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 …
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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.
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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.
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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.
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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
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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.
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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.
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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...
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