#TipsForNewAttendings Pay attention to team dynamics and morale. Who's happy, who's not- and why. Let team members know you're available for little problems. If they know you care, they're more likely to share big problems with you too. #kittlesonrules

Healthcare workers be like: 2020: “How do I avoid Covid?” 2021: “How do I avoid crippling depression?” 2022: “How do I avoid getting shot at work?”

Updates in addiction medicine: don’t worry so much about weaning stable patients’ opioids bc evidence suggests they’re more likely to have OD and mental health probs in the year following AND because according to Twitter commenters this is reasonable grounds to get you shot

Are physicians to blame? Are Nurse Practitioners at fault? Do patients bear the responsibility? We all know the truth. Healthcare workers and patients are simply pawns in an ongoing assault on the way in which healthcare is delivered today here in the U.S. More and more 7/

This is the best thing ever.

I’m sure many will say that it is not possible to do so with additional responsibilities or that there is some barrier to this approach However, as Rabih Geha shared with me: we are lucky to be a teaching attending and we should respect our trainees time.

“Few doctors will admit this, certainly not young ones, but subconsciously, in entering the profession, we must believe that ministering to others will heal our woundedness. And it can, but it can also deepen the wound.” - Abraham Verghese, “Cutting for Stone.”

The pendulum has swung too far. Penalizing falls in the hospital has resulted in patients who aren’t allowed to get out of bed. They get weaker, depressed, constipated, pressure ulcers and ultimately need SNF placement. Ambulation should be viewed as a key to healing.

She’s a 10, but she’s non-formulary

Something saddens me about reading 19th century perspectives on good bedside manner compared to 21st century ones. eg, this 1892 piece in JAMA (jamanetwork.com/journals/jama/…) quotes the author Robert Louis Stephenson describing what makes a good bedside manner:

Rounding tips for the new attending cardiologist. With a few 🥵 takes, focused on efficiency, IMHO after doing this many different ways for nearly a decade. A thread 🧵

A thread about why the US medical profession urgently needs to face some hard truths about its ethical status and role in American society. Most doctors believe we belong to one of the most virtuous, caring, and progressive professions; reality has long been very different. 1/

so here's a story I volunteer helping seniors with their technology issues. One of my regulars came in with a Lenovo laptop. It still had a retail sticker; I imagine she bought it used, for over $500 "I bought this so recently, how is it already so slow," she asked me

I have to say I hate the algorithm and also what this app does to my brain space but I’m really quite touched by all these fond farewells. I guess there is good in the world after all??

Overwhelmingly it feels like so much public discourse (about suffering, scarcity, healthcare etc) can be boiled down to one circular conversation, over and over: WHOSE FAULT IS IT?? I don’t know if this is something new or just something human. But it seems fruitless

I have to say I know we’re burnt out but I’m not sure that’s an a excuse for callousness and cruelty. Now’s the time to show your internal moral compass. Having a bad boss or working for a corrupt system does not excuse the individual for their actions

Anyone else hear npr say “It’s giving Tuesday!” And initially been astonished by their youth forward delivery?

Why is it that physicians love vanity plates so much?? Always seeing them in the doctor parking lot. I mean, there’s the obvious… or maybe just that we feel comfortable distilling our identity into a career-related one-liner? I genuinely do kinda love em

On the 1 hand, I’m kinda enjoying my chaos timeline. On the other, I hate th idea that my stupid scrolling generates ad revenue for a man who reminds me of every idiot who makes his personality playing “devil’s advocate.” You couldn’t get it in high school and you def can’t now.