Discover and read the best of Twitter Threads about #patientcentered

Most recents (10)

The 3 most powerful (& liberating) words a #clinicianeducator can use…

“..I don’t know”

Most junior #MedEd faculty will be tempted to avoid them b/c of #impostersyndrome.

I went far too long resisting them but now am free. Don’t make the same mistake I did.

Here’s why…👇
Saying “I don’t know” will…

-Normalize gaps in knowledge – “we can’t know it all” (say it with me 👏)
-Flatten the hierarchy to increase psychological safety
-Increase the collective curiosity on the team to increase dialogue and stimulate learning

-Model a #masteradaptivelearner framework of looking up the answer and asking for help when we don’t know
Read 7 tweets
Next up: Is less more? A critical appraisal of medication abortion follow up with @VitalaGlobal @uoftobgyn @Stanford @Gynuity @UTAustin and Alamo Women's Health Clinic in Albuquerque

Mifepristone approval/access has grown in so many ways:
- Globally access improved
- Indications for use expanded
- Methods of delivery expanding (telemedicine, meds by mail)

#SFP2022 Image
In Europe, Germany had the lowest uptake of medication abortion. This might be due to low reimbursement for simple and safe care in Germany and medication abortion is so safe!

Read 26 tweets
Dear @OptumRx & @SanfordHealth you are NOT his #physician. You know nothing of his #health hx. Two years ago #Sanford #Bismarck #pain clinic pulled all #patients off #opioid #pain medications. This was not #patientcentered care, but care deemed appropriate BY administrators 1
Now @OptumRx & @SanfordHealth #insurance sending out letters re #opioid #pain #medications. My son had to move from a #Sanford clinic to another clinic due to #abandonment. Yep, abandonment. Plain & simple what you did was harmful & not based on #patients needs. You need 2
to look at research, that shows the harms of what u r doing. @SanfordHealth administration in Bismarck informed me 2 years ago when all #patients pulled off #opioids that it was the ‘national standard’ of care established by @CDCInjury @CDCDirector. The guidelines are NOT 3/
Read 9 tweets
I posted this yesterday with parents permission. I wanted to expand on this video a bit.

1st, a big part of me feels very uncomfortable with posting. Just like a big part of me felt uncomfortable about posting about my kids experience (w permission). It feels exploitive. 1/
Yet, when I share experiences of #caregivers & or #patients (who had given me permission to share) those experiences were/are often questioned or I’ve been excused of exaggerating. Or like many others called a #shill for #Pharmaceutical companies. I am a mother, who 2/
witnessed first hand the harms of pain ignored, not treated, under treated or labeled as #psychosomatic. I remember very vividly how my kids would arch their backs in pain & scream. How helpless I felt. I have seen the repercussions of this #harm & am absolutely obsessed 3/
Read 15 tweets
#PatientCentric care, #PtExperience #Tokenism, #HoldingSpace #WeAreBetterTogether ⚠️ long thread.
Recently I attended a meeting of an organization whose focus is in improving #healthcare. This is a highly respected organization. One ☝🏼 of their founding principles is the 1/
engagement of various #stakeholders including #patients and #caregivers. This was not the 1st meeting of this org. I have attended. I walked away from this particular meeting sad, frustrated & a bit angry. The topic was on #patientcentric care. A topic that is near & dear 2/
to me. The caliber of individuals involved was spectacular; academics, researchers, consultants. As I scrolled through participants as well as listened to the conversation and watched the comments come across the screen I was enthralled with the dialogue however 3/
Read 21 tweets
SNEAK PREVIEW: Complete Path Enumeration (CPE) for CRM #dosefinding designs

Featuring a vignette for #Rstats package #precautionary update v0.2-3, currently under review by CRAN. 1/…
This demonstrates the feasibility of a programme I’ve set forth, for the ‘exact’ simulation of ANY dose-escalation design.

Influenced by @MarkusTriska‘s exacting perspective on ’exactness’, however, I now use the more precise term ‘MCSE-free’. 2/
@MarkusTriska ‘MCSE-free’ in turn alludes to the title of recent work by Thomas M. Braun, from which I adapt my application.

(Braun’s mean-field approach truly can be called ‘simulation-free’, whereas I DO simulate the trials—just without Monte Carlo error.) 3/
Read 21 tweets
As a physician, can say this about doctor culture in the U.S.: we are a socially stunted puerile bunch easily manipulated by sales & marketing ppl or by metrics of competition, obsessed with status, prestige, ego..

...not my doctor friends...but we hang out at the margins.
The high school level drama that plays out in hospitals, then the replica, amplified, on #MedTwitter is 😱 No wonder our profession kills so many patients when we are so busy policing on pettiness & ignoring standards of quality, safety, population health…
There are many reasons why I am hanging up the stethoscope, one of which is that I cannot in good faith go into any clinical setting and feel confident about “first do no harm” - The system is too misaligned, not driving quality, safe results

Then, the human dynamics are
Read 30 tweets
This is extremely concerning. Where is the #patientcentered care? What if the medications that the #patient had been on were working? My kids have an extensive history. They have tried multiple medications and treatments some to their great detriment, should there 1/
not be a discussion w #patient and/or #caregiver on needs, concerns, desired outcomes previous treatments tried? I would never want to again have my kids be placed on a medication & or have treatment that did not work or worse caused harm previously. Due to the #CDC 2/
guidelines, the reinforcement of these guidelines by other governmental entities such as @CMSGov physicians have stopped assessing need and providing legitimate care - there actions are based on what is best for their organization and themselves. @CDCInjury and @SeemaCMS have 3/
Read 8 tweets
10 tips for caring for #immigrant & limited Eng prof pts during #COVID19. Created w physician experts in #languagebarriers. Full recs:…. 1- No shortcuts with interpreters. This is not time to “get by” w limited lang skills. Reinforce confidentiality. 1/7
2- Interpreted conversations often less #patientcentered. Ask about pt concerns & feasibility of recs. Dispel rumors. Inquire abt medicines/herbs or high-risk contacts (e.g. elderly parents at home, etc). If #COVID19 #isolation advised, explore open-ended❓about concerns 2/7
3- Highlight #publiccharge suspended for #COVID19 testing & treatment. Spread the word. #Greencard eligibility not jeopardized by seeking #COVID19 testing & treatment… 3/7
Read 7 tweets
Thread/ Here's my walkthrough of our new @radiology_rsna paper examining barriers to patient access of radiology images! @thehowie @hmkyale @JodiDaniel @ePatientDave @MarilynMann @allenlh @YaleMed @YaleRadiology… (1/10) Image
Through simulated patient telephone calls to 80 U.S. hospitals, we gathered data on the patient request process for imaging studies. (2/10)
The most striking finding was that CDs were the only format universally offered by hospitals; only 8% of hospitals offering imaging studies via email and 4% via online patient portals. (3/10) Image
Read 10 tweets

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