Tom Levin, MD

husband, father, cardiologist, photographer, cyclist, musician/music lover, drummer and sound engineer for The Interlopers

[C. Michael Gibson MD @CMichaelGibson]

The mean age of physicians who leave clinical practice in the US is now 48.1 years, 9 years younger than observed in a similar cohort in 2008.

The biggest causes cited were stress and the hassles of practice.

11% of women decided not to even enter practice.

What are your thoughts about this?
https://t.co/eXmYbeOoOF

[Tom Levin, MD @tlevin]

@DrJayMohan @drjohnm I think much of Laao is industry driven.

[Tom Levin, MD @tlevin]

@RitikaTuliMD How was the x axis defined?

[Ritika Tuli @RitikaTuliMD]

❤️ #CardioNuggets

Some exercise > none.

Even small activity → big ↓ CV risk.

Guidelines:
👉 150–300 min/wk moderate OR
👉 75–150 min/wk vigorous (+ strength 2 days) (NCBI)

👉 Consistency > intensity

#CardioNuggets #Prevention

[Tom Levin, MD @tlevin]

I’m not sure if this is a win or not given all the controversy surrounding the ABIM. but, it’s necessary to maintain staff privileges. #cardiology #boardcertification.

[Tom Levin, MD @tlevin]

@Hragy At times, there’s an over exuberance particularly among younger ICs to offer the latest and greatest technology because it’s ‘doable’ without fully considering other alternatives and long term hard endpoint outcomes. Sometimes the ‘old ways’ are better

[Tom Levin, MD @tlevin]

@progrocksongs @Mikehomeseller @rushtheband Absolutely

[Tom Levin, MD @tlevin]

@jbspadoni I can't imagine doing a left main in the current era without IVUS guidance

[Tom Levin, MD @tlevin]

@jbspadoni Agree 100%. Unclear if results are related to less than optimal study design or excellent operators.

[Tom Levin, MD @tlevin]

@SVRaoMD Perhaps this relates to the design of the trial and the skill of the operators. Im evidence based but im not doing a left main without IVUJS guidance

[Rush @rushtheband]

Rush performs Finding My Way live | 2026 Juno Awards - YouTube https://t.co/jbWuUYg70p

[Tom Levin, MD @tlevin]

Lots of truth here

[Anthony DiGiorgio, DO, MHA @DrDiGiorgio]

When a patient is in the hospital, doctors used to use paper notes to communicate with one another.

In the EHR era, the note stopped being a clinical communication tool and became a billing and compliance artifact. The results have been a disaster.

One JAMA study found notes got 60.1% longer from 2009 to 2018, while redundancy rose 22%. ONC has explicitly acknowledged that clinicians use templates to stuff notes with unnecessary information into the chart to meet billing requirements, creating note bloat.

The clinical note was no longer a method of communication. It was a billing document.

So hospitals layered secure chat on top just to communicate the actual plan of care. And even that workaround is not working.

A 2024 JAMA study found more secure messaging was associated with more time on the phone, not less. Doctors needed to call to clarify the now constant message stream.

Another study found higher messaging volume was associated with higher odds of errors. More messages means a higher cognitive load with most of the information being low-importance. This increased cognitive load leads to more errors.

We took what should have been efficiency improving technology, a computerized chart, and so over-regulated it and misaligned incentives that it has led to harmful downstream effects.

Now, please don't do this with AI...

[Tom Levin, MD @tlevin]

@fmfclips Really?

[Tom Levin, MD @tlevin]

@DrMarthaGulati Agree but the geni is out of the bottle and we have to deal with it. Can’t recall a test that has generated so much disagreement and consternation. Add in our litigious society, CAC scores are becoming the bane of our existence.

[Tom Levin, MD @tlevin]

So true

[C. Michael Gibson MD @CMichaelGibson]

The most invasive cardiologist is the non-invasive cardiologist #cmgsays

[Eric Topol @EricTopol]

The stuff you don't need but more than half Americans take every day
by @alicegcallahan
gift link
https://t.co/im96TI8ECg

[Brandon Luu, MD @BrandonLuuMD]

Dog ownership was linked to ~40% lower odds of disabling dementia.

There was no protective signal for cat owners.

[Tom Levin, MD @tlevin]

@djc795 @Hragy Spot on

[Dr Terry Simpson @drterrysimpson]

Longevity gurus sell certainty. Science sells boring wins.

Real longevity isn’t peptides, rapamycin cosplay, ice baths, or supplement stacks with no human outcome data.

What actually works in humans:
• Mediterranean or DASH eating patterns
• Normal blood pressure
• ApoB <70 mg/dL (lower if high risk)
• Don’t smoke
• Don’t drink alcohol
• Move your body, sleep, repeat

There is no biohack