Thread by @PulmCrit

Zentensivism! The triad of mastery, risk tolerance, and humanism.
- @msiuba at #HRreloaded

Zentensivism doesn't mean not responding rapidly when necessary. but it may mean rapid de-escalation of therapy when possible. when the patient is improving, allow them to heal and get out of the way.
- @msiuba at #HRreloaded

"they quote need a bronchoscopy" I'm dying 🤣.
Zentensivist - do more with fewer interventions
- @msiuba at #HRreloaded

less aggressive care could improve outcomes, especially in more fragile patients.
- @msiuba at #HRreloaded

minimalization requires mastery and understanding which elements of care can be removed. this evolves gradually over time, with intentional practice and reflection.
- @msiuba at #HRreloaded

how can we develop risk tolerance? we can stretch the boundaries of what we are comfortable with, to avoid iatrogenic harm.
- @msiuba at #HRreloaded

we over-estimate the benefits of our interventions. instead, in reality we need therapeutic humility.
- @msiuba at #HRreloaded

what makes sense for this patient for this patient in the context of their lives, values, and preferences? this requires empathy, listening, and common sense.
- @msiuba at #HRreloaded

minimally invasive but maximally attentive actually takes a lot of work. resisting the urge to do lots of stuff while closely monitoring the patient takes more thought than simply reflexively doing everything.
- @msiuba at #HRreloaded

and finally some take-home references on Zentensivism (both of which are open-access I believe).
- @msiuba at #HRreloaded