David N. Alter MPH MD DABCC🧬
@ClinChemMD
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The Director of Clinical Chemistry @EmoryPathology ; Associate Professor-Clinical Chemistry is Pathology’s connective tissue. #LabMedX 30-24 #GoBlue 2023〽️🏆 🟦
Atlanta GA
Joined March 2009
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SEVENTEEN
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土用の丑の日
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Is anybody seeing or hearing about patients that clinically are COVID19 but test negative??
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Best “Scrubs” quote IMO: Hematopathologist: What can I do for you?
JD: I was hoping that you could recheck Ben Sullivan’s blood smear.
HP: That depends, do you actually think I made a mistake or do you wish I did?
JD: I kinda wish you did.
HP: (smiling kindly)Then I’ll do it.
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37,000 died in 2019 from seasonal flu; 41,000 have died in six weeks in 2020 from COVID19
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@DGlaucomflecken
A institutional rule where the highest paid salary is capped at 7x the lowest paid salary
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What would’ve happened if John Snow had not been allowed to remove the pump handle because the neighborhood associated refused to let him? Retweet if you know the reference without looking it
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Whoo Hooo!!!! A long haul over a difficult path but here I am!!!
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COUGH VARIANT ASTHMA is asthma WITHOUT wheezing!!! Retweet, educate and save some lives!!!
@gretchemaben
@RyanMarino
@EmergencyMedBMJ
@EMEducation
@em
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@Gabby_Brauner27
I also find those comments real irritating!!! Nobody complains about 8 figure hedge fund managers but being a physician to some, means you shouldn’t earn a good salary 🤦♂️
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@DShadowgazer
Pathology: do a frozen section to confirm its snow and send a sample to the lab for confirmation
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Once Again:
Pathologists are Clinicians. The only distinction being we are not the treating or patient facing physician
Please retweet
#MedTwitter
#PathTwitter
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@DShadowgazer
Parents with their first child Parents with their second child Parents with their third child
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@BillKristol
Do you think the SEALs realize that they have now been painted as above the law dishonorable gruesome civilian killers because of Trump’s actions
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Fellow Attending Physicians; lets all remember to call residents as “Dr”, they have earned it!! Please retweet!
@medicalaxioms
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@gretchemaben
@PedsHemeDoc
@acweyand
Of the people, that I follow, I thought the three of you would appreciate it the most!
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As a pathologist, I really don’t like most abbreviations (except for test names) esp. WNL: a) to me it means “We Never Looked” & b) nobody is really “normal” instead we are “asymptomatic healthy”. “Normal” in my opinion can be a very subjective term.
@medicalaxioms
@BenMazer
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@DShadowgazer
Rheumatology : Start a course of prednisone or rituxamab and see if it goes away
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@paulkrugman
@john_chu
I think we should all send postcards to Mitch McConnell with one comment “Remember Merrick Garland” I say this as a Republican who was annoyed that MM changed the rules.
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Non Healthcare Workers: when you see flagged (“abnormal”) results on your patient portal, its natural to be worried & contact your Doctor. Knowing 95% of those abnormal results have no clinical significance; how could they be better presented to allay fear?? PLEASE RETWEET!!!
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@gtconway3d
It occurred to me this morning that if the hearings hadn’t been private Republicans would’ve insisted that they should’ve been
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@BeauWillimon
@eileen_gunn
I like to think that none of this would’ve happened if McConnell hadn’t blocked the Garland nomination
#merrickgarland
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PATHOLOGY RESIDENCIES need good people! If you are the student that likes the science, the pathology, chapter references, if you feel an emptiness due to the lack of pathologic disease education! Consider a residency in Pathology!!!
#MedStudentTwitter
@JMGardnerMD
@DrFNA
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@DGlaucomflecken
the problem is not you the problem is that Welch Allyn only makes its ophthalmoscope in one color and u had the absolute nerve to cutesy up a medical device with eyes, mustache, beard and a hat. How dare you! Shame, Medical Humor is now officially dead, I will do the autopsy
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PATHOLOGISTS are CLINICIANS: dont let anybody tell you otherwise!!!
#pathtwitter
repost please
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The Supreme Court voted 6-3 in favor of accepting unlabeled specimens.
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“70% of all medical decisions depend on laboratory results”not sure abt the evidence; but no physician can deny that clinical lab testing has a frequent role in patient care.
#LabWeek2022
to all my nonPath followers; DON’T FORGET TO WISH YOUR LABORATORY STAFF, A HAPPY LAB WEEK.
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@WarrenKinghorn
@KristinCollie20
@UMich
The students prob wouldn’t have walked out if SCOTUS hadn’t overturned RoeVWade; taking away a woman’s right to privacy & her right to guide her own healthcare. Prior to the overturning, it was a “we can agree to disagree” now its“we control your body/we know what’s best for you”
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Bloodbank response to IR ordering 2u FFP for an INR of 1.6
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@DGlaucomflecken
And the presenter replies (everytime) “…..great question…. We considered that angle…..we are going to have to consider that for our next study…..that is correct but let me show you where our assumptions differed…..”
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@BromoSouthern
As an intern; I knew I had achieved respect when the RNs only called o/n once to renew med orders in batch as opposed to onesies twosies all noght long
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@JoeNBC
Irony- The candidate that ran on a platform of law, order and Amercan values in opposition to the candidate touted as the coming of communism and socialism trying to throwout votes and cancel an election because he didn’t win.
@jaketapper
@JoeNBC
@maggieNYT
@CuomoPrimeTime
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Best opening sentence for Biden’s inaugural address:
“Before I begin, we should all have a moment of silence for those that have died in the last 11 months from COVID19”
@jaketapper
@ChrisCuomo
@maggieNYT
@JoeBiden
@vivek_murthy
@CarlosdelRio7
@jeremyfaust
@meganranney
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@olsonplanner
What I dont get is why other high income positions arent as vilified. As if, we have to be embarrassed for our relatively high incomes
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@realDonaldTrump
In other words, the investigation is happening because I couldn’t obstruct it from the start
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Political rant w/ healthcare implications. Instead of deciding who gets bailed out or not; why isn’t the government buying unsold produce from the farmers and re-distributing to the people out of work??? Why Is the Government letting good food gets thrown away?? Please Retweet
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Trump sees mistakes, I see a scientist grappling with a rapidly evolving epidemiologic viral pandemic establishing, evaluating and discarding (as needed) hypothesis on a day to day basis. We are foolish if we think lay people can understood the concept of the scientific method.
I am deeply disturbed that an expert like Fauci, member of
@theNAMedicine
&
@theNASEM
Lasker Award winner (2007) and Presidential Medal of Honor awardee (2008) is being not only sidelined by but also smeared by
@WhiteHouse
This is THE EXPERT. Doing so makes us weaker!
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I have a hypothesis that we will eventually learn/discover that SARS-CoV-2 serologic diagnosis involves multiple “components” similar to HepB or EBV testing
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And yet Physician salaries are the problem???
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#ShareAStoryInOneTweet
StVincents Hospital NYC 91-93 too numerous to count KS PCP PML MDRTB CRYPTO and so on.... we have come a long way.. they came in and died
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@joshmcgoo
Typical, blame the lab- show me your evidence- probably because a specimen was collected by a non phlebotomist using a too small needle and aspirating back strongly on the syringe
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@jhary_lee
@jtrebach
Knowing to think of the zebras even though we mostly see horses is what distinguishes physicians. We are taught “When you hear hoofs, think horse, not zebra.” However, I maintain that Hospitals are a zoo not a ranch.
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Pathologists are Clinicians; Don’t, tell yourself, or let our direct patient care facing colleagues convince you; otherwise.
#Pathtwitter
Retweet to spread the message
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@ryannpdatsme
For me; it was,
when a CDC/Emory Faculty person told us at a faculty meeting, “…brace yourselves….in two weeks the world is going to go to sh
#t
…”
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@theblondeMD
THINK ABOUT Asking your evaluators “Did I meet/exceed/not the expectations of a PGY1 surgery resident and if not; “can you specifically explain, why” also if this was an issue throughout the year, “why wasnt I told sooner?”
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Happy Lab Week!! Please Retweet if you are a laboratory professional. If you aren’t one; remember to say “thank you” this week and always!
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@kidney_boy
Easier than making personal statements; reimburse the PCP for preventive medicine as much as the specialist earns for fixing the consequences of “non prevention”
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@Kyle_Feldscher
Herd immunity math for the nonbeliever
US population 300 Million
60 to 70% infected needed for herd immunity
COVID19 pick the fatality rate that you like estimates range from 0.65 to 4%
Do the math yourself.
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@RpsAgainstTrump
NATO is NOT A BUSINESS ARRANGEMENT!!! It is a mutual defense treaty!!!! 🤦♂️
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@JamesGleick
ITS VERY SIMPLE;reducing the testing, reduces the number of identified cases;however, since individuals don’t know they are positive; they will unknowingly infect others; leading to more cases more hospitalizations and more and more deaths!
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Personal Milestone for me!! cowrote 54.Bone and Mineral Metabolism & have authored the same for the 9th edition of Tietz Fundamentals of Clinical Chemistry. Astounding what I have been able to accomplish (and how much more I could have done) since my arrival
@EmoryPathology
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#MedTwitter
#MedStudentTwitter
#MedEd
As I say choose the specialty that resonates with you with the epiphanic moment “..OMG, I could do this the rest of my life and love it till I retire….” If you choose a specialty for the wrong reasons, you will regret it!
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@Laurie_Garrett
@NewYorker
@nytimes
@POTUS
stepping down would be an unmitigated disaster for
@TheDemocrats
; no other candidate stands a chance at this stage; worse it would project an image of weakness, indecision for the Democratic Party that would never be healed. Am I the only one that sees that!!!
@rimmnick
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All you Fauci haters/deniers; shame on you! Feel free to unfollow me &if you are a physician; you should really know better! he is the ultimate synergy of clinical internal medicine, immunology, virology& infectious diseases based on his editorships, publications and experience.
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#PathTwitter
The Clinical Chemistry rotation should be the rate limiting step for evaluating a pathology residency program! In my biased opinion, if a program has a committed/engaged CC rotation, you can be confident that the rest of the program (esp. CP) is excellent as well!
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30 more followers needed to crack the 3000 barrier! Clinical Pathologist specializing in Clinical Chemistry/Chemical Pathology everyday bridging the gap btwn direct patient care clinicians & clinical laboratory! W/ a passion for SciFi movies & The University of Michigan-GoBlue!!
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@HarkerDavid
@medicalaxioms
I’ve taken some of those calls And dealt with the issue. Last one there was a critical care doc and a physiatrist: I am immediately ceded authority to the critical care doc but Took a great good history from the patient’s relative
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@thehill
@GovRonDeSantis
What if the truck driver needed a loan to learn how to drive a truck??
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@thehill
I think we should all send postcards to Mitch McConnell with one comment “Remember Merrick Garland” I say this as a Republican who was annoyed that MM changed the rules.
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Most Surgical Pathologists (especially those in private practice) looking at Clinical Pathologists
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Shame on
@washingtonpost
&
@EricTopol
4 conflating lab developed tests w/medical errors- Its a specious argument as many “LDTs” are baked into routine daily clinical decision making 4 the last 50yrs ; e.g. drug/hormone lvls by LC-MS or pleural/peritoneal fluid tests are LDTs
Each year in the U.S. there are more than 12 million medical diagnostic errors. This is one of the root causes that needs to be addressed
today's
@washingtonpost
editorial
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@AshleyGWinter
Did you ever hear about the guy asked to collect a 24h urine?
The next day, he came in and told the nurse that it was unfortunately it was only 23h, 45min — the nurse said how could it be that?
He replied “..I couldn’t hold it in any longer…”
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#Pathtwitter
#Medtwitter
- first time overseas several years ago in Edinburgh; we had the pleasure to stay at a hotel near this homage to the history of medicine and forensic pathology.
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Once again;
Alanine Aminotransferase ALT & Aspartate Aminotransferase AST; ARE NOT LFTs (markers of Liver Function)!!! They are makers of hepatocyte integrity!! Markers of liver function are; PT (F7), Albumin, PreAlbumin & Bilirubin.
#MedTwitter
#MedEd
#PathTwitter
@Pathologists
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@Gabby_Brauner27
Don’t forget iF in the light of day the ED says why didn’t you bring him in last night; You vocally remind them that you were advised not to
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#medstudenttwitter
Pathologist shortages are a coming! Average comp +300K; excellent lifestyle! Don’t let your medical school dissuade you! If you feel that medschool was an unsatisfying meal; EXPLORE PATHOLOGY AS A CAREER!!! PLZ retweet!
@BenMazer
@JMGardnerMD
@alcampbellmd
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@joshchafetz
To those who believe this demeans the office of the President, it does.
However, this president has reset downwards the standards of the office of the President, so nobody should ben surprised.
“Whatsoever a a man soweth, that shall he also reap” Gal VI
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@JunodColton
@medicalaxioms
Evolution of doctors....1980s/1990
Undergrad: "wow, they wear pagers
Med school: "Wow I can't wait to get a pager
Residents: "Wow I can't wait to get rid of the pager; I hate the pager; the pager is my enemy
Attendings: "What nerve do you think you have paging me!
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This is what makes us laboratory people freak out. 70% of all lab errors happen before they even get to the lab!!!!
@joesph_wiencek
@JMGardnerMD
@jhuntpath
@LabConcisionDoc
@JLaudadioMD
Lab tweeples PLEASE RETWEET
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#pathtwitter
Academic pathologists without significant research funding;
Why are you in an Academic practice instead of a more lucrative nonAcademic practice??
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@MsCourtneyBurns
You should talk to someone
@umichmedicine
about his wildly inappropriate comments
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@justinamash
Justin! We have your back! Keep fighting for the constitution! History will label you as a true patriot!
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@acweyand
Could have been worse; it could have been mtx for rheumatoid arthritis that he refused to fill because it can used for an abortion
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