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BC ICU Doc

@LPorayko

Intensivist & Anaesthesiologist. Aspiring stoic. Avid Nak Muay. Professional value investor. Proud and grateful husband, step-father and grandpa. Slava Ukraini!

Victoria, British Columbia Katılım Haziran 2013
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Mark Roseman
Mark Roseman@markroseman·
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tobi lutke
tobi lutke@tobi·
Share a bit. I don’t want to belittle the category of software. People did amazing work in the world of payroll software (agile manifest etc). But at some point a csv is created and it has a row per payee and it happens twice a week. Shopify pays out millions of businesses and moves billions a day. And we took 20m of financing ever before we went public (and had it all still in the bank when we did). The scale of nonsense that’s happening with government bespoke software is just unexplainable without fraudulent intent. But it also tracks with everything else you hear about government efficiency (minus maybe military). It’s not that it costs 10b to make a payroll software that is the problem. It’s that it costs this much for anything that the government tries to do itself. The only conclusion is that the government needs to do a lot less.
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Patrick S. Tomlinson
Patrick S. Tomlinson@stealthygeek·
By 1943, the Allies had forbidden any new assassination attempts against Hitler because they viewed his paranoia, incompetence, drug abuse, and megalomania as so damaging to the Axis war effort they considered him a net strategic positive. History doesn't repeat, but it rhymes.
Normal Island News@NormalIslandNws

BREAKING: Iran confirms it has no interest in a reciprocal assassination against Trump because no weapon it could possibly build, not even nukes, could do more harm to the US than the current president. Iran actually sees Trump as a major asset 👀

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BC ICU Doc@LPorayko·
@austincamp You guys are worth your weight in gold. That is understatement! 😃
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Austin Camp
Austin Camp@austincamp·
MONDAY Me: Hello! I’m the ICU pharmacist. We usually do rounds at 9 if you're up for it? New locum intensivist: Oh uh well okay that’s fine. FRIDAY Me: He- NLI: Omg I’m glad you’re here I have questions on this and need help with that… Predictable but feels good every time!🤷‍♂️
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Kuppy
Kuppy@hkuppy·
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BC ICU Doc@LPorayko·
@JohnRustad4BC It makes me grateful that I am closer to the end of my career than the beginning of it. Sadly.
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John Rustad
John Rustad@JohnRustad4BC·
What this bill really does is send a message, and it’s not subtle: fall in line or risk your career. You build a system where every complaint, no matter how small, gets dragged into the open, where discipline is ultimately overseen by government-appointed bodies, and where there’s no appeal if they decide you stepped out of bounds. Then you act surprised when professionals stop speaking freely? Of course they will. Because now imagine you’re a doctor who questions the prevailing line, maybe you raise concerns about “safe supply,” maybe you don’t parrot “trust the science” on every issue, maybe you think a struggling kid needs counselling before life-altering decisions. Under this framework, that’s not just a conversation anymore. That’s a risk calculation. This doesn’t build trust. It builds silence. It creates a system where the safest move for any professional is to keep their head down, repeat the approved script, and never challenge anything even when their training, their experience, or their conscience tells them something isn’t right. #bcpoli
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Richard Woodruff 🇺🇦
Richard Woodruff 🇺🇦@frontlinekit·
I fucking LOVE Ukraine 🇺🇦 To be honest, at first I doubted the ability of Ukrainians to use the "Patriot" system due to its complexity, but they have mastered it so well that now the US Army is learning from them, — a general of the US Army European Command.
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Brian Day
Brian Day@DrBrianDay·
More Government control = greater inefficiency, more bureaucracy, and political interference in patient care.The way B.C. health-care workers are regulated is changing April 1 | Vancouver Sun vancouversun.com/news/bc-health…
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Mark Roseman
Mark Roseman@markroseman·
That annual increase of $2.375 billion in bureaucracy would sure pay for a lot of front-line care. It would pay for ~6000 more family doctors. (BC has ~8000 family docs now, but several thousand do something OTHER than longitudinal family medicine). Spending choices matter.
Mark Roseman@markroseman

What area of health spending has grown the fastest since the BC NDP came to power? Hospitals? Long-term care? Physicians? Drugs? Nope. While absolute spending rose in each of these, as a %age of overall health budget spent in each of these areas, they all DECREASED. Biggest %increase? "Corporate" (health authority head office bureaucracy etc.) Grew from 6.80% to 9.18% of total budget. An additional $2.375 billion per year.

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Mark Roseman
Mark Roseman@markroseman·
What area of health spending has grown the fastest since the BC NDP came to power? Hospitals? Long-term care? Physicians? Drugs? Nope. While absolute spending rose in each of these, as a %age of overall health budget spent in each of these areas, they all DECREASED. Biggest %increase? "Corporate" (health authority head office bureaucracy etc.) Grew from 6.80% to 9.18% of total budget. An additional $2.375 billion per year.
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Ron Chusid
Ron Chusid@RonChusid·
Study investigating whether Covid vaccines can lead to sudden death in young health recipients found that risk of sudden death was actually lower in those who received the vaccine. journals.plos.org/plosmedicine/a…
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Nick Mark MD
Nick Mark MD@nickmmark·
It’s a really interesting observation that in AI can improve physician performance at tasks like polyp detection but that performance drops below baseline when the AI is removed. I’ve heard the same argument about docs using VL instead of DL for intubation, or POCUS instead of landmarks for central line placement. Outside of medicine, pilots are criticized for being over dependent on automation even though flying has never been safer. I think it’s OK to depend on technology if it meaningfully improves outcomes. But we need to be certain that there is real and sustained benefit.
Berci Meskó, MD, PhD@Berci

One of the biggest fears about healthcare's AI revolution is that AI can erode physicians’ expertise and their performance may drop when AI is removed. A new scoping review provides examples for that. In colonoscopy, the adenoma detection rate dropped significantly from 28.4% to 22.4% when endoscopists reverted to non-AI procedures after repeated AI use. In radiology, erroneous AI prompts increased false-positive recalls by up to 12%, even among experienced readers. In computational pathology, over 30% of participants reversed correct initial diagnoses when exposed to incorrect AI suggestions under time constraints. "𝐴𝑙𝑡ℎ𝑜𝑢𝑔ℎ 𝑙𝑖𝑚𝑖𝑡𝑒𝑑 𝑖𝑛 𝑛𝑢𝑚𝑏𝑒𝑟, 𝑒𝑚𝑝𝑖𝑟𝑖𝑐𝑎𝑙 𝑠𝑡𝑢𝑑𝑖𝑒𝑠 𝑐𝑜𝑛𝑠𝑖𝑠𝑡𝑒𝑛𝑡𝑙𝑦 𝑑𝑒𝑚𝑜𝑛𝑠𝑡𝑟𝑎𝑡𝑒 𝑡ℎ𝑎𝑡 𝐴𝐼 𝑐𝑎𝑛 𝑖𝑛𝑎𝑑𝑣𝑒𝑟𝑡𝑒𝑛𝑡𝑙𝑦 𝑖𝑚𝑝𝑎𝑖𝑟 𝑝ℎ𝑦𝑠𝑖𝑐𝑖𝑎𝑛𝑠’ 𝑝𝑒𝑟𝑓𝑜𝑟𝑚𝑎𝑛𝑐𝑒 𝑜𝑟 𝑟𝑒𝑑𝑢𝑐𝑒 𝑜𝑝𝑝𝑜𝑟𝑡𝑢𝑛𝑖𝑡𝑖𝑒𝑠 𝑓𝑜𝑟 𝑠𝑘𝑖𝑙𝑙 𝑚𝑎𝑖𝑛𝑡𝑒𝑛𝑎𝑛𝑐𝑒. 𝑆𝑎𝑓𝑒𝑔𝑢𝑎𝑟𝑑𝑖𝑛𝑔 𝑐𝑙𝑖𝑛𝑖𝑐𝑎𝑙 𝑒𝑥𝑝𝑒𝑟𝑡𝑖𝑠𝑒 𝑠ℎ𝑜𝑢𝑙𝑑 𝑏𝑒 𝑐𝑜𝑛𝑠𝑖𝑑𝑒𝑟𝑒𝑑 𝑎 𝑐𝑒𝑛𝑡𝑟𝑎𝑙 𝑐𝑜𝑚𝑝𝑜𝑛𝑒𝑛𝑡 𝑜𝑓 𝐴𝐼 𝑠𝑎𝑓𝑒𝑡𝑦 𝑎𝑛𝑑 𝑟𝑒𝑠𝑖𝑙𝑖𝑒𝑛𝑐𝑒 𝑖𝑛 𝑚𝑒𝑑𝑖𝑐𝑖𝑛𝑒." The study: sciencedirect.com/science/articl…

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Jeff Gilchrist
Jeff Gilchrist@jeffgilchrist·
*** Ontario COVID Hospitalization Rates by Age *** Data is now available for hospital admissions due to COVID by age group going back to Oct 2021. This provides interesting insights into how much children have been impacted with serious infections compared to adults. 🧵1/
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Darth Putin
Darth Putin@DarthPutinKGB·
OTD 1933 Adolf Hitler was officially sworn in as chancellor of Germany. He immediately pardoned 8,000 violent Nazis, many of whom were involved in the failed 1923 coup.
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