General Internist / Clinician Educator. #proudtobeGIM. #meded. #advocacy. #GME. anti-#burnout. Nutty collector of vintage baseball cards. 🎹🎼. Opinions mine
Aug 13 • 14 tweets • 3 min read
Hey #medtwitter #meded #primarycare
Doing physician/team delivered #IMProud internal medicine for a lot of years, I’ve come to a psychologically eroded state
I look forward to my longstanding patients
I look forward to our residents and other learners
So what’s up? ->
2/
Factors in early retirements of generalists:
Disrespect for primary care doctors
Myopic short term thinking and insistence on clinical earnings siloes
Loyalty to narrative
Margin over mission, professional oaths be damned
->
Apr 14 • 13 tweets • 2 min read
Hey #medtwitter #meded #primarycare
Declaration of Current Truths in American Primary Care
1/x?
We are dealing w many more early retirements
We are attracting far fewer students &residents to generalism &to longitudinal holistic care across age ranges
We are strained ->
2/
We are having a much harder time finding and recruiting primary care doctors to replace ones who’ve left
We are therefore all seeing more patients in a panel
We are therefore sometimes unable to physically see our continuity patients for all their needs
These needs ->
Dec 27, 2023 • 22 tweets • 4 min read
Dear American #patient
It’s a giving time of year ..
We #primarycare docs give to your better health every day
If you are feeling what I’m trying to say in this thread 🧵, then a PLEA .. we pediatrics/internal medicine/family medicine/geriatrics docs/teams NEED you NOW ->1/?
2/
So reviewing, primary care are the docs who get to know you &your life from age 18 - 100+ - we are your touch point of connection, knowledge, navigation, prevention when possible, diagnoses &its care - your CARE ..
Secondary &tertiary care are specialist, procedural,
..->
Aug 13, 2023 • 18 tweets • 3 min read
#medtwitter #meded #primarycare
Open letter to academic institutions who provide #healthcare
You employ pediatricians, internal medicine &family med docs &geriatricians
We are the physicians who take care of the children and adults of the communities you inhabit and serve 1/?
2/
We extend life, we improve safety and quality, we teach general peds/adult medicine earning you GME$, we connect w communities, innovate for equity/better medication and whole person care access, refer within our institution networks
1/4 I like to share my 🎹 on here, trying to brush up mid career for peace/decompression, #wellness. Wrote some lyrics to Imagine and put it out, thought I’d share lyrics &video (see attached at end):
Imagine there’s no covid
And all it forced to see
2/
No white and brown between us
Within reach equity
Imagine all the people
Livin’ for that day
Imagine there’s no despots
And all disparity
Nothin to kill or suppress for
No tribes or chambers be
From: All primary care docs (community, employed in large network, academic medical centers)
To: #healthcare system writ large, administrators/financial lever pullers
2/
Primary care docs are in a precariously fatigued way
We deliver longitudinal relational care, which is foundational to the whole person rewarding work we need to be professionally happy, and to the revenue and reputational growth you need to maintain community market
My Aunt Joanie loves her classical music, I got it from her
Yesterday on road 2wedding (see nice posts) played mellow rock 4the car, not like classical for her
I caught her index finger tapping to the beat of a few, sharing->
2/
First up, she tapped and the band well, won’t stop believing.. hee hee
Then a voice came up that I will confess as a teenager I crushed on. Aunt Joanie tapped slowly: what an interesting voice, singing about Sara
->
Oct 25, 2020 • 11 tweets • 4 min read
1/ Debating whether to dignify this ... but here goes
I think most of us endangered docs/nurses/respiratory therapists/social workers/hospital chaplains are also frustrated re clarity of the campaign &publicly voiced narrative re this administration’s &our nation’s response ->
The ‘it didn’t have to be this way’ - must remind the public, the on the fence voter, of the following:
Pandemic preparedness structures were pared down ¬ present 2help initial strategy
‘Leadership’ must b holistic/humble - it sits back &listens deeply to expertise ->
Oct 25, 2020 • 15 tweets • 9 min read
1/ This past Thurs, I was honored to ‘emcee’ a grand rounds @HofNorthwellDOM, presenting the Candee Award for Education Excellence in Medicine 2our beloved Ron Rosen of @NorthwellDGIM
Ron is a 50 yr general internist who has taught no less than 40 yrs worth of learners -> 🧵
2/ Ron had so much to tell us about his aunt and uncle, who were early family medicine practitioners in the Bronx/Manhattan. Ambulance drivers would take them to a patient’s home. A beautiful sepia tone showing his aunt going to a call, and another of his uncle in the office
... and of course that made me think #baseballcards ->
2/ I was reminded that one hobby I have to relax me when pandemics, hubris, RVUs and #disparities are driving me bonkers 😜 = old ⚾️ cards.
On my recent B day my nieces/nephew bought me a pack of 2020 (?lost season) cards. Decided to open them ->
Apr 25, 2020 • 20 tweets • 7 min read
1/Many of my colleagues and I have not been redeployed to the hospital during the #COVID pandemic. We have been doing the ambulatory care of pre/non hospitalized patients, helped w admitted pts and starting to see post discharge pts.
Many thoughts/advice points:
A 🧵THREAD
2/ First our #primarycare triage function in this process is crucial.
Workflows/teamwork/infrastructure have to be worked out and optimized.
An updated list of daily follow up #telehealth covid pts must be kept. Day of illness, daily update notes and tracking has to happen
I've been sitting on a @SocietyGIM#sgim19 debrief #medthread since the meeting, and thought I might finally take a swing at it - here goes ..
I am considering whether I can do more division/systems leadership in coming years .. ->
2/ Theme of the conference was 'Courage to Lead', and single best workshop for me was :
Leading Change: Tools/Tips for Change Management
Crediting Alfred Burger, Emily Fondahn, Brent Petty, Nathan Spell, Dan Steinberg - can't find them on Twitter, so giving proper 🗣🗣.
