Frank Cacace MD FACP Profile picture
General Internist / Clinician Educator. #proudtobeGIM. #meded. #advocacy. #GME. anti-#burnout. Nutty collector of vintage baseball cards. 🎹🎼. Opinions mine
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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

We therefore are foundation of ..->
May 18, 2023 12 tweets 8 min read
#medtwitter #meded #pediatrics #IMProud

Reflecting on an undeniable threat to our patients - pregnant Moms, children, seniors, families, communities

Denied freedom.. a 🧵

Denied freedom to

shop for a prom dress

walk the mall with your child

go to your doctor 2/?

Denied freedom to

worship

go to the supermarket

go to school

teach in school

To do these things without being snuffed out, there one second and gone the next

Freedom to breathe, to come home that day

Freedom to access life, liberty and the pursuit of happiness ->
Apr 27, 2023 7 tweets 3 min read
Hey #medtwitter #meded

Dear #healthcare employers, academic medical centers/institutional structures

#primarycare is the foundation of care in a large system. It is not treated as such

Metrics rating us and attracting scrutiny include

1/? -> … 2/

% A1C > 9

blood pressure <140/90 at last touch across board,
w/o regard to age/context

% mammo (w many outside your system and clicks to result burdensome)

% colon screening

% flu or pnvx

% PHQ screened

average # patients seen / exam room / day

90% RVU target->
Feb 27, 2022 4 tweets 2 min read
#medtwitter #primarycare

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

Imagine all the people
Livin’ lives safely

You may say God’s a dreamer
Feb 7, 2022 23 tweets 19 min read
#medtwitter #meded #primarycare @primarycarechat

Sorry going long, not sorry

1/?

Letterhead

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
Feb 6, 2022 5 tweets 7 min read
#medtwitter

1/3 Music 🎼 post Sunday morn

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 -> 2/

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 &not 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
May 25, 2020 10 tweets 9 min read
1/ Had a really interesting day on #medtwitter today, re: #advocacy #activism #primarycare courtesy of @MParshleyMD @sagar_ankita @EricLast3 @gabrieldane @meggerber @mmteacherdoc @sulane7 @SusanHingle @dhpomerantz @UREssien

... 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
Mar 26, 2020 5 tweets 4 min read
1/ Hey #medtwitter #proudtobeGIM

cc @mmteacherdoc @templeratcliffe @tony_breu @meggerber @laurelfick @adamcifu @DrSinhaEsq @SusanHingle

Received a text this AM from division’s admin coordinator

‘What a beautiful day it would have been for opening day - Let’s Go Mets ..’
-> 2/ 2which my Chief of DGIM responded:

The one constant through all the years, Ray, has been baseball.

America has rolled by like an army of steamrollers. It's been erased like a blackboard, rebuilt, and erased again. But baseball has marked the time.

This field, this game->
Sep 23, 2019 16 tweets 6 min read
1/

A TALE OF TWO STENTS

a #twitternist #clinicalreasoning and #implicitbias reflection

Wanted to share 2vignettes with you #medtwitter, w permission (identities, some details changed)

Both involve rapid thinking, stretched foci of attention, unanticipated clinical events-> 2/ first vignette :

Seeing last pt in morning session, 45 mins back

Finishing up, see another pt’s e mail & message on desk phone

Need 2finish up w pt in front of me, but odd message left in both places

Call back - 72 yo man, remote preDM but got that BMI to 23 long ago, ->
Jun 8, 2019 16 tweets 9 min read
1/ #medtwitter #twitternists #proudtobeGIM

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 🗣🗣.