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 đ
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: đ§ľ
FAQ here acep.org/administration/reimbursement/reimbursement-faqs/2023-ed-em-guidelines-faqs/
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). âŹď¸âŹď¸
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 ama-assn.org/system/files/2023-e-m-descriptors-guidelines.pdf
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.)
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 đ
twitter.com/kindofsquishy/status/1306355884650455040?s=20&t=ZoUwNyegPaOD2nLYnGJzVQ
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? đŹ
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
stateofthevirus.com/blog/fda-should-expand-access-of-tecovirimat-for-monkeypox-now
How to Take a History and Examine a Monkeypox Patient
Iâm sick and tired of gay men being misdiagnosed with something ELSE when itâs clearly monkeypox and you canât be bothered to examine them or take a history, doctors.
THIS IS NOT ROCKET SCIENCE
Take twoâď¸ minutes and let me catch you the fuck up.
Seeing a patient with a new rash, especially if it:
âis around their genitals đor anusđ?
âhas another new distant lesion (face, arms)
âlooks like papules, vesicles, pustules, or ulcers
âis in a gay man, esp with new partners?
Yeah. It's probably monkeypox.