Very General Orthopaedist @generalorthomd Twitter profile

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Very General Orthopaedist

@generalorthomd

3 years

I do hundreds of surgeries a year and the few that don’t go well occupy 99% of my mind space.

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Very General Orthopaedist

@generalorthomd

1 year

I looked up my “peer” who denied an indicated surgery. My “peer” hasn’t been allowed to do surgery for 10 years because he put a hip replacement in backwards, but he gets to overrule my decisions. This is insane.

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Very General Orthopaedist

@generalorthomd

9 months

6 years ago, 9 months before residency graduation, baby girl arrived! My pathetic residency director tried to suspend me for missing 7 morning didactic sessions (to take older children to school) after the birth. I argued this was a blatant FMLA violation. He persisted. 🧵

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Very General Orthopaedist

@generalorthomd

9 months

Im here, the chief of surgery, busy, happy, healthy, an AAOS ambassador, and a 2023 AAHKS speaker. I’m thriving. He’s a sad little man who garners no professional respect. Fuck him. The lesson, when US residents talk about abuse and power imbalance, listen. #MedTwitter

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Very General Orthopaedist

@generalorthomd

2 years

My PA has filed 3 appeals with his insurance company to cover the $3000 pathology bill they deemed “medically unnecessary” for his wife’s melanoma excision. If aggressive cancer pathology is “medically unnecessary”, what IS necessary? For profit health insurance is a scam.

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Very General Orthopaedist

@generalorthomd

1 year

My scrub tech gave me a puppy! Name undecided but I’m thinking of naming him Bones. I love bones.

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Very General Orthopaedist

@generalorthomd

1 year

I think we found it! Thanks to @OrthoYour . Placed backwards✔️ Cemented ✔️ Done for fracture✔️ Done in my state✔️ Done around the same time✔️

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Very General Orthopaedist

@generalorthomd

1 year

Update: After writing the appeal letter for backwards hip guy turned insurance peer's denial/absurd treatment recommendation on my pt that he's never seen, I went ahead and filed a complaint with the state medical board. It was accepted and a case is now open against him.

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Very General Orthopaedist

@generalorthomd

9 months

In retaliation for me standing up to him, he RETROACTIVELY took away excused absences and said I wouldn’t graduate. I went to HR. They were appalled and had a meeting with him and legal. He looked bad. I was not punished and graduated on time with a clean record. He wasn’t done.

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Very General Orthopaedist

@generalorthomd

9 months

That job was over before it started. He then held up credentialing at my current job. It took me this long to speak out because it was painful and professionally dangerous for me. If I need credentialed at another hospital, it STILL goes through him. Now I can afford lawyers.

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Very General Orthopaedist

@generalorthomd

3 years

CDC now says it’s ok for healthcare workers to drive drunk, but only if they are going to the hospital to do maskless cpr on a Covid+ patient.

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Very General Orthopaedist

@generalorthomd

9 months

After graduation, he falsely and without evidence, claimed I was unethical, dishonest, and lazy on hospital credentialing forms. I had a rough time at first, but graduated residency with a clean record. No disciplinary history. Good evals the last 3 years, including from him.

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Very General Orthopaedist

@generalorthomd

1 year

@OrthoYour For those just getting caught up. The surgeon who performed this ghastly surgery was permanently banned from operating by the State Medical Board. He now does "peer" reviews for an insurance company and recently denied a surgery for one of my patients.

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Very General Orthopaedist

@generalorthomd

2 months

Cigna denied a reverse total shoulder. The reason? "Good deltoid function" was documented. For those unfamiliar, good deltoid function is a requirement for a reverse total shoulder. It would be laughable if there wasn't a person being harmed by these greedy insurance companies.

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Very General Orthopaedist

@generalorthomd

1 year

This is workman's comp. Maybe @Pinnacol can defend their "peer?" On one side, a board certified surgeon with no board/disciplinary action who does shoulder surgery weekly. On the other, you have the guy who puts hips in backwards and can no longer touch people. Tough call.

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Very General Orthopaedist

@generalorthomd

7 months

Dirty move by @UHC . Submit a surgery for pre-auth. Denied. We can't get anyone on the phone for 2 days at the end of last week. Today, 2 business days after the denial, they say the window has passed for peer to peer and claim needs resubmitted. This should be illegal.

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Very General Orthopaedist

@generalorthomd

9 months

A former co-resident, who was the only Jewish person in the program, just reminded me of his experience. A chief resident targeted him by putting an anti-Semitic graphic on a resident work computer. The same program director did NOTHING. That resident left the program.

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Very General Orthopaedist

@generalorthomd

1 year

As a reminder, the person who performed this surgery and was subsequently banned from doing surgery is now working for insurance companies and making medical decisions to deny care. Even if nothing comes of the complaint, he will at a minimum have to answer for his actions.

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Very General Orthopaedist

@generalorthomd

1 month

I guess @Humana just doesn’t pay for ACL surgery anymore? Literally just denied it and declined peer to peer in a man with an unstable knee that gives out on him daily. Non operative management tried and failed. This should be illegal.

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Very General Orthopaedist

@generalorthomd

2 years

Anyone who enters an allergy into the medical record without also entering the reaction should be thrown straight in jail.

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Very General Orthopaedist

@generalorthomd

1 year

UPDATE: after my appeal letter (with the purposefully petty “board certified” sign off) to the insurance co. that denied surgery based on the opinion of Banned from the OR Backwards Hip Guy, they called to tell us the surgery has been approved and BHG was removed from the case.

Very General Orthopaedist

@generalorthomd

1 year

Update: After writing the appeal letter for backwards hip guy turned insurance peer's denial/absurd treatment recommendation on my pt that he's never seen, I went ahead and filed a complaint with the state medical board. It was accepted and a case is now open against him.

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@generalorthomd

3 years

Admin has dictated that if we take call on a weekday holiday (labor day, memorial, etc) and are NOT called in to the hospital, we get charged a day of PTO. This ignores the fact that a day of call is a day of work, requiring us to be available, in town, and worst of all, sober.

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Very General Orthopaedist

@generalorthomd

2 months

We have a OR tech/sterile processing/clean the blood off the ceiling guy named Josh. He’s quiet and effective. We like Josh. Josh stocks shelves at the grocery at night. He lost childcare and asked to work part time. The hospital let him go. Josh doesn’t care about #HospitalWeek

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Very General Orthopaedist

@generalorthomd

1 year

One “medical director” denied 121 THOUSAND claims in 2 months. That’s ~ 350 claims an hour. They’re supposed to review the medical record. This is illegal. Do something. @Hickenlooper @laurenboebert @MichaelBennet @GovofCO

How Cigna Saves Millions by Having Its Doctors Reject Claims Without Reading Them

Internal documents and former company executives reveal how Cigna doctors reject patients’ claims without opening their files. “We literally click and submit,” one former company doctor said.

www.propublica.org

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Very General Orthopaedist

@generalorthomd

1 year

You’re operating in a hole. One assistant is holding a retractor and can MAYBE see the stem insertion. He inexcusably resected the greater troch which is the only easily identifiable landmark for everyone but the surgeon. The surgeon is to blame. No one else.

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Very General Orthopaedist

@generalorthomd

1 year

@elliotthaut @OrthoYour Are anonymous xrays without a single patient identifier, location, or year concerning to you? If so, you are going to be OUTRAGED by google images.

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Very General Orthopaedist

@generalorthomd

1 year

@OrthoYour Everyone throwing shade at the nurses/reps/anesthesia in the room for "not saying anything" need to chill. Note that NO surgeons are saying that. The surgery is inexcusable, but those folks can't see what's going on in the hip.

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Very General Orthopaedist

@generalorthomd

9 months

@BarronGhost That’s illegal. And I’m sorry you went through that.

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Very General Orthopaedist

@generalorthomd

1 year

Just took a stroll down the administration hallway at 1:30 PM on a Friday. CEO: gone CNO: present COO: gone HR: 0/3 present Quality: 1/5 present CFO: gone Chief Information Officer: gone *My hospital has 17 beds...so we have 1 Quality Officer for every 3.4 beds.

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Very General Orthopaedist

@generalorthomd

1 year

@charleston_doc Are you saying NSAIDs do not in fact improve knee stability?

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Very General Orthopaedist

@generalorthomd

10 months

My 9 year old has football practice every evening after school from 630-730. Is this normal? It shouldn’t be. There is ZERO value in that volume of practice for a 9 year old. It’s likely detrimental to their school/family life, not to mention burning them out on football.

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Very General Orthopaedist

@generalorthomd

2 years

Me: Calling in prescription Pharmacy: what’s your NPI number? Me: hold on let me google that for you.

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Very General Orthopaedist

@generalorthomd

10 months

Patient yelled at my nurse “That’s ridiculous. I’ll just go somewhere else!” bc I had the audacity to get sick and had to delay his arthroplasty for a week. If only he knew how relieved we are. 🎉 HCWs, like all humans, prefer not deal with mean/unreasonable people.

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Very General Orthopaedist

@generalorthomd

1 year

Playing football at Northwestern was the worst experience of my life. As much as I hate reliving it, I can’t in good conscience sit this one out. Emotional and physical abuse, including hazing similar to what is described, was very much real. 1/7

Northwestern football hazing allegations: Players claim 'vile and inhumane' practices as coach Pat...

One day after Northwestern football coach Pat Fitzgerald was suspended for two weeks after a hazing investigation, explosive allegations of what players experienced surfaced.

www.sportingnews.com

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Very General Orthopaedist

@generalorthomd

1 year

The for profit insurance scam is out of control. @UHC denied a hip replacement because the patient needs to do more “conservative care.” She can barely walk. #orthotwitter #MedTwitter

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@generalorthomd

5 months

I had no idea our hospital was this poor.

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Very General Orthopaedist

@generalorthomd

1 year

@mital1982 He's not, but his website says he is, which was something I included in the complaint.

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Very General Orthopaedist

@generalorthomd

1 year

me: arrives early for OR day nurse: we are starting 30 mins late b/c of a meeting. Admin said surgeons had to go m: what meeting? n: the trauma meeting.. me: checks email and finds an email sent at 649AM notifying us of a 7AM meeting. These people don't care about us.

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Very General Orthopaedist

@generalorthomd

1 year

So can I let my Stryker™️ rep take me and my family on the Stryker™️ private jet and yacht with all the other Stryker™️ people, or would that be considered a conflict of interest? Just want to be sure I hold myself to the HIGHEST POSSIBLE STANDARD.

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@generalorthomd

1 year

Met a male “Karen,” who rudely told my 9 yo expert skier he needs to slow down and told me my son is out of control My response was not polite 😉 Wont repeat, but my kids said “dad! We’ve never heard you talk to a grown up like that! Me: I didn’t like the way he talked to you

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@generalorthomd

1 year

@ronhekier I will agree to call him “Backwards Hip Guy, MD-minus, former surgeon banned from touching any mammals due to being the worst surgeon in the world”

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Very General Orthopaedist

@generalorthomd

2 years

I’ll exceed my RVU target by 70% this year, and have already done more surgeries this year than any ortho here has done in the last 20 years; including more than the combined total of 2 full time orthos in the last 10. My reward? A proposal for a 25% pay cut. Quite upsetting.

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@generalorthomd

2 months

1. It’s insulting and out of touch. 2. Patients are here because they need help…and not from someone dressed as a Smurf. 3. We are doing our jobs between 2 and 3pm, and send our regrets that we will not be able to attend your superhero costume contest.

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Very General Orthopaedist

@generalorthomd

1 year

Please everyone stop messaging me and telling me the document isn't redacted appropriately. It's public record. You can find the document if you do a physician license check, which anyone can do, and click on BOARD ACTIONS.

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Very General Orthopaedist

@generalorthomd

1 year

For my birthday, my awesome office staff that loves to tease gave me this OR hat and some bourbon, my CRNA buddy got me some Willett, and my PA got me a fishing pole. These people make my job even more enjoyable. I’m 40. 😬

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@generalorthomd

4 months

This is a TERRIBLE IDEA. A good surgical rep is an invaluable resource. With the high turnover among OR staff, my trusty rep is often the only other person in the room who knows the steps of the surgery and what equipment I need to perform an efficient and SAFE surgery.

Daniel Cognetti, MD

@CognettiMD

4 months

A bill introduced in Connecticut aims to ban surgical reps in the OR for the purpose of “patient safety” Whose idea was this? Did they ask surgeons? IMO it will be less safe for patients. We need advocacy @AAOS1 @AAHKS @otatrauma @MilOrtho

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@generalorthomd

2 years

SCAM 🚨 JCAHO type organization is here and I was told I couldn’t wear a cloth hat in the OR. In the year 2022, we pay an organization to come to our hospitals and force us to do things not backed by evidence.

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Very General Orthopaedist

@generalorthomd

1 year

@NinjaMama617 He is definitely not board certified and has a permanently restricted license.

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@generalorthomd

2 years

Is it tacky to hand out business cards at ski bars when you hear 3 people in their 20s talking about their torn ACLs?

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@generalorthomd

1 year

“I’m concerned you’re not saving enough. Maybe you should work more and ski less.” -my dads 72 yo friend, after hearing me talk about skiing and traveling. He works 6 days/week and is on his first ever trip out of USA. I was polite, but SEETHING 😡 What would you say?

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@generalorthomd

3 years

Chiropractic nightmare: this poor lady, with known metastatic endometrial cancer, was told by chiro her worsening thigh pain was due to the peritoneal tumor pushing against a nerve in her back??!! No XR. Spinal adjustments for a month and broke femur at home. 1/3

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Very General Orthopaedist

@generalorthomd

2 years

I cried after an OR day Primary knee requiring aggressive posterior capsule release (pre op ROM 10-100) went well until tourniquet down and brisk posterior bleeding I was unable to find/control. I calmly finished the case, asked for doppler and CTA on the ready as I closed. 1/3

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@generalorthomd

2 years

OR nurses: if you want a 4 day work week and time and a half on Fridays, which you will rarely work, come work with me! *must be willing to live 4 hours from Trader Joe’s, Costco, and Whole Foods. We have Walmart, Safeway, and City Market. Internet is bad. Pluses: see pics

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Very General Orthopaedist

@generalorthomd

3 years

The OR director sat me down to tell me that me doing 4 total joints in 1 day is “stressing out the OR staff.” They take me 65 minutes incision to closure and I have the room from 730-530. I’m booking into January. This place hates making money.

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@generalorthomd

2 months

Middle admin over the hospital wide loudspeaker: “📢 HEY HEY HEY healthcare heroes happy hospital week! Come to the cafeteria between 2 and 3pm dressed up as your favorite superhero and win a prize!” 🧵 1/4

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@generalorthomd

2 years

Got my suit all steamed up and wrinkle free by hanging it in the bathroom with the shower running. I’m a 39 year old surgeon with 3 children.

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@generalorthomd

1 year

@bone00afide Did I though? Can we still call him "surgeon?"

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@generalorthomd

1 year

“My aim is not just to be a surgeon – it is to be a damn good one. I didn’t go into it to be average,” she says as she pours tea. The most badass British surgeon quote by @RoshanaMN Men need to do better and stand up for our female colleagues.

Sexual assault, crude banter — what it’s like to be a female surgeon

One of Roshana Mehdian-Staffell’s earliest memories is of sitting on the worktop in the kitchen watching her father carve a leg of lamb. “He put his surgical gl

www.thetimes.com

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@generalorthomd

3 years

My patented single AF dinner on the porch.

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@generalorthomd

2 years

At least my mom and dad were here visiting. I got the best mom and dad hug when I got home after telling them I had a bad day and needed a hug.

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@generalorthomd

1 year

I love that my hospital’s newest interim CEO doesn’t bother PRETENDING to care. No wasting my time with “how can I help you meetings” that will lead to no change. He sits in his office and does nothing. I do ortho stuff. We coexist peacefully.

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@generalorthomd

1 year

My hospital system has: -5 full time HR positions -5 full time Quality positions -3 nurse managers for 17 beds. -FIFTEEN doctors total between primary care, ED, surgeons, hospitalists. Admin up there really scratching their heads on how to cut costs.

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@generalorthomd

2 months

My parents cleaned my garage as a gift bc they’re awesome and know time is the best gift for me. My garage is clean. My standup freezer with over 100 pounds of beef was shut off and my outdoor router was unplugged and placed neatly on a shelf. I caught the freezer in time. 😅

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@generalorthomd

7 months

…or when my awful/still employed as program director said “shouldn’t have scheduled yourself to be on call” when I, scared for the lives of my 39wk pregnant wife with a hx of precipitous labor and 2 children, asked to take home call - like normal- during a major hurricane. 1/3

Shematologist, MD

@acweyand

7 months

Or the time my 34 week pregnant co-resident went into labor & began to bleed from placenta previa only to be instructed by one of the chief residents to stay at her ER shift until a replacement arrived.

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@generalorthomd

2 months

@Cigna Hi Nick, we already did the peer to peer and got it approved, which I’m sure Cigna is so relieved to hear because this senseless denial was in the interest of patient right? Can you give me a good mailing address at Cigna so that I can bill for my time? Thanks!

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@generalorthomd

6 months

Oh…ok.

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@generalorthomd

1 year

@OrthoYour

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@generalorthomd

7 months

We do not need 12-character passwords, vpn, and 2-factor authentication to access our work email. No one is hacking in to see who the employee of the week was. Fix the EHR, CHUCK! how's everybody else's holiday weekend going?

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@generalorthomd

1 year

@MrsPA_C I wish I could see the xrays. Maybe I'll ask him if we get to do a phone call? This was just a letter explaining that I'm super wrong for trying to scope a high grade torn rotator cuff after PT...need to try steroid injections first.

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@generalorthomd

1 year

I have traded the ability to shop at target, Costco, etc so that I can walk out my door and ride my bike here, among all the other outdoor things. Best decision I ever made.

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@generalorthomd

1 year

We are literally playing out a John Grisham novel. “Donny Ray, could have been saved by a bone marrow transplant..but the claim was instead denied. Rudy uncovers a scheme by Great Benefit to deny every insurance claim submitted, regardless of validity.”

How Cigna Saves Millions by Having Its Doctors Reject Claims Without Reading Them

Internal documents and former company executives reveal how Cigna doctors reject patients’ claims without opening their files. “We literally click and submit,” one former company doctor said.

www.propublica.org

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@generalorthomd

4 months

Remember that the person who trained into their 30's to learn to do the surgery, does most of the work, and takes on most of the risk is the recipient of 6% of the overall payment. Where does the rest go you ask? It's hard to come up with 20K. It really is. This is criminal.

Brian Chalmers

@BrianChalmersMD

4 months

Here is a nice schematic from our first @aahks health policy fellowship meeting outlining what everyone is discussing - reimbursements to hospitals have a law factoring in inflationary benefit while physicians do not

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@generalorthomd

7 months

Physicians (or anyone else who can relate): Imagine competent and motivated administrators who just competently fix stuff and make things better.

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@generalorthomd

2 months

Maybe I’m the old man yelling at the sun, but I think small town medical clinics need to work in time-sensitive matters within a few days or weeks depending on issue. “Oh your tibia is broken, we can see you in 5 weeks” “Rapidly losing vision? Sounds scary. How’s September.”

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@generalorthomd

1 year

Bones is a good boy. Biscuit Orange Cat isn’t quite sure what to think of him.

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@generalorthomd

2 months

I should clarify…they let him resign rather than work with him on his schedule. The end result is the same.

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@generalorthomd

2 years

Rancher. Doesn’t bother him (shoulder or clavicle). Needs to chase cows. 🤷‍♂️

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@generalorthomd

2 years

I had to use my DAD VOICE in the OR today.

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@generalorthomd

1 year

OPPORTUNITY FOR UNMATCHED MD/DO IN ORTHOPEDIC SURGERY. Opportunities include: using a computer, cleaning, mowing my yard, and following me around with one of those little handheld fans to keep me cool.

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@generalorthomd

2 years

What if we had a set of rules for medicine written in 1787 and it required 2/3 majority of physicians to change the rules but 45% of us didn’t believe in science.

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@generalorthomd

2 years

So basically everyone was like “full Windsor knot?! I think we are done here. Pass.” We then high fived and talked shit about chiropractors for the next 29 minutes.

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@generalorthomd

2 months

Because the 📢 people have forgotten the purpose of hospitals, and the seriousness that comes with it, they fail to understand that someone hearing “today is dress like a cowboy day!” was just brought in by ambulance, having the worst day of their life, or is visiting their 2/4

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@generalorthomd

3 years

Farmer. No elbow pain. Just stiff. Right knee “aches a bit”. No left knee pain.

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@generalorthomd

1 year

Large joint trifecta day…to my knowledge, all of the implants were inserted in the correct orientation.

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@generalorthomd

2 years

@olsonplanner Have people with far less education and no medical experience oversee their every move.

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@generalorthomd

5 months

My sweet 12 yo boy broke his leg skiing. He’s handling it well. Fortunately it’s not bad and he will be good as new with a cast.

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@generalorthomd

2 years

Then, A MOTHERFUCKING HELICOPTER CRASHES ON THE RUNWAY (no injuries), and the runway is shut down. I got off that plane so fast, got a refund for the trip, and am now doing a Friendsgiving with people I love who don’t judge me for being a bit unpolished and having a shitty car.

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@generalorthomd

2 years

Nah, the tweet accurately reflects my feelings.

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@generalorthomd

2 years

Turns out, the bleeding had stopped by the time pt arrived. No pop artery injury, only incidentally had thrown clots. No history of clots. No arteriosclerosis. I can't explain it. I don't know what else to say. It was awful, for the patient, for me. Surgery is hard sometimes.

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@generalorthomd

1 year

Tweaked my hammy.

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@generalorthomd

2 months

dying mother, or just got a needle stick by a patient, or was just told they had a terminal illness, or just showed up in scrubs and did their best for 14 hours for the 19th day in a row. 3/4

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@generalorthomd

4 months

A covering CRNA told us a 1st hand report of a surgeon closing up a total knee after the exposure due to a robot malfunction. He didn't know how to do manual technique. I have a hard time understanding how you can do a good total knee without understanding those principles.

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@generalorthomd

3 years

Serious question: I got a trampoline for my kids. Is that tantamount to a pulmonologist opening a cigarette store? #orthotwitter #MedTwitter

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@generalorthomd

3 years

I’m a 38 year old orthopedic surgeon and my mom still tells me I need a haircut.

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348

Very General Orthopaedist

@generalorthomd

3 years

BCBS denied an MRI on a patient with a recent injury, positive Lachman, + effusions, + joint line pain, AND refused to even allow a peer to peer because they hadn't done 6 weeks of therapy. How is this legal? For profit insurance companies are not our friends.

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346

Very General Orthopaedist

@generalorthomd

3 months

There’s a term for systematically taking advantage of people by presenting false information to dupe them into paying exorbitant fees for unproven treatments. These fraudsters need exposed.

Jesse Morse, MD

@DrJesseMorse

3 months

If you’re trying to fix a bad back & a bad hip (torn labrum) you need 3 things: Potency of product + High Volume + Accurate Needle Placement In this picture is bone marrow + PRP taken out of a patient and immediately injected back in over 30 different places to hip

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341

Very General Orthopaedist

@generalorthomd

1 year

@MountSinaiNYC Looks like you paid administrators about $30,000,000 last year. Care to explain? Your CEO makes 12 million dollars a year. What exactly does he do that makes him worth more than 100 nurses? MSHS is putting admin pay over patient safety. See, I can do that too!

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333

Very General Orthopaedist

@generalorthomd

9 months

@InvictaOrtho No. He does not.

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336

Very General Orthopaedist

@generalorthomd

1 year

Oh and if you don’t already hate insurance companies, they imposed a TEN CALENDAR day FROM THE DATE OF MAILING via snail-mail - not business days, not upon receipt - for us to fax an appeal. I can’t believe this is legal. @laurenboebert @Hickenlooper @MichaelBennet @vote4varela

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321

Very General Orthopaedist

@generalorthomd

7 months

Great read by the amazing team at @propublica and @PatrickMRucker . In the article, Backwards Hip Guy said my reporting him to the state medical board was “overkill.” I disagree. Sellouts who unethically deny medical care to save greedy insurance companies money deserve to be

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