mdchat twitter healthcare chat for january 18, 2011

8/8/2019 MDchat Twitter Healthcare Chat for January 18, 2011

1/17

#MDchat

Healthcare Hashtag Twitter Transcript

From: Tue Jan 18 18:00:00 PST 2011

To: Tue Jan 18 19:15:00 PST 2011

Learn more about #MDchat at The Healthcare Hashtag Project

s_eller Good evening everyone - Susan here - RN & Educator at Medical School in Chicago #mdchTue Jan 18 18:00:51 PST 2011

EinsteinMed Hey crew! Paul here from Albert Einstein College of Medicine. #MDchatTue Jan 18 18:01:12 PST 2011

EllenRichter Hi there folks! Its #MDchat hour I see! Hope everyone is doing well! Ellen here, an ICU nurse

Legal nurse consultantTue Jan 18 18:01:42 PST 2011

GailZahtz #leadershipchat Thank for letting me drop in. Have to go put on my medical coat and stop by

#MDChatTue Jan 18 18:01:49 PST 2011

RichmondDoc Mark, family doc in #RVA; glad to see familiar faces here, and ready for another hour of activ

discussion! #mdchatTue Jan 18 18:02:30 PST 2011

Mtnmd @EllenRichter Hi, Ellen, great to see you - and everyone. #mdchatTue Jan 18 18:02:46 PST 2011

s_eller @EllenRichter, @GailZahtz@njfrantz - good evening #mdchatTue Jan 18 18:02:57 PST 2011

EinsteinMed @njfrantz Niles - good to see you on... Paul #MDChat

Tue Jan 18 18:03:12 PST 2011

EllenRichter @Mtnmd@RichmondDoc Hi to you too! :) #MDchatTue Jan 18 18:03:45 PST 2011

CrescendoCG Good evening, everyone. Beth here. #mdchatTue Jan 18 18:03:48 PST 2011

njfrantz Good to be seen :) #MDchatTue Jan 18 18:03:56 PST 2011
http://www.foxepractice.com/healthcare-hashtags/MDchat/http://www.foxepractice.com/healthcare-hashtags/http://www.twitter.com/s_ellerhttp://www.foxepractice.com/healthcare-hashtags/mdchat/http://www.twitter.com/EinsteinMedhttp://www.foxepractice.com/healthcare-hashtags/MDchat/http://www.twitter.com/EllenRichterhttp://www.foxepractice.com/healthcare-hashtags/MDchat/http://www.twitter.com/GailZahtzhttp://www.foxepractice.com/healthcare-hashtags/leadershipchat/http://www.foxepractice.com/healthcare-hashtags/MDChat/http://www.twitter.com/RichmondDochttp://www.foxepractice.com/healthcare-hashtags/RVA/http://www.foxepractice.com/healthcare-hashtags/mdchat/http://www.twitter.com/Mtnmdhttp://www.twitter.com/EllenRichterhttp://www.foxepractice.com/healthcare-hashtags/mdchat/http://www.twitter.com/s_ellerhttp://www.twitter.com/EllenRichterhttp://www.twitter.com/GailZahtzhttp://www.twitter.com/njfrantzhttp://www.foxepractice.com/healthcare-hashtags/mdchat/http://www.twitter.com/EinsteinMedhttp://www.twitter.com/njfrantzhttp://www.foxepractice.com/healthcare-hashtags/MDChat/http://www.twitter.com/EllenRichterhttp://www.twitter.com/Mtnmdhttp://www.twitter.com/RichmondDochttp://www.foxepractice.com/healthcare-hashtags/MDchat/http://www.twitter.com/CrescendoCGhttp://www.foxepractice.com/healthcare-hashtags/mdchat/http://www.twitter.com/njfrantzhttp://www.foxepractice.com/healthcare-hashtags/MDchat/http://www.foxepractice.com/healthcare-hashtags/MDchat/http://www.twitter.com/njfrantzhttp://www.foxepractice.com/healthcare-hashtags/mdchat/http://www.twitter.com/CrescendoCGhttp://www.foxepractice.com/healthcare-hashtags/MDchat/http://www.twitter.com/RichmondDochttp://www.twitter.com/Mtnmdhttp://www.twitter.com/EllenRichterhttp://www.foxepractice.com/healthcare-hashtags/MDChat/http://www.twitter.com/njfrantzhttp://www.twitter.com/EinsteinMedhttp://www.foxepractice.com/healthcare-hashtags/mdchat/http://www.twitter.com/njfrantzhttp://www.twitter.com/GailZahtzhttp://www.twitter.com/EllenRichterhttp://www.twitter.com/s_ellerhttp://www.foxepractice.com/healthcare-hashtags/mdchat/http://www.twitter.com/EllenRichterhttp://www.twitter.com/Mtnmdhttp://www.foxepractice.com/healthcare-hashtags/mdchat/http://www.foxepractice.com/healthcare-hashtags/RVA/http://www.twitter.com/RichmondDochttp://www.foxepractice.com/healthcare-hashtags/MDChat/http://www.foxepractice.com/healthcare-hashtags/leadershipchat/http://www.twitter.com/GailZahtzhttp://www.foxepractice.com/healthcare-hashtags/MDchat/http://www.twitter.com/EllenRichterhttp://www.foxepractice.com/healthcare-hashtags/MDchat/http://www.twitter.com/EinsteinMedhttp://www.foxepractice.com/healthcare-hashtags/mdchat/http://www.twitter.com/s_ellerhttp://www.foxepractice.com/healthcare-hashtags/http://www.foxepractice.com/healthcare-hashtags/MDchat/


2/17

AnthonyBurich Good evening - Anthony, RN student following along. #mdchatTue Jan 18 18:03:59 PST 2011

KathyKastner Greetings all. Kathy Kastner patient eductor. of sorts. #MDchatTue Jan 18 18:04:04 PST 2011

EllenRichter @njfrantz@GailZahtz Welcome~ #MDchatTue Jan 18 18:04:14 PST 2011

EinsteinMed @SarahBethRN Welcome! Thanks for joining. #MDChatTue Jan 18 18:04:44 PST 2011

s_eller @KathyKastner@sarahbethrn - welcome #mdchatTue Jan 18 18:04:53 PST 2011

s_eller @philbaumann - hello Phil #mdchatTue Jan 18 18:05:08 PST 2011

RichmondDoc @fidouglas Discussion on #MDChat is pretty broad: our fearless moderator suggeststopics/questions, and the rest is up to us participants.Tue Jan 18 18:05:55 PST 2011

EllenRichter What a nice turnout! Hi @KathyKastner@sarahbethrn@AnthonyBurich and of course

@PhilBaumann! #MDchatTue Jan 18 18:06:09 PST 2011

MD_chat T1 Withholding Info: Are there times when w/holding info from patients is ethical & less harm

than truth? See http://qr.ae/Yw2l#MDchat

Tue Jan 18 18:07:04 PST 2011

EllenRichter @GailZahtz Thanks for the intro! I didnt know you! But now I do :) #MDchatTue Jan 18 18:07:09 PST 2011

RichmondDoc @fidouglas Feel free to listen in & see how this flows; my caution is that if one starts as a lur

one ends up in the discussion. #mdchatTue Jan 18 18:07:16 PST 2011

GailZahtz Aw, TY for the shoutout welcomes! @EllenRichter@s_eller@Mtnmd#MDChatTue Jan 18 18:07:23 PST 2011

fidouglas @RichmondDoc Starting off as a lurker. Here goes... #MDchatTue Jan 18 18:07:53 PST 2011

KathyKastner Indeed and hi 2 u RT @EllenRichter: What a nice turnout! Hi @KathyKastner@sarahbethrn

@AnthonyBurich and of course @PhilBaumann! #MDchatTue Jan 18 18:08:07 PST 2011

AnthonyBurich @EllenRichter Greetings to you! #mdchatTue Jan 18 18:08:14 PST 2011
http://www.twitter.com/AnthonyBurichhttp://www.foxepractice.com/healthcare-hashtags/mdchat/http://www.twitter.com/KathyKastnerhttp://www.foxepractice.com/healthcare-hashtags/MDchat/http://www.twitter.com/EllenRichterhttp://www.twitter.com/njfrantzhttp://www.twitter.com/GailZahtzhttp://www.foxepractice.com/healthcare-hashtags/MDchat/http://www.twitter.com/EinsteinMedhttp://www.twitter.com/SarahBethRNhttp://www.foxepractice.com/healthcare-hashtags/MDChat/http://www.twitter.com/s_ellerhttp://www.twitter.com/KathyKastnerhttp://www.twitter.com/sarahbethrnhttp://www.foxepractice.com/healthcare-hashtags/mdchat/http://www.twitter.com/s_ellerhttp://www.twitter.com/philbaumannhttp://www.foxepractice.com/healthcare-hashtags/mdchat/http://www.twitter.com/RichmondDochttp://www.twitter.com/fidouglashttp://www.foxepractice.com/healthcare-hashtags/MDChat/http://www.twitter.com/EllenRichterhttp://www.twitter.com/KathyKastnerhttp://www.twitter.com/sarahbethrnhttp://www.twitter.com/AnthonyBurichhttp://www.twitter.com/PhilBaumannhttp://www.foxepractice.com/healthcare-hashtags/MDchat/http://www.twitter.com/MD_chathttp://qr.ae/Yw2lhttp://www.foxepractice.com/healthcare-hashtags/MDchat/http://www.twitter.com/EllenRichterhttp://www.twitter.com/GailZahtzhttp://www.foxepractice.com/healthcare-hashtags/MDchat/http://www.twitter.com/RichmondDochttp://www.twitter.com/fidouglashttp://www.foxepractice.com/healthcare-hashtags/mdchat/http://www.twitter.com/GailZahtzhttp://www.twitter.com/EllenRichterhttp://www.twitter.com/s_ellerhttp://www.twitter.com/Mtnmdhttp://www.foxepractice.com/healthcare-hashtags/MDChat/http://www.twitter.com/fidouglashttp://www.twitter.com/RichmondDochttp://www.foxepractice.com/healthcare-hashtags/MDchat/http://www.twitter.com/KathyKastnerhttp://www.twitter.com/EllenRichterhttp://www.twitter.com/KathyKastnerhttp://www.twitter.com/sarahbethrnhttp://www.twitter.com/AnthonyBurichhttp://www.twitter.com/PhilBaumannhttp://www.foxepractice.com/healthcare-hashtags/MDchat/http://www.twitter.com/AnthonyBurichhttp://www.twitter.com/EllenRichterhttp://www.foxepractice.com/healthcare-hashtags/mdchat/http://www.foxepractice.com/healthcare-hashtags/mdchat/http://www.twitter.com/EllenRichterhttp://www.twitter.com/AnthonyBurichhttp://www.foxepractice.com/healthcare-hashtags/MDchat/http://www.twitter.com/PhilBaumannhttp://www.twitter.com/AnthonyBurichhttp://www.twitter.com/sarahbethrnhttp://www.twitter.com/KathyKastnerhttp://www.twitter.com/EllenRichterhttp://www.twitter.com/KathyKastnerhttp://www.foxepractice.com/healthcare-hashtags/MDchat/http://www.twitter.com/RichmondDochttp://www.twitter.com/fidouglashttp://www.foxepractice.com/healthcare-hashtags/MDChat/http://www.twitter.com/Mtnmdhttp://www.twitter.com/s_ellerhttp://www.twitter.com/EllenRichterhttp://www.twitter.com/GailZahtzhttp://www.foxepractice.com/healthcare-hashtags/mdchat/http://www.twitter.com/fidouglashttp://www.twitter.com/RichmondDochttp://www.foxepractice.com/healthcare-hashtags/MDchat/http://www.twitter.com/GailZahtzhttp://www.twitter.com/EllenRichterhttp://www.foxepractice.com/healthcare-hashtags/MDchat/http://qr.ae/Yw2lhttp://www.twitter.com/MD_chathttp://www.foxepractice.com/healthcare-hashtags/MDchat/http://www.twitter.com/PhilBaumannhttp://www.twitter.com/AnthonyBurichhttp://www.twitter.com/sarahbethrnhttp://www.twitter.com/KathyKastnerhttp://www.twitter.com/EllenRichterhttp://www.foxepractice.com/healthcare-hashtags/MDChat/http://www.twitter.com/fidouglashttp://www.twitter.com/RichmondDochttp://www.foxepractice.com/healthcare-hashtags/mdchat/http://www.twitter.com/philbaumannhttp://www.twitter.com/s_ellerhttp://www.foxepractice.com/healthcare-hashtags/mdchat/http://www.twitter.com/sarahbethrnhttp://www.twitter.com/KathyKastnerhttp://www.twitter.com/s_ellerhttp://www.foxepractice.com/healthcare-hashtags/MDChat/http://www.twitter.com/SarahBethRNhttp://www.twitter.com/EinsteinMedhttp://www.foxepractice.com/healthcare-hashtags/MDchat/http://www.twitter.com/GailZahtzhttp://www.twitter.com/njfrantzhttp://www.twitter.com/EllenRichterhttp://www.foxepractice.com/healthcare-hashtags/MDchat/http://www.twitter.com/KathyKastnerhttp://www.foxepractice.com/healthcare-hashtags/mdchat/http://www.twitter.com/AnthonyBurich


3/17

s_eller Welcome @fidouglas - you will do fine - we all had a first time here #mdchatTue Jan 18 18:08:41 PST 2011

PhilBaumann @s_eller Hello! #mdchatTue Jan 18 18:08:44 PST 2011

RichmondDoc T1 Withholding information from a patient is unethical. Individual HCPs decide how to break

news, but pts should be aware. #mdchat

Tue Jan 18 18:08:57 PST 2011

s_eller @swan5675 welcome to a group of former lurkers at #mdchatTue Jan 18 18:09:43 PST 2011

RichmondDoc T1 One could argue how much info to provide to pts who cannot make their own decisions (e

elderly pts w/ dementia)... #mdchatTue Jan 18 18:09:49 PST 2011

pjmachado Hello #mdchat ers looking forward to this chat...

Tue Jan 18 18:09:51 PST 2011

aliciad3 Hi everyone! Alicia, pediatric infectious diseases fellow in Boston. Looking forward to #MDCTue Jan 18 18:10:33 PST 2011

RichmondDoc T1 ...but even then I think medical ethics would side on the principle of patient autonomy and

determination. #mdchatTue Jan 18 18:10:46 PST 2011

EinsteinMed T1: If pt is not emotionally stable - complete disclosure may not be wise. Timing is impt and

support systems must be assessed. #MDchatTue Jan 18 18:11:09 PST 2011

EllenRichter T1 There are those patients who absolutely dont want to hear bad news. Even when told, th

wont hear. #MDchatTue Jan 18 18:11:09 PST 2011

s_eller T1 I have to agree - witholding information is unethical - patients have right to know info -nee

work on how to deliver news #mdchatTue Jan 18 18:11:54 PST 2011

fidouglas T1 In UK, pts can submit a request for their med records. Only denied if risk of harm is to pt

others, but not med professionals. #mdchatTue Jan 18 18:12:01 PST 2011

RichmondDoc T1 One approach is: ask the patient how much they want to know, and provide in the inform

accordingly. #mdchatTue Jan 18 18:12:17 PST 2011
http://www.twitter.com/s_ellerhttp://www.twitter.com/fidouglashttp://www.foxepractice.com/healthcare-hashtags/mdchat/http://www.twitter.com/PhilBaumannhttp://www.twitter.com/s_ellerhttp://www.foxepractice.com/healthcare-hashtags/mdchat/http://www.twitter.com/RichmondDochttp://www.foxepractice.com/healthcare-hashtags/mdchat/http://www.twitter.com/s_ellerhttp://www.twitter.com/swan5675http://www.foxepractice.com/healthcare-hashtags/mdchat/http://www.twitter.com/RichmondDochttp://www.foxepractice.com/healthcare-hashtags/mdchat/http://www.twitter.com/pjmachadohttp://www.foxepractice.com/healthcare-hashtags/mdchat/http://www.twitter.com/aliciad3http://www.foxepractice.com/healthcare-hashtags/MDChat/http://www.twitter.com/RichmondDochttp://www.foxepractice.com/healthcare-hashtags/mdchat/http://www.twitter.com/EinsteinMedhttp://www.foxepractice.com/healthcare-hashtags/MDchat/http://www.twitter.com/EllenRichterhttp://www.foxepractice.com/healthcare-hashtags/MDchat/http://www.twitter.com/s_ellerhttp://www.foxepractice.com/healthcare-hashtags/mdchat/http://www.twitter.com/fidouglashttp://www.foxepractice.com/healthcare-hashtags/mdchat/http://www.twitter.com/RichmondDochttp://www.foxepractice.com/healthcare-hashtags/mdchat/http://www.foxepractice.com/healthcare-hashtags/mdchat/http://www.twitter.com/RichmondDochttp://www.foxepractice.com/healthcare-hashtags/mdchat/http://www.twitter.com/fidouglashttp://www.foxepractice.com/healthcare-hashtags/mdchat/http://www.twitter.com/s_ellerhttp://www.foxepractice.com/healthcare-hashtags/MDchat/http://www.twitter.com/EllenRichterhttp://www.foxepractice.com/healthcare-hashtags/MDchat/http://www.twitter.com/EinsteinMedhttp://www.foxepractice.com/healthcare-hashtags/mdchat/http://www.twitter.com/RichmondDochttp://www.foxepractice.com/healthcare-hashtags/MDChat/http://www.twitter.com/aliciad3http://www.foxepractice.com/healthcare-hashtags/mdchat/http://www.twitter.com/pjmachadohttp://www.foxepractice.com/healthcare-hashtags/mdchat/http://www.twitter.com/RichmondDochttp://www.foxepractice.com/healthcare-hashtags/mdchat/http://www.twitter.com/swan5675http://www.twitter.com/s_ellerhttp://www.foxepractice.com/healthcare-hashtags/mdchat/http://www.twitter.com/RichmondDochttp://www.foxepractice.com/healthcare-hashtags/mdchat/http://www.twitter.com/s_ellerhttp://www.twitter.com/PhilBaumannhttp://www.foxepractice.com/healthcare-hashtags/mdchat/http://www.twitter.com/fidouglashttp://www.twitter.com/s_eller


4/17

KathyKastner Wht do u do?RT @EllenRichter: T1 There are those patients who absolutely dont want to he

bad news. Even when told, they wont hear. #MDchatTue Jan 18 18:12:37 PST 2011

EllenRichter T1 Not all health care providers are good at telling information patients may not want to hear

Communication is an art. #MDchatTue Jan 18 18:12:51 PST 2011

RichmondDoc @GailZahtz But who are we/families to decide if a pt can emotionally handle the news? Reashould be just the patient who decides #mdchatTue Jan 18 18:12:53 PST 2011

EllenRichter @KathyKastner T1 You get family to help. You find out the way to get thru to them. There is

always a way, just harder in some #MDchatTue Jan 18 18:13:39 PST 2011

ocamsrazor T1 always tell patients the truth, whole truth, nothing but the truth #mdchatTue Jan 18 18:13:56 PST 2011

CrescendoCG Agree RT @EllenRichter: T1 Not all h/c providers are good at telling information pts may not

to hear. Communication is an art. #mdchatTue Jan 18 18:14:25 PST 2011

AnthonyBurich #mdchat T1 - Patients deserve the right to full disclosure. I think we should tell with sensitivit

support them in coping.Tue Jan 18 18:14:46 PST 2011

westr And U wud know! RT @EllenRichter: T1 There are those patients who absolutely dont want

hear bad news. Even when told, wont hear. #MDchatTue Jan 18 18:14:51 PST 2011

GailZahtz Well, no-one WANTS to be dying. But if they are, for example, they have a right to know and

decide how to spend that time. #MDChatTue Jan 18 18:14:52 PST 2011

RichmondDoc T1 If pts are not ready to hear the info you would like to provide, figure out how far you shou

Get family/spiritual support. #mdchatTue Jan 18 18:14:54 PST 2011

s_eller T1 - should decide with patient and surrogates how much patient can handle and what supp

they need when hearing the news #mdchatTue Jan 18 18:15:08 PST 2011

JeanneAWebb * T1 Withholding information from a patient is unethical. Individual HCPs decide how to brea

news, but pts should be aware. #mdchat...Tue Jan 18 18:15:47 PST 2011

GailZahtz @KathyKastner@RichmondDoc Always for the full team approach. It takes a village to raise

child, a village to comfort the sick. #MDChatTue Jan 18 18:15:47 PST 2011
http://www.twitter.com/KathyKastnerhttp://www.twitter.com/EllenRichterhttp://www.foxepractice.com/healthcare-hashtags/MDchat/http://www.twitter.com/EllenRichterhttp://www.foxepractice.com/healthcare-hashtags/MDchat/http://www.twitter.com/RichmondDochttp://www.twitter.com/GailZahtzhttp://www.foxepractice.com/healthcare-hashtags/mdchat/http://www.twitter.com/EllenRichterhttp://www.twitter.com/KathyKastnerhttp://www.foxepractice.com/healthcare-hashtags/MDchat/http://www.twitter.com/ocamsrazorhttp://www.foxepractice.com/healthcare-hashtags/mdchat/http://www.twitter.com/CrescendoCGhttp://www.twitter.com/EllenRichterhttp://www.foxepractice.com/healthcare-hashtags/mdchat/http://www.twitter.com/AnthonyBurichhttp://www.foxepractice.com/healthcare-hashtags/mdchat/http://www.twitter.com/westrhttp://www.twitter.com/EllenRichterhttp://www.foxepractice.com/healthcare-hashtags/MDchat/http://www.twitter.com/GailZahtzhttp://www.foxepractice.com/healthcare-hashtags/MDChat/http://www.twitter.com/RichmondDochttp://www.foxepractice.com/healthcare-hashtags/mdchat/http://www.twitter.com/s_ellerhttp://www.foxepractice.com/healthcare-hashtags/mdchat/http://www.twitter.com/JeanneAWebbhttp://www.foxepractice.com/healthcare-hashtags/mdchat/http://www.twitter.com/GailZahtzhttp://www.twitter.com/KathyKastnerhttp://www.twitter.com/RichmondDochttp://www.foxepractice.com/healthcare-hashtags/MDChat/http://www.foxepractice.com/healthcare-hashtags/MDChat/http://www.twitter.com/RichmondDochttp://www.twitter.com/KathyKastnerhttp://www.twitter.com/GailZahtzhttp://www.foxepractice.com/healthcare-hashtags/mdchat/http://www.twitter.com/JeanneAWebbhttp://www.foxepractice.com/healthcare-hashtags/mdchat/http://www.twitter.com/s_ellerhttp://www.foxepractice.com/healthcare-hashtags/mdchat/http://www.twitter.com/RichmondDochttp://www.foxepractice.com/healthcare-hashtags/MDChat/http://www.twitter.com/GailZahtzhttp://www.foxepractice.com/healthcare-hashtags/MDchat/http://www.twitter.com/EllenRichterhttp://www.twitter.com/westrhttp://www.foxepractice.com/healthcare-hashtags/mdchat/http://www.twitter.com/AnthonyBurichhttp://www.foxepractice.com/healthcare-hashtags/mdchat/http://www.twitter.com/EllenRichterhttp://www.twitter.com/CrescendoCGhttp://www.foxepractice.com/healthcare-hashtags/mdchat/http://www.twitter.com/ocamsrazorhttp://www.foxepractice.com/healthcare-hashtags/MDchat/http://www.twitter.com/KathyKastnerhttp://www.twitter.com/EllenRichterhttp://www.foxepractice.com/healthcare-hashtags/mdchat/http://www.twitter.com/GailZahtzhttp://www.twitter.com/RichmondDochttp://www.foxepractice.com/healthcare-hashtags/MDchat/http://www.twitter.com/EllenRichterhttp://www.foxepractice.com/healthcare-hashtags/MDchat/http://www.twitter.com/EllenRichterhttp://www.twitter.com/KathyKastner


5/17

RichmondDoc @GailZahtz@KathyKastner Agree. Involve pts, family, counselors (spiritual or mental health

take your time if needed. #mdchatTue Jan 18 18:16:42 PST 2011

aliciad3 T1 That said, often the medical plan is work in progress and the usual back and forths can

understandably cause anxiety... #MDChatTue Jan 18 18:16:48 PST 2011

EllenRichter T1 What a great question! :) #MDchatTue Jan 18 18:17:38 PST 2011

EinsteinMed T1: Many docs need more training on how to disclose difficult info. Pts can be devastated by

manner in which a dx is delivered. #MDchatTue Jan 18 18:18:01 PST 2011

EllenRichter @PracticalWisdom@aliciad3 Welcome folks! You get a late slip! ;) #MDchatTue Jan 18 18:18:18 PST 2011

AnthonyBurich @GailZahtz: Always for the full team approach. It takes a village to raise a child, a village tocomfort the sick. #MDChatTue Jan 18 18:18:22 PST 2011

aliciad3 Great approach. RT @westr@RichmondDoc: T1 One approach is: ask the pt how much the

want to know, and provide info accordingly. #MDChatTue Jan 18 18:19:08 PST 2011

GailZahtz @PracticalWisdom Waving hi. Good to see you. #MDChatTue Jan 18 18:19:20 PST 2011

s_eller @apjonas@RichmondDoc - I think it is okay to asks patients if they want to involve surroga

before breaking difficult news = prep #mdchatTue Jan 18 18:19:32 PST 2011

KathyKastner By gosh: I think this is being patient centrdRT @westr: RT @RichmondDoc: T1 Ask the pt ho

mch they want 2 know,provide accordingly. #MDchatTue Jan 18 18:19:36 PST 2011

aliciad3 @EllenRichter Thanks Ellen ;) #MDChatTue Jan 18 18:19:43 PST 2011

PracticalWisdom @EllenRichter@PracticalWisdom@aliciad3 Late slip better than pink slip. thanks. Gail wav

back at your. Thanks #MdchatTue Jan 18 18:19:52 PST 2011

EllenRichter T1 Many times a patient needs a surrogate with them. They dont always process bad info ve

well. 4 ears better than 2. #MDchatTue Jan 18 18:19:59 PST 2011
http://www.twitter.com/RichmondDochttp://www.twitter.com/GailZahtzhttp://www.twitter.com/KathyKastnerhttp://www.foxepractice.com/healthcare-hashtags/mdchat/http://www.twitter.com/aliciad3http://www.foxepractice.com/healthcare-hashtags/MDChat/http://www.twitter.com/EllenRichterhttp://www.foxepractice.com/healthcare-hashtags/MDchat/http://www.twitter.com/EinsteinMedhttp://www.foxepractice.com/healthcare-hashtags/MDchat/http://www.twitter.com/EllenRichterhttp://www.twitter.com/PracticalWisdomhttp://www.twitter.com/aliciad3http://www.foxepractice.com/healthcare-hashtags/MDchat/http://www.twitter.com/AnthonyBurichhttp://www.twitter.com/GailZahtzhttp://www.twitter.com/GailZahtzhttp://www.foxepractice.com/healthcare-hashtags/MDChat/http://www.twitter.com/aliciad3http://www.twitter.com/westrhttp://www.twitter.com/RichmondDochttp://www.foxepractice.com/healthcare-hashtags/MDChat/http://www.twitter.com/GailZahtzhttp://www.twitter.com/PracticalWisdomhttp://www.foxepractice.com/healthcare-hashtags/MDChat/http://www.twitter.com/s_ellerhttp://www.twitter.com/apjonashttp://www.twitter.com/RichmondDochttp://www.foxepractice.com/healthcare-hashtags/mdchat/http://www.twitter.com/KathyKastnerhttp://www.twitter.com/westrhttp://www.twitter.com/RichmondDochttp://www.foxepractice.com/healthcare-hashtags/MDchat/http://www.twitter.com/aliciad3http://www.twitter.com/EllenRichterhttp://www.foxepractice.com/healthcare-hashtags/MDChat/http://www.twitter.com/PracticalWisdomhttp://www.twitter.com/EllenRichterhttp://www.twitter.com/PracticalWisdomhttp://www.twitter.com/aliciad3http://www.foxepractice.com/healthcare-hashtags/Mdchat/http://www.twitter.com/EllenRichterhttp://www.foxepractice.com/healthcare-hashtags/MDchat/http://www.foxepractice.com/healthcare-hashtags/MDchat/http://www.twitter.com/EllenRichterhttp://www.foxepractice.com/healthcare-hashtags/Mdchat/http://www.twitter.com/aliciad3http://www.twitter.com/PracticalWisdomhttp://www.twitter.com/EllenRichterhttp://www.twitter.com/PracticalWisdomhttp://www.foxepractice.com/healthcare-hashtags/MDChat/http://www.twitter.com/EllenRichterhttp://www.twitter.com/aliciad3http://www.foxepractice.com/healthcare-hashtags/MDchat/http://www.twitter.com/RichmondDochttp://www.twitter.com/westrhttp://www.twitter.com/KathyKastnerhttp://www.foxepractice.com/healthcare-hashtags/mdchat/http://www.twitter.com/RichmondDochttp://www.twitter.com/apjonashttp://www.twitter.com/s_ellerhttp://www.foxepractice.com/healthcare-hashtags/MDChat/http://www.twitter.com/PracticalWisdomhttp://www.twitter.com/GailZahtzhttp://www.foxepractice.com/healthcare-hashtags/MDChat/http://www.twitter.com/RichmondDochttp://www.twitter.com/westrhttp://www.twitter.com/aliciad3http://www.foxepractice.com/healthcare-hashtags/MDChat/http://www.twitter.com/GailZahtzhttp://www.twitter.com/AnthonyBurichhttp://www.foxepractice.com/healthcare-hashtags/MDchat/http://www.twitter.com/aliciad3http://www.twitter.com/PracticalWisdomhttp://www.twitter.com/EllenRichterhttp://www.foxepractice.com/healthcare-hashtags/MDchat/http://www.twitter.com/EinsteinMedhttp://www.foxepractice.com/healthcare-hashtags/MDchat/http://www.twitter.com/EllenRichterhttp://www.foxepractice.com/healthcare-hashtags/MDChat/http://www.twitter.com/aliciad3http://www.foxepractice.com/healthcare-hashtags/mdchat/http://www.twitter.com/KathyKastnerhttp://www.twitter.com/GailZahtzhttp://www.twitter.com/RichmondDoc


6/17

GailZahtz @s_eller@apjonas@RichmondDoc One approach- see if patient and proxy have "had the

to see who can "take the news" #MDChatTue Jan 18 18:20:32 PST 2011

EinsteinMed @RichmondDoc Agree regarding surrogate as last resort. Even when in shock - many pts va

privacy/self-dignity above all else. #MDchatTue Jan 18 18:20:52 PST 2011

RichmondDoc @s_eller@apjonas Yes--can ask for a surrogate ahead of time; I was thinking more when ocould inform someone w/o pt presence. #mdchatTue Jan 18 18:21:07 PST 2011

s_eller @EllenRichter, @GailZahtz - agree, if patients have identified resources ahead of time, we s

honor that need #mdchatTue Jan 18 18:21:34 PST 2011

westr @KathyKastner Staging- is this sort of thing an actual protocol? #mdchatTue Jan 18 18:21:36 PST 2011

CrescendoCG Agree that surrogates are critical - are pts generally good about having someone at appts w/

I hear mixed reports. #mdchatTue Jan 18 18:21:59 PST 2011

EllenRichter Oh I agree!! RT @GailZahtz:One approach- see if patient and proxy have "had the talk" to se

who can "take the news" #MDchatTue Jan 18 18:22:04 PST 2011

SarahBethRN good discussion. I would not agree w/holding, but sometimes partial disclosure in some

circumstances. or disclosure in pieces #MDchatTue Jan 18 18:22:15 PST 2011

GailZahtz @EinsteinMed@RichmondDoc Maybe 1st find out WHO and HOW the patient has decided

gets the news- pt, proxy, clergy #MDChatTue Jan 18 18:22:27 PST 2011

KathyKastner Yep: A principle of adult ed RT @westr: @KathyKastner Staging- is this sort of thing an actu

protocol? #MDchatTue Jan 18 18:22:45 PST 2011

RichmondDoc T1 In med school they taught that if you say "cancer", most of the rest of the conversation is

after pts hear the Dx... #mdchatTue Jan 18 18:23:12 PST 2011

westr Send a link? RT @KathyKastner: Yep: A principle of adult ed RT @westr: @KathyKastner

Staging- is this an actual protocol? #MDchatTue Jan 18 18:23:33 PST 2011

GailZahtz @s_eller@EllenRichter So perhaps part of "who gets what information" is really a question

do we educate the healthy #MDChatTue Jan 18 18:23:45 PST 2011
http://www.twitter.com/GailZahtzhttp://www.twitter.com/s_ellerhttp://www.twitter.com/apjonashttp://www.twitter.com/RichmondDochttp://www.foxepractice.com/healthcare-hashtags/MDChat/http://www.twitter.com/EinsteinMedhttp://www.twitter.com/RichmondDochttp://www.foxepractice.com/healthcare-hashtags/MDchat/http://www.twitter.com/RichmondDochttp://www.twitter.com/s_ellerhttp://www.twitter.com/apjonashttp://www.foxepractice.com/healthcare-hashtags/mdchat/http://www.twitter.com/s_ellerhttp://www.twitter.com/EllenRichterhttp://www.twitter.com/GailZahtzhttp://www.foxepractice.com/healthcare-hashtags/mdchat/http://www.twitter.com/westrhttp://www.twitter.com/KathyKastnerhttp://www.foxepractice.com/healthcare-hashtags/mdchat/http://www.twitter.com/CrescendoCGhttp://www.foxepractice.com/healthcare-hashtags/mdchat/http://www.twitter.com/EllenRichterhttp://www.twitter.com/GailZahtzhttp://www.foxepractice.com/healthcare-hashtags/MDchat/http://www.twitter.com/SarahBethRNhttp://www.foxepractice.com/healthcare-hashtags/MDchat/http://www.twitter.com/GailZahtzhttp://www.twitter.com/EinsteinMedhttp://www.twitter.com/RichmondDochttp://www.foxepractice.com/healthcare-hashtags/MDChat/http://www.twitter.com/KathyKastnerhttp://www.twitter.com/westrhttp://www.twitter.com/KathyKastnerhttp://www.foxepractice.com/healthcare-hashtags/MDchat/http://www.twitter.com/RichmondDochttp://www.foxepractice.com/healthcare-hashtags/mdchat/http://www.twitter.com/westrhttp://www.twitter.com/KathyKastnerhttp://www.twitter.com/westrhttp://www.twitter.com/KathyKastnerhttp://www.foxepractice.com/healthcare-hashtags/MDchat/http://www.twitter.com/GailZahtzhttp://www.twitter.com/s_ellerhttp://www.twitter.com/EllenRichterhttp://www.foxepractice.com/healthcare-hashtags/MDChat/http://www.foxepractice.com/healthcare-hashtags/MDChat/http://www.twitter.com/EllenRichterhttp://www.twitter.com/s_ellerhttp://www.twitter.com/GailZahtzhttp://www.foxepractice.com/healthcare-hashtags/MDchat/http://www.twitter.com/KathyKastnerhttp://www.twitter.com/westrhttp://www.twitter.com/KathyKastnerhttp://www.twitter.com/westrhttp://www.foxepractice.com/healthcare-hashtags/mdchat/http://www.twitter.com/RichmondDochttp://www.foxepractice.com/healthcare-hashtags/MDchat/http://www.twitter.com/KathyKastnerhttp://www.twitter.com/westrhttp://www.twitter.com/KathyKastnerhttp://www.foxepractice.com/healthcare-hashtags/MDChat/http://www.twitter.com/RichmondDochttp://www.twitter.com/EinsteinMedhttp://www.twitter.com/GailZahtzhttp://www.foxepractice.com/healthcare-hashtags/MDchat/http://www.twitter.com/SarahBethRNhttp://www.foxepractice.com/healthcare-hashtags/MDchat/http://www.twitter.com/GailZahtzhttp://www.twitter.com/EllenRichterhttp://www.foxepractice.com/healthcare-hashtags/mdchat/http://www.twitter.com/CrescendoCGhttp://www.foxepractice.com/healthcare-hashtags/mdchat/http://www.twitter.com/KathyKastnerhttp://www.twitter.com/westrhttp://www.foxepractice.com/healthcare-hashtags/mdchat/http://www.twitter.com/GailZahtzhttp://www.twitter.com/EllenRichterhttp://www.twitter.com/s_ellerhttp://www.foxepractice.com/healthcare-hashtags/mdchat/http://www.twitter.com/apjonashttp://www.twitter.com/s_ellerhttp://www.twitter.com/RichmondDochttp://www.foxepractice.com/healthcare-hashtags/MDchat/http://www.twitter.com/RichmondDochttp://www.twitter.com/EinsteinMedhttp://www.foxepractice.com/healthcare-hashtags/MDChat/http://www.twitter.com/RichmondDochttp://www.twitter.com/apjonashttp://www.twitter.com/s_ellerhttp://www.twitter.com/GailZahtz


7/17

RichmondDoc T1 ...so instead you mention the Dx once pt is ready, and you assess how much they can he

now. Schedule quick follow-up... #mdchatTue Jan 18 18:23:57 PST 2011

westr ELSI nightmare! RT @EllenRichter: T1 What a great question! :) #MDchatTue Jan 18 18:24:16 PST 2011

RichmondDoc ...in order to provide more depth of discussion and what this means. This allows pts to truly h

the conversation. #mdchatTue Jan 18 18:24:20 PST 2011

KathyKastner U ok 4 after chat RT @westr: Send a link? Yep: A principle of adult ed RT @westr: @KathyK

Staging- is this an actual protocol? #MDchatTue Jan 18 18:24:34 PST 2011

EllenRichter How true! RT @RichmondDoc T1 In med school they taught if you say "cancer" most of the

conversation lost after pts hear Dx #MDchatTue Jan 18 18:24:45 PST 2011

s_eller @RichmondDoc - yes but do you need to say "cancer" for comprehension, just as you need

death - agree or disagree? #mdchatTue Jan 18 18:25:05 PST 2011

westr Of course; anytime its convenient. RT @KathyKastner: U ok 4 after chat RT @westr: Send a

#MDchatTue Jan 18 18:25:30 PST 2011

RichmondDoc @s_eller I think you need to be honest: you need to name the Dx and say what it means. Ha

but otherwise is dishonest. #mdchatTue Jan 18 18:26:23 PST 2011

EinsteinMed @RichmondDoc Re: word "cancer" & hearing no further. Several pts I know well told me the

minds went blank upon hearing the word. #MDChatTue Jan 18 18:26:34 PST 2011

EllenRichter T1 Must be so hard for docs to care for new pt with bad dx. Dont know how they behave, rea

anything. So hard to be theraputic #MDchatTue Jan 18 18:27:00 PST 2011

RichmondDoc @GailZahtz@s_eller Clearly different conversations. But even if the cancer is resectable, st

hard to hear. #mdchatTue Jan 18 18:28:26 PST 2011

pjmachado Doctor that knows his patient well will know how to communicate effectively to his patient- th

no template-it is personal... #mdchatTue Jan 18 18:28:40 PST 2011

PracticalWisdom These are all such important question. Families many times live so far away and folks remai

single/Div. not as much support. #MdchatTue Jan 18 18:28:54 PST 2011
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8/17

EinsteinMed @RichmondDoc Some docs say "abnormal growth" or "malignancy" but that can leave pts

confused. #MDchatTue Jan 18 18:28:57 PST 2011

RichmondDoc @GailZahtz@s_eller And even if a serious illness is treatable, still need to consider side

effects/life changes/other harms. #mdchatTue Jan 18 18:29:21 PST 2011

s_eller @GailZahtz@RichmondDoc - agree - goal of conversation can drive how it is delivered- butclear explanation w/ plain language #mdchatTue Jan 18 18:29:23 PST 2011

cmizer17 @RichmondDoc You Needed Med School To Teach You That??? #MDChat No Disrespect

AskingTue Jan 18 18:29:54 PST 2011

RichmondDoc @EinsteinMed "You have a malignant neoplasm of the colon, probably resectable so long a

distant metasteses." Ugh: terrible. #mdchat

Tue Jan 18 18:30:11 PST 2011

KathyKastner Yesss!!RT @EinsteinMed: @RichmondDoc Some docs say "abnormal growth" or "malignan

but that can leave pts confused. #MDchatTue Jan 18 18:30:13 PST 2011

apjonas @s_eller@RichmondDoc pt vocab and readiness determines flow of conversation and use

power words unless OR waiting for pt #mdchatTue Jan 18 18:30:35 PST 2011

s_eller @cmizer17@RichmondDoc - part of what we use standardized patients for - so med studenpractice difficult conversations #mdchatTue Jan 18 18:30:37 PST 2011

RichmondDoc @cmizer17 To teach what? Sorry--I lose myself easily in the Twitter stream in these convos

#mdchatTue Jan 18 18:31:01 PST 2011

s_eller @apjonas@RichmondDoc - agree patient vocab can have impact on flow of conversation


EinsteinMed @PracticalWisdom Gr8 pt abt distance of families/pts being single/divorced. Docs may have

have access 2 their support systems. #MDchatTue Jan 18 18:31:47 PST 2011

GailZahtz @RichmondDoc@s_eller Really thinking we need to be thinking of education of the healthy

prepare for the un-preparable news. #MDChatTue Jan 18 18:31:54 PST 2011
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9/17

PracticalWisdom Critical when giving bad news to have time to listen, make sure tone of voice is correct, no

distractions. #MdchatTue Jan 18 18:31:56 PST 2011

RichmondDoc @s_eller@cmizer17 Standardized patients help; so does a good mentor and teachers who

demonstrate how to deliver bad news. #mdchatTue Jan 18 18:32:07 PST 2011

PracticalWisdom Thanks for the reminder. Opps me too RT @s_eller: @MDchat realized I havent been usingmea culpea #MdchatTue Jan 18 18:33:06 PST 2011

s_eller @RichmondDoc@cmizer17 - I am biased due to my profession, but also believe in the pow

reflective learning - video debriefing #mdchatTue Jan 18 18:33:24 PST 2011

MD_chat @s_eller No worries at all. The topic numbers are nice to have, but this works fine. #MDchatTue Jan 18 18:33:51 PST 2011

PracticalWisdom Loved the book conversations at the Kitchen Table. Dr. Naomi ?Kntspl. She talks about

listening/Giving bad news! #MdchatTue Jan 18 18:34:10 PST 2011

KathyKastner @PracticalWisdom: Critical when giving bad news to have time to listen, make sure tone of v

is correct, no distractions. #MDchatTue Jan 18 18:34:32 PST 2011

GailZahtz @MD_chat Bad-da-dum acknowledging the spinal tap for those who missed ;) #MDChatTue Jan 18 18:35:42 PST 2011

westr @KathyKastner You seem to have some background on this topic #mdchatTue Jan 18 18:36:17 PST 2011

s_eller T1 - we have student give bad news to SP - they watch themselves get rated by SP, themse

faculty - practice & feedback. #mdchatTue Jan 18 18:36:17 PST 2011

EllenRichter T1 Bad news should also not be in a hallway or a busy open room. There needs to B approp

environment so communication can occur #MDchatTue Jan 18 18:36:33 PST 2011

SarahBethRN In breaking bad news to patients, i think it is beneficial to spend time listening. we can hear w

the patient needs to know. #MDchatTue Jan 18 18:36:44 PST 2011

PracticalWisdom So difficult to really listen though when you have pts stacked up in the waiting room and you

to make quota for insurance comp #MdchatTue Jan 18 18:36:47 PST 2011
http://www.twitter.com/PracticalWisdomhttp://www.foxepractice.com/healthcare-hashtags/Mdchat/http://www.twitter.com/RichmondDochttp://www.twitter.com/s_ellerhttp://www.twitter.com/cmizer17http://www.foxepractice.com/healthcare-hashtags/mdchat/http://www.twitter.com/PracticalWisdomhttp://www.twitter.com/s_ellerhttp://www.twitter.com/MDchathttp://www.foxepractice.com/healthcare-hashtags/Mdchat/http://www.twitter.com/s_ellerhttp://www.twitter.com/RichmondDochttp://www.twitter.com/cmizer17http://www.foxepractice.com/healthcare-hashtags/mdchat/http://www.twitter.com/MD_chathttp://www.twitter.com/s_ellerhttp://www.foxepractice.com/healthcare-hashtags/MDchat/http://www.twitter.com/PracticalWisdomhttp://www.foxepractice.com/healthcare-hashtags/Mdchat/http://www.twitter.com/KathyKastnerhttp://www.twitter.com/PracticalWisdomhttp://www.foxepractice.com/healthcare-hashtags/MDchat/http://www.twitter.com/GailZahtzhttp://www.twitter.com/MD_chathttp://www.foxepractice.com/healthcare-hashtags/MDChat/http://www.twitter.com/westrhttp://www.twitter.com/KathyKastnerhttp://www.foxepractice.com/healthcare-hashtags/mdchat/http://www.twitter.com/s_ellerhttp://www.foxepractice.com/healthcare-hashtags/mdchat/http://www.twitter.com/EllenRichterhttp://www.foxepractice.com/healthcare-hashtags/MDchat/http://www.twitter.com/SarahBethRNhttp://www.foxepractice.com/healthcare-hashtags/MDchat/http://www.twitter.com/PracticalWisdomhttp://www.foxepractice.com/healthcare-hashtags/Mdchat/http://www.foxepractice.com/healthcare-hashtags/Mdchat/http://www.twitter.com/PracticalWisdomhttp://www.foxepractice.com/healthcare-hashtags/MDchat/http://www.twitter.com/SarahBethRNhttp://www.foxepractice.com/healthcare-hashtags/MDchat/http://www.twitter.com/EllenRichterhttp://www.foxepractice.com/healthcare-hashtags/mdchat/http://www.twitter.com/s_ellerhttp://www.foxepractice.com/healthcare-hashtags/mdchat/http://www.twitter.com/KathyKastnerhttp://www.twitter.com/westrhttp://www.foxepractice.com/healthcare-hashtags/MDChat/http://www.twitter.com/MD_chathttp://www.twitter.com/GailZahtzhttp://www.foxepractice.com/healthcare-hashtags/MDchat/http://www.twitter.com/PracticalWisdomhttp://www.twitter.com/KathyKastnerhttp://www.foxepractice.com/healthcare-hashtags/Mdchat/http://www.twitter.com/PracticalWisdomhttp://www.foxepractice.com/healthcare-hashtags/MDchat/http://www.twitter.com/s_ellerhttp://www.twitter.com/MD_chathttp://www.foxepractice.com/healthcare-hashtags/mdchat/http://www.twitter.com/cmizer17http://www.twitter.com/RichmondDochttp://www.twitter.com/s_ellerhttp://www.foxepractice.com/healthcare-hashtags/Mdchat/http://www.twitter.com/MDchathttp://www.twitter.com/s_ellerhttp://www.twitter.com/PracticalWisdomhttp://www.foxepractice.com/healthcare-hashtags/mdchat/http://www.twitter.com/cmizer17http://www.twitter.com/s_ellerhttp://www.twitter.com/RichmondDochttp://www.foxepractice.com/healthcare-hashtags/Mdchat/http://www.twitter.com/PracticalWisdom


10/17

BonnieRN @EllenRichter is it #MDChat or #RNChat ???Tue Jan 18 18:37:16 PST 2011

MD_chat T2 Nutrition: How can physicians do more to educate patients on nutrition? Does medical sc

CME provide enough training? #MDchatTue Jan 18 18:37:17 PST 2011

GailZahtz T1 And as an add-on bad news not great coming from an intern the patient has never met w

the MD is in surgery elsewhere #MDChatTue Jan 18 18:37:26 PST 2011

RichmondDoc @MD_Chat Re: taps--there is no part of the body that cannot be reached with a strong arm

14-gauge needle. TAP :) #mdchatTue Jan 18 18:37:26 PST 2011

EllenRichter @AureliaCotta Well, maybe a nurse can talk to you first, then :) #MDchatTue Jan 18 18:37:30 PST 2011

EllenRichter @BonnieRN MD :) #MDchatTue Jan 18 18:37:51 PST 2011

AureliaCotta @MHSMchat both you and #mdchat have some hard convos going on......freaking me out to

#mhsmTue Jan 18 18:38:19 PST 2011

EinsteinMed @EllenRichter Agree about no dx in halls and open spaces. Unfortunately - still happens too

#MDChatTue Jan 18 18:38:23 PST 2011

GailZahtz @EllenRichter@AureliaCotta Honestly as a pt also- nurses can have tremendous impact af

news is delivered to help pt. #MDChatTue Jan 18 18:38:30 PST 2011

EllenRichter @BonnieRN But you are welcome to join in. You always have much to offer! #MDchatTue Jan 18 18:38:31 PST 2011

PracticalWisdom The patient needs to know the truth always. The key is to determine how this truth needs to

told. Customization. #MdchatTue Jan 18 18:39:02 PST 2011

EllenRichter @EinsteinMed I know. I know only too well :( #MDchatTue Jan 18 18:39:10 PST 2011

GailZahtz @AureliaCotta Almost have the stun-gun app finished for you iPhone ;) #MDChatTue Jan 18 18:39:12 PST 2011

RichmondDoc @MD_Chat T2: No, medical school does not teach nearly enough about nutrition. Period. Ha

learn on your own--CME, colleagues. #mdchatTue Jan 18 18:39:18 PST 2011
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11/17

cmizer17 Amen! RT @RichmondDoc: RT @PracticalWisdom: Critical when giving bad news 2 have ti

listen, no distractions #MdchatTue Jan 18 18:39:29 PST 2011

fidouglas T2 In three years of pre-med, we get two lectures dedicated to nutrition. #mdchatTue Jan 18 18:40:13 PST 2011

s_eller T2 - I work there, and am not sure what med students get in terms of education about nutritio


aliciad3 T2 very little is taught in med school about nutrition. all docs (esp. pediatricians) need to rea

provide the right info to pts #MDChatTue Jan 18 18:41:30 PST 2011

RichmondDoc T1 most of our nutrition info was in the context of biochemistry lectures; very little info in the

clinical years. #mdchatTue Jan 18 18:41:54 PST 2011

RichmondDoc @ocamsrazor 4th year electives are a great way for in-depth instruction; but should be mean

content in years 1-3. #mdchatTue Jan 18 18:42:54 PST 2011

RichmondDoc @EllenRichter T2 Nutrition: How can physicians do more to educate patients on nutrition? D

medical school, CME provide training? #mdchatTue Jan 18 18:43:39 PST 2011

PracticalWisdom T2: Oh, thank God I thought I was the only one confused. Now I know the smart ones are off

#MdchatTue Jan 18 18:43:42 PST 2011

s_eller @EllenRichter - cracking me up - I had to scroll to find it. #mdchatTue Jan 18 18:43:57 PST 2011

EinsteinMed T2: Curric at med schools slowly changing. Team approach often needed: e.g., certified diab

educators working w/docs. #MDchatTue Jan 18 18:44:16 PST 2011

EllenRichter@RichmondDoc Ah, thanks! #MDchatTue Jan 18 18:44:17 PST 2011

RichmondDoc T2 Med training like our culture overall: we talk a lot about lifestyle/exercise/nutrition but do l

actually promote it. #mdchatTue Jan 18 18:44:36 PST 2011

GailZahtz T2 I think nutrition is a FINE example of how #mHealth and #HCSM can help #physicians an

#patients work together ;)))) #MDChatTue Jan 18 18:44:36 PST 2011
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12/17

westr I happen to give some! RT @s_eller: T2 - I work there, and am not sure what med students g

terms of education about nutrition #mdchatTue Jan 18 18:44:41 PST 2011

EllenRichter @s_eller I was scrolling my head off. I lost patience ;) LOL #MDchatTue Jan 18 18:44:45 PST 2011

Mtnmd T2 Symtrimics (disclosure, my company) has turn key, high tech ability 2 ed. pt, Dr and prov

powerful ongoing interactive support.#mdchatTue Jan 18 18:45:00 PST 2011

CrescendoCG @EinsteinMed Are you also seeing more RDs and others on the care team? #mdchatTue Jan 18 18:45:23 PST 2011

RichmondDoc @EinsteinMed Definitely: med students should be required to work w/ dieticians and/or CDE

some extent to learn needed skills. #mdchatTue Jan 18 18:45:27 PST 2011

s_eller @westr - would love to hear how & what you teach #mdchatTue Jan 18 18:45:37 PST 2011

Mtnmd T2 We are able to teach doctor comprehensive wellness care while doing it, which is great fo

patient and for doctor.#mdchatTue Jan 18 18:46:07 PST 2011

KathyKastner YAY RT @EinsteinMed: T2: Curric at med schools slowly changing. Team approach ofen ne

eg certified diabetes ed working w/docs. #MDchatTue Jan 18 18:46:09 PST 2011

EllenRichter T2 Of course nutrition is an important, no vital aspect of health care. No health care provider

should be lax in that area! #MDchatTue Jan 18 18:46:21 PST 2011

PracticalWisdom T2: Many adults to not like to ask questions because they find this embarrassing. #MdchatTue Jan 18 18:46:49 PST 2011

Mtnmd T2 Point is, right now without leaving their practice for weeks or months, no where for docs t

good info. #mdchatTue Jan 18 18:46:51 PST 2011

s_eller @RichmondDoc@EinsteinMed T2 - agree that both MDs & RNs should spend time learning

dieticians or educators #mdchatTue Jan 18 18:47:15 PST 2011

EinsteinMed @CrescendoCG Re: T2 and more RNs. With diabetes yes. Anything behavioral requires mo

time than most docs can provide in a visit. #MDChatTue Jan 18 18:47:19 PST 2011
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13/17

RichmondDoc T2 for our medical outreach project, do a lot of nutritional teaching--thinking of having nutritio

come teach students re: this #mdchatTue Jan 18 18:47:28 PST 2011

westr Yup! RT @RichmondDoc: T1 most of our nutrition info was in the biochemistry lectures; very

info in the clinical years. #mdchatTue Jan 18 18:47:38 PST 2011

EllenRichter @Mtnmd T2 How about utilizing the services of a nutritionist for those docs who arent up oncurrent dietary education? #MDchatTue Jan 18 18:47:57 PST 2011

RichmondDoc T2 as we are better at identifying illnesses before meds needed, we really should be better a

teaching nutritional interventions. #mdchatTue Jan 18 18:48:27 PST 2011

PracticalWisdom Perhaps with the focus on nutrition from the White House down this will help. #MdchatTue Jan 18 18:49:00 PST 2011

RichmondDoc @KathyKastner We do the best we can, find online resources that seem useful, work w/

nutritionists if need more intensive care. #mdchatTue Jan 18 18:49:10 PST 2011

KathyKastner Nice! RT @RichmondDoc: @KathyKastner Find online resources that seem useful, work w/

nutritionists if need more intensive care. #MDchatTue Jan 18 18:50:24 PST 2011

GailZahtz @KathyKastner Oh Kathy, anything outside of the O.R. is offered more in Canada- you mus

that :) #MDChat#HCSMCATue Jan 18 18:50:30 PST 2011

PracticalWisdom My daughters Ped. wrote script for Nutrition Education program for children. Great program,

experiential, focus for children. #MdchatTue Jan 18 18:50:32 PST 2011

EinsteinMed @Mtnmd Behavioral change re: diet especially is especially complex. Pts need ongoing sup

which few PCPs have time 2 provide. #MDChatTue Jan 18 18:50:36 PST 2011

KathyKastner Patient Centrd Medical Home RT @GailZahtz: @apjonas Sorry, whats PCMH? New to me.


s_eller @RichmondDoc@KathyKastner - agree that nutrition should be part of early treatment plan

late - including registered expert #mdchatTue Jan 18 18:50:55 PST 2011

PracticalWisdom But the program went broke. Prevention many times is one of the first programs cut. #MdchaTue Jan 18 18:50:57 PST 2011
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14/17

RichmondDoc @GailZahtz PCMH: patient-centered medical home; new model of care that is a hot topic in

primary care. @apjonas#mdchatTue Jan 18 18:51:11 PST 2011

GailZahtz @KathyKastner@RichmondDoc What does patient=centered medical home mean though?

education. #MDChatTue Jan 18 18:51:50 PST 2011

EllenRichter @hrana Try Tweetchat.com #MDchatTue Jan 18 18:52:04 PST 2011

KathyKastner LOL :) RT @GailZahtz: @KathyKastner Oh Kathy, anything outside O.R. offered more in Ca

you must know that :) #MDChat#HCSMCA#MDchatTue Jan 18 18:52:12 PST 2011

RichmondDoc @PracticalWisdom T2 prevention, low-tech/high-touch care not valued in our system; we se

favor paying for intervention instead #mdchatTue Jan 18 18:52:20 PST 2011

apjonas @GailZahtz PCMH=patient centered medical home. the savior of primary per gov, docs and

others. #mdchatTue Jan 18 18:52:33 PST 2011

GailZahtz @apjonas@RichmondDoc@KathyKastner Does anyone have a link on PCMH? TY. #MDCTue Jan 18 18:53:11 PST 2011

Mtnmd @s_eller@PracticalWisdom So true, that reimbursement is a big issue. So much to share o

this,no room in 140 characters! HA #mdchatTue Jan 18 18:53:22 PST 2011

PracticalWisdom @RichmondDoc: Same sad story in the Mental Health Field. Sad, very sad #MdchatTue Jan 18 18:53:32 PST 2011

RichmondDoc @GailZahtz@KathyKastner This might give a little more context re: PCMH

http://tinyurl.com/68e8zgq#mdchatTue Jan 18 18:53:35 PST 2011

CrescendoCG @GailZahtzhttp://www.transformed.com/practice-

improvement2.cfm?gclid=CKG7xfKhxaYCFYbb4AodYD4tGw Focus on team, HIT, etc. #mdTue Jan 18 18:53:48 PST 2011

aliciad3 Love it. RT @PracticalWisdom My daughters Ped. wrote script for Nutrition Education progra

children. #MDChatTue Jan 18 18:54:03 PST 2011

melanoma_mama #mdchat Oops, sorry I think I just barged into your chat session.Tue Jan 18 18:54:24 PST 2011
http://www.twitter.com/RichmondDochttp://www.twitter.com/GailZahtzhttp://www.twitter.com/apjonashttp://www.foxepractice.com/healthcare-hashtags/mdchat/http://www.twitter.com/GailZahtzhttp://www.twitter.com/KathyKastnerhttp://www.twitter.com/RichmondDochttp://www.foxepractice.com/healthcare-hashtags/MDChat/http://www.twitter.com/EllenRichterhttp://www.twitter.com/hranahttp://www.foxepractice.com/healthcare-hashtags/MDchat/http://www.twitter.com/KathyKastnerhttp://www.twitter.com/GailZahtzhttp://www.twitter.com/KathyKastnerhttp://www.foxepractice.com/healthcare-hashtags/MDChat/http://www.foxepractice.com/healthcare-hashtags/HCSMCA/http://www.foxepractice.com/healthcare-hashtags/MDchat/http://www.twitter.com/RichmondDochttp://www.twitter.com/PracticalWisdomhttp://www.foxepractice.com/healthcare-hashtags/mdchat/http://www.twitter.com/apjonashttp://www.twitter.com/GailZahtzhttp://www.foxepractice.com/healthcare-hashtags/mdchat/http://www.twitter.com/GailZahtzhttp://www.twitter.com/apjonashttp://www.twitter.com/RichmondDochttp://www.twitter.com/KathyKastnerhttp://www.foxepractice.com/healthcare-hashtags/MDChat/http://www.twitter.com/Mtnmdhttp://www.twitter.com/s_ellerhttp://www.twitter.com/PracticalWisdomhttp://www.foxepractice.com/healthcare-hashtags/mdchat/http://www.twitter.com/PracticalWisdomhttp://www.twitter.com/RichmondDochttp://www.foxepractice.com/healthcare-hashtags/Mdchat/http://www.twitter.com/RichmondDochttp://www.twitter.com/GailZahtzhttp://www.twitter.com/KathyKastnerhttp://tinyurl.com/68e8zgqhttp://www.foxepractice.com/healthcare-hashtags/mdchat/http://www.twitter.com/CrescendoCGhttp://www.twitter.com/GailZahtzhttp://www.transformed.com/practice-improvement2.cfm?gclid=CKG7xfKhxaYCFYbb4AodYD4tGwhttp://www.transformed.com/practice-improvement2.cfm?gclid=CKG7xfKhxaYCFYbb4AodYD4tGwhttp://www.foxepractice.com/healthcare-hashtags/mdchat/http://www.twitter.com/aliciad3http://www.twitter.com/PracticalWisdomhttp://www.foxepractice.com/healthcare-hashtags/MDChat/http://www.twitter.com/melanoma_mamahttp://www.foxepractice.com/healthcare-hashtags/mdchat/http://www.foxepractice.com/healthcare-hashtags/mdchat/http://www.twitter.com/melanoma_mamahttp://www.foxepractice.com/healthcare-hashtags/MDChat/http://www.twitter.com/PracticalWisdomhttp://www.twitter.com/aliciad3http://www.foxepractice.com/healthcare-hashtags/mdchat/http://www.transformed.com/practice-improvement2.cfm?gclid=CKG7xfKhxaYCFYbb4AodYD4tGwhttp://www.transformed.com/practice-improvement2.cfm?gclid=CKG7xfKhxaYCFYbb4AodYD4tGwhttp://www.twitter.com/GailZahtzhttp://www.twitter.com/CrescendoCGhttp://www.foxepractice.com/healthcare-hashtags/mdchat/http://tinyurl.com/68e8zgqhttp://www.twitter.com/KathyKastnerhttp://www.twitter.com/GailZahtzhttp://www.twitter.com/RichmondDochttp://www.foxepractice.com/healthcare-hashtags/Mdchat/http://www.twitter.com/RichmondDochttp://www.twitter.com/PracticalWisdomhttp://www.foxepractice.com/healthcare-hashtags/mdchat/http://www.twitter.com/PracticalWisdomhttp://www.twitter.com/s_ellerhttp://www.twitter.com/Mtnmdhttp://www.foxepractice.com/healthcare-hashtags/MDChat/http://www.twitter.com/KathyKastnerhttp://www.twitter.com/RichmondDochttp://www.twitter.com/apjonashttp://www.twitter.com/GailZahtzhttp://www.foxepractice.com/healthcare-hashtags/mdchat/http://www.twitter.com/GailZahtzhttp://www.twitter.com/apjonashttp://www.foxepractice.com/healthcare-hashtags/mdchat/http://www.twitter.com/PracticalWisdomhttp://www.twitter.com/RichmondDochttp://www.foxepractice.com/healthcare-hashtags/MDchat/http://www.foxepractice.com/healthcare-hashtags/HCSMCA/http://www.foxepractice.com/healthcare-hashtags/MDChat/http://www.twitter.com/KathyKastnerhttp://www.twitter.com/GailZahtzhttp://www.twitter.com/KathyKastnerhttp://www.foxepractice.com/healthcare-hashtags/MDchat/http://www.twitter.com/hranahttp://www.twitter.com/EllenRichterhttp://www.foxepractice.com/healthcare-hashtags/MDChat/http://www.twitter.com/RichmondDochttp://www.twitter.com/KathyKastnerhttp://www.twitter.com/GailZahtzhttp://www.foxepractice.com/healthcare-hashtags/mdchat/http://www.twitter.com/apjonashttp://www.twitter.com/GailZahtzhttp://www.twitter.com/RichmondDoc


15/17

PracticalWisdom @RichmondDoc@GailZahtz@KathyKastner: Golly Mark, you are so valuable. #MdchatTue Jan 18 18:54:39 PST 2011

s_eller Have to say goodnight now folks - it has been a lively chat as always. @PhilBaumann - y

are a host beyond compare - thanks! #mdchatTue Jan 18 18:55:00 PST 2011

Mtnmd @apjonas@GailZahtz I think medical home is a start of a way to think about a simple co

someone cares abt the pt- -retro!!! #mdchat.Tue Jan 18 18:55:10 PST 2011

RichmondDoc @PracticalWisdom@GailZahtz@KathyKastner I try to pull my weight :) #mdchatTue Jan 18 18:55:34 PST 2011

EinsteinMed @s_eller Thanks for stopping by! #MDChatTue Jan 18 18:55:43 PST 2011

swan5675 Thank you for letting me sit in on your brainstorming. #MDchat

Tue Jan 18 18:57:47 PST 2011

CrescendoCG @GailZahtz Pretty much :-) #mdchATTue Jan 18 18:58:10 PST 2011

EllenRichter I like that! RT @GailZahtz T2 I think nutrition is a FINE example of how #mHealth, #HCS

help #doctors & #patients work together #MDchatTue Jan 18 18:58:14 PST 2011

Mtnmd @PracticalWisdom@RichmondDoc@apjonas@GailZahtz So true! #mdchat

Tue Jan 18 18:58:46 PST 2011

hrana @Mtnmd@PracticalWisdom@RichmondDoc Interesting #mdchat tonight. I missed quit

of it but caught the tail end.Tue Jan 18 18:58:46 PST 2011

KathyKastner Wow: ethics, diet, education and all in one hour. Awesome. #MDchatTue Jan 18 18:58:49 PST 2011

RichmondDoc Final thoughts (1/2): "Act at all times as if the patient is fully autonomous; ... #mdchatTue Jan 18 18:58:59 PST 2011

RichmondDoc (2/2) ... the weaker the patient is, the more vulnerable you are to violating his/her person


swan5675 After all, the patient is why we are all here. Goodnight and thank you. #MDchatTue Jan 18 18:59:11 PST 2011
http://www.twitter.com/PracticalWisdomhttp://www.twitter.com/RichmondDochttp://www.twitter.com/GailZahtzhttp://www.twitter.com/KathyKastnerhttp://www.foxepractice.com/healthcare-hashtags/Mdchat/http://www.twitter.com/s_ellerhttp://www.twitter.com/PhilBaumannhttp://www.foxepractice.com/healthcare-hashtags/mdchat/http://www.twitter.com/Mtnmdhttp://www.twitter.com/apjonashttp://www.twitter.com/GailZahtzhttp://www.foxepractice.com/healthcare-hashtags/mdchat/http://www.twitter.com/RichmondDochttp://www.twitter.com/PracticalWisdomhttp://www.twitter.com/GailZahtzhttp://www.twitter.com/KathyKastnerhttp://www.foxepractice.com/healthcare-hashtags/mdchat/http://www.twitter.com/EinsteinMedhttp://www.twitter.com/s_ellerhttp://www.foxepractice.com/healthcare-hashtags/MDChat/http://www.twitter.com/swan5675http://www.foxepractice.com/healthcare-hashtags/MDchat/http://www.twitter.com/CrescendoCGhttp://www.twitter.com/GailZahtzhttp://www.foxepractice.com/healthcare-hashtags/mdchAT/http://www.twitter.com/EllenRichterhttp://www.twitter.com/GailZahtzhttp://www.foxepractice.com/healthcare-hashtags/mHealth/http://www.foxepractice.com/healthcare-hashtags/HCSM/http://www.foxepractice.com/healthcare-hashtags/doctors/http://www.foxepractice.com/healthcare-hashtags/patients/http://www.foxepractice.com/healthcare-hashtags/MDchat/http://www.twitter.com/Mtnmdhttp://www.twitter.com/PracticalWisdomhttp://www.twitter.com/RichmondDochttp://www.twitter.com/apjonashttp://www.twitter.com/GailZahtzhttp://www.foxepractice.com/healthcare-hashtags/mdchat/http://www.twitter.com/hranahttp://www.twitter.com/Mtnmdhttp://www.twitter.com/PracticalWisdomhttp://www.twitter.com/RichmondDochttp://www.foxepractice.com/healthcare-hashtags/mdchat/http://www.twitter.com/KathyKastnerhttp://www.foxepractice.com/healthcare-hashtags/MDchat/http://www.twitter.com/RichmondDochttp://www.foxepractice.com/healthcare-hashtags/mdchat/http://www.twitter.com/RichmondDochttp://www.foxepractice.com/healthcare-hashtags/mdchat/http://www.twitter.com/swan5675http://www.foxepractice.com/healthcare-hashtags/MDchat/http://www.foxepractice.com/healthcare-hashtags/MDchat/http://www.twitter.com/swan5675http://www.foxepractice.com/healthcare-hashtags/mdchat/http://www.twitter.com/RichmondDochttp://www.foxepractice.com/healthcare-hashtags/mdchat/http://www.twitter.com/RichmondDochttp://www.foxepractice.com/healthcare-hashtags/MDchat/http://www.twitter.com/KathyKastnerhttp://www.foxepractice.com/healthcare-hashtags/mdchat/http://www.twitter.com/RichmondDochttp://www.twitter.com/PracticalWisdomhttp://www.twitter.com/Mtnmdhttp://www.twitter.com/hranahttp://www.foxepractice.com/healthcare-hashtags/mdchat/http://www.twitter.com/GailZahtzhttp://www.twitter.com/apjonashttp://www.twitter.com/RichmondDochttp://www.twitter.com/PracticalWisdomhttp://www.twitter.com/Mtnmdhttp://www.foxepractice.com/healthcare-hashtags/MDchat/http://www.foxepractice.com/healthcare-hashtags/patients/http://www.foxepractice.com/healthcare-hashtags/doctors/http://www.foxepractice.com/healthcare-hashtags/HCSM/http://www.foxepractice.com/healthcare-hashtags/mHealth/http://www.twitter.com/GailZahtzhttp://www.twitter.com/EllenRichterhttp://www.foxepractice.com/healthcare-hashtags/mdchAT/http://www.twitter.com/GailZahtzhttp://www.twitter.com/CrescendoCGhttp://www.foxepractice.com/healthcare-hashtags/MDchat/http://www.twitter.com/swan5675http://www.foxepractice.com/healthcare-hashtags/MDChat/http://www.twitter.com/s_ellerhttp://www.twitter.com/EinsteinMedhttp://www.foxepractice.com/healthcare-hashtags/mdchat/http://www.twitter.com/KathyKastnerhttp://www.twitter.com/GailZahtzhttp://www.twitter.com/PracticalWisdomhttp://www.twitter.com/RichmondDochttp://www.foxepractice.com/healthcare-hashtags/mdchat/http://www.twitter.com/GailZahtzhttp://www.twitter.com/apjonashttp://www.twitter.com/Mtnmdhttp://www.foxepractice.com/healthcare-hashtags/mdchat/http://www.twitter.com/PhilBaumannhttp://www.twitter.com/s_ellerhttp://www.foxepractice.com/healthcare-hashtags/Mdchat/http://www.twitter.com/KathyKastnerhttp://www.twitter.com/GailZahtzhttp://www.twitter.com/RichmondDochttp://www.twitter.com/PracticalWisdom


16/17

RichmondDoc Thanks for the discussion everyone. These chats always keep me on my toes and make

assess where I stand & work to improve. #mdchatTue Jan 18 19:00:10 PST 2011

bfishgold @einsteinmed: that was a great ending statement by you. #mdchatTue Jan 18 19:00:12 PST 2011

njfrantz This move is from where an individual receives care determined by a professional, to on

has person at its heart. #MDchatTue Jan 18 19:00:19 PST 2011

PracticalWisdom We are adults so treat us like adults. RT @RichmondDoc: Final (1/2): "Act at all times as

patient is fully autonomous; ... #MdchatTue Jan 18 19:00:26 PST 2011

PracticalWisdom @swan5675: Thank you. #MdchatTue Jan 18 19:00:46 PST 2011

njfrantz ...with the individual firmly at the centre in identifying what is personally important to delivor her outcomes. #MDchatTue Jan 18 19:00:57 PST 2011

GailZahtz #MDChat great chance for me to repeat- if empowered patients work with a team led by

physician evidence-based medicine, everyone wins. ;)Tue Jan 18 19:01:01 PST 2011

Mtnmd @hrana@PracticalWisdom@RichmondDoc Glad to have you in!! #mdchatTue Jan 18 19:01:22 PST 2011

PracticalWisdom Love itRT @Mtnmd: RT @RichmondDoc (2/2) ... the weaker the patient is, the more

vulnerable you are to violating his/her personhood. #MdchatTue Jan 18 19:01:24 PST 2011

RichmondDoc (quote from A Decalogue for Family Practice Residents Entering Practice--G. Gayle Step


PracticalWisdom @Mtnmd@hrana@PracticalWisdom@RichmondDoc: Blushing~Thank you! #MdchatTue Jan 18 19:02:22 PST 2011

GailZahtz TY@Mtnmd@EllenRichter@CrescendoCG@PracticalWisdom@RichmondDoc@apjo

@KathyKastner@westr@PhilBaumann@s_eller@AnthonyBurich#MDChatTue Jan 18 19:03:10 PST 2011

EllenRichter @MD_Chat What? You tell us that & then stop? Haha...I wanna know the special stuff!!

http://www.twitter.com/RichmondDochttp://www.foxepractice.com/healthcare-hashtags/mdchat/http://www.twitter.com/bfishgoldhttp://www.twitter.com/einsteinmedhttp://www.foxepractice.com/healthcare-hashtags/mdchat/http://www.twitter.com/njfrantzhttp://www.foxepractice.com/healthcare-hashtags/MDchat/http://www.twitter.com/PracticalWisdomhttp://www.twitter.com/RichmondDochttp://www.foxepractice.com/healthcare-hashtags/Mdchat/http://www.twitter.com/PracticalWisdomhttp://www.twitter.com/swan5675http://www.foxepractice.com/healthcare-hashtags/Mdchat/http://www.twitter.com/njfrantzhttp://www.foxepractice.com/healthcare-hashtags/MDchat/http://www.twitter.com/GailZahtzhttp://www.foxepractice.com/healthcare-hashtags/MDChat/http://www.twitter.com/Mtnmdhttp://www.twitter.com/hranahttp://www.twitter.com/PracticalWisdomhttp://www.twitter.com/RichmondDochttp://www.foxepractice.com/healthcare-hashtags/mdchat/http://www.twitter.com/PracticalWisdomhttp://www.twitter.com/Mtnmdhttp://www.twitter.com/RichmondDochttp://www.foxepractice.com/healthcare-hashtags/Mdchat/http://www.twitter.com/RichmondDochttp://www.foxepractice.com/healthcare-hashtags/mdchat/http://www.twitter.com/PracticalWisdomhttp://www.twitter.com/Mtnmdhttp://www.twitter.com/hranahttp://www.twitter.com/PracticalWisdomhttp://www.twitter.com/RichmondDochttp://www.foxepractice.com/healthcare-hashtags/Mdchat/http://www.twitter.com/GailZahtzhttp://www.twitter.com/Mtnmdhttp://www.twitter.com/EllenRichterhttp://www.twitter.com/CrescendoCGhttp://www.twitter.com/PracticalWisdomhttp://www.twitter.com/RichmondDochttp://www.twitter.com/apjonashttp://www.twitter.com/KathyKastnerhttp://www.twitter.com/westrhttp://www.twitter.com/PhilBaumannhttp://www.twitter.com/s_ellerhttp://www.twitter.com/AnthonyBurichhttp://www.foxepractice.com/healthcare-hashtags/MDChat/http://www.twitter.com/EllenRichterhttp://www.twitter.com/MD_Chathttp://www.foxepractice.com/healthcare-hashtags/MDchat/http://www.foxepractice.com/healthcare-hashtags/MDchat/http://www.twitter.com/MD_Chathttp://www.twitter.com/EllenRichterhttp://www.foxepractice.com/healthcare-hashtags/MDChat/http://www.twitter.com/AnthonyBurichhttp://www.twitter.com/s_ellerhttp://www.twitter.com/PhilBaumannhttp://www.twitter.com/westrhttp://www.twitter.com/KathyKastnerhttp://www.twitter.com/apjonashttp://www.twitter.com/RichmondDochttp://www.twitter.com/PracticalWisdomhttp://www.twitter.com/CrescendoCGhttp://www.twitter.com/EllenRichterhttp://www.twitter.com/Mtnmdhttp://www.twitter.com/GailZahtzhttp://www.foxepractice.com/healthcare-hashtags/Mdchat/http://www.twitter.com/RichmondDochttp://www.twitter.com/PracticalWisdomhttp://www.twitter.com/hranahttp://www.twitter.com/Mtnmdhttp://www.twitter.com/PracticalWisdomhttp://www.foxepractice.com/healthcare-hashtags/mdchat/http://www.twitter.com/RichmondDochttp://www.foxepractice.com/healthcare-hashtags/Mdchat/http://www.twitter.com/RichmondDochttp://www.twitter.com/Mtnmdhttp://www.twitter.com/PracticalWisdomhttp://www.foxepractice.com/healthcare-hashtags/mdchat/http://www.twitter.com/RichmondDochttp://www.twitter.com/PracticalWisdomhttp://www.twitter.com/hranahttp://www.twitter.com/Mtnmdhttp://www.foxepractice.com/healthcare-hashtags/MDChat/http://www.twitter.com/GailZahtzhttp://www.foxepractice.com/healthcare-hashtags/MDchat/http://www.twitter.com/njfrantzhttp://www.foxepractice.com/healthcare-hashtags/Mdchat/http://www.twitter.com/swan5675http://www.twitter.com/PracticalWisdomhttp://www.foxepractice.com/healthcare-hashtags/Mdchat/http://www.twitter.com/RichmondDochttp://www.twitter.com/PracticalWisdomhttp://www.foxepractice.com/healthcare-hashtags/MDchat/http://www.twitter.com/njfrantzhttp://www.foxepractice.com/healthcare-hashtags/mdchat/http://www.twitter.com/einsteinmedhttp://www.twitter.com/bfishgoldhttp://www.foxepractice.com/healthcare-hashtags/mdchat/http://www.twitter.com/RichmondDoc


17/17

PracticalWisdom KathyKastner: Great to see you tonight. I really, cross my heart want to catch up with y

and chat. #MdchatTue Jan 18 19:04:49 PST 2011

KathyKastner Likewise -sry 2 be bad e-responder RT @PracticalWisdom: KathyKastner: I really, cros

heart want to catch up with you and chat. #MDchatTue Jan 18 19:05:43 PST 2011

AnthonyBurich Thank you all for letting me tag along for the education. Good night! #mdchatTue Jan 18 19:05:55 PST 2011

PracticalWisdom KathyKastner: Takes 2 to Tango. Later ; < ) #MdchatTue Jan 18 19:07:25 PST 2011

EllenRichter @MD_Chat :P Stinker! #MDchatTue Jan 18 19:07:28 PST 2011

westr Like taking candy... From a baby... RT @EllenRichter: @MD_Chat What? You tell us th

then stop? I wanna know the special stuff!! #MDchatTue Jan 18 19:08:10 PST 2011

PracticalWisdom So long farewell we had to say Good bye. #MdchatTue Jan 18 19:08:16 PST 2011

bfishgold @einsteadmed: you are welcome Paul. We have to do it. #mdchatTue Jan 18 19:08:55 PST 2011

PracticalWisdom @westr: You are so spot on. #MDchat

Tue Jan 18 19:09:10 PST 2011

RichmondDoc @westr Is that part of what you teach in your nutrition lectures? Best baby-candy-taking

methods? :) @EllenRichter@MD_Chat#mdchatTue Jan 18 19:09:11 PST 2011

EllenRichter @westr@KathyKastner@MD_Chat ~LMAO #MDchatTue Jan 18 19:09:21 PST 2011

PracticalWisdom You all are Candy for my Brain. The best kind. #MDchatTue Jan 18 19:09:58 PST 2011

bfishgold @einsteinmed: you are welcome Paul. We will do it. #mdchatTue Jan 18 19:10:33 PST 2011
http://www.twitter.com/PracticalWisdomhttp://www.foxepractice.com/healthcare-hashtags/Mdchat/http://www.twitter.com/KathyKastnerhttp://www.twitter.com/PracticalWisdomhttp://www.foxepractice.com/healthcare-hashtags/MDchat/http://www.twitter.com/AnthonyBurichhttp://www.foxepractice.com/healthcare-hashtags/mdchat/http://www.twitter.com/PracticalWisdomhttp://www.foxepractice.com/healthcare-hashtags/Mdchat/http://www.twitter.com/EllenRichterhttp://www.twitter.com/MD_Chathttp://www.foxepractice.com/healthcare-hashtags/MDchat/http://www.twitter.com/westrhttp://www.twitter.com/EllenRichterhttp://www.twitter.com/MD_Chathttp://www.foxepractice.com/healthcare-hashtags/MDchat/http://www.twitter.com/PracticalWisdomhttp://www.foxepractice.com/healthcare-hashtags/Mdchat/http://www.twitter.com/bfishgoldhttp://www.twitter.com/einsteadmedhttp://www.foxepractice.com/healthcare-hashtags/mdchat/http://www.twitter.com/PracticalWisdomhttp://www.twitter.com/westrhttp://www.foxeprac

mdchat twitter healthcare chat for january 18, 2011

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