Ron Ree

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Ron Ree

Ron Ree

@ronmree

Katılım Temmuz 2013
192 Takip Edilen367 Takipçiler
Ron Ree
Ron Ree@ronmree·
@nickmmark Not completely inane. Plenty of places put PACs in for routine cardiac surgery at all levels of risk. Even though it’s not the PAC itself, decisions and protocols made on the basis of that info frequently delay recovery and may cause harm.
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Ron Ree
Ron Ree@ronmree·
@DrDiGiorgio At my school even “chief resident” is considered offensive to the indigenous people. They are referred to as “lead residents “.
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Anthony DiGiorgio, DO, MHA
Anthony DiGiorgio, DO, MHA@DrDiGiorgio·
An internal medicine colleague of mine once told me that their chief resident refused to have more than 8 patients on their service because any more would be unsafe. Another got written up for asking a med student what their thought process was for coming up with a diagnosis. Another was reprimanded for criticizing an intern in front of the team instead of privately.
Benjamin Ryan@benryanwriter

How Tufts anesthesiology announced its next chief residency class on Instagram:

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Harvey Motulsky
Harvey Motulsky@Hmotulsky·
Convert a continuous variable into a binary variable (hi/low) loses info unless n goes up " in the most favorable case, the loss of information due to dichotomization would have to be compensated for by an increase in sample size by a factor = 1.57". onlinelibrary.wiley.com/doi/10.1002/si…
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Ron Ree
Ron Ree@ronmree·
@TristinHopper The necessary changes to provide a modern efficient public healthcare system are beyond the capabilities and incentive structures of those leading and managing it currently.
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Tristin Hopper
Tristin Hopper@TristinHopper·
Oh, they're admitting it. Just in the last few years, public trust in Canadian health care has utterly plummeted. A majority no longer believe that it's there for you if you get sick.
S C Foley@SeanCFoley12

I don't think you could get Canadians to agree on the reasons why things are getting worse, in fact many would not even agree things will continue to get worse without any changes. Take medicare - it has steadily deteriorated since its inception, to the point of constant crisis, yet Canadians refuse to admit it and also refuse to change it in any meaningful way.

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Ron Ree
Ron Ree@ronmree·
@NicholasChrimes True. I use it to introduce uncertainty rather than direct opposition in a discussion
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Nicholas Chrimes
Nicholas Chrimes@NicholasChrimes·
The phrase “there isn’t evidence” shouldn’t be used. We should either be talking in terms that there IS evidence that something does/doesn’t work/harm, or saying we don’t know. “There isn’t evidence” misrepresents ignorance as knowledge. Absence of evidence of effect ≠ Evidence of absence of effect.
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Ron Ree
Ron Ree@ronmree·
@BradenMannsYYC I agree, the ideal answer is to improve the efficiency of delivery of publicly funded surgical services. However in reality I feel that change of this magnitude this is outside the capability and incentive structure of our current managers and leaders.
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Braden Manns
Braden Manns@BradenMannsYYC·
In a time where we seem to ignore the lessons history has taught us, here we go again ignoring the evidence. A parallel private-pay system will worsen access to publicly funded surgery | CMAJ cmaj.ca/content/198/8/…
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Ron Ree
Ron Ree@ronmree·
@Paddy_Barrett Their discomfort about taking the statin is felt in their muscles
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Dr Paddy Barrett
Dr Paddy Barrett@Paddy_Barrett·
Over 90% of people who report muscle side effects on statins are not experiencing a drug effect. This hasd been confirmed in blinded, placebo-controlled trials. That doesn't make the reported symptoms imaginary. It makes them real — and probably caused by something else.
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Ron Ree
Ron Ree@ronmree·
@AmyPearlman1 Nobody loves guidelines more than the guideline makers
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Amy Pearlman, MD
Amy Pearlman, MD@AmyPearlman1·
“Guidelines are designed to make bad doctors average and good doctors average” - just heard this quote. Do you agree or disagree?!
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Ron Ree
Ron Ree@ronmree·
@MichaelAlbertMD Obesity medicine may be different but in my specialty the number of high quality practice changing studies come along relatively infrequently so not a huge challenge to keep current.
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Michael Albert, MD
Michael Albert, MD@MichaelAlbertMD·
Saying the quiet part out loud: “Do your own research” is mostly a farce. Many physicians are so busy with clinical care and administrative burden that keeping up with the rapidly expanding medical literature is genuinely difficult. Many physicians also lack formal training in program evaluation, epidemiology, and biostatistics—skills required to rigorously assess study design, bias, confounding, and internal & external validity. The general public is even less equipped. Without training in scientific methods, most people cannot reliably interpret primary research, assess evidentiary strength, or distinguish high-quality data from noise, hype, or misinformation. This isn’t a moral failing. It’s a structural reality of modern medicine and science.
Michael Albert, MD tweet media
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Ron Ree
Ron Ree@ronmree·
@stansyke An intern doctor can independently do none of those things
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Ron Ree
Ron Ree@ronmree·
@SyedAAhmad5 I don’t think that is true in my hospital
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Syed A. Ahmad
Syed A. Ahmad@SyedAAhmad5·
I always tell my resident that the General Surgery Chief Resident is the one person in the hospital who can handle most disasters/ situations. They can intubate, open a chest or belly, manage vents, manage drips, Swann pts, write for antbx. etc……
Ron Barbosa MD FACS@rbarbosa91

Rapid vascular access is often the most important part of the big Trauma ‘saves’. As the trauma attending, you should walk into work knowing that you are the fastest person in the building at getting central access. If you aren’t, then you still need more reps and more speed.

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Ron Ree
Ron Ree@ronmree·
@DrGorfinkel Means nothing if it isn’t sustainable. If it requires two staffed ORs to carry out parallel processing then is it an improvement?
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Iris Gorfinkel, M.D.
Iris Gorfinkel, M.D.@DrGorfinkel·
Wow! 7 hip replacements instead of the usual 4-5 This HUGE difference is mostly efficiency - "cleaning the room, making sure everything is set up with all the instruments ready." This ortho team in Nova Scotia lights the path. ctvnews.ca/atlantic/nova-…
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Ron Ree
Ron Ree@ronmree·
@KalagaraHari @AoraIndia @DrDiveshArora @AmandaKumarMD @MonikaNandaMD @paindrkoneti @kajal_pgi @MayoAnesthesia @ross_prager @salmannaeem217 @DrRiteshRoy1 @EMARIANOMD @shaskinsMD @DrPhilipPeng @DrBluesNYC @athmathottungal @KohanLynn @RenukaGeorge @SudiptaSen_MD @anesthesiadocmd @ajrmacfarlane I agree! Just this week placed a stellate catheter which terminated a VT storm in a patient with scar related VT post emergency CABG. Infusion kept stable rhythm until danger period over.
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Public Land Use Society
Public Land Use Society@PublicLandBC·
The Department of @FishOceansCAN is considering removing the principle that salmon are a public resource managed for all Canadians. This would be a colossal shift in conservation law and public access. If adopted, fishing would no longer be a shared right but a "privilege" granted by First Nations, placing non-Indigenous Canadians last. Email your objections and feedback by January 23, 2026: DFO at DFO.SAPreviewBC-PASRevueBC.MPO@dfo-mpo.gc.ca Visit @SFIBC and @BCWildlife's website: fishingrights.ca #fishingrights
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Ron Ree
Ron Ree@ronmree·
@MadanNarayanan It’s possible. A PIB regime may have been better but with the results we got we are not going to be the ones to find out!
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MadanKumar Narayanan
MadanKumar Narayanan@MadanNarayanan·
Results similar to Continuous Vs single shot ACB in TKR, no difference in pain scores for continuous SPIP catheters Vs single shot in Sternotomy. Could the infusion regimes in fascial planes be the reason for the lack of difference?
Regional Anesthesia & Pain Medicine@RAPMOnline

🤔 Do continuous SPIP catheters improve sternotomy pain 🚀 A new RCT in RAPM found no difference in pain, opioid use, or recovery vs single-injection SPIP blocks after cardiac surgery. Evidence > assumption! 🔗 doi.org/10.1136/rapm-2…

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Ron Ree
Ron Ree@ronmree·
@doctimcook One is pitched toward a retail audience. The other is intended to emphasize to family members how sick a patient is to prepare them for a possible bad outcome.
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Tim Cook
Tim Cook@doctimcook·
Answer me this Why when a patient is anaesthetised…..almost always full unconscious, often paralysed are they popularly described as ‘asleep’ Yet when sedated in ICU the term ‘put into an induced coma’ is most often used. These patients are usually sedated, non fully unconscious and very rarely paralysed. Both basically wrong and potentially misleading. One seemingly trivialising anaesthesia and the other dramatising ICU sedation. Anyone explain it to me?
GIF
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Ron Ree
Ron Ree@ronmree·
@NicholasChrimes @Anaes_Journal Totally agree. Especially diuretics - I’m sure that there is enough crystalloid in the hospital to overcome any effect of those!
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Nicholas Chrimes
Nicholas Chrimes@NicholasChrimes·
@Anaes_Journal This I agree with. Can we stop interrupting antihypertensive therapy for surgery? (& educate staff that anaesthetic fasting doesn’t preclude taking tablets!)
Nicholas Chrimes tweet media
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Regional Anesthesia & Pain Medicine
Regional Anesthesia & Pain Medicine@RAPMOnline·
🤔 Do continuous SPIP catheters improve sternotomy pain 🚀 A new RCT in RAPM found no difference in pain, opioid use, or recovery vs single-injection SPIP blocks after cardiac surgery. Evidence > assumption! 🔗 doi.org/10.1136/rapm-2…
Regional Anesthesia & Pain Medicine tweet media
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Keşfet

@nickmmark @DrDiGiorgio @MayoProceedings @RAPMOnline @TristinHopper @NicholasChrimes @BradenMannsYYC @Paddy_Barrett