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The Phlegmfighter
@phlegmfighter
#proclimate #pronuclear #professor #pulmonary #intensivist #diagnosis #decisionmaking #clinicalreasoning #probability #firstgen #truthteller #BSdetector
West Desert
Joined December 2013
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    The Phlegmfighter
    @phlegmfighter
    Oct 28, 2024
    Here is our article that defines and disambiguates both #ockhamsrazor and #hickamsdictum for #differentialdiagnosis link.springer.com/article/10.100… And a blog post with additional information: medicalevidenceblog.com/2024/10/hickam… And tweetorial as promised
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    The Phlegmfighter
    @phlegmfighter
    Dec 18, 2021
    Hey, y'all my I'm headed off today to staff an overworked [COVID] ICU in a remote area in the Southwest for a week. Looking forward to an adventure and to decompress some overworked docs. Wish me luck and please get vaccinated! #COVID #pandemic #newmexico #nthwave #anothersurge
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    The Phlegmfighter
    @phlegmfighter
    Oct 21, 2022
    23-year-old female. Ask me questions.
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    The Phlegmfighter
    @phlegmfighter
    Jan 24, 2020
    Took med stud into patient room to see a proper history taking today. By the time we left, we had diagnosed (possible) invasive S. pneumoniae *despite* a normal chest CT. 5 hours later, blood cultures + for strep. History taking is the quintessential skill of #diagnosis #rigors
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    The Phlegmfighter
    @phlegmfighter
    Apr 16, 2022
    PSA: You *CANNOT* use a "bougie" or Eschmann Intubating Stylet to do an endotracheal tube exchange. I have seen this mistake twice in the past 6 months. You will lose the airway. A simple look at the length of the bougie and an #ETT will make this clear.
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    The Phlegmfighter
    @phlegmfighter
    Sep 8, 2019
    #vapingpneumonia #vaping #vapinglunginjury #lipoidpneumonia
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    The Phlegmfighter
    @phlegmfighter
    Sep 13, 2018
    After u talk to a family & write a DNR/DNI & morphine for comfort order: “Why isnt he on Comfort Care Only? Why are we giving antibiotics? Why arent we pulling the feeding tube? Why is he still getting XYZ?” Because DNR/DNI is where we left it. And it was hard. Dont get greedy.
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    The Phlegmfighter
    @phlegmfighter
    Dec 28, 2024
    First time working with a 1st-year fellow. I had to issue my now-standard warning: don't dismiss/deflect #consults on first contact. Nowadays, many/most of the folks calling you have not had internal medicine or residency training, and they don't even know what the question is
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    The Phlegmfighter
    @phlegmfighter
    Jun 27, 2022
    This just out: Physicians do not logically/correctly estimate the probability of outcomes resulting from sequences of events - a thread. #conjunctionfallacy #probability #medicaldecisionmaking #clinicalreasoning #innumeracy #numeracy jamanetwork.com/journals/jaman… @JAMANetworkOpen
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    Physicians’ Probability Estimates of a Medical Outcome Based on a Sequence of Events
    From jamanetwork.com
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    The Phlegmfighter
    @phlegmfighter
    Apr 5, 2020
    The Phlegmfighter is taking the fight to the virus. You can too. Join us. #COVID #COVID19 #NYC #epicenter
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    The Phlegmfighter
    @phlegmfighter
    Mar 28, 2025
    Replying to @DrToddLee
    Agree But a positive analysis in an elderly woman with mental status changes in low blood pressure in the ICU is a UTI until proven otherwise and the pendulum should not swing too far
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    The Phlegmfighter
    @phlegmfighter
    Nov 3, 2024
    Exactly. I don’t want to overwork you but when you bounce early and I follow you on Strava and you immediately go out and do a 15 mile run, I’m thinking you’ve got plenty work life balance. Too much, in fact.
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    Vinay Prasad MD MPH
    @VPrasadMDMPH
    Nov 3, 2024
    There is a balance. We worked too many hours but some (not all, nor even most) young doctors want to bounce early and seem uninterested in learning. The profession talks endlessly about wellness but not how to improve our practice. Workaholic is bad but so is lazy.
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    The Phlegmfighter
    @phlegmfighter
    Jul 22, 2023
    In my 1st yr of fellowship ('01-'02), Roy Brower wrote an inscription on an article reprint that he himself wrote after I vigorously debated an issue with him that was covered in the article. He scrawled "To Scott - Don't believe everything you read! - Roy" - an anecdote
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    The Phlegmfighter
    @phlegmfighter
    Aug 5, 2024
    You’ve heard the saying “ uncommon presentations of common diseases are more common than common presentations of uncommon diseases.” Here is a picture that explains the adage followed by a more in-depth explanation #clinicalreasoning #medicaldecisionmaking
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