Discover and read the best of Twitter Threads about #primarycare

Most recents (9)

Yesterday I gave a talk to my #primarycare residency on PTSD in ICU Survivors. It's a topic I've learned a lot about here on Twitter (special thx to @Potato_Chip and @brookevitti), so feels appropriate to share as my first #Tweetorial. #PCCM #MedHumChat #TraumaInformedCare
Modern medicine has developed the tools to bring people back from the brink of death. What is life like for patients after surviving the previously unsurvivable? How can we provide better care for them?
~10% of ICU patients die during their hospitalization. 90% survive. (ncbi.nlm.nih.gov/pubmed/28800866)

~20% of ICU survivors will develop symptoms of PTSD by 12 months (ncbi.nlm.nih.gov/pubmed/31186070)
Read 14 tweets
I listen to ~90 #Podcasts on a (semi) regular basis. Let me give you a rundown of ALL of them and why you should listen to some amazing #FOAMed, especially for all the new #EmergencyMedicine interns. #FOAMed #MedEd #medtwitter
First of all, you need a good podcast app. I absolutely love Downcast. Great app, gives you more control over playback, downloading, and allows you to categorize your podcasts into playlists (picture 2). This is where you get to customize your #FOAMed experience! #medtwitter
In no particular order,

- Anesthesia and Critical Care Reviews and Commentary (ACCRAC). Great insight into Crit Care from an anesthesia perspective. Coming from EM, this is great to listen to- much different from my day-to-day! #FOAMed #FOAMcc #CriticalCare
Read 88 tweets
1/6 What is the usefulness of inflammatory markers such as CRP, ESR and PV in #primarycare? My #PhD findings may make you think carefully about doing these tests. A thread 👇bjgp.org/content/early/…
2/6 Inflammatory markers have an overall sensitivity of <50% so are not a useful 'rule out' test:
3/3 1000 inflammatory marker tests generates:
236 false-positives ...resulting in an additional
710 GP appointments
229 phlebotomy appointments
and 24 referrals
....in the following 6 months
Read 7 tweets
1/ It’s been a week.

It’s well into Friday evening & I just got off the phone with a patient who had urgent radiology results. This was after spending > 40 min on the phone w another patient discussing the same this afternoon.

(18 more to come; stick with me.)
2/ I only got 2 items on today’s long “to do” list done — but that’s on me. I was finally able to sit down for a couple hours uninterrupted and dig deep into a few patient cases from the week.

(And I “don’t work” on Fridays.)
3/ As I hung up the phone, I reflected on how #directprimarycare has enabled me to get to the heart of medicine & the doctor-patient relationship.

During that call, my patient’s spouse broke down and — through sobs — simply said: “Thanks for being so kind.”
Read 19 tweets
(Thread)
I’m going to discuss how physician payment rates in the US are set and suggest a reason why #primarycare is poorly valued from a salary standpoint in the U.S. I’ll also suggest how anyone interested can work to improve payment for #primarycare.
1/
I am targeting younger physicians and medical students - this may be too simplistic for some, and go into the weeds too much for others. But the whippersnappers are the ones that are more likely to lead change, and so that is the audience here.
2/
Disclaimer: I am an academic #pulmcc physician, not a #primarycare physician. So I’m in a procedure-heavy specialty. I'm also not an expert in health policy, so feel free to gently correct anything that seems off.
3/
Read 27 tweets
#TodayWe announced 5 major systems entering two-sided Accountable Care Organization contracts. But what about independent primary care providers? We haven't forgotten about you! /1
In parallel with #BluePremier, we have an exciting new opportunity to help independent #PrimaryCare physicians in North Carolina thrive. More advanced than medical home models, it is a glide path to greater financial opportunity directly tied to total cost and quality of care. /2
We are working with @AledadeACO @Farzad_MD to accelerate the success of these independent practices in accountability for their patients. Aledade will arm practices with workflow technology, analytic insights, and risk mitigation. /3
Read 6 tweets
1/ Is willpower myth or muscle? Using eating & #dieting as an example, let’s discuss the science behind #willpower, when willpower fails, and what we can learn from all of this to help us break bad #habits. A long thread, but follow along to learn why willpower is really a myth.
2/ If you're a #primarycare provider trying to help patients lose weight, a #nutritionist trying to get someone to stick to a healthy #diet, or simply trying to eat better yourself: Do you ever feel frustrated, helpless or like a failure in changing #habits?
3/ Why is habit change so hard? Have we not come up with the perfect strategy? Do we simply need more #willpower (or a kick in the pants)?

For years you’ve been told that willpower is the 🔑 to breaking bad habits… but what if I told you that science says otherwise?
Read 18 tweets
First day back at work and I saw the "moral injury" with clear eyes statnews.com/2018/07/26/phy…
I think one of the things that people who are not poor don't understand is just how unstable and violent the bureaucracy of poverty is.
Case in point: being dropped from your health insurance without warning for obscure bureaucratic reasons. Having to navigate complex paperwork to reapply. Being denied because you make a dollar over income.
Read 7 tweets
[THREAD] Over the weekend, I ran a poll on initiatives aimed at improving access to #NHS #primarycare. While respondents probably aren’t representative of the wider population, I think the results are striking: what people want most is convenience. (1/5)
@harrylongman’s much larger survey of patients of 12 GP practices using @askmygp shows that only 15% of patients prefer face-to-face appointments as the default. (2/5)
Meanwhile, @GPatHand – while hugely popular with its patients – breaks the NHS’s traditional #placebased funding model. pulsetoday.co.uk/news/gp-topics… (3/5)
Read 5 tweets

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