Steve Driver

Medical Rounds over time..🥶

🧵There seems to be so much discussion on TAVR vs SAVR at the moment. Having implanted a lot of TAVI valves, but my job not being dependent on it (!) I hope I can post….moderately…. unbiased observations. /1

Luigi Mangione's manifesto includes a superficially damning claim. However, it's wrong. Want to understand why the US spends so much on healthcare to get such poor results? Read this thread to see the greatest (and most unknown) analysis of US healthcare ever done.

For IC FIT in July. RotaShock of RCA. 4.0 DES. Could not advance NC over Ironman wire. Re-introduced workhorse wire as "buddy wire". Pic shows NC on work horse. You can see the wire bias of the Ironman & understand why the 🎈 cath would not go. Better solution is a Wiggle wire.

The business school version of how Doordash gained market share so rapidly is through clever strategy: targeting the suburbs where others weren't operating, acquiring untapped supply. That is not wrong, but it is also not all (or even most) of the real story. The actual story is that the team executed relentlessly. They made deliveries just a little faster and more reliable every week. They scrutinized the quality of every one of their restaurants and dashers. They optimized cost out of the system and gave it back to customers in the form of Dashpass (which launched in 2018 at the start of this chart). Over time, there was just better selection and faster, cheaper, more reliable delivery on Doordash, and consumers stuck. Virtually every startup is like this. There is a neat version of the strategy that fits into a 5-minute case study. But get under the hood and you'll realize that a lot of success is just showing up with grit and attention to detail every day.