NNP ⚡️

[Keith Siau @drkeithsiau]

When I see a patient who has been starved of water for more than 8 hours before a procedure.

[NNP ⚡️ @ncpjs_]

@jaicabajar Ang goal ko nalang ay sana hindi na ako PH citizen by then 😂

[NNP ⚡️ @ncpjs_]

If you are a health care professional (esp if an MD!) I recommend you go through this app and see which diagnoses you can use and which you cant (sadly may mga diagnosis pag wala sa list walang claim!!)

Anyway yun lang dami ko nang sinabi 😂 not an expert but feel free to ask 😂

[NNP ⚡️ @ncpjs_]

tagal ko nang hindi nag ttwitter but I had time today, so lets dig in

the amount of Philhealth (PH) reimbursement is based on the declared case rate of the diagnosis

[𝒈𝒉𝒊𝒂 ʚïɞ @kittieknows]

decades of contributions, 127k yung hospital bill ko tapos 7.8k lang yung bawas sa philhealth 💀

[NNP ⚡️ @ncpjs_]

But a diagnosis with a higher case rate? “Subacute alcoholic hepatic failure,” which, by definition captures the pt’s clinical case.

So MDs should also be aware of the rates.

Win-win ito: pt’s get bigger bill deductions, MDs and hospitals get larger reimbursements as well.

[NNP ⚡️ @ncpjs_]

I feel seen

[Skylar ✨ @Skylar_Lorena]

Funny how the busiest people always reply fastest. Asked my mentor and she said, letting things linger means you'll have a backlog to revisit, and delaying communication also holds up other people's work, which means efficiency is compromised. I've seen it. I believe it 🙂

[NNP ⚡️ @ncpjs_]

Ang tunay na talo dito sa laban ng kadiliman vs kasamaan ay ang mamamayang Pilipino. God bless na lang.

[NNP ⚡️ @ncpjs_]

@kyleugenio Get ready to feel like nakikiduty ka lang sa kanila and it might not be a nice feeling 😂

[NNP ⚡️ @ncpjs_]

@kyleugenio you’d be surprised (or maybe not) kung gaano ka behind sa actual evidence based medicine ang ibang ospital at doktor lol

[NNP ⚡️ @ncpjs_]

@grecombm @rayragasa @kimpauldecastro @pawikanpandesal @jimsarsagat Congrats Richard!!! 😂

[NNP ⚡️ @ncpjs_]

i remember so many people

[Keith Siau @drkeithsiau]

The iron saga continues 😅

[NNP ⚡️ @ncpjs_]

@liyyow1111 Kung adult yan baka naman cirrhosis 😅 pero kung pedia, check mo lang ibang labs/ symptoms hehe

[NNP ⚡️ @ncpjs_]

Today’s good news came in the form of a message from a rheumatologist several kms away, thanking me for the early recognition of a pt’s lupus.

This young female presented w abdo pain (everyone’s least favorite chief concern 😅) with nonspecific SGPT elevations.

[NNP ⚡️ @ncpjs_]

A mentor once told me, “when you hear hoofbeats, think horses not zebras,” but I also learned over time that you have to know what these zebras look like so you don’t resort to making diagnoses of ‘atypical horses’ 😂

Anyway, yun lang hehe also ty po P/GH for the clinical eye.

[NNP ⚡️ @ncpjs_]

What I found unusual was that she had lymphopenia, thrombocytopenia, and incidental minimal pleural effusion and ascites on abd US.

Long story short, I sent her to a rheum MD (which was hours away, since we don’t have one in the province 😢), who confirmed the diagnosis.

[NNP ⚡️ @ncpjs_]

@ellamimasamayor 😂 darating ka rin sa era na yan

[NNP ⚡️ @ncpjs_]

sometimes low-key inggit, but mostly happy for my fellow doctors’ travel eras 😂 especially knowing na for YEARS after finishing college, ang hirap maghanap ng time/ money/ energy for travel 😂