Daniel Pham

resident internist & psychiatrist; views mine alone

[Daniel Pham @danielxpham]

Not sure who’s still on here, but would love to hear from you or anyone that did NCSP or GIM Fellowship!

[Adam Gaffney @awgaffney]

Extraordinary study in JAMA IM confirms what many of us have warned against: "pay-for-performance" incentives in medicine reward "teaching to the test" with potentially harmful results

In this quasi-experimental study, incentivizing doctors to control blood pressure (BP)...

1/X

[Adam Gaffney @awgaffney]

This was a well-known episode in the late 1940s/early 1950s when the AMA helped defeat a national health insurance proposal. Also true that (70+ years later) the AMA represents a minority of US doctors — a majority of which by some surveys now support single-payer.

[Daniel Pham @danielxpham]

we do have this language: “board-certified” or “board-eligible” for docs that finished residency

[Nikhil Krishnan @nikillinit]

need a different indicator for docs that completed med school vs docs that finished residency

[Max Jordan Nguemeni @MaxJordan_N]

Just so you know, in order to graduate medical school, you must pass three licensing exams. USMLE (US Medical Licensing Exam!) Step 1, Step 2 CK, & Step 2 CS. Abdul El-Sayed did in fact complete this rigorous process, he’s as entitled to the title of physician as the rest of us.

[Craig Spencer MD MPH @Craig_A_Spencer]

I can tell you that my family in Michigan doesn't give a damn about this faux 'scandal'. I can also tell you a fixation and fetishization of 'title's and degrees is exactly why many of them hate the Democratic party.

@AbdulElSayed is a MD PhD Rhodes Scholar that successful ran Detroit's health department for years.

Plus, this isn't new news at all, it was reported years ago. But it conveniently became a big deal today when a new poll showed him in the lead.

Y'all, we need to get over ourselves. If he comes at you trying to do brain surgery, yeah, maybe its a thing. But if he's putting forward policy about the absolutely embarrassing mess that is health care is in this country, its hard to imagine anything that matters less.

[Rob Howse @howserob]

.@AbdulElSayed is a physician. In professional terms he could be described as a research physician or physician-scientist. This requires as MD but usually additional scientific training. This kind of doctor is concerned w advancing medical knowledge, they may interact w patients through research & clinical trials but not necessarily as a treating physician.

[Daniel Pham @danielxpham]

@mattheweadie22 I’ve been following Dr. Abdul El-Sayed for years since I started medical school in 2019. Now a resident physician actively seeing patients. This doesn’t bother me. He’s been upfront in various forums about not pursuing residency after medical school. He’s still a physician.

[Rachael Bedard @RBMD1982]

Lol, ok. Many such cases, friends - he got the MD, he gets claim it

[Daniel Pham @danielxpham]

doing internal medicine and psychiatry concurrently has made me appreciate this. we don’t discuss this enough in our medical training.

[Adam Gaffney @awgaffney]

Thoughtful essay on the problem with rigid constructions of mental health diagnosis — in truth, these are utilitarian categorizations of symptoms that exist on a spectrum.

Imho this applies beyond mental health to many "physical" diagnoses. For instance,

https://t.co/rEB7jHS1wG

[Adam Gaffney @awgaffney]

Thoughtful essay on the problem with rigid constructions of mental health diagnosis — in truth, these are utilitarian categorizations of symptoms that exist on a spectrum.

Imho this applies beyond mental health to many "physical" diagnoses. For instance,

https://t.co/rEB7jHS1wG

[Daniel Pham @danielxpham]

@awgaffney On call this weekend :( but planning for next year

[Daniel Pham @danielxpham]

@MaxJordan_N smartest attendings i know: dual certified in critical care + ID or Neph

[Ellen Barry @EllenBarryNYT]

As RFK Jr. sets out to rein in the use of SSRIs, a group of top psychiatrists are developing ground rules for helping patients get off medications, acknowledging that patients are often "parked" on a drug for years without any endpoint in sight. Comments are open.

https://t.co/QdEsEKPfoB

[Barry Switzer @Barry_Switzer]

Twenty five years tomorrow Oklahoma City Marathon was initiated with 3500 runners! Tomorrow there will be 30,000 runners, representing all 50 states and 17 countries.
Last week the Boston Marathon had 32,000 participants! @OKCNM @okcmarathon
@OU_Athletics @OU_Football

[Clement Lee, MD, MSc @ClementLeeMD]

False. The two largest NIH-funded studies of all time, the Women’s Health Initiative and the Framingham Heart Study, studied ONLY chronic diseases: cancer, menopause, heart disease, and osteoporosis.

[Adam Gaffney @awgaffney]

A new trial in Annals of Internal Medicine finds that an SSRI, fluvoxamine, reduces long-COVID-related fatigue, whereas metformin has no effect.

https://t.co/khYEu8cyyZ

[Adam Gaffney @awgaffney]

Unquestionably there is diagnostic upcoding, but apart from true fraud, what some such articles miss is that the very existence of billing prerogatives changes the very meaning of diagnostic categories that traditionally lack formal rigid boundaries.

1/7

https://t.co/MgZ7NRFU1F

[Adam Gaffney @awgaffney]

There's more medicine to know today than anytime in human history — bad time to cut the length of medical school by 4 to 3 years.

In 1231, a decree from Frederick II required medical school be 5 years — I think could have been shortened back then.

https://t.co/NasfbqklQ7

[Jonathan Fine @jonathanbfine]

Something big is happening

STEM is dead. CS jobs are gone.

I hate to break it to you, but we’re dealing with a

Total.
Technological.
Bloodbath.

The ONLY choice you have is to dedicate your life to the humanities.

Words. Books. Art. Music.

The only lifeline we have left.

[Adam Gaffney @awgaffney]

GLP-1’s are impressively effective, but they are not “miracle drugs” or a standalone intervention that can be adequately delivered a la carte outside primary care. Like much else in medicine their population health benefits will depend on …