ED doc, corridor medic. ACCS Survivor #FOAMed . Views my own. @tombircher.bsky.social
Joined October 2012
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Why don’t rotating doctors, or locally employed doctors get their own laptops?
Seems like an open goal for improved productivity…
Tom Bircher retweeted
What happened to my patient? Innovative Sheffield ED initiative developed by Joseph Harding and @tombircher. Written up with @becky_hartshorn as ‘Really good stuff’ in this month’s Medical Education Journal.
asmepublications.onlinelibra…
@NIHR_ARC_YH @SHEFF_AEM @CURE_ScHARR
A story 🧵
So I was driving to a nearby city when my automatic electric hybrid car (don’t @ me) started making juddering noises when I accelerated past the point when the car needs to change gear.
A yellow blinky light came on.
I now have a car appointment for next Friday. I’ve just got an email with the *exact* same form I filled in earlier.
“This patient can’t come to our unit as they don’t fit the criteria”
“Ok. I kind of think they do, but ok, Can you tell me what the criteria are?”
“No”
“Ok. Are they written down anywhere?”
“No”
“Have you seen the patient?”
“No”
It’s not a zebra it’s a horse dressed as a zebra.
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
Tom Bircher retweeted
The biggest prize at the general election? The chance to stop the Tories coming second, and forming the official Opposition.
It's the difference between them biding their time until they can regroup, and being finished as a political force.
Here's what they would lose:
- 6 questions at PMQs every week
- Automatic media coverage
- 17 Opposition Days when they get to set the agenda and hold votes
- First right to reply to key speeches like the King's Speech and the Budget
- A lot of their Short Money
- The right to form a Shadow Cabinet (other parties can mirror government functions but nobody really cares) as a government in waiting
- Chairs of several Select Committees
- Privy Council membership for senior figures
- Office of the Leader of the Opposition, with additional resources, funding and staff
As you can imagine, without any of that good stuff to fall back on, the path to rebuilding would be a vertical cliff.
That's why it's essential to vote tactically to get the Tories out, no matter what you feel about the current incarnation of Labour.
The chance will never come again to wipe them out for good.
The other wheeze is deciding where/when to stop the clock. Clinical Decision Units can increase reported performance by 10-40% in some centers.