Jennifer Hamilton, MD PhD

Family physician, public health advocate, bicyclist and occasional maker of liquid nitrogen ice cream. Views are my own, and not medical advice. (she/her)

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npub1v9ge5cmy709d4xegzkywz5qlljheuprltnu6phydprumj9hv2l6slsuzuq

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jeneralist@med--mastodon-com.mostr.pub

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nprofile1qqsxz5v6vdj08jk6nv5ptz8p2q0letu7q3l4e7dqmjxs37dezmk90agpz3mhxue69uhhyetvv9ujuerpd46hxtnfduqs6amnwvaz7tmwdaejumr0ds4zjnt5

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relay.damus.io

nos.lol

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Last Notes

2026-03-02 00:55:57 UTC

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@nprofile…2zu7
Exactly so.

2026-03-01 22:44:23 UTC

#USPol
#trans
Meanwhile, the US Department of Justice (DoJ) published a document outlining how in intends to care for trans inmates. Recall that there's already an executive order keeping the Bureau of Prisons (BoP) from spending money on maintaining hormone treatment for trans inmates. The next step is to eval folks for gender dysphoria and "treating" for that -- aka conversion therapy.
DoJ document at https://www.documentcloud.org/documents/27307934-bop-526001-management-of-inmates-with-gender-dysphoria/
More info at https://transitics.substack.com/p/the-trump-administration-is-testing

2026-03-01 19:21:01 UTC

Dr Glaucomflecken AND Senator Elizabeth Warren team up!
What happens when one company owns the medical office, the insurance company, the pharmacy, and the pharmacy benefit manager? This might be a "choose your own adventure" -- we can write the next chapter!
https://www.youtube.com/shorts/C3iitzCI3RA

2026-02-28 00:55:39 UTC

Dr Glaucomflecken has the goods on a hospital in Oregon that fired all of its ER docs. Said they were too slow, and pt dissatisfaction was too high. Why were the ER wait times getting higher? It couldn't have anything to do with the fact that the hospital owners had already closed another nearby ED, could it?
https://www.youtube.com/shorts/tcHwqb8yEGY

2026-02-27 21:39:37 UTC

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@nprofile…f5pz On the CDC website, I did find the recommendation for those 65 and older to get 2 doses annually. However, but that everything there also says "shared clinical decision-making", you may want to check with the folks you'd be thing to fit the vaccine ( Clinic? Pharmacy? ) to see how they handle it before you drive to get it.

2026-02-27 19:55:05 UTC

#ACIP meeting slated for March 18 & 19 -- and they're going to be taking about covid vaccine injury.
If you were giving of getting a covid vaccine booster this spring -- maybe you get the vaccine twice a year because of health risks -- you might want to get it before the meeting.
https://www.nbcnews.com/health/health-news/rfk-jrs-cdc-panel-discuss-covid-vaccine-injuries-upcoming-meeting-rcna260694

2026-02-25 19:12:01 UTC

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@nprofile…59f2 I see your .ca server address, and I'm reminded of a joke about the TV/streaming show Breaking Bad. It was the sort of series that would only come from the US. Anywhere else, when Walter got diagnosed with lung cancer, he'd know that the cost of his treatment would be taken care of by nat'l health insurance. No financial problems, very different drama.

2026-02-25 16:27:32 UTC

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@nprofile…qu5m Most of these are local to Chicago (where it happened, no surprise to see it there.) I tend towards Philly Inquirer (local paper where I live), NPR, and the increasingly unpopular Washington Post / NY Times (you can still scan their headlines without subscribing), CNN, etc. I'll even look at Fox once in a while to see what their headlines are.
Thanks for the list!

2026-02-25 13:20:11 UTC

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@nprofile…wn0a I have several patients who got GLP1 meds through websites or specialty clinics who lost weight, stopped the meds, and had the weight come back -- and now complain that the meds didn't work.
"They're not like antibiotics. They don't cure a problem. They're like blood pressure meds. As soon as you stop them, the numbers go back up." I say as empatheticly as I can.

2026-02-25 13:14:32 UTC

Why am I hearing about this from The Guardian rather than USian media?
Feb 18 high winds blew a baby stroller into Lake Michigan-- with baby in it! Man jumps into frigid lake, treads water holding stroller and tot until rescued. Baby doing well, but man needed to be hospitalized for several days.
In true USA fashion, there's a GoFundMe for his hospital fees and lost wages.
https://www.gofundme.com/f/help-lio-recover-after-heroic-rescue
https://www.theguardian.com/us-news/2026/feb/25/chicago-baby-saved-lake
Could the rescue be getting little attention bc rescuer is trans?

2026-02-24 12:37:58 UTC

The good news: Polio has gotten rare enough in the US, thanks to vaccines, that there are very few doctors with experience in caring for its long-term complications.
The bad news: who is going to be able to take care of the people who feel its effects when the vaccination rates drop?
https://www.theguardian.com/us-news/2026/feb/23/polio-vaccines-us

2026-02-21 03:11:22 UTC

Measles in Delaware: the Delaware public health department is warning folks that someone with Measles was in the emergency department of Nemours hospital on Wednesday Feb 18.
🎁:
https://www.inquirer.com/health/measles-exposure-nemours-childrens-hospital-emergency-room-delaware-20260220.html?utm_source=social&utm_campaign=gift_link&utm_medium=referral
#measles #Delaware #wilmington

2026-02-17 11:52:50 UTC

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@nprofile…x9q9 My 16 year old niece was on her first date when the drunk blew through a stop sign and hit her boyfriend's car.

2026-02-13 20:33:34 UTC

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@nprofile…h3g9
Some back-of-the-envelope calculations: new vaccines are generally introduced to more affluent countries first, especially for diseases that aren't immediately fatal. The market for vaccines against EBV, HSV, and VZV would be in this category.
EU: 450M people
Canada: 40M
US: 350M
Australia & NZ: 30M
Without US, the market is about 40% smaller.

2026-02-13 16:04:10 UTC

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@nprofile…73zx Yep! And I really want any potential vaccine to evaluate the effect on ME/CFS. Is it the pathogen that causes problems, or the immune system's response to the pathogen? Could a poorly-designed vaccine make things worse?

2026-02-13 16:00:55 UTC

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@nprofile…3qcf
I'm not the right person to be explaining the perverse intersection of healthcare and capitalism. The short answer is, most large companies won't do anything that loses money. In fact, in US law they are specifically prohibited from doing things that are expected to lose money.

2026-02-13 15:35:11 UTC

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@nprofile…6fwm
A vaccine manufacturer would normally apply for approval in many jurisdictions.
But for some back-of-the-envelope calculations: new vaccines are generally introduced to more affluent countries first, especially for diseases that aren't immediately fatal. The market for vaccines against EBV, HSV, and VZV would be in this category.
EU: 450M people
Canada: 40M
US: 350M
Without US, the market is AT LEAST 40% smaller. Is it still worth it do to the studies?

2026-02-13 14:46:29 UTC

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@nprofile…9vnr Sadly, that's a more hopeful interpretation than mine: the administration is pursuing an anti-vaccine agenda, and is doing what it can to make EVERY vaccine manufacturer pack up and leave. Moderna is just the first.

2026-02-13 14:10:21 UTC

The FDA decided not to even review Moderna's mRNA flu vaccines for approval, even though the studies the FDA would be reviewing were conducted the way the FDA told Moderna to do them.
Now #Moderna expects that none of its other #mRNA #vaccines will be reviewed, and has halted studies on vaccines for EBV, HSV, and shingles.
A lot of people with herpes would be angry if they found out.
A lot of people who have family members with #MS -- now thought to be caused in part by EBV -- will be livid.
https://cdn.masto.host/medmastodoncom/media_attachments/files/116/063/701/098/021/963/original/09f8c492a027d70b.png

2026-02-13 13:47:07 UTC

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@nprofile…wn0a I find Breathertarian short internal training to be more effective. I break up my Breather sprints with dark chocolate.

2026-02-13 12:22:58 UTC

Great news in #Philadelphia: A group of clinics that provides healthcare services in low income neighborhood has had its funding restored.
🎁:
https://www.inquirer.com/health/fpcn-family-practice-fqhc-health-center-grant-20260213.html?utm_source=social&utm_campaign=gift_link&utm_medium=referral

2026-02-12 20:35:28 UTC

A quote from RFK Jr, which may go a long way to helping us understand rather a lot about the current head of Health & Human Services:
"I'm not scared of a germ. I used to snort cocaine off of toilet seats."
https://bsky.app/profile/factpostnews.bsky.social/post/3meoq2jnrgb2z

2026-02-06 15:23:32 UTC

The Guardian and the AP uncovered emails that found that when RFK Jr went to Samoa in 2018, he was planning on addressing vaccine policy -- no matter what he told his Senate confirmation committee.
https://www.theguardian.com/us-news/2026/feb/06/rfk-jr-samoa-trip

2026-02-04 13:24:19 UTC

A heartfelt request: if you find across an interesting article on a paywalled site (for example, NY Times, Washington Post, half of CNN these days) and you post a link to the article, please use a gift link if you can. If you're worried that gift links are too trackable, you can post a regular link also.
Signed, someone who already tried to follow "read this it's interesting!" posts 3 times this morning and can't get past the title of the story.

2026-02-04 01:35:47 UTC

The Philadelphia Inquirer has a good piece today on Medicare updates that make prescriptions more affordable -- bit only if you know about the program and sign up.
Gift: https://share.inquirer.com/HAXDY2

2026-02-01 13:32:58 UTC

An article summarizing the new head of the ACIP's outlook on vaccination policy makes for a dispiriting start to the week.
https://www.theguardian.com/us-news/2026/feb/01/vaccine-recommendations-acip
Summary: he thinks we don't need vaccines anymore because we don't have the incidence we used to (BECAUSE OF VACCINATION!) and because we can better treat illness now.
The exchange rate between ounces of prevention and pounds of cure must have changed from what I remember.
#ACIP #vaccines

2026-01-31 21:54:17 UTC

@nprofile…9x02
On a particularly trying day, when I was feeling beyond the end of my reserves, I saw that you had posted something that cheered me up.
So often I find that you post or boost something that reframes a previously overwhelming problem, or provides hope, or centers beauty.
Thank you.

2026-01-28 14:09:57 UTC

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@nprofile…wn0a It looks like at least this time we'd be able to do an orderly withdrawal, so we can find each other on whatever different servers we migrate to.

2026-01-28 14:08:25 UTC

Article that came out in early January that I missed at the time, helping explain why "shared clinical decision-making" can keep kids from getting vaccines that docs and parents support. Short answer: there are only 24 hours in a day and 15 minutes in a clinic visit.
https://theconversation.com/shared-decision-making-for-childhood-vaccines-sounds-empowering-but-it-may-mean-less-access-for-families-already-stretched-thin-272815

2026-01-27 12:59:23 UTC

Kirk Milhoan, a pediatrician cardiologist and current head of the ACIP, told a podcast this month "I've never seen a case of congenital rubella affecting a child in my career.”
Of course he hasn't. He's a pediatric cardiologist. The rubella vaccine came out more than 50 years ago. Congenital rubella causes deafness, blindness, developmental delays -- but not heart problems. We've been using the vaccine for so long that the affected kids are now adults.
Including one who came to my clinic.

2026-01-26 23:37:30 UTC

Doximity sent me an email telling me they used DoxGPT to update my online bio, and that I should "[t]ake a look, make modifications..."
I wrote back, "Please do not use any AI to modify my bio, ever. You are making things harder for me. Now I need to go and check what slop you've put into the info...."
Their reply told me I could update my bio at any time. Their closing? "Disclaimer: This response is generated by an AI system and may be inaccurate."
#AI
#irony

2026-01-26 13:18:18 UTC

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@nprofile…wn0a Call it a "profitable" business model, instead of "good", and my comment will then be "both".

2026-01-25 20:57:44 UTC

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@nprofile…xxtn I value the information you send, but I'm going to have to mute you for a while. I would strongly prefer not to see photos or videos of this kind of horror.
I am muting people who do not consistently require click-thru to see such images.

2026-01-24 20:51:20 UTC

https://bsky.app/profile/dimitridrekonja.bsky.social/post/3md6xdjppvs27
#USPol
#Minneapolis

2026-01-24 14:00:47 UTC

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@nprofile…wn0a Somewhere nearby there's a raccoon thinking, "that could have been mine. "

2026-01-24 04:03:30 UTC

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@nprofile…gaql Maybe because I've done a few neural network style machine learning projects, I try not to lump everything in the same bucket with large language models.
But I'll certainly agree you probably saved yourself a few bucks on that one!

2026-01-24 03:13:00 UTC

You probably heard that the United States quit the World Health Organization (WHO) today.
But have you heard that California joined the WHO's Global Outbreak Alert and Response Network on its own?
https://www.gov.ca.gov/2026/01/23/governor-newsom-meets-with-world-health-organization-director-general-announces-california-becomes-first-state-to-join-who-coordinated-international-network/
https://www.reuters.com/business/healthcare-pharmaceuticals/california-joins-un-health-network-following-us-departure-who-2026-01-23/

2026-01-23 23:53:27 UTC

What would you do if, while you were in handcuffs inside an ICE vehicle being driven to a detention center, one of the agents in the SUV had a seizure?
Two women in that situation recognized the seizure, then asked the driver to pull over and uncuff them so they could deliver first aid.
After EMS services arrived --
-- the women were placed back in handcuffs and taken to the local detention center.
🎁: https://www.startribune.com/detained-by-ice-two-women-became-first-responders-during-agents-seizure/601569667?utm_source=gift
#USPol

2026-01-23 20:05:15 UTC

I don't want AI in my electronic medical record to try to summarize other clinicians' notes, or to listen in on my conversations with my patients to try to write my notes for me.
On days like this, with a big storm bearing down, I just want a plain old database to show me which of my patients will need their prescriptions refilled within the next 5 days, so that I can refill them now and patients can pick them up before the storm comes.
Guess which I don't have?
#AI
#EMR
#LLM

2026-01-22 15:52:35 UTC

As a large part of the US gets ready for a snowstorm forecast Saturday-Monday, add medications to your shopping list. If you're going to run out of prescriptions in the next week or so, call your doc now. It may be another day ot two after before things get back to normal.
Even if today might be "too soon" for a refill, insurance companies often give some leeway around storms.
Call today (Thursday), pick them up tomorrow, have a safe and healthy weekend.
#snow
#snowstorm
#Fern

2026-01-20 13:03:21 UTC

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@nprofile…wn0a In my family it has always been, "when you're down, shine your shoes. "

2026-01-17 23:59:06 UTC

Remember my post a few days ago about a patient getting a generic even though I specified name brand only?
Here's a report of a pt whose prescription said :::generics were OK, except from one particular manufacturer -- which is the one she got.
The prescription was for tacrolimus, an anti-rejection drug.
The patient's immune system went after her transplanted lungs.
More horrible details, including why pharmacies still stock a medication that might not work:
https://www.propublica.org/article/fda-generic-drug-equivalents-tacrolimus

2026-01-17 21:59:23 UTC

I've often told my patients that I don't really know which health insurance plan is better, or what gets covered, etc.
Here's a new one that I REALLY don't have an answer for: a patient who is getting treated for cancer wants to know what #InternationalHealthInsurance plans are available to them, that will cover cancer treatment, if they manage to emigrate away from 47's America. (Looking at Ireland, Portugal, and the Netherlands.)
New world, new questions, no ideas.
Suggestions?

2026-01-17 14:03:43 UTC

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@nprofile…90t6 @nprofile…9x02
You're both making it out to other servers. I follow CoastalCoasting and I can see Kaysee's reply.

2026-01-17 14:00:14 UTC

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@nprofile…9x02 @nprofile…gyjv You're both making it through to other servers. I follow CoastalCoasting, and I can also see Wild's reply.

2026-01-15 19:59:49 UTC

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@nprofile…9x02
It looks like it has been cancelled!
https://www.theguardian.com/us-news/2026/jan/15/hepatitis-b-vaccines-study-africa-cancel

2026-01-15 18:01:49 UTC

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Good news update! The hepatitis B vaccine "study" in which the control group would receive no vaccine has been cancelled!
Reports are that folks are going back to the drawing board to come up with a different, more ethical study protocol.
https://www.theguardian.com/us-news/2026/jan/15/hepatitis-b-vaccines-study-africa-cancel

2026-01-15 10:27:29 UTC

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@nprofile…fh5j I think the passive voice here is appropriate. We can't tell whether the parents wanted to get the vaccine for their kids but couldn't take off work; whether they truly believed that by declining vaccination they were protecting their kids from toxins; or maybe they're now thinking that this proves their faith in God was insufficient. Maybe their doc told them to skip it!
Calling someone a murderer isn't the best way to get them to trust you. And right now, we need that trust.

2026-01-15 03:37:46 UTC

Buried in the story about new cases of measles in South Carolina:
"At least three deaths were recorded in 2025, including two among unvaccinated school-aged children in Texas and one among an unvaccinated adult in New Mexico, marking the first U.S. deaths from measles in a decade."
https://abcnews.go.com/Health/south-carolina-reports-124-new-measles-cases-outbreak/story?id=129136137
#ItsNotJustARash

2026-01-14 14:12:57 UTC

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@nprofile…wn0a With AI folded in to so much software these days, there may have been someone who just looked at their search results and didn't realize the results came from AI.

2026-01-14 13:09:14 UTC

#AI news from England that US readers might not have seen: police banned fans of a particular soccer team from attending a game because of high risk of violence, citing their behavior at a previous match.
Except the previous match never happened.
Turns out the police used Microsoft CoPilot when hunting for info about the team's fans.
https://www.bbc.com/news/live/c394zlr8e12t
#MicroSlop

2026-01-13 18:25:07 UTC

I'm at a conference. The hotel has set out many parallel self-service buffet lines to feed over 4000 people. Lines start with plates and utensils.
Can anyone explain why every line has roasted veggies, then rice, then refried beans, and then the tortillas? Wouldn't it make more sense to get the tortilla first, and THEN the things you put on/in it?
#DocButAnEngineerToo

2026-01-12 16:40:55 UTC

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@nprofile…wn0a 🍿

2026-01-12 12:44:38 UTC

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@nprofile…xxtn When you post vids like this, could you please include the where/ when along with it? Yes, it's horrid; yes, it needs to be stopped; and it matters for response whether it's in Minneapolis or somewhere else, and when.

2026-01-11 20:47:38 UTC

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@nprofile…2c6z I don't honestly know. The conference is also a trade show. The organizers go to a lot of effort to make us feel HAPPY! when we're at the trade show part, and that includes photographers going around, taking pics, and using them in the conference newsletter the next day. Presumably those on X, LinkedIn, etc are taking pics of themselves and posting them.

2026-01-11 20:43:08 UTC

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@nprofile…30yh
Not a bad thought!

2026-01-10 15:24:14 UTC

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@nprofile…vqm3 Or, as drawn, can't bring himself to shave off his beard.

2026-01-09 04:19:21 UTC

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@nprofile…7cq5 If you stop taking your blood pressure medicine, you're blood pressure goes back up. The medication is a treatment, not a cure. Why are people surprised that obesity medicines work the same way?

2026-01-08 23:35:26 UTC

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@nprofile…7cq5 We have a "dispense as written" box. My problem is more on the #EHR side. When I type "Procardia", what comes up on my screen is "nifedipine (Procardia)". Next step is to call the pharmacy and find out how they actually receive the prescription. After that, most likely, is yelling impotently at the programming team.

2026-01-08 20:03:01 UTC

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@nprofile…rx35 Outpatient.
And I had the same thing happen later today with Spiriva tiotropium. Patient needs brand name to keep her PBM happy. (Yes, her insurance will pay for the brand name and not the generic. )

2026-01-07 03:02:24 UTC

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@nprofile…960f As I understand it, CHC Restored is deliberately stuck in January 2025, during the Biden administration. That's good as a point of reference.
The AMA website doesn't focus on information for the public. It's targeted towards doctors. You may want to look at CIDRAP, the Center for Infectious Disease Research and Policy, instead: https://www.cidrap.umn.edu/

2026-01-06 13:43:27 UTC

I missed this article when it appeared on The Guardian last month:
US plan for $1.6m hepatitis B vaccine study in Africa called ‘highly unethical’ https://www.theguardian.com/society
/2025/dec/19/hepatitis-b-vaccine-study-guinea-bissau-rfk?CMP=share_btn_url
In a country where over 10% of toddlers are infected with hep B, some will receive the vaccine at birth, and some will have the vax deliberately withheld until 6 weeks. And researchers will know who's in which group.
H/t Paul Offit's newsletter

2026-01-05 23:42:16 UTC

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The CDC is also reiterating its idea that children don't need to be vaccinated against covid. I'll readily agree that covid isn't as deadly to healthy children as it is to, say, octogenarians. But we're still learning about just how long it can take to recover from covid. Any many, children or adults, never get back to baseline.

2026-01-05 19:57:26 UTC

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@nprofile…wn0a YES! Yes it is!

2025-12-27 16:07:38 UTC

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@nprofile…jljv I sent an annoyed message via Doximity to the editor repeating back what the note said, then following with "in other words, you want me to fact- check your AI, doing the work you should be doing, for free. No, thank you. "

2025-12-27 00:36:36 UTC

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@nprofile…jljv I had a similar Doximity message saying that their LLM AI had cited an article I wrote, and would I like to look over their summary? When I responded that no, I was not going to do their editing and review for free, I got a message back saying they of course they meant to pay me.
Heck no.
Interesting that they haven't improved their communication 🙄

2025-12-21 14:28:53 UTC

The Alaska Department of Health recently published a report about deaths in the state over 3 years beginning in March 2020. About 1 in 500 people in the state died of COVID during that time.
“Seventy-four percent of those who died and were eligible for COVID-19 vaccine had opted not to receive it‚" states the report, published earlier in December by the state’s Section of Epidemiology.
Summary at https://www.adn.com/alaska-news/2025/12/19/1-in-500-alaskan-deaths-during-pandemic-was-from-covid-19-state-reports/

2025-12-19 00:55:10 UTC

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Plus, withholding care for all might make the current administration happy. Docs stopping treating kids except in emergencies means no vaccines, after all.
Better ideas welcomed.
/3

2025-12-19 00:53:41 UTC

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With the current US administration proposing to cut off Medicare & Medicaid funding for hospitals that provide gender-affirming care to children, how do we keep our promises?
Part of me wants every hospital to stop treating children, birth to 18 years, except in emergencies. Go on strike, since #GenderAffirmingCareIsHealthcare. If the gov't doesn't want hospitals to provide medical care, we won't. But I don't think we'd get enough hospitals on board.
/2

2025-12-19 00:48:45 UTC

Many physicians have pledged to uphold the "Declaration of Geneva", an update of the #HippocraticOath dating back to 1948. It includes:
I WILL NOT PERMIT considerations of age, disease or disability, creed, ethnic origin, gender, nationality, political affiliation, race, sexual orientation, social standing or any other factor to intervene between my duty and my patient...
I WILL NOT USE my medical knowledge to violate human rights and civil liberties, even under threat.
1/

2025-12-15 21:12:45 UTC

Update: I sent Doximity a note letting them know that I was not pleased with their request to fact-check their #AI on a topic I wrote about. It seems I was mistaken about the "work for free" part:
"As you (and we) know, automated systems can make mistakes, and your expertise in this field is incredibly valuable. We never expect that you, or any of our members, would work for us for free - rather, we provide an honorarium for any review time."
Re https://med-mastodon.com/@jeneralist/115709085589518984

2025-12-13 21:30:32 UTC

Putting this year's measles cases in perspective:
https://cdn.masto.host/medmastodoncom/media_attachments/files/115/714/355/217/651/470/original/061b6dd5024ad383.jpg
https://cdn.masto.host/medmastodoncom/media_attachments/files/115/714/357/437/364/230/original/6ced9d20c895ea18.jpg

2025-12-12 23:02:09 UTC

Last year I had a review article on strep throat published in _American_Family_Physician_. Today, I got email from Doximity letting me know that their #AI system had generated a summary about strep throat that cited my work, and asked me to review that summary for accuracy.
In other words: they're using a computer program to scrape my work, and they want me to double-check it out of the goodness of my heart.
I declined.
#UnpaidLabor

2025-12-09 11:49:16 UTC

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@nprofile…fax2 @nprofile…2v53
Right -- which is why I described my line as a counter-factual that anti-vaxxers might use anyway. There's a big difference between "an honest assessment of the study" and "what anti-vaxxers will say to discredit it."

2025-12-09 02:05:19 UTC

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@nprofile…2v53 Attack the randomization (note, what follows is counter-factual I can imagine and anti-vaxxer saying) : "In France vaccination is required. The icky reason people were asked to refuse the vaccine was if they were already at death's door from cancer or liver disease. So of course the folks who weren't sick enough to be excused from the vaccine lived longer. "

2025-12-07 19:14:59 UTC

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@nprofile…eyz0 Do NOT tie drug prices to value. Then life-saving or life-sustaining drugs (things like insulin, not just chemo) will have near-infinite pricing.
"What's a human life worth? Let's find out!" is a bad way to set drug prices.

2025-12-07 16:33:51 UTC

Yes, if you follow me, you're getting tired of this. But for the Sunday audience, here's another good summary of the problems with this week's #ACIP decision to stop recommending a hepatitis B (#HepB) #vaccine for all children at birth.
https://www.pbs.org/newshour/health/fact-checking-the-cdc-panels-reasons-for-dropping-universal-newborn-hepatitis-b-vaccine-recommendation

2025-12-07 04:30:31 UTC

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@nprofile…td0m @nprofile…jljv The boyfriend? The EX-boyfriend?

2025-12-06 16:06:26 UTC

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@nprofile…wqfx @nprofile…jljv
Here's a gift link to the article in The Atlantic, without needing to go thru Facebook:
https://www.theatlantic.com/national-security/2025/12/pete-hegseth-strikes-venezuela-congress/685156/?gift=d22D6h-Ryp8L2u-__iL2fQhbCpEuOPH_pxyaWc8PdTY&utm_source=copy-link&utm_medium=social&utm_campaign=share

2025-12-06 13:15:52 UTC

Great summary of Bizzaro #ACIP meeting, no paywall:
https://www.theguardian.com/us-news/2025/dec/06/vaccine-panel-hepatitis-b-change
“It’s really very devastating to have seen what unfolded today,” said Susan Wang, a pediatrician and the former lead for prevention of perinatal hepatitis B at the CDC. “It’s also laying the groundwork for destroying the rest of the childhood immunization schedule."

2025-12-06 12:49:13 UTC

I was able to access this summary of #ACIP and administration events yesterday (12/5) without a subscription:
https://www.washingtonpost.com/health/2025/12/05/acip-childhood-immunization-schedule-hepatitis-b/
The suggestion that the US cut its vaccination program to better match Denmark, a country the size of Michigan's upper peninsula with population less than NY city, is especially galling. Comparison to ANY Western democracy is misleading, because they all have universal health care -- which the US, of course, does not.

2025-12-05 18:10:57 UTC

The vaccine injury lawyer Aaron Siri is now using the current CDC webpage to state that a possible link between autism and vaccines has not been thoroughly studied.
Here's a link to what that web page looked like on January 16 2025, when it referenced 9 CDC-funded studies looking at that very topic: https://web.archive.org/web/20250116040502/https://www.cdc.gov/vaccine-safety/about/autism.html
(#ACIP meeting in progress 5 December 2025)

2025-12-05 17:51:54 UTC

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@nprofile…xm8u Kudos to you and your team for live-posting these.

2025-12-05 17:29:16 UTC

The current presenter at the #ACIP, Aaron Siri, is suggesting that the only true placebo is water or salt water. If you're going to maintain blinding, you need to use a placebo that gives many of the same reactions (sore arm, etc). If saline had been used, I'm sure he'd be arguing that studies weren't appropriately blinded and vaccines shouldn't be trusted because of that.
(Most placebos are other/older vaccines, or the adjuvants used in the vaccine.)

2025-12-05 17:23:38 UTC

The current presenter at the #ACIP, after talking about the importance of blinded, randomized control trials, just suggested that an oral polio vaccine could have been used as the placebo for the injected polio vaccine.during testing.
That would have blown blinding, do you think?

2025-12-05 17:09:37 UTC

When I show my residents the difference between the childhood vaccine schedules in the 1980s and now, I cheer the longer schedule now -- WE PROTECT MORE KIDS FROM MORE ILLNESSES. I wrote a paper citing the update in Hib vaccination as a reason why LITTLE KIDS WITH FEVER DON'T NEED A SPINAL TAP TO GET CHECKED FOR MENINGITIS ANYMORE. But right now the #ACIP is saying that more vaccinations are a bad thing, because,
Usually "reasons" would finish that but I'm not even hearing that much.

2025-12-04 19:31:56 UTC

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@nprofile…xm8u Left in the middle? I know the pediatricians weren't there to start with.

2025-12-04 16:37:08 UTC

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@nprofile…2363 Thank you for live-posting this. I don't have the stomach to watch for myself.

2025-11-29 18:27:43 UTC

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@nprofile…awhx
FDA internal memo from Vinay Prasad, head of the FDA's vaccine section -- referenced in one of my posts earlier today. Very short summary: if the reports are true, FDA set to question vaccine approvals, make it harder for individuals to get vaccinated, and make it harder for new vaccines to be approved.
https://med-mastodon.com/@jeneralist/115633555352553335

2025-11-29 16:42:53 UTC

Back in the days of the lockdown, my medical office shifted to televisits only; in-person evaluations were sent to other clinics with more masks.
EMTs didn't have that luxury.
Here's one's reaction to today's news about the FDA internal memo:
https://bsky.app/profile/realqrampage.fightins.online/post/3m6rfj7wy7s2d

2025-11-29 14:53:49 UTC

#Vaccine news today, and I'm eager to find original documents rather than newspaper reports --
Vinay Prasad at #FDA claims to have found ten childhood deaths caused by covid vaccines; wants to rework the process for vaccine approval; limit people who get flu vaccine; prevent administering multiple respiratory vaccines at once, etc.
I was able to read this without a subscription: https://www.washingtonpost.com/health/2025/11/29/fda-vaccine-approval-child-covid-deaths/

2025-11-28 15:27:38 UTC

Nature Scientific Reports published a piece on using #AI to detect autism. The staggeringly bad infographic calls the entire article into question
https://www.nature.com/articles/s41598-025-24662-9
h/t @erik.angner on Bluesky
https://cdn.masto.host/medmastodoncom/media_attachments/files/115/628/005/892/078/691/original/edc16fd6af94312b.jpg

2025-11-26 14:20:30 UTC

In the past, #Doximity notified me when CMS data is released to give me an easy way to look at my numbers compared to other docs'.
I will admit that this year I didn't read closely enough to see that they had wrapped the report in #AI hypeware before I clicked the link, so I was taken aback when I saw the intro to the report appear on screen one stuttering word at a time.
I don't need or want an enshittified pseudo-personalty wrapped around a spreadsheet and mailmerge report.

2025-11-25 13:00:35 UTC

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@nprofile…2v53 But colonoscopy doesn't expose anyone to radiation (it has other risks, of course), and mammography is lower dose X-rays compared to CT scans for lung cancer screening. If repeated CT scans are expected to cause 5% of all cancers if we don't make a change (https://cancer.ucsf.edu/news/2025/04/15/popular-ct-scans-could-account-for-5-of-all-cancer-cases-a-year), how does the number needed to screen compare to the number needed to harm?
(Sorry - the article you linked to was paywalled.)

2025-11-22 04:36:56 UTC

Benjamin Mazer at The Atlantic understands the current moment.
https://www.theatlantic.com/health/2025/11/rfk-vaccines-dont-not-cause-autism/685026/?gift=d22D6h-Ryp8L2u-__iL2faN4v8zgFV7BAG5sV8A-bk8&utm_source=copy-link&utm_medium=social&utm_campaign=share
https://cdn.masto.host/medmastodoncom/media_attachments/files/115/591/481/042/422/790/original/7b60df500272e313.jpg

2025-11-20 03:52:01 UTC

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@nprofile…6j3p My signature at work includes, "AI-free email: written by a human to be read by a human."

2025-11-20 03:50:50 UTC

The CDC website is now bending over backwards to suggest that childhood #vaccines cause autism.
Under the heading "Vaccines do not cause Autism*" is a statement that studies supporting a link have been ignored, but "* the header 'Vaccines do not cause autism' has not been removed due to an agreement with the chair of the U.S. Senate Health, Education, Labor, and Pensions Committee that it would remain on the CDC website."
I tell my students and residents to look at the #AAFP schedule.
https://cdn.masto.host/medmastodoncom/media_attachments/files/115/579/954/046/993/428/original/081d19d5d1da1cb1.png

2025-11-18 18:15:58 UTC

My mis-statement. "Adjuvants" aren't on the #ACIP schedule. "Adjuvants and contaminants" are.

2025-11-18 17:58:41 UTC

The agenda for next month's #ACIP meeting has been posted at https://www.cdc.gov/acip/downloads/agendas/draft-posted-2025-11-14-508.pdf and it looks ominous. Day 1, December 4, dedicated to child/teen #vaccine schedule and adjuvants? Day 2 on the #HepB vaccine?
I'm expecting them to try to change a lot of things that plenty of data showing that they work well as-is. Also noticing there are no times given for particular discussions, lunch breaks, etc. This suggests they haven't planned thoughtful presentations of well-researched findings .

2025-11-16 20:11:56 UTC

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@nprofile…08py @nprofile…jljv I don't have the luxury of making a stand unless I know my family will be safe.