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grepmeded's profile
GrepMed
GrepMed
GrepMed
@grepmeded

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GrepMed

@grepmeded

Image Based Medical Reference: Sharing crowd-sourced checklists, algorithms, decision aids, #PhysicalExam #POCUS, and more - by @GeraldMDMD + @k00bideh

Sacramento, CA
grepmed.com
Joined March 2018

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    1. John Mandrola, MD‏Verified account @drjohnm 31 May 2018
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      John Mandrola, MD Retweeted Harlan Krumholz

      I loved this commentary on the failings of the stethoscope. It’s unfortunate that many of the “stakeholders” of echocardiography put up road blocks to #POCUS < which elegantly allows us to examine the heart w our eyes. cc @EricTopolhttps://twitter.com/hmkyale/status/1002264836447834112 …

      John Mandrola, MD added,

      Harlan Krumholz @hmkyale
      There are some master clinicians, but on average, listening to the heart is not a good medical test. I wonder if it is time to admit it and employ new approaches in the routine examination. Maybe technology will give the exam a makeover. https://blogs.wsj.com/experts/2018/05/31/its-time-to-get-rid-of-the-stethoscope/ … https://twitter.com/demetria_g/status/1002254873398824962 …
      4 replies 3 retweets 29 likes
    2. Clinically Conservative Cardiologist‏ @DavidLBrownMD 31 May 2018
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      Replying to @drjohnm @EricTopol

      CT scanning is probably a lot more accurate than palpation or percussion. Should we give those up too? In fact why touch the patient at all? Just look at their images.

      3 replies 0 retweets 7 likes
    3. Shannon Brownlee‏ @ShannonBrownlee 31 May 2018
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      Replying to @DavidLBrownMD @drjohnm @EricTopol

      My son's pediatrician once detected his sinus infection by holding his head in both hands and smelling his nose. It was an intimate and caring act, and it instilled trust in my little son. Is there a technological way to diagnose? Sure. What's lost is the human connection.

      1 reply 1 retweet 6 likes
    4. Clinically Conservative Cardiologist‏ @DavidLBrownMD 31 May 2018
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      Replying to @ShannonBrownlee @drjohnm @EricTopol

      Exactly.

      1 reply 0 retweets 1 like
    5. Edward J Schloss MD‏ @EJSMD 31 May 2018
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      Replying to @DavidLBrownMD @ShannonBrownlee and

      Need also to consider the regulatory issues. I fear leaving out auscultation from the cardiac exam will violate CMS E&M requirements for E&M services. This is not a trivial issue as RAC auditors specifically look for these violations and assess what can be huge penalties.

      1 reply 0 retweets 1 like
    6. Edward J Schloss MD‏ @EJSMD 31 May 2018
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      Replying to @EJSMD @DavidLBrownMD and

      Here’s the original source. Asking for lifeline from @CardiologyCoder. Can we substitute POCUS for cardiac auscultation and still meet documentation requirements? https://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNProducts/downloads/referenceii.pdf …pic.twitter.com/JwExnpRakE

      2 replies 0 retweets 0 likes
    7. Jim Collins, CPC CCC‏ @CardiologyCoder 31 May 2018
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      Replying to @EJSMD @DavidLBrownMD and

      POCUS is a dx. test, not a physical exam. Either the 1995 or the 1997 guidelines apply - whichever is more beneficial. The 1995 guidelines https://goo.gl/7pJ38j  will always be best for cardiology, they don't prescribe exam elements. The source referenced is the 1997 set.

      3 replies 0 retweets 0 likes
    8. John Mandrola, MD‏Verified account @drjohnm 31 May 2018
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      Replying to @CardiologyCoder @EJSMD and

      This may be correct technically, but it’s anachronistic now. PCOUS is an extension of the physical exam. #FOAMed

      3 replies 0 retweets 0 likes
      GrepMed‏ @grepmeded 31 May 2018
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      Replying to @drjohnm @CardiologyCoder and

      unfortunately outside of the ED and ICUs myself and the residents have to twist arms to get access to one of these things on the floors...

      2:29 PM - 31 May 2018
      0 replies 0 retweets 0 likes

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