Tweet

More from @tjwebbmd

The Real WebbMD

@tjwebbmd

Aug 10

Content Warning; death of a child.

I wanted to share about the single most salient experience I had deciding who I was as a physician from directly observing an attending. Tragically, it involved the death of a pediatric patient; a child about 18 months old.

#MedTwitter

2/ I was an intern on the FM medicine service; our hospital didn't have any other residency programs, so we typically went to every Code because we were frequently more readily available than other doctors in the hospital, and often the first to arrive to help.

3/ One morning our team ran to a Code Blue in the ER; an EM doctor was leading the team when we arrived. My co-intern and I both had 18 month old children at home, the same size and age of the child we were trying to resuscitate. We were both assigned to chest compressions.

Read 14 tweets

The Real WebbMD

@tjwebbmd

Mar 17

I'll never forget the morning in clinic, a couple of years out of Family Medicine residency, when I walked out of a patient's room around 10:30 AM and was told I had "7 Walk-Ins."

#MedTwitter

2/ I was working at a busy FQHC and had a full schedule; 14 patients scheduled that morning, mostly adults who each needed my help with a mix of medical, psychiatric, and social concerns. This work has always involved that of doctor, counselor, and social worker.

3/ I was running about 30-45 minutes behind (which is pretty good for FM clinic) so I had about half (7) of those patients to see in the next hour and a half. Unfortunately not everyone can keep their appointment, so I felt ok on time, anticipating I would see 4-5 of those 7.

Read 25 tweets

The Real WebbMD

@tjwebbmd

Mar 15

"Non-Compliant"
"Difficult Patient"
"Poor Historian"
"Unreliable"
"Drug-Seeking"
"Low Health Literacy"
Or the indefensibly still in use, "Poor Protoplasm"

So many of the labels Medicine uses for patients are just a way of saying, "Not one of Our People."

#MedTwitter

2/ Medical Students and Residents, don't accept this terminology; don't allow it to dehumanize your patient, remove their agency, and undermine their care. Phrases like these can and do kill people. Fight back against this; both subtly and explicitly. #MedStudentTwitter

3/ When someone on your team says the patient is non-compliant, ask whether the plan they 'didn't comply' with was guided by shared decision making and realistic considering their healthcare barriers; ask whether the plan was discussed with them, and if they consented to it.

Read 10 tweets

The Real WebbMD

@tjwebbmd

Feb 7

I don't know who on #MedStudentTwitter needs to hear this, but Step 1 is not the High Jump. A high score doesn't win, and a low score doesn't eliminate you from contention; it doesn't determine how good of a doctor you will be, and it certainly doesn't determine your worth.

It's not really a competition at all, but if you need a track and field analogy it's more like that weird water obstacle in the Steeplechase.

You might leap right over it. You might stumble. You might fall face first with an embarrassing splash and get trampled a bit like I did.

But all that matters is that you get over it somehow; and then you can keep running. If you really stumble it might mean you have some catching up to do, but the nice thing about this- compared to the real Steeplechase- is that finishing is the goal, not beating anybody else.

Read 6 tweets

The Real WebbMD

@tjwebbmd

Feb 7

"Live like a resident for a few years so you can pay off your debt" appears to be a bit of a controversy right now.

I finished college with $0 in debt and about $1,000 in savings. By the end of residency in 2016, my med school loans had grown to $470,000.

2/ My living like a resident included a lot of awesome factors. I was married; we had 2 children and an awesome dog we had adopted in med school. We had a reliable baby sitter and went on dates semi-regularly. We had a little rent house that was fairly priced. We had two cars.

3/ If we had continued on my resident salary- or given ourselves a 50% raise- and used the rest of my new income to pay loans, we would have been able to pay off my med school debt in about 5-6 years.

That does sound really nice, but I don't think it would have been sustainable.

Read 24 tweets

The Real WebbMD

@tjwebbmd

Feb 6

https://twitter.com/pjputh/status/1490119504625553408

There's this theory that "capitalism breeds innovation," so our healthcare system must be improved and advanced by the competition of private insurers.

It fails because it doesn't account for the fact that all innovation of insurance companies is directed at increasing profits.

https://twitter.com/pjputh/status/1490119504625553408

2/ Under our current model, there is no incentive- none at all- for insurance companies to innovate in the direction of improving peoples' health; not the health of their clients, and certainly not the health of others in our society.

3/ In most industries, if you get poor service or have deeply negative experiences with one company, you try a competitor. You can typically do it right away, even with other forms of insurance; I can switch from Geico to Allstate tomorrow if I want to.

Read 14 tweets

Share this page!

The Real WebbMD

People who liked this thread also liked...

Try unrolling a thread yourself!

More from @tjwebbmd

The Real WebbMD

The Real WebbMD

The Real WebbMD

The Real WebbMD

The Real WebbMD

The Real WebbMD

Did Thread Reader help you today?

Don't want to be a Premium member but still want to support us?