Patrick Varley

@LenovoSupport You are making it incredibly difficult to buy one of your products. Place an order, I'm not home during the day to receive delivery (the only delivery windows). You've restricted changing delivery options. I call support, and they basically say "Out of Luck".

@daviesbj Just because we can doesn't mean we should. I wonder how many screening colonoscopies and mammograms the total investment would get us.

@USMNTroll_ @RatedR_NFL 👀

@RatedR_NFL Get your wins where you can I guess

Cedric Tillman with a NASTY HIT on Kyle Van Noy #Browns #Ravens

@daviesbj @uroegg @DrLauraEsserman I'd argue that changing terminology may not be the root of the problem. The issue is how the information is related to the patient. We harm patients not necessarily by our word choice, but by not spending the time to help them understand what those words mean.

@WiscSurgery's @DrDJawara from @lmfunk2's lab presenting a pilot RCT of the TOTAL intervention to improve outcomes for patients with obesity @VAsurgeons

@BestBuy @SIMPLEMobile Just a terrible experience trying to activate a mobile hotspot while traveling. $70 and an hour wasted, and now I still have to go back to the store. Rest assured I will be returning and using another store/provider.

@WiscSurgery @PittSurgery @UPMCnews @UPMC

Frailty is a critical target for quality improvement in an aging surgical population. @pr_varley ja.ma/3IJajVI

@Iocono_PedSurg @BrooketheOstomy Conversion rate is a different, though perhaps related, discussion. And there is more involved there than why the pathway exists.

@pr_varley @BrooketheOstomy Numbers don’t bear this out. Careers in surgery academic research are decreasing despite this spike in academic development time

Can someone walk me through how academic general surgery residencies started the 2 y research "requirement"? It's the most extensive across all specialties, no? Who decided specifically general surgeons needed to lead the pack in that? Genuinely curious because it seems random.

@pr_varley I think the # has increased (anecdotally, we now require it). Also they looked online which idk how clear that is. They also don't list the programs but if you go by Doximity rankings, I'd guess (from memory) the 30 are in the top ~50. Which goes back to your earlier point.

@BrooketheOstomy I obviously don't have knowledge of all the other 212 programs, but I suspect many (most? all?) would allow you to become a very good clinician and/or teacher.

@pr_varley That makes sense. My summary is just I think other fields have more flexibility in this. And I think there is still benefit in training people at academic places that may go into the community or are more interested in teaching than research. But I acknowledge my bias/ naivety.

@BrooketheOstomy But the flexibility is available when choosing your residency. For the sake of numbers, as of 2018 only 30 out of 242 GS programs required research (tinyurl.com/3htz8kkx).

@BrooketheOstomy No, the narrative is that research institutions seek to train/produce surgeons interested in research. And perhaps the mistake is a heuristic which equates "top" with [insert well-known University-affiliate].

@pr_varley Still < 2 y, so the question is just why are we objectively the most extensive? Is the narrative people need to be researchers to be good surgeons? Or just good if in academics? It seems unfortunate to eliminate strong applicants from "top" programs if less research inclined.

@BrooketheOstomy I think 18mo+ isn't uncommon for those programs. And the content area of your academic development time is not inextricably linked to your final destination. The goal should be developing the skills which can be transferrable into a wide array of content areas.

@pr_varley Sure, but across the board there is more flexibility there and usually one year. So why not do the same for gen surg? Esp programs that do it after PGY-2. People may change their mind for fellowship upon returning clinically.

@BrooketheOstomy If you look at other subspecialty fellowships, particularly those in the IM fields, there can be substantial portions which allow/require dedicated research. In GS, that has been shifted into residency...for those that are interested.

@pr_varley But why is this specific to surgery? Wouldn't this be true across all specialties equally?

I can now confirm through multiple sources that Marcus Freeman will become the next Head Coach at the University of Notre Dame. All eyes now turn to Tommy Rees who is deciding between LSU and Notre Dame. #PayTommyRees

@PFF_AndrewR Aged like milk. twitter.com/PFF_Browns/sta…

The Browns don't have a single CB graded about 60.0 in man coverage. Denzel Ward (44.2) is their worst CB in man coverage. By all means, play Chase in man to man. Please.

@cchildersmd Of course this is right. The safety argument favors the resident in the case placing them, as they are the one who (hopefully) communicated directly with the attending surgeon. Avoiding an unnecessary "hand-off" almost certainly outweighs any other consideration.

Senior residents should put in post op orders for their patients. Calling interns to do it is abusive.

More evidence to support preop frailty assessments can be implemented across all specialties, regardless of case-mix, to facilitate risk stratification & shared decision-making - join us @PeriopSummit in March @SPAQIedu to learn more! #Frailty jamanetwork.com/journals/jamas…