Joe Silletti

@DrJohnSfakianos @MountsinaiUro Congratulations

So blessed to have been Promoted to Professor and obtain a fundable score for our second R01. All this is only because I have been lucky enough to train with, collaborate with and just allowed to be around so many amazing individuals! Thank you to all of you! @MountsinaiUro

Looking for a robotics trained urologist to take over our established practice at Bronxcare. Reach out with any questions. #urologist #urology

@CanesDavid Where is testis??

Confirmed. This checks out.

@CanesDavid @tryheidi I love this. Efficacy leads to more productivity and better outcomes. Your error rates go down. This sounds like a win-win.

@CanesDavid That’s a bad look.

Wow. Dues shaming. #neaua24

@SWilliams_MD @siadaneshmand Wait. So you just pull hard and ligate at the external ring??

@siadaneshmand Nice job and agree no longer open external ring aligns with internal but still get high ligation. No more opioids.

Pts should rarely require opioids post radical orchiectomy. This study puts its use into perspective. Don’t open the external ring! Significantly reduces pain and does not impact high ligation of cord or oncologic principles.

@EitanGlucksman Send me a CV at jsilletti@bronxcare.org and we can chat

@JoeSilletti How do I find out more about this opportunity?

@CanesDavid I bet they do

@JoeSilletti By the way I wonder if med schools still teach that mystery novel approach? 🤔

☎️ A frame for residents calling the on call attending:☎️ #TipsForNewDocs “I have a patient with ____ who I think needs ____”… …and then comes the story. 👊 PUNCHLINE FIRST 👊 Why? This changes how the recipient listens, and the old med school model of unfolding a dramatic story leaving suspense for the eventual punchline should not exist. Urology examples: “I have a 78 year old with an infected 8mm UPJ stone who needs a stent” “I have a 54 year old woman with a 3mm UVJ stone who I think we can send home” 👂The attending listens with intent to support or disprove your plan. It’s perfectly fine if the assessment or plan is wrong. “Sure,” you say, “but this is July, and interns may not know what needs to be done!” Agree- but taking a stab is the only way to learn. As @TedEdson1 taught me in 2001, “Be right or be wrong, but be something.” So the frame can be: “I have a 64 year old woman in the ER with a 6mm right mid ureteral stone and I am on the fence about whether we need to intervene” Or, “We got consulted on incidental bilateral hydro in the ICU and I am unsure how to put it all together” Bingo… now the attending listens differently. {caveat— not all attendings will agree with this, and I’m sure they’ll tell us why 👇} p.s. this should be the same frame for ER docs calling just about anyone

@_ToddBeane @NobletStrength I don’t know a lot about soccer. But from what I have seen, the difference between good and great players is not skill, but the ability to think quickly.

@NobletStrength Repeating the task of finding solutions in the challenging environment of context is exactly what I suggest to be most fruitful. 💥🕺🏼 (And a productive alternative to traditional training) All the best. #TOVO

Ya, let's throw out over a hundred years of sport science understanding of skill development because Todd Beane has some doubts about it. This isn't even controversial, repeating a task and progressively making it more challenging absolutely improves technical skills.

@CanesDavid How about, the days after a vacation are not over booked as to “catch up” for time taken off.

I was asked what I would do to mitigate burnout. Here is my list. What would you add? 🧯🔥🔥🔥🔥🔥🔥🔥

@CanesDavid Limiting PVP to prostates 80g or less seems short sighted. It’s safe and works well if one is patient.

It’s 2024, AI and machine learning are all the rage, 3D printers are now toys for children, and we are still reminding uros to ✅ know the prostate size before operating 😂 😶 😞 🫠

@Carrozzaf So, not open yet?

NOTE: TOVO opens this coming week to public Monterey, California Camp --> tovoinstitute.com/monterey-resid… Princeton, New Jersey Camp --> tovoinstitute.com/princeton-resi… About TOVO Academy --> tovoacademy.com About Todd Beane --> toddbeane.com

💥💥💥⚽️⚽️ Summer USA TOVO Programs We have already received several applications for Monterey and Princeton. Monterey, California July 2-11 Princeton, New Jersey July 23-Aug 1 If you have interest, please fill out an application to reserve a spot.

@tomsan106 sometimes the element that is lost on critics of your approach is that this is not the idea that early coaching gives a kid a leg up. The kids learn is failure, trying, learning, failing again, and eventual success, and that process can be fun. They become resilient learners.

This is a parent interacting with their child helping them to develop the ability to focus his/her attention. Perhaps the most important skill for a child to possess which is learning how to learn. Without focused attention learning does not take place. This is playtime between and parent and child, something that there is not enough of all over the world. It just so happens they are using a ball as the tool. This interaction between child and parent is crucial for a child’s cognitive, emotional, social and physical well being. We should be celebrating a parent playing with their child since we know statistically a child will do much better in life because of it. I hope you can see this is little to do with coaching and more to do with great parenting. Helping a child develop confidence, focused attention, memory, balance and coordination, are all good things parents should encourage.

@tompowles1 Wow.

Enfortumab vedotin & Pembrolizumab improving PFS & OS by 55% & 53% respectively compared to platinum based chemo in 1st line UC (+avelumab in 30%). Chemo has not been beaten before (despite multiple efforts). RR and CR of 68% & 29% is hard to beat. DOR not reached (1/3)#ESMO2023

@FCAFigueiredo That’s bad outlet obstruction. Assuming no neurological issues such as DSD, he needs an operation.

BPH case of the week: 54y, moderate LUTS USG, Prostate 29g, trabeculated bladder, PVR: 350ml Cystoscopy: 🎥👇🏼 How would you treat him?

@drbrianwilliams @broadleaf_books It’s terrific. Finished it this weekend. Eye opening and tender. I was truly moved.

One more day until book launch and #TheBodiesKeepComing will be available in stores nationwide. A years-long journey is about to begin a new chapter. #authorlife #bookstoread

@alextatem You don’t. Suprapubic tube and time.

@JoeSilletti 😱 jeez. How’d you fix that one??

PSA: Don’t conceal carry your pistol in your pants pocket sans holster. Sincerely, Your friendly neighborhood urologist.