Cmoneman🌺
8.3K posts

Cmoneman🌺
@CMoneman
2 x (nerd) + 2 x ('confused, aspiring pacifist') + 1 x (sucker for a good love song in minor key)///('99)
Kerala, India Inscrit le Temmuz 2018
81 Abonnements46 Abonnés
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the cowlick makes him look like a cat with airplane ears
kashie⁷ 🪷 IS SEEING BTS!!!@yoonviayoongi
so like thats a cat
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@mintminnim Your talent?? Thats incredible work, i hope you see your creations with pride, its soo goood
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@yo6434130971922 @stardustxsilver They do. Your degree title need not change, that's all. If you want to get a PhD or MPH or something, thats different.
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@CMoneman @stardustxsilver Ohh but after residency can one become professor directly? Don't they have those assistant or associate professor kind a thing there?
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@yo6434130971922 @stardustxsilver In the US, your degree doesn't change after residency. Med school is MD or DO. Pathology residency is 3 years after that. If he did med school abroad, he probably did MBBS, before coming to the US for residency. Some doctors call themselves MD after that because its equivalent
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@stardustxsilver How can a person be only mbbs but professor at the same time?
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Sounds like interesting work from a primary care perspective
Arjun (Raj) Manrai@arjunmanrai
1/ Last week I had the privilege of hooding my PhD student @aashnapshah (now Dr. Shah!) at @Harvard, alongside her co-advisor @chiragjp. She defended her thesis a few weeks ago, excelling while grappling with ambitious & thorny questions that matter for patients👇
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A 77-year-old marathon walker developed a headache. Over the next four months, she was seen by a nurse practitioner, a PA twice, a medical assistant, and an emergency room. She was given two Medrol dose packs, NSAIDs, and a prescription for fluoxetine after a PA decided she had anxiety. She had never actually seen her primary care physician. She had giant cell arteritis. A sed rate of 41 confirmed it, the moment her neurologist finally examined her, took her history, palpated her temporal arteries, and asked about jaw claudication.
The patient told her neurologist: "if you think I need fluoxetine I'll be on it, but I don't think I'm anxious and this headache is just crazy."
The structural argument matters more than the cinematic detail. Team-based care is sold as a solution to the physician shortage. The math runs the other way. If a physician is the diagnostic instrument that holds the differential together on a multi-system presentation in a 77-year-old, the marginal cost of putting that physician in the room at visit 1 is zero. The marginal cost of NOT putting that physician in the room across this case was four office visits, an ER visit, two courses of steroids that partially masked the inflammatory signal, a misdiagnosis of anxiety, an SSRI prescription, and a delay in identifying a vision-threatening time-sensitive diagnosis. The team did not save physician time. It spent physician time everywhere except with the patient.
Reeta Achari, MD, a neurologist in solo private practice in Houston for 25 years, makes the operational case in plain terms. There is a physician shortage. The response has been to use physician time for documentation, prior authorizations, peer-to-peer calls, board recertification weeks, and electronic-record data entry. The response should have been the opposite. If there is a shortage of the diagnostic instrument, the workflow has to put the instrument in front of the patient, not behind four other people.
Her own response was structural. She opted out of Medicare. She built a quarterly subscription practice with prices middle-class patients can afford and scholarships for long-relationship patients. New patients get a one to one-and-a-half hour intake. Follow-ups get 30 minutes. The model is not concierge. It is continuity, priced to clear.
The diagnostic line from her conversation: "No physician touched her."
Listen to the full conversation on The Podcast by KevinMD. Link in the replies.
What does the cascade in your practice or your own care look like? Where in the workflow did the physician finally enter the room?
#ThePodcastbyKevinMD

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Cmoneman🌺 retweeté

@time4anewone @hslotsuga Yeah, this is tripping me up a little.. i myself share drinks with friends all the time, even with casual friends. My classmates and I used to share pipettes in the lab and I didn't care. So I shouldn't feel weird about drinking from said bottle? Right...idk. V parasocial bff but
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@hslotsuga Like how can you drink after a stranger I wouldn’t take it in the first place
lowkey it’s kinda disgusting 😬
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real question, would u drink it and clean the bottle so u can keep it, or would u preserve it as it is and watch as it grows mold?….
TG@taeguide
Last day in Vegas so Taehyung gave away his own drink to an Army in the crowd
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Cmoneman🌺 retweeté

jungkook’s prime is basically a permanent state of being
ً@koomifilms
do ppl understand he’s in his prime now
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I was telling someone yesterday that I'd tell my pediatric patients in India to call me auntie or doctor. Doctor, auntie or madam. I'm fine with all of those....please don't call me umma. That's my limit
ariel saw twice and miss them@talljihyo
in her defense, being called omma and mommy are two different things😭😭😭😭
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