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Stefan Kertesz, MD

@StefanKertesz

Feb 10

@CDCgov

1/The revised draft version of @CDCgov opioid Rx guideline is covered appropriately here by @DrewQJoseph

This guideline must be assessed not just for what it says,but for how it may or may not guide institutional actions that abused the prior guideline & could do the same here

https://twitter.com/statnews/status/1491811702882508804

@HHSGov

2/This means that whatever arguments we may offer about the *science*, a key challenge is what to do about other agencies, including those in @HHSGov itself, that decided to make a *misreading* of the 2016 Guideline key to their regulation of care, despite resultant patient harm

@NCQA

3/The most crucial examples are the Office for the Inspector General of HHS and the nonprofit @NCQA, because the @OIGatHHS refers prescribers for criminal investigation, while the @NCQA obligates the hand of all payers and providers

Read 14 tweets

Stefan Kertesz, MD

@StefanKertesz

Feb 8

1/“Maus” author Art Spiegelman participated in a *wonderful.* discussion of his book sponsored by 4 faith groups in Tennessee

The webinar is at bottom of the report.

Min 30-45 highlight some key points not discussed in most coverage

newschannel9.com/news/local/mau…

2/the Board was upset by sexuality - the book depicts Art being urged by his father not to mention a premarital affair.

Art’s choice: to make the contract with his *readers* rather than his father

He knows it depicts him being “a jerk” but this is wise -

3/We tell so many stories that are designed to clothe the story-teller in virtue or omniscience.

But adolescents have excellent BS-detectors.

They pay more attention to honesty

Read 7 tweets

Stefan Kertesz, MD

@StefanKertesz

Feb 3

@KeithNHumphreys

1/There is a new “Lancet Commission” report on the North American opioid crisis.

It is led by @KeithNHumphreys and includes @DrSeanMackey & @ChelseaLShover

I will share a few shots of some messages & recs as it is behind paywall

Selectivity is unavoidable. It is 50 pages!

2/These are the key messages of the Commission

3/The Commission does see the opioid overdose/poisoning crisis as a result of a multi system regulatory failure

Read 11 tweets

Stefan Kertesz, MD

@StefanKertesz

Feb 3

1/This is an update 🧵re: our research on suicides after Rx opioid reduction
Clinical context of SuicIde following OPIOID transitionS
(CSI OPIOIDs)
TL;DR: we're progressing. The pilot study is NOW.
A "bigger" study is coming
We are preparing docs for the funder & ethical review

2/Background: CSI OPIOIDs does *not* seek more statistical papers.
There are already *3* papers that find a tendency of higher suicide event frequency in persons who are tapered versus those who are not:
pubmed.ncbi.nlm.nih.gov/33863865/
jamanetwork.com/journals/jama/…
bmj.com/content/368/bm…

@AJ_Gordon

3/I'm going to detour one tweet here on ADVOCACY:
In my role as ADVOCATE, not researcher, I have been decrying the imposition of nonconsensual changes to care of disabled patients, changes lacking evidentiary support, since 2017 (here with @AJ_Gordon ) statnews.com/2017/02/24/opi…

Read 14 tweets

Stefan Kertesz, MD

@StefanKertesz

Feb 2

https://twitter.com/funchefchick/status/1488959838151270400

One of the most fascinating pieces of evidence in the Washington opioid litigation (against distributors) is this chart

1: I credit anyone's ability to diagram a problem

2: It's crazy to diagram problems of opioid prescription without referring to clinicians or patients

https://twitter.com/funchefchick/status/1488959838151270400

2/It is *harmful* to make clinicians invisible from the chain of accountability in our drug death crisis.

Civil litigators like to portray the medical profession understood as "putty". For people who like cop-outs and shirking responsibility, this is just fine.

3/But there's no drug company that convinced med schools to NOT prioritize training in addiction, in pain, in rehabilitation or in long-term care of complex problems.

And that choice, by OUR profession, is a big part of why many docs were pliant to marketing pushes

Read 5 tweets

Stefan Kertesz, MD

@StefanKertesz

Feb 2

@SaulWeiner

1/The White Coat ceremony ideally would disclose what the profession knows about itself, wrote @SaulWeiner

“We have to be candid about our own imperfections. You probably won’t always be treated respectfully. We apologize in advance for that”

“On Becoming a Healer” (2020)

https://twitter.com/gabby_brauner27/status/1488659988197249026

2/“We don’t know which among you have an open heart and an open mind, and which have just learned to appear that way.

We’ve done our best to screen out the latter, but medical school admissions is an imperfect process”

3/“During the early years of training you may be in survival mode..so that you can get through all the stuff we foist on you to memorize. You won’t need much of it when you practice medicine, but a fair amount of the content will be on board exams”
#TwitterGIFs

Read 5 tweets

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