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We are underestimating the downside of our current system when we contemplate change. We need to take some risks to do better. #abimf2013
Harlan Krumholz
21.5K posts
Harlan Krumholz
@hmkyale
Harold H. Hines Jr Professor, Yale Univ; Director, YNHH CORE; Editor-in-Chief, JACC. Working to improve the future for those who follow us...
Yale School of Medicine
Joined September 2009
- So interesting… the choice for @YaleMed Commencement Speaker is @tiktok_us star @DGlaucomflecken …academia, your time has passed. This 36yo private practice doc has 2.5+m subscribers…and lots of influence through poking fun at the foibles of modern medicine. Sign of the times.
- Sleep as medicine... On behalf of hospitalized patients, what is we simply stopped ordering routine lab draws before 7am. What is we wrote an order, do not disturb before 7am except for an urgent need. Or an order for 7 hrs of peace and quiet. @FutureDocs nam12.safelinks.protection.outlook.com/?url=https%3A%…
- This is one of most important studies published this century. 29 teams used same data set to address same research question; estimated effect sizes ranged from 0.89 to 2.93 in odds-ratio units. Dramatic implications for observational research. @BrianNosek journals.sagepub.com/doi/pdf/10.117…
- “...first longitudinal imaging study in #COVID19 where patients initially scanned before contracted the disease.” An incredibly important @uk_biobank study… 'Brain imaging before and after COVID-19 in UK Biobank’ by an esteemed group. medrxiv.org/content/10.110… @medrxivpreprint
- Is Omicron benign? No. In our @JAMA_current study, led by @jeremyfaust, more all-cause excess mortality occurred in MA during the first 8 wks of Omicron period than during the entire 23-week Delta period. @YaleMed @harvardmed @YaleCardiology @EMRES_MGHBWH jamanetwork.com/journals/jama/…
- A friend is in the hospital…asked for test reports…was told he could not get them until after discharge. I suggested he ask again. He said he was afraid that it would make the staff angry and would affect his care. So chose not to ask. Real life. How patients experience care.
- My piece @nytimes: If You Have Coronavirus Symptoms, Assume You Have the Illness, Even if You Test Negative; 'It’s a lesson that endures throughout medicine: Look at the big picture, not a single piece of data.’ And false negatives seem common. nytimes.com/2020/04/01/wel… #COVID19
- I am beginning to doubt that a vaccine will get us out of this pandemic mess. There are many questions about immunity…and its sustainability. We should not wait to be saved. We need take responsibility for what we can control. It is possible to get it under control w/o vaccine.
- The paradox I cannot resolve w/respect to national policy: we let people go homeless, w/o food, w/o basic medical care; w/o social services…but if they get real sick we will spend millions to stand them up again and push them back to the land of on your own. Does it make sense?
- I learned something very very interesting today from Chinese colleagues… they prohibited doctors 60+ from the wards; they worked remotely because of the strong relationship between age and risk of death. They also worked to protect all healthcare workers w/protective gear.
- So the Lilly neutralizing antibody did not produce benefit. Regeneron cocktail has a v modest effect. Anticoagulation for ICU patients w/COVID didn’t help. Remdesivir has a v modest to no effect. HCQ & azithromycin don’t help. Except for dexamethasone…results have been sobering.
- How is it the UK is about to administer vaccines and the US is about to grant EUAs and other countries are providing them… yet we still have not seen preprints or publications. How can we promote trust without transparency. Data should be shared now. Public needs time to review.
- Wow, Bain survey says that 25% of clinicians are considering a switch in occupation. Even if they are overestimating by 50%, it is a huge number. How did we get here? Not paying attention to design & burden of today's healthcare from a clinician's perspective.
