#JHMChat Transcript

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

Sign up for FREE Symplur Account and Get
  • Create Transcripts with Custom Dates
  • Get Custom Influencer Lists
  • 3x Hashtag Search Results
Sign Up Now
ProfileTweet
Society of Hospital Medicine @SHMLive
#JHMChat with @JHospMedicine @WrayCharles @DKorenstein starts NOW! Claim #CME after the discussion here: https://t.co/JJDy0rvjGh https://t.co/KOFLtENk75
J 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:…
Tony Breu @tony_breu
Tony Breu here from VA Boston. #JHMChat
Michelle Brooks, MD, FACP, FHM @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
J Hospital Medicine @JHospMedicine
FYI. 4 topics tonight! Don't forget to tag your tweets with #JHMChat. T1 up in a moment…
Joshua Allen-Dicker @DrJoshuaAD
Josh Allen-Dicker, hospitalist in Boston, excited to discuss this paper #JHMChat
Deborah Korenstein @dkorenstein
I"m an internist at MSK (cancer center!) in NY and health services researcher. Love to talk about overuse! #JHMchat
J 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…
Daniel Wolfson @WolfsonD
Real pioneers in addressing overuse #JHMchat https://t.co/Qj778ZsqzA
J Hospital Medicine @JHospMedicine
Be sure to register for #CME for participation in tonight's #JHMChat - sign up here!--> https://t.co/eF9tllkDbU
J 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 @RJmdphilly
Rebecca Jaffe from philly - currently suffering sticker shock from 3 weeks on service. Ready for some #JHMChat
J Hospital Medicine @JHospMedicine
Welcome, Guilherme! Glad you could make it to #jhmchat https://t.co/vwGc0A1Ho3
J 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
J Hospital Medicine @JHospMedicine
T1: In your experiences, why has decreasing medical overuse been so difficult? #JHMChat
Nancy H Stewart DO, MS @nvhstewart
Excited for the #JHMChat tonight w @WrayCharles -- Nancy Stewart here, @creightonpccm fellow in #omaha
Society of Hospital Medicine @SHMLive
RT @JHospMedicine: Special thanks to our partners @SHMLive @Costsofcare @ABIMFoundation 4 bringing you #JHMChat tonight - #CME edition!
J Hospital Medicine @JHospMedicine
RT @WolfsonD: Real pioneers in addressing overuse #JHMchat https://t.co/Qj778ZsqzA
Nancy H Stewart DO, MS @nvhstewart
RT @JHospMedicine: Want to welcome @DKorenstein as an author on tonight's article exploring and understanding medical overuse…
Deborah Korenstein @dkorenstein
Culture! it's everywhere #JHMchat
Rebecca Jaffe @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!
Benjamin P. Geisler @ben_geisler
@ben_geisler from Boston #jhmchat
Deborah Korenstein @dkorenstein
Plus poor appreciation of clinical harms, docs see just benefit from doing #JHMchat
Society of Hospital Medicine @SHMLive
T1 is live - Join in the #JHMChat discussion on understanding and reducing #medicaloveruse! https://t.co/mh0N4rOazE
J Hospital Medicine @JHospMedicine
Can you tell us more about what you mean, when you say "culture", Deb? #jhmchat https://t.co/6cEkdM8m5V
J Hospital Medicine @JHospMedicine
@ben_geisler Welcome, Ben. Glad you could join us! #jhmchat
Nancy H Stewart DO, MS @nvhstewart
T1: I think one thing driving overuse is medical #uncertainty #JHMChat
Michelle Brooks, MD, FACP, FHM @michellebr00ks
T1: diagnostic uncertainty, patient expectations, provider misunderstanding test characteristics...agree with the article #JHMChat
Deborah Korenstein @dkorenstein
Culture=all the norms of being a doc. Feeling we need to do rather than just listen #JHMchat
Tony Breu @tony_breu
@nvhs0401 Yes, and the (often false) belief that more tests will relieve us of the uncertainty. #JHMChat
J Hospital Medicine @JHospMedicine
RT @tony_breu: @JHospMedicine I agree with @DKorenstein that "Practice norms within the group” have a high magnitude of effect. #JHMChat
J Hospital Medicine @JHospMedicine
Can you give us an example, Nancy? #jhmchat https://t.co/KiwMR0kEvo
Ralph Martello, MD @gatorpedsMD
#JHMChat
Vinny Arora MD MAPP @FutureDocs
RT @DKorenstein: Culture=all the norms of being a doc. Feeling we need to do rather than just listen #JHMchat
Daniel Wolfson @WolfsonD
#JHMChat Both physicians & patients are well trained in overuse.
J Hospital Medicine @JHospMedicine
RT @michellebr00ks: T1: diagnostic uncertainty, patient expectations, provider misunderstanding test characteristics...agree with the arti…
J Hospital Medicine @JHospMedicine
RT @nvhs0401: 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, FACP, FHM @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: diagnostic uncertainty, patient expectations, provider misunderstanding test characteristics...agree with the arti…
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
Deborah Korenstein @dkorenstein
Great point- uncertainty is key and the misperception that more tests will resolve it. Need to embrace it instead #JHMchat
Joshua Allen-Dicker @DrJoshuaAD
T1: This paper's model highlights why change is difficult: complex interactions, many players, various incentives, lots of inertia #JHMChat
Rab Razzak @rabrazzak
Rab - #palliativecare #hpm #hospitalist at @Hopkins_GIM @HopkinsMedicine Enjoyed #HospMed17 in Vegas! #JHMChat
Benjamin P. Geisler @ben_geisler
T1: spending patterns determined by trainings https://t.co/RD82ezdweX #jhmchat
Rebecca Jaffe @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, FACP, FHM @michellebr00ks
@tony_breu @nvhs0401 BUT...they often lead to more questions/testing!! #jhmchat
Nancy H Stewart DO, MS @nvhstewart
Yes, specifically provider or trainee uncertainty can lead to ordering many unnecessary tests/labs/imaging studies #jhmchat https://t.co/RAJZPn4LRU
J Hospital Medicine @JHospMedicine
It appears as if many might ascribe to the @MDaware adage: "don't just do something, stand there" approach? #jhmchat
Deborah Korenstein @dkorenstein
Docs also misperceive that ppl want stuff done- they often just want reassurance and a plan #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
Rab Razzak @rabrazzak
RT @DKorenstein: Culture=all the norms of being a doc. Feeling we need to do rather than just listen #JHMchat
J 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.
Deborah Korenstein @dkorenstein
Agree that poor clinical reasoning is key too. Hard to fix though (I tried for yrs as an EBM educator!) #JHMchat
J 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
J Hospital Medicine @JHospMedicine
RT @DrJoshuaAD: T1: This paper's model highlights why change is difficult: complex interactions, many players, various incentives, lots of…
Rebecca Jaffe @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: "don't just do something, stand there" approach? #jhmchat
Michelle Brooks, MD, FACP, FHM @michellebr00ks
@translatedmed And in the literature...it takes longer to explain why not + risk/benefits! #jhmchat
Deborah Korenstein @dkorenstein
tot agree about standing there and not doing. Also key to say "I don't know" and show that's OK #JHMchat
Vinny Arora MD MAPP @FutureDocs
@DKorenstein oh I'm light years away from that #agirlcandream #jhmchat
Michelle Brooks, MD, FACP, FHM @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…
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?…
Nancy H Stewart DO, MS @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, FACP, FHM @michellebr00ks
@nvhs0401 Glorifying those zebras again! #jhmchat
J 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 @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!
Deborah Korenstein @dkorenstein
@nvhs0401 Plus there is evidence of association btwn discomfort with uncertainly and more testing #JHMChat
Salah S. Qutaishat @salahq
T1: practice habits, patient and family expectations, and not knowing the harm that may be caused by overuse #jhmchat
Seth Trueger @MDaware
"Congratulations to [x] for finding that zebra…" https://t.co/Kd09KIaJg8
Nancy H Stewart DO, MS @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…
J 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.
Deborah Korenstein @dkorenstein
@FutureDocs IDK is one of my fave things to say. And then I add that I know what it is NOT and that's key #JHMchat
Guilherme Barcellos @brhospitalist
Agree. Deal with uncertainty is a big issue. #JHMChat https://t.co/ZbWaNHpdyl
J Hospital Medicine @JHospMedicine
RT @rabrazzak: T1: Terrific piece by @LizDzeng re: Influence of Institutional #Culture on DNR decision making @ EOL #JHMChat #hpm https://t…
Deborah Korenstein @dkorenstein
@salahq Great point about harms- they are often hard to define (and downstream) but benefits feel immediate #JHMChat
Vinny Arora MD MAPP @FutureDocs
#morningreport never just a case of sinusitis #jhmchat https://t.co/nQPk80xTI4
Vinny Arora MD MAPP @FutureDocs
RT @DKorenstein: @FutureDocs IDK is one of my fave things to say. And then I add that I know what it is NOT and that's key #JHMchat
J 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 @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
J Hospital Medicine @JHospMedicine
RT @DKorenstein: @FutureDocs IDK is one of my fave things to say. And then I add that I know what it is NOT and that's key #JHMchat
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
Deborah Korenstein @dkorenstein
@rabrazzak @LizDzeng thx for posting! #JHMChat
Tamer Hudali @t_hudali
RT @DKorenstein: @FutureDocs IDK is one of my fave things to say. And then I add that I know what it is NOT and that's key #JHMchat
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 @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, FACP, FHM @michellebr00ks
T1: Zebras are fun. But should we spend a lot of $$ on a horse painted with stripes? Pre-test probability is important. #jhmchat
Deborah Korenstein @dkorenstein
One key culture barrier is fear of omission vs commission. We don't reward for NOT doing #JHMchat
J Hospital Medicine @JHospMedicine
RT @DrJoshuaAD: @DKorenstein Reminds me of #hospmed17 HVC track talk by Emily Gottenborg: How to talk to patients about HVC. Availa…
Society of Hospital Medicine @SHMLive
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, FACP, FHM @michellebr00ks
@nvhs0401 @RJmdphilly YOU'VE SEEN A UNICORN?!?!?!? #jhmchat
Rebecca Jaffe @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
J Hospital Medicine @JHospMedicine
RT @DKorenstein: One key culture barrier is fear of omission vs commission. We don't reward for NOT doing #JHMchat
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
Deborah Korenstein @dkorenstein
@WolfsonD Lots of docs actually feel that too- big barrier #JHMChat
Guilherme Barcellos @brhospitalist
RT @rabrazzak: T1: Terrific piece by @LizDzeng re: Influence of Institutional #Culture on DNR decision making @ EOL #JHMChat #hpm https://t…
J 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…
Michelle Brooks, MD, FACP, FHM @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: Zebras are fun. But should we spend a lot of $$ on a horse painted with stripes? Pre-test probability is important…
Stephanie Starr @stephrstarr
Throat swab for strep in child with significant cough, ex/signs of viral URI is a great example https://t.co/N6uhlaBrXJ
Michelle Brooks, MD, FACP, FHM @michellebr00ks
RT @JHospMedicine: .@michellebr00ks with some killer #highvalue care analogies on #jhmchat https://t.co/m5v7ufnTgU
Vinny Arora MD MAPP @FutureDocs
RT @DKorenstein: One key culture barrier is fear of omission vs commission. We don't reward for NOT doing #JHMchat
Vinny Arora MD MAPP @FutureDocs
RT @SHMLive: You can still join in for tonight's #JHMChat - T2 is live! https://t.co/ZX5GGtc8MK
Deborah Korenstein @dkorenstein
@tony_breu That's a real challenge #JHMChat. Often residents do things bc they think attending want tests. Upcoming JAMA IM paper about that...
Rebecca Jaffe @RJmdphilly
RT @tony_breu: T2: One of the biggest barriers I encounter is desire to provide resident autonomy. Don’t want to be attending-tern…
Becky Haines @grebeccahaines
T2: #jhmchat Not including patients in development & use of evidence 2 support shared decision making #PFCC #imaging3 https://t.co/bJ34I9dubZ
J Hospital Medicine @JHospMedicine
.@ReshmaGuptaMD & @ChrisMoriates have a gr8 paper exploring ways to create a culture of high value #jhmchat --> https://t.co/IgsfvJ9nR3
J Hospital Medicine @JHospMedicine
RT @FutureDocs: We have a study on this related to CKMB @mprochaska04 #jhmchat https://t.co/G3S37URcDO
J 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
J Hospital Medicine @JHospMedicine
RT @DKorenstein: @tony_breu That's a real challenge #JHMChat. Often residents do things bc they think attending want tests. Upcoming…
Michelle Brooks, MD, FACP, FHM @michellebr00ks
RT @JHospMedicine: .@ReshmaGuptaMD & @ChrisMoriates have a gr8 paper exploring ways to create a culture of high value #jhmchat --> https://…
Rebecca Jaffe @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
Deborah Korenstein @dkorenstein
Real tension perceived between patient advocacy and stewardship. I think best to focus on costs to the PT personally #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…
Rebecca Jaffe @RJmdphilly
@DKorenstein @tony_breu AM labs #jhmchat how many months ago?
Benjamin P. Geisler @ben_geisler
T2: Bayes' theorem?? #jhmchat
Vinny Arora MD MAPP @FutureDocs
RT @salahq: T2: "Just to make sure that..." culture #jhmchat
Deborah Korenstein @dkorenstein
@grebeccahaines Agreed SDM is a great tool- we all need to learn how to do it well! #JHMChat
Nancy H Stewart DO, MS @nvhstewart
RT @JHospMedicine: 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, FACP, FHM @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 @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
Ralph Martello, MD @gatorpedsMD
I agree with the poster that mentioned most have no sense of costs of tests/time/etc. huge problem imo. #JHMChat
Jorge A Rodriguez MD @translatedmed
@StephRStarr Antibiotics are another #jhmchat
J Hospital Medicine @JHospMedicine
T2a: What about patient cultural influences…? #jhmchat
Deborah Korenstein @dkorenstein
@ben_geisler Few docs really understand diagnostic reasoning (sadly) #JHMChat Not sure how to educate better...
Rebecca Jaffe @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, FACP, FHM @michellebr00ks
RT @tony_breu: @translatedmed So true. “This is a teaching hospital.” #JHMChat
J Hospital Medicine @JHospMedicine
RT @grebeccahaines: Resource here 4 #jhmchat https://t.co/o2l13nrtml Costs of care in #imaging3 #pfcc https://t.co/Xf4PdEA6Df
Benjamin P. Geisler @ben_geisler
T2: Learn from low-cost regions? #jhmchat https://t.co/t8MxqOZJVU
J Hospital Medicine @JHospMedicine
RT @DKorenstein: @ben_geisler Few docs really understand diagnostic reasoning (sadly) #JHMChat Not sure how to educate better...
Michelle Brooks, MD, FACP, FHM @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
Deborah Korenstein @dkorenstein
@tony_breu @translatedmed That's the worst! I always tell trainees they are not allowed to say "for academic interest". EVER! #JHMChat
Rab Razzak @rabrazzak
T2: Barrier- Need to overcome poor communication skills; lack of connection; inefficiencies; daily labs #JHMChat
Rebecca Jaffe @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
Deborah Korenstein @dkorenstein
@giasison Absolutely #JHMChat
J Hospital Medicine @JHospMedicine
RT @FutureDocs: De value of history and physical exam cc @jeannemfarnan @PaulBerglMD #jhmchat https://t.co/tFODSEXnGr
Michelle Brooks, MD, FACP, FHM @michellebr00ks
T2a: Patient expectations definitely play a role - they want a diagnosis that isn't just their chief complaint. #JHMChat
J Hospital Medicine @JHospMedicine
RT @tony_breu: @ebtapper @JHospMedicine CHF is classic example. This is a clinical diagnosis, but residents NEED the echo. #JHMChat
Ralph Martello, MD @gatorpedsMD
All hospitals have an updated list of service costs. U can audit patient stays and their bill. Hospital finance has this info #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
Deborah Korenstein @dkorenstein
@FutureDocs @jeannemfarnan @PaulBerglMD Also important to realize that history and PE are diagnostic tests. Often the best ones. #JHMChat
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
Vinny Arora MD MAPP @FutureDocs
RT @DKorenstein: @FutureDocs @jeannemfarnan @PaulBerglMD Also important to realize that history and PE are diagnostic tests. Often the best…
Gretchen Diemer @gretchendiemer
#jhmchat https://t.co/wFBvIjWsh6 can give approximate costs for self pay. https://t.co/Ko7NS7RnGI
J 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
J Hospital Medicine @JHospMedicine
RT @DKorenstein: @FutureDocs @jeannemfarnan @PaulBerglMD Also important to realize that history and PE are diagnostic tests. Often the best…
Deborah Korenstein @dkorenstein
@gatorpedsMD Great point about cost. But cost to whom? To patient, system, institution, payer etc. Very complex #JHMChat
Benjamin P. Geisler @ben_geisler
@DKorenstein Replace biochemistry with probability theory? #jhmchat
Jorge A Rodriguez MD @translatedmed
Integrating nomograms, Bayes, etc is a great opportunity for clinical decision support to improve medical overuse #EHR #daretodream #JHMChat
J Hospital Medicine @JHospMedicine
RT @gretchendiemer: #jhmchat https://t.co/wFBvIjWsh6 can give approximate costs for self pay. https://t.co/Ko7NS7RnGI
Rebecca Jaffe @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
J Hospital Medicine @JHospMedicine
RT @michellebr00ks: T2a: Patient expectations definitely play a role - they want a diagnosis that isn't just their chief complaint. #JHMChat
Michelle Brooks, MD, FACP, FHM @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
Deborah Korenstein @dkorenstein
@michellebr00ks True. Tho sometimes they just want reassurance that its not a bad scary thing #jhmchat
Michelle Brooks, MD, FACP, FHM @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://…
Rebecca Jaffe @RJmdphilly
@DKorenstein @gatorpedsMD exactly. Does bill reflect cost to patient? And no way to know prospectively?? #jhmchat
Deborah Korenstein @dkorenstein
@RJmdphilly Great point. Plus adhering to quality metrics can drive overuse. #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
Neha Bhatnagar @nbhatnagar_md
RT @JHospMedicine: Feeling inspired on #highvalue care, #hospmed17? We're continuing the conversation - Mon May 8th 9PM EST w/#JHMChat
J 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
Deborah Korenstein @dkorenstein
@rabrazzak Love that! #JHMChat
Rebecca Jaffe @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 @nvhstewart
RT @JHospMedicine: 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
Deborah Korenstein @dkorenstein
People have already said it- better communication/SDM skills key #JHMchat
Vinny Arora MD MAPP @FutureDocs
RT @JHospMedicine: T3: What type of training or resources do clinicians need to improve overutilization? #JHMChat
J Hospital Medicine @JHospMedicine
RT @salahq: T2: poor knowledge of diagnostic testing guidelines. Should I mention C. diff and laxatives?! #jhmchat
Anika Kumar, MD @freckledpedidoc
RT @gretchendiemer: #jhmchat https://t.co/wFBvIjWsh6 can give approximate costs for self pay. https://t.co/Ko7NS7RnGI
J Hospital Medicine @JHospMedicine
RT @FutureDocs: Thx for joining #jhmchat always great to have perspectives of other colleagues @MDaware @TirathPatelMD https://t.co/QRMxx2X…
Robert J. Mahoney, MD @mahoneyr
T3 #JHMChat Bayes' Theorem
Vinny Arora MD MAPP @FutureDocs
Def topics for another #jhmchat @DrToddLee https://t.co/oA4Jvsud4E
Deborah Korenstein @dkorenstein
@FutureDocs @MDaware @TirathPatelMD Wow- a radiologist talking about overuse with us #JHMChat Welcome!
Anika Kumar, MD @freckledpedidoc
I use https://t.co/kO7leUffWV for resident education on high-value care! https://t.co/8RVCCUpR7K
Vinny Arora MD MAPP @FutureDocs
RT @DKorenstein: @FutureDocs @MDaware @TirathPatelMD Wow- a radiologist talking about overuse with us #JHMChat Welcome!
Nancy H Stewart DO, MS @nvhstewart
@JHospMedicine I think discussions about #uncertainty should be woven into training-- could help mitigate #overutilization #jhmchat
Rebecca Jaffe @RJmdphilly
RT @ben_geisler: @DKorenstein Replace biochemistry with probability theory? #jhmchat
J Hospital Medicine @JHospMedicine
RT @FutureDocs: Def topics for another #jhmchat @DrToddLee https://t.co/oA4Jvsud4E
Society of Hospital Medicine @SHMLive
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 @nvhstewart
RT @tony_breu: @DKorenstein @michellebr00ks Telling them early in the hospitalization that “we might not find the answer” helps to…
Deborah Korenstein @dkorenstein
@mahoneyr Agreed! But very hard to really get docs to understand. Maybe earlier education as someone said. #JHMChat
Tirath Patel @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 #j
Deborah Korenstein @dkorenstein
@tony_breu @michellebr00ks I like that- thanks #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…
Michelle Brooks, MD, FACP, FHM @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: Zebras are fun. But should we spend a lot of $$ on a horse painted with stripes? Pre-test probability is important…
Benjamin P. Geisler @ben_geisler
T3: learn from residency programs in low-cost regions #jhmchat Chen JAMA 2014;31(22)2385-93 https://t.co/7FLC4qoy1w
Deborah Korenstein @dkorenstein
Agree there are great tools to facilitate communication. For EOL I like the Values Framework #JHMchat
Rebecca Jaffe @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 #j
J Hospital Medicine @JHospMedicine
When should we start to add #value to the educational process? Day 1of #medicalschool...? #jhmchat https://t.co/UIqM8sZjuJ
Tirath Patel @TirathPatelMD
@FutureDocs @DrToddLee @salahq #jhmchat Different chat, but many radiologists are asking referring doctors to use appropriateness criteria when requesting.
Stephanie Starr @stephrstarr
T3 #JHMChat Pretest probabilities; strategies for 'less is more' conversations with patients that enables pt-centered approach
Tirath Patel @TirathPatelMD
@DKorenstein @FutureDocs @MDaware I couldn't help myself. I saw the conversation on twitter. #jhmchat
Michelle Brooks, MD, FACP, FHM @michellebr00ks
RT @JHospMedicine: When should we start to add #value to the educational process? Day 1of #medicalschool...? #jhmchat https://t.co/UIqM8sZj…
Deborah Korenstein @dkorenstein
@TirathPatelMD @WolfsonD Absolutely. And time is more problematic when communication skills are poor- things take longer. All real barriers tho #JHMChat
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
Benjamin P. Geisler @ben_geisler
@subatomicdoc you're welcome! hope you're enjoying #jhmchat too
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
Deborah Korenstein @dkorenstein
@TirathPatelMD @FutureDocs @DrToddLee @salahq CMS will soon require CDS/appropriateness criteria to be part of the process. At least as of now... #JHMChat May be a game changer
Neel Shah, MD @neel_shah
RT @FutureDocs: T3 Gonna plug new free value conversations series @CostsofCare @doctorschannel website on #JHMChat #CME https://t.co/mePgd2…
Michelle Brooks, MD, FACP, FHM @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
J Hospital Medicine @JHospMedicine
RT @FutureDocs: T3 Gonna plug new free value conversations series @CostsofCare @doctorschannel website on #JHMChat #CME https://t.co/mePgd2…
Costs of Care @CostsofCare
RT @FutureDocs: T3 Gonna plug new free value conversations series @CostsofCare @doctorschannel website on #JHMChat #CME https://t.co/mePgd2…
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 w…
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/mePgd2…
Jorge A Rodriguez MD @translatedmed
T3 Need more: "How will this change management?" #mantra #JHMChat
Vinny Arora MD MAPP @FutureDocs
RT @DKorenstein: @TirathPatelMD @FutureDocs @DrToddLee @salahq CMS will soon require CDS/appropriateness criteria to be part of the…
Deborah Korenstein @dkorenstein
Yes I think we start talking about embracing uncertainty and diagnostic reasoning day 1 of med school #JHMchat
Rab Razzak @rabrazzak
@JHospMedicine @vitaltalk @CAPCpalliative Oh, also @AriadneLabs serious illness conversation guide https://t.co/sFSJdKmmk2 Great Tool! #JHMChat #HPM
Stephanie Starr @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
Benjamin P. Geisler @ben_geisler
@gatorpedsMD think we need to look more into this #jhmchat
J Hospital Medicine @JHospMedicine
RT @rabrazzak: @JHospMedicine @vitaltalk @CAPCpalliative Oh, also @AriadneLabs serious illness conversation guide…
Gretchen Diemer @gretchendiemer
#jhmchat and sources coaching appropriate use such as (shameless plug) https://t.co/j1UyGew8nf @MyASNC https://t.co/lVkhEGAC86
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
fastest news @thewebsfastest
ben_geisler : gatorpedsMD think we need to look more into this #jhmchat (via Twitter https://t.co/NA95X0iOXc)
Deborah Korenstein @dkorenstein
@michellebr00ks @tony_breu @mahoneyr Yes definitely- the proof is in the pudding. It could make things worse if not done right #JHMChat
Tony Breu @tony_breu
@JHospMedicine T3: Having a toddler has made me more of a fan of “just take it away” #JHMChat
Ralph Martello, MD @gatorpedsMD
What about AI. I think hats the future. AI assited care. #JHMChat
J Hospital Medicine @JHospMedicine
@tony_breu @mahoneyr Isn't this what residents want from attendings! #jhmchat
Rebecca Jaffe @RJmdphilly
@mahoneyr @michellebr00ks @tony_breu agree with this one. Concept is more important than calculation #jhmchat
Katren @katren_tyler
RT @JHospMedicine: It appears as if many might ascribe to the @MDaware adage: "don't just do something, stand there" approach? #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, FACP, FHM @michellebr00ks
RT @gretchendiemer: #jhmchat and sources coaching appropriate use such as (shameless plug) https://t.co/j1UyGew8nf @MyASNC https://t.co/lV…
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
Deborah Korenstein @dkorenstein
Anyone have great approaches for teaching diagnostic reasoning? I was an EBM educator for years and never felt like it stuck #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 @stephrstarr
RT @StephRStarr: We teach value (IOM dimensions of quality /cost) and perspectives of value (pt, team, insurers) during first week o…
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
Deborah Korenstein @dkorenstein
@FutureDocs @Jed_Gonzalo15 Not sure. Might be best to integrate into everything, since it's part of everything we all do #JHMChat
J 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 @sonodoc99
Bell meets Cat https://t.co/kRKo8sur9C
Dave @dave_dotson
RT @michellebr00ks: T1: Zebras are fun. But should we spend a lot of $$ on a horse painted with stripes? Pre-test probability is important…
Rab Razzak @rabrazzak
@FutureDocs It's the last wednesday of every month ;) #HPM Cheers! #jhmchat
Society of Hospital Medicine @SHMLive
Don't forget to claim #CME after tonight's #JHMChat, info here: https://t.co/KFMEG32Y0V
J Hospital Medicine @JHospMedicine
@rabrazzak @FutureDocs Thanks for joining, Rab! Hope you can join us again on June 5th #jhmchat
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
Neha Bhatnagar @nbhatnagar_md
Lesson for budding docs: "Spend 3 more minutes in the room, ask 2 more questions, and do 1 less test." Dr. Zane at @DenverEMed #jhmchat
Deborah Korenstein @dkorenstein
@StephRStarr that's great! #JHMChat
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 applica…
J Hospital Medicine @JHospMedicine
RT @DKorenstein: Anyone have great approaches for teaching diagnostic reasoning? I was an EBM educator for years and never felt like it stu…
Benjamin P. Geisler @ben_geisler
T3: also few of the NQMCH metrics on efficiency/value #jhmchat https://t.co/hyukjwaflp
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, FACP, FHM @michellebr00ks
T4: Focus on individual. Americans don't care about a collective utilization of resources. from #hospmed17 #jhmchat
J Hospital Medicine @JHospMedicine
@doctorakelso21 Just as important in the inpatient setting, Kelsey! #jhmchat
Michelle Brooks, MD, FACP, FHM @michellebr00ks
T4: Focus on individual benefits. Americans don't care about a collective utilization of resources. from #hospmed17 #jhmchat #jhmchat
Deborah Korenstein @dkorenstein
Help patients grasp clinical harms of overuse and clarify what they want- often caring. Doing doesn't = caring #JHMchat
Stephanie Starr @stephrstarr
T4 #JHMChat Center patient/parent conversations on 'what matters to you?' vs yes/no on specific test
J Hospital Medicine @JHospMedicine
RT @SHMLive: 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 @RJmdphilly
@DKorenstein already said, but reason out loud. Checkout #greenQOD & follow @greenQoDay! Where we try to reason as team on twitter #JHMChat
Nancy H Stewart DO, MS @nvhstewart
RT @DKorenstein: Help patients grasp clinical harms of overuse and clarify what they want- often caring. Doing doesn't = caring #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: also few of the NQMCH metrics on efficiency/value #jhmchat https://t.co/hyukjwaflp
J Hospital Medicine @JHospMedicine
RT @nbhatnagar_md: Lesson for budding docs: "Spend 3 more minutes in the room, ask 2 more questions, and do 1 less test." Dr. Zane at @Denv
Deborah Korenstein @dkorenstein
@nbhatnagar_md @DenverEMed I like that. Also great question to ask: "What are you most afraid of right now?" #JHMChat
J Hospital Medicine @JHospMedicine
RT @michellebr00ks: T4: Focus on individual benefits. Americans don't care about a collective utilization of resources. from #hospmed17 #jh
Rebecca Jaffe @RJmdphilly
RT @nbhatnagar_md: Lesson for budding docs: "Spend 3 more minutes in the room, ask 2 more questions, and do 1 less test." Dr. Zane at @Denv
Nancy H Stewart DO, MS @nvhstewart
RT @FutureDocs: T3 Gonna plug new free value conversations series @CostsofCare @doctorschannel website on #JHMChat #CME https://t.co/mePgd2…
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
Benjamin P. Geisler @ben_geisler
T4: as others said, time spent w/ pt explaining critical. explaining WHY (or why not) #jhmchat
J Hospital Medicine @JHospMedicine
RT @DKorenstein: Help patients grasp clinical harms of overuse and clarify what they want- often caring. Doing doesn't = caring #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 wh…
Daniel Wolfson @WolfsonD
Better comm plus more trusting long term clinician relationships - better use of teams to comm #JHMchat https://t.co/DuHH4gVwtg
Deborah Korenstein @dkorenstein
Love the idea of reasoning out loud. I think patients appreciate that we are really thinking about their problem, not just reflex #JHMchat
Joshua Allen-Dicker @DrJoshuaAD
T4: Partnerships w patient sources for health info - #ChoosingWisely + Consumer Reports is great example: https://t.co/xn0dWC5bW6 #JHMChat
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: @vitaltalk - gold standard;…
J Hospital Medicine @JHospMedicine
RT @FutureDocs: @JHospMedicine @doctorakelso21 our next #JHMChat is about care transitions so please join on june 5th with…
Nancy H Stewart DO, MS @nvhstewart
RT @nbhatnagar_md: Lesson for budding docs: "Spend 3 more minutes in the room, ask 2 more questions, and do 1 less test." Dr. Zane at @Denv
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." #J
Ralph Martello, MD @gatorpedsMD
#JHMChat I like this resource https://t.co/WxkHEZ0kjn
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 fin…
Michelle Brooks, MD, FACP, FHM @michellebr00ks
RT @DrJoshuaAD: T4: Partnerships w patient sources for health info - #ChoosingWisely + Consumer Reports is great example: https://t.co/xn0d…
Rebecca Jaffe @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/DuHH4gVw…
Guilherme Barcellos @brhospitalist
more people agree with that? #JHMChat https://t.co/xQphUe8ZZt
Daniel Wolfson @WolfsonD
RT @DrJoshuaAD: T4: Partnerships w patient sources for health info - #ChoosingWisely + Consumer Reports is great example: https://t.co/xn0d…
Deborah Korenstein @dkorenstein
@mahoneyr ...and then I'll have to subject you to invasive, painful, and potentially harmful tests all for nothing" #JHMChat
J Hospital Medicine @JHospMedicine
RT @DrJoshuaAD: T4: Partnerships w patient sources for health info - #ChoosingWisely + Consumer Reports is great example: https://t.co/xn0d…
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
Guilherme Barcellos @brhospitalist
RT @DrJoshuaAD: T4: Partnerships w patient sources for health info - #ChoosingWisely + Consumer Reports is great example: https://t.co/xn0d…
Vinny Arora MD MAPP @FutureDocs
RT @nbhatnagar_md: Lesson for budding docs: "Spend 3 more minutes in the room, ask 2 more questions, and do 1 less test." Dr. Zane at @Denv
Margaret Fleming @mlsfleming2
Hope there's a day for considering that patient knows what she's talking about https://t.co/tWjyidUf7G
J Hospital Medicine @JHospMedicine
RT @FutureDocs: Would bedside rounds help? lots of time spent outside room discussing testing @BradMonash @WrayCharles topic of ano…
Benjamin P. Geisler @ben_geisler
T4: anyone using #choosingwisely for pts? https://t.co/tU8jCag7Ni #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
Jorge A Rodriguez MD @translatedmed
@DrJoshuaAD This is great! Wonder how to encourage pt to look at these on the inpatient setting ? #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
Nancy H Stewart DO, MS @nvhstewart
RT @DrJoshuaAD: T4: Partnerships w patient sources for health info - #ChoosingWisely + Consumer Reports is great example: https://t.co/xn0d…
Michelle Brooks, MD, FACP, FHM @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
Natalie Azar, MD @drnatalietv
RT @nbhatnagar_md: Lesson for budding docs: "Spend 3 more minutes in the room, ask 2 more questions, and do 1 less test." Dr. Zane at @Denv
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
J Hospital Medicine @JHospMedicine
RT @doctorakelso21: @nbhatnagar_md @DenverEMed Any advice for feeling pressed for time when prerounding? Start earlier? Rising pgy1 here #…
Rebecca Jaffe @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 @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 @DrJoshuaAD: T4: Partnerships w patient sources for health info - #ChoosingWisely + Consumer Reports is great example: https://t.co/xn0d…
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 proc…
Michelle Brooks, MD, FACP, FHM @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
Lisa Sanders @lisasandersmd
RT @nbhatnagar_md: Lesson for budding docs: "Spend 3 more minutes in the room, ask 2 more questions, and do 1 less test." Dr. Zane at @Denv
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 a…
Madhu S. 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
J 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
gm @gmnamedlong
RT @nbhatnagar_md: Lesson for budding docs: "Spend 3 more minutes in the room, ask 2 more questions, and do 1 less test." Dr. Zane at @Denv
Deborah Korenstein @dkorenstein
@FutureDocs There are a few qualitative studies. Don't have the refs on me... #JHMChat
J Hospital Medicine @JHospMedicine
RT @StephRStarr: T4 #JHMChat Overuse of referrals: partner w/ subspecialtists to identify ways to educate pts/families re reasons to wait…
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
Joshua Allen-Dicker @DrJoshuaAD
Example: a WebMD search for #highvaluecare reveals nothing relevant; It is either silently well-integrated or not there at all #JHMchat
Deborah Korenstein @dkorenstein
@michellebr00ks @brhospitalist And the flip side- individual clinical harm #JHMChat
J Hospital Medicine @JHospMedicine
RT @FutureDocs: curious if anyone has data on this #jhmchat https://t.co/rI1i3AcoB7
Michelle Brooks, MD, FACP, FHM @michellebr00ks
RT @DKorenstein: @michellebr00ks @brhospitalist And the flip side- individual clinical harm #JHMChat
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
Jorge A Rodriguez MD @translatedmed
RT @DrJoshuaAD: Example: a WebMD search for #highvaluecare reveals nothing relevant; It is either silently well-integrated or not there at…
J 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
Ralph Martello, MD @gatorpedsMD
#JHMChat https://t.co/CdFBcg4lz5
Jorge A Rodriguez MD @translatedmed
@DrJoshuaAD On point ! #jhmchat
Michelle Brooks, MD, FACP, FHM @michellebr00ks
RT @nbhatnagar_md: Lesson for budding docs: "Spend 3 more minutes in the room, ask 2 more questions, and do 1 less test." Dr. Zane at @Denv
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/DuHH4gVw…
Madhu S. 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
surgicalcaps.com @surgicalcaps
RT @DrJoshuaAD: T4: Partnerships w patient sources for health info - #ChoosingWisely + Consumer Reports is great example: https://t.co/xn0d…
Deborah Korenstein @dkorenstein
I think language of not doing matters. Not "you don't need" but "it won't help you and might hurt you" #JHMchat
Rebecca Jaffe @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
Vinny Arora MD MAPP @FutureDocs
RT @gatorpedsMD: #JHMChat https://t.co/CdFBcg4lz5
Benjamin P. Geisler @ben_geisler
T4: could bedside overuse rounds be like the "evidence cart" rounds that Sackett et al. did in the 90s? #jhmchat https://t.co/y8vDzfysN4
Madhu S. MD @thinkalot
I like it https://t.co/bODinWWo5r
William Dale, MD/PhD @WilliamDale_MD
Yep. #geriatrics https://t.co/G2afqg53O3
J Hospital Medicine @JHospMedicine
RT @DKorenstein: I think language of not doing matters. Not "you don't need" but "it won't help you and might hurt you" #JHMchat
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 #…
Matthew Katz, MD @subatomicdoc
RT @DKorenstein: @michellebr00ks @brhospitalist And the flip side- individual clinical harm #JHMChat
J Hospital Medicine @JHospMedicine
RT @ben_geisler: T4: could bedside overuse rounds be like the "evidence cart" rounds that Sackett et al. did in the 90s? #jhmchat https://t…
Vinny Arora MD MAPP @FutureDocs
cc @MedChiefs get a chief resident consult on tips ? #jhmchat https://t.co/EhCRv13xk8
J 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
Deborah Korenstein @dkorenstein
@FutureDocs @AlexSmithMD @NotesOnNursing Great point about geri skills #JHMChat We should learn from them
Brett Sadowski @bwsadowskimd
RT @nbhatnagar_md: Lesson for budding docs: "Spend 3 more minutes in the room, ask 2 more questions, and do 1 less test." Dr. Zane at @Denv
Andrew Auerbach @ADAuerbachMD
RT @DKorenstein: I think language of not doing matters. Not "you don't need" but "it won't help you and might hurt you" #JHMchat
Kelsey Murray @doctorakelso21
My 2¢ is learning how to address pt worry #1, and provider uncertainty, time to discuss, and challenging norms #JHMChat
Joshua Allen-Dicker @DrJoshuaAD
RT @JHospMedicine: Join #JHMChat again on June 5th 9PM EST when @FutureDocs will discuss Inter-Hospital Transfers w/@leorahorwitzmd https:/…
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 #…
Michelle Brooks, MD, FACP, FHM @michellebr00ks
RT @JHospMedicine: Join #JHMChat again on June 5th 9PM EST when @FutureDocs will discuss Inter-Hospital Transfers w/@leorahorwitzmd https:/…
Vinny Arora MD MAPP @FutureDocs
looking forward to it! #JHMChat https://t.co/nzwUDW443H
Deborah Korenstein @dkorenstein
Thanks all, this has been fun! #JHMchat
Rebecca Jaffe @RJmdphilly
RT @doctorakelso21: My 2¢ is learning how to address pt worry #1, and provider uncertainty, time to discuss, and challenging norms #JHMChat
Vinny Arora MD MAPP @FutureDocs
RT @DKorenstein: @FutureDocs @AlexSmithMD @NotesOnNursing Great point about geri skills #JHMChat We should learn from them
J 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 @RJmdphilly
Couldn't have summarized better myself :) #JHMChat https://t.co/eYiEpGXNBh
Rafael Bloise MD, MA @rbloise24
RT @rabrazzak: @JHospMedicine @vitaltalk @CAPCpalliative Oh, also @AriadneLabs serious illness conversation guide…
Rafael Bloise MD, MA @rbloise24
RT @rabrazzak: @JHospMedicine T3: Strong communication skills. Lots of great resources: @vitaltalk - gold standard;…
J Hospital Medicine @JHospMedicine
RT @FutureDocs: looking forward to it! #JHMChat https://t.co/nzwUDW443H
Tony Breu @tony_breu
Thanks @WrayCharles @dkorenstein for great discussion! See you next month. #JHMChat
Benjamin P. Geisler @ben_geisler
how does everyone feel about #choosingwisely dominating the #overuse conversation? too society-driven? #jhmchat https://t.co/00YH4Vnlm0
Guilherme Barcellos @brhospitalist
RT @ben_geisler: T4: could bedside overuse rounds be like the "evidence cart" rounds that Sackett et al. did in the 90s? #jhmchat https://t…
Guilherme Barcellos @brhospitalist
RT @gatorpedsMD: #JHMChat https://t.co/CdFBcg4lz5
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
J Hospital Medicine @JHospMedicine
@tony_breu @WrayCharles @DKorenstein It's always a pleasure, Tony! #jhmchat
Benjamin P. Geisler @ben_geisler
thanks @JHospMedicine & @DKorenstein for #jhmchat
Guilherme Barcellos @brhospitalist
RT @ben_geisler: how does everyone feel about #choosingwisely dominating the #overuse conversation? too society-driven? #jhmchat https://t.…
J 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, FACP, FHM @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 #jhmcha
Leora Horwitz @leorahorwitzmd
RT @FutureDocs: @JHospMedicine @doctorakelso21 our next #JHMChat is about care transitions so please join on june 5th with…
J Hospital Medicine @JHospMedicine
RT @ADAuerbachMD: Thanks to @WrayCharles @FutureDocs @SHMLive @CostsofCare @ABIMFoundation and most especially @DKorenstein for our #jhmcha
Leora Horwitz @leorahorwitzmd
RT @JHospMedicine: Join #JHMChat again on June 5th 9PM EST when @FutureDocs will discuss Inter-Hospital Transfers w/@leorahorwitzmd https:/…
Deborah Korenstein @dkorenstein
Yes thanks @WrayCharles! Can't wait to go back through and check out the links #JHMchat
Elliot Tapper @ebtapper
@tony_breu @FutureDocs @TirathPatelMD @MDaware longtime listener, first time caller. #jhmchat
Society of Hospital Medicine @SHMLive
RT @ADAuerbachMD: Thanks to @WrayCharles @FutureDocs @SHMLive @CostsofCare @ABIMFoundation and most especially @DKorenstein for our #jhmcha
Tirath Patel @TirathPatelMD
@DKorenstein @FutureDocs Had a typo. Go figure. It's exactly 26 years old. (May 8, 1991). #jhmchat
J 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 @SHMLive
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: https://t.co/KFMEG32Y0V
Leonard D'Avolio PhD @ldavolio
RT @FutureDocs: T3 Gonna plug new free value conversations series @CostsofCare @doctorschannel website on #JHMChat #CME https://t.co/mePgd2…
applam @applam1
RT @ADAuerbachMD: Thanks to @WrayCharles @FutureDocs @SHMLive @CostsofCare @ABIMFoundation and most especially @DKorenstein for our #jhmcha
Vinny Arora MD MAPP @FutureDocs
RT @JHospMedicine: Thank you #JHMChat participants for helping us break 3K followers tonight! Look forward to future tweets & readers @JHos
Grace Farris MD @gracefarris
RT @ebtapper: @tony_breu @JHospMedicine hard2contextualize the ltd value of such tests. Lectures on pre/post tx probs often fall flat #jhmc
Grace Farris MD @gracefarris
RT @tony_breu: @ebtapper @JHospMedicine CHF is classic example. This is a clinical diagnosis, but residents NEED the echo. #JHMChat
Ash Paul @pash22
RT @nbhatnagar_md: Lesson for budding docs: "Spend 3 more minutes in the room, ask 2 more questions, and do 1 less test." Dr. Zane at @Denv
#JHMChat content from Twitter.