tony Breu @tony_breu @DKorenstein I find it remarkable how consistent culture is across institutions. Somehow “iron studies” includes B12/folate at all hospitals #JHMChat |
 | Jorge A Rodriguez MD @translatedmed T1 sometimes it's easier to order a test, than take the time to explain why not. #rounding #JHMChat |
 | Rab Razzak @rabrazzak Rab - #palliativecare #hpm #hospitalist at @Hopkins_GIM @HopkinsMedicine Enjoyed #HospMed17 in Vegas! #JHMChat |
| Rebecca Jaffe, MD @RJmdphilly @tony_breu @nvhs0401 seems then like root cause is poor understanding of diagnostic process/clinical reasoning. #jhmchat |
| Vinny Arora MD MAPP @FutureDocs #meded rewards overuse - need to recalibrate #jhmchat @ChrisMoriates @CostsofCare https://t.co/tQSZVGM4gr |
| Michelle Brooks, MD, SFHM @michellebr00ks @tony_breu @nvhs0401 BUT...they often lead to more questions/testing!! #jhmchat |
| Nancy H. Stewart, DO, MS (she/her) @nvhstewart Yes, specifically provider or trainee uncertainty can lead to ordering many unnecessary tests/labs/imaging studies #jhmchat https://t.co/RAJZPn4LRU |
| Journal of Hospital Medicine @JHospMedicine It appears as if many might ascribe to the @MDaware adage: "don't just do something, stand there" approach? #jhmchat |
| Tony Breu @tony_breu @michellebr00ks @nvhs0401 There is typically something behind the curtain (another curtain). #JHMChat |
| Vinny Arora MD MAPP @FutureDocs Reminds me of status quo bias from #Nudge #jhmchat https://t.co/OZurOYLPsg |
| Journal of Hospital Medicine @JHospMedicine RT @FutureDocs: #meded rewards overuse - need to recalibrate #jhmchat @ChrisMoriates @CostsofCare https://t.co/tQSZVGM4gr |
 | Salah S. Qutaishat @salahq RT @WolfsonD: #JHMChat Both physicians & patients are well trained in overuse. |
| Journal of Hospital Medicine @JHospMedicine Per uncertainty, here's a link to an article we published a few years ago on #medical #uncertainty #jhmchat https://t.co/cTXr2pXXFk |
| Rebecca Jaffe, MD @RJmdphilly @FutureDocs @ChrisMoriates @CostsofCare all case conferences read as "here's the story...what is the next appropriate test?" #jhmchat |
 | Seth Trueger @MDaware RT @JHospMedicine: It appears as if many might ascribe to the @MDaware adage: It appears as if many might ascribe to the @MDaware adage: "don't just do something, stand there" approach? #jhmchat |
| Michelle Brooks, MD, SFHM @michellebr00ks @translatedmed And in the literature...it takes longer to explain why not + risk/benefits! #jhmchat |
| Vinny Arora MD MAPP @FutureDocs @DKorenstein oh I'm light years away from that #agirlcandream #jhmchat |
| Michelle Brooks, MD, SFHM @michellebr00ks RT @JHospMedicine: Per uncertainty, here's a link to an article we published a few years ago on #medical #uncertainty #jhmchat https://t.co/cTXr2pXXFk |
| Vinny Arora MD MAPP @FutureDocs RT @RJmdphilly: @FutureDocs @ChrisMoriates @CostsofCare all case conferences read as "here's the story...what is the next appropriate test?" #jhmchat |
| Nancy H. Stewart, DO, MS (she/her) @nvhstewart T1: trainees also seem to always want to "search" for zebras instead of rule out obvious things first. If it looks like a duck...#jhmchat |
 | Becky Haines @grebeccahaines Gr8 oppty 2 fix in #radiology https://t.co/1XkSu0U0qc #CDS @DrMarcWillis @RadiologyACR @bcmhouston https://t.co/X3oIPIExIr |
| Michelle Brooks, MD, SFHM @michellebr00ks @nvhs0401 Glorifying those zebras again! #jhmchat |
| Journal of Hospital Medicine @JHospMedicine Modeling how to deal with #uncertainty as a way to decrease #overuse. #jhmchat https://t.co/WIAWUvdu1S |
| Nancy H. Stewart, DO, MS (she/her) @nvhstewart Yes !! https://t.co/pZAHDepa45 |
| Vinny Arora MD MAPP @FutureDocs @JHospMedicine @WrayCharles well I'm biased but I think doctor moms are amazing:) @PhysicianMomsGp any #pmg welcome to #jhmchat! |
| Salah S. Qutaishat @salahq T1: practice habits, patient and family expectations, and not knowing the harm that may be caused by overuse #jhmchat |
| Nancy H. Stewart, DO, MS (she/her) @nvhstewart RT @JHospMedicine: Per uncertainty, here's a link to an article we published a few years ago on #medical #uncertainty #jhmchat https://t.co/cTXr2pXXFk |
| Seth Trueger @MDaware "Congratulations to [x] for finding that zebra…" https://t.co/Kd09KIaJg8 |
| Journal of Hospital Medicine @JHospMedicine We'll be announcing T2 shortly... #JHMChat |
| Rab Razzak @rabrazzak T1: Terrific piece by @LizDzeng re: Influence of Institutional #Culture on DNR decision making @ EOL #JHMChat #hpm https://t.co/GPCMEaNyAV |
| Vinny Arora MD MAPP @FutureDocs Yes great resource for #jhmchat https://t.co/3ZEbjtAFcK |
| Seth Trueger @MDaware RT @WolfsonD: #JHMChat Both physicians & patients are well trained in overuse. |
| Guilherme Barcellos @brhospitalist Agree. Deal with uncertainty is a big issue. #JHMChat https://t.co/ZbWaNHpdyl |
| Journal of Hospital Medicine @JHospMedicine RT @rabrazzak: T1: Terrific piece by @LizDzeng re: T1: Terrific piece by @LizDzeng re: Influence of Institutional #Culture on DNR decision making @ EOL #JHMChat #hpm https://t.co/GPCMEaNyAV |
| Vinny Arora MD MAPP @FutureDocs #morningreport never just a case of sinusitis #jhmchat https://t.co/nQPk80xTI4 |
| Journal of Hospital Medicine @JHospMedicine T2: Speaking of "culture"...What are some specific (medical) cultural barriers that we have to overcome? #JHMChat |
| Nancy H. Stewart, DO, MS (she/her) @nvhstewart @RJmdphilly @michellebr00ks Yes but I can count on 1 hand how many I've actually seen #jhmchat 🦄🦄🦄 |
| Daniel Wolfson @WolfsonD And docs lead the charge in teaching patients in overuse - "just to be sure" #JHMchat https://t.co/Fyclik4GMo |
| Tony Breu @tony_breu @BostonChiefs Mission Statement. https://t.co/7Zm0L88J0o |
| Vinny Arora MD MAPP @FutureDocs RT @JHospMedicine: Modeling how to deal with #uncertainty as a way to decrease #overuse. #jhmchat https://t.co/WIAWUvdu1S |
 | Gretchen Diemer @gretchendiemer can i like this twice? "what will the test tell you?" is my fav uncertainty question. #jhmchat If you won't act on answer, don't get test. https://t.co/9m66GPGrgH |
| Joshua Allen-Dicker MD MPH @DrJoshuaAD @DKorenstein Reminds me of #hospmed17 HVC track talk by Emily Gottenborg: How to talk to patients about HVC. Available on demand from @SHMLive! #jhmchat |
| Vinny Arora MD MAPP @FutureDocs @rabrazzak @Hopkins_GIM @HopkinsMedicine great to see you on #jhmchat ! |
| Vinny Arora MD MAPP @FutureDocs RT @translatedmed: T1 sometimes it's easier to order a test, than take the time to explain why not. #rounding #JHMChat |
| Michelle Brooks, MD, SFHM @michellebr00ks T1: Zebras are fun. But should we spend a lot of $$ on a horse painted with stripes? Pre-test probability is important. #jhmchat |
| Journal of Hospital Medicine @JHospMedicine RT @DrJoshuaAD: @DKorenstein Reminds me of #hospmed17 HVC track talk by Emily Gottenborg: @DKorenstein Reminds me of #hospmed17 HVC track talk by Emily Gottenborg: How to talk to patients about HVC. Available on demand from @SHMLive! #jhmchat |
| Society of Hospital Medicine @SocietyHospMed You can still join in for tonight's #JHMChat - T2 is live! https://t.co/ZX5GGtc8MK |
| Becky Haines @grebeccahaines Doc satisfaction improves w > certainty yr doing right thing #JHMChat patients too #PFCC #imaging3 |
| Michelle Brooks, MD, SFHM @michellebr00ks @nvhs0401 @RJmdphilly YOU'VE SEEN A UNICORN?!?!?!? #jhmchat |
| Rebecca Jaffe, MD @RJmdphilly Is the answer is uncertainty then what's the driver behind that? Why can't we tolerate? Patient expectation? litigation fear? #JHMChat |
| Vinny Arora MD MAPP @FutureDocs We have a study on this related to CKMB @mprochaska04 #jhmchat https://t.co/G3S37URcDO |
| Tony Breu @tony_breu T2: One of the biggest barriers I encounter is desire to provide resident autonomy. Don’t want to be attending-tern. #JHMChat https://t.co/DmHBNHPHcE |
| Guilherme Barcellos @brhospitalist RT @rabrazzak: T1: Terrific piece by @LizDzeng re: T1: Terrific piece by @LizDzeng re: Influence of Institutional #Culture on DNR decision making @ EOL #JHMChat #hpm https://t.co/GPCMEaNyAV |
| Journal of Hospital Medicine @JHospMedicine .@michellebr00ks with some killer #highvalue care analogies on #jhmchat https://t.co/m5v7ufnTgU |
| Guilherme Barcellos @brhospitalist RT @JHospMedicine: Per uncertainty, here's a link to an article we published a few years ago on #medical #uncertainty #jhmchat https://t.co/cTXr2pXXFk |
| Michelle Brooks, MD, SFHM @michellebr00ks T2: It's like when you're in Vegas, playing with chips. Transparency with costs is important. This is real $$. #jhmchat |
| Vinny Arora MD MAPP @FutureDocs RT @michellebr00ks: T1: T1: Zebras are fun. But should we spend a lot of $$ on a horse painted with stripes? Pre-test probability is important. #jhmchat |
| Michelle Brooks, MD, SFHM @michellebr00ks RT @JHospMedicine: .@michellebr00ks with some killer #highvalue care analogies on #jhmchat https://t.co/m5v7ufnTgU |
 | Stephanie Starr, MD @StephRStarr Throat swab for strep in child with significant cough, ex/signs of viral URI is a great example https://t.co/N6uhlaBrXJ |
| Vinny Arora MD MAPP @FutureDocs RT @SHMLive: You can still join in for tonight's #JHMChat - T2 is live! https://t.co/ZX5GGtc8MK |
| Rebecca Jaffe, MD @RJmdphilly RT @tony_breu: T2: T2: One of the biggest barriers I encounter is desire to provide resident autonomy. Don’t want to be attending-tern. #JHMChat https://t.co/DmHBNHPHcE |
| Becky Haines @grebeccahaines T2: #jhmchat Not including patients in development & use of evidence 2 support shared decision making #PFCC #imaging3 https://t.co/bJ34I9dubZ |
| Journal of Hospital Medicine @JHospMedicine .@ReshmaGuptaMD & @ChrisMoriates have a gr8 paper exploring ways to create a culture of high value #jhmchat --> https://t.co/IgsfvJ9nR3 |
| Journal of Hospital Medicine @JHospMedicine RT @FutureDocs: We have a study on this related to CKMB @mprochaska04 #jhmchat https://t.co/G3S37URcDO |
| Journal of Hospital Medicine @JHospMedicine .@ReshmaGuptaMD & @ChrisMoriates have a gr8 paper exploring ways to create a culture of high value #jhmchat -->... https://t.co/Hm9EHln5x8 |
| Rab Razzak @rabrazzak @FutureDocs @Hopkins_GIM @HopkinsMedicine Thanks! Great catching up @SHMLive #HospMed17 though brief. You're quite popular ;) #jhmchat |
| Vinny Arora MD MAPP @FutureDocs T2 The Faculty #jhmchat https://t.co/Td9Ai23oD8 |
| Michelle Brooks, MD, SFHM @michellebr00ks RT @JHospMedicine: .@ReshmaGuptaMD & @ChrisMoriates have a gr8 paper exploring ways to create a culture of high value #jhmchat --> https://t.co/IgsfvJ9nR3 |
| Rebecca Jaffe, MD @RJmdphilly Would it be paralyzingly to know how much we're really spending? #JHMChat https://t.co/f82S4S0C76 |
| Salah S. Qutaishat @salahq T2: "Just to make sure that..." culture #jhmchat |
| Jorge A Rodriguez MD @translatedmed T2 Balancing curiosity of trainee with medical overuse. #zebras #jhmchat |
| Vinny Arora MD MAPP @FutureDocs @rabrazzak @Hopkins_GIM @HopkinsMedicine @SHMLive #hospmed17 was a blast - those are my ppl:) #jhmchat |
| Guilherme Barcellos @brhospitalist Here a presentation about uncertainty, Brazil 2016 https://t.co/KJNZthPZDT #jhmchat |
| Daniel Wolfson @WolfsonD #JHMchat We assume symmetry of info b doc & pat w the hope the pat can redirect care - not happening often. |
| Vinny Arora MD MAPP @FutureDocs RT @JHospMedicine: Per uncertainty, here's a link to an article we published a few years ago on #medical #uncertainty #jhmchat https://t.co/cTXr2pXXFk |
| Rebecca Jaffe, MD @RJmdphilly @DKorenstein @tony_breu AM labs #jhmchat how many months ago? |
| Vinny Arora MD MAPP @FutureDocs RT @salahq: T2: T2: "Just to make sure that..." culture #jhmchat |
| Nancy H. Stewart, DO, MS (she/her) @nvhstewart RT @JHospMedicine: T2: T2: Speaking of "culture"...What are some specific (medical) cultural barriers that we have to overcome? #JHMChat |
| Becky Haines @grebeccahaines Resource here 4 #jhmchat https://t.co/o2l13nrtml Costs of care in #imaging3 #pfcc https://t.co/Xf4PdEA6Df |
 | Elliot Tapper @ebtapper @tony_breu @JHospMedicine there is a false sense that tests make diagnoses. Clinical diagnoses become "of exclusion" #jhmchat |
| Vinny Arora MD MAPP @FutureDocs Love this for #jhmchat @CostsofCare https://t.co/sl3rNds2h6 |
| Tony Breu @tony_breu @translatedmed So true. “This is a teaching hospital.” #JHMChat |
| Michelle Brooks, MD, SFHM @michellebr00ks RT @grebeccahaines: Resource here 4 #jhmchat https://t.co/o2l13nrtml Costs of care in #imaging3 #pfcc https://t.co/Xf4PdEA6Df |
| Gretchen Diemer @gretchendiemer #jhmchat T1: Have showed this to trainees and they react strongly. Pretest prob matters--tests only help in the middle to change post test https://t.co/YV7Ru7ibTu |
| Stephanie Starr, MD @StephRStarr T2: Fee for service incentives to do more; patient/parent view that more = 'safer', 'more thorough' https://t.co/IbvKZzVmly |
| Seth Trueger @MDaware RT @FutureDocs: Love this for #jhmchat @CostsofCare https://t.co/sl3rNds2h6 |
| Jorge A Rodriguez MD @translatedmed @StephRStarr Antibiotics are another #jhmchat |
| Journal of Hospital Medicine @JHospMedicine T2a: What about patient cultural influences…? #jhmchat |
| Rebecca Jaffe, MD @RJmdphilly @DKorenstein but how do you know the cost? I don't feel I have access to that info... #jhmchat |
 | Dr. Gia Sison @giasison I would have to agree on this great point #jhmchat https://t.co/oKYI87p803 |
| Salah S. Qutaishat @salahq RT @ebtapper: @tony_breu @JHospMedicine there is a false sense that tests make diagnoses. Clinical diagnoses become "of exclusion" #jhmchat |
| Michelle Brooks, MD, SFHM @michellebr00ks RT @tony_breu: @translatedmed So true. “This is a teaching hospital.” #JHMChat |
| Journal of Hospital Medicine @JHospMedicine RT @grebeccahaines: Resource here 4 #jhmchat https://t.co/o2l13nrtml Costs of care in #imaging3 #pfcc https://t.co/Xf4PdEA6Df |
| Michelle Brooks, MD, SFHM @michellebr00ks @gretchendiemer Love a nomogram! :) #JHMChat |
| Vinny Arora MD MAPP @FutureDocs De value of history and physical exam cc @jeannemfarnan @PaulBerglMD #jhmchat https://t.co/tFODSEXnGr |
| Rab Razzak @rabrazzak T2: Barrier- Need to overcome poor communication skills; lack of connection; inefficiencies; daily labs #JHMChat |
| Rebecca Jaffe, MD @RJmdphilly RT @ebtapper: @tony_breu @JHospMedicine there is a false sense that tests make diagnoses. Clinical diagnoses become "of exclusion" #jhmchat |
| Tony Breu @tony_breu @ebtapper @JHospMedicine CHF is classic example. This is a clinical diagnosis, but residents NEED the echo. #JHMChat |
| Journal of Hospital Medicine @JHospMedicine RT @FutureDocs: De value of history and physical exam cc @jeannemfarnan @PaulBerglMD #jhmchat https://t.co/tFODSEXnGr |
| Michelle Brooks, MD, SFHM @michellebr00ks T2a: Patient expectations definitely play a role - they want a diagnosis that isn't just their chief complaint. #JHMChat |
| Journal of Hospital Medicine @JHospMedicine RT @tony_breu: @ebtapper @JHospMedicine CHF is classic example. This is a clinical diagnosis, but residents NEED the echo. #JHMChat |
| Salah S. Qutaishat @salahq Agreed! https://t.co/WsdTKj59Ye |
| Becky Haines @grebeccahaines PAMA starting 1/18 will require #CDS use 4 advanced #imaging3 https://t.co/54fXaPwjvz Legislation beats culture #jhmchat https://t.co/SLrr7XXBXp |
| Daniel Wolfson @WolfsonD RT @WolfsonD: #JHMchat We assume symmetry of info b doc & pat w the hope the pat can redirect care - not happening often. |
| Elliot Tapper @ebtapper RT @tony_breu: @ebtapper @JHospMedicine CHF is classic example. This is a clinical diagnosis, but residents NEED the echo. #JHMChat |
| Gretchen Diemer @gretchendiemer #jhmchat https://t.co/wFBvIjWsh6 can give approximate costs for self pay. https://t.co/Ko7NS7RnGI |
| Journal of Hospital Medicine @JHospMedicine Couple more minutes until T3 is up…#JHMChat |
| Rab Razzak @rabrazzak use a cheat sheet or cheat tattoo ;) to communicate more effectively #JHMChat #hpm https://t.co/rStro740WD |
| Jorge A Rodriguez MD @translatedmed Integrating nomograms, Bayes, etc is a great opportunity for clinical decision support to improve medical overuse #EHR #daretodream #JHMChat |
| Journal of Hospital Medicine @JHospMedicine RT @gretchendiemer: #jhmchat https://t.co/wFBvIjWsh6 can give approximate costs for self pay. https://t.co/Ko7NS7RnGI |
| Rebecca Jaffe, MD @RJmdphilly Which brings me to decision support. Why does Epic ask me for a TTE on every CHF pt?? Build smart systems #jhmchat https://t.co/3Z53QsAAse |
| Journal of Hospital Medicine @JHospMedicine RT @michellebr00ks: T2a: T2a: Patient expectations definitely play a role - they want a diagnosis that isn't just their chief complaint. #JHMChat |
| Michelle Brooks, MD, SFHM @michellebr00ks RT @gretchendiemer: #jhmchat https://t.co/wFBvIjWsh6 can give approximate costs for self pay. https://t.co/Ko7NS7RnGI |
| Elliot Tapper @ebtapper @tony_breu @JHospMedicine hard2contextualize the ltd value of such tests. Lectures on pre/post tx probs often fall flat #jhmchat #keeptryin |
| Becky Haines @grebeccahaines No access 2 chargemaster, no transparency #jhmchat https://t.co/AZnIYen55o |
| Michelle Brooks, MD, SFHM @michellebr00ks RT @RJmdphilly: Which brings me to decision support. Why does Epic ask me for a TTE on every CHF pt?? Build smart systems #jhmchat https://t.co/3Z53QsAAse |
| Rebecca Jaffe, MD @RJmdphilly @DKorenstein @gatorpedsMD exactly. Does bill reflect cost to patient? And no way to know prospectively?? #jhmchat |
| Vinny Arora MD MAPP @FutureDocs T2a I'll admit when I'm on exam table, it's reassuring to get test - so need to comfort patients about uncertainty too #JHMChat |
| Jorge A Rodriguez MD @translatedmed T2a always interesting to discuss inpt vs outpt work up with pts. Why can't I just get things done while I'm here ? #JHMChat |
| Journal of Hospital Medicine @JHospMedicine T3: What type of training or resources do clinicians need to improve overutilization? #JHMChat |
| Daniel Wolfson @WolfsonD #JHMChat Docs often preempt pat thinking they want a drug/proced rather than talk/explain/reduce my anxiety which is really what is wanted |
| Rebecca Jaffe, MD @RJmdphilly @gretchendiemer @HCBlueBook but who is self pay? My "self pay" pts are charity care or retroactive MA... #JHMChat |
| Salah S. Qutaishat @salahq T2: poor knowledge of diagnostic testing guidelines. Should I mention C. diff and laxatives?! #jhmchat |
| Tony Breu @tony_breu @DKorenstein @michellebr00ks Telling them early in the hospitalization that “we might not find the answer” helps to make the conversation on d/c easier. #JHMChat |
| Vinny Arora MD MAPP @FutureDocs Thx for joining #jhmchat always great to have perspectives of other colleagues @MDaware @TirathPatelMD https://t.co/QRMxx2X2Ld |
| Nancy H. Stewart, DO, MS (she/her) @nvhstewart RT @JHospMedicine: T3: T3: What type of training or resources do clinicians need to improve overutilization? #JHMChat |
 | Erica Bednar @EMBOSU Interesting chat re: overuse of medical services--applicable to genetic testing imo #GCchat Q1: why is decreasing medical overuse difficult? https://t.co/TJxKhMhUa9 |
| Vinny Arora MD MAPP @FutureDocs RT @JHospMedicine: T3: T3: What type of training or resources do clinicians need to improve overutilization? #JHMChat |
| Journal of Hospital Medicine @JHospMedicine RT @salahq: T2: T2: poor knowledge of diagnostic testing guidelines. Should I mention C. diff and laxatives?! #jhmchat |
 | Anika Kumar, MD (she/her) @freckledpedidoc RT @gretchendiemer: #jhmchat https://t.co/wFBvIjWsh6 can give approximate costs for self pay. https://t.co/Ko7NS7RnGI |
| Journal of Hospital Medicine @JHospMedicine RT @FutureDocs: Thx for joining #jhmchat always great to have perspectives of other colleagues @MDaware @TirathPatelMD https://t.co/QRMxx2X2Ld |
 | Robert J. Mahoney, MD @mahoneyr T3 #JHMChat Bayes' Theorem |
| Vinny Arora MD MAPP @FutureDocs Def topics for another #jhmchat @DrToddLee https://t.co/oA4Jvsud4E |
| Anika Kumar, MD (she/her) @freckledpedidoc I use https://t.co/kO7leUffWV for resident education on high-value care! https://t.co/8RVCCUpR7K |
| Nancy H. Stewart, DO, MS (she/her) @nvhstewart @JHospMedicine I think discussions about #uncertainty should be woven into training-- could help mitigate #overutilization #jhmchat |
| Rebecca Jaffe, MD @RJmdphilly RT @ben_geisler: |
| Journal of Hospital Medicine @JHospMedicine RT @FutureDocs: Def topics for another #jhmchat @DrToddLee https://t.co/oA4Jvsud4E |
| Society of Hospital Medicine @SocietyHospMed T3 is live! https://t.co/ugckb8VNo2 |
| Rab Razzak @rabrazzak @JHospMedicine T3: Strong communication skills. Lots of great resources: @vitaltalk - gold standard; @CAPCpalliative - great online modules #jhmchat |
| Nancy H. Stewart, DO, MS (she/her) @nvhstewart RT @tony_breu: @DKorenstein @michellebr00ks Telling them early in the hospitalization that “we might not find the answer” helps to make the conversation on d/c easier. #JHMChat |
 | Tirath Patel, MD @TirathPatelMD @WolfsonD #jhmchat Combination of work demands (limited time w patient, other patients to see), patient satisfaction (e.g. ratings), med-mal worry. |
| Rab Razzak @rabrazzak RT @nvhs0401: @JHospMedicine I think discussions about #uncertainty should be woven into training-- could help mitigate #overutilization #jhmchat |
| Tony Breu @tony_breu @mahoneyr Bayes’ is appealing, but do you have easy access to pre-test probs and likelihood ratios? Hard to implement for many decisions #JHMChat |
| Erica Bednar @EMBOSU RT @gretchendiemer: can i like this twice? "what will the test tell you?" is my fav uncertainty question. #jhmchat If you won't act on answer, don't get test. https://t.co/9m66GPGrgH |
| Michelle Brooks, MD, SFHM @michellebr00ks T3: #ChoosingWisely is mainly about what not to do. #twdfnr is important too...both mentioned in the article. #jhmchat |
| Erica Bednar @EMBOSU RT @michellebr00ks: T1: T1: Zebras are fun. But should we spend a lot of $$ on a horse painted with stripes? Pre-test probability is important. #jhmchat |
| Rebecca Jaffe, MD @RJmdphilly @tony_breu @DKorenstein @michellebr00ks agree but have had that backfire awkwardly a few times! #jhmchat |
| Guilherme Barcellos @brhospitalist RT @nvhs0401: @JHospMedicine I think discussions about #uncertainty should be woven into training-- could help mitigate #overutilization #jhmchat |
| Journal of Hospital Medicine @JHospMedicine When should we start to add #value to the educational process? Day 1of #medicalschool...? #jhmchat https://t.co/UIqM8sZjuJ |
| Tirath Patel, MD @TirathPatelMD @FutureDocs @DrToddLee @salahq #jhmchat Different chat, but many radiologists are asking referring doctors to use appropriateness criteria when requesting. |
| Stephanie Starr, MD @StephRStarr T3 #JHMChat Pretest probabilities; strategies for 'less is more' conversations with patients that enables pt-centered approach |
| Tirath Patel, MD @TirathPatelMD @DKorenstein @FutureDocs @MDaware I couldn't help myself. I saw the conversation on twitter. #jhmchat |
| Michelle Brooks, MD, SFHM @michellebr00ks RT @JHospMedicine: When should we start to add #value to the educational process? Day 1of #medicalschool...? #jhmchat https://t.co/UIqM8sZjuJ |
| Robert J. Mahoney, MD @mahoneyr @DKorenstein Hard to understand statistically, but not conceptually: A test can only increase/decrease likelihood of disease, not make diagnosis #JHMChat |
| Tony Breu @tony_breu @RJmdphilly @DKorenstein @michellebr00ks Yipes! Hopefully didn’t scare you away from trying again. #JHMChat |
| Vinny Arora MD MAPP @FutureDocs T3 Gonna plug new free value conversations series @CostsofCare @doctorschannel website on #JHMChat #CME https://t.co/mePgd2bgS7 |
| Robert J. Mahoney, MD @mahoneyr @tony_breu Decision support tools (TIMI, Wells, etc.) can get you part of the way. The rest is "clinical judgment". #JHMChat |
 | Neel Shah, MD @neel_shah RT @FutureDocs: T3 Gonna plug new free value conversations series @CostsofCare @doctorschannel website on #JHMChat #CME https://t.co/mePgd2bgS7 |
| Michelle Brooks, MD, SFHM @michellebr00ks @tony_breu @mahoneyr Agreed...unless it is somehow automated, not useful for most clinical decision making. #jhmchat |
| Vinny Arora MD MAPP @FutureDocs Sign of culture change ! #jhmchat @WolfsonD @DKorenstein https://t.co/M8amDGBz9a |
| Journal of Hospital Medicine @JHospMedicine RT @FutureDocs: T3 Gonna plug new free value conversations series @CostsofCare @doctorschannel website on #JHMChat #CME https://t.co/mePgd2bgS7 |
| Costs of Care @CostsofCare RT @FutureDocs: T3 Gonna plug new free value conversations series @CostsofCare @doctorschannel website on #JHMChat #CME https://t.co/mePgd2bgS7 |
| Costs of Care @CostsofCare RT @FutureDocs: Love this for #jhmchat @CostsofCare https://t.co/sl3rNds2h6 |
| Erica Bednar @EMBOSU RT @WolfsonD: #JHMChat Docs often preempt pat thinking they want a drug/proced rather than talk/explain/reduce my anxiety which is really what is wanted |
| Costs of Care @CostsofCare RT @FutureDocs: #meded rewards overuse - need to recalibrate #jhmchat @ChrisMoriates @CostsofCare https://t.co/tQSZVGM4gr |
| Guilherme Barcellos @brhospitalist RT @FutureDocs: T3 Gonna plug new free value conversations series @CostsofCare @doctorschannel website on #JHMChat #CME https://t.co/mePgd2bgS7 |
| Jorge A Rodriguez MD @translatedmed T3 Need more: "How will this change management?" #mantra #JHMChat |
| Rab Razzak @rabrazzak @JHospMedicine @vitaltalk @CAPCpalliative Oh, also @AriadneLabs serious illness conversation guide https://t.co/sFSJdKmmk2 Great Tool! #JHMChat #HPM |
| Stephanie Starr, MD @StephRStarr We teach value (IOM dimensions of quality /cost) and perspectives of value (pt, team, insurers) during first week of @MayoClinicSOM https://t.co/b2Lh6Bge8w |
| Gretchen Diemer @gretchendiemer #jhmchat and sources coaching appropriate use such as (shameless plug) https://t.co/j1UyGew8nf @MyASNC https://t.co/lVkhEGAC86 |
| Journal of Hospital Medicine @JHospMedicine RT @rabrazzak: @JHospMedicine @vitaltalk @CAPCpalliative Oh, also @AriadneLabs serious illness conversation guide https://t.co/sFSJdKmmk2 Great Tool! #JHMChat #HPM |
| Daniel Wolfson @WolfsonD Second that plug @ABIMFoundation Addresses use & cost conversations. https://t.co/aGNawREO77 |
| Robert J. Mahoney, MD @mahoneyr @michellebr00ks @tony_breu Does not need to be automated. Don't order tests where likelihood is really high or really low. Use judgment to tell the difference #JHMChat |
| Tony Breu @tony_breu @JHospMedicine T3: Having a toddler has made me more of a fan of “just take it away” #JHMChat |
| Journal of Hospital Medicine @JHospMedicine @tony_breu @mahoneyr Isn't this what residents want from attendings! #jhmchat |
| Rebecca Jaffe, MD @RJmdphilly @mahoneyr @michellebr00ks @tony_breu agree with this one. Concept is more important than calculation #jhmchat |
| Vinny Arora MD MAPP @FutureDocs Should this be a new "course?" #changemeded everything is disease based @Jed_Gonzalo15 #jhmchat https://t.co/ksEBZmTAWC |
| Michelle Brooks, MD, SFHM @michellebr00ks RT @gretchendiemer: #jhmchat and sources coaching appropriate use such as (shameless plug) https://t.co/j1UyGew8nf @MyASNC https://t.co/lVkhEGAC86 |
| Robert J. Mahoney, MD @mahoneyr @RJmdphilly @michellebr00ks @tony_breu At least until we have a calculation, we can use concept. #JHMChat |
| Tony Breu @tony_breu @JHospMedicine @mahoneyr It absolutely is. #JHMChat |
| Rab Razzak @rabrazzak Great chatting. Sorry, gotta go! Hope to hop on periodically, if I'm welcome. Thanks @FutureDocs for the invitation! #JHMChat |
| Stephanie Starr, MD @StephRStarr RT @StephRStarr: We teach value (IOM dimensions of quality /cost) and perspectives of value (pt, team, insurers) during first week of @MayoClinicSOM https://t.co/b2Lh6Bge8w |
| Robert J. Mahoney, MD @mahoneyr @JHospMedicine @tony_breu This is what attendings owe their residents. This is where the learning happens. #JHMChat |
| Vinny Arora MD MAPP @FutureDocs Thx for coming to your first #jhmchat we should do #hpm one sometime https://t.co/vTamrfcEYo |
| Journal of Hospital Medicine @JHospMedicine T4: Are there ways can we better engage with patients to improve overutilization? #JHMChat |
 | Matthew Katz, MD 🟦 @subatomicdoc @ben_geisler Thanks! Yes, new and mainly lurking :-) #jhmchat |
 | Kelsey Murray @doctorakelso21 Need more TIME for communication to get GOOD H&P from pt. Especially in outpatient. I know this is jhm ;) still applicable #JHMChat |
| Vinny Arora MD MAPP @FutureDocs RT @mahoneyr: @JHospMedicine @tony_breu This is what attendings owe their residents. This is where the learning happens. #JHMChat |
 | Art Fougner (vaXXXXXXXed) @sonodoc99 Bell meets Cat https://t.co/kRKo8sur9C |
| Rab Razzak @rabrazzak @FutureDocs It's the last wednesday of every month ;) #HPM Cheers! #jhmchat |
| Journal of Hospital Medicine @JHospMedicine @rabrazzak @FutureDocs Thanks for joining, Rab! Hope you can join us again on June 5th #jhmchat |
| Society of Hospital Medicine @SocietyHospMed Don't forget to claim #CME after tonight's #JHMChat, info here: https://t.co/KFMEG32Y0V |
| Erica Bednar @EMBOSU As @GeneticCouns, how often do we say "we may not find the answer"? Would this be helpful for our patients to hear upfront? #GCchat https://t.co/I48WG0jfMM |
| Vinny Arora MD MAPP @FutureDocs RT @doctorakelso21: Need more TIME for communication to get GOOD H&P from pt. Especially in outpatient. I know this is jhm ;) still applicable #JHMChat |
| Robert J. Mahoney, MD @mahoneyr @JHospMedicine T4 I try to explain concept of false-pos and false-neg to pts before ordering tests, particularly when further tests on the line #JHMChat |
| Michelle Brooks, MD, SFHM @michellebr00ks T4: Focus on individual. Americans don't care about a collective utilization of resources. from #hospmed17 #jhmchat |
| Journal of Hospital Medicine @JHospMedicine @doctorakelso21 Just as important in the inpatient setting, Kelsey! #jhmchat |
| Michelle Brooks, MD, SFHM @michellebr00ks T4: Focus on individual benefits. Americans don't care about a collective utilization of resources. from #hospmed17 #jhmchat #jhmchat |
| Stephanie Starr, MD @StephRStarr T4 #JHMChat Center patient/parent conversations on 'what matters to you?' vs yes/no on specific test |
| Journal of Hospital Medicine @JHospMedicine RT @SHMLive: Don't forget to claim #CME after tonight's #JHMChat, info here: Don't forget to claim #CME after tonight's #JHMChat, info here: https://t.co/KFMEG32Y0V |
| Gretchen Diemer @gretchendiemer Comfort with ambiguity included in AAMC personal development competency #jhmchat #meded @AAMCtoday https://t.co/KO3jEf4HqC |
| Rebecca Jaffe, MD @RJmdphilly @DKorenstein already said, but reason out loud. Checkout #greenQOD & follow @greenQoDay! Where we try to reason as team on twitter #JHMChat |
| Vinny Arora MD MAPP @FutureDocs RT @tony_breu: @ebtapper @JHospMedicine CHF is classic example. This is a clinical diagnosis, but residents NEED the echo. #JHMChat |
| Guilherme Barcellos @brhospitalist RT @ben_geisler: T3: |
| Journal of Hospital Medicine @JHospMedicine RT @michellebr00ks: T4: T4: Focus on individual benefits. Americans don't care about a collective utilization of resources. from #hospmed17 #jhmchat #jhmchat |
| Nancy H. Stewart, DO, MS (she/her) @nvhstewart RT @FutureDocs: T3 Gonna plug new free value conversations series @CostsofCare @doctorschannel website on #JHMChat #CME https://t.co/mePgd2bgS7 |
| Seth Trueger @MDaware @RJmdphilly @DKorenstein @greenQoDay agreed. there's no shortcuts, a 2 hour class won't do it. takes years of work, like, say, writing #jhmchat |
| Robert J. Mahoney, MD @mahoneyr T4 "I can order a stress test, but it is may show something that isn't real just like it may show something that is real." #JHMChat |
| Vinny Arora MD MAPP @FutureDocs @JHospMedicine @doctorakelso21 our next #JHMChat is about care transitions so please join on june 5th with @leorahorwitzmd #primarycare welcome! |
| Salah S. Qutaishat @salahq RT @mahoneyr: @JHospMedicine T4 I try to explain concept of false-pos and false-neg to pts before ordering tests, particularly when further tests on the line #JHMChat |
| Daniel Wolfson @WolfsonD Better comm plus more trusting long term clinician relationships - better use of teams to comm #JHMchat https://t.co/DuHH4gVwtg |
| Robert J. Mahoney, MD @mahoneyr T4 Or "Even if the stress test shows something, I'm not sure I would believe it. And we would have to do further tests to find out" #JHMChat |
| Tony Breu @tony_breu @DKorenstein Bedside rounds! #JHMChat |
 | Diane E. Meier @DianeEMeier RT @rabrazzak: @JHospMedicine T3: Strong communication skills. Lots of great resources: @JHospMedicine T3: Strong communication skills. Lots of great resources: @vitaltalk - gold standard; @CAPCpalliative - great online modules #jhmchat |
| Journal of Hospital Medicine @JHospMedicine RT @FutureDocs: @JHospMedicine @doctorakelso21 our next #JHMChat is about care transitions so please join on june 5th with @leorahorwitzmd #primarycare welcome! |
| Vinny Arora MD MAPP @FutureDocs i do know a lot of cardiologist working on appropriate use for echo/stress incidentally #jhmchat cc @AkhilNarangMD https://t.co/cp6oAi4fxy |
 | FlightBridgeED @FlightBridgeED RT @mahoneyr: T4 "I can order a stress test, but it is may show something that isn't real just like it may show something that is real." #JHMChat |
| FlightBridgeED @FlightBridgeED RT @mahoneyr: T4 Or "Even if the stress test shows something, I'm not sure I would believe it. And we would have to do further tests to find out" #JHMChat |
| Rebecca Jaffe, MD @RJmdphilly @mahoneyr @JHospMedicine that's a tough place to start!! #jhmchat |
| Matthew Katz, MD 🟦 @subatomicdoc RT @WolfsonD: Better comm plus more trusting long term clinician relationships - better use of teams to comm #JHMchat https://t.co/DuHH4gVwtg |
| Guilherme Barcellos @brhospitalist more people agree with that? #JHMChat https://t.co/xQphUe8ZZt |
| Vinny Arora MD MAPP @FutureDocs Would bedside rounds help? lots of time spent outside room discussing testing @BradMonash @WrayCharles topic of another #JHMChat https://t.co/kVoukfMUdT |
 | Margaret Fleming @mlsfleming2 Hope there's a day for considering that patient knows what she's talking about https://t.co/tWjyidUf7G |
| Journal of Hospital Medicine @JHospMedicine RT @FutureDocs: Would bedside rounds help? lots of time spent outside room discussing testing @BradMonash @WrayCharles topic of another #JHMChat https://t.co/kVoukfMUdT |
| Jorge A Rodriguez MD @translatedmed @DrJoshuaAD This is great! Wonder how to encourage pt to look at these on the inpatient setting ? #jhmchat |
| Robert J. Mahoney, MD @mahoneyr T4 Many patients believe (because they have been taught) that the tests make the diagnosis. Takes a while to explain the process. #JHMChat |
| Tony Breu @tony_breu @FutureDocs @BradMonash @WrayCharles They absolutely help. I’ve had many patients say “I can see you really think about this stuff” when we debate/discuss at bedside #JHMChat |
| Kelsey Murray @doctorakelso21 @nbhatnagar_md @DenverEMed Any advice for feeling pressed for time when prerounding? Start earlier? Rising pgy1 here #jhmchat |
| Michelle Brooks, MD, SFHM @michellebr00ks @brhospitalist If you focus on collective, most patients will think you're just trying to say someone else needs the resource more than them. 1/2 #JHMChat |
| Matthew Katz, MD 🟦 @subatomicdoc @brhospitalist Personalized, evidence-based risk assessment tools are great. Whenever possible I use nomograms if available #jhmchat |
| Vinny Arora MD MAPP @FutureDocs curious if anyone has data on this #jhmchat https://t.co/rI1i3AcoB7 |
| Journal of Hospital Medicine @JHospMedicine RT @doctorakelso21: @nbhatnagar_md @DenverEMed Any advice for feeling pressed for time when prerounding? Start earlier? Rising pgy1 here #jhmchat |
| Rebecca Jaffe, MD @RJmdphilly Secret to T4 I think is time with the patient. There's no quick acronym...have to find out their drivers and address them #JHMChat |
| Stephanie Starr, MD @StephRStarr T4 #JHMChat Overuse of referrals: partner w/ subspecialtists to identify ways to educate pts/families re reasons to wait (ex PE tubes) |
| Vinny Arora MD MAPP @FutureDocs RT @mahoneyr: T4 Many patients believe (because they have been taught) that the tests make the diagnosis. Takes a while to explain the process. #JHMChat |
| Michelle Brooks, MD, SFHM @michellebr00ks @brhospitalist The pt is unlikely to respond kindly. Focusing on individual benefits is important in this culture, less so in other cultures 2/2. #JHMChat |
| Vinny Arora MD MAPP @FutureDocs RT @tony_breu: @FutureDocs @BradMonash @WrayCharles They absolutely help. I’ve had many patients say “I can see you really think about this stuff” when we debate/discuss at bedside #JHMChat |
 | Madhusree⚕️ Singh, MD @thinkalot A 78yo man was praising his #PrimaryCare doc (sent for AFib mgt) 'cos he was 'thorough'&sent a screening #PSA https://t.co/4nIvVRwyrb |
| Journal of Hospital Medicine @JHospMedicine Well, we have about 5 more minutes left in our discussion. Please feel free to give any final thoughts on #overuse #JHMChat |
| Guilherme Barcellos @brhospitalist RT @FutureDocs: curious if anyone has data on this #jhmchat https://t.co/rI1i3AcoB7 |
| Journal of Hospital Medicine @JHospMedicine RT @StephRStarr: T4 #JHMChat Overuse of referrals: T4 #JHMChat Overuse of referrals: partner w/ subspecialtists to identify ways to educate pts/families re reasons to wait (ex PE tubes) |
| Robert J. Mahoney, MD @mahoneyr @FutureDocs @BradMonash @WrayCharles Bedside rounds can help, but lots of topics are brought up that could be worrisome - like any time cancer enters the differential #JHMChat |
| Journal of Hospital Medicine @JHospMedicine RT @FutureDocs: curious if anyone has data on this #jhmchat https://t.co/rI1i3AcoB7 |
| Robert J. Mahoney, MD @mahoneyr @RJmdphilly @JHospMedicine I do feel like I am as obligated to explain why I didn't do a test as I am to explain why I did. #JHMChat |
| Journal of Hospital Medicine @JHospMedicine @DrJoshuaAD This sounds like a problem we should solve, Josh! #jhmchat |
| Vinny Arora MD MAPP @FutureDocs IMHO #Geriatrics is a master at explaining risk vs benefit on personal level #jhmchat @AlexSmithMD @NotesOnNursing https://t.co/8c5GM8GZ2w |
| Jorge A Rodriguez MD @translatedmed @DrJoshuaAD On point ! #jhmchat |
 | Anup Patel, M.D. @PedsEpilepsyDoc RT @WolfsonD: Better comm plus more trusting long term clinician relationships - better use of teams to comm #JHMchat https://t.co/DuHH4gVwtg |
| Madhusree⚕️ Singh, MD @thinkalot Key point. We need to explain our actions better. Being thorough can mean taking a good history & physical exam. #meded https://t.co/T8sZ7jCrEL |
| Rebecca Jaffe, MD @RJmdphilly yes but now if it takes time to make dx it's seen as dx delay & lumped in w med error ("3rd leading cause" etc). Bad culture #jhmchat |
| Madhusree⚕️ Singh, MD @thinkalot I like it https://t.co/bODinWWo5r |
 | William Dale, MD, PhD, FASCO @WilliamDale_MD Yep. #geriatrics https://t.co/G2afqg53O3 |
| Vinny Arora MD MAPP @FutureDocs RT @RJmdphilly: Secret to T4 I think is time with the patient. There's no quick acronym...have to find out their drivers and address them #JHMChat |
| Journal of Hospital Medicine @JHospMedicine RT @ben_geisler: T4: |
| Vinny Arora MD MAPP @FutureDocs cc @MedChiefs get a chief resident consult on tips ? #jhmchat https://t.co/EhCRv13xk8 |
| Journal of Hospital Medicine @JHospMedicine Join #JHMChat again on June 5th 9PM EST when @FutureDocs will discuss Inter-Hospital Transfers w/@leorahorwitzmd https://t.co/eF9tllkDbU |
| Guilherme Barcellos @brhospitalist I do not disagree, but maybe it's more Human than American. Couldn't be +/- complementary? https://t.co/vWxLvbRVAG |
| Joshua Allen-Dicker MD MPH @DrJoshuaAD RT @JHospMedicine: Join #JHMChat again on June 5th 9PM EST when @FutureDocs will discuss Inter-Hospital Transfers w/@leorahorwitzmd https://t.co/eF9tllkDbU |
| Kelsey Murray @doctorakelso21 My 2¢ is learning how to address pt worry #1, and provider uncertainty, time to discuss, and challenging norms #JHMChat |
| Matthew Katz, MD 🟦 @subatomicdoc RT @RJmdphilly: Secret to T4 I think is time with the patient. There's no quick acronym...have to find out their drivers and address them #JHMChat |
| Michelle Brooks, MD, SFHM @michellebr00ks RT @JHospMedicine: Join #JHMChat again on June 5th 9PM EST when @FutureDocs will discuss Inter-Hospital Transfers w/@leorahorwitzmd https://t.co/eF9tllkDbU |
| Vinny Arora MD MAPP @FutureDocs looking forward to it! #JHMChat https://t.co/nzwUDW443H |
| Rebecca Jaffe, MD @RJmdphilly RT @doctorakelso21: My 2¢ is learning how to address pt worry #1, and provider uncertainty, time to discuss, and challenging norms #JHMChat |
| Journal of Hospital Medicine @JHospMedicine That's a wrap...Enjoyed the lively conversation on tonight's #JHMChat! Thanks everyone for participating! Thx again to @DKorenstein |
| Rebecca Jaffe, MD @RJmdphilly Couldn't have summarized better myself :) #JHMChat https://t.co/eYiEpGXNBh |
 | Rafael Bloise MD, MA, MBA, CPE @rbloise24 RT @rabrazzak: @JHospMedicine @vitaltalk @CAPCpalliative Oh, also @AriadneLabs serious illness conversation guide https://t.co/sFSJdKmmk2 Great Tool! #JHMChat #HPM |
| Rafael Bloise MD, MA, MBA, CPE @rbloise24 RT @rabrazzak: @JHospMedicine T3: Strong communication skills. Lots of great resources: @JHospMedicine T3: Strong communication skills. Lots of great resources: @vitaltalk - gold standard; @CAPCpalliative - great online modules #jhmchat |
| Tony Breu @tony_breu Thanks @WrayCharles @dkorenstein for great discussion! See you next month. #JHMChat |
| Journal of Hospital Medicine @JHospMedicine RT @FutureDocs: looking forward to it! #JHMChat https://t.co/nzwUDW443H |
| Guilherme Barcellos @brhospitalist RT @ben_geisler: T4: |
| Vinny Arora MD MAPP @FutureDocs great to see other subspecialty colleagues @TirathPatelMD @MDaware discussing overuse. together we can overcome #jhmchat |
| Robert J. Mahoney, MD @mahoneyr Thanks @JHospMedicine and @DKorenstein for great #JHMChat conversation |
| Margaret Fleming @mlsfleming2 inserting smile... https://t.co/vnCzAZyJmT |
| Journal of Hospital Medicine @JHospMedicine @tony_breu @WrayCharles @DKorenstein It's always a pleasure, Tony! #jhmchat |
| Guilherme Barcellos @brhospitalist RT @ben_geisler: |
| Journal of Hospital Medicine @JHospMedicine RT @FutureDocs: great to see other subspecialty colleagues @TirathPatelMD @MDaware discussing overuse. together we can overcome #jhmchat |
| Vinny Arora MD MAPP @FutureDocs Props @WrayCharles @DKorenstein for amazing #jhmchat tonight! could barely keep up & I was not moderating @JHospMedicine |
| Tony Breu @tony_breu @FutureDocs @TirathPatelMD @MDaware @ebtapper (GI) joined tonight too! #JHMChat |
| Michelle Brooks, MD, SFHM @michellebr00ks @tony_breu @WrayCharles @DKorenstein Great job moderating! Thanks for the chat everyone! #jhmchat |
| Matthew Katz, MD 🟦 @subatomicdoc @ben_geisler Good question - does it narrow the field for possible solutions to overutilization? #jhmchat |
 | Andrew Auerbach @ADAuerbachMD Thanks to @WrayCharles @FutureDocs @SHMLive @CostsofCare @ABIMFoundation and most especially @DKorenstein for our #jhmchat tonight. Amazing! |
| Vinny Arora MD MAPP @FutureDocs RT @ADAuerbachMD: Thanks to @WrayCharles @FutureDocs @SHMLive @CostsofCare @ABIMFoundation and most especially @DKorenstein for our #jhmchat tonight. Amazing! |
 | Leora Horwitz @leorahorwitzmd RT @FutureDocs: @JHospMedicine @doctorakelso21 our next #JHMChat is about care transitions so please join on june 5th with @leorahorwitzmd #primarycare welcome! |
| Journal of Hospital Medicine @JHospMedicine RT @ADAuerbachMD: Thanks to @WrayCharles @FutureDocs @SHMLive @CostsofCare @ABIMFoundation and most especially @DKorenstein for our #jhmchat tonight. Amazing! |
| Leora Horwitz @leorahorwitzmd RT @JHospMedicine: Join #JHMChat again on June 5th 9PM EST when @FutureDocs will discuss Inter-Hospital Transfers w/@leorahorwitzmd https://t.co/eF9tllkDbU |
| Elliot Tapper @ebtapper @tony_breu @FutureDocs @TirathPatelMD @MDaware longtime listener, first time caller. #jhmchat |
| Society of Hospital Medicine @SocietyHospMed RT @ADAuerbachMD: Thanks to @WrayCharles @FutureDocs @SHMLive @CostsofCare @ABIMFoundation and most especially @DKorenstein for our #jhmchat tonight. Amazing! |
| Tirath Patel, MD @TirathPatelMD @DKorenstein @FutureDocs Had a typo. Go figure. It's exactly 26 years old. (May 8, 1991). #jhmchat |
| Journal of Hospital Medicine @JHospMedicine Thank you #JHMChat participants for helping us break 3K followers tonight! Look forward to future tweets & readers @JHospMedicine |
| Society of Hospital Medicine @SocietyHospMed Special thanks to our #JHMChat partners @ABIMFoundation & @CostsofCare! |
| Vinny Arora MD MAPP @FutureDocs @TirathPatelMD @DKorenstein still timely #jhmchat ! |
| Vinny Arora MD MAPP @FutureDocs RT @SHMLive: Don't forget to claim #CME after tonight's #JHMChat, info here: Don't forget to claim #CME after tonight's #JHMChat, info here: https://t.co/KFMEG32Y0V |
 | Len D’Avolio, PhD @ldavolio RT @FutureDocs: T3 Gonna plug new free value conversations series @CostsofCare @doctorschannel website on #JHMChat #CME https://t.co/mePgd2bgS7 |
| applam @applam1 RT @ADAuerbachMD: Thanks to @WrayCharles @FutureDocs @SHMLive @CostsofCare @ABIMFoundation and most especially @DKorenstein for our #jhmchat tonight. Amazing! | |
| Vinny Arora MD MAPP @FutureDocs RT @JHospMedicine: Thank you #JHMChat participants for helping us break 3K followers tonight! Look forward to future tweets & readers @JHospMedicine |
#JHMChat content from Twitter.