gkirschh

rheumatology fellow. UB ➡️OSU➡️UF. white coat avoider. Sports, music, memes, video games, and the occasional medicine take.

[gkirschh @gkirschh]

@EricTopol @midjourney The bony cortex of the skull would like a word with this “whole body ultrasound”

[gkirschh @gkirschh]

@EBRheum Free? Is there a catch ?

If not thank you. There’s a huge gap with ACR not producing any CARE questions anymore

[gkirschh @gkirschh]

@PulmCrit administrators used to come into our resident workrooms and ask why we hadn't used the pre-built sepsis order sets w/ 30 cc/kg fluid orders... you would also get a "kudos" (currency to the hospital gift shop) if you did use their order set.

[gkirschh @gkirschh]

@CardioNP @Papa_Heme See a rheumatologist that does MSK ultrasound … if you put three rheums in a room to examine they would all tell you something different re inflammatory vs non inflammatory pain. Ultrasound is the arbiter of truth

[gkirschh @gkirschh]

@Papa_Heme Guilty as charged… but will always try and get the M protein, FLC, and quant immunoglobulins to make your life easier

[Dutch Rojas @DutchRojas]

Your “nonprofit” hospital has an $8M CEO, a bond-rated real estate empire, and a tax exemption. But the facility fee on your 12-minute MRI is just to “keep the lights on for the community.” Sure.

[Anthony DiGiorgio, DO, MHA @DrDiGiorgio]

This is the ultimate midwit healthcare take.

No, 32 countries have not “figured out” universal healthcare.

The UK has “free” healthcare, and roughly 1 in 3 cancer patients in England still fail to start treatment within 62 days of urgent referral.

Canada has “free” healthcare, and the median wait for neurosurgical treatment is around a year.

Australia has “free” healthcare, and over half the country still buys private insurance despite paying for a public universal system with their taxes.

Switzerland has universal coverage, because residents are required to buy private insurance. There is no government system where benevolent bureaucrats tuck you in at night with a warm blanket and an MRI appointment.

The actual lesson from other wealthy countries is not “they figured it out.”

America’s system has huge problems. Our prices are insane, insurance markets are distorted, and hospital systems are cartelized. Our regulations make care more expensive than it needs to be.

Yet we still guarantee access to even the 8% who don’t have coverage. We give easy routes to qualify for medicaid for those with disabilities.

Pretending the rest of the world solved healthcare because they slapped the word “universal” on a rationing scheme is not analysis.

It is bumper sticker policy for people who think access means having a card in your wallet while you wait a year to see the doctor you need.

[gkirschh @gkirschh]

@morrisonMSK Those sesamoids can add up

[gkirschh @gkirschh]

Josh Doan

[gkirschh @gkirschh]

@hjluks Tendinitis???? Also presumptive terminology

[greg @greg16676935420]

IRS: you owe us taxes

Me: how much do I owe?

IRS: you get to figure that out

Me: can I just pay what I want?

IRS: no we know exactly how much you owe but you have to guess the number too

Me: what if I guess wrong?

IRS: jail

Happy tax day!

[gkirschh @gkirschh]

@Papa_Heme Spill more of the tea…

What is making one of the most heterogeneous multi systemic diseases clearly lupus ?

[gkirschh @gkirschh]

@CoffeeBlackMD Modern survival of the fittest

[gkirschh @gkirschh]

@RheumMSKUS Feel like I’ve never seen an erosion on the lat epi. Very cool images !

[gkirschh @gkirschh]

@kidney_boy Use case is steroid sparing, less infectious complications, and in those with worse renal function at diagnosis seems to have better gfr recovery…

However will say I have discontinued it in 2/4 pts I put on it due to transaminitis

[Madeon @madeon]

album 3 is done

[gkirschh @gkirschh]

@PulmCrit The longer I have been in medical training the more I analogize medical training to a guild

[gkirschh @gkirschh]

@CoffeeBlackMD These ones usually come with pANCA positivity… but there is usually discordance with upper and lower airway involvement

drug induced: p ANCA + upper airway
MPA: p ANCA + lower airways
GPA: c ANCA + upper airways

[Nick shirley @nickshirleyy]

🚨 Here is the full 40 minutes of my crew and I exposing California fraud, Minnesota was big but California is even bigger... We uncovered over $170,000,000 in fraud as these fraudsters live in luxury with no consequences. Like it and share it, the fraud must STOP.

We ALL work way too hard and pay too much in taxes for this to be happening. These fraudsters have been able to defraud American taxpayers for years without any pushback from the public and politicians.

It is time to EXPOSE IT ALL and end America's fraud crisis.