Taz Profile picture
Emergency Physician/Army Vet/Patient-Physician Advocate/Model/Opinionated Citizen/Hippie chick; opinions expressed are mine and mine alone, thank you very much.
Nadine Roumaya Profile picture WPR MD🩺🧠💗 Profile picture 2 added to My Authors
Apr 17 10 tweets 3 min read
Listen, I don't want anymore f***ing trolls coming into my threads trying to tell me who I am. I am CLEARLY stating right here, right now that I don't and never will embrace that f***ing title "provider". Why? Because it is a verbal construct of the corporate practice of medicine 2)(CPOM)/PE that was designed to do exactly what it is doing...depersonalize, dehumanize and conflate HCPs. Perfect for a business that doesn't give one s**t about HCPs or patients who they view as widgets and commodities, respectively. I DESPISE the business of medicine--it is
Apr 16 11 tweets 4 min read
Some of you may recall the abhorrent Instagram video in which two FNPs performed liposuction on a patient using unsterile techniques. The fact that they were working happily and openly outside their SOP was not the only issue. midlevel.wtf/nurse-practiti… 2)Plenty of HCPs, particularly surgeons and OR/ER nurses were appalled by their lack of sterility...and said so. These FNPs doubled-down stating they did follow sterile technique. You don't know what you don't know. To add to this display of uneducated arrogance, there was no
Feb 1 10 tweets 4 min read
VIRGINIA PHYSICIANS!!! The s**t just gets worse. There is a proposed bill(by a NP no less) that permits NPs to practice unsupervised after 2 years while mandating MD/DO to complete 3 years of residency BEFORE they can get a license to practice. Right now they can practice after 2)one year which enables PGY2s and above to moonlight while completing residency. In addition, this legislator wants to remove the requirement for medmal insurance from NPs while MANDATING it for physicians. An idiot can see the writing on the wall. If this legislator can
Jan 22 18 tweets 6 min read
Twitter peeps....This. Is. Huge.
"10 year review of Hattiesburg clinic shows decreased healthcare quality & patient experience, increased cost & resource utilization with ‘independent’ NPs."--@HalstedMD

ejournal.msmaonline.com/publication/?m… 2)For those who may not know, the Hattiesburg Clinic in MS is the real deal. An extraordinary clinic with a stellar reputation. Kudos to them for this exceptionally well done study. The authors of the study admit that they were both surprised and disappointed in the results of
Jan 14 6 tweets 2 min read
Dear Med Schools and all affiliated academic centers, STOP using med students as your own personal stash of free labor because you don't want to pay a fair wage to people actually trained to do the jobs you want covered. STOP exploiting med students because you can. Dear 2)Attendings/Supervising Physicians, stop enabling this abuse. Dear Med Students, JUST SAY NO!! You are paying to go to med school--they are not paying you. You notoriously volunteer for many community events and activities w/o being asked. Do not allow these schools/centers to
Dec 23, 2021 9 tweets 3 min read
Physician colleagues, please, please, please stop accepting positions from recruiters like the one below. This is how you keep enabling the illegal practice of medicine. In response to a perfectly legitimate question by a physician, he accuses the doc of being egotistical. ImageImage 2)In addition to being unprofessional, the recruiter is incorrect in implying that an attorney would advise a physician that it is perfectly safe(or legal)for them to "collaborate" with an unknown NP in another state practicing hormone replacement therapy(HRT). For the record,
Dec 23, 2021 14 tweets 5 min read
I typically have no interest in petty, childish tweets. However, this one in particular provides an opportunity to educate the public and HCPs interested in what the law has to say about the title "Doctor" and who uses it. Every state has a Business and Professions code(BPC) for 2)nearly every profession under the sun. That includes medicine and nursing. It is apparent to me whenever this issue arises, physicians and nurses have no clue what the BPC states when it comes to using the title "Doctor". First of all, it is imperative to understand,
Dec 20, 2021 10 tweets 4 min read
Kudos to Dr. Allison Brown, for going public and exposing more of the Cartel of private equity in medicine and how it affects the quality of care being provided to patients. Specifically in the specialty of Dermatology. nbcnews.com/health/health-… 2)Not surprising in the article is that the CMO and president of Pinnacle, the Pimp corporation backed by the Cartel, does what many of these sellout, traitor-trash docs do, parrot the same old bulls**t rhetoric about their prioritization of patient safety and quality of care.
Oct 23, 2021 6 tweets 3 min read
An adversarial "conversation" in Medical Economics between the new president of the American Association of Nurse Practitioners(AANP) and members of Physicians for Patient Protection(PPP). AANP president April Kapu, DNP, APRN got a bit 2)testy with PPP member Dr. Alyson Maloy's take on filling the physician shortage with NPPs medicaleconomics.com/view/covid-exa…
Oct 19, 2021 9 tweets 4 min read
There is not only structural racism in medicine, there is structural misogyny. EM is no different where the "Old Boys Network" is alive and well. When the cronies are at their best, there is no meritocracy. You can be the best physician you can be but if one does not fit in their 2)particular demographic, one will not receive equitable pay, benefit packages, promotions, etc. The powers that be are in charge and not objective--they have no ability to be. They assist each other to move upward and onward--qualifications be damned. I've read the complaint by
Sep 15, 2021 6 tweets 3 min read
Dear Student Doctors and Unmatched grads, DO NOT allow yourselves to be used as free labor by any medical institution or facility. You are not indentured servants who are required to put your lives at risk for the business of medicine. If they want you to work as 2)medical or nursing assistants, they should pay you as such. Do not agree to work as RNs because you are not. RNs are a specialized discipline and trained accordingly. They are in demand and being paid their worth...finally. They deserve it. However, the powers that be don't
Aug 8, 2021 4 tweets 3 min read
Envision does it again. First, there was the removal of a gaggle of anesthesiologists in Watertown, WI(). Then it was their powerpoint on how to save money and increase profits in the ER by using BC EM docs less and FM/IM docs and NPPs more. Then they 2)devalue interns, stating they add slowness and complexity to the EM doc's day. Guess they forgot when people are in training, it takes time to learn s**t right. Now an Envision contract(yes, it's been validated) which requires EM docs being hired to join ACEP. This is utter BS.
Jul 20, 2021 17 tweets 5 min read
The corporate practice of medicine(CPOM) is killing medicine. It's happened again. Docs being displaced under the guise of providing "continued excellent care" or some other rhetorical bulls**t. Along with the "collaborative" blah, blah, blah hogwash. Sigh....Were I one of the 2)docs reading this letter, I would be offended that Dr. Gard would presume he could dictate who I could speak to about a patient. He doesn't own my license and he has no say. If a doc wants to talk to a doc, no one can say a f***ing word. Their choice if it is their patient.
Jul 18, 2021 11 tweets 4 min read
Every physician, fellow, resident and medical student should read this article. It remains as relevant as the time it was written in 2014. I will share excerpts that I believe most exemplify what we are experiencing today. They thehealthcareblog.com/blog/2014/09/1… 2)clarify the tactics used by corporate entities to control physicians who are strong patient advocates. And my suggestions on ways to take our power back. Unfortunately, the vitriol that docs think we are gods is prevalent. The toxic environment in which docs are trained
Jul 15, 2021 7 tweets 3 min read
MedTwitter, this is what a spin to feigned victimhood looks like. In real time. This is intended especially for the virtue-signalers who come in on the tail end of the conversation and never see when the NPPs initiate s**t. This doc asked a simple question. Probably could have Image 2)left off questioning whether the person was in healthcare as it is triggering. Nevertheless, the instigator's commentary as to why RRTs began is also triggering. And false. And this is where a conversation that could have been civil goes south. So instigator says, "To have the
Jul 7, 2021 17 tweets 6 min read
I like analogies that are apropo. Healthcare is a cesspool of Pimps, Hoes and Johns. I discussed the transformation of medicine in this article for Authentic Medicine(authenticmedicine.com/2020/09/the-me…). I elaborated on Pimp #1(RWJF), who approached the National Academy of Medicine(NAM), 2)aka "The Hoes", for a White Paper on the Future of Nursing campaign which was designed to transition physician-led medicine to nursing-led. The Hoes didn't care that nurses aren't trained to practice medicine, they got on board with the campaign. The goal in 2010....
Jun 30, 2021 6 tweets 2 min read
All EM docs and residents out there in Twitterland need to view this video. Summarizes the f***ed up situation with my beloved specialty--in a nutshell. Beautifully done. I remember the days when I would be hired for a job, sight unseen. Sent in my CV and 2)boom, I was hired. My training was spectacular and my attendings supportive. And I recall when I became concerned about the changing landscape of EM, especially when CMGs began to become more prominent and small democratic groups sold their practices. We did this. We gave away
Jun 30, 2021 5 tweets 2 min read
CA docs: I was unaware of the class action lawsuit against Sutter Health, the largest health care system(and a non-profit) in northern CA. They settled a $575 million dollar antitrust class action lawsuit alleging anticompetitive practices that drove up revcycleintelligence.com/news/judge-app… 2)the cost of health care services in the region. Just when the case was set to go to trial in 2019, they decided to settle. It is interesting to note that in November 2017, Sutter was sanctioned by the judge for "intentionally destroying 192 pieces of evidence that were relevant
Jun 29, 2021 12 tweets 3 min read
Deception is so common in scope creep that it barely raises an eyebrow. Words matter, context matters. So a bit of education...Here is an ad seeking a "collaborating" or supervising doc for a NP practice in MA. Collaboration is not supervision. By the ad, the poster is clearly 2)seeking a doc to function as a safety net; however, a lot of NPs hate the term "supervision". They prefer the misnomer, "collaboration", which connotes being on an equal plane with doctors. Here's the kicker though. MA is an unsupervised state, the governor signed it into law
Jun 5, 2021 12 tweets 3 min read
Can we physicians, for the love of God, stop qualifying our opposition to FPA/OTP and misappropriation of titles with "NPPs are an important part of the team"? Since dirt, RNs, NPs, PAs have, in some capacity, even prior to their official designations, always worked alongside 2)docs. Who doesn't know this s**t? "Team" is not a neologism. No man is an island. Teams have also existed since dirt, so how about we stop perpetuating corporate medicine's rhetoric as if there have been no teams until the 21st century? Medicine would not function w/o
Apr 30, 2021 7 tweets 2 min read
A FYI for followers: State insurance commissioners are consumer advocates. They deal with insurance fraud as well as health, homeowners, life, flood, etc. companies which tend to be obstructive when it is time to pay the piper. Health insurance is the worst. This is MedTwitter, 2)so I will focus on the health insurance scumbags. If you and your doctor determine that your health insurance company is denying a claim or refusing to honor a medication and instead is telling your doctor how to practice medicine, you as a consumer can contact your state