ajhahg504

what’s up doc ?

[ajhahg504 @ashlinh504]

@olsonplanner Thank you I was resisting logging in because I knew it would just spiral me into a wormhole of uncertainty. Like what is the next step??!!!🤣 still unsure how to get all of this time during intern year to count for forgiveness. It’s exhausting!!!!

[ajhahg504 @ashlinh504]

@olsonplanner Absolutely not. One time $800 continuing education stipend. Used it to help pay bills, but I guess me having bills is my problem. No particular allocation to step three.

[naashika 👸🏾 @kareashanti]

Im sick of the microsoft authenticator like who would be logging in to do my work? Tf 😭😭😭😭

[M. Skalski @docskalski]

Made this stained glass design for my new office once it's finished. Can't wait to install it! https://t.co/JAtiik2FFW

[Sayed Tabatabai, M.D. @TheRealDoctorT]

Patients I see who’ve lost weight with GLP-1 agonists like Ozempic often seem embarrassed when they mention it.

Don’t be embarrassed! Your blood pressure is great, your A1C is down, you look and feel great, your quality of life is better.

This is the whole point of Medicine.

[Jason Ryan @jasonryanmd]

There’s an old saying about diagnostic testing in medicine: “Ask yourself what you will do if the test is positive. Ask yourself what you will do if the test is negative. If the answers are the same, don’t do the test.”Best examples I know of where this principle applies are coronary calcium scores and Lp(a).

[Jeremy Faust MD MS (ER physician) @jeremyfaust]

This meme is making the rounds and it is accurate.

[Adi @IDdocAdi]

Medicine note versus surgery note

[Dr. AP | Action Potential Mentoring, LLC @action_ap]

Example of an “expectations email” I just sent to an incoming MS3 for our vascular surgery rotation:

Setting general expectations is clear, to help with anxiety, giving clear metrics of what needs accomplished, as well as giving rotating students an idea of how to improve! Also, as a chief resident, it’s key to be able to delegate work to your intern/midlevel residents so they can help the medical students grow too!

Email:
Hello! Welcome to the vascular surgery team. We are excited to have you join us.

For a daily basis:
The time that we round is dependent upon what surgeries we have that day. Nikita arrives at 5am every day to pre round & pick up the pager. Our first surgery is usually at 7am but can be earlier if there are emergencies. Nikita will be in charge of delegating your instructions for assisting her with pre rounds.

For surgery:
My personal expectations are that you attend as many operative cases as possible to get the best experience you can, as well as that you know the anatomy of the area we are operating on prior to the surgery and that you meet every patient before surgery to introduce yourself as a member of our team to build rapport.

For clinic:
When you are not in the operating room, if there is clinic underway, you are expected to help out in clinic by seeing followup patients. You can present to Nikita, Jared or myself for practice if you would like, before presenting to the attending.

For patient care/improving:
You are always free to ask Nikita, Jared and I questions regarding patient care, operative plans and how to improve. We will do our absolute best to help you learn something from this rotation about vascular surgery. Nikita is a great teacher and resource & she will help you learn how it is to be in charge of patient care and wound/incision management. Jared and I can help discuss operative plans with you.

For rounds:
On rounds, I expect you to be attentive and anticipatory (after the first week of getting acclimated).  Examples: If a patient has dressings that need changed, you can have supplies ready to expedite rounds. If a patient requires a Doppler for their pulse exam, you can have the Doppler ready to use to show forethought. I will also expect you to have at least 1-2 patients you are in charge of presenting to me (after you become acclimated to the service, generally by week 2). You will help us follow up on studies/imaging/labs for those 1-2 patients. You are welcome to be in charge of more patients as you feel able, but that is the minimum requirement from my standpoint. 

I hope this gives you a better idea of what to expect. Any questions you may have, I highly encourage you to ask. We are happy to help you learn as much as possible.   If you have special areas of interest within the field of vascular surgery, wound care, critical care management, postoperative care or preoperative workup, please let us know so that we can tailor your learning and you get the most possible out of your month with us to help facilitate your future goals & learning. 

Talk to you soon,
Austin Price 
Vascular Surgery PGY4

[ajhahg504 @ashlinh504]

@action_ap This is great. Concise and clear. Now we just pray they read until the end 🥹

[ajhahg504 @ashlinh504]

@olsonplanner YES. At least 2-3+ months rent. Def June, +/-July + Security deposit if you move and rent again. Round off at +2K if buying a home (if your closing costs are covered, if not 🤷🏼‍♀️). Licensing: 100~, car insurance: 100$x3M if you drive my hoopty that I own. 5k already w/o food or ⚡️

[Dr. Glaucomflecken @DGlaucomflecken]

How to Ace your United Healthcare Interview @UHC

[ajhahg504 @ashlinh504]

@EmmaRoseDiFiore You got this! Living in solidarity with you closing on a house tomorrow with a car packed full. Icing on the cake is starting on surgery as a resident who did not match surgery and soap’d :))))))

[Eric Alper 🎧 @ThatEricAlper]

Did people solve the Bermuda Triangle problem? I haven't heard anything about it since I was a kid.

[Dr. Glaucomflecken @DGlaucomflecken]

A lot of people are dragging this person. The knee jerk reaction of “92% coverage?! That’s amazing! Why are you complaining. Leave the country.” This shows how low the bar has been set for health insurance coverage in the US. Let’s put on our empathy hats for a moment.

Imagine paying a ~$1k per month premium for the privilege of having health insurance. It was $750 last year, but the company you work for had a lot of employees use their health insurance in 2023, so Blue Cross decided to hike up the premiums to defray the cost of actually paying for their customer’s healthcare. You’re annoyed but fortunately, are still able to pay the monthly premium.

Over the course of the year, you seek preventative medical care like you’re supposed to, paying a $20 co pay for every visit. Maybe you have a few extra visits to your PCP or the emergency room. These bills go entirely to your deductible, which means you pay for 100%. The high deductible plan was all you could afford due to the rising premiums. Again, you’re annoyed but you can manage.

Finally you reach your deductible, thinking “great, I won’t have to pay anything the rest of the year.” At least that’s what it sounded like from the intro pamphlet you received from HR at the beginning of the year. It was all pretty confusing.

With your deductible met, you finally schedule that procedure your doctor has been nagging you to get that will prevent further health care issues down the road. However, you didn’t realize co-insurance charges still apply until you reach your out of pocket maximum (~$12,000 for the plan you chose. Again, the only plan you could afford). You are frustrated, but fortunately still able to cover the estimated cost.

Then, while recovering from major surgery, you receive a bill for $4,457 that you can’t pay. This is more than you were quoted by your doctor’s medical office. Turns out Blue Cross thought some of the medication you received during the procedure was unneccesary, so they refused to pay for it.

You’re angry. You have done everything right. You paid your premiums, you did everything your doctors suggested to keep yourself as healthy as possible, and yet, you still end up with a bill that will take months, if not years, to pay off. If you don’t, you will be sent to collections, wrecking your credit, and making life an even harder uphill climb. Does all of this apply to the OP here? Maybe, maybe not. But it does apply to millions of other people in the US every year.

Does this person not have a right to be angry? Should we just be ok with a health care system that is death by a thousand cuts? Or should we strive for a system in which a person can access health care without risk of financial distress? Unfortunately, many people can’t understand this point of view until they are on the receiving end of those medical bills. Health insurance companies don’t care about you. They are evil. Don’t settle for slightly less evil.

[Alok Patel @AlokPatelMD]

Repeat after me:
Doctor salaries make up less than 10% of US healthcare costs.

......

The insurance, admin, device, and pharma industries all laugh and applaud when ppl blame healthcare costs on us.

[ajhahg504 @ashlinh504]

@medbrisbon These feelings shake up my self-confidence as well. Our thoughts influence our perception of reality. This is when I lean on my support system before medicine and it helps shift my focus to how far I’ve come in life. Easier said than done, but it helps me🫶🏼🫶🏼

[ajhahg504 @ashlinh504]

@mowwyjane Hahah! My latest favorite word from my rural elderly college landlord. “Yonder!”and it has infiltrated my vocabulary. not mad about it 🌾🌾👩🏼‍🌾

[ajhahg504 @ashlinh504]

Wow! Why is outlook STILL so awful and not user friendly?💩💩💩 any tips on changing standard settings that make this app the WORST? #MedTwitter #MedEd

[Paul Sufka, MD @psufka]

Sharing @DGlaucomflecken's latest newletter because it's worth reading his cancer story. Both informative, and as expected, humorous! Take you for everything you're doing for medicine, Dr. G!

https://t.co/bu0PPCwlZe