Dear physician, The reward for being an altruistic, conscientious, hardworking achiever is more work. The system knows this. That’s why it constantly gives you more responsibilities but never takes any away. It knows that you will find a way even if it means sacrificing yourself. The solution is not to abandon who you are. The solution is to recognize you are being exploited and advocate for yourself. Set your boundaries.

US nonprofit hospitals spent $7.8 billion on management consultants from 2009 to 2023, but contracts were not associated with meaningful changes in finance, operations, or quality of care. 🧵 ja.ma/4d46zfq

One of the most expensive mistakes a man can make is to carry responsibility without carrying authority, because once you are expected to absorb pressure without being able to shape outcomes, you stop becoming valuable and start becoming convenient to exploit for other people’s comfort.

Hospitals have convinced a generation of doctors that the building is the value. (Funny how that theory disappears the second there is a lawsuit) Without doctors: no admissions, no surgeries, no procedures, no E&M billing, no facility fees, no DRGs, no MCC/CC capture, no 340B scripts, no quality metrics. The building collects the fee. The doctor creates the value. That is the relationship. Time physicians started acting like it.

The cover of the Lancet. It says it all.

Bro has just launched the ultimate description of today’s Russia

Amazing article exposing how Big Pharma abuses the patent process to artificially inflate lifesaving drugs: bit.ly/4iRX3Pg

This should be the new mid-city L line above Western Ave in Chicago (proposed in the 70s), instead it’s 🇨🇴 Bogotá.

Thanks for being a poster judge at the symposium, @InkedHeartDoc. The #Midwest #CardioOncology Symposium in #Chicago was a wonderful success! With over 100 attendees and 24 posters—plus even more abstracts submitted—it was a vibrant day of learning, networking, and idea exchange. Students, trainees, and attendees left energized, better equipped to care for #patients and move forward in their careers. That was the heart of our mission. #CardioTwitter #MedTwitter #MedEd #Cardiology #Oncology #Pharmacy #Medicine

Great to meet such a great cardio-onc group during the regional Cardio-onc symposium on current paradigms in CV care of cancer patients and survivors #cardiotwitter #CardioOnc

Very dramatic visual

✨ Exciting day at @CookCountyHealth! Starting fellowship interviews for the next generation of cardiologists. Grateful to be part of the recruitment committee and to meet the brilliant minds shaping the future of cardiovascular care. ❤️🫀 #Cardiology #MedTwitter #Fellowship

NPO before elective cath lab? Data say rethink it. 1/ SCOFF RCT (Eur Heart J 2024, n=716): primary safety composite 12.0% (no-fast) vs 19.1% (fast) → non-inferior & superior, with higher patient satisfaction. 2/ TONIC (JACC:CI 2024, n=739): ad-lib food/drink vs standard fasting before coronary procedures → primary composite 8.2% vs 9.9% = non-inferior; less hunger/thirst. No food-related adverse events. 3/ CALORI (JSCAI 2024, n=198): liberal oral intake up to the procedure vs NPO after midnight → better well-being & satisfaction, no safety penalty (no ↑ emesis/aspiration/intubation). 4/ AJCC 2024 RCT (n=197): heart-healthy diet allowed vs NPO before elective cath → no safety signal, satisfaction ↑; thirst/hunger ↓. 5/ 📌 Big picture: Across multiple RCTs, routine NPO for elective cath under conscious sedation isn’t supported—comfort improves, safety is comparable or better with non-fasting. Time to modernize protocols. 💬 What’s your lab doing? #CardioTwitter #FOAMed

Join us: rushcardio-oncologysymposium… in #Chicago, on Oct. 3rd. The abstract submission window has now closed, but it's not to late to register. Excited for an amazing day of learning in #CardioOnc, geared towards all involved in #cancer care. #physicians, #oncology, #cardiology, #internalmedicine, #pharmacy, #AdvancedPracticeProvider, #nurses. #MedEd #MedTwitter **Free for #medicalstudents, #residents, #fellows. @NMHheartdoc @sdent_cardioonc @Dr_Mike_Fradley @AartiAsnaniMD @DSadlerMD @md_addison @SPauwaa @AbusinSalah @braun_lynne @avirupguha @nakhtermd @RushUniversity

Fibrinous deposits/small thrombi are common on leads, especially when using tee or ice jacc.org/doi/10.1016/j.jacep…

This will be absolutely devastating in the medical field. ~30% residents are international medical graduates & ~10k of 43k residency spots are filled by docs with H1-B visas. Previously the h-1B fee was <$5,000. No hospital will pay a $100k fee for a $55k resident salary.

Reliability of left ventricular global longitudinal strain across acquisition and analysis techniques: a prospective comparative study @JGrapsa @EZancanaroMD @denisamuraru @VDelgadoGarcia @saramoscatelli7 @SilCastelletti academic.oup.com/ehjimp/arti…

Your heart beats ~100,000 times a day. When was the last time you checked how well it’s doing? 🫀✨ 👀 Echo tells a story your stethoscope can’t… So tell me… Is your heart 🙂 or overwhelmed and 😕 #Cardiology #Echo #Heart

Medicine teaches precision. Training teaches resilience. Both demand consistency. Every rep, every heartbeat, every patient—it all adds up. What’s harder to stay consistent with? 🏋️ Training 💼 Work 🧠 Mental health 🍎 Nutrition”