BillyD

@fuqekgs By the grace of God.

@thewcd4 You got in

Here to say sometimes the highest MCAT/USMLE scorers aren't always the best physicians. You can ace a test, but if you don't know how to communicate with others and be considerate, you won't go to many places Plus there's evidence showing MCAT scores is associated with SES

@gasmantx @dr_huffer 🥱

@thewcd4 @dr_huffer You’re not thinking that when interviewing candidates. You’re looking at their appearance, their grooming, their body language when answering different and potentially difficult questions, etc. These type of things matter when evaluating applicants. We aren’t robots.

If we did medical school admissions completely race blind: application without a photo or racial demographics, interview via zoom with camera off… Who would object, and why?

@otokyo__ And Fritos

WHAT ADULT IS STILL OUT HERE EATING PEANUT BUTTER AND JELLY SANDWICHES

@_CurtMD @AmputationSuck That’s the tell.

You know you’re doing good work when your boss brings their spouse to you for surgery 🥹💙

@SavannahMaeUSA 11

She’s a 10, but she's MAGA. What now?

@gasmantx @dr_huffer But when your premise is “we dont have enough of x” or “we have too much of y”, how do you stay objective?

@dr_huffer I would definitely object. You learn a lot about people meeting them face to face. In medicine part of our job is communication and professionalism. I’ve seen some interesting things meeting with candidates for admission for both med school and residency.

@thewcd4 Telling a 36 year old mother of three that the lesion we biopsied was a melanoma met and she is now stage IV. A leukemia cutis diagnosis in an 27 year old with no medical history. Telling a parent their infant has Langerhans cell histiocytosis.

Medicine is a language only physicians fully speak. The weight of a difficult diagnosis. The 3am second guessing. The smile you put on before walking into the next room. Find the people who speak it. You need them more than you think.

@Papa_Heme Agree. Using technical jargon only exacerbates the issue.

Try to avoid using lots of “doctor” words when explaining stuff to patients. Granted it makes you sound smart but also clueless to patients needs.

@SalaryDr That gap is easily closed with honoraria, not to mention covered travel and registration for multiple meetings per year.

salaryDr data, attendings: Private/group practice average: $691K Academic average: $440K Same residency. Same boards. Same overnight calls. $250K/year is a steep price for "the academic mission."

@saniyafatma1278 Rick James

I Can't Find a Suitable Name For Him…

@drjohnm Agree. We start Oac all the time in the office with nothing prior.

Why do people use heparin or enoxaparin for acute AF? It drives me bananas. There’s zero data!

@augsby “That must be hard for you”.

A study found that doctor empathy decreases across medical training. Not because we don't care. Because empathy without protection causes emotional hemorrhage. We survive by disconnecting. That's the tragedy.

@BrentAWilliams2 “Time for rounds”. Let’s see who will be…..the weakest link”.

I was in the middle of a LONG breast reconstruction surgery. I was retracting for a very long time and couldn’t see anything. The surgeon was peppering me with anatomical questions as I was retracting, and I was struggling.. So after a while he says, “Williams. You’re a rock. What I mean is - you’re as dumb as one.” 😂😂😂

@FCademartiri So CT for everyone then.

🫀⚠️ We used to say: “It’s non-obstructive, don’t worry.”
 This paper suggests we may have been… very wrong. Photon Counting CT answers NEW questions. A simple but powerful case: 👉 74-year-old patient 👉 unstable angina 👉 non-obstructive disease on CT And yet: 👉 Photon Counting CT detected plaque ulceration. Confirmed by OCT. Let that sink in. This was NOT a tight stenosis. This was: 👉 biologically dangerous plaque 👉 invisible to conventional paradigms 👉 clinically relevant The key finding Ultra-high-resolution PCCT showed: 👉 non-calcified plaque 👉 spotty calcification 👉 positive remodeling 👉 sharp angular protrusion (ulceration) —all non-invasively. Translation We are starting to see: 👉 plaque rupture biology without a catheter. And this matters. Because plaque ulceration (cap disruption + cavity formation) is: 👉 one of the main substrates of ACS Traditionally detected only with: ❌ invasive angiography ❌ OCT This is the real shift From: ❌ “Is there a stenosis?” To: 👉 “Is this plaque dangerous?” The uncomfortable implication A patient can have: 👉 “non-obstructive CAD” and still carry: 👉 rupture-prone disease. My take Photon Counting CT is not just improving image quality. It is: 👉 exposing the blind spots of lumen-based cardiology. Bottom line If you only look for stenosis: 👉 you will miss biology 👉 you will miss risk 👉 you will miss patients ⚡ The future is not: “better detection of narrowing” It is: 👉 detection of instability #PCCT #PhotonCounting #CCTA #PlaqueImaging #Atherosclerosis #Cardiology #PrecisionMedicine #CardiacCT

@DrRumberger Love that. See one do one publish one. May I borrow it?

As I go through the variety of clinical cardiac comments on this platform I continue to learn from facts and challenges to my understanding and am convinced that scientists use a different numbering system than the deniers , the grifters, the braggarts, and the truly confused use. I am brought back to the old medical jokes such as do one then teach one then publish one. But my favorite is the first time you see or hear of a case it in your experience; the second time is in your series; and the third time is case after case after case.

@Gunblaze1969 Ramen

What is this hair style called?🤣🤣

@DrRumberger Well all of these 50-70 by ct end up in the cath lab.

You are quite right that we visually call a stenosis higher than visually seen on cath because we see the whole vessel and not just a shadow of the vessel inside. That is why CCTA FFR eliminates the over all and now with AI and plaque WALL imaging with CCTA we see the whole inside and outside of the vessels. Also BTW a 25% stenosis is not normal and increases risk significantly

@ThrillaRilla369 Space invader

It's 1984, you've just walked into the arcade, where does your first quarter go?