Mixed Nuts, Unsalted ✅ Just Accepted 🔗 https://bit.ly/44FUDwL

Thank you for making me just realize I am the og "nottheogdrv" and I am going to definitely own this, Dr. Adamson. ("The one and only!" It is so meta, as the kids say.) Would love for folks to have a read. Grateful for Drs. Sara Bares and Paul Sax for helping us elevate our voices in ID.

Paul Adamson MD MPH@padamsonmd.bsky.social · 4w ago

A great essay on maintaining our humanism in medicine. Definitely worth a read! By the one and only @nottheogdrv.bsky.social Mixed Nuts, Unsalted academic.oup.com/cid/article/...

And this is how it is. Perversity in Medicine — When Vocation and Corporatization Clash | New England Journal of Medicine www.nejm.org/doi/full/10....

Perversity in Medicine — When Vocation and Corporatization Clash | NEJM

Increasingly, in the age of corporate medicine, the fundamental values of U.S. health system leaders and clinicians are diverging, to the detriment of trust, communication, morale, and patient care.

nejm.org

Curious if folks here have come across this new fancy thing in healthcare called self-funded plans. Employers choose insurers who cover non specialty drugs and then contract with another company who helps them budget the cost of specialty drugs that they cover out of pocket.

Who is up for a 5am talk on antibiotics at the end of life (the week of daylight savings no less)? Thanks for inviting us BIDMC Gen Med and previously the MGH ID group. 🌇

Dan Karlin is an essential part of my community. (He also was my "phone-a-friend" in a prior piece I wrote.) The path ahead: Building community between palliative care and infectious disease teams - Clinical Microbiology and Infection www.clinicalmicrobiologyandinfection.org/article/S119...

I have tried to use my personal social media accounts to reach my loved ones to think about re-framing polarizing global viewpoints. The events of the last week, though, were too much to bear. But this quote is holding me up: Fear is a reaction, Courage is a decision. Thank you, Rebecca Denison. ❤️

Thanh Neville, MD, MSHS@thanh-neville.bsky.social · last yr.

My friend's @nottheogdrv.bsky.social fb post was heartbreaking. She went to an international #HIV conference, where #NIH & #CDC collaborators were notably absent. #HIV disproportionately affects vulnerable populations--and the word "vulnerable" has been targeted. This is so shameful. #medsky

Loved doing this qualitative study with Dave Dickson, former UCLA resident, current Stanford ID fellow. Some amazing quotes here. 🌊 Feeling the Vibes: An Investigation into Resident Antibiotic Prescribing Practices url: academic.oup.com/ofid/article...

Feeling the Vibes: An Investigation into Resident Antibiotic Prescribing Practices

AbstractBackground. Efforts to improve inpatient antibiotic prescribing are limited by a lack of insight into the complicated decisions around antibiotic u

academic.oup.com

#Cefixime is an alternative treatment for #gonorrhea, typically when #ceftriaxone isn’t available or feasible, but clinical data are limited, esp in areas w/ high #AMR Here, we report outcomes from patients treated with cefixime in Hanoi 🇻🇳 🔗 academic.oup.com/cid/article/... #STIsky #IDsky 1/

Cefixime for the Treatment of Neisseria gonorrhoeae Infections in a Setting With Increased Antimicrobial Resistance: A Retrospective Study in Hanoi, Vietnam

In Vietnam, cefixime effectively treated rectal and urethral gonococcal infections but showed higher pharyngeal NAAT positivity at test of cure (TOC) compa

academic.oup.com

So many gems here, including a breathtaking piece by Andrew Sullivan in that famous year, 1996, when AZT, 3TC and protease inhibitors in combination changed everything.

Paul Sax@paulsaxmd.bsky.social · 8mo ago

“AZT killed more people than AIDS” is false. I was a medical resident in the late 1980s. AZT wasn’t perfect, but it saved lives and was the first step on the way to modern HIV therapy. Evidence, history, and context here. paulsaxmd.substack.com/p/no-azt-did...

MGMA wRVU benchmarks are ⬆️ again. I want to understand what (and who) drives these decisions. From my perspective, forcing doctors to see more patients in the same amount of time results in MORE expenditures because no one has time to think. This drives more tests, more consultations.

Today I shared with my med student that her piece definitely has a home somewhere, but the sting of rejection is real no matter what. I don't know if anyone else needs to hear that. To paraphrase Beckett: Ever tried, ever failed, try again, fail better. (Pic of just 2 MDs after a 75-story climb.)

Reducing Antimicrobial Use at the End of Life url:https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2838657. Thank you for the opportunity to write this commentary on a great piece by Jeong-Han Kim and colleagues in South Korea, @eliowa.bsky.social.

Colleagues- in case this was missed during summer vacation, please share. I just went to the Bowl again last week and saw Yo-Yo Ma and Angelique Kidjo. The Bowl is not the only reason to be in LA....but it is pretty spectacular. Also my ASP team is just the bee's knees.

Tara Vijayan@nottheogdrv.bsky.social · last yr.

Please consider joining our incredible faculty and ASP program at UCLA Health. Los Angeles is an incredible city and always will be. recruit.apo.ucla.edu/JPF10331

I was reading a handwritten timed essay I wrote on Hamlet in AP English. My teacher, who in hindsight was a saint, gave me an A- for ideas and a B+ for structure and cautioned me against superfluous citations. (I learned so much from her.) Handwritten essays may be one way to mitigate AI influence.

Really important Med Ed piece in NEJM. "Diagnosis-related group and payment models based on relative value units (RVUs) incentivize volume over value, with little focus on collaboration or coordination efforts" www.nejm.org/doi/full/10....

Navigating the Discontinuity Crisis in Medical Education | NEJM

Discontinuity negatively affects patients, learners, and health care systems. Changes that create continuity could improve both patient outcomes and the learning environment for medical trainees.

nejm.org

#TeachID #idsky #idmeded #meded #idfellows #idfellowship @cidjournal.bsky.social State-of-the-ART Reviews: STAR reviews are great for new fellows/faculty: Abx at End of Life academic.oup.com/cid/article/...

State-of-the-Art Review: Use of Antimicrobials at the End of Life

Abstract. Navigating antibiotics at the end of life is a challenge for infectious disease (ID) physicians who remain deeply committed to providing patient-

academic.oup.com

There are many important perspectives and ideas to share in medicine at this moment that are more important than mine. But this is a reminder of why I keep doing what I do, despite everything. I would be honored if you took the time to read it. www.nejm.org/doi/full/10....

Libraries Burned, a Life Lived | NEJM

As her patients near the end of life, an infectious disease physician who knows their stories sometimes needs to step out of her proverbial lane to help them assess and achieve their goals of care.

nejm.org

Took my kids to their first protest. 1000s showed up in our sleepy little part of LA County. It was beautiful and peaceful. My favorite chant was "We stand united. We'll never be divided." 🇺🇸🗽

Please consider joining our incredible faculty and ASP program at UCLA Health. Los Angeles is an incredible city and always will be. recruit.apo.ucla.edu/JPF10331

Working on this chalk talk at home and feeling some graduation vibes. 🎓 Share feedback or your own examples of what I am trying to impart here.

You've Got a Friend in Me: Curbside Questions Infectious Diseases Clinicians Ask Infectious Diseases Pharmacists ✅ Just Accepted #IDSky

You've Got a Friend in Me: Curbside Questions Infectious Diseases Clinicians Ask Infectious Diseases Pharmacists

This multicenter study highlights the critical role of ID pharmacists in supporting ID consult services, with 89% of 1,518 curbside inquiries from ID clinicians resulting in clinical management changes as recommended by the pharmacist. These findings emphasize the necessity of ID pharmacists in optimizing multidisciplinary patient care.

doi.org

Because I am on Bluesky today: Phosphate binders (dosed TID in patients on HD!) are a major problem for PWH on INSTIs (most!). But it is NOT discussed often enough. In my experience it has been very hit or miss whether it impacts the VL. I welcome thoughts from my #IDbluesky PharmDs and HIV MDs.

87% of NBA basketball players are between 6 feet 3 inches and 7 feet tall. About 14% of males in the United States are over 6 feet tall. 0.002% of all US college athletes are transgender. Maybe we should ban tall people from competitive sports to give the short people a chance.

So much to say here. The FFS/RVU with benchmarking also merits quantity over quality. I love all my ID colleagues. They definitely care. But I worry that some may succumb to the plug and chug, copy forward approach. Many notes have become unreadable these days. (It is not just us.)

Paul Sax@paulsaxmd.bsky.social · last yr.

We love what we do. But yes, we’d also like to get paid. ID is a cognitive, consult-heavy specialty -- and often a “loss leader” in a fee-for-service world. A look at how the money actually flows (or doesn’t), Part 1. #IDSky blogs.jwatch.org/hiv-id-obser...

State-of-the-Art Review: Modern Approach to Nocardiosis ⭐The duration of antibiotic treatment is understudied and based on few data ➡️ can be shortened if harms begin to outweigh potential benefits ⭐~5% develop recurrence ➡️ close monitoring needed doi.org/10.1093/cid/... #IDSky

Breaking News: A federal prosecutor interrogated the The New England Journal of Medicine — which is considered the world’s most prestigious medical journal — in what its editor described as a “vaguely threatening” letter.

‘Vaguely Threatening’: Federal Prosecutor Queries Leading Medical Journal

The New England Journal of Medicine received a letter suggesting that it was biased and compromised by external pressure. Other journals have also received the letter.

nytimes.com

“Such anti-LGBTQ legislation, including the censorship of accepted medical terminology, can have several downstream effects on patients, including dissuading patients from seeking care, resulting in higher rates of sexually transmitted infections and human immunodeficiency virus (HIV) acquisition.”

Tara Vijayan@nottheogdrv.bsky.social · last yr.

Reposting this State-of-the-Art review, and adding an accompanying editorial I wrote to honor and celebrate those who persist and to show compassion for those who remain silenced. academic.oup.com/cid/advance-...

Reposting this State-of-the-Art review, and adding an accompanying editorial I wrote to honor and celebrate those who persist and to show compassion for those who remain silenced. academic.oup.com/cid/advance-...

Executive Orders and Caring for Our Transgender Patients

Within hours of the presidential inauguration on 20 January 2025, the new administration signed an executive order that formally rejected gender identities

academic.oup.com

Tara Vijayan@nottheogdrv.bsky.social · last yr.

This State-of-the-Art review could not be better timed. academic.oup.com/cid/article/.... We were thrilled to have Nick Van Sickels & colleagues (from Kentucky, Hawaii & Louisiana) write this excellent piece, highlighting the importance of inclusive care & informed consent. @cidjournal.bsky.social

🚫Inhaled corticosteroids treat or cure measles. 🚫Clarithromycin (an antibiotic) can treat measles. With so much information out there, it can be hard to know what’s true. Learn the facts: www.idsociety.org/public-healt...