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My top ten tips for graduating fellows and faculty entering and continuing “early career” as I am transitioning into “mid-career”. A thread:
Andrew J Sauer MD
20K posts
Andrew J Sauer MD
@AndrewJSauer
Cardiologist @MidAmericaHeart, building programs to implement therapies, advance discovery, and foster innovation for patients suffering from heart disease.
- 🔥 this just in Patient could not afford SGLT2i that I prescribed for HF. Understandable and common challenge. Patient called insurance. Insurance directed patient to glimepiride which would cost $5 Patient wants Rx for glimepiride. This now requires 30 minutes of
- A patient on my service died. I have spent hours now reviewing the case. Many lessons learned. But need to be honest. I feel like a failure. We don’t really talk about these feelings. We tend to dismiss them. Medicine is not just humbling. Sometimes it’s plain defeating.
- Medical staff meeting to discuss “resiliency” just scheduled at 6:50 AM on Friday morning. 😳Wish I was making a joke. But no, just reporting reality.
- I just put in my note, “if the insurance company peer MD wants to deny my patient sac/val being Rx for symptomatic HFrEF with EF 30% this would be denying patient Class I guideline recommended therapy—which is malpractice.” #GDMTWorks Yeah, I’m going there now.
- Replying to @allisonoconnDisagree. It’s actually the best way to learn anatomy. And get some dissection skills. I honestly can’t think of an alternative. And every “dead human body” was donated with full understanding of what we would be doing. Gross anatomy is still a good thing for medical students.
- I will be stepping down as Section Chief effective July. My goals from then forward will be focused on clinical care, scholarly activity and innovations, as well as continuing to serve my family at home. I want to be a better Dad and take better care of myself. Lead in a new way.
- Heart failure is more deadly than most cancer diagnoses. Let’s treat this disease with greater respect. Putting heart failure into remission means giving the disease our best fight. Carvedilol 6.25 and losartan 25 and see you next year is not our best. I’m here all day.
- Didn’t work on a manuscript, a presentation, or respond to an email today.
- For the new cardiovascular fellows about to begin, congrats on the new adventure! My ten tips to follow:
- Six months ago I saw a new patient with EF only 15%. Today, I saw him to give great news, no ICD needed because EF now 55% on BB, MRA, ARNI, SGLT2I. #FunctionNotFailure. #GDMTWorks @JJheart_doc @gcfmd @DrNasrien @JonathanDavisHF @gmac78 @dranulala @SJGreene_md @noshreza
- Rounding tips for the new attending cardiologist. With a few 🥵 takes, focused on efficiency, IMHO after doing this many different ways for nearly a decade. A thread 🧵
- Replying to @cmmtchllIt’s definitely a challenge and we do all we can to raise resources for assistance within the limits of the law and managed care. But to refer a patient to a completely different medication class is malpractice and insurance companies pull this nonsense too often
- Heart failure cardiologists when somebody stops the spironolactone for K of 4.5:
