Dr. @ShikhaJainMD is orienting audience to the amt of time #MedTwitter spends doing prior auth & peer-to-peer calls, in many cases w/ insurance company "peers" w/ no training in the specialty. Some could not even pronounce the tumor type or drug name. #DenialOfCare#FixPriorAuth
Dr. @ShikhaJainMD says that she cares for a patient with #cancer whose insurance company only allow 4 CT scans LIFETIME for their #cancer, which prevents her from assessing how well the treatment is working. This is absurd & MUST be fixed. #DenialOfCare#FixPriorAuth#MedTwitter
The audience at tonight's @MedicineForward & @ACPinternists mtg to #FixPriorAuth was asked about key drivers for overly burdensome prior auth processes. Payers/insurers (96% of respondents) & PBMs (74%) are overwhelmingly viewed as key culprits (>1 response allowed). #MedTwitter
I just sent email to both of my Senators about this in 2 actual minutes. Action gets things done. Scrolling does not, #MedTwitter. Let’s get this done! Reply with your screenshot. #FixPriorAuth
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We have GOT to be able to identify patients w/ #longCovid who instead (or also) have persistent #SARSCoV2 &/or other reactivated virus. If we immunosuppress them (w/o treating 🦠), we can inadvertently harm them AND potentially abandon therapy that could help others w/ LC.
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Our ability to get products into the 🧠 will be more important than ever. That might be products that already cross the blood-brain barrier or novel product delivery strategies (devices to ferry a product across the BBB or strategies to open/close BBB like a drawbridge).
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Because some are asking me to translate this, the very brief version is that massive inflammation & cell death occurred in heart, lungs, brain, & eyes of cats who drank unpasteurized milk from cows with #H5N1. In all, >50% of cats at that dairy farm died. #MedTwitter #BirdFlu
#H5N1 #birdflu is likewise very dangerous to us. More than 50% of the people who have tested positive for it globally in the last 20y have died. This is why #MedTwitter is watching closely. Finding increasing cases in humans & esp spreading btwn humans would set off alarms. 😷
NEW: Prosp study in 225 pts w/ “mild” #COVID19 & future surgery or other procedures. People w/ viral RNA detection in tissue or🩸5.2 times more likely to dev #longCOVID symptoms (OR 5.2, 95% CI 2.6–10.1, p<0·0001). Higher copy #, higher odds. #MedTwitter thelancet.com/journals/lanin…
Months after a positive #COVID19 test, viral RNA was found in 10 diff types of tissue, incl the liver, kidney, stomach, intestine, brain, blood vessel, lung, breast, skin, & thyroid + blood cells, which could explain the wide range of reported #longCovid symptoms. #MedTwitter /2
Growing evidence IMO that #COVID19 viral persistence contributes to many cases of #longCovid, though it’s prob not acting alone. Still learning how genetics, immune response, & reactivation of other viruses in us intersect, producing LC in some people & not others. #MedTwitter /3
I’ve received 4 major media requests in the 2h since #KateMiddleton announced her #cancer diagnosis. I have declined them all. She has not revealed what type or stage of cancer she has, & any dr, including oncologists such as myself, appearing on the news would be speculating. /1
I’ve been asked questions on live broadcasts before that we had agreed were off-limits. I know if I agreed here, I’d be asked to speculate on the type of cancer, type of treatment, how long it might last, what the side effects might be, what her prognosis is. I won’t do it. /2
I won’t do it not only because it’s unprofessional to talk about things you don’t know about—& unless you’re #KateMiddleton’s medical team or you’ve been told by her, you don’t know what you’re talking about—but also because doing so causes concrete harm. /3
Devastating study in NEJM. Prospective study of 257 patients having carotid artery surgery: micro/nanoplastics (MNP) in 58% of atheromas & those w/ MNP present had 4.5x ⬆️ risk of stroke, heart attack, & death at mean of 34 mos follow-up. #MedTwitter nejm.org/doi/full/10.10…
Add this to the list of health concerns about micro/nanoplastics (MNP) in food. For example, this recent thread I wrote expressing concern about how we're seeing more young-onset colon cancer. Unfortunately MNP are already in soil, water, foods, etc. This is a big problem.
I hesitate to tweet concerning things without next steps since creating anxiety without an action plan I believe is harmful, but this is important info. In my 🏠 , we avoid cooking/reheating in plastic, replaced cutting boards, & are trying to avoid eating/drinking from plastics.
#MedTwitter, This is an important 🧵 from a bereaved husband’s perspective as a caregiver. I’ve been an oncologist for >20y; all of my patients by definition have a serious illness. So I hadn’t thought much about the power of affirming it. When the #COVID19 #pandemic began… 1/
& we all did more outpatient care via 📱, I had the good fortune of overhearing bits of how my husband (an infectious diseases dr) speaks to his patients. I don’t know them or their diagnoses of course, but I know it’s not all cancer, which everyone agrees is real & serious. /2
Infectious disease drs not only see people w/ things like HIV or hepatitis C, but also poorly understood complications of prior infections incl #MECFS & #LongCovid. I have lost count of the number of times I’ve overheard him say things like “what you’re experiencing is real.” /3