Ryan P. Daly, MD
@DrRyanPDaly
Followers
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CV Imaging factotum. Fisherman. CV prevention. Seeker of wisdom, best-practices and mental models. Not medical advice. opinions my own. #HealthyIndy
The ocean I hope..
Joined March 2015
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Pinned Tweet
Hey docs, esp cardiologists. When negotiating your contract with your hospital do you use a lawyer skilled in negotiating or use a professional negotiating services? Please comment why. Do you have any special skills in contract negotiations?
#MedTwitter
#CardioTwitter
Do it yourself
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Use lawyer
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Professional negotiators
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Sticking a needle for a biopsy through lung tissue - right next to a pulsatile major artery- getting paid $155.00. Plumber gets more. Yeah this is inane. Meanwhile UAW looking for a 40 percent pay raise….
Should be worth more than 3 RVUs in my opinion…
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Called an insurance company for a peer to peer pre-auth. They told me they were recording me. I told them I was recording them. They did not consent to being recorded. Huh. Go figure.
#Cardiotwitter
#Patientsafety
#Ambetter
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Makes me wonder what the utility and purpose of the USMLEs and IM and Cardiology boards are? Esp if you can get a FACC and put in TAVRs without doing it…🤔 why did I have to pass my cardiology boards to get my FACC and others don’t ?
@GHCardiology
this is so inappropriate on so many levels. Being a TAVR operator is not just about deploying a valve, but working up the pt for the optimal mx of their AS, managing the patient prior to procedure and dealing with complications. This is not safe for patients…
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And here it is. Maybe we shouldn’t give midlevels that haven’t passed cardiology boards FACC…I know this will generate some hate. But scope creep is real.
Nurse practitioners sue California over restricted use of 'doctor'
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Can we please just start calling Prediabetes, Diabetes type 2 stage 1 ? It’s a continuum. Prediabetes sounds so innocuous. It’s not.
#medtwitter
Words matter.
#Cardiometabolics
#healthyIndy
#CVprev
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Why do we tolerate MOC when no other physicians across the world do so? What’s the justification and why the acquiescence and complicity by our professional societies and their representatives?
#MedTwitter
#Cardiotwitter
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I wish so many doctors didn’t trade their health and fitness for their career. As healthleaders we should be health and fitness role models. Medical training is the anti-thesis of this. Insane hours, fragmented sleep and poor access to good food. Kinda goes to credibility No?
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@RaoulGMI
Raoul sometimes I’m flabbergasted by the quality of education and content u provide for free on Twitter. Ty
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@DGlaucomflecken
That’s a nice board certification you have there after passing your exam for 1800.00 it’d be shame if something happened to it…
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Can confirm- 🚩🚩🚩🚩🚩esp if a farmer….
Just a reminder that when an ER patient says “my wife made me come in”, something is really fucking wrong until proven otherwise.
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Thread : The value of 50K+ patient encounters is often marginalized by some academic elites. The voice of the community cardiologist should be a loud one on twitter, as we represent >80% of all cardiologists. 1
Pearls of wisdom from
@califf001
👇
“We should hope for few Kardashian-style commentators and many more professionals who do the hard work....
and then use social media to develop a mutual understanding of what it means”
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Wow
Closest pic of Saturn, from inside its rings, by the Cassini Spacecraft two weeks ago...
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Fact check:True.
Has put more people to sleep than Ambien, NyQuil, and Xanax combined.
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@AaronGoodman33
Have you asked the leaders of American Society of Heamtology and Oncology about their public response to this ? Honestly this should be an emergency press release and condemnation. Decertifying doctors also is a public heath access issue and should be condemned by American…
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IM boards $1430. Cards boards $2480. CT Boards $1050 Echo Boards $995.00 Nuke Boards $1095. Total:$7050.00
7 Days missed office or 154 patient visits.
Board Review IM Mayo $1099. ACCSAP $1500.00 $SCCT $825.00 Nuke/ASNC $800.00 total $5324.00 Not counting hotels, days of missed…
Board certified in:
1. Internal medicine 2017
2. Echocardiography 2022
3. Nuclear Cardiology 2022
4. Cardiac Computed Tomography 2022
5. Cardiovascular Disease 2023
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The older I get the more I admire grit, consistency, compassion, and creativity.
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@kyeishalaurence
Congratulations- you didn’t get- you earned and were granted, you’re just too polite to write that.💪💪Strong work!
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While there are untold long hours, many challenges, with tons of social and family sacrifice. I am privileged to be a physician, esp in the US. There is an opportunity to change lives, to heal, to make a meaningful difference, mitigate suffering daily. A mistake? Hell no.
$1 million mistake: Becoming a doctor - eye-opening article. They don't make as much as you think, work long hours, accumulate massive education debt, and the majority would not choose to do it again.
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Time spent on hold fighting for pre-authorizations should be billable. We need to stop being punching bags for insurance companies.
@MinnowWalsh
Lawyers certainly wouldn’t do this work for free. Nor would they pay a doc to be on hold....
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I just hit a milestone- 5k followers. Humbled to be sure. Thanks for reading and will try to continue to provide value in CV imaging/prevention/cardioonc and share what I learn in macro/finance!
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Read Best Practices for Prognostic Evaluation of a Patient with TTR Amyloid Cardiomyopathy by Kent Y Feng et al in
#JACCCardioOnc
#CardioOnc
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Interested In practicing in Indianapolis? We’re hiring IC, EP and noninvasive cardiologists. Meet us at the
#ACC23
career fair between 2-4pm! It’s a amazing opportunity. Can’t wait to see you!
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In some circles we called this Internal Medicine residency.
#Cardiotwitter
#SGLT2i
Dr Braunwald suggests that cardiology fellows spend 6 months studying diabetes and treating patients due to the profound impact on CV outcomes with new therapies.
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You’re never too smart, never too rich, never too successful to be nice to people. To everyone. Character is who you are when no one is looking.
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Harsh but fair.
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Took more than 40k hours closer to 45k of medical training before I started practicing.
This completely devalues true expertise and mastery. Its frankly an insulting hashtag. And it’s patently false. This same person if their kid gets in a car wreck is going to want the trauma…
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Tips for networking at
#ACC19
. Hat-tip to
@dorieclark
my inspiration.
1. Be active on twitter and social media
#ACC19
2.Attend your Sections meeting
3. Attend the tweet-up Ritz Davenport Lounge.
4. Dress strategically-using icebreakers (a snazzy tie or brooch or colorful socks1/n
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I’m suprised more Cardiologists aren’t discussing the IRIS study. Pioglitazone reduces Stroke ARR 2.6 percent and MI by ARR 1.7 percent in patients with Insulin resistance. Wow!
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Helping people lose weight, lower blood pressure and achieve improved glycemic control through lifestyle changes may be one of the most satisfying things I do.
#CVPrevention
Not as sexy as PCI or TAVR, but equally life changing.
#Cardiotwitter
#NSNG
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@sgremminger
@_Dehra
Scheduling less appointments will reduce access. That means when your kid has a sore throat you wont be able to get in. SO you will have to go to urgent care- which I hear runs like the train station. Margins for pediatricians are already tight to begin with. On top of this as a…
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Sorry not Cardiology. Not Sorry.🔥🔥💥☄️🔥Wins the Internets today. The look of joy is incomparable!
#LedZeppelin
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I’ll start. Stronger and fitter people live longer- in general. Walking is a great start, but I want more. Can you do push-ups? A pull-up? What are you doing daily to become fitter. The habit is what is most important. Create the habit of fitness.
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Twitter friends please take this time to congratulate the esteemed
@ErinMichos
for being named Director of Women’s CV Heath at Hopkins! Bravo.
Congratulations to
@ErinMichos
for being named Director of Women’s CV Health for the
@hopkinsheart
Division of Cardiology and to
@MMukherjeeMD
for being named Medical Director of Johns Hopkins Bayview Echo Lab! Two amazingly talented women! 🧬🎊🎉
@DrLenaMathews
@GarimaVSharmaMD
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Wow
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I don’t know how oncologists do it. The emotional toll of dealing with the suffering and morbidity of cancer on a daily basis. Heart failure and cardiOnc is hard enough, my hats off these special physicians. You develop emotional connects with these patients and their families.…
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3D printing enhances comprehension of medical student understanding of complex congenital heart disease. Maybe cardiology fellows too?!?
#SCCT2019
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Peak modern art. Looking forward to the pendulum swinging.
@saifedean
An invisible sculpture, otherwise known as nothing, sold for $18,000
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Humbled and excited to be presenting Grand Rounds tomorrow at
@IU_Health
Dept of Cardiology on “Understanding and Leveraging Social Media In Cardiology”
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In the next few months - some of you will be representing cardiologists in your state at your local ACC chapter meetings. Please let your representatives know your displeasure about
@ABIMFoundation
#MOC
and the burdens of recertification. Ask them for concrete solutions.
@inacc
…
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This gives me chills.
Fate whispers to the warrior, 'You can not withstand the storm.'
The warrior whispers back, 'I am the storm.'
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US true interest expense is 111% of all time record tax receipts. -
@LukeGromen
This doesn’t end well.
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@antonioatanasv
Idealism and ideology > math and reality. A plan with good goals not well thought out as to the downstream and financial consequences. Similar things in California. Math wins.
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You may thought you were cool but are you Gold jacket wearing iggy pop bracelet wearing irresponsibly long
#BTC
rum drinking on private island cool?
@RaoulGMI
#Livinghisbestlife
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@AaronGoodman33
We need our professional societies to assertively push back against this- otherwise what’s the point of their whole existence?
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@DGlaucomflecken
While funny do you know how many major places have stopped taking new patients? That you have to “apply” to be seen despite having a referral? Or not getting an appt for 2 years?
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This slide should be enough to give you chest pain. We must do better about treating heart disease in women.
#SCCT2023
@DrMarthaGulati
@purviparwani
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@TgMacro
When the brothel gets raided, everybody gets arrested, even the piano man…- source unknown.
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A 10 percent reduction in weight reduces Visceral Adipose Tissue 30%! VAT is metabolically active…
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On CHF service. Hours are tight. My future self is worth 30 minutes of cardio and sweat. Some is better than none. Thanks for the workout Hannah.
#pelotonmedtwitter
#pelotondocs
#healthyIndy
It’s a win for me today.
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I want to thank
@DoctorTro
and
@BrianLenzkes
for hosting me on the Low Carb MD podcast talking about
#CVPrevention
Calcium scoring and CV imaging and challenges for the medical community. Lots of fun, humbled to be a guest.
#CAC
#YesSCCt
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Wisdom of farmers. Not meant to apply just to plants..
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Iconic photo
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Starting to believe much of what we were taught regarding diet was wrong. Too many Carbs and hyper insulinemia is killing us.
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I may have a new weekend project
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On call this past weekend. I’m pretty tired after a week on service &late day of clinic &
#CMR
reading. Did NOT want to go the gym. I don’t like doing my inbox either. Did it anyways. Taking a W today.
#healthyIndy
Here’s to success from showing up.
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I’ve posted about this heuristic before, but not so eloquently! This thread is worth a read, it challenges the preconceived notions and bias that we all have. If you don’t already follow
@SahilBloom
- you’re missing out.
Hanlon's Razor is a simple mental model for cutting through negative noise and unlocking growth in your career, startup, business, or relationships.
A short thread on what it is and how it can change your life...
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@tednaiman
@DietDoctor1
your argument is unbelievably strong. I'm converting, and am overwhelmed by the logic and evidence
#Lowcarb
#VLCD
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EVERYTHING WE DO BEFORE A PANDEMIC WILL SEEM ALARMIST. EVERYTHING WE DO AFTER WILL SEEM INADEQUATE”
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Cardiologists do you prescribe low fat diets, low carb,Mediterranean, paleo or other ? Why in comments.Please RT.
#LCHF
#Paleo
#Nutrition
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Other
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Welcome to private practice outside the Ivory tower. This is normal. I still remember my Chief fellow sending an email to all the fellows. The answer is always yes. A doc in the community and their patient need help. The his has stuck with me and become a mantra.
On my first shift as an attending, the cardiologist I consulted came down to the ED and introduced himself, welcomed me to the hospital, gave me his cell phone number, and said to call/text him if I have trouble getting cards help.
Am I being punked?!?!
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It’s a chocolate lab 🐕🦺🐾🦴
Apparently, if you can see two people hugging, you're left-brained, and if you can see a dinosaur, you're right-brained. What do you see in the mountain?
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The future is jaw dropping for
#YesCCT
. Ultra-high resolution imaging of 3.0 stents, calcium subtraction, tissue characterization with spectral imaging using multiple contrast agents, even vulnerable plaque imaging with gold nanoparticles, CT perfusion. What a time to be alive.…
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DOACs, SGLT2Is and GLP-RAs don’t reduce events if your patient can’t afford them.
#cardiotwitter
#HealthyIndy
#DalyMusings
@purviparwani
@PrevCardioOnc
@onco_cardiology
#diabetes
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One of my favorite maxims: Hanlon's razor:
Never attribute to malice that which is adequately explained by stupidity or incompetence. Gives you a lot more patience when you think this way.
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"Most people don’t want accurate information, they want validating information.
Growth requires you to be open to unlearning ideas that previously served you."
–
@JamesClear
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@DGlaucomflecken
It could clearly be shortened. It’s free labor. Usually significant “research” requirement as well whether you want to or not.
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Fasting is an under utilized tool for modern day weight loss.
I do a 24-hour fast twice a week. The more you do this, the less "hungry" you feel. This helps with weight loss.
Start with the 16:8 routine, where you eat during a set 8-hour window during the day.
Proceed from there. It's not as painful as you'd think.
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Dear
@ACCinTouch
leadership. We the members are dissatisfied with your position and actions on
@ABIMFoundation
and MOC. Attn:
@TimAttebery
@DickKovacs
@MinnowWalsh
. Please stop this profiteering of your members.
#cardiotwitter
#Medtwitter
#CardioEd
#NoMOC
This weekend I paid 1500$ and spent many hours answering esoteric test questions and I am now going to be listed as “board certified”
What a crock! Shame on
@ACCinTouch
and
@HRSonline
for not standing up to ABIM.
Support
@doctorwes
and
@PPA_USA
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How to think about CAC score of 1-100. I need this awesome image for my patient handouts!!
#SCCT2019
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@BruckelJeffrey
Taking care of complicated , e.g. CHF patients, CardioOnc patients not adequately compensated compared to peers. Tons of high value low RVU work out there. RVU programs award high volume low complexity work disproportionately. We need to bill hourly like lawyers
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Everyone can see how this would completely change the patient experience of being ill, you would feel ‘cared for’. Hard to do w/ratios of 4-5 patients/nurse. Administrations have to re-think what their true goals are. How do we achieve ideal patient care?
#empathy
#patientsfirst
I shampooed my patient's hair.
Big whoop, right?
Well, imagine how good it would feel to have someone comb out knots and scrub your scalp after weeks in the hospital not being allowed to shower.
It's the littlest things that make the biggest differences.
#ptexp
#medtwitter
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Electric vehicles are exploding from water damage after Hurricane Ian, top Florida official warns
#FoxNews
Bullish Telsa?
@contrarian8888
@TheAlte22837262
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Can’t tell you how excited I am to announce
@Vijayrao7474
with be the next
@inacc
Governor. Succeeding a long line of luminaries. So proud of him.
#cardiotwitter
let’s congratulate him!!
@dwester001
@EdwardFryMD
@MinnowWalsh
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@YogiStonks
@kittysquiddy
FWIW If looking for an equity play -Amerigo has ridiculous torque to copper prices. I’ve been adding to Altius Resources as I believe in the LT Secular Copper Bull and electrification of India/China et al. My duration tends to be longer.
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Heart of stone.
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