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gorskon's profile
David Gorski, MD, PhD
David Gorski, MD, PhD
David Gorski, MD, PhD
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@gorskon

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David Gorski, MD, PhDVerified account

@gorskon

Surgeon/scientist promoting science in medicine and exposing quackery. Editor of Science-Based Medicine. My opinions do NOT represent those of my employers.

Michigan, USA
sciencebasedmedicine.org
Joined October 2009

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    1. Matthew Loxton‏ @mloxton 12 Jul 2019
      Replying to @JHowardBrainMD @gorskon

      um .. yes … but.. I sense that you are heading off down the wrong path. Medical errors are not "something the clinician did wrong" but a deviation from the desired outcome, and far more about the process than the person The doc is just one element of one dimension of causationpic.twitter.com/MhOEpKlOzT

      3 replies 0 retweets 2 likes
    2. Jonathan Howard‏ @JHowardBrainMD 12 Jul 2019
      Replying to @mloxton @gorskon

      I mean I’ve had patients die. It was never the desired outcome.

      1 reply 0 retweets 0 likes
    3. Matthew Loxton‏ @mloxton 12 Jul 2019
      Replying to @JHowardBrainMD @gorskon

      Right, so re VoC. The value-based care aspect of quality is that you as physician and your patient are a team, and you will jointly agree health outcomes that are to be the measure of care quality. High quality = meeting pt health goals Low quality = not meeting them

      2 replies 0 retweets 0 likes
    4. Jonathan Howard‏ @JHowardBrainMD 12 Jul 2019
      Replying to @mloxton @gorskon

      And to my point that, at times, an "error" can be made no matter what.pic.twitter.com/DrKzKdfH5m

      1 reply 0 retweets 2 likes
    5. Matthew Loxton‏ @mloxton 12 Jul 2019
      Replying to @JHowardBrainMD @gorskon

      Yes! and 3. You assessed the pt as not needing opioids, they became dysregulated later at home due to pain, and suicided We could have a really long discussion here on whether a bad outcome is necessarily a medical error, but that maybe distracts from more likely error modes /2

      1 reply 0 retweets 1 like
    6. Matthew Loxton‏ @mloxton 12 Jul 2019
      Replying to @mloxton @JHowardBrainMD @gorskon

      For example - pt got the wrong medication - wrong concentration - wrong dose - wrong frequency - drug-drug interaction There are a lot of near misses, and far too many injuries or deaths from preventable errors

      1 reply 0 retweets 0 likes
    7. Jonathan Howard‏ @JHowardBrainMD 12 Jul 2019
      Replying to @mloxton @gorskon

      No one would deny those are preventable errors. I just don’t think 20% of Americans die because they were given the wrong med in the hospital. Or the wrong patient was operated on.

      1 reply 0 retweets 0 likes
    8. Matthew Loxton‏ @mloxton 12 Jul 2019
      Replying to @JHowardBrainMD @gorskon

      Neither do I But until a revised estimate comes along that is better, I will tolerate the number 3 on the whiteboard. In the meantime, I will focus on the practical level of patient journey

      1 reply 1 retweet 1 like
    9. Jonathan Howard‏ @JHowardBrainMD 12 Jul 2019
      Replying to @mloxton @gorskon

      Lord knows quacks use this number as a marketing tool.pic.twitter.com/hg2K64uPTI

      2 replies 0 retweets 3 likes
    10. Matthew Loxton‏ @mloxton 12 Jul 2019
      Replying to @JHowardBrainMD @gorskon

      Of course they do.. Now try to argue that there are all these statistical things wrong with the measure, and we don't really know what the right measure is, but trust us, we aren't nearly this bad. See how the quacks seize on that one as proof positive we are a bunch of liers

      2 replies 1 retweet 1 like
      David Gorski, MD, PhD‏Verified account @gorskon 12 Jul 2019
      Replying to @mloxton @JHowardBrainMD

      And if you think the quacks won't keep cherry picking those numbers and claim "cover-up" if better, lower numbers are published, you're astonishingly naive.

      2:57 PM - 12 Jul 2019
      • 1 Like
      • Lloyd Frombriz
      1 reply 0 retweets 1 like
        1. New conversation
        2. Matthew Loxton‏ @mloxton 12 Jul 2019
          Replying to @gorskon @JHowardBrainMD

          David, in what universe do you think this continually abrasive and rude tone is either useful or professional? Knock it the hell off, will you? Act like a person Yes, improving on the existing numbers will result in far less leverage for quacks than setting fire to it

          2 replies 1 retweet 3 likes
        3. David Gorski, MD, PhD‏Verified account @gorskon 12 Jul 2019
          Replying to @mloxton @JHowardBrainMD

          Says the guy who's pretty darned abrasive himself.🙄

          2 replies 0 retweets 1 like
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