Steve Carroll DO MEd

@king_pearxe Meh-I agree it’s distasteful to record someone without checking with them first and you are within your hospital’s/office’s policy to ask them to leave if they don’t stop I don’t see why this is such a big deal-before anyone says it HIPAA doesn’t apply to non-healthcare people

Was about to do an abdominal examination for a patient. A nurse was inside the room, same as the patient's relative. She then goes and brings out a phone and starts recording. I said it's unethical to video me without my consent and hence I will stop doing what I was doing. She replied that she's within her rights to video her sister. That's how the consultation ended

How Tufts anesthesiology announced its next chief residency class on Instagram:

@DrCasteelEM @cardiojaydoc02 @DrRyanPDaly Co-sign- if you work more than you did as a resident it’s a (very very bad) choice that you should do for a limited time for a clear goal with a clear endpoint

@cardiojaydoc02 @DrRyanPDaly EM 100% does. Full time is like 30-36hrs a week.

I’m not sure of any physician that works LESS as an attending than they did in training. That’s news to me. One of the myths is that you will work less when you’re done.

@SPuro88 @ALMannixMD

@embasic @ALMannixMD Just do your own difficult foley next time and we’re even.

When the ED calls, it’s not “just another consult.” It’s because your skill can change a life.

@grok @aakashgupta @grok put that 22-25k estimated deaths into the context of the number of hospital admissions each year

No, the 250k-400k annual deaths claim is not accurate as a confirmed figure. It stems from 2013 (James) and 2016 (Makary BMJ) papers using extrapolations from limited, non-representative studies (e.g., Medicare-focused). Critics note it implies 1/3+ of all US hospital deaths are error-caused, which strains plausibility. Rigorous expert chart reviews (UK, Norway, Yale meta-analysis) find ~3-5% of hospital deaths preventable, equating to ~22k-25k/year. CDC does not track medical errors as a cause; 2023 leading causes: heart disease (681k), cancer (613k), unintentional injuries (223k). It's a real problem needing better tracking, but the high estimate is widely disputed for overcounting.

Hospitals kill between 250,000 and 400,000 Americans per year through preventable medical errors. That makes “your doctor’s mistake” the third leading cause of death in the United States, behind only cancer and heart disease. Everyone reads advice like “stay with your loved one in the hospital” as a family values tip. The actual reason is darker. A board-certified physician is publicly admitting the system he operates in has enough failure points that an untrained person sitting in a chair provides a meaningful safety layer. The math explains why. A landmark Penn study tracked 170,000+ surgeries across 168 hospitals. Each additional patient added to a nurse’s workload raised the odds of dying within 30 days by 7%. Staffing ratios across US hospitals range from 4.3 to 10.5 patients per nurse. That means one hospital gives your family member 2.4x less nursing attention than the hospital down the street, and you have zero way of knowing which one you walked into. So what does a family member in the room actually do? They catch the wrong medication bag. They notice breathing changes at 2am when the nurse is covering nine other beds. They flag a deteriorating condition 6 hours before anyone on staff would have checked. They function as an unpaid, around-the-clock monitor compensating for a staffing model designed around reimbursement rates, not patient survival. When a physician says “be cordial with staff but watch everything like a hawk,” he’s describing a system where the margin between good outcome and catastrophe is one missed check during a shift change. Hospitals don’t optimize for your family member’s recovery. They optimize for throughput. 700 people die from preventable hospital errors every single day. Your presence in that room isn’t emotional support. It’s a rounding error in a broken staffing equation that nobody has the budget to fix.

@aakashgupta You think that 250K to 400K number is real Bless your heart you sweet dumb child

@SPuro88 @ALMannixMD On behalf of my specialty, I sincerely apologize

@ALMannixMD What about the 1am call to a urologist for glucosuria?

@gbunny @JeromeAdamsMD I also wonder if she is worried that someone might take her to task with the medical board over the nonsense she continues to peddle- if she doesn’t have a license then she can avoid that issue We are getting closer and closer to idiocracy every day

@embasic @JeromeAdamsMD Yes it’s very easy to keep an active license & we know she can well afford the fee. I think part of it is her arrogance & her attitude that with her limited experience, she knows all, when most of her gig is grifting & junk “science”.

🚨 I have been told that despite bragging about her Stanford medical degree, HHS is technically proposing to have Casey Means be the first non-physician to ever be confirmed as Surgeon General - because she can’t actually be commissioned as a physician in the PHS (as every SG before her has been) because she doesn’t have an active medical license. In other words, they acknowledge that their nominee for “America’s doctor,” can’t even join the uniformed service she would be charged with leading… as a doctor (they are proposing she join in the health service officer category- which doesn’t uniformly require an active medical license. Ironically even in this category, she wouldn’t even meet the criteria to be a physician’s assistant, because it also requires an active license)🤦🏽‍♂️ They are literally attempting to lower 100+ years of merit and safety standards, so that she can take on the role. 👇🏽 A physician nominee for Surgeon General would need to meet the below Corps commissioning standards to be appointed and serve effectively in the role. While 42 U.S.C. § 205 doesn't explicitly require an active medical license for the SG position itself, the Surgeon General must be a member of the Regular Corps - and USPHS Commissioned Corps policy mandates that PHYSICIAN officers hold a current, unrestricted, and valid medical license from a U.S. state, D.C., Puerto Rico, U.S. Virgin Islands, or Guam. This is required for commissioning, adhering to appointment standards, maintaining basic readiness, eligibility for special pay, promotion, and overall conditions of service. Official sources confirm this: USPHS Physician profession page: "Current, unrestricted, and valid medical license from any U.S. state..." (usphs.gov/professions/ph…) Commissioned Corps Licensure policy: Keeping licenses "active and unrestricted" is mandatory for officers whose qualifying degree requires it (dcp.psc.gov/CCMIS/Licensur… & Inst 251.01) Bottom line: the current nominee for Nation’s top doctor… can’t legally be commissioned in the Corps she would be charged to lead, as a doctor! Past Surgeons General have been required to maintain active licenses to lead credibly as the nation's top public health physician. Lacking said licensure creates a practical (and legal) barrier to commissioning AS A PHYSICIAN and undermines the role's integrity and authority, and compromises the Corps itself. 😞

@JeromeAdamsMD Good point- there are plenty of ways to get 60 CMEs quickly- this is just laziness

@embasic Physicians in Oregon are required to renew their licenses every two years. To do so, they MUST complete 60 hours of Category 1 CME in the two-year period leading up to the renewal. She hasn’t done this.

Who could have predicated that NPs who lobbied for independent practice without oversight to serve Rural and primary care shortages are mostly working in Med Spas, Addiction/Psych, Cardiology😳 with no supervision in FL.

@AndrewKaufmanMD *checks profile*

Let’s pause and think about what actually happens during a colonoscopy. You’re sedated. A flexible tube with a small camera is inserted into the colon so physicians can examine the lining and remove abnormal growths at the discretion of the doctor. That lesion may become cancerous in 15-20 years or it may never become cancer. In the meantime, poking a little too hard with the instruments can make a hole, leaking fecal matter into your abdominal cavity. So you could end up with emergency surgery for a possible lesion that could possibly become cancerous someday. Now, instead of reacting emotionally or projecting the program you’ve been given, step back and think logically. Does this sound like a good idea? When a procedure can lead to death or permanent damage, don’t you think it’s time to rethink our approach?

@SPuro88 @AndrewKaufmanMD lol same

@AndrewKaufmanMD Before I even checked your profile I knew you were in a speciality that literally has nothing to do with colon cancer detection.

@CE_HandSurg For an ortho doc writing your own d/c summary- absolutely agree For a medicine doc- let’s just say as an EM doc the first thing I look for in a patient’s chart is their most recent discharge summary

The discharge summary is the most antiquated useless documentation of a clinical documentation.

@SPuro88 New phone who dis

There’s this really annoying ED doc at my hospital. She calls me on my personal phone without going through my PA first. Calls me even on days when I’m not on call about dumb crap. Also happens to be my wife and idk how to get out of it.

@miffer79 @drjohnm @VPrasadMDMPH What a brave Russian bot you are

@embasic @drjohnm @VPrasadMDMPH Coming from someone with MEd in their profile. Those who can, do and those who can't teach.

I see widespread criticism of @VPrasadMDMPH and FDA decision to not review Moderna vaccine Why has no one on this website considered the potential upside of requiring industry to fund and conduct more rigorous trials? Would this not improve trust in vaccines? If we are to have an FDA (I get the libertarian case against) should regulation not be rigorous? See this thread from @kaulcsmc on dubious FDA device approvals x.com/kaulcsmc/statu… Exhibit B: one of the top HF drugs passed muster in only one trial that had serious limitations. That's a regulatory failure IMO, because we aren't sure that generic replacements would be similar. If we are to have an FDA, it ought to demand a higher bar for approval--especially of Rx's used in common conditions

@PulmCrit Heck I give IV iron along with a lot of my blood transfusions in the ED- we should probably be doing a lot more of this - can’t make new RBCs without it!

dropping gram doses of IV iron dextran is such a boss move 😁

@Rick_Pescatore PIT works when you put resources to it- we agree- but to say unequivocally that it’s bad for patients isn’t reality

@Rick_Pescatore It’s nonsensical because you are saying that we should just let patient languish in the waiting room when there isn’t a room/bed available- how is that helping anyone? The FCA issue in a valid one and needs regulation to catch up to it- but let’s not throw the baby out

TLP/“doc-in-triage” is typically not a benefit to most hospitals (and definitely never to patients). At a certain point, it’s quite obviously a shell game of shifting LWBS numbers to AMA, and here’s the big key: Systems that continue this practice are starting to (rightfully) hit False Claims Act accusations. When 80% of patients hit a doc who puts in a haphazard orders knowing they’ll never get done…it’s just plain fraud.