#MDchat

Healthcare Hashtag Twitter Transcript

From: Tue Jan 11 17:45:00 PST 2011
To: Tue Jan 11 19:15:00 PST 2011
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Learn more about #MDchat at The Healthcare Hashtag Project

MD_Chat In just a few minutes, we'll be live on #MDchat 9pm Eastern. Topic: Sleep, Perchance
to Be Policed
Tue Jan 11 17:45:08 PST 2011

mdstudent31 Getting ready for #mdchat. Topic: Should physicians report their sleep? Will be fun!
Tue Jan 11 17:57:43 PST 2011

s_eller @mdstudent31 - yes, it should be good - if I can stay awake for it. ;) Long day #mdchat
Tue Jan 11 17:58:42 PST 2011

MD_Chat Welcome to tonight's #MDchat everyone! We'll start it up in a moment, but let's warm
up with introductions!
Tue Jan 11 18:00:02 PST 2011

mdstudent31 A big hello from snowy PA! Kevin, 4th year med student, soon-to-be family med intern,
dreaming of the beach #mdchat
Tue Jan 11 18:02:07 PST 2011

RichmondDoc Mark, family doc in Richmond, VA; back from a week-long service trip to the Dominican
Republic; re-adapting to the cold again. #mdchat
Tue Jan 11 18:03:10 PST 2011

MD_chat @mdstudent31 @s_eller Welcome & good evening! #MDchat

Tue Jan 11 18:03:15 PST 2011

MD_chat @RichmondDoc Hi Mark. Welcome back to the cold! ;) #MDchat

Tue Jan 11 18:04:09 PST 2011

s_eller Susan from snowy Chicago -ED Rn who now works at Medical school teaching teams
via simulation #mdchat
Tue Jan 11 18:04:23 PST 2011

s_eller @RichmondDoc - good evening Mark - cold seems to be a theme tonight #mdchat
Tue Jan 11 18:04:55 PST 2011
EllenRichter Hi there! Ellen here, a critical care RN & legal nurse consultant from south Florida. :)
#MDchat
Tue Jan 11 18:05:09 PST 2011

RichmondDoc @MD_Chat Seriously. Where did the balmy 80-85 degrees go? #TropicalWinter
#mdchat
Tue Jan 11 18:05:18 PST 2011

apjonas #mdchat Hi everyone. I'm Pat Jonas, MD Holistic Family Physician. Dayton, OH
(snowing here)
Tue Jan 11 18:05:36 PST 2011

s_eller @EllenRichter - Hello Ellen - hope you don't have snow as well ;) #mdchat
Tue Jan 11 18:05:43 PST 2011

RichmondDoc @s_eller Definitely chilly. Though not nearly as icy as many feared. #mdchat
Tue Jan 11 18:06:19 PST 2011

EllenRichter It was 82 degrees here today @RichmondDoc :) #MDchat

Tue Jan 11 18:06:22 PST 2011

mkmackey Kathy Mackey, joining from snowless Houston #mdchat

Tue Jan 11 18:06:39 PST 2011

MD_Chat OK - we're warming up here. Will start the chat in a moment with our first question.
Have fun! #MDchat
Tue Jan 11 18:07:24 PST 2011

mdstudent31 @EllenRichter I'll be in FL for residency this time next year.... sooon enough, it will be
warm #mdchat
Tue Jan 11 18:07:24 PST 2011

RichmondDoc @EllenRichter Grrr! or maybe Brrr! :) #mdchat

Tue Jan 11 18:07:25 PST 2011

CrescendoCG Beth here - not snowing in ME yet (but it's coming...) #mdchat
Tue Jan 11 18:07:57 PST 2011

s_eller @mkmackey - good evening Kathy #mdchat

Tue Jan 11 18:08:04 PST 2011

EllenRichter @s_eller @mkmackey @RichmondDoc @apjonas @mdstudent31 @philbaumann Hi

there! #MDchat
Tue Jan 11 18:08:05 PST 2011

MD_chat T1 Mandated Disclosure of Sleep: See @Doctor_vʼs post http://bit.ly/hCjbBR Should

surgeons or other physicians have to disclose? #MDchat
Tue Jan 11 18:08:44 PST 2011

RichmondDoc @EllenRichter @s_eller @mkmackey @apjonas @mdstudent31 @philbaumann The

gang's all here! Missed y'all last week. #mdchat
 Tue Jan 11 18:08:51 PST 2011

EllenRichter @CrescendoCG Welcome :) #MDchat

Tue Jan 11 18:10:07 PST 2011

AndyKetch Andy Ketch - listening in on our heros, MD's, to learn. Thank you. #mdchat
Tue Jan 11 18:11:10 PST 2011

RichmondDoc T1 I think it will be a terribly difficult and unproductive process to try and legislate or
require certain hours of sleep from MDs. #mdchat
Tue Jan 11 18:11:13 PST 2011

s_eller Didn't read the post initially - so thanx for sharing link. I agree with Dr. V - hard for
someone else to make that call for you #mdchat
Tue Jan 11 18:11:39 PST 2011

RichmondDoc T1 So no, I don't think we should be disclosing. After all, hrs of sleep are not all equal.
Are 6 hrs on call = 6 hrs off call? #mdchat
Tue Jan 11 18:11:50 PST 2011

mdstudent31 T1: Resident restrictions, stressed attendings pick up slack + workforce shortage.
Slippery slope, enjoy the ride #mdchat
Tue Jan 11 18:12:17 PST 2011

RichmondDoc T1 More importantly: we need to teach students differently. We need to demystify the
legend of the doc who pushes on at all costs. #mdchat
Tue Jan 11 18:12:29 PST 2011

RichmondDoc T1 Teachers need to teach/model the idea of understanding one's own limits, and to
rest/take sick days when needed. #mdchat
Tue Jan 11 18:13:14 PST 2011

mkmackey T1 I would be more concerned w sleep deprived med students who lack the
experience as opposed to surgeons who know limits #mdchat
Tue Jan 11 18:13:27 PST 2011

s_eller T1 - In healthcare, we all have nights when we have less than desirable sleep -
individual judgment vs disclosure #mdchat
Tue Jan 11 18:13:41 PST 2011

fidouglas . @RichmondDoc Maybe give MDs an opportunity to express concern about when
they are too sleep-deprived to work properly....? #mdchat
Tue Jan 11 18:13:55 PST 2011

s_eller @RichmondDoc -T1 agree that we need to teach student to understand their own
limits - when are they impaired #mdchat
Tue Jan 11 18:14:30 PST 2011

RichmondDoc @s_eller T1 agreed: but med schools and residencies need to teach/guide students
re: how to judge their status and readiness. #mdchat
Tue Jan 11 18:14:39 PST 2011

apjonas #mdchat If we're Hawkeye Pierce in war, or in a disaster, maybe a tired surgeon is the
only one available, so we do what we can. BUT...
 Tue Jan 11 18:14:42 PST 2011

RichmondDoc @fidouglas I think that's a great approach: but we need to ensure docs won't feel
lessened or penalized if they step back when tired #mdchat
Tue Jan 11 18:15:22 PST 2011

RichmondDoc @apjonas T1 In crisis, there will always be a call for people to push to their limits. But
most of our lives are not at that level. #mdchat
Tue Jan 11 18:15:48 PST 2011

s_eller @mkmackey - to be devil's advocate - would med student w/ lack of sleep be more
cautious than exp MD who thinks they can function? #mdchat
Tue Jan 11 18:15:48 PST 2011

apjonas @mdstudent31 Good point about tired attendings. Coffee used to be the drug of
choice in allnight OB call w/deliveries.#mdchat
Tue Jan 11 18:16:36 PST 2011

dorameulman Survey: Docs Struggling Financially, but New Tech Makes Job Easier:
http://t.co/oGf21pv #MDChat
Tue Jan 11 18:16:39 PST 2011

EllenRichter T1 Something as personal & individualized as fatigue & ability to concentrate can be
result of many factors besides sleeplessness #MDchat
Tue Jan 11 18:16:43 PST 2011

mdstudent31 @RichmondDoc Not sure how much that myth still lives on. We already observe
residents who have no choice about leaving #mdchat
Tue Jan 11 18:16:58 PST 2011

mkmackey T1 Professionals in all industries have this issue. A personal decision. #mdchat
Tue Jan 11 18:17:19 PST 2011

fidouglas We all know when we're too tired and are likely to make mistakes. It's a subjective
thing that can't easily be measured. #mdchat
Tue Jan 11 18:17:24 PST 2011

mdstudent31 @apjonas Good thing it's not four loko #mdchat

Tue Jan 11 18:17:37 PST 2011

fidouglas But at the moment, I get the impression that doctors don't feel they can express these
concerns, esp. junior doctors. #mdchat
Tue Jan 11 18:17:54 PST 2011

RichmondDoc @mdstudent31 That might be true--the stories might be fading. I remember stories of
docs rounding while receiving IV fluids... #mdchat
Tue Jan 11 18:18:23 PST 2011

RichmondDoc T1 If we want docs to step back when at their limits, we need to ensure they won't be
penalized/marginalized; team must pick them up #mdchat
Tue Jan 11 18:18:51 PST 2011

EllenRichter T1 All health profssnls must be aware of the negative effects of lack of sleep no matter
what the task: surgery, prescriptions, etc #MDchat
 Tue Jan 11 18:19:29 PST 2011

s_eller @EllenRichter - agree that there are many other factors that can affect concentration
besides sleep #mdchat
Tue Jan 11 18:19:39 PST 2011

fidouglas @mkmackey In other industries, it tends not to be life and death, though, so it's not so
vital. #mdchat
Tue Jan 11 18:20:18 PST 2011

CrescendoCG T1- WSJ blog about it suggests that pts be "empowered to ask". Not sure that's helpful,
or a reasonable responsibility for a pt. #mdchat
Tue Jan 11 18:20:28 PST 2011

apjonas #mdchat T1 Peer to peer prof obligation should be emphasized in tng for pt safety.
Nudge a colleague when needed and save a pt and law suit
Tue Jan 11 18:20:34 PST 2011

mdstudent31 @RichmondDoc then there's always those who brag about how much they can do w/o
sleep - like it's a competition #mdchat
Tue Jan 11 18:20:35 PST 2011

RichmondDoc @mdstudent31 That's exactly the culture we need to undo. The war stories need to be
retired; must focus on safety/responsibility. #mdchat
Tue Jan 11 18:21:47 PST 2011

mkmackey @fidouglas no question the stakes are higher here. I think its acceptable to have the
discussion if concerns are present #mdchat
Tue Jan 11 18:22:22 PST 2011

s_eller @CrescendoCG - T1 - agree, hard enough to have pts remind providers to wash
hands, let alone ask if they have had enough sleep #mdchat
Tue Jan 11 18:22:33 PST 2011

EllenRichter T1 A health provider under a great deal of stress can have as much negative effect as
one w/ sleep deprivation so why pick on sleep? #MDchat
Tue Jan 11 18:22:44 PST 2011

fidouglas . @CrescendoCG Yer, where does the line of patient autonomy lie? #mdchat
Tue Jan 11 18:22:46 PST 2011

jodyms Agree RT @CrescendoCG T1- WSJ blog suggests that pts b "empowered t2 ask" Not
sure that's helpful or reasonable respon for a pt. #mdchat
Tue Jan 11 18:22:46 PST 2011

drsteventucker @mdstudent31 #mdchat Its when they tweet they have been up all night that the legal
troubles start.
Tue Jan 11 18:22:51 PST 2011

RichmondDoc T1 It is also necessary for HCPs to police each other. If we see an impaired colleague,
we need to address that. #mdchat
Tue Jan 11 18:23:11 PST 2011

EllenRichter Yes, how true! RT @drsteventucker: @mdstudent31 #mdchat Its when they tweet they
have been up all night that the legal troubles start.
 Tue Jan 11 18:23:59 PST 2011

mdstudent31 @drsteventucker Or on facebook. Students already do this to pass the time without
realizing implication #mdchat
Tue Jan 11 18:24:13 PST 2011

fidouglas @mkmackey Agreed. but while bankers etc. work crazy hours & might risk $, if they
choose to overdo it, they're not risking lives. #mdchat
Tue Jan 11 18:25:31 PST 2011

apjonas @s_eller @CrescendoCG eventually could lead to patient action guidelines. Pt ck list
to querie doc RE items b4 they can get service #mdchat
Tue Jan 11 18:25:39 PST 2011

drsteventucker @mkmackey #mdchat The crazy part is we know ppl can't function at 100 percent all
the time. Look at sports training. Must stay at 80%
Tue Jan 11 18:26:11 PST 2011

mdstudent31 @drsteventucker @EllenRichter I have many med and nursing friends that tweet/status
hour countdowns, etc. Not cool #mdchat
Tue Jan 11 18:26:23 PST 2011

EllenRichter T1 We all realize how important it is for health providers to maintain appropriate
demeanor when represented on social media sites #MDchat
Tue Jan 11 18:26:34 PST 2011

RichmondDoc T1 In all honesty, part of being in a profession is being professional. We need to teach
that this includes knowing your limits. #mdchat
Tue Jan 11 18:26:47 PST 2011

s_eller @apjonas @s_eller @CrescendoCG - very interesting - like the concept of educating
pts on guidelines - also need to empower them #mdchat
Tue Jan 11 18:27:00 PST 2011

apjonas @s_eller @EllenRichter Good point Brain fog bad no matter the cause.#mdchat
Tue Jan 11 18:27:35 PST 2011

RichmondDoc T1 If we are going to be professionals, we need to know if we are unsafe & we should
be talking w/ colleagues who are unsafe #mdchat
Tue Jan 11 18:28:01 PST 2011

CrescendoCG @apjonas @s_eller Agree that pts should be aware of guidelines. #mdchat
Tue Jan 11 18:28:08 PST 2011

MD_Chat Shoulder tap: we'll continue with the topic, just shift it a bit. Coming up in a moment.
#MDchat
Tue Jan 11 18:28:34 PST 2011

mdstudent31 Tracing/tracking social media activity whether on call or at home. Verification of sleep
or lack thereof? #mdchat
Tue Jan 11 18:28:35 PST 2011

RichmondDoc T1 But the culture of medicine is hard to break. Many docs in current practice feel the
resident work hours coddle docs in training #mdchat
Tue Jan 11 18:28:37 PST 2011
apjonas @MD_chat Thanks for the nudge #mdchat
Tue Jan 11 18:29:43 PST 2011

RichmondDoc @mdstudent31 But some SocMed tools allow people to pre-schedule posts for late
hours; hard to prove if a person is awake & posting. #mdchat
Tue Jan 11 18:29:53 PST 2011

healthpolicygrp I have many med &nursing friends that tweet/status hour countdowns, etc. Not cool
@mdstudent31 @drsteventucker @EllenRichter #mdchat #hcsm
Tue Jan 11 18:30:08 PST 2011

mkmackey I believe patients should be able to trust that physicans will know their limits and do no
harm to patients. #mdchat
Tue Jan 11 18:30:37 PST 2011

apjonas #mdchat Sully Sullenberger gives good talk RE use of ck list for pt safety. Rest, sleep
and stress mgmt should B on all our ck list
Tue Jan 11 18:31:54 PST 2011

drsteventucker @RichmondDoc We carried wood in the snow uphill both ways! ;) #mdchat
Tue Jan 11 18:33:09 PST 2011

RichmondDoc @drsteventucker We wrapped our feet in barbed wire for better traction in the ice and
snow! #mdchat
Tue Jan 11 18:33:54 PST 2011

apjonas @mkmackey Good thought, but doc need tng in res pgm to emphasize that as a skill
#mdchat
Tue Jan 11 18:34:26 PST 2011

ArthritisAshley Yes! // RT @mkmackey: I believe patients should be able to trust that physicans will
know their limits and do no harm to patients. #mdchat
Tue Jan 11 18:34:35 PST 2011

drsteventucker @mkmackey How do people feel when they get an email from a doc (or other) with a
wee hours time stamp? #mdchat
Tue Jan 11 18:34:43 PST 2011

RichmondDoc T1a The most "adult" approach: emphasize pt safety; teach students/residents to speak
up if they/others are unsafe for their task. #mdchat
Tue Jan 11 18:34:46 PST 2011

EllenRichter T1a What if doc slept 9 hours but took 2 Percocet for back pain right before start of the
procedure. So they pass the sleep mandate #MDchat
Tue Jan 11 18:35:00 PST 2011

RichmondDoc T1a but those who speak up need to know that their action is not going to result in any
negative repercussions for anyone. #mdchat
Tue Jan 11 18:35:23 PST 2011

s_eller T1a I think that students need to be taught not to work when impaired - sleep,
emotional stress, ETOH, etc - self monitoring #mdchat
 Tue Jan 11 18:35:29 PST 2011

EllenRichter YES RT @s_eller T1a I think students need to be taught not to work when
impaired:sleep, emotional stress, ETOH etc - self monitoring #MDchat
Tue Jan 11 18:36:39 PST 2011

mdstudent31 T1a All members of the team should not be afraid to speak up, no matter what level of
licensure #mdchat
Tue Jan 11 18:36:49 PST 2011

drseisenberg T1: Never underestimate the magical power of the siesta. Only wish I could block 20
min of "siesta time." #MDchat
Tue Jan 11 18:37:20 PST 2011

mkmackey @drsteventucker I think an off hours email from a physician would mean they are
doing a wonderful job caring for a patient #mdchat
Tue Jan 11 18:37:51 PST 2011

drsteventucker @EllenRichter Or if they lept well but constantly look at their iPhone and not the
patient/nurse/admin? Distractions are a problem #mdchat
Tue Jan 11 18:37:55 PST 2011

apjonas @s_eller #mdchat impaired is such a power word that doing otherwise would be
illegal. What about distracted? fatigued? infected? etc.?
Tue Jan 11 18:38:14 PST 2011

healthgist http://j.mp/d5Z8gi @mkmackey Kathy Mackey, joining from snowless Houston

#mdchat
Tue Jan 11 18:38:54 PST 2011

mkmackey @apjonas I can only imagine the difficulty in mastering time management in medicine
#mdchat
Tue Jan 11 18:39:07 PST 2011

drsteventucker @mkmackey Thats great to hear but I can say I have had patients wonder why I am up
in the middle of the night. #mdchat
Tue Jan 11 18:39:30 PST 2011

jodyms Why is medicine different? RT @RichmondDoc T1 on the Coast Guard... crew

expected 2 address *any* safety issue, regardless of rank #mdchat
Tue Jan 11 18:39:31 PST 2011

EllenRichter T1a Same goes for docs, nurses, pharmacists etc. No one should work at a loss due to
any impairment. People must know own limits #MDchat
Tue Jan 11 18:39:36 PST 2011

s_eller @apjonas - T1a understand your point about word - but fatigued or infected can also
be less than optimal - who decides impairment? #mdchat
Tue Jan 11 18:40:17 PST 2011

jodyms @mkmackey @drsteventucker and if same late-night tweeting doc has 7 am surgery?
We equate late nights, hard work with caring #MDChat
Tue Jan 11 18:41:15 PST 2011

mdstudent31 Speaking up -something taught, encouraged to do, yet still struggle with. Remember
 the patient, make the right choice #mdchat
Tue Jan 11 18:41:15 PST 2011

mkmackey @drsteventucker a dedicated-doctor.. you could use the email settings to have you
email sent at a regular hour? #mdchat
Tue Jan 11 18:41:31 PST 2011

a_singledrop Wow. Timely. We definitely just discussed the issue of disclosing sleep hours in ethics
class this afternoon! #mdchat
Tue Jan 11 18:42:31 PST 2011

drsteventucker @jodyms Some argue medicine is different because of moral obligations/constraints

that may not apply in other economic activities #mdchat
Tue Jan 11 18:42:45 PST 2011

mkmackey @apjonas wow #mdchat

Tue Jan 11 18:43:14 PST 2011

RichmondDoc @a_singledrop Was there some sort of consensus? #mdchat

Tue Jan 11 18:43:30 PST 2011

RichmondDoc @drsteventucker @jodyms I think docs feel strong obligation to profession/pts; this
*should* include emphasis on safety/capabilities #mdchat
Tue Jan 11 18:44:11 PST 2011

EllenRichter @a_singledrop Interested to hear what you all deduced from your ethical chat today!
#MDchat
Tue Jan 11 18:44:13 PST 2011

a_singledrop My classmates agreed that reporting it would be unrealistic. Many (esp surgeon
wannabes) scoffed at the idea even being brought up. #mdchat
Tue Jan 11 18:44:47 PST 2011

drsteventucker @apjonas Practice in Asia veyr different. I am generally available 24/7/365 on my cell
phone and email #mdchat
Tue Jan 11 18:44:51 PST 2011

apjonas @apjonas @drsteventucker @mkmackey My mirror has to provide good feedback RE

my energy to stay fresh, sane & available Or one of them#mdchat
Tue Jan 11 18:45:36 PST 2011

drsteventucker @EllenRichter @RichmondDoc @ArthritisAshley Hey! We could all wear a #FitBit!

http://www.fitbit.com/ #mdchat
Tue Jan 11 18:46:07 PST 2011

RichmondDoc @a_singledrop Not terribly encouraging, then. Sounds like the war stories and fear of
being the "weak link" are still going strong. #mdchat
Tue Jan 11 18:46:19 PST 2011

apjonas @drsteventucker ? No vacation? Could become stressful after a year or two #mdchat
Tue Jan 11 18:47:19 PST 2011

jodyms @RichmondDoc @drsteventucker Great points. Emphasis on safety to me is part of the

 professional obligation #mdchat
Tue Jan 11 18:47:30 PST 2011

RichmondDoc @drsteventucker @EllenRichter @ArthritisAshley Oof. Another reason the profession

*should* act: we want to avoid such requirements. #mdchat
Tue Jan 11 18:47:44 PST 2011

mdstudent31 Setting residency hour restrictions will lead to more yrs of residency training. Does that
mean more CME time for docs? #mdchat
Tue Jan 11 18:47:59 PST 2011

EllenRichter @drsteventucker Theres an interesting apparatus! LOL, I wonder how much of a hit
overall fitness transparency would make! #MDchat
Tue Jan 11 18:48:03 PST 2011

drsteventucker @apjonas Vacation-Yes, Travel - Yes, still the phone is there. Hard to disconnect
when away (but I can!) #mdchat
Tue Jan 11 18:48:40 PST 2011

drsteventucker @EllenRichter Fitness transparency? I love it! Docs should publish params like lipids,
BP, sleep, FOB? :) #mdchat
Tue Jan 11 18:49:34 PST 2011

apjonas @mkmackey I know a lot of 6-7 hour sleep docs. Stress of mental processing various
pt situations huge factor in docs regrdls of slep #mdchat
Tue Jan 11 18:49:39 PST 2011

CrescendoCG @drsteventucker @EllenRichter LOL. Not sure patients need to be *that* empowered.
#mdchat
Tue Jan 11 18:51:08 PST 2011

MDPartner @RichmondDoc How does a student learn when things are better left unsaid?
#mdchat
Tue Jan 11 18:51:31 PST 2011

mkmackey @apjonas I am sure it is hard to decompress #mdchat

Tue Jan 11 18:52:03 PST 2011

apjonas @drsteventucker @EllenRichter Web site area for pers hlth parameters of doc. Like
Doc-Harmony for pts to match w//doc hlth/lifestyle #mdchat
Tue Jan 11 18:52:17 PST 2011

drsteventucker @MDPartner @RichmondDoc WHAT does a student learn when things are left
unsaid? #mdchat
Tue Jan 11 18:52:21 PST 2011

RichmondDoc @MDPartner What things? Some personal things, maybe. But if sleep deprivation
results in possibly risking pt safety...? #mdchat
Tue Jan 11 18:52:44 PST 2011

apjonas @MDPartner @RichmondDoc professonal role modeling and citizenship tng helpful
for student development #mdchat
Tue Jan 11 18:53:48 PST 2011

@MDPartner @RichmondDoc- maybe topic for another chat, what things do you think
s_eller are better left unsaid? We teach 2 verbalize threats #mdchat
Tue Jan 11 18:54:01 PST 2011

drsteventucker @mdstudent31 @MDPartner @RIchmondDoc Bottom line - in all relationships best

NOT to leave any concerns unsaid. #mdchat
Tue Jan 11 18:54:22 PST 2011

ArthritisAshley @drseisenberg @EllenRichter @RichmondDoc - #MDchat True, most people lack

proper sleep - but then again a lot of ... http://tmi.me/5lEHG
Tue Jan 11 18:54:30 PST 2011

mdstudent31 @drsteventucker @MDPartner @RichmondDoc Problem w/ many errors already is

probs w/ communication. Fostering more hurts pts #mdchat
Tue Jan 11 18:55:19 PST 2011

EllenRichter @ArthritisAshley LOL hey thats no fair! You used more than 140!! ;) #MDchat
Tue Jan 11 18:55:46 PST 2011

mkmackey Better to send that afterhours email! :) RT @drsteventucker: in all relationships best
NOT to leave any concerns unsaid. #mdchat
Tue Jan 11 18:56:35 PST 2011

EllenRichter @ArthritisAshley T1 Sleep deprivation affects pilots, bus drivers, train conductors,
anyone whose job peoples lives depend on #MDchat
Tue Jan 11 18:56:54 PST 2011

RichmondDoc @s_eller @MDPartner If there is a colleague whose physical/emotional status makes

them unsafe, that should be addressed. #mdchat
Tue Jan 11 18:57:32 PST 2011

mdstudent31 After being up for >30 hours, adrenaline rush is no excuse to compromise pt safety -
what is this proving? #mdchat
Tue Jan 11 18:59:37 PST 2011

mkmackey Glad there are those who find being a physician rewarding.. hearing how challenging
the profession is at #mdchat
Tue Jan 11 18:59:57 PST 2011

drsteventucker @mdstudent31 And it compromises the doctors/students health as well. #mdchat

Tue Jan 11 19:00:29 PST 2011

RichmondDoc But, although docs should be willing to address impaired peers, peers should not put
each other in that position. Be responsible! #mdchat
Tue Jan 11 19:01:06 PST 2011

EllenRichter @RichmondDoc Too bad many turn their heads away from dealing with impaired or
unsafe colleagues. Some just dont want to make waves. #MDchat
Tue Jan 11 19:02:20 PST 2011

MD_chat Is anyone going to get to sleep after this chat? ;) #MDchat

Tue Jan 11 19:02:51 PST 2011

apjonas @RichmondDoc Loving our profession implies a willingness to help each other and
protect patients. Confrontation for better or better #mdchat
 Tue Jan 11 19:03:11 PST 2011

RichmondDoc @EllenRichter True. But that is the ingrained culture of medicine, and the one that we
should be working to address. #mdchat
Tue Jan 11 19:03:24 PST 2011

EllenRichter @MD_Chat LOL! Funny. #MDchat

Tue Jan 11 19:03:56 PST 2011

apjonas @MD_chat Thanks for your leadership tonite. Interesting chat/ important topic.
#mdchat
Tue Jan 11 19:04:35 PST 2011

mdstudent31 Time to study :) #mdchat

Tue Jan 11 19:04:49 PST 2011

MD_chat OK, folks, this was fun! Transcript will be up shortly. Next chat is next Tuesday 9pm
Eastern. #MDchat
Tue Jan 11 19:06:18 PST 2011

drsteventucker @s_eller @MD_Chat @dorameulman Interesting that I do this chat during the day
(11AM in Singapore now). Now off to sleep peoples... #mdchat
Tue Jan 11 19:06:25 PST 2011

doctorpreneur @RichmondDoc what is #mdchat?

Tue Jan 11 19:06:33 PST 2011

RichmondDoc Thanks, all. Sleep tight! #mdchat

Tue Jan 11 19:06:52 PST 2011

EllenRichter Great discussion as always! I really enjoy sharing an hour with health care friends, the
Twitter #doctors & @MD_Chat #MDchat
Tue Jan 11 19:07:07 PST 2011

MD_chat Also: if any of you would like to moderate let me know. And topics can always be
submitted: http://tinyurl.com/MDtopic #MDchat
Tue Jan 11 19:07:31 PST 2011

mdstudent31 Safe travels to all those in the snow! And hopefully it will be warm again soon #mdchat
Tue Jan 11 19:08:06 PST 2011

RichmondDoc @doctorpreneur @MD_Chat might have a better definition than mine. #mdchat
Tue Jan 11 19:08:41 PST 2011

EllenRichter @doctorpreneur Check it out http://mdchat.org/about/ #MDchat

Tue Jan 11 19:09:34 PST 2011

EllenRichter @MD_Chat LOL we both sent the same page link! ;) #MDchat
Tue Jan 11 19:10:09 PST 2011
doctorpreneur @MD_chat @richmonddoc great thanks- travelling next week but look forward to
joining you soon- looks like a great discussion! #mdchat
Tue Jan 11 19:11:51 PST 2011

nursingpins A plenitude of council should be welcomed by ALL healthcare professionals -Enjoyed

lurking at #MDchat - Thanks.
Tue Jan 11 19:14:54 PST 2011