Josh Tyler

Dad, colorectal surgeon. Robot enthusiast, rural surgery/LMIC advocate. Passionate about all things FSU.

[Josh Tyler @JoshuaTylerMD]

Innovation cannot happen if you only pay attention to textbooks, dogma, and currently published data.

[Josh Tyler @JoshuaTylerMD]

@strugglemade105 Congrats Freddie!!!

[Josh Tyler @JoshuaTylerMD]

Great work today @OSHS_Greyhounds! Proud of y'all!

[@OSHS Powerlifting @OSHSPowerlift]

It’s that time… the 2024 season kicks off tomorrow with Regionals at Gulfport High School! Lifting starts at 10:00AM! Let’s go!! 💪🏽

[Josh Tyler @JoshuaTylerMD]

@fsuzeigler Purple is the way to go, with the base. Got one a few months ago and love it.

[Josh Tyler @JoshuaTylerMD]

@JohnRTMonsonMD Was in regard to finishing residency/GME my friend. We are all life-long learners in this profession (or should be at least).

[Josh Tyler @JoshuaTylerMD]

💯. I always tell my graduating residents, their final training is their first 2-3 years as an attending.

[Kevin K. Chung, MD @chungk1031]

Real clinical growth as a physician begins when formal training ends.

Agree?🤔

#MedTwitter
#lifelonglearner
#GrowthMindset

[Josh Tyler @JoshuaTylerMD]

Fair points, for both you and @dr_samehhany81 . Must be interpreted in reality, especially in the US and LMICs. Most surgeons aren't out here changing practice on what's published. We change how we train residents/fellows is how we change practice....

[Neil Smart @Neil_J_Smart]

@dr_samehhany81 @nirhoresh @nlavellaneda @SWexner @MarkSoliman @debby_keller @CleveClinicFL @AnnalsofSurgery @ZGaroufalia @mikifreund @RachellGefen I think that paradigm has gone. The resuscitate overnight and operate in the morning went about 15 years ago in the UK. CCrISP teaches that patients don't magically get better between 4 and 8am. Operate at 4am. Waiting = MOF & ⬆️✝️

[Josh Tyler @JoshuaTylerMD]

@gruntdoc Should it be? Yes absolutely. Is it though? Not at all. Broken system.

[Josh Tyler @JoshuaTylerMD]

@DissanaikeMD Such lessons are difficult to learn (as the learner) unless you have the care continuity to be the one doing the reversal, which is often not the case for many of our peers. We've got to teach our trainees these things well. Anticipate/prevent future trouble

[Josh Tyler @JoshuaTylerMD]

Great point @DissanaikeMD. IMO true debate is less about Hartmann as being useful, and more how we teach our trainees/future surgeons how to address the pathology w/o compromising future reversal (don't get in TME plane, minimal mobilization, etc). Would be difficult study to do

[Josh Tyler @JoshuaTylerMD]

@dr_samehhany81 @rbarbosa91 As stated in many replies, the first sentence of the introduction being "We propose the hypothesis that 100 years after its invention, Hartmann’s procedure no longer has a role in colorectal surgery" is eliciting some angst and likely should have been thoughtfully revised

[Josh Tyler @JoshuaTylerMD]

@FezaRemziMD Wise words my friend. The concept of triage applies to far more than trauma. Go for the best outcome possible for the particular patient and circumstance with what you have (equipment/skillset included), where you are.

[Dr Feza Remzi @FezaRemziMD]

I dropped 2 words in my practice; never, ever. If I may there are 3 cirmcumstances that impacts the procedure of choice in perforated diverticulitis surgery.
1-Patient’s level of sepsis
2-Surgeon’s experience
3- Hospital Infrastructure

[Josh Tyler @JoshuaTylerMD]

@coachstorms @DrewTyler2023

[SEC Shorts @SECShorts]

Florida State gets hosed.

presented by: @renasant

[Josh Tyler @JoshuaTylerMD]

@IngramSmith @TheBattlesEnd donated. Monthly.

[Josh Tyler @JoshuaTylerMD]

@KirkHerbstreit went party line, not whats best for CFB. I understand for yall's paychecks. Seems kinda gross. I'd feel dirty.

[Andrea Adelson @aadelsonESPN]

I am spitting nails and have nowhere to spit them, and while I want nothing to do with this site, I have a lot to say. Florida State rose from the depths of hell - as one player said yesterday - to go 13-0 and win an ACC title with an 18-year-old QB who missed half the season.

[Josh Tyler @JoshuaTylerMD]

Spot on. Even in peer to peer for prior auth I ask "ok cool, what's your training background for you to deny imaging X or procedure Y for this complex colorectal surgery disease?". Answer: "Oh I'm a pediatrician".🤦‍♂️

[Dr. Glaucomflecken @DGlaucomflecken]

🚨PRIOR AUTHORIZATION REFORM🚨

[Josh Tyler @JoshuaTylerMD]

This 👇. Fighting insurance and small town GI docs not well versed in IBD is insufferable. GI fellows need a rotation with colorectal surgery in their fellowship to guide understanding and decision-making.

[Jordan Shapiro, MD, MS @drjshapiro]

Dear @BCBSTX, my patient with a new diagnosis of perianal Crohn's disease who has blood/stool soaked underwear every night due to his condition needs standard therapy - ie: not immunomodulator first (step) therapy - to help treat his disease. Please contact me. @CrohnsColitisFn

[Josh Tyler @JoshuaTylerMD]

@luciacolorectal MIS Total abdominal colectomy. Depending on birth trauma history and anticipated bowel function postop either ileorectal anastomosis or ileostomy.

[Josh Tyler @JoshuaTylerMD]

@olsonplanner Almost like we did a podcast on it 😉