#hpm Transcript
Healthcare social media transcript of the #hpm hashtag.
– ().
See #hpm Influencers/Analytics.
| Profile | Tweet |
|---|---|
 | renée berry 🌿 @rfberry Hello & Welcome to the #hpm Tweetchat! Please take the next few minutes to introduce yourself and where you're from. This evening we are doing a special collaboration with the #btsm community. Learn more about tonights theme here: https://t.co/hErblq0I4D |
 | 🧠Julia Robertson @Ailuj_Nostrebor RT @TheLizArmy: Dear Twitter friends: Dear Twitter friends: Expect increased tweet activity from me over the next hour. I am participating in the #HPM tweet chat. Topic linked below. Join us! https://t.co/zHILmW08XK #btsm #btsmqol |
 | Shirley Otis-Green @sotisgreen RT @rfberry: Hello & Welcome to the #hpm Tweetchat! Please take the next few minutes to introduce yourself and where you're from. This evening we are doing a special collaboration with the #btsm community. Learn more about tonights theme here: https://t.co/hErblq0I4D |
| renée berry 🌿 @rfberry I'm Renee Berry, living in San Luis Obispo, CA, I'm a cofounder of the #hpm chat, hosting tonight and a long time early palliative care advocate. I'm currently working on ways to help the public sector with technology. Looking forward to our discussion! |
| Bruce Scott @BruceScott_MD Is nobody else playing #hpm Tweetchat today? | |
 | Michael Fratkin @MichaelDFratkin Woohoo!!! Hi #hpm friends, from foggy NorCal. Michael Fratkin here. |
| Michael Fratkin @MichaelDFratkin RT @rfberry: Hello & Welcome to the #hpm Tweetchat! Please take the next few minutes to introduce yourself and where you're from. This evening we are doing a special collaboration with the #btsm community. Learn more about tonights theme here: https://t.co/hErblq0I4D |
 | Matt Cotcher @MLCotcher @rfberry 11-year brain tumor survivor, currently battling recurrence. Part of the #btsm community. #hpm |
 | Terri Lewis, PhD #GratefulToBeVaccinated in TN-6 @tal7291 RT @AlexSmithMD: Bruce Leff giving the clearest explanation of the range of home-based care services I’ve heard. @UCSFGeriatrics #geriatrics #hpm grand rounds. @HopkinsMedicine https://t.co/ZmiVuzyxwo |
 | Ashley C Deringer @acderinger @rfberry Hello @rfberry, #hpm & #btsm Tweeps! Excited to join for this special chat tonight. I'm Ashley, #Palliative NP in the Deep South. Mainly inpatient, but our group has a fledgling new outpatient clinic! :-) |
| Michael Fratkin @MichaelDFratkin @rfberry Lovely to "see" you! #hpm |
 | Liz Salmi @TheLizArmy @rfberry Liz here, living with astrocytoma. PI for the Brain Cancer Quality of Life Collaborative funded by @PCORI. Learn about our project here: https://t.co/6bTFwwuzYN. We also use hashtag #BTSMQoL. And when I am not doing that, I work on @myopennotes. 👍 Glad to be here! #HPM |
 | Paul Tatum @doctatum Hey #hpm friends. Long time no chat. Paul from Missouri |
| Liz Salmi @TheLizArmy @BruceScott_MD Me! #HPM |
| renée berry 🌿 @rfberry Please excuse the high tweet volume for the next hour, I'm participating in a live discussion on issues in hospice and palliative care. It's open to all, just use #hpm in your tweets. |
 | Dr. PNW Ex-pat (she/her) @katie_harmoney @rfberry I'm Katie, (recovering) peds heme-onc fellow and soon to be #hpm fellow @UR_Med. |
| renée berry 🌿 @rfberry @MichaelDFratkin Likewise Michael! #hpm |
| Liz Salmi @TheLizArmy @MichaelDFratkin Great to see you here, Michael! We will miss you at #MedX this weekend. #HPM |
| renée berry 🌿 @rfberry @acderinger Hi Ashley, thanks for joining! #hpm |
| Dr. PNW Ex-pat (she/her) @katie_harmoney @TheLizArmy @rfberry @PCORI @myopennotes Welcome! #hpm |
 | Bethany Kwan, PhD, MSPH @BethanyKwan I'm @BethanyKwan, a researcher at the University of Colorado School of Medicine. I'm here tonight to listen to thoughts on communication around #hpm https://t.co/G0ZaLILse8 |
| renée berry 🌿 @rfberry @MLCotcher Hi Matt, thanks so much for joining our conversation tonight. #hpm |
| Liz Salmi @TheLizArmy @MLCotcher @rfberry Welcome, Matt! Glad to see you crossing over into #HPM. Way to represent #BTSM! 🤜🤛 |
| renée berry 🌿 @rfberry @BruceScott_MD Oh we're here. How are ya Bruce? #hpm |
| Paul Tatum @doctatum @katie_harmoney @rfberry @UR_Med Welcome. Fellowship will be great. #hpm you are so needed! |
| Michael Fratkin @MichaelDFratkin @TheLizArmy #sadface #hpm |
| renée berry 🌿 @rfberry @KtNeuendorf Hi Katie, thanks for joining! Such an important role! #hpm |
| Liz Salmi @TheLizArmy @rfberry @PCORI @myopennotes Forgot to mention, I am coming to you live tonight from Sacramento, California! #HPM |
| renée berry 🌿 @rfberry @katie_harmoney @UR_Med congrats and welcome! #hpm |
| Ashley C Deringer @acderinger GREAT to see patients perspective on #hpm chat (thanks #btsm <3) https://t.co/SdUWPosHMe |
| Dr. PNW Ex-pat (she/her) @katie_harmoney @doctatum @rfberry @UR_Med I mean, what's #pgy7 after 6 years? #hpm |
| renée berry 🌿 @rfberry A special thank you and shout out to @TheLizArmy & @BethanyKwan for designing our topics for the evening! #hpm |
| Liz Salmi @TheLizArmy @StevenLaFond @NBTStweets Glad you joined us tonight, Steven! You've seen it all. #HPM |
| Michael Fratkin @MichaelDFratkin @BethanyKwan @Kathy_Brandt Yea!!!! #hpm |
| Liz Salmi @TheLizArmy @BethanyKwan Teamwork makes the dream work, @BethanyKwan! #HPM #btsmqol |
| Michael Fratkin @MichaelDFratkin RT @rfberry: A special thank you and shout out to @TheLizArmy & @BethanyKwan for designing our topics for the evening! #hpm |
| renée berry 🌿 @rfberry RT @acderinger: GREAT to see patients perspective on #hpm chat (thanks #btsm <3) https://t.co/SdUWPosHMe |
| Liz Salmi @TheLizArmy @Kathy_Brandt Glad tweet with you in real time, Kathy! #hpm |
| Shirley Otis-Green @sotisgreen RT @TheLizArmy: @BethanyKwan Teamwork makes the dream work, @BethanyKwan! #HPM #btsmqol |
| Liz Salmi @TheLizArmy RT @acderinger: GREAT to see patients perspective on #hpm chat (thanks #btsm <3) https://t.co/SdUWPosHMe |
| renée berry 🌿 @rfberry @StevenLaFond @NBTStweets Thanks for joining Steven! We'll get started with T1 in just a couple of minutes. #hpm |
 | Nickas Arbata @nickasarbata #hpm Hi all, I’m an icu nurse turned palliative care nurse working to develop a program across my entire hospital network! #behind #help |
 | Beth Fand Incollingo @FandIncollingo Hi, All, Managing Editor of CURE magazine here. We write a lot about the importance of palliative care early in treatment for people with cancer. #HPM |
| Ashley C Deringer @acderinger @katie_harmoney @doctatum @rfberry @UR_Med 🤓❤️🤓💗 📚📚📚📚📚📚📚 Congrats on your (next) fellowship! #hpm |
| Liz Salmi @TheLizArmy Oh yeah, well I love everyone who loves patient voices. 😉 #HPM https://t.co/zBUNjhQZKY |
| Bethany Kwan, PhD, MSPH @BethanyKwan @KtNeuendorf We love patient voices! #BTSM #hpm |
| Liz Salmi @TheLizArmy @nickasarbata Congrats and good luck! You are in good company here with #HPM. |
 | SarahScott Dietz @SDietzMD Hi all! SarahScott, internist in a mostly primary care setting with some wards weeks thrown in for good measure. Fellowship starts in about 127 days!! (But who’s counting?) #hpm |
| renée berry 🌿 @rfberry T1 As a healthcare professional, how do you help patients make medical decisions when the person is suffering from a neurological/cognitive condition in which that person is no longer the person “they used to be,” or struggling to make decisions? #hpm |
| renée berry 🌿 @rfberry T1 For anyone who isn't working in healthcare: How does your healthcare team help when you find your way if you're struggling to make medical decisions? #HPM |
| Liz Salmi @TheLizArmy @FandIncollingo Welcome! I just read a great blog post about @myopennotes in @cure_magazine last week: https://t.co/EROdD3bbsI. This person learned about #opennotes through #BCSM tweet chat! #HPM |
| Bruce Scott @BruceScott_MD @SDietzMD I bet some people are counting. #hpm | |
| Liz Salmi @TheLizArmy RT @rfberry: T1 As a healthcare professional, how do you help patients make medical decisions when the person is suffering from a neurological/cognitive condition in which that person is no longer the person “they used to be,” or struggling to make decisions? #hpm |
 | National Brain Tumor Society @NBTStweets The #hpm chat tonight is talking palliative care for people suffering cognitive and neurological conditions. If you've been dealing with #braintumor, come on by with the hashtag #hpm https://t.co/oUc9SNE8Si |
| renée berry 🌿 @rfberry @FandIncollingo thanks for joining Beth, I'm very passionate about early #palliative care! #hpm |
| Dr. PNW Ex-pat (she/her) @katie_harmoney @BruceScott_MD @SDietzMD We're trying to keep a low profile. #hpm |
| National Brain Tumor Society @NBTStweets RT @TheLizArmy: @FandIncollingo Welcome! I just read a great blog post about @myopennotes in @cure_magazine last week: @FandIncollingo Welcome! I just read a great blog post about @myopennotes in @cure_magazine last week: https://t.co/EROdD3bbsI. This person learned about #opennotes through #BCSM tweet chat! #HPM |
| National Brain Tumor Society @NBTStweets RT @rfberry: T1 For anyone who isn't working in healthcare: T1 For anyone who isn't working in healthcare: How does your healthcare team help when you find your way if you're struggling to make medical decisions? #HPM |
| Bethany Kwan, PhD, MSPH @BethanyKwan Excuse the high tweet volume for the next hour - I'll be participating in a Tweet chat with the #hpm community around communications between health care teams, patients and care partners regarding palliative care for serious neurological conditions. Join us if interested! |
| Bethany Kwan, PhD, MSPH @BethanyKwan RT @rfberry: T1 As a healthcare professional, how do you help patients make medical decisions when the person is suffering from a neurological/cognitive condition in which that person is no longer the person “they used to be,” or struggling to make decisions? #hpm |
| Ashley C Deringer @acderinger @rfberry T1 Depends greatly on whether condition was acute/known in advance/planned for..if they had time to establish surrogate decision makers. But I always try to be inclusive of the patient even if they "aren't the same" so they don't feel as though they've lost all agency #hpm |
| Paul Tatum @doctatum T1. Complex. For a geriatrician who believes in partially preserved decision-making (express preference, if not full decision making) My answer: 1 formal cognitive assessment and 2 discuss goals. #hpm |
| renée berry 🌿 @rfberry T1 I've seen a lot of layers of confusion as my family consider the many choices in healthcare decisions. Especially around the right care at the right time. It's been even more challenging for my family experiencing dementia. #hpm |
| Liz Salmi @TheLizArmy @rfberry T1: When I was being presented w/all the treatment options for my brain tumor, mainly, everything was presented to me (and my husband and uncle who were w/me), we wrote everything down, then went home to think about everything over dinner/meal. We'd take a bit of time. #HPM |
| Shirley Otis-Green @sotisgreen RT @rfberry: T1 I've seen a lot of layers of confusion as my family consider the many choices in healthcare decisions. Especially around the right care at the right time. It's been even more challenging for my family experiencing dementia. #hpm |
| renée berry 🌿 @rfberry @NBTStweets Thanks so much for the highlight! We really appreciate all of the people contributing to this conversation. #hpm |
| Dr. PNW Ex-pat (she/her) @katie_harmoney @rfberry In my (very) limited experience, I try to help people to talk about what their loved one is/was like at when they were well, and go from there. #hpm |
| Shirley Otis-Green @sotisgreen RT @doctatum: T1. Complex. For a geriatrician who believes in partially preserved decision-making (express preference, if not full decision making) My answer: 1 formal cognitive assessment and 2 discuss goals. #hpm |
| Ashley C Deringer @acderinger RT @NBTStweets: The #hpm chat tonight is talking palliative care for people suffering cognitive and neurological conditions. If you've been dealing with #braintumor, come on by with the hashtag #hpm https://t.co/oUc9SNE8Si |
| Shirley Otis-Green @sotisgreen RT @acderinger: @rfberry T1 Depends greatly on whether condition was acute/known in advance/planned for..if they had time to establish surrogate decision makers. But I always try to be inclusive of the patient even if they "aren't the same" so they don't feel as though they've lost all agency #hpm |
| Shirley Otis-Green @sotisgreen RT @TheLizArmy: @FandIncollingo Welcome! I just read a great blog post about @myopennotes in @cure_magazine last week: @FandIncollingo Welcome! I just read a great blog post about @myopennotes in @cure_magazine last week: https://t.co/EROdD3bbsI. This person learned about #opennotes through #BCSM tweet chat! #HPM |
| Bruce Scott @BruceScott_MD I might not be fully understanding the crux of the question... I make a capacity assessment. I'm actually in favor of a sort of sliding scale capacity designation, but that is VERY controversial. I want people participating in their decisions as much as possible. #hpm https://t.co/hmQP0XOsIO | |
| Bethany Kwan, PhD, MSPH @BethanyKwan @doctatum What's your preferred strategy for discussing goals? #hpm |
| National Brain Tumor Society @NBTStweets RT @TheLizArmy: @rfberry T1: @rfberry T1: When I was being presented w/all the treatment options for my brain tumor, mainly, everything was presented to me (and my husband and uncle who were w/me), we wrote everything down, then went home to think about everything over dinner/meal. We'd take a bit of time. #HPM |
| Liz Salmi @TheLizArmy @rfberry T1: When it came to having brain surgery, there was not a lot of time to consider whether or not I would have surgery... It was like, "Holy shit, a BRAIN SURGEON is saying I need brain surgery RIGHT NOW. He must know what he's talking about, right?" #HPM #btsm |
| Liz Salmi @TheLizArmy RT @NBTStweets: The #hpm chat tonight is talking palliative care for people suffering cognitive and neurological conditions. If you've been dealing with #braintumor, come on by with the hashtag #hpm https://t.co/oUc9SNE8Si |
| Bruce Scott @BruceScott_MD @doctatum That's a better way to put it than I did. I think I was shooting for the same idea. #hpm | |
| renée berry 🌿 @rfberry @acderinger Important point. @TheLizArmy how does it feel to be on the side of this where you can feel you are yourself, but at certain points of care, are concerned about how that is managed during different phases of an illness? #hpm |
| Bruce Scott @BruceScott_MD RT @doctatum: T1. Complex. For a geriatrician who believes in partially preserved decision-making (express preference, if not full decision making) My answer: 1 formal cognitive assessment and 2 discuss goals. #hpm | |
 | Torrie Fields @TorrieKFields RT @TheLizArmy: @rfberry T1: @rfberry T1: When I was being presented w/all the treatment options for my brain tumor, mainly, everything was presented to me (and my husband and uncle who were w/me), we wrote everything down, then went home to think about everything over dinner/meal. We'd take a bit of time. #HPM |
| Liz Salmi @TheLizArmy RT @acderinger: @rfberry T1 Depends greatly on whether condition was acute/known in advance/planned for..if they had time to establish surrogate decision makers. But I always try to be inclusive of the patient even if they "aren't the same" so they don't feel as though they've lost all agency #hpm |
| Dr. PNW Ex-pat (she/her) @katie_harmoney @TheLizArmy @rfberry T1: Thank you for sharing! As an oncologist (for now), I give all new patients a notebook and pen to write stuff down. #hpm |
| SarahScott Dietz @SDietzMD @rfberry T1 Not exactly an answer to the question, but as a primary care doc I am more assertive with frank talk about advanced care planning and discussing wishes in patients with neurological conditions than any other. As soon as they’re diagnosed I bring it up as urgent. #hpm |
| National Brain Tumor Society @NBTStweets RT @TheLizArmy: @rfberry T1: @rfberry T1: When it came to having brain surgery, there was not a lot of time to consider whether or not I would have surgery... It was like, "Holy shit, a BRAIN SURGEON is saying I need brain surgery RIGHT NOW. He must know what he's talking about, right?" #HPM #btsm |
| Dr. PNW Ex-pat (she/her) @katie_harmoney @TheLizArmy @rfberry T1: We are very good at expressing urgency in medicine, whether or not it's necessary. I often think we express urgency to the detriment of communication. #hpm |
| renée berry 🌿 @rfberry Was it presented by a team of different specialists or by a team with the same area of expertise? #hpm https://t.co/D9nSxDTUqx |
| Nickas Arbata @nickasarbata @rfberry T1 I work in the ICU of a comprehensive stroke center. Early identification of surrogate decision maker, evaluate for competency, and advocate for inclusion of the patient in decision making and discussion. Why are we always leaving the room to talk about our patients? #hpm |
| renée berry 🌿 @rfberry RT @SDietzMD: @rfberry T1 Not exactly an answer to the question, but as a primary care doc I am more assertive with frank talk about advanced care planning and discussing wishes in patients with neurological conditions than any other. As soon as they’re diagnosed I bring it up as urgent. #hpm |
| Bruce Scott @BruceScott_MD That's exactly what we need. Primary care (or neurology) have to either have these discussions or refer to #hpm very early. You can't put these off. https://t.co/zfqQy7Wrsz | |
| Shirley Otis-Green @sotisgreen RT @TheLizArmy: @rfberry T1: @rfberry T1: When it came to having brain surgery, there was not a lot of time to consider whether or not I would have surgery... It was like, "Holy shit, a BRAIN SURGEON is saying I need brain surgery RIGHT NOW. He must know what he's talking about, right?" #HPM #btsm |
 | Kayla Sheehan, MD @kksheehan Hi everyone! Hope I'm doing this right. Kayla Sheehan, second year medical student. I'll be popping in and out (studying for finals and Step 1), but eager to learn from you all! #hpm |
| SarahScott Dietz @SDietzMD @TheLizArmy @rfberry This was my father’s experience, too (glioblastoma.) #hpm |
| Liz Salmi @TheLizArmy @rfberry @acderinger It's weird with a brain tumor because you go through phases where you can manage on your own, but then there are times (such as after brain surgery, or right after seizures) where you really can't do things for yourself and have to rely on others. #HPM #btsm |
| Dr. PNW Ex-pat (she/her) @katie_harmoney So true. Have discussions about goals of care early and often. #hpm https://t.co/1K5n5xDuLh |
| Shirley Otis-Green @sotisgreen Excellent observation - @katie_harmoney #hpm #btsm https://t.co/vEv6DD85wG |
| Ashley C Deringer @acderinger @kksheehan Patients AND Med Students-we're on a roll tonight! Welcome & glad you're here for #hpm chat! |
| Nickas Arbata @nickasarbata @BruceScott_MD What does your sliding scale capacity designation look like, in practical terms? T1 #hpm |
| renée berry 🌿 @rfberry @KtNeuendorf thanks for the perspective! I think this is easier though if the care team takes time to get to know the patient and asks for their goals in life (not just goals in care). #hpm |
| Liz Salmi @TheLizArmy @katie_harmoney @rfberry "I am so sorry to hear you have received a cancer diagnosis. Here is your official notebook." 😂 #HPM |
| renée berry 🌿 @rfberry @kksheehan awesome, join any time. We chat the last Wednesday of the month, every month at 6p PST. Welcome! #hpm |
| Bethany Kwan, PhD, MSPH @BethanyKwan @katie_harmoney In your experience, do patients and families resonate with the idea of "goals of care"? How does that conversation go? #hpm |
| Shirley Otis-Green @sotisgreen Welcome!! Good luck on your finals! @kksheehan #hpm https://t.co/YVQ8NHMi78 |
| Liz Salmi @TheLizArmy Quote of the night! #HPM https://t.co/zvnxP4Lzf3 |
| renée berry 🌿 @rfberry RT @BruceScott_MD: That's exactly what we need. Primary care (or neurology) have to either have these discussions or refer to #hpm very early. You can't put these off. https://t.co/zfqQy7Wrsz |
| Dr. PNW Ex-pat (she/her) @katie_harmoney @TheLizArmy @rfberry @acderinger I think as a patient, it's important to try to tell the medical professional to slow the heck down. I fail at that as a patient, I will admit. #hpm |
| renée berry 🌿 @rfberry RT @katie_harmoney: @TheLizArmy @rfberry T1: @TheLizArmy @rfberry T1: We are very good at expressing urgency in medicine, whether or not it's necessary. I often think we express urgency to the detriment of communication. #hpm |
 | Shoshana Ungerleider, MD @ShoshUMD This is fantastic! @raverbuch #meded #hpm https://t.co/0ezreTIuCo |
| Michael Fratkin @MichaelDFratkin Yikes. Patient care interruption! T1-I try to slueth out as clear a sense of their whole personhood through those that know them well, pictures on the wall, magazines in the rack, and any actionable truths about themselves that they can share, even if garbled by illness. #hpm |
| Shirley Otis-Green @sotisgreen RT @katie_harmoney: So true. Have discussions about goals of care early and often. #hpm https://t.co/1K5n5xDuLh |
| Torrie Fields @TorrieKFields Hi there. Torrie. Health policy wonk, insurance person. Daughter to #btsm dad. Daughter to Parkinson’s mom. Late joiner. #HPM |
| Ashley C Deringer @acderinger @TheLizArmy @rfberry Liz-Were you prepared for that? I actually mean "Did your medical/treatment team prepare you for the degree of variability of cognition & how to plan for that?" #hpm #btsm |
| Dr. PNW Ex-pat (she/her) @katie_harmoney @BethanyKwan Not if you use the expression "goals of care." I find that talking about what they find important, what they love to do, what drives them in life to be more revealing, and to get closer to the needed discussion. #hpm |
| Bethany Kwan, PhD, MSPH @BethanyKwan @MichaelDFratkin I love that concept of "whole personhood" and how you capture that. Does that affect the communications? #hpm |
| Shirley Otis-Green @sotisgreen RT @katie_harmoney: @BethanyKwan Not if you use the expression "goals of care." I find that talking about what they find important, what they love to do, what drives them in life to be more revealing, and to get closer to the needed discussion. #hpm |
| renée berry 🌿 @rfberry @BethanyKwan @katie_harmoney The most critical element of this is establishing what quality of life looks like for each individual and ensuring that as different care types evolve, that the individual's quality of life is at the center. Sometimes professionals don't call it by name, they just do it. #hpm |
| Liz Salmi @TheLizArmy @rfberry Treatment information for my brain tumor came rolling in in waves. It was a process, because getting the diagnosis took time... It wasn't like they could just point out the problem as easy as a cut on my skin. So the answer is: I received information from SO MANY people. #HPM |
| renée berry 🌿 @rfberry RT @katie_harmoney: @BethanyKwan Not if you use the expression "goals of care." I find that talking about what they find important, what they love to do, what drives them in life to be more revealing, and to get closer to the needed discussion. #hpm |
| Shirley Otis-Green @sotisgreen RT @rfberry: @BethanyKwan @katie_harmoney The most critical element of this is establishing what quality of life looks like for each individual and ensuring that as different care types evolve, that the individual's quality of life is at the center. Sometimes professionals don't call it by name, they just do it. #hpm |
| Shirley Otis-Green @sotisgreen RT @BethanyKwan: @MichaelDFratkin I love that concept of "whole personhood" and how you capture that. Does that affect the communications? #hpm |
| Liz Salmi @TheLizArmy RT @katie_harmoney: @TheLizArmy @rfberry @acderinger I think as a patient, it's important to try to tell the medical professional to slow the heck down. I fail at that as a patient, I will admit. #hpm |
| Bethany Kwan, PhD, MSPH @BethanyKwan @rfberry @katie_harmoney If you were going to teach some of these trainees how to "just do it", how would you show them? #hpm |
| Dr. PNW Ex-pat (she/her) @katie_harmoney @BethanyKwan In some ways, my blue collar upbringing helps me, I think. I am easily able to sit down and talk with steel workers, farmers, etc. Those are my people. #hpm |
| SarahScott Dietz @SDietzMD RT @katie_harmoney: @BethanyKwan Not if you use the expression "goals of care." I find that talking about what they find important, what they love to do, what drives them in life to be more revealing, and to get closer to the needed discussion. #hpm |
| Torrie Fields @TorrieKFields This is critical. There is often time. #hpm https://t.co/ATznUOq9jl |
| Torrie Fields @TorrieKFields RT @TheLizArmy: Quote of the night! #HPM https://t.co/zvnxP4Lzf3 |
| Bruce Scott @BruceScott_MD @nickasarbata #hpm Mostly thinking about this in terms of dementia (I'm a geriatrician too). The more serious the potential intervention/disease is, the higher the threshold for capacity. You might advocate a patient has the capacity to choose a regular diet rather than a restricted one... | |
| renée berry 🌿 @rfberry @TorrieKFields Hi Torrie, thanks for joining and sharing. #hpm I didn't share with the group, but realize this is relevant to our discussion, especially tonight, my grandmother had Parkinson's and another grandparent has dementia. |
| Paul Tatum @doctatum @BethanyKwan Ah the great art. 1. Shoot the breeze. 2 discuss hobbies. 3 discuss family/who is important. 4 more gab 5 then tie it into medical issues limitations and next steps #hpm |
| Bethany Kwan, PhD, MSPH @BethanyKwan @TorrieKFields One person's urgency is another person's anxiety? #hpm |
| Bruce Scott @BruceScott_MD @nickasarbata ...while you might go to the health care power of attorney for something like question of a TAVR. #hpm | |
| Dr. PNW Ex-pat (she/her) @katie_harmoney @BethanyKwan @rfberry T1: I think I'd try first to make them explain something really complex to me, using simple terminology. Probably then, we'd do some role playing. Then, we'd probably have them watch a few. #hpm |
 | Sonia Malhotra,MD,MS @SoniaMKhunkhun Hello @hpmchat friends - sonia malhotra from New Orleans, past chair of @EarlyCareerSIG , mostly adult pal now with some peds #HPM |
| renée berry 🌿 @rfberry @BethanyKwan @katie_harmoney This is one of my favorite videos on this. #hpm There are great professional resources @CAPCpalliative and family resources @GetPalliative https://t.co/y5RrJaJUxp |
 | Aelaf Worku @DrAelaf RT @AlexSmithMD: Bruce Leff giving the clearest explanation of the range of home-based care services I’ve heard. @UCSFGeriatrics #geriatrics #hpm grand rounds. @HopkinsMedicine https://t.co/ZmiVuzyxwo |
| Shirley Otis-Green @sotisgreen I've found that folks understood that phrase- it's pretty descriptive and addresses what people intuitively want to know @KtNeuendorf @katie_harmoney @BethanyKwan #hpm https://t.co/vFStf83yHA |
| Liz Salmi @TheLizArmy @acderinger @rfberry Actually, no. No one prepared me for the aspect of the disease that meant I would occasionally HAVE TO give up all control of my life. This was the hardest part. #HPM |
| Nickas Arbata @nickasarbata @BruceScott_MD I see the controversy. But i appreciate the input. I like the idea. I also fear the instant line of questioning about exactly who decided what they can and cannot make decisions about and when do those guidelines change. #hpm |
 | Ishwaria Subbiah, MD MS FASCO @IshwariaMD @rfberry Hi all! Joining in late - palliative care and med onc physician in Houston TX. I'll catch up reading through the #hpm tweets! |
| renée berry 🌿 @rfberry T2 is very connected to T1, so get ready team, I'm adding it to our conversation. #hpm |
| Bethany Kwan, PhD, MSPH @BethanyKwan @comfortpeace_V @rfberry Fantastic! Who's on your team? #hpm |
| Bruce Scott @BruceScott_MD @katie_harmoney @doctatum @BethanyKwan When non #hpm attending happen to be in the room when I'm executing Paul's strategy, they often get very twitchy. | |
| Sonia Malhotra,MD,MS @SoniaMKhunkhun T1:first have to educate myself on type of neuro condition Bc there is considerable prognositic variability #HPM #neuropalliative #hpmchat |
| Dr. PNW Ex-pat (she/her) @katie_harmoney @BruceScott_MD @doctatum @BethanyKwan I love making people twitchy. #hpm |
| Liz Salmi @TheLizArmy @doctatum @BethanyKwan So this is the secret @doctatum recipe! #hpm |
| Sonia Malhotra,MD,MS @SoniaMKhunkhun @BethanyKwan Welcome! #hpm #hpmchat |
| Paul Tatum @doctatum @BruceScott_MD @katie_harmoney @BethanyKwan I have that effect on people #twitchy #hpm |
| Dr. PNW Ex-pat (she/her) @katie_harmoney @ZHeatherChamp Unfortunately, sometimes you have to demand it of them. That's totally unfair, I know. #hpm |
| Ashley C Deringer @acderinger @rfberry @TorrieKFields All in the family...my Dad almost certainly has #Parkinsons (def degenerative neuro/movement disorder), cardiologist referred him to a neuro...no appt avail in area for *8 months*. He's coming here next week to see my neurologist friend...to officially be diagnosed #hpm |
| renée berry 🌿 @rfberry T2: What kind of communication techniques work well for people suffering from cognitive difficulties? If you've experienced these conversations as a patient or family, do you have thoughts on what was good or not good about the healthcare professional's approach? #HPM |
| Torrie Fields @TorrieKFields @TheLizArmy @acderinger @rfberry It’s funny you bring that up; my mom says the same. “No one told me he’d have to feed me.” That’s when she wanted to know about her disease. What do you do when you love control? #hpm |
| Paul Tatum @doctatum @TheLizArmy @BethanyKwan Know the patient. Mine are my friends. I love my patients #hpm |
| Liz Salmi @TheLizArmy What's weird is, after being a brain tumor patient for 9 years, I can explain how brain surgery works, what treatment is like for malignant gliomas, the various biomarkers, and all about precision medicine... But I still don't know how to change the oil in my car. #HPM #btsm https://t.co/UGIMVM4rFU |
| Bruce Scott @BruceScott_MD @nickasarbata I chart my rationale. I talk to the other docs about it. We are always making capacity evaluations in all of our patients. Some of it is implicit. But you can't really can't allow a patient to consent to something if you don't think they have the capacity to do so. #hpm | |
| Dr. PNW Ex-pat (she/her) @katie_harmoney @ZHeatherChamp Again, I'm cheating, because my dad's from the south. I do NOT talk fast. #hpm |
| Dr. PNW Ex-pat (she/her) @katie_harmoney @doctatum @BruceScott_MD @BethanyKwan #triggered #hpm |
| Bruce Scott @BruceScott_MD @kksheehan Look at this for a tool to help with capacity evaluations. #hpm https://t.co/sR82xWvtwa | |
| Paul Tatum @doctatum T2 Time. Straight talk in simple language. With family. #hpm |
| renée berry 🌿 @rfberry I think that's an ok thing to want! It's also reasonable to want to know, at what point will I need help when eating, but it's not always clearly communicated. #hpm https://t.co/GBLmSLjz07 |
| Shirley Otis-Green @sotisgreen RT @BruceScott_MD: @nickasarbata I chart my rationale. I talk to the other docs about it. We are always making capacity evaluations in all of our patients. Some of it is implicit. But you can't really can't allow a patient to consent to something if you don't think they have the capacity to do so. #hpm |
| Dr. PNW Ex-pat (she/her) @katie_harmoney @TheLizArmy I'm a 34 year old woman who can't send a fax, but I have a medical degree, two bachelors degrees, and am completing my first of two fellowships. And I can't change my oil either. You're awesome! #hpm |
| Liz Salmi @TheLizArmy THIS. 👇 #HPM #btsmqol https://t.co/LVgQXl7cJw |
| Paul Tatum @doctatum So good to hear from many patients and families teaching us in #hpm tonight. Thank you!!! |
 | Lynne P. Taylor, M.D. @neulpt #BTSMqol #hpm Greetings all! Joining from the Neurology annual meeting in Los Angeles. Sorry to be late; just seeing if I can actually take part in this chat. |
| renée berry 🌿 @rfberry @TheLizArmy thank you for sharing this Liz. It's quite exceptional and delightfully down to earth at the same time. #hpm |
| Shirley Otis-Green @sotisgreen RT @BruceScott_MD: @kksheehan Look at this for a tool to help with capacity evaluations. #hpm https://t.co/sR82xWvtwa |
| Nickas Arbata @nickasarbata @BruceScott_MD Certainly. I’m a PCRN and where I am, capacity eval falls on the hospital psychologist and it’s all-or-nothing, so I was curious about alternatives! T1 #hpm |
| renée berry 🌿 @rfberry @katie_harmoney @TheLizArmy lol, love it. #hpm |
| renée berry 🌿 @rfberry RT @doctatum: T2 Time. Straight talk in simple language. With family. #hpm |
| Dr. PNW Ex-pat (she/her) @katie_harmoney Truth. I love my kids. Each and every one of them. Yes, even that kid. #hpm https://t.co/iU7XbkRmgW |
| Shirley Otis-Green @sotisgreen RT @TheLizArmy: THIS. 👇 #HPM #btsmqol https://t.co/LVgQXl7cJw |
| Bethany Kwan, PhD, MSPH @BethanyKwan @ZHeatherChamp If you could choose, what convos would you want them to have with you? #hpm |
 | HPM Chat @hpmchat RT @rfberry: T1 As a healthcare professional, how do you help patients make medical decisions when the person is suffering from a neurological/cognitive condition in which that person is no longer the person “they used to be,” or struggling to make decisions? #hpm |
| HPM Chat @hpmchat RT @rfberry: T2: T2: What kind of communication techniques work well for people suffering from cognitive difficulties? If you've experienced these conversations as a patient or family, do you have thoughts on what was good or not good about the healthcare professional's approach? #HPM |
| SarahScott Dietz @SDietzMD @rfberry T2: As a physician, I try to always start with the patient and let them respond first, before I talk to a family member/caregiver. As a family member, watching people treat my still-brilliant but now aphasic and hemiplegic father like an idiot was intensely painful. #hpm |
| Bethany Kwan, PhD, MSPH @BethanyKwan @nickasarbata @BruceScott_MD I'm curious about the capacity evals - how do they inform your communication strategy? Does it change who, how, what you talk about? #hpm |
| Bruce Scott @BruceScott_MD @nickasarbata I dislike the approach of punting to psychiatry or psychology. As an internist, a geriatrician, or a palliative doc, I think I should be doing my own evals. I only call in psych when there is a disagreement among providers about capacity. #hpm | |
| Sonia Malhotra,MD,MS @SoniaMKhunkhun @TheLizArmy @rfberry I wish systems understood the time that is needed to give patients all info & options. 20-30 min visits don't do that. Thanks 4 sharing #hpm |
| Ashley C Deringer @acderinger @rfberry T2 For difficult conversations especially with cognitive challenges, I often have our #LCSW with me. She is great @ slowing things down, asking clarifying questions, reading body language I miss to make sure we are connecting #hpm #btsm |
| Lynne P. Taylor, M.D. @neulpt #hpm #BTSMqol I struggle with simultaneously answering the questions of the patient and caregivers. Different minds and brains; different needs. |
| Paul Tatum @doctatum @BethanyKwan @katie_harmoney Nope. But Being from East Texas I speak in less noble terms. Some might say I speak Redneck. In a nice way of course. #hpm |
| Ishwaria Subbiah, MD MS FASCO @IshwariaMD @rfberry T2: Our/my #hpm goal is to get a better understanding of that person's values. Some of my ?s are 'tell me about the last time you were in the hospital, your thoughts on being hospitalized frequently, tell me about artificial life support, have you had a fam member in the ICU... |
| renée berry 🌿 @rfberry @neulpt Hi Lynne, we just started #hpm T2, thanks for joining! https://t.co/HiazYr2WeG |
| renée berry 🌿 @rfberry RT @doctatum: So good to hear from many patients and families teaching us in #hpm tonight. Thank you!!! |
| Dr. PNW Ex-pat (she/her) @katie_harmoney @SDietzMD @rfberry T2: I actually take this approach with cognitively impaired kiddos. I assume they can understand and/or hear me, and talk to them in an age-appropriate manner. It doesn't matter if they can't. #hpm |
| Bruce Scott @BruceScott_MD @BethanyKwan @nickasarbata If I assess that the patient has capacity, then I'm going to suggest that they involve others in difficult decisions. If they DON'T then I'm going to insist. I'm still going to involve the patient to the extent that I can (and they wish to be involved). #hpm | |
| Shirley Otis-Green @sotisgreen Thanks for sharing! Is there a similar tool that patients might use to evaluate capacity of their medical providers? (just wondering...) #hpm @BruceScott_MD https://t.co/aBdwokGoeE |
| Dr. PNW Ex-pat (she/her) @katie_harmoney @doctatum @BethanyKwan Apparently you're my people too #hpm |
| Kayla Sheehan, MD @kksheehan Is it common for neuro residents to do any kind of palliative rotation? How on a neurologist's radar is the palliative team? #hpm |
| Liz Salmi @TheLizArmy @rfberry T2: Since I was the patient who was "out of it" after surgery/seizures, I just asked my husband. He said the best communication technique for talking to me during those times was by being calm and slowing down. #HPM |
| Sonia Malhotra,MD,MS @SoniaMKhunkhun @acderinger @rfberry Ashley why do I always forget you are in the Deep South! We need to get together! #hpm #buildingthesouth |
| Nickas Arbata @nickasarbata @BethanyKwan @BruceScott_MD Where I am, for better or worse, it dictates who we can accept direction from. In stroke world where I reside, and in palliative and end of life discussions where I work, it often means patient requests are ignored b/c they’ve lost capacity to decide. #hpm |
| renée berry 🌿 @rfberry @ZHeatherChamp I understand what you mean. One of the best things I've personally seen is a palliative care team will bring different specialists together with a patient and family so everyone can get on the same page. Sometimes this needs to be requested by families. #hpm |
| Liz Salmi @TheLizArmy @doctatum My husband agrees with @doctatum. Two for two. #HPM |
| Shirley Otis-Green @sotisgreen yeah for the Social Work shout out! @acderinger #hpm #swhpn #btsm https://t.co/vLz3qVba5k |
| Nickas Arbata @nickasarbata @BruceScott_MD This is excellent. I wonder if this ability varies by state? I’m in Texas. #hpm |
| Bethany Kwan, PhD, MSPH @BethanyKwan @sotisgreen @BruceScott_MD Now there's an idea, @sotisgreen! Rate my doctor's communication... #hpm |
| Torrie Fields @TorrieKFields @rfberry T2: write things down, and repeat them. Consider hearing needs/difficulty. Consider shame the person is feeling. Consider the isolation they feel, as pt or caregiver. #hpm |
| Dr. PNW Ex-pat (she/her) @katie_harmoney @kksheehan Honestly, at my institution, our (peds) neurologists basically do their own palliative care, and do an excellent job. I don't know where they learn it, however. They don't do rotations "unless interested." #hpm |
| Shirley Otis-Green @sotisgreen RT @rfberry: @ZHeatherChamp I understand what you mean. One of the best things I've personally seen is a palliative care team will bring different specialists together with a patient and family so everyone can get on the same page. Sometimes this needs to be requested by families. #hpm |
| Shirley Otis-Green @sotisgreen RT @TheLizArmy: @rfberry T2: @rfberry T2: Since I was the patient who was "out of it" after surgery/seizures, I just asked my husband. He said the best communication technique for talking to me during those times was by being calm and slowing down. #HPM |
| Liz Salmi @TheLizArmy @neulpt You rock! I am seriously impressed with your tweet volume lately. #HPM #btsmqol |
| Dr. PNW Ex-pat (she/her) @katie_harmoney RT @TorrieKFields: @rfberry T2: @rfberry T2: write things down, and repeat them. Consider hearing needs/difficulty. Consider shame the person is feeling. Consider the isolation they feel, as pt or caregiver. #hpm |
| Bruce Scott @BruceScott_MD @sotisgreen Sure! Ask them if they prescribe Colace alone for opioid-induced constipation, ask them if they ever prescribe Zetia. Ask them how often they prescribe codeine or Demerol for pain. #hpm | |
| renée berry 🌿 @rfberry @ZHeatherChamp In my grandmother's care I advocated for a "family meeting" because I could see some specialists communicating information that wasn't consistent with what other specialists were saying. It was challenging and a meeting where I demanded everyone in the same room helped. #hpm |
| Sonia Malhotra,MD,MS @SoniaMKhunkhun @skipbidder Herelong actings are considered worse than short actings & you have to fail multiple meds before methadone approved #HPM #HealthDisparities |
| Shirley Otis-Green @sotisgreen I LOVE you @katie_harmoney #hpm https://t.co/T9UdhUbCmL |
| renée berry 🌿 @rfberry RT @TorrieKFields: @rfberry T2: @rfberry T2: write things down, and repeat them. Consider hearing needs/difficulty. Consider shame the person is feeling. Consider the isolation they feel, as pt or caregiver. #hpm |
| Bethany Kwan, PhD, MSPH @BethanyKwan @nickasarbata @BruceScott_MD Capacity evals trump preference? Even if preference/values have been communicated in the past? #hpm |
| Shirley Otis-Green @sotisgreen RT @rfberry: @ZHeatherChamp In my grandmother's care I advocated for a "family meeting" because I could see some specialists communicating information that wasn't consistent with what other specialists were saying. It was challenging and a meeting where I demanded everyone in the same room helped. #hpm |
| Ashley C Deringer @acderinger @SoniaMKhunkhun @rfberry Because we are about as far apart as we can be & be in the south (GA to LA), but I am quite sure we share similar challenges! Do you know about UAB's #Palliative #Southeast conf in Nov? If not I'll DM you #Tweetup?! #hpm |
| Lynne P. Taylor, M.D. @neulpt #hpm T2. We need better graphic tools to show outcomes so we don't have to struggle with words. |
| Shirley Otis-Green @sotisgreen RT @BethanyKwan: @sotisgreen @BruceScott_MD Now there's an idea, @sotisgreen! Rate my doctor's communication... #hpm |
| Liz Salmi @TheLizArmy RT @neulpt: #hpm #BTSMqol I struggle with simultaneously answering the questions of the patient and caregivers. Different minds and brains; different needs. |
| Bruce Scott @BruceScott_MD @nickasarbata I don't believe that it does. You are literally asserting that a patient has decision making capacity when you accept that they can consent to medical treatment. #hpm | |
| renée berry 🌿 @rfberry 100% yes please! I'd love this as a mobile app... and for all of the healthcare team, not just the doctor. How is it that I rate every Uber/Lyft ride & none of my healthcare interactions? #hpm https://t.co/VxHp1kamp9 |
 | Sheriff Tennant @brianatennant @rfberry #HPM T2 from a patient point of view: practitioners your bedside manner and non-verbal communication is very important during these conversations |
| Shirley Otis-Green @sotisgreen RT @rfberry: 100% yes please! I'd love this as a mobile app... and for all of the healthcare team, not just the doctor. How is it that I rate every Uber/Lyft ride & none of my healthcare interactions? #hpm https://t.co/VxHp1kamp9 |
| Torrie Fields @TorrieKFields T2: my grandmother died of dementia. And w/ my mom’s decline, the best info I got as caregiver was about preparing for getting help. We preach death @ home but may not be possible. Plan. #hpm #btsm |
| Liz Salmi @TheLizArmy @sotisgreen @BruceScott_MD Shirley is getting sassy! #HPM https://t.co/QMp1hKuVFD |
| SarahScott Dietz @SDietzMD Yes, all of this. There is a loss of dignity involved in this process, but we can help preserve it if we are aware and respectful. #hpm https://t.co/92eMcFbYzd |
| Paul Tatum @doctatum @rfberry @ZHeatherChamp Renée you are awesome! #hpm |
| Nickas Arbata @nickasarbata @BethanyKwan @BruceScott_MD Most of the capacity evals I am involved with are related to withdrawal of life support, and I’m in a southern, pro-life state. It may be the physicians doing CYA work? #hpm |
| Dr. PNW Ex-pat (she/her) @katie_harmoney @KtNeuendorf @kksheehan I think it can even be department dependent, even within the same institution. We get "buy in" from some departments (oncology), but not others. #hpm |
| Bethany Kwan, PhD, MSPH @BethanyKwan @brianatennant @rfberry What non-verbals help you have a good experience? #hpm |
| Liz Salmi @TheLizArmy @kksheehan Great question! This is something @BethanyKwan (and the #BTSMqol) are trying to figure out with our work: https://t.co/6bTFwwuzYN. Interestingly, @neulpt is board certified in neuro-onc and palliative care. #HPM |
| Sheriff Tennant @brianatennant RT @BethanyKwan: @brianatennant @rfberry What non-verbals help you have a good experience? #hpm |
 | dustin dillon @dustindillon2 In cognitively impaired or cognitively normal children I have to say the child life specialist tend to be of the utmost importance in helping and guiding those conversations #hpm |
| renée berry 🌿 @rfberry T3: Are there ever unintended consequences or unintended harm of navigating complex medical decisions and discussing palliative care with patients with neurological conditions? How can communication go wrong and how do you address those challenges? #HPM |
| Sonia Malhotra,MD,MS @SoniaMKhunkhun T2:rule of3's:3 sec pauses,3 words @ a time,3rd grade level-communication with cognitive difficulties and really for all #hpm #hpmchat #btsm |
| Torrie Fields @TorrieKFields @rfberry There is an app for that!! We use it in our health systems. Easy, 3 questions. I love seeing the results. #hpm |
| Bethany Kwan, PhD, MSPH @BethanyKwan @dustindillon2 What's a child life specialist? What credentials/training/background? #hpm |
| Bruce Scott @BruceScott_MD @BethanyKwan @nickasarbata Can you give an example of what sort of situation you are worried about? #hpm | |
| Shirley Otis-Green @sotisgreen RT @SoniaMKhunkhun: T2:rule of3's:3 sec pauses,3 words @ a time,3rd grade level-communication with cognitive difficulties and really for all #hpm #hpmchat #btsm |
| Ashley C Deringer @acderinger @neulpt Yes! So excited to see advances in #DecisionAids & excited to see what comes from recent #PFCDecisionAids Conf proceedings! #hpm |
| Bethany Kwan, PhD, MSPH @BethanyKwan RT @rfberry: T3: T3: Are there ever unintended consequences or unintended harm of navigating complex medical decisions and discussing palliative care with patients with neurological conditions? How can communication go wrong and how do you address those challenges? #HPM |
| renée berry 🌿 @rfberry @doctatum @ZHeatherChamp Thanks Paul, didn't feel awesome at the time. Worth a blog post. I felt I had to abandon my role as a granddaughter and put every ounce of energy in to advocating for what my grandmother requested in her advance directive as it was being ignored :) Got there eventually #hpm |
| Liz Salmi @TheLizArmy @rfberry @ZHeatherChamp When my dad was diagnosed with glioblastoma (7yrs after my brain tumor dx), I already knew A LOT about brain tumors and palliative care. The first thing I did was call a family meeting, work on an advance directive, and walk my dad through a POLST form. #HPM https://t.co/brFvmmYrHu |
| Lynne P. Taylor, M.D. @neulpt #hpm Agitation and anger are, unfortunately, quite common. Security guards, tearful family members. Very difficult to navigate. |
| renée berry 🌿 @rfberry RT @TheLizArmy: @kksheehan Great question! This is something @BethanyKwan (and the #BTSMqol) are trying to figure out with our work: @kksheehan Great question! This is something @BethanyKwan (and the #BTSMqol) are trying to figure out with our work: https://t.co/6bTFwwuzYN. Interestingly, @neulpt is board certified in neuro-onc and palliative care. #HPM |
| Sonia Malhotra,MD,MS @SoniaMKhunkhun @acderinger @rfberry Yes hoping to be there! #uabpalliative #buildingthesouth #hpm |
| renée berry 🌿 @rfberry RT @brianatennant: @rfberry #HPM T2 from a patient point of view: @rfberry #HPM T2 from a patient point of view: practitioners your bedside manner and non-verbal communication is very important during these conversations |
| Liz Salmi @TheLizArmy @BethanyKwan @sotisgreen @BruceScott_MD It's called @Yelp. #HPM |
| Bruce Scott @BruceScott_MD @nickasarbata Actually, let me add an addendum here. If I think that a patient doesn't have capacity due to depression or delusion, then I'm probably going to ask psych for an opinion, even if I'm really sure about it. #hpm Part of that is confirmation. Part is potential intervention. | |
| Dr. PNW Ex-pat (she/her) @katie_harmoney @BethanyKwan @dustindillon2 A childlife specialist is usually a master's level degree, which focuses on utilizing play and age appropriate language to help children cope with medical intervention. They're pretty much awesome and I should have done their jobs. #hpm |
| Shirley Otis-Green @sotisgreen RT @TheLizArmy: @rfberry @ZHeatherChamp When my dad was diagnosed with glioblastoma (7yrs after my brain tumor dx), I already knew A LOT about brain tumors and palliative care. The first thing I did was call a family meeting, work on an advance directive, and walk my dad through a POLST form. #HPM https://t.co/brFvmmYrHu |
| Lynne P. Taylor, M.D. @neulpt @acderinger Thank you Ashley! I knew there was a lingo for it but couldn't find it. Great information! T2 #hpm |
| Liz Salmi @TheLizArmy @katie_harmoney @kksheehan I think it's because they are in peds. Pediatricians are something special. CC @chethanr @calonghurst #HPM |
| renée berry 🌿 @rfberry Put the phone down. Close the computer. Sit down. Look me in the eye. Focus. Be present. Listen. Ask me to communicate what I understand. Listen. Recognize that I am a person, as a person I am bigger than my illness. #hpm https://t.co/g2fup0tV0q |
| Dr. PNW Ex-pat (she/her) @katie_harmoney @TheLizArmy @kksheehan @chethanr @calonghurst We're okay. Mostly, we just like toys still. #hpm |
| Bethany Kwan, PhD, MSPH @BethanyKwan @acderinger @neulpt Fantastic! Do you have preferred decision aids that you think should be used more widely? #hpm |
| Shirley Otis-Green @sotisgreen RT @katie_harmoney: @BethanyKwan @dustindillon2 A childlife specialist is usually a master's level degree, which focuses on utilizing play and age appropriate language to help children cope with medical intervention. They're pretty much awesome and I should have done their jobs. #hpm |
| renée berry 🌿 @rfberry @TheLizArmy @ZHeatherChamp perfect gif. #hpm |
| Dr. PNW Ex-pat (she/her) @katie_harmoney @rfberry I never use the computer in the room, unless the patient's family wants me to look something up. I have a pen and paper to jot down notes if necessary. #hpm |
| Bruce Scott @BruceScott_MD Families sometimes get irritated with me when I talk to the patient first (or primarily). I probably overdo it. #hpm https://t.co/GpHtTMj5R4 | |
| renée berry 🌿 @rfberry @TorrieKFields can you connect me with it? Would love to check it out. #hpm |
| Sonia Malhotra,MD,MS @SoniaMKhunkhun T3:have to address prognostic uncertainty & make sure specialists involved!this is a team effort not a solo one! #hpm #hpmchat #btsm |
| renée berry 🌿 @rfberry We're getting to the last 10 minutes of the chat! The fastest hour of the month!! Please take a look at T4 --> How might we better improve upon existing methods of discussing palliative care with patients living with serious neurological conditions? & T3 below #hpm https://t.co/tDEB1P8sbH |
| HPM Chat @hpmchat RT @rfberry: We're getting to the last 10 minutes of the chat! The fastest hour of the month!! Please take a look at T4 --> How might we better improve upon existing methods of discussing palliative care with patients living with serious neurological conditions? & T3 below #hpm https://t.co/tDEB1P8sbH |
| Dr. PNW Ex-pat (she/her) @katie_harmoney @comfortpeace_V @rfberry It can backfire too, because (very rarely) we are wrong, and the patient will do fine. It's a delicate balance. #hpm |
| Nickas Arbata @nickasarbata @BruceScott_MD @BethanyKwan I’m not worried, just wanting to learn about alternatives to our system. Stroke patient,vent dependent, disoriented, AOx0-1, keeps pulling on PEG and dislodging trach. Indicating wants to die but doesn’t know own birthday. Let him decide or restrain and put on suicide watch? #hpm |
| Bethany Kwan, PhD, MSPH @BethanyKwan RT @rfberry: We're getting to the last 10 minutes of the chat! The fastest hour of the month!! Please take a look at T4 --> How might we better improve upon existing methods of discussing palliative care with patients living with serious neurological conditions? & T3 below #hpm https://t.co/tDEB1P8sbH |
 | Elemental @elementalnw RT @GriefHealing: ‘Death is not a failure’: Medical schools adapt end-of-life lessons | Boston Herald https://t.co/cUT9hqRTi2 #hpm #eolc |
| Lynne P. Taylor, M.D. @neulpt #hpm T3 #BTSMqol A lot of misunderstanding of a patient's ability to communicate their goals when they are aphasic. If the family has trouble understanding the language barrier, I will often ask the question in two different ways to see if I can get a consistent response. |
| Shirley Otis-Green @sotisgreen RT @rfberry: We're getting to the last 10 minutes of the chat! The fastest hour of the month!! Please take a look at T4 --> How might we better improve upon existing methods of discussing palliative care with patients living with serious neurological conditions? & T3 below #hpm https://t.co/tDEB1P8sbH |
| Liz Salmi @TheLizArmy @neulpt @acderinger The @CoalitionCCC has some pretty great decision aids on life-sustaining treatments. https://t.co/UnnK0IUaiJ #HPM https://t.co/js7T3xsBLj |
| Ashley C Deringer @acderinger @BethanyKwan @neulpt A great recap of the #PFDecisionAids Conf by @The_Palliator @PetrieFlom #DecisionAids #hpm |
| Lynne P. Taylor, M.D. @neulpt #hpm T3. "So, do you want me to give you chemotherapy?" and "So, I think you just said that you wanted to stop chemotherapy, right?" If the answers are logically consistent, I know we are on to something! |
| Dr. PNW Ex-pat (she/her) @katie_harmoney It's not failure; it's a change in being. #hpm https://t.co/YnjtqE8ibh |
| renée berry 🌿 @rfberry @BruceScott_MD Interesting. My first reaction to this is why? But then my caregiver hat on & sometimes, my grandparent with dementia is so confused that it helps when my I get to give a quick overview of context to the healthcare professional. #hpm |
| Shirley Otis-Green @sotisgreen RT @TheLizArmy: @neulpt @acderinger The @CoalitionCCC has some pretty great decision aids on life-sustaining treatments. https://t.co/UnnK0IUaiJ #HPM https://t.co/js7T3xsBLj |
| Dr. PNW Ex-pat (she/her) @katie_harmoney @TheLizArmy @neulpt @acderinger @CoalitionCCC Wow. Do they have pediatric specific materials? #hpm |
| Torrie Fields @TorrieKFields T4: I wonder if we shouldn’t explore different types of info gathering—pictures, fewer words, AR, experiential, etc. what works for whom when? #hpm |
| Bruce Scott @BruceScott_MD @nickasarbata @BethanyKwan That's why computers can't do our jobs yet. Consult palliative medicine! #hpm Restrain temporarily. Talk with HCPOA (or surrogate) emergently. Try to find out if this is at all consistent with previously expressed thoughts. Gently direct the HCPOA to make decisions based on... | |
| Shirley Otis-Green @sotisgreen RT @acderinger: @BethanyKwan @neulpt A great recap of the #PFDecisionAids Conf by @The_Palliator @PetrieFlom #DecisionAids #hpm |
| Sheriff Tennant @brianatennant @KtNeuendorf @BethanyKwan @rfberry Don’t be disengaged or seem preoccupied(even though I fully understand you probably are) don’t check your watch/phone repeatedly during the conversation. Acknowledge that is an important conversation and as such, will probably take more of your time... #hpm |
| Ashley C Deringer @acderinger @BethanyKwan @neulpt And this is a wonderful resource from @SpringsStacey tweeting from #PFDecisionAids..have only had a chance to look through a few #hpm https://t.co/QNyZWaYJmV |
| Lynne P. Taylor, M.D. @neulpt #hpm T4 #BTSMqol. Earlier and more often! (Did I say, earlier and more often) earlier and more often. OK. you get the point. |
| Sonia Malhotra,MD,MS @SoniaMKhunkhun @kksheehan Very institution specific. Neuro palliative now a developing community within @AAHPM #hpm #hpmchat #btsm |
| Ashley C Deringer @acderinger #DecisionAids from @CoalitionCCC #hpm https://t.co/VfEo8iCmew |
| Shirley Otis-Green @sotisgreen yes we do! @CoalitionCCC @katie_harmoney #hpm https://t.co/TF5ye9mnBe |
| Bruce Scott @BruceScott_MD @nickasarbata @BethanyKwan ...what they think the patient would say were they able to look at the situation themselves. (i.e. ask them to guide you to what they think the patient would say, not what they themselves want) #hpm But no easy answers to the tough ones like this. | |
| Liz Salmi @TheLizArmy @rfberry T3: When my dad was dx w/glioblastoma, he had expressive aphasia; he could understand but couldn't talk. I helped him create an advance directive by asking a series of yes/no questions. You can navigate many decisions by breaking things into simple steps. #HPM |
| Dr. PNW Ex-pat (she/her) @katie_harmoney @brianatennant @KtNeuendorf @BethanyKwan @rfberry If possible, turn off your pager or leave with a co-worker. Don't bring your phone. Relocate (if possible) to a comfortable room that isn't adjacent to a bathroom. #hpm |
| Shirley Otis-Green @sotisgreen just like voting - early and often! @neulpt #hpm https://t.co/SDhRnlAQ69 |
| renée berry 🌿 @rfberry Yes, I think this is a very important consideration. It's critical for people to have the chance to understand that #hpm is a continuation of medical treatment. https://t.co/x9wZdV2UqF |
| renée berry 🌿 @rfberry RT @brianatennant: @KtNeuendorf @BethanyKwan @rfberry Don’t be disengaged or seem preoccupied(even though I fully understand you probably are) don’t check your watch/phone repeatedly during the conversation. Acknowledge that is an important conversation and as such, will probably take more of your time... #hpm |
| Bethany Kwan, PhD, MSPH @BethanyKwan @KtNeuendorf Love this - prioritizing "goals of life" over treatment discussions #hpm |
| Paul Tatum @doctatum @rfberry @TorrieKFields Ditto. Want a copy. App. 3 questions. #hpm @TorrieKFields Pretty please! |
| Bruce Scott @BruceScott_MD @rfberry They sometimes seem to think I don't know that mom has dementia. They don't realize that I'm actually talking to them at the same time I'm talking to the patient. #hpm | |
| Shirley Otis-Green @sotisgreen RT @BruceScott_MD: @nickasarbata @BethanyKwan ...what they think the patient would say were they able to look at the situation themselves. (i.e. ask them to guide you to what they think the patient would say, not what they themselves want) #hpm But no easy answers to the tough ones like this. |
| Liz Salmi @TheLizArmy @katie_harmoney @neulpt @acderinger @CoalitionCCC They do! Go here and scroll down for the blue ones for peds: https://t.co/UnnK0IUaiJ #HPM |
| Shirley Otis-Green @sotisgreen RT @BethanyKwan: @KtNeuendorf Love this - prioritizing "goals of life" over treatment discussions #hpm |
| Paul Tatum @doctatum @TorrieKFields Family stories. Picture books. Music. And dont forget food! Family recipes! Smells! #hpm |
 | Vinny Arora MD MAPP @FutureDocs RT @AlexSmithMD: Bruce Leff giving the clearest explanation of the range of home-based care services I’ve heard. @UCSFGeriatrics #geriatrics #hpm grand rounds. @HopkinsMedicine https://t.co/ZmiVuzyxwo |
| Sonia Malhotra,MD,MS @SoniaMKhunkhun T4:#neuropalliative-needs to be in neuro residency curricula. These pts deserve #qol discussions & s/s mngmt! #hpm #hpmchat #btsm |
| Bruce Scott @BruceScott_MD @neulpt I try to preference the patient's questions first. I let the carers know I'll plan on talking with them after. #hpm | |
| renée berry 🌿 @rfberry I know we cover our topics very fast and want to emphasize, if you are a patient and have more questions, please message me. I'd be happy to add answers to those questions in to a list for blog #hpm posts. https://t.co/y5RrJaJUxp |
| Liz Salmi @TheLizArmy @SoniaMKhunkhun @kksheehan @AAHPM Sonia: Do you know how one might connect with the @AAHPM neuro SIG??!!! #HPM CC @BethanyKwan @sotisgreen @neulpt @MichaelDFratkin https://t.co/VeVschrnbT |
| Paul Tatum @doctatum #hpm community- You teach me. You lift me up. You are my colleagues and my friends. Thank you! |
| Sonia Malhotra,MD,MS @SoniaMKhunkhun @comfortpeace_V @KtNeuendorf @rfberry Yes absolutely true. Can damage rapport in any relationship! #hpm #hpmchat |
| Ashley C Deringer @acderinger RT @rfberry: I know we cover our topics very fast and want to emphasize, if you are a patient and have more questions, please message me. I'd be happy to add answers to those questions in to a list for blog #hpm posts. https://t.co/y5RrJaJUxp |
| Shirley Otis-Green @sotisgreen RT @rfberry: I know we cover our topics very fast and want to emphasize, if you are a patient and have more questions, please message me. I'd be happy to add answers to those questions in to a list for blog #hpm posts. https://t.co/y5RrJaJUxp |
| Shirley Otis-Green @sotisgreen RT @doctatum: #hpm community- You teach me. You lift me up. You are my colleagues and my friends. Thank you! |
| Bruce Scott @BruceScott_MD #hpm Is this the point in the chat when we post non-germane closing thoughts videos? I've got a non-germane closing thoughts video right here, in fact: https://t.co/Gnn0BdOIKV | |
| Lynne P. Taylor, M.D. @neulpt @BruceScott_MD Great that you are so clear about your plan. I should articulate mine more clearly, I think; perhaps I too often get led first by the family's plan. Both are important but, in this case, I think your approach is best for the sake of patient autonomy. #hpm |
 | Susan Nelson MD @geripaldoc RT @SoniaMKhunkhun: T4:#neuropalliative-needs to be in neuro residency curricula. These pts deserve #qol discussions & s/s mngmt! #hpm #hpmchat #btsm |
| Liz Salmi @TheLizArmy @SoniaMKhunkhun Is #neuropalliative a THING now??! The @BTSMchat community has been using #BTSMqol (Brain Tumor Social Media Quality of Life). Where is @subatomicdoc when you need him? #HPM |
| renée berry 🌿 @rfberry @BethanyKwan @KtNeuendorf In my grandmother's care, I knew they were having this conversation because of my background in #hpm, but the doctor never said they were doing it. Yet, they spent an hour listening to the life and relationship of my grandparents. No healthcare choices discussed initially. |
| Bruce Scott @BruceScott_MD @neulpt I really feel like I can cover some of the caregiver questions while I talk with the patient. The patient-first approach tends to slow things down a bit too. Sometimes that helps. #hpm | |
| Shirley Otis-Green @sotisgreen RT @rfberry: @BethanyKwan @KtNeuendorf In my grandmother's care, I knew they were having this conversation because of my background in #hpm, but the doctor never said they were doing it. Yet, they spent an hour listening to the life and relationship of my grandparents. No healthcare choices discussed initially. |
| Lynne P. Taylor, M.D. @neulpt #hpm #neuropalliative @TheLizArmy Yes. I should have told you. |
| Ashley C Deringer @acderinger @TheLizArmy @SoniaMKhunkhun @BTSMchat @subatomicdoc It's a very new thing, but it's definitely a thing! There was a #neuropalliative SIG (special interest group) meeting @ #HPM18. #hpm |
| Bethany Kwan, PhD, MSPH @BethanyKwan What a great chat tonight! I'm grateful to have the chance to hear from everyone working and living in this space. #hpm |
| renée berry 🌿 @rfberry Everyone, thank you so much for joining this conversation. It was (as usual) both personally and professionally engaging. Special thanks again to #btsm, @TheLizArmy & @bethanykwan. Again please don't hesitate to reach out to me with any #hpm questions. https://t.co/hErblqiiWb |
| Sonia Malhotra,MD,MS @SoniaMKhunkhun T4:we also need R cubed:don't RUSH when building RAPPORT to give RECS #hpm #hpmchat #btsm #neuropalliative |
| Shirley Otis-Green @sotisgreen RT @SoniaMKhunkhun: T4:we also need R cubed:don't RUSH when building RAPPORT to give RECS #hpm #hpmchat #btsm #neuropalliative |
| renée berry 🌿 @rfberry RT @doctatum: #hpm community- You teach me. You lift me up. You are my colleagues and my friends. Thank you! |
| Ashley C Deringer @acderinger @SoniaMKhunkhun Like this! Stealing! <3 #hpm |
| Liz Salmi @TheLizArmy Big thanks to everyone who joined #HPM tonight to talk about palliative care for people w/neurological conditions. This will really help inform my work w/the Brain Cancer Quality of Life Collaborative (s/o to @PCORI for funding us). Learn more here: https://t.co/a9EitWa4s5 |
| Sonia Malhotra,MD,MS @SoniaMKhunkhun @acderinger Woohoo!! ♥️ #HPM |
| Sheriff Tennant @brianatennant @rfberry @hpmchat T3, T4 #hpm I had a healthcare provider who presented the conversation in a very poor way. I have since had a negative opinion of palliative care. I am/was here to see different points of views |
| Shirley Otis-Green @sotisgreen WootWoot! @acderinger Way to go! #hpm18 @AAHPM #neuropalliative #hpm #BTSM #btsmqol @TheLizArmy https://t.co/bdNgVt2SDR |
 | National Academies of Practice (NAP) @NAPractice RT @rfberry: @BethanyKwan @KtNeuendorf In my grandmother's care, I knew they were having this conversation because of my background in #hpm, but the doctor never said they were doing it. Yet, they spent an hour listening to the life and relationship of my grandparents. No healthcare choices discussed initially. |
| Shirley Otis-Green @sotisgreen RT @TheLizArmy: Big thanks to everyone who joined #HPM tonight to talk about palliative care for people w/neurological conditions. This will really help inform my work w/the Brain Cancer Quality of Life Collaborative (s/o to @PCORI for funding us). Learn more here: https://t.co/a9EitWa4s5 |
| Ashley C Deringer @acderinger @rfberry @TheLizArmy @BethanyKwan Thank you @TheLizArmy @BethanyKwan & members of the #btsm community for joining us tonight, what a GREAT chat! THANK you @rfberry for organizing & hosting, I have learned a lot & made new connections! #hpm |
| Liz Salmi @TheLizArmy @acderinger @SoniaMKhunkhun @BTSMchat @subatomicdoc OK, I can't believe #neuropalliative exists, and @neulpt didn't tell me. I am starting to question if I am even cool anymore. #HPM8008 How can patients get more involved with #neuropalliative??! Reach outto me at #BTSM. #HPM |
| Sonia Malhotra,MD,MS @SoniaMKhunkhun @acderinger Implementing this at my institution as a part of communications skills training #HPM #communicationskills |
| Liz Salmi @TheLizArmy @rfberry @BethanyKwan Thank for facilitating this great #HPM chat tonight, Renee! You are a wonderful moderator. I learn a lot from you. |
| Liz Salmi @TheLizArmy @brianatennant @rfberry @hpmchat Hey Sheriff! We are just wrapping up, but check the hashtag history! Also, here's a transcript: https://t.co/ArmUzYssap #HPM |
| Ashley C Deringer @acderinger @brianatennant @rfberry @hpmchat THANK you @brianatennant for being a part of #hpm chat & hopefully giving #Palliative a 2nd chance. May one of us from @hpmchat contact you to find out more about your experience/share your lessons? #hpm |
| National Academies of Practice (NAP) @NAPractice RT @katie_harmoney: @BethanyKwan @dustindillon2 A childlife specialist is usually a master's level degree, which focuses on utilizing play and age appropriate language to help children cope with medical intervention. They're pretty much awesome and I should have done their jobs. #hpm |
 | Emily Hahn, MD @EHahnMD OMG. I missed #hpm chat working on my #hpm19 abstract... https://t.co/96FrVZ6VgX |
| Shirley Otis-Green @sotisgreen RT @TheLizArmy: @rfberry @BethanyKwan Thank for facilitating this great #HPM chat tonight, Renee! You are a wonderful moderator. I learn a lot from you. |
| renée berry 🌿 @rfberry @brianatennant Thanks for sharing this Sheriff. This is a very challenging element on the healthcare professional side, there is actually a lot of misunderstanding as to what palliative care is. #hpm |
| Shirley Otis-Green @sotisgreen RT @acderinger: @rfberry @TheLizArmy @BethanyKwan Thank you @TheLizArmy @BethanyKwan & members of the #btsm community for joining us tonight, what a GREAT chat! THANK you @rfberry for organizing & hosting, I have learned a lot & made new connections! #hpm |
| National Academies of Practice (NAP) @NAPractice RT @sotisgreen: yeah for the Social Work shout out! @acderinger #hpm #swhpn #btsm https://t.co/vLz3qVba5k |
| Ashley C Deringer @acderinger @TheLizArmy @SoniaMKhunkhun @BTSMchat @subatomicdoc @neulpt You are MOST definitely still cool & probably know more from experience than the #neuropalliative collective ;-) Don't feel left out yet...I think the hashtag is VERY new & the group is just forming..you're def still getting in on the ground floor <3 #hpm |
#hpm content from Twitter.