Scott Truhlar
@ScottTruhlar
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Radiologist. Award winning financial educator. MD, MBA, and MS in Personal Financial Planning. Passed CFP® exam in 2008, not a CFP®. #FinTwit #Radiology
Iowa City, Iowa
Joined March 2013
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@adamcifu
There are so many Woozle's in regards to health. Two I particularly despise:
That it's healthy and necessary to drink eight 8oz glasses of water a day. Thats utterly made up.
And that "superfoods" are a real thing. It's a made up term that means nothing at all.
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@SPuro88
I fired a pt for aggressively swearing at my imaging center receptionist.
This is the power you retain when you are in private practice - YOU make the rules (within applicable laws and ethics, of course.)
Why again do people choose to work for big corporate entities?
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@AshleyGWinter
In my high school biology class we did a simple test to find out our blood type.
That is no longer done because too many children had blood types that could not have come from their biological parents and that led to parental drama and even violence.
True story.
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@CuomoPrimeTime
@drsanjaygupta
@ChrisCuomo
Your chest radiograph is normal Chris. Dr. Gupta doesn’t do this for a living. I do. Get well soon!
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@MrsPA_C
I was in a Masters level Social Policy class at
@LSESocialPolicy
before learning that *all US public/social policy* is predicated on a married, female, nonworking spouse as part of the assumed economic unit.
Once you know that, lots of ‘quirks’ in US policy make sense.
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In New York.
Another stratospheric job ad, and again, shades of 1998-2004 for me.
There are no Radiologists out there left to hire.
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Radiologists observing the evolution of CT imaging over the last 20 years.
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@ToddZywicki
@sgremminger
You are a Professor of Law, but publicly post this?
Find a school of medicine. Ask ten fellow Professors of Medicine what hours physicians work. Or maybe you have a clerk or research assistant that can do it for you.
That’s how easy it is to write truthful things on Twitter.
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We’ll call this segment “the one where Dr. Sanjay Gupta calls a normal chest X-ray abnormal.”
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Ok Radiologists, how about a little locums for $17,500/week?
Once again, for the people in back: There Are No Radiologists Left To Hire At Any Price.
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@TheBlondeRN
@DGlaucomflecken
He should have kept going with "and then while it is still young, it is trapped and consumed by the very body it is working so hard to keep alive."
May have been too much tho.
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@LilyBelfi
@CuomoPrimeTime
@ChrisCuomo
@RadChicks
Dr. Gupta should not have taken the bait when asked his opinion. Called a normal chest xray maybe abnormal. Cringey.
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Radiology partnership.
There are no Radiologists left to hire at any price.
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Mon - Fri I spent reading imaging studies of wicked new Covid pneumonia cases in 20-60 year olds.
Today, this happened one mile from my hospital, & across the street from the ICUs of the Univ hospital.
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@DGlaucomflecken
I survived by luck a “widow maker” MI eight weeks ago. I agree. I won’t live til I’m ninety but I will try to see my granddaughters go to college. Good enough for a man to ask for in this life.
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@citazworld
It seems totally rational. If you can't convince your employer to give you safe working conditions or compensation to entice you to provide your labor, then the right (ethical? moral?) thing to do is withdraw your labor. Health care workers are "essential" not "sacrificial."
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@morrisonMSK
If his knee has been stiff for greater than four hours he needs to go to the emergency room.
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@pjputh
It'll be overturned on appeal long before the judge completes all the training modules for EPIC.
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Radiology is complex knowledge work which does not lend itself to "just work faster." Rads have a set interpretations speed. No one asks musicians to "compose faster," computer coders to "code faster," authors to "write novels faster," or researchers to "research faster."
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@DGlaucomflecken
@shirleneobuobi
. . . because your depiction of all the other specialities is so, so attractive . . .
I guess if people want to be offended, they will be. You only ever make Ophtho look amazing, and that is a send-up of a different type.
Putting my dark glasses back on now & back to work!
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"1.1 Million Income Potential"
I'll say it again. There are no Radiologists left to hire.
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M4s. In case you SOAP this week, realize that 2-3 years from now no one will care or remember that you went through that process. I can go through the docs at my hospital and tell you which ones I would trust and which to avoid. I can’t tell you their med school or residency.
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Who is this frightening character living in my patient’s neck??
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@LongbowMkII
@PTMcGann
@pookleblinky
@MDaware
Even that’s not enough. I personally know people who had family members hospitalized with severe Covid and they still deny it was Covid. Because if that were true they’d have to admit that their preferred TV network might be lying to them about other things too.
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@emily_fri
I have been. Utterly destroyed lungs. May never come off ventilatory support. One after another after another. Puts an ache deep in the pit of my stomach.
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@NPRobertV
@AshleyGWinter
Had a gf whose grandparents had a genealogy embroidery (with dates) on their wall. Showed her dad was born at six months gestational age. I pointed it out to her and what it meant & she got FURIOUS that I would think her dad was created “illegitimately.”
Truth is hard for some.
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@PKLong62
@MrsPA_C
@LSESocialPolicy
And that *is* the safety net, and perhaps one that exists in many, many cultures around the world.
But for a rich modern nation's social safety net to *assume* the presence of those as the starting point of policy seems to reflect a time and place in the US that does not exist.
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@SocialAdmission
Joint Commission can’t ban drinking soda at work if you never put it down near a computer.
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@mahad_minhas
I can!
That type of back pain is caused by birthday candles.
The more candles, the more you get vague back pain.
You're welcome!
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“Understand why cost of medical school education is increasing in less than 60 seconds.”
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@DaniellekPenney
Yes, you are correct, that is what it was designed by and for. That is historically accurate.
Also some of the creators of the Residency system were addicted to cocaine … so there’s that, too.
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Radiology services used to be mostly provided during an 8 hour day.
Now expectation is ever increasing service for 3 8-hour shifts daily with the same national pool of radiology dept staff/docs.
Who's going to staff the other two shifts each day?
Who?
@RadiologyACR
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@DShadowgazer
The fact that it's a jellyfish and the history is "acute abdominal pain" is example
#8205836928
of "once again, nobody has done a physical exam on this patient prior to just ordering a bunch of radiology studies."
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@_zaynahjay
Yup, nailed it. 16 years into practice and I’m still seeing/learning about new diseases . . . some of which I then remember learning about once upon a time in training.
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@emily_fri
@DennisG_Shea
It's like having a boxing match with Mike Tyson. Even if you win the fight, you are not going to feel as good when you get out of the ring as when you went in. What does not kill you does not, in fact, make you stronger.
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@dougboneparth
You and Batnick gotta rein in these jokes man. People are going to believe this stuff.
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@DShadowgazer
The medical analogue of Cunningham's Law: "the best way to get the right answer on the internet is not to ask a question; it's to post the wrong answer."
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@pamelacolloff
True story: the first decade I worked at my hospital I never signed onto my hospital email account. I assumed if there was something important I would be contacted about the email. I was never contacted. For 10 years.
Think about that.
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Don’t know whose original work this is but it’s outstanding and I thought worth sharing.
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This week’s exhibit for admission into the court record in my ongoing case that “there are no Radiologists left to be hired at (almost) any price.”
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@RedStethoscope
@DGlaucomflecken
@Cigna
It's inexplicable why people say we have "the best system in the world."
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@NotechAna
@khemaridh
@dvassallo
@waitbutwhy
But did you print it off, hang it on your door, and fill it in as time passes?
Helps me focus on reality.
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@burgerpug69
Think “Makes sense, it’s 2020.” Then carry on. Just like every equivalent episode that has happened the rest of this year.
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@morganhousel
Twymans Law: if a statistic looks interesting or unusual, it is probably wrong
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“You might be in Kansas, if . . .
A beer run involves stepping over a dune of tumbleweeds.
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@traependergrast
I agree . . .it is literally what I tell people. If there’s anything else you were thinking you might want to do, do that. If there is literally nothing but medicine you can imagine, do medicine. The sacrifice otherwise isn’t worth it.
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@scubacuda999
@AshleyGWinter
Pretty sure I did that to my innate curiosity during Med school.
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@MateoFM3
@Dr_Michael_PJ
Q: “Have you traveled internationally in the last two weeks?”
A: “No, but we live in a hotspot and I work around Covid+ patients. Were you planning on warning the international places I traveled to?”
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@RogueRad
It’s amazing what good things can happen when you simply let professionals act professionally.
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Costs never drop in American medicine. Who gets paid may change, but cost never drops.
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@RegZeller
Futurists say less of us, realists say more of us, those of us working at the coal face just want a helper to make our day to day work go smoother and have less hassle.
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So many fundamental truths and great examples in here. I highly recommend the Farnham Street blog. First Principles: The Building Blocks of True Knowledge via
@farnamstreet
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Should . . . should I tell them? I feel like I should tell them.
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@alinabazarian
@DGlaucomflecken
See the frosted look of a Grey Goose bottle? (left) Thats ground glass. Resembles the “ground glass opacity in a chest CT (middle). Does NOT look like a “consolidation of a traditional bacterial pneumonia (right)
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@Amladydragonfly
@VotePulver
@DemsFight4U
Call it what it is - religion. Talking someone out of a religious belief is basically impossible, even after it nearly kills them, as this demonstrates.
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@charlajevans
@EMHighAK
@MiscSusan
Ok, being pedantic, but a “historian” is the person taking the history. A “poor historian” by definition is a doctor that isn’t good at taking a history, not a patient who doesn’t give a good history.
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@sgremminger
The Pediatrician didn’t count on the 1st pt of the day having a Wilms tumor & has a devastated mom and dad crying in the room she needed to spend time with.
That’s medical practice. What would you suggest she do to accommodate those types of events and not inconvenience you?
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@DShadowgazer
Hospital employees who pull up to the hospital ramp parking gate, THEN once fully stopped start digging around in their car/purse for their badge to open the gate. Like, I don't even come to a stop I keep rolling and my hand with badge is outside the car as I approach.
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Radiologists, the corporatization of our field by private equity will rob your future. Don’t sign up with them. They can’t exit without your participation! Read the linked piece for how they think and operate.
"This 'oversupply' of emergency physicians will likely never be apparent to the average patient sitting in an ER waiting room, where skeleton staffing has been thoroughly baked into the business model."
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@PeterBaggenst0s
@LadyDoctorSays
Same with the nurses that can demand elevated pay equal to the value they provide the hospital.
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Being able to walk to and from work each day makes me a very lucky Radiologist.
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TSA PreCheck has got to be one of the best purchases I ever made in my life.
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@savannah512
@travisakers
We in the hospital wear personal protective equipment at all times, and all in our walls wear masks. Princess and Pluto costumes are not PPE.
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@joshmcgoo
@gaydocpnw
OK but you may be missing the point. Medical systems are replacing physicians with non-physicians with practice authority all across America, and they’re doing it BY DESIGN to cut labor costs. It’s literally a display of “our worth” to them.
Sorry if that’s grim.
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@TheRealDoctorT
The Expanse. The visuals and music were beautiful, but they also always updated the intro slightly to reflect changes in the story. For example, the destruction of Deimos.
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@TCKMed
@BuckDancerMD
No I think that is just a badly rotated film wigging folks out. A rad tech needs to be called and images repeated before much can be said about it.
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Whoa. Although I felt the same paying $12,000 for a two man 4 hour job putting in a new AC and heating unit in my 1980's ranch house last week. Meanwhile I reading life-altering MRIs for $60 a pop.
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@DrPayItBack
Did you get shot *with* a bruise or did you get shot and *get* a bruise.
How would anybody ever know?
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@TheRealRhllor
@SPuro88
@DGlaucomflecken
Ortho bro has already been helping out in the ICU for a while! Just goes from room to room proning and repositioning patients like an absolute *unit!*
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@nntaleb
Did you check to see if this is true? My mom assumes things she sees on the internet are true, then I have to guide her through the process of checking them.
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@starstrickenSF
Your open sharing of this journey, and your effusive joy and agency in the face of what would make others quail, is going to save so many lives. I’m awed.
(And I still like to think there is a TED talk from you at the end of all this.)
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"If a monkey hoarded more bananas than it could eat, while most of the other monkeys starved, scientists would study that monkey to figure out what the heck was wrong with it. When humans do it, we put them on the cover of Forbes.” - Nathalie Robin
This is truly incredible.
Billionaire property developer Tim Gurner said in September that "We need to see unemployment rise. We need it to rise 40-50%. We need to see pain in the economy. We need to remind people that they work for the employer, not the other way around."
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@elliotthaut
@DShadowgazer
@ctisus
@PamelaJohnsonMD
@brianchiong
Well, you think you have the whole history. Radiologists live in a world where we ROUTINELY don’t get full or accurate histories. So, no, I’ll be vague until the histories are accurate and an actual physical exam has been performed by a physician on every single patient.
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@shmeshmergency
If I read a staging CAP CT at night, I’m delaying the care of the stroke, appy, trauma pt. That’s the reality of how ER radiology coverage works and isn’t good for any pt, radiologist, or ED doc.
Lack of perspective is *why* we don’t treat our family members after all.
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@UmoyeAlexis
The pandemic has proven living on a physical campus in a specific geographic location is completely unnecessary for most educational endeavors. But universities have massive investments in physical plant they need to justify.
Physical universities are now just a social club.
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@Drnicolecb
Same advice I give now. If there is nothing else a student can imagine doing, then absolutely go ahead and do medicine. If there is anything else they could imagine themselves doing, do that instead. Otherwise what you get isn’t worth what it costs you.
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@DGlaucomflecken
God I would love to be a fly on the wall hearing the chit chat amongst the clinic staff about that new Ophthomologist they hired two years ago.
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@olsonplanner
The correct way to say that is “would physician compensation go down MORE THAN IT HAS ALREADY DRIFTED DOWN FOR THE LAST 25 YEARS due to Medicare policy choices if single payer system is enacted.”
After inflation, we’ve had a 50% pay cut.
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Today's mass email supports my ongoing series entitled "There Are No Radiologists Left to Hire At Any Price."
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@clairezagorski
My CPR instructor said repeatedly: “You are attempting a resurrection, not a resuscitation. The pt has died and you are trying to bring them back and occasionally it will work, but usually it won’t. So don’t be too hard on yourselves.” Shocked me at the time. Not now.
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@dreamspace2
@Bobby__Aleman
@ElectProject
The difference would be that McDonald’s is playing a long game, and wants their sites to be successful. Private equity is a 5 to 7 year timeframe and they don’t give two hoots about what happens once they extract every bit of money possible.
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@DrLongissimus
Radiologists will just crouch like Shelob behind the 5-gauss fringe field in the MRI suite, waiting for metal-bearing victims to get sucked into and trapped in the bore of the magnet. Then once immobilized . . .
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FYI:
1. Doc incomes are basically stagnant, given payment gearing off the Medicare Conversion Factor which is where it was nominally in the mid 1990s.
2. Every year that passes is a year less of future income. All doc careers end. We aren’t a McDonalds or other equity business.
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