Marp Mittelschmerz

@the_grafixmedic My post bronchial embo patient has “weakness” in his lower extremities

Doctors/medical practitioners, what is the scariest disease you know of?

@sulmoney Ahhh the old “cervical hyperlordosis” treatment with a bonus vertebral artery dissection 💪

Do not go to any chiropractor period

@DrDiGiorgio I was on call at the VA covering gen surg, vascular, uro, and SICU. Patient came in w/ Fourniers, also had aortic PAU found on CT. I WROTE 11 NOTES: Surg consult, surg H&P, code status note, VA risk, vasc consult, uro consult, surg transfer, ICU H&P, preop/post, foley ins, PO…

Imagine your surgeon preparing for your operation. They see you in pre-op, answer your questions, calm your fears, examine you, confirm the plan, and go get ready for the case. They review the imaging and think through the critical parts of the operation. Then a nurse interrupts them: “Doctor, your pre-op documentation isn’t good enough. You can’t just say you discussed the risks and benefits. You need a full H&P.” The surgeon points out that the H&P was already done in clinic. The note is right there in the chart. “No. That note is 31 days old. It has to be within 30 days. But it’s fine if you just copy and paste that old note.” Think about how insane that is. There is no new clinical information. There is no patient benefit. There is no improvement in safety or quality. The only thing being demanded is duplication. A pointless bureaucratic ritual to satisfy the machine. So now you have a frustrated surgeon, a delayed case, a bloated chart, and one more example of modern medicine confusing clerical box-checking with patient care. This is exactly what is wrong with the system. Endless note bloat. Pointless duplication. Administrative nonsense dressed up as professionalism. If there are no changes, there are no changes. Forcing a doctor to re-paste an unchanged H&P adds absolutely nothing for the patient. And the most insulting part is the tone. That smug, condescending “of course you have to do it this way” attitude, as if this is self-evidently necessary instead of obviously stupid. At this point, a lot of doctors would probably take a substantial pay cut to never touch a computer again. Cut the salary and use the savings to hire people to do the computer garbage. Epic. CDI queries. Coding queries. H&P updates. Order entry. Case booking. Inbox nonsense. All of it. Never touch Epic again. Never answer another coding query. Never update another unchanged H&P. Never place another order that a clerk or protocolized team could enter. Never do another ounce of hospital data-entry cosplay. Just let us be goddamn doctors instead of highly trained documentation technicians.

@operationdanish The first season had a day 1 intern place a REBOA unsupervised and third year med students slinging in chest tubes. Everything in the show is over glorified but that’s cause it’s a tv show lol.

I’m gonna say it… The Pitt over glorifies ER docs. It’s like Matt Damon and Good Will Hunting, but for ER docs. 99% of them wouldn’t be able to do half the 💩 they pretend to do on that show. I love you guys, but you know I’m right.

@TheViciousSnake @RepLuna Google squamous cell carcinoma of the penis. Also think about how stupid you are (it’s gonna be tough I know) and then delete your tweet.

@RepLuna I will never, ever understand why they market this to boys.

Gardasil needs to stop advertising their garbage to young people. I had friends in the military who had this pushed on them and later developed arthritis. Recommend you don’t take it.

@dr__idz I am getting pretty tired of my fellow docs indulging/responding to these posts. The guy sells fitness books and supplements. He gives zero fucks about science or patients in general, he wants money. We need to stop debating medicine on twitter it’s bad for everyone.

This is the dumbest thing I’ve read all day. Do you really think doctors don’t tell patients to “exercise and eat a healthy diet?” 🤦🏽‍♂️ The reality is, it’s far easier to adhere to taking a medication once a day than it is to go to the gym / for a walk and change your diet every day. Not to mention the social determinants of health that create barriers to healthy eating and exercise… but clearly this guy doesn’t have the capacity to understand these nuances.

@FlyersJohnny As a pens fan I will be disappointed if it’s not chanted and I fully expect it to be changed game 3 during or before the opening face off. Love this rivalry

Re: all of the “Don’t chant at Crosby” people - He’s a top 5 player of all time. Hes going to get his goals/points whether we chant at him or not. “Crosby Sucks” has a certain irreplaceable nostalgia to it. It will be chanted.

@Tina848Laczko @CyborgPeds Some good bubs you have there. Hell yeah

@FrommyFromm @CyborgPeds She is a cutie. She has a brother, too. Litter mates.

If you’re a diabetic, a diabetic meal can (and likely will) be ordered for you. Are you even a real doctor?

@CyborgPeds The best AI response I’ve gotten. “Ma’am unfortunately the problem is with your Suprspinnatus sipspiniatus”

I love the accounts telling me I don’t know how to use AI because I report incorrect responses. Kiddo, if I can’t get it to stop making shit up, 99.9% of the rest of the population can’t either. It’s probably 100% but I’ll give that wiggle room just in case.

@Tina848Laczko @CyborgPeds I was scrolling through the replies on the original post and noticed that your cat looks like my cat so I decided to comment. Quality cat ya got there 💪

@CyborgPeds My FIL diabetic meal at the hospital was pasta and garlic bread. ALL CARBS. They only eliminate "concentrated sweets" . This was true at the rehab too. Dietitians need more training. They gave him pancakes, oj, bacon and low sugar syrup for breakfast.

Map showing which U.S. states contain giant letters

@MAHA_Action @calleymeans Have you ever been post surgery or pre op and been NPO?? In my career I would say 60% of the patients who left AMA left because we restricted their diet. Bowel obstruction, anastomotic leak, whatever, they wanted to eat. I hate starving patients. They hate it. Who does this help?

Calley Means: “I was at Stanford Hospital with my mom… they served her Coca-Cola.” “She was a diabetic dying of a metabolic condition from cancer.”

@MAHA_Action @calleymeans I fully do not understand this argument. We should force feed dying cancer patients healthy food instead of what they want?

@colligocritters Just google phimosis and paraphimosis.

my wokest take is that circumcision being performed on newborns for non-medical purposes is a fucked up surgery that should be outlawed because why the hell are we doing plastic surgery on babies genitals. This is the typa shit anti-trans people should be ACTUALLY on!!

@HawkEmDownChris Thomas Starlz, father of transplant medicine and undisputed GOAT

Who’s your favorite doctor of all time?

@ALMannixMD A great chief/senior also masters the art of miming out answers to juniors on rounds when the attending pimps. Ya gotta remember where you came from 🤙

The best senior residents teach without making you feel small.

@IhabFathiSulima By the time I finish residency I will have over 400k in student debt. 90% of the learning I did in undergrad/med school was from Anki decks I downloaded or videos/question banks that I paid for myself.

Tell me shocking fact about universities and medical schools in the World that most people don’t know.

@grinnell555 @aawayne @SarahKarlin What does food stamps have to do with hospital food ?

@FrommyFromm @aawayne @SarahKarlin Oh, people on food stamps need to be able to buy birthday cakes, too. So let's them then use it to buy cookies and chips every week.

One of my firmly held opinions is that if a sick kid in the hospital asks for ice cream or a soda and it's not, like, medically contraindicated, they should get it. Apparently this is now controversial.

@grinnell555 @aawayne @SarahKarlin Please explain the point cause I’m looooostt

@aawayne @SarahKarlin No, that wasn't really the point. But go ahead and misconstrue the entire issue so that you can humblebrag how compassionate you are.

@FrenlyOfficer Its obvious and sad. “Kids don’t make money” I was told, and is true. Look at the RVU’s. Pediatric care is now subpar unless it’s at a dedicated peds hospital. Why would someone go into pediatrics when they graduate with 500K debt and a single malpractice case could sink them?

1. Half of all children in America are on Medicaid. 2. Many pediatricians are women, they less likely to negotiate their salary, and more likely to choose lower earning jobs exchange for better physical proximity to their children. They are also more likely to work fewer boursz