#MedTwitter: let’s have a chat about how to have professional, educational disagreements on #SoMe. In the last few days, I’ve seen a lot of trainees who feel they can’t voice an opinion anymore, and I’ve also seen attendings who feel that they can’t ever correct a trainee 1/
All of this started over a popular resident who claimed that tension pneumothoraces are a clinical diagnosis. Much, much debate ensued, and people were mean. Feelings were hurt. We can do better—here’s how 2/
So, the first step is that when someone tweets a medical opinion you disagree with: assume the best of them. Assume they’re a kind, smart, humble individual and try to see their opinion as being voiced by the best version of themselves. 3/
Next, ask questions instead of jumping to conclusions! When there’s a disagreement, often it’s due to not understanding what someone says. Let’s use the recent debate as an example—is tension a clinical diagnosis? 4/
I was taught that tension is, definitionally, a PTX that has increased intrathoracic pressure to the degree that cardiac venous return has been reduced. In other words, a PTX that has caused shock, to one degree or another. 5/
Under that definition, tension IS a clinical diagnosis. It requires signs of shock in order to be diagnosed. But at the same time, there ARE radiographic signs that tension is happening as well! Midline shift, expanding sub-q air, etc. 6/
I think everyone agrees that the goal of PTX management is to intervene before your patient crumps. So when a trainee says something you disagree with, find out what precisely they mean before you try to educate them. You may not disagree after all! 7/
Last: when it’s become clear that your words are causing offense or a trainee isn’t in a good place to be educated, just. stop. talking. At the end of the day, your intentions matter much less than the effect you’re having. Recognize when it’s not your role to educate. 8/
And trainees: same goes for us. When an attending says “hey I’m not sure about that”, ask them why they say that. Try to learn from them. But, also, it’s okay to vent and not want to be educated about every opinion you offer. 9/
At the end of the day, we’re all adults who want the best for our patients. Don’t project onto internet strangers, don’t be a dick, and in the wise words of Keanu, “be excellent to each other.” Thank you for coming to my Ted talk. X/
