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Graham Walker, MD

@grahamwalker

Emergency physician; I made @mdcalc; Tweets = my own/not employers'. Not a hero, just a well-trained human. So, so tired of COVID. #GetVaccinated 💉

Medical Decision Making FAQ Review for EM Coding

New emergency medicine level of service billing changes coming in 2023! @EmergencyDocs @ACEPNow @JeffreyLDavis44 just released a really helpful FAQ, thread calling out the big points: 🧵 FAQ here https://www.acep.org/administration/reimbursement/reimbursement-faqs/2023-ed-em-guidelines-faqs/

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My CCD Health Design Submission from 2012

Came across a health design contest I entered in 2012 and couldn't believe the site was still up! 💡Ideas I still think are good: This is the Health Matrix, patient clicks on diseases or drugs or doctors and it shows them how they're all related and their importance (square size)

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2023 Emergency Medicine Coding/Billing Updates

Quick thread on changes to emergency medicine billing requirements coming in a few months (Jan 1, 2023)! Most importantly: goodbye to the absolutely inane HPI, ROS, and PE elements for billing. Hooray! Instead, EVERYTHING is based on medical decision-making (MDM). ⬇️⬇️

Props to my friend and colleague @RobPNorris who spent a ton of time summarizing all of this. I'm stealing his slides. This is all based on AMA guidelines here https://www.ama-assn.org/system/files/2023-e-m-descriptors-guidelines.pdf

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You Can Literally Prevent Future Fucking Cancer

Isn't it kind of incredible that you can prevent your older self from getting cancer? Here's my own recent adventure in fucking future cancer in the ass (literally), and why you should say "Fuck Future Cancer" too:

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Announcing WTFentanyl.com - Correcting Fentanyl Misinformation

Proud to announce WTFentanyl.com, a resource to correct the ridiculous misinformation about fentanyl exposures online that spreads at a fever pitch these days. Please take a look and bookmark for future reference. You can also reference @WTFentanylBot in replies!

(Formerly the bot was @FentanylSafety but that URL was associated with... more fentanyl misinformation, so we're using @ryanmarino's #WTFentanyl inspiration instead.)

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How and Why Gifted Kids Struggle

Are you a former Gifted Kid? Anxious about trying new things as an adult because you'll be bad at them? Me too! I'd highly recommend a video from psychiatrist @dr_alokkanojia on his channel @HealthyGamerGG. Video inside 👇 https://twitter.com/kindofsquishy/status/1306355884650455040?s=20&t=ZoUwNyegPaOD2nLYnGJzVQ

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85 Days into MPX: COVID-Level Growth in Gay Men

Today is day 85 since the first confirmed US monkeypox case. If you graph out cases relative to the gay male population, it starts to look a lot like the 84 days of early 2020: infecting ~0.2% of the population. COVID-level growth in gay men.

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85 Days into Monkeypox: COVID-Level Growth for Gay Men

Today is day 85 since the first confirmed US monkeypox case. If you graph out cases relative to the gay male population, it starts to look a lot like the 84 days of early 2020: infecting ~0.2% of the population. COVID-level growth in gay men.

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Change My Mind: We Don't Need an RCT for TPOXX

Change My Mind: I do not support waiting for a blinded randomized placebo-controlled monkeypox trial before expanding access to tecovirimat(TPOXX). Despite being an online educator and supporter of evidence-based medicine. Is my thinking wrong? 💬

My main reason is that I think TPOXX can help stop the spread of MPX in this country. If it shortens the duration of illness, and illness duration is similar to contagiousness duration, that alone is worth it. See this Op-Ed @LeoNissolaMD @theIDPharmD https://www.stateofthevirus.com/blog/fda-should-expand-access-of-tecovirimat-for-monkeypox-now

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How to Take a History and Examine a Monkeypox Patient

I’m sick and tired of gay men being misdiagnosed with something ELSE when it’s clearly monkeypox and you can’t be bothered to examine them or take a history, doctors. THIS IS NOT ROCKET SCIENCE Take two✌️ minutes and let me catch you the fuck up.

Seeing a patient with a new rash, especially if it: —is around their genitals 🍆or anus🍑? —has another new distant lesion (face, arms) —looks like papules, vesicles, pustules, or ulcers —is in a gay man, esp with new partners? Yeah. It's probably monkeypox.

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