Brian F. Chapin

It amazes me to hear patients say “thank you for taking so much time with me”. Isn’t that what I’m supposed to do? Shouldn’t leave my office until you understand your situation and your options. @MDAndersonNews makes this possible.

@benristau @UPMCUrology @FCUroOnc @NewEngland_AUA @AmerUrological @UConnUrology @uconnhealth @waterburyhosp Congrats Ben. Happy for you and for UCONN. My daughter is likely headed to Connecticut for college. Will take you out for a drink to celebrate when we are up there.

Thrilled to announce that I have accepted the position of Chief of Urology at UConn Health. Grateful for foundation from Dr Albertsen’s long stewardship. Excited for what we are building here in Farmington, CT. Go Huskies! @UPMCUrology @FCUroOnc @NewEngland_AUA @AmerUrological

📢 We're growing the statistical editing team for the @EUplatinum family of journals! We're looking for multiple Statistical Editors with biostatistics expertise and clinical research experience to join @EUplatinum @EurUrolOncol @EurUrolFocus @EurUrolOpen Know someone great? DMs are open — send names our way 🔬📊

@CanesDavid @jasonryanmd I have uploaded 20 or so letters. Use the same structure. Usually add the persons CV and prompt it with how I know them. To what capacity. Specific things to highlight and a score from 0-10 on enthusiasm. Still have to edit but saves me 75% of the time.

The issue you have is context, not the LLM. If you provide good context, you will get incredible output. Give it the last ten letters of recommendation that you've written, or give it a few samples from a colleague that you like. If this is one of your first letters, tell it to make a brief describing your writing style and to adhere to the brief. Then give it some idea of your actual thoughts about this applicant that it can draw on as a seed. These have to be your own unique thoughts and insights so it knows what to focus on If you do that, it won't matter which LLM you use; the results will be phenomenal

I need to write a letter of recommendation for someone and I tried asking ChatGPT to generate a first draft. It was terrible. All fluffy, over-the-top, meaningless language. Just a run-on list of cheesy buzzwords. "...displays a combination of intellectual rigor, scientific curiosity, and persistence." "...when faced with challenges—whether technical setbacks or interpersonal constraints—{student name} approaches them methodically and constructively." I don't recommend using AI to write your personal statements or other letters. It won't sound authentic. And it's just bad writing.

Some ✈️ photos 🛫 PDX 🛬 SAN @ChapinMD

@TylerSbrt7 @UroOnc We will sign you up when it expands to include friends!

@UroOnc @ChapinMD I was hoping it was Friends of Urologic Oncologists, but this is good, too 😉

The SUO is pleased to introduce FUO: Future Urologic Oncologists, an immersive, in-person educational program designed to introduce senior urology residents to the clinical, collaborative, and leadership dimensions of Urologic Oncology. Learn more here: bit.ly/4bGE0UI

@UroOnc This is going to be a great intro to the value of an SUO fellowship + what joining this community of like-minded individuals provides: a career supported in growth, innovation, clinical care + education. Preference will be given to PGY3s + limited spots available. Apply soon!

@marklewismd Isn’t this an Irish exit?

When the consult service stops following without formally signing off

@CanesDavid @BrennanSpiegel Hard to have eye contact with shades on! I get enough grief from patients about wearing a mask (required).

@BrennanSpiegel I can’t tell if this is parody This looks absolutely absurd

First day using AI-powered smart glasses in clinic. Real-time EHR. No turning to the screen. Just eye contact and conversation. All the data I need, when I need it, dynamically served up and projected into the room. Even differential diagnosis! Early… but unbelievably good 👇

@DrJesseMorse @WallStreetApes Accident compensation corporation in New Zealand is just this. Covers costs of health care for an accident or injury, including 80% of your lost wages. Results in limited to no situations where people sue for personal injury. No fault = No sue.

@WallStreetApes I think there should be some type of special health insurance that only covers emergencies and health bills over $50k. Maybe it exists, but I think many Americans would purchase that over traditional insurance for the exact reason you just described.

American is a healthy 28 year old, he decided to skip paying for health insurance this year because the cheapest plan was $900 per month with a high deductible He had to spend 2 nights in the ER without insurance, he breaks down the bill “This is my receipt from spending 2 days in the hospital: - It totaled about $24,000 - My CT scan alone was $8,300 - Laboratory, 6,000 - IV therapy, $1,020, $4,000 in total And while $24,000 seems like a lot of money, let me show you something. This is what I'm actually paying, $2,478 because when you don't have insurance, these hospitals give you a discount. They discounted $22,000 off of this bill” “But if I had insurance, I wouldn't have gotten that discount. So it would've been a $24,000 bill billed to my insurance, and then my insurance would've said, ‘Hey, you have a $5,000 deductible. You need to pay $5,000 for this last emergency room visit.’ Then you tack on the $900 a month that I'd be paying for that insurance. I'd be paying $20K this year for healthcare. So the craziest part about this is even if I have another hospital visit, by the end of this year, I'm still gonna be paying less than I would if I had insurance. At minimum, my cost for healthcare this year would've been $20,000 with insurance. Right now I'm at $2,400.” US Health Insurance is a scam

@HThompsonMD 😅. Thought you just didn’t want to reply to my texts.

Tip: Make sure you know your Apple ID password (without looking at your phone), especially if you restore your phone. I had to restore my IPhone, did not know Apple ID password, and was essentially locked out of my phone for 2 weeks due to apple security restrictions #Painful

@DrSpratticus @CanesDavid @dr_coops @urotoday @UroOnc @Uroweb @wandering_gu @BogdanaSchmidt @DrMLChua @HimanshuNagarMD @AmarUKishan @piet_ost @alison_tree @declangmurphy @uroegg I don’t disagree with this given you aren’t tailoring radiation margin or using as a decision tool. My rad Onc colleagues usually defer to my exam for our multi clinic visits. I find it helpful in my counseling and decision tree so would only defer if the Pt is not willing.

I am all for it if it helps you make decisions and your patients. Struggling to find utility as a radonc as by the time I see them they have at minimum a PSA, MRI, Biopsy, often a DRE, sometimes a PET scan and genomics. So doing a DRE seems pointless but because guidelines recommend it our accreditation bodies in radonc require it be in the consult note. Men do not like it and plenty of studies showing this.

#EAU26 DRE not recommended for asymptomatic men. What are people’s thoughts on need for routine DRE in era of MRI? @ChapinMD @urotoday @UroOnc @Uroweb @wandering_gu @BogdanaSchmidt @CanesDavid @DrMLChua @HimanshuNagarMD @AmarUKishan @piet_ost @alison_tree @declangmurphy

@DrSpratticus @CanesDavid @dr_coops @urotoday @UroOnc @Uroweb @wandering_gu @BogdanaSchmidt @DrMLChua @HimanshuNagarMD @AmarUKishan @piet_ost @alison_tree @declangmurphy @uroegg I think it helps the Pt. So not sure where that comes from. If I can’t provide a NS + that’s a high priority I recommend radiation. So the DRE is one aspect of that decision matrix. I am not going to invest in a study to generate evidence in something that has minimal risk.

That’s the beauty of truth—it doesn’t need permission. Free or not, no point in doing them if they don’t help the patient. Doing a DRE pre-op very different than in clinic during consult. You appear to use it for surgical planning, so irrelevant if going to AS or RT? Perhaps should be just recommended if having RP pre-op 😁 I haven’t seen evidence a DRE helps in a patient already diagnosed with an MRI. Enlighten me! I am open to be convinced, just need data not old school dogma. Beautify of evidenced based medicine…evidence drives it.

@CanesDavid @DrSpratticus @dr_coops @urotoday @UroOnc @Uroweb @wandering_gu @BogdanaSchmidt @DrMLChua @HimanshuNagarMD @AmarUKishan @piet_ost @alison_tree @declangmurphy @uroegg And if the dominant lesion is by the nerve bundle but no clear EPE on MRI and exam feels confined, I still Nspare if patient has a baseline high IIEF-5 and after counseling on risk.

I also tend to NS in high risk if dominant lesions not near NVB on MRI I highly value your opinions Brian nearly without fail. This one shocked me tbh. This has “near-retirement open surgeon still justifying Open Prostatectomy” vibes. 😂🤣 I kid, but… hey. That’s what it reminds me of. I wonder how often your DRE is discordant with what you already planned/saw based on MRI?

@CanesDavid @DrSpratticus @dr_coops @urotoday @UroOnc @Uroweb @wandering_gu @BogdanaSchmidt @DrMLChua @HimanshuNagarMD @AmarUKishan @piet_ost @alison_tree @declangmurphy @uroegg People make such a big deal about it and I just don’t agree. I do a DRE on every patient after positioning before a Prostatectomy. Can’t convince me otherwise, sorry.

@CanesDavid @DrSpratticus @dr_coops @urotoday @UroOnc @Uroweb @wandering_gu @BogdanaSchmidt @DrMLChua @HimanshuNagarMD @AmarUKishan @piet_ost @alison_tree @declangmurphy @uroegg If it’s T3 on exam I incrementally spare. If feels confined I approach as a Nspre, MRI doesn’t tell you that. MRI is a good Test when overtly involved but most often it provides tumor size + proximity only. MRI is often an overcall compared to DRE. It’s free + easy to do a DRE.

@DrSpratticus @dr_coops @urotoday @UroOnc @Uroweb @wandering_gu @BogdanaSchmidt @CanesDavid @DrMLChua @HimanshuNagarMD @AmarUKishan @piet_ost @alison_tree @declangmurphy @uroegg Limited data zone, I find it helps me w/nerve sparing decision/plan. Equivocal MRIs + Rads comments on EPE/abutment doesn’t provide the risk assessment of a full Nspare like palpating the surface + tumor. I tend to Nspare even in higher risk tumors when a high priority for Pts

@dr_coops @ChapinMD @urotoday @UroOnc @Uroweb @wandering_gu @BogdanaSchmidt @CanesDavid @DrMLChua @HimanshuNagarMD @AmarUKishan @piet_ost @alison_tree @declangmurphy @uroegg So for patients with already confirmed PCa post biopsy and who have or will have MRI, why is DRE recommended? I understand pre biopsy and during screening, but post diagnosis and MRI I don’t see a reason to recommend it as it won’t change management.

@DrSpratticus Docetaxel ⬆️OS when added to ADT + ARPI, yet not every trial mandates triplet tx as control 1 value of a RCT is the consent process +clearly defined standards w/in the study We follow the same in S1802 w/the LV subset. Not every Pt in routine practice gets every available Tx

#EAU26 Curious to study team or others how the trial was allowed to run when EAU guidelines recommends RT in low volume mHSPC? How are you justifying withholding a treatment that improves rPFS and debatably OS? Control arm should be SOC systemic tx plus RT to primary, like in STAMPEDE. @Prof_Nick_James @alison_tree @achoud72 @parker @nickva1 @Uroweb @piet_ost @_ShankarSiva

@cardiojaydoc02 I work differently. More autonomy of schedule helps with managing the work load. But research, educational curricula, and building programs take a lot of my time. No complaints but I often see my fellows leave before me.

I’m not sure of any physician that works LESS as an attending than they did in training. That’s news to me. One of the myths is that you will work less when you’re done.

@DrSpratticus @urotoday @UroOnc @Uroweb @wandering_gu @BogdanaSchmidt @CanesDavid @DrMLChua @HimanshuNagarMD @AmarUKishan @piet_ost @alison_tree @declangmurphy DRE probably not needed for screening alone. But I still perform it in men with suspected cancer, prior to biopsy of an MRI lesion, and in anyone considering prostatectomy for staging.