Mohit Harsh, MD @MohitHarshMD Twitter profile

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Mohit Harsh, MD

@MohitHarshMD

2 years

I’m 3 months into my hospitalist job and I’ve already become that attending who believes a good history, physical exam, and med rec is 90% of the work A few stories to highlight how investing time into the above can reduce unnecessary work ups and treatments for our patients

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Mohit Harsh, MD

@MohitHarshMD

5 years

Few take aways from my #EM rotation 1) The breadth of patients that EM docs can manage is astonishing 2) The undifferentiated patient is both exciting and terrifying 3) When surgeons are needed, they are NEEDED 4) Cocaine is a hell of a drug 5) Ketamine is a hell of a drug

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Mohit Harsh, MD

@MohitHarshMD

2 years

Medicine is a life long learning journey I recently completed IM training + Chief Year and joined a community hospitalist group I am little over a month into my new role and have more clinical questions than ever! I left academia for this very reason: clinical reps 🧵

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Mohit Harsh, MD

@MohitHarshMD

4 years

That feeling when you finish your last 28 hour call of residency and feel the sun shining on your face as you walk out of the hospital

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Mohit Harsh, MD

@MohitHarshMD

3 years

Did I really just see a commercial for impella on TV? @DavidLBrownMD

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Mohit Harsh, MD

@MohitHarshMD

1 year

Dear new interns, I’m a full time hospitalist and I still forget to order morning labs It’s okay If it was absolutely critical, someone would’ve caught it and ordered it

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Mohit Harsh, MD

@MohitHarshMD

3 years

Board certified in Internal Medicine!!!

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Mohit Harsh, MD

@MohitHarshMD

3 years

During May I’ll tweet #TipsForNewDocs from the perspective of an outgoing IM Chief Resident who has learned a ton from #MedTwitter Tip #1 Residency will make keeping friendships hard. As often as you can, invest in those who have been there for you. They will keep you energized!

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Mohit Harsh, MD

@MohitHarshMD

2 years

Invest in gathering a thorough history Rephrase your questions if you feel like miscommunication is occurring Gain collateral on medication history Don’t underestimate the iatrogenic harm that can occur with meds Doing this can help our patients avoid expensive testing

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Mohit Harsh, MD

@MohitHarshMD

2 years

Word of advice: If you have the luxury of documented telephone encounters from outpatient clinics, READ THEM You gain valuable insight into: Symptom chronology Any recent changes to meds barriers to care that their PCP/outpatient specialist have been working on

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Mohit Harsh, MD

@MohitHarshMD

2 years

This @journal_CHEST review article really improved my ability to think about cavitary lung lesions. I highly recommend reading! #MedTwitter #IDTwitter #PulmTwitter

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Mohit Harsh, MD

@MohitHarshMD

2 years

It is unfortunate that this attitude re: IM. It is a distinct reason many dislike their experiences on ward teams It doesn’t have to be this way, but it is our fault as a specialty that this idea persists in 2022 A 🧵…

Garrison Leach, MD

@leach_md

2 years

If you’re in surgery and feeling sad, walk by a medicine team doing their purgatory-esque rounds. Watch your face brighten as you realize you never ever have to do that again

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Mohit Harsh, MD

@MohitHarshMD

5 years

Your boy is starting an EM rotation next week. As an IM resident, I’m excited (and nervous) to be out of my element. Any tips/pearls from #EM colleagues? #medtwitter @reverendofdoubt @EM_RESUS @jmugele @MDaware @MKleinMD @WUSTL_EM

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Mohit Harsh, MD

@MohitHarshMD

4 years

Y’all, I’m so proud!!! I’ve been teaching my med students about #ClinicalReasoning while on wards We have a pt w/ new pancytopenia My student CREATED A SCHEMA to help with his diagnostic reasoning and used it in his A/P to discuss his DDx

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Mohit Harsh, MD

@MohitHarshMD

5 years

Truly honored and humbled to announce that I’ll be serving as a Chief Resident for @WUDeptMedicine in 2020-2021 A thread on perseverance. #medtwitter #medstudenttwitter #premedtwitter

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Mohit Harsh, MD

@MohitHarshMD

4 years

Med student got excited to see a pt with acute DVT “I’ve never seen a DVT before!” Oh to be young again... There is always an opportunity to learn with every pt No matter how mundane the Dx, celebrate and join in learner’s excitement @DxRxEdu @rabihmgeha @medrants

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Mohit Harsh, MD

@MohitHarshMD

1 year

Dx a pt w/ CHF and spent several days educating about his new dx Day of dc he provided me with some new terminology “Doc, failure is scary. I don’t feel like my heart is failing. I got something for ya” I like the term Heart Fatigue and think it’s time for change!

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Mohit Harsh, MD

@MohitHarshMD

4 years

What is on your ddx for green urine? Wonder if @CPSolvers has a schema for this one! #MedTwitter #NephTwitter #ToxTwitter #MedEd

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Mohit Harsh, MD

@MohitHarshMD

2 years

Her exam is reassuring. I cancel the brain MRI We trial off venlafaxine the following morning, dizziness resolves I walk with her. We have a competition on who can stand on one leg the longest She wins We avoid an expensive brain MRI and relief that she didn’t have a stroke

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Mohit Harsh, MD

@MohitHarshMD

2 years

A bit of rambling but…TL;DR Don’t let anyone tell you community practice is a bad choice. It isn’t. You can learn a lot and feel immensely fulfilled Good medicine happens everywhere, not just in academia It’s a personal choice where you choose to work Ask questions daily

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Mohit Harsh, MD

@MohitHarshMD

2 years

May the 4th be with you! Tip #4 #TipsForNewDocs #MedTwitter You’ve probably heard this one time and time again: “read more” or “read up on your patients” Yet no one tells you HOW they read more and make that information stick! A 🧵 on the system I developed in residency

Mohit Harsh, MD

@MohitHarshMD

2 years

May 3rd = tip #3 #TipsForNewDocs #MedTwitter When pts are admitted, update families. Ideally daily! Don’t assume they’ve been updated by others Start w/ “What do you know about the reason for admission/status of their condition?” This allows you to gauge their understanding

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Mohit Harsh, MD

@MohitHarshMD

2 years

Call wife 2-3 times during the day, tell his nurse to inform me if wife comes to bedside She arrives with a med list. She has been in conversation with PCP re: high BP readings at home PCP doubled Coreg dose two days ago We observe off Coreg, brady and symptoms resolve

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Mohit Harsh, MD

@MohitHarshMD

2 years

Pt recalled syncope at night when she went to bathroom, stood up, then woke up on bathroom floor She told others “I don’t know how I collapsed” which is different than not recalling events leading up to collapse Unexplained syncope was from miscommunication, not recollection

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Mohit Harsh, MD

@MohitHarshMD

1 year

A good diagnostician must ask why. It changes trajectory and lives of patients. Not everyone has done the hard work of asking, so don’t assume A brief anecdote from the community… 35F admitted to my service for progressive dyspnea and edema. Not new for her, she had HFrEF

Robert Centor MD MACP 🇮🇱

@medrants

1 year

1/ #UncleBob - thinking about clinical reasoning this week (after 2 wonderful weeks of diastole in London, Paris and Cardiff). Listened to 4 RLR this week ( @DxRxEdu @rabihmgeha ) have done 2 morning reports (2 more scheduled) and attended our big Tinsley conference @CPSolvers

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Mohit Harsh, MD

@MohitHarshMD

4 years

Where does “quit blowing smoke up my ass” come from? #MedicalHistory As early as 1746, English docs used tobacco enemas to resuscitate near dead victims of drowning Reasoning included warming the body, drying out the insides, and increasing heart rate @AdamRodmanMD tweetorial?

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Mohit Harsh, MD

@MohitHarshMD

2 years

A tale of dizziness Pt admitted overnight for dizziness eval. signout is posterior stroke rule out I ask, “did anything change in your life when symptoms began?” She just started venlafaxine from psychiatrist She got her morning dose of it before I saw her. Still dizzy

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Mohit Harsh, MD

@MohitHarshMD

3 years

Dear students, If you are on a clinical rotation and not feeling like part of the team, it is NOT your fault That is your team not cultivating a safe learning culture That is the system not prioritizing your/team’s experience It is not you. <3 @DxRxEdu @rabihmgeha

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Mohit Harsh, MD

@MohitHarshMD

2 years

A tale of unexplained syncope I came onto service with signout that pt came in with unwitnessed syncope with no recollection of events. Negative w/u. Pt w/ hx of seizure Assumed to be breakthrough seizure I spent 30 min on 1st day asking every way I could about HPI

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Mohit Harsh, MD

@MohitHarshMD

4 years

@mahad_minhas In med school I had an attending say he wished he could punch certain criminals in the face, “especially if they were a foreigner” as he looked at me Also had an attending make me defend why Trump should be considered racist during the Muslim travel ban

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Mohit Harsh, MD

@MohitHarshMD

4 years

Hey #MedTwitter ! If you had the chance to round w/ twitter friends, who would it be? A few from my long list: @gradydoctor @sargsyanz @DxRxEdu @rabihmgeha @medrants @PulmCrit @msiuba @AndreMansoor @AnnKumfer @JenniferSpicer4 @MelBreggs @ShreyaTrivediMD @AdamRodmanMD @aoglasser

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Mohit Harsh, MD

@MohitHarshMD

2 years

Word of advice I wish I had received as an MS4 and resident: Don’t wait till your an attending to learn about personal finance If you can learn the Kreb’s Cycle, you can learn how to manage your finances and set yourself up for success Highly recommend following @olsonplanner

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Mohit Harsh, MD

@MohitHarshMD

2 years

May 6th = Tip #6 #TipsForNewDocs #MedTwitter Improving your history taking skills can prevent unnecessary work ups and expedite care Residency doesn’t always provide the time needed to gather thorough histories like you had in med school Thoughts on improving as a historian…

Mohit Harsh, MD

@MohitHarshMD

2 years

May 5th = Tip #5 #TipsForNewDocs #MedTwitter The hidden curriculum is real Your students will pay close attention to how you treat pts, RNs, PT, custodians, & every other colleague Be respectful and kind Never disparage another specialty or group We are all here for our pts

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Mohit Harsh, MD

@MohitHarshMD

3 years

Such an important chart! Meningitis is hard to determine clinically based on symptoms and signs alone We are often not great at performing these exam maneuvers as well, which worsens post-test probability

GrepMed

@grepmeded

3 years

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Mohit Harsh, MD

@MohitHarshMD

3 years

Wholeheartedly agree. I used to send an expectations email as a senior resident. Now I get to send it again, only this time as an attending Grateful for my role models on setting expectations, modeling a positive culture, and creating a safe learning environment for all

Andrew M. Ibrahim MD, MSc (He/Him)

@AndrewMIbrahim

3 years

@ChristleNwora Set your expectations before the rotations begins. Juniors don’t usually get upset about not getting what they want, it’s usually because it’s different than what they expected… Here was my standard email to welcome juniors onto the service…

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Mohit Harsh, MD

@MohitHarshMD

1 year

You start inpatient service and pick up a 60F w/ COPD a/w hypoxic resp failure She is on day 3 of admission and has been on CTX/Doxy + steroids for CAP She feels better. CXR 👇🏾 Do you complete 5d of ABX or do you D/C? How do you discuss w/ pt? #CommunityMed #Stewardship

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Mohit Harsh, MD

@MohitHarshMD

3 years

Internists don’t use scalpels to help patients, but they do use their minds - @abbyWUim The first way to help patients is to improve our diagnostic skills by reflecting on patient care Without an accurate dx, you cannot start the therapeutic journey <3 @DxRxEdu @rabihmgeha

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Mohit Harsh, MD

@MohitHarshMD

2 years

There is often explicit bias against joining community practices when you leave academic training I’m here to tell you it can be incredibly fulfilling, rewarding, and help you grow just as much as continuing on in academia Neither option is better than the other, it’s personal

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Mohit Harsh, MD

@MohitHarshMD

2 years

UTI associated delirium is a diagnosis of exclusion And even then, it is overdiagnosed What other conditions come to mind like this? @rabihmgeha @DxRxEdu @medrants

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Mohit Harsh, MD

@MohitHarshMD

4 years

I can’t begin to describe how excited I am for @WashUIMRes @WUDeptMedicine #GrandRounds this week with the Magician and Mathematician themselves! @rabihmgeha @DxRxEdu @CPSolvers #RLR

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Mohit Harsh, MD

@MohitHarshMD

3 years

I’ve reached official attending status… Today a patient called their spouse and said “I have the oldest doctor on the team with me. He wants to speak with you” #thisis30 ?

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Mohit Harsh, MD

@MohitHarshMD

3 years

Perspectives from a very early (7 days in) ward attending Even more rewarding and fun than teaching medicine is cultivating the culture of the team As an attending this is not only a duty to serve your trainees in this way, but also a privilege @DxRxEdu @rabihmgeha @medrants

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Mohit Harsh, MD

@MohitHarshMD

3 years

#TipsforNewDocs Embrace asynchronous learning and #FOAMed You will learn a lot through residency and didactics, but Digital Education is the present and future Utilize podcasts, blog sites, #Medtwitter , and more I promise they will enhance your clinical knowledge and skills

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Mohit Harsh, MD

@MohitHarshMD

2 years

Had dinner w/ med school classmates and we discussed how poorly Biostats/Bayesian reasoning is taught in med school Applying these concepts to clinical practice is a game changer and DOES impact patients Excellent examples below by @phlegmfighter 👇🏾

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Mohit Harsh, MD

@MohitHarshMD

2 years

May 5th = Tip #5 #TipsForNewDocs #MedTwitter The hidden curriculum is real Your students will pay close attention to how you treat pts, RNs, PT, custodians, & every other colleague Be respectful and kind Never disparage another specialty or group We are all here for our pts

Mohit Harsh, MD

@MohitHarshMD

2 years

May the 4th be with you! Tip #4 #TipsForNewDocs #MedTwitter You’ve probably heard this one time and time again: “read more” or “read up on your patients” Yet no one tells you HOW they read more and make that information stick! A 🧵 on the system I developed in residency

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Mohit Harsh, MD

@MohitHarshMD

2 years

A tale of bradycardia Pt presented to ED w/ weakness, dyspnea, found to be Brady to 40s by wife at home In ED same sx and Brady to 40s, being admitted for w/u Tried to get med rec, pt doesn’t recall meds, wife manages Wife not at bedside, phone goes to VM

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Mohit Harsh, MD

@MohitHarshMD

2 years

I love teaching, but I also love my new role. I really do. There is something about focusing on being a clinician and nothing else that energizes and motivates me, as this is my only responsibility: To care for my patients to the best of my abilities

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Mohit Harsh, MD

@MohitHarshMD

2 years

2 things I have seen to be true every week while working in community hospital med First learned from @medrants @DxRxEdu @rabihmgeha 1. Pts w/ uncomplicated CAP rapidly improve in 24-48 hrs with appropriate ABX 2. Rigors should make you think of bacteremia. Get cultures

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Mohit Harsh, MD

@MohitHarshMD

2 years

What is the biggest compliment you can give to a #Hospitalist ? I’ll go first: “Can you be my PCP?” @SocietyHospMed @ACPinternists @SocietyGIM

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Mohit Harsh, MD

@MohitHarshMD

3 years

One of my goals going into Chief year was to have @Gurpreet2015 invited for grand rounds or CPC Thanks to efforts by my co-Chief Dr. John Hickman, that goal is realized (virtually)! Beyond thrilled for this week’s @WUDeptMedicine Grand Rounds with one of my idols in medicine!

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Mohit Harsh, MD

@MohitHarshMD

1 year

Would trainees be interested in posts like this discussing dx and mgmt reasoning on cases seen frequently as a community hospitalist?

Mohit Harsh, MD

@MohitHarshMD

1 year

55M w/ T2DM, ischemic HFrEF is mowing the lawn and runs over piece of wood and feels immediate pain in his calf 2 days later his leg look like pic (not of pt) Does the mechanism change your causative bacteria ➡️ cellulitis? What empiric ABX would you choose? #IDTwitter

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Mohit Harsh, MD

@MohitHarshMD

5 years

Time for my first #medtwitter #Tweetorial on Insulin and Potassium regulation! This is part 1 of a tweetorial series on K homeostasis/Hyperkalemia. This is a big topic, so I’ll stick to concepts. Poll: What percent of total body Potassium is within extracellular fluid?

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I don’t know!

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Mohit Harsh, MD

@MohitHarshMD

9 months

All I’ll say is time off work ⬆️QOL One of the main differences b/w IM residency & #hospitalist life is schedule, not content of work I went from sometimes having 2days off work a month in residency… …to having minimum 14 days off a month consistently if I want MINIMUM!

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Mohit Harsh, MD

@MohitHarshMD

1 year

@nickmmark Ingest a bottle of soy sauce?

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Mohit Harsh, MD

@MohitHarshMD

4 years

#Tweetorial on #NTProBNP comes from a case of volume overload 73M w/ hx of EtOH Use Disorder (2 pints bourbon daily), CAD, PVD, HTN, admitted for subacute dyspnea and anasarca NT-ProBNP 30,000. Cr 2.8 (2.0 1yr prior). Albumin 2 Given these results, what’s your most likely dx?

New Dx CHF

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New Dx Cirrhosis

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Worsening CKD

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New Dx Nephrotic Syndrome

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Mohit Harsh, MD

@MohitHarshMD

3 years

Hey #MedTwitter ! I’m putting together a clinical reasoning skills night for med students interested in IM! Regardless of specialty, crowdsourcing answers to this question so I can share with them: Why is diagnostic reasoning important to you?

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Mohit Harsh, MD

@MohitHarshMD

4 years

I want to improve at appraising medical evidence in 2021 (gee, I wonder why?) Just purchased Malignant & Ending Medical Reversal. I listen to @Plenary_Session Any texts/resources to help? I have no stats training so basics appreciated @VPrasadMDMPH @adamcifu @reverendofdoubt

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Mohit Harsh, MD

@MohitHarshMD

3 years

#TipsForNewDocs Perform a cognitive autopsy on cases where diagnosis was changed, delayed, nearly missed, or missed...basically all cases Discuss cases with trusted colleagues This will benefit you and, more importantly, the next patient @DxRxEdu

Improving Diagnostic Reasoning to Improve Patient Safety

Both clinicians and patients rely on an accurate diagnostic process to identify the correct illness and craft a treatment plan. Achieving improved diagnostic accuracy also fulfills organizational...

pmc.ncbi.nlm.nih.gov

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Mohit Harsh, MD

@MohitHarshMD

2 years

It’s May 2nd which means tip #2 #TipsForNewDocs #MedTwitter Becoming a great clinician is your first responsibility and is what your pts deserve Only pursue other endeavors if you want it for yourself Don’t fall to the pressure that being a great clinician isn’t enough IT IS!

Mohit Harsh, MD

@MohitHarshMD

3 years

During May I’ll tweet #TipsForNewDocs from the perspective of an outgoing IM Chief Resident who has learned a ton from #MedTwitter Tip #1 Residency will make keeping friendships hard. As often as you can, invest in those who have been there for you. They will keep you energized!

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Mohit Harsh, MD

@MohitHarshMD

4 years

Hey #MedTwitter fam! Time for the inaugural #MedDermTwagTeam #tweetorial on #Scleroderma This is a diffuse (get it?) topic so @RashDecisionz & I will try to keep it focused I’ll tweet on illness script S/O to @CPSolvers @MedEdTwagTeam and many others for the inspiration! 1/12

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Mohit Harsh, MD

@MohitHarshMD

3 years

One of the most influential moments in med school was with a general surgeon Dr. Finley who held the door open for med students during rounds. He was older, nearing retirement. I offered to hold the door for him and he said… “No, you are paying to learn not hold doors open”

Avraham Z. Cooper, MD 🩺

@AvrahamCooperMD

3 years

5/ I have never, ever forgotten what that moment felt like. Instead I swung the pendulum the other way. Every medical student I work w/ deserves my full attention, focus, and dedication. No matter how busy or stretched or hungry I feel. Their time matters. #MedTwitter

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Mohit Harsh, MD

@MohitHarshMD

4 years

The inpatient Heart Failure consult attending said this today: “We aren’t the Heart Failure team, we are the Heart Success team” It even made it into Epic! @wustlcardfellow #HappyFriday #HeartMonth

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Mohit Harsh, MD

@MohitHarshMD

2 years

@DxRxEdu @rabihmgeha @medrants @Sharminzi @Gurpreet2015 @rav7ks @PrathitKulkarni @MadellenaC @DoctorVig @AnandJag1 @Rafameed @ShreyaTrivediMD @AdamRodmanMD @CPSolvers @UnremarkableLab

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Mohit Harsh, MD

@MohitHarshMD

3 years

I tell residents and students that “I don’t know” is my favorite answer on rounds.

Avraham Z. Cooper, MD 🩺

@AvrahamCooperMD

3 years

“I don’t know” is an awesome answer to questions on rounds. #medtwitter

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Mohit Harsh, MD

@MohitHarshMD

3 years

Had the incredible opportunity to share why Clinical Reasoning is so important w/ @WUSTLmed students! We even had a waitlist for the event! Was inspired and humbled by the mature reasoning skills these bright stars already have. Thanks to all who attended and made it possible!

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Mohit Harsh, MD

@MohitHarshMD

3 years

If you ever forget what it’s like to be an intern, do a cross cover shift and you’ll quickly get PTSD from all the calls. Oh but don’t forget, interns also admit while cross covering. And do this for weeks straight on nights. Oh and they are underpaid…and under appreciated.

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Mohit Harsh, MD

@MohitHarshMD

1 year

It is Friday and you get an ED admit call 45M w/ hx of duodenal ulcer p/w epigastric pain, fatigue, melena x3. HR 70s, BP 130/80. No melena on DRE. Hgb 11 (b/l 14) BUN/Cr 89/1.5 (b/l 35/0.8) There is no GI coverage until Monday What would you do? #CommunityMed #GITwitter

IV PPI 40 BID & admit

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Don’t accept, Transfer

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Mohit Harsh, MD

@MohitHarshMD

4 years

Had a long conversation with a close friend who works in finance. We talked about what makes a good leader. It’s striking how these qualities span professions 1. Intellectual humility 2. Providing autonomy 3. Fostering creativity 4. Positive reinforcement 5. Deliberate feedback

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Mohit Harsh, MD

@MohitHarshMD

4 years

Thank you @CPSolvers for a wonderful #Hypercalcemia schema that helped teaching this AM on our overnight admissions. Also a great for @UnremarkableLab listeners

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Mohit Harsh, MD

@MohitHarshMD

3 years

Have you heard of heparin induced thyroid function test abnormality?? Heparin products can falsely elevate fT4 readings up to 5x baseline value within minutes Heparin releases vascular Lipoprotein Lipase -> FFA production -> displaces T4 with no effect on TSH, total T4, nor T3

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Mohit Harsh, MD

@MohitHarshMD

2 years

The outgoing @WashUIMRes chiefs give a series of Grand Rounds @WUDeptMedicine Incredibly excited to present next week on The Pursuit of Clinical Excellence! I’ll be focusing on how we improve Clinical Reasoning!

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Mohit Harsh, MD

@MohitHarshMD

3 years

I may be biased but Indo-Chinese food is the best cross-cultural cuisine in the world. Paneer manchurian Crispy mushroom chili Vegetable fried rice 🔥 🔥 🔥 🔥 🔥 🔥 🔥 🔥 🔥 #DesiMedTwitter #DesiTwitter #MedCooking

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Mohit Harsh, MD

@MohitHarshMD

10 months

Tell me you don’t make these decisions at the bedside routinely without telling me you don’t make these decisions at the bedside Can count on my hand the times I’ve ordered an ABG to make a decision about NPPV initiation

Conrad Fischer

@SeeFisch

10 months

We CANNOT use the carbon dioxide level on a VENOUS blood gas (VBG) to accurately assess the need for BiPap or intubation Ventilation problems cannot be assessed on a VBG

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Mohit Harsh, MD

@MohitHarshMD

4 years

I shared my story on #COVID19 #burnout with @AAMCtoday Grateful for @dcoscomd @WashUIMRes supporting trainees during the pandemic. Seeing a #GME therapist made a huge difference Thanks to @drjessigold @jbullockruns for promoting mental health stories

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Mohit Harsh, MD

@MohitHarshMD

2 years

Don’t be fooled by lab values that are “within normal limits” On occasion they are “inappropriately normal” Example: A normal PTH level in the face or hypocalcemia and low vitamin D levels This is hypoPTH, you expect a compensatory ⬆️PTH Any others #MedTwitter ?

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Mohit Harsh, MD

@MohitHarshMD

5 years

A curious case of sinus arrest Follow along for my reflections on a patient I evaluated in the hospital 33M w/ poorly controlled T1D w/ vascular complications p/w OM/septic arthritis s/p AKA day prior Called to bedside after syncopal episode w/ tele showing sinus pauses 1/8

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Mohit Harsh, MD

@MohitHarshMD

2 years

I wanted this kind of exposure to broaden my clinical skills and push my limits I’m so glad I did. I’m caring for patients and conditions I never once saw in residency, even at a tertiary referral center I learn something new every day

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Mohit Harsh, MD

@MohitHarshMD

2 years

The onus is on attendings to fix perception that IM rounds are inherently long Read overnight events/labs before rounds, take time to read full H&P from NF or call team, etc Do this so rounds are not stuck in the past of reporting data, but rather focused on eval of reasoning

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Mohit Harsh, MD

@MohitHarshMD

2 years

#IMProud to advocate for my rural patients who don’t have access to care! @FutureDocs @ACPIMPhysicians

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Mohit Harsh, MD

@MohitHarshMD

2 years

May 3rd = tip #3 #TipsForNewDocs #MedTwitter When pts are admitted, update families. Ideally daily! Don’t assume they’ve been updated by others Start w/ “What do you know about the reason for admission/status of their condition?” This allows you to gauge their understanding

Mohit Harsh, MD

@MohitHarshMD

2 years

It’s May 2nd which means tip #2 #TipsForNewDocs #MedTwitter Becoming a great clinician is your first responsibility and is what your pts deserve Only pursue other endeavors if you want it for yourself Don’t fall to the pressure that being a great clinician isn’t enough IT IS!

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Mohit Harsh, MD

@MohitHarshMD

1 year

Why not? Because they didn’t ask why? Why would a 35F have HFrEF? Why was she not improving? Getting to the why is at the core of being a good diagnostician, internist, generalist, and patient advocate

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Mohit Harsh, MD

@MohitHarshMD

3 years

What increases both PTT and INR? Anything influencing Factors 2, 5, and 10 5x2=10 it’s that easy! ⁦ @DxRxEdu ⁩ ⁦ @rabihmgeha ⁩

Coagulopathy- Elevated INR and PTT

Download PDF Here

clinicalproblemsolving.com

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Mohit Harsh, MD

@MohitHarshMD

4 years

Got consulted for acute hyperkalemia management while on #MedConsults ... ...Dx an RTA Type 4 after calculating a +Urine Anion Gap and TTKG i/so NAGMA As an intern, RTA was so abstract and only in textbooks Now it is on my ddx. Talk about #diagnosticgrowth #clinicalreasoning

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Mohit Harsh, MD

@MohitHarshMD

4 years

Deliberate practice leads to progress @DxRxEdu @rabihmgeha Some reflection and a schema for non-healing gastric ulcers. Feedback welcome! #GITwitter #MedTwitter

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Mohit Harsh, MD

@MohitHarshMD

1 year

Also a plug: consider community practice if you are academically trained. Your training goes a long way for patients and you can influence their care in a very powerful way by bringing evidence based practices and improving the quality of their management

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Mohit Harsh, MD

@MohitHarshMD

3 years

It is a Chik’n Tikka Masala pizza kinda day

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Mohit Harsh, MD

@MohitHarshMD

3 years

Thanks @abbyWUim for the swag! Proud to represent #HeForShe and always promote #WomenInMedicine . We must #GiveHerAReasonToStay to better serve our patients and communities!

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Mohit Harsh, MD

@MohitHarshMD

2 years

In the era of EMRs, ability to access on our phones, constant communication with care teams, attendings should not be asking what basic lab values were overnight nor playing a game of telephone on what the echo showed, consultant said, etc. Excellent 🧵 here

Brad Spellberg

@BradSpellberg

2 years

Soon to wrap up another go around on ID consult service, and some observations to share. Some may be controversial, but things humming along and the team running like a well-oiled machine, thought I'd begin a dialogue. 2 major observations, with detail for both.

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Mohit Harsh, MD

@MohitHarshMD

2 years

May 9th = Tip #9 #TipsForNewDocs #MedTwitter One of the biggest lessons from intern year is getting a gestalt for sick vs not sick This relies on recognizing signs and symptoms that should give you pause A brief list and crowdsourcing to add to this list!

Mohit Harsh, MD

@MohitHarshMD

2 years

May 8th=Tip #8 #TipsForNewDocs #MedTwitter Intern yr you may be on several “off service” rotations Some of my most impactful rotations were not in my specialty (IM) Soak up as much knowledge & perspective as you can You’ll inevitably work with that specialty in the future!

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Mohit Harsh, MD

@MohitHarshMD

3 years

#TipsForNewDocs Find your Joy in Medicine à la @DxRxEdu but also... Find your Joy outside of medicine to keep you grounded Mine is gardening, cooking, and the outdoors What’s yours?

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Mohit Harsh, MD

@MohitHarshMD

2 years

After a long hiatus, I’m back on VMR Monday presenting a case to the one and only @Gurpreet2015 !! Great minds bald alike 😂😂 @DxRxEdu @CPSolvers

Rafael Medina

@Rafameed

2 years

Join us this Monday (August 22th) for another Clinical Reasoning VMR at 6pm EST. This time with @Gurpreet2015 discussing a case by @MohitHarshMD . @MadellenaC will be facilitating the session. It's free to join us! Hope to see you all there (:

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Mohit Harsh, MD

@MohitHarshMD

4 years

Having my neuro exam confirmed and critiqued by neurologists is a humbling experience The subtleties they pick up are remind me that consistent practice is the key to growth #progressnotperfection #EndNeurophobia @DxRxEdu @rabihmgeha @AaronLBerkowitz @medrants @CPSolvers

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Mohit Harsh, MD

@MohitHarshMD

5 years

As promised, pt 2 in Potassium #Tweetorial series. This time, Aldosterone and Potassium Homeostasis Another large physiology topic, so I’ll be brief and stick to highlights from reading #BurtonRose textbook, which I highly recommend for all levels of learner Thread ⬇️

Mohit Harsh, MD

@MohitHarshMD

5 years

Next time, we’ll take a deep dive into the role of #Aldosterone in K Homeostasis. Ref: PMID 355876, 27756725, 1146998 Happy to take in any feedback since this is my first venture into tweetorials!

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Mohit Harsh, MD

@MohitHarshMD

2 years

My rounds never lasted more than 2 hours and that included ample teaching. I can make a 🧵later on how I achieved this but just goes to show it is possible if attendings took time to know data and interpret it themselves before rounds

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Mohit Harsh, MD

@MohitHarshMD

3 years

One of my responsibilities is organizing @WashUIMRes noon conference I made a goal to ⬆️ representation of lecturers who are #WomeninMedicine and #URM Proud to say thus far 60% of lecturers are faculty/fellows who identify as women or are URM! I plan to keep that % growing!

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Mohit Harsh, MD

@MohitHarshMD

4 years

Being on a teaching service again has been so refreshing. I’ve prepared on how to be a better senior since last time and how to utilize #MedTwitter Look out for learning points from our team daily #spacedlearning #FOAMEd #MedEd #MedStudentTwitter

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Mohit Harsh, MD

@MohitHarshMD

2 years

Great grabbing lunch with the living legend @medrants Just missing @DxRxEdu @rabihmgeha

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Mohit Harsh, MD

@MohitHarshMD

2 years

@Dr_Oubre Someone didn’t do contract negotiations

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Mohit Harsh, MD

@MohitHarshMD

3 years

I’m now holding our Chief Resident On Call phone aka the CROC 🐊 Let’s hope I keep the residency afloat @dcoscomd @abbyWUim @RakheeBhayaniMD @AmberDeptola Thanks outgoing @WashUIMRes chiefs for the tips! @amaad_md Had to change the background though @sanchaMD @DevinCashMD

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Mohit Harsh, MD

@MohitHarshMD

4 years

Lots of mixed emotions after getting the #COVID19 vaccine Grateful to receive the @pfizer vaccine that many will have to wait on or will never receive Thank you @BarnesJewish @WUSTLmed and the many volunteers today including the CMOs who registered me #HereWithUs #IGotTheShot

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Mohit Harsh, MD

@MohitHarshMD

4 years

Loved this personal, reflective, and honest discussion on what it is like creating medical podcasts and creative content from an AMAZING panel of superstars! @ShreyaTrivediMD @kidney_boy @tony_breu @AdamRodmanMD @HannahRAbrams @ Dr. Michael Shen @iMedEducation #iMED2021

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