Cliff Marks

I wrote about why ultrasound may soon replace the stethoscope, and what its story tells us about the development and adoption of new technologies in @NewYorker newyorker.com/science/annals…

In case you're wondering what happens when the government increases tariffs across the board, the Times (of 1890) is on it! timesmachine.nytimes.com/timesmachine/1…

“Rapid unscheduled disassembly” is just an amazing euphemism

@outbreakupdates FWIW, given the overlapping time periods for the peds office and ER on the same day, I'm guessing these times include two hours (or some amount of time) after the patient left; would have been good to do the office-to-ER transfer not via the waiting room though

The Philadelphia measles patient sat in a pediatric waiting room for nearly three hours. If you were there, you were exposed.

@khakrish @dvasishtha I think there's promise here but the devil is really in the details - both ED doc and home care company need to be comfortable with the risk

@khakrish @dvasishtha That's fair - I think it depends on what capabilities really exist for monitoring in the community - if I'm worried enough about stroke to need an MRI before discharge, sending them out of the hospital feels like it's going to go badly a non-negligible percentage of the time

A great example of why I'm bullish on looping private duty home care into VBC arrangements: - 75 year old presents to ED late Friday and team feels they need an MRI to rule out low likelihood of stroke - this hospital doesn't have any radiology techs over the weekend - team doesn't feel patient can come back on Monday on their own for the MRI - team admits patient into Obs or inpatient for monitoring until Monday Total waste of $25k that would have been avoided if the patient had access to transportation and safety supports in the home to make it to the Monday MRI

@khakrish @dvasishtha But also, wouldn't you just transfer this patient to a hospital with an MRI?

Good example, but the issue is ultimately getting the ER doc comfortable enough to discharge the patient. Has bugged me for a long time that EDs don’t do any value-based contracting, but we know they can practice this way - Kaiser EDs and EDs in areas of FL with lots of delegated risk are much better about discharging the “marginal” admission. cc @HashemZikry

@mlchild Just seasonal right now but god help us if one of these bird flu variants manages to spread well human to human

@cliffmarks So are we cooked?

I have seen 12 patients with Flu A in the last 24 hours…

The cruelty is truly mind boggling nytimes.com/2025/01/27/hea…

We’ve raised over 10K so far! Please consider donating/sharing - these candidates need your help and their races are key to winning back the House!

I'm working with a group of health care workers called Moonlighting for Democracy - we're pledging to pick up an extra shift and donate the proceeds to Democratic candidates in close congressional races. Hope you'll consider donating/sharing! moonlightingfordemocracy.org

Tried to settle a bet using chat gpt and honestly don’t think AI is going to replace us just yet

Excited to learn that the fifth circuit believes ER docs have standing to sue government agencies for lax regulation of firearms! (Not to mention inadequate responses to homelessness, poverty, etc.)

Please God let Brian Cox be on the next season of Curb

@HKalodimos Feel like they would have had an uncomfortable discussion about who should do compressions before realizing Gerri wasn't there to lose that game

Thinking a lot about the flight attendant on Succession who seemed to be the only person doing chest compressions for 30 minutes straight (if Kendall had gotten a hold of the best airplane medicine expert in the world, maybe they would have known to switch out)

I still reflexively use TKTKTK sometimes in draft medical notes and it confuses the hell out of everybody

If you make a list of unwritten rules and don’t include “stand right, walk left” on escalators, you’re doing it wrong

@pujalms @khakrish Thank you!

@khakrish @cliffmarks Such a well written and very true article!!

My friend and old coresident @cliffmarks wrote about ultrasound, the rare medical technology that brings us back to the bedside. Some great anecdotes here and a good reminder that the most important part of tech-enabled care is the care newyorker.com/science/annals…