Amol Koldhekar, MD

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Amol Koldhekar, MD

Amol Koldhekar, MD

@_amolk

GI | UNLV Gastroenterology | ATL VA CRQS | Emory IM #GradyMade | Pitt Med #H2P | Californian #LA | World Traveler #MillionMiler | Boy and dog dad

Los Angeles, CA Katılım Temmuz 2013
269 Takip Edilen381 Takipçiler
Anthony DiGiorgio, DO, MHA
Finished our taxes and came to a realization: In a two-physician household, one spouse's income is entirely confiscated by the government.
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Joseph D. Janizek
Joseph D. Janizek@joejanizek·
this claim is always funny for 2 reasons — (1) you can’t pick a non-quantitative profession in the world more explicitly didactically trained in bayesian stats than physicians, (2) you can’t pick a group of people more interested in low PPV tests (MRI/labs/etc) than Bay Area tech
Ben Landau-Taylor@benlandautaylor

My healthcare blackpilling moment was when I was ~14, my dad explained false positive/false negative statistical tests as he drove me home, and at the end he mentioned most of his medical students never really understand how to apply the basic stuff I’d just learned.

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Dr. Gripesalot
Dr. Gripesalot@pgipe·
Love that Epic ‘care everywhere’ still has Op Notes in ‘Misc Notes’ tab-buried in with all the endless RT,RN,RD, etc notes. Entire campus of useless computer geeks and this trash is the best they can fathom?
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Amol Koldhekar, MD
Amol Koldhekar, MD@_amolk·
@DrDiGiorgio The people you wrote this for will not read it or will refuse to understand the depth of your experience and give banal retorts.
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Anthony DiGiorgio, DO, MHA
Anthony DiGiorgio, DO, MHA@DrDiGiorgio·
To guarantee a rested neurosurgeon is always immediately available at 2am, you are not asking for one extra doctor. You are asking for a whole coverage model where post call relief is structurally guaranteed. That generally takes something like 6 to 8 neurosurgeons per center, not 2 or 3. Scale that expectation across the country and you are quickly talking about a multiple of the current workforce, not a small tweak. That is not achievable by simply expanding residency slots without breaking the training model. A competent neurosurgeon requires years of supervised decision making plus a very large operative experience across a wide breadth of pathology and acuity. You cannot train that safely at low volume hospitals. Training capacity is constrained by case volume, ICU infrastructure, OR teams, and faculty bandwidth. Even if you pushed expansion aggressively, you might squeeze out an extra few dozen new neurosurgeons per year. Helpful but not enough to staff every hospital with guaranteed rest coverage. Extending careers and reducing early burnout could also help at the margin, but it does not meaningfully move the needle. You could also open the doors to every foreign trained neurosurgeon overnight. That would improve headcount, but you still run into the hard part: verifying training quality, ensuring competence across the full emergency spectrum, credentialing, malpractice, and integrating people into systems that can actually support high acuity neurosurgery. And cost matters. If you want more specialists to take more call for longer careers, you have to pay for it and you have to build the supporting teams. Otherwise the same people will keep burning out or leaving for industry and non clinical work. You simply cannot have all three at once: -Near instant local access everywhere -Always rested subspecialists -High quality maintained by adequate volume and experienced teams Pick two, maybe. True neurosurgical emergencies are relatively uncommon but catastrophic when they occur. That forces regionalization. Regionalization concentrates call. Concentrated call produces fatigue unless you have large groups and real relief. Large groups require volume, infrastructure, and money. There are no solutions, only tradeoffs.
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Anthony DiGiorgio, DO, MHA
Anthony DiGiorgio, DO, MHA@DrDiGiorgio·
Safetyism is destroying American healthcare. Everything in the below post happens in hospitals around the country. Endless resources are devoted to unrealistic goals. We must eliminate all falls, all deep venous thromboses, all urinary catheter associated infections. Meanwhile true safety issues get ignored. The electronic health record doesn’t allow for blood product administration. The sterilization department can’t process surgical instruments. The computer in the operating room won’t load the radiographs. We are forced to go through endless modules on cybersecurity, harassment, and physician burnout. Yet the system can’t ensure a patient gets a routine Xray and has the images pushed over to a clinic appointment. Doctors who bring up safety concerns are labeled problematic and quickly burn out or are forced to stop practicing. They are admonished by nurse administrators who openly state that “physician preferences don’t dictate practice here.” Read the thread below and realize all this is happening in healthcare.
John Ʌ Konrad V@johnkonrad

I wrote a book on the BP oil disaster, & there’s a critical parallel with ICE protests in Minnesota that almost everyone is missing. When the Deepwater Horizon explosion dominated Twitter for months, the narrative was simple: BP cut corners on safety. That story was comforting. It was also wrong. Dead wrong. The disaster wasn’t caused by too little safety. It was caused by safetyism. Before the explosion, HR and HSE departments overwhelmingly filled with women who never worked a dangerous job in their life became obsessed with eliminating all injuries offshore. Not major hazards. Not catastrophic risk. ALL injuries, even minor cuts & bruises. Tens of millions of dollars. Thousands of hours of paperwork. Endless training modules. Everyone,from dishwasher to captain, was empowered to shut down a drilling operation costing millions per day to prevent a sprained ankle. Meanwhile, people with deep technical expertise, guys who actually understood blowout risk, were sidelined or fired for saying the obvious: That HR induced exhaustion causes accidents. That drowning crews in paperwork makes them miss real danger. That spending money on back-injury training means less money preventing explosions. Like the protesters in Minnesota, HR and Safety became powerful, organized, coordinated via expensive software, mobile & completely detached from reality. One crewman reported a serious onboard fire that nearly killed someone. Nothing happened for weeks. When he kept pushing a manager told him to STFU. He called HR to report the “verbal abuse.” Within hours, an executive helicopter full of HR Quick Reaction Team launched from Houston. They didn’t investigate the fire. They investigated him, the guy who called HR. Their conclusion? The man reporting the fire was “repeatedly harassing the crew to report the fire.” He was fired. A company-wide HR memo publicly shamed him. All in the name of “safety.” Here’s the truth they refused to accept: offshore drilling is dangerous. You cannot extract tens of millions of barrels of oil without injuries & yes, sometimes death. Now apply that lesson to Minnesota. Law enforcement is dangerous. You cannot deport tens of millions of people without injuries & yes, sometimes death. Yes, Renee Good was shot. Yes, Alex Pretti was shot. Yes, ICE operations result in injuries. And yes more people will be hurt by ICE this year. But HR didn’t eliminate injuries offshore. They just reclassified them for statistics, exhausted the workforce, and made people afraid to report real problems setting the stage for a major explosion. That’s exactly what’s happening now. ICE agents are being forced to waste time protecting identities, managing feelings, navigating activist “volunteers” & hesitating rather than acting decisively when seconds matter. Every minute an agent loses sleep worrying about this is a minute less rested. Every hour spent on crowd-management training is an hour not spent on training to manage violent criminals. And worse.. I’m a ship captain. I was trained to make the hardest choice: to do the most good for the most people. I was taught that one day I might have to send a fire team into a space they won’t come back from to buy passengers ten more minutes to reach lifeboats. That’s the job. Numbers matter. Yes, Renee Good was shot. That’s tragic. But it pales next to the hundreds killed by violent illegal immigrants under Biden. It’s nothing compared to the thousands who died between the Darién Gap and Mexico. It’s microscopic compared to the 400,000 fentanyl deaths many in ICUs like the one Alex Pretti worked in. Yes, some children were separated from families. But FAR fewer than the number raped, killed, or abandoned between the Darien Gap & Mexico under Biden The hard truth is this: Safetyism caused the BP explosion. Safetyism has killed millions. Safetyism is killing this nation right now. ICE protestors aren’t saving lives, they are pushing the body count higher.

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Tyler Olson, EA
Tyler Olson, EA@olsonplanner·
My friend just got a $100k bonus at work He’s 35, married with 2 kids Has ~$250k in student loans at a fixed rate around 7% Here are his options: Invest the bonus Put it toward the student loans Take the family on a much-needed luxury vacation What would you do?
Matt | The Mini-Retirement Maximalist@TheMattViera

My friend just got a $20k bonus at work He’s 45, married with 2 kids Has ~$25k in student loans at a variable rate around 5% Here are his options: Invest the bonus Put it toward the student loans Take the family on a much-needed luxury vacation What would you do?

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Amol Koldhekar, MD
Amol Koldhekar, MD@_amolk·
@helixcardinal I’m not academic. My procedure days I’m done by end of lunch anyway so I go home early those days too.
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DNA Cardinal
DNA Cardinal@helixcardinal·
@_amolk Most academics get a full admin day each week.
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Amol Koldhekar, MD
Amol Koldhekar, MD@_amolk·
I get a half day off each week which I made Wed AM. Today I woke up without an alarm, had breakfast with my toddler, walked with him to daycare, went to the gym across the street, then met my wife & dog at our neighborhood coffee patio. Best part of being done with training.
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Amol Koldhekar, MD
Amol Koldhekar, MD@_amolk·
@Papa_Heme @UCSDHealth I did fellowship in Vegas and I got free parking, physician lounge access with free breakfast and lunch and coffee, and physician parking lot access. A lot of my peers in other states at academic institutions didn’t believe it.
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Papa Heme
Papa Heme@Papa_Heme·
A pointer for ⁦@UCSDHealth⁩ Unlimited Starbucks and free parking for your healthcare workers will solve a lot of your problems
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Anthony DiGiorgio, DO, MHA
Anthony DiGiorgio, DO, MHA@DrDiGiorgio·
Life in a large hospital system. Book a short case. Park in the faculty parking lot. Case gets delayed 5 hours. Miss dinner with kids. Get a ticket for parking too long.
Anthony DiGiorgio, DO, MHA tweet media
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Amol Koldhekar, MD
Amol Koldhekar, MD@_amolk·
I asked my office for patient reviews after my 1st month because I want to see what I could work on Apparently I should’ve have started my job before I finished training because the wait was too long to get an appointment. Also, I should move my office to be closer to their home
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Congressman Greg Murphy, M.D.
Congressman Greg Murphy, M.D.@RepGregMurphy·
There is absolutely no reason that physicians should not be able to own hospitals. Period.
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Amol Koldhekar, MD
Amol Koldhekar, MD@_amolk·
Doesn’t “viewpoint diversity” fall under DEI? I thought they thought that was bad. 🤔
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