8:1:12 #Hpm Transcript

7/31/2019 8:1:12 #Hpm Transcript

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2/12 #hpm Healthcare Social Media Transcript

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#hpm transcript

Healthcare Social Media Transcript

From: Wed Aug 01 18:00:00 PDT 2012

To: Wed Aug 01 19:15:00 PDT 2012

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Explore the world of healthcare social media: Healthcare Conferences - Healthcare Tweet Chats - Disease Hashtags

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aliciabloom it's that time again-- #hpm chat! expect a downpour of #hospice & #palliative carerelated tweets from me for the next hour.

Wed Aug 1 18:01:07 PDT 2012

aliciabloom excited to host #hpm chat as we focus on communication-- power of language &patient perception. welcome! let's start with introductions...Wed Aug 1 18:03:13 PDT 2012

_lizzy_ It's #hpm tweetchat time!! Come join us! If you're a twitter friend and not #hpm, pleasefeel free to ignore me for the next hour! #hpm

Wed Aug 1 18:03:51 PDT 2012

aliciabloom hi @_lizzy_! #hpmWed Aug 1 18:04:52 PDT 2012

WaywardChad Me, too...let the ideas flow! MT@aliciabloom#hpm chat! expect downpour of #hospice& #palliative care tweets from me for the next hr. #hpm

Wed Aug 1 18:05:01 PDT 2012

theyoganurse @aliciabloom Greetings. My first time in your chat. My first gig in nursing was inhospice. Amazing grace. #hpm

Wed Aug 1 18:05:22 PDT 2012


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aliciabloom awesome @WaywardChad! welcome! #hpmWed Aug 1 18:06:18 PDT 2012

aliciabloom welcome @theyoganurse! always great to have new people joining the conversation!#hpm

Wed Aug 1 18:06:54 PDT 2012

WaywardChad I think it's the first time I've made it, too. Social worker and now thanatologist in training.Passionate about #hospice and #hpm! #hpmWed Aug 1 18:06:57 PDT 2012

_lizzy_ Hello @aliciabloom I'm excited about tonight's topic! As a MSW and MA grad, I'm allabout communication. #hpm

Wed Aug 1 18:06:59 PDT 2012

ravipm2000 Hello all. #hpmWed Aug 1 18:07:35 PDT 2012

aliciabloom @WaywardChad glad you're here-- the more the merrier! #hpmWed Aug 1 18:07:56 PDT 2012

ravipm2000 I'm Ravi. Recently graduated pall care fellow. #hpmWed Aug 1 18:08:15 PDT 2012

aliciabloom @_lizzy_ the NYTimes piece you tweeted earlier today served as inspiration! #hpmWed Aug 1 18:08:19 PDT 2012

aliciabloom hi @ravipm2000! #hpmWed Aug 1 18:08:28 PDT 2012

rfberry @aliciabloom good luck tonight! Looks like great topics!! Logging offline w/aheadache though, wanted to say hi & goodnight #hpm -ers

Wed Aug 1 18:09:02 PDT 2012

AnkurB_MD Hi #hpm friends :) Joining the tweetchat for the next hour! Geriatrics and Palliative docin Boston, MA. #hpm

Wed Aug 1 18:09:07 PDT 2012

aliciabloom looks like we're getting a good crowd here tonight! i'm going to send along a l ink tospur some opening discussion.... #hpm

Wed Aug 1 18:09:14 PDT 2012

Kamiyamay #hpm.. you deserve my honesty & respect-may say things U don't like but here to walkthrough this with U .... More similar content next hr!

Wed Aug 1 18:09:18 PDT 2012


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aliciabloom feel better @rfberry. hope to see you next week. #hpmWed Aug 1 18:09:54 PDT 2012

aliciabloom good to see you @AnkurB_MD, it's been a while! hi @Kamiyamay#hpmWed Aug 1 18:10:16 PDT 2012

jfclearywisc Jim Cleary, @uwhealth palliative care & @painpolicy (PPSG) joining #hpm chat for

the next 50 minutes.Wed Aug 1 18:11:10 PDT 2012

AnkurB_MD @rfberry Hii and Byee! Catch up with yaa later.. Best.. :) #hpmWed Aug 1 18:11:11 PDT 2012

AnkurB_MD I know.. Moved and Almost settled. Missed yaa all :) RT @aliciabloom: good to seeyou @AnkurB_MD, its been a while! #hpm

Wed Aug 1 18:12:03 PDT 2012

aliciabloomFor T1, a quick read: "When a Doctor's Words Aren't Soothing" (http://t.co/wTbzabj5)#hpm

Wed Aug 1 18:12:11 PDT 2012

schwartzbrown Hi, Mindy here. Social Worker from NJ #hpmWed Aug 1 18:12:32 PDT 2012

aliciabloom @AnkurB_MD oh, that's right. glad to hear you're getting settled. #hpmWed Aug 1 18:12:55 PDT 2012

jfclearywisc@aliciabloom T1: Fairly dreadful examples in this. Nice finish but overall hard tobelieve all from one patient! #hpm

Wed Aug 1 18:13:17 PDT 2012

aliciabloom hi @schwartzbrown! i just sent out a l ink to get us started with T1. #hpmWed Aug 1 18:13:19 PDT 2012

aliciabloom @jfclearywisc i found most of the interactions pretty awful & left me wondering howoften poor communication like that happen #hpm

Wed Aug 1 18:15:39 PDT 2012

_lizzy_ T1 This article hit home for me because I've been told (without tests) that I had a braintumor once and MS another time. I had neither #hpm

Wed Aug 1 18:16:25 PDT 2012

WaywardChad Wow...what a journey and a mixed bag -- but it sounds l ike she started to know what toask for to get what she sought on her terms. #hpm

Wed Aug 1 18:17:19 PDT 2012

Kamiyamay @aliciabloom@jfclearywisc#hpm Usually no communication - I knock on door "your


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what from where" "who sent you here and why"!!!

Wed Aug 1 18:17:21 PDT 2012

jfclearywisc @aliciabloom Friend of ours got cell phone call fr surgeon re new diagnosis of breastcancer (metastatic). Called me 2 minutes later #hpm

Wed Aug 1 18:17:46 PDT 2012

aliciabloom T1: please share initial thoughts & reactions related to "When a Doctors Words Aren't

Soothing"... #hpmWed Aug 1 18:17:57 PDT 2012

Kamiyamay @Kamiyamay@aliciabloom@jfclearywisc#hpm sorry not usually but most have noidea what test show just not good is all, then want disclosure

Wed Aug 1 18:18:40 PDT 2012

_lizzy_ T1 Oh yes, and a different doc didn't even sit down to tell me that I had a 50/50 chanceof having my mom's Myotonic Dystr. It happens! #hpm

Wed Aug 1 18:18:40 PDT 2012

aliciabloom @jfclearywisc seems to me that life changing news like a metastatic cancer diagnosiswould be best broken in person, not by phone. #hpm

Wed Aug 1 18:18:51 PDT 2012

jfclearywisc @aliciabloom T1: when I first saw title I thought it may be good examples of deliveringbad news. But it's bad examples of bad news #hpm

Wed Aug 1 18:19:30 PDT 2012

_lizzy_ T1 Now I need to say for the MDs that are on twitter, u ARE the ones who care & whoare trying to make things better & i love u #hpm

Wed Aug 1 18:20:11 PDT 2012

Kamiyamay @jfclearywisc@aliciabloom#hpm that is awesome and right person to call - think itvaries (geographical too)

Wed Aug 1 18:20:12 PDT 2012

AnkurB_MD @aliciabloom T1 One of my Mentor's once said: "If you think you won't be able to Endit well, Don't even Start!" #givingbadnews#hpm

Wed Aug 1 18:20:23 PDT 2012

aliciabloom @_lizzy_ reminds us that words are not the only way we communicate. body language

matters. #hpmWed Aug 1 18:20:30 PDT 2012

ravipm2000 T1: Emails and telephones can't replace the subtle non verbal communication signs#hpm

Wed Aug 1 18:20:35 PDT 2012

ctsinclair T1: Just the title of the article alone reminds me of many situations I observed as atrainee "When a doctor's words arent soothing" #hpm

Wed Aug 1 18:20:35 PDT 2012


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jfclearywisc @aliciabloom I have told people over phone but it was planned sharing. Whenordering test, should enquire about communicating results. #hpm

Wed Aug 1 18:20:47 PDT 2012

ctsinclair @_lizzy_ Very sweet! #hpmWed Aug 1 18:20:48 PDT 2012

theyoganurse @aliciabloom They speak those words cuz 'they don't know any better'-newbies, orhearts are deadened, dull- weary spirits. #hpm

Wed Aug 1 18:21:41 PDT 2012

aliciabloom "When the Doctor's Words Aren't Soothing" shows us that it's not just what we say, buthow & where we say i t that matters. #hpm

Wed Aug 1 18:21:44 PDT 2012

schwartzbrown You're assuming these people communicate better in person than on phone or email.Not always true. #hpm

Wed Aug 1 18:21:51 PDT 2012

ctsinclair T1: You can learn a lot from observation. Always try and learn from the mistakes ofothers, so YOU don't have to learn the hard way #hpm

Wed Aug 1 18:21:52 PDT 2012

_lizzy_ T1 My issue wi th communication training is that too often it's focused on what NOT 2do, & not offering practical tips 4 good practice. #hpm

Wed Aug 1 18:22:38 PDT 2012

ravipm2000 T1: Thk goodness that for the most part, communication skills can be learned andpolished. Only a few people are natural communicators. #hpm

Wed Aug 1 18:22:41 PDT 2012

aliciabloom @jfclearywisc absolutely. although, you had previously discussed the communicationplan and that matters. #hpm

Wed Aug 1 18:22:44 PDT 2012

ctsinclair T1: When using role play with trainees for 'breaking bad news' I encourage them topurposely mess up first. Eases pressure to perform. #hpm

Wed Aug 1 18:22:53 PDT 2012

jfclearywisc @ravipm2000 at #hpm Fellowship graduation. Most impt tool in medicine "a chair andbox of tissues" Great!!! #hpm

Wed Aug 1 18:23:43 PDT 2012

aliciabloom T1: So, can we teach people to communicate more effectively & compassionately?What are key messages for learners? #hpm

Wed Aug 1 18:24:04 PDT 2012


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schwartzbrown My doc told me he wanted a f/u of a questionable lung scan - just to close the issue inhis records. Does that inspire compliance? #hpm

Wed Aug 1 18:24:14 PDT 2012

_lizzy_ Totally agree! I have people whose communication I try to model . RT @ctsinclair: Ucan learn a lot from observation. #hpm

Wed Aug 1 18:25:22 PDT 2012

ravipm2000 @ctsinclair: I agree! Learn from mistakes of others. You don't have enough time tomake them all yourself! #hpm

Wed Aug 1 18:25:26 PDT 2012

theyoganurse @_lizzy_ my issue with corporate med communication is that it leaves out the heartand soul. #hpm

Wed Aug 1 18:25:37 PDT 2012

jfclearywisc @aliciabloom All our med students do breaking bad news w standardized patients.Feedback "v powerful even tho simulation" #hpm

Wed Aug 1 18:25:44 PDT 2012

aliciabloom MT @jfclearywisc at #hpm fellowship graduation. Most important tool in medicine: "achair and box of tissues" First thing to consider for "Discussing Serious News".#Palliative care #Meded#hpm

Wed Aug 1 18:26:26 PDT 2012

Kamiyamay #hpm Key lessons: in person look in eye, honesty, respect, compassion - becomfortable w/ self & learn from every situation & msg hpm cares

Wed Aug 1 18:26:39 PDT 2012

_lizzy_ @theyoganurse Yes, the classroom is no substitute for RL experience. Also, when I'mstuck, I admit, "I don't know how to say this" #hpm

Wed Aug 1 18:27:02 PDT 2012

theyoganurse @aliciabloom Yes, one lesson there is a big movement called "ConsciousCommunication" vs ugh! unconscious. Foundation in compassion. #hpm

Wed Aug 1 18:27:17 PDT 2012

aliciabloom great points @Kamiyamay-- body language sends powerful messages & can helpbuild rapport, put people at ease. #hpmWed Aug 1 18:27:38 PDT 2012

theyoganurse @Kamiyamay I second this. Yes. #hpmWed Aug 1 18:28:04 PDT 2012

WaywardChad RT @jfclearywisc at #hpm Fellowship graduation. Most impt tool in medicine "a chairand box of tissues" Great!!! #hpm


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Wed Aug 1 18:28:31 PDT 2012

theyoganurse RT @aliciabloom: MT @jfclearywisc at #hpm fellowship graduation. Most importanttool in medicine: "a chair and box of tissues"


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aliciabloom @jfclearywisc that is such a great line! looks like i'll be quoting @ravipm2000 in mynext lecture about goals of care discussions. #hpm

Wed Aug 1 18:31:46 PDT 2012

jfclearywisc @theyoganurse: Communication training is not a bout recipe or script. It is frameworkon which to base communication #hpm

Wed Aug 1 18:31:59 PDT 2012

ravipm2000 @jfclearywisc Thanks Sir! I had great teachers! #hpmWed Aug 1 18:32:06 PDT 2012

WaywardChad MT @theyoganurse Good. Honest. And Silence is OK. Some space for the other tobreathe it all in. Not feeling compelled to talk 2 much. #hpm

Wed Aug 1 18:32:15 PDT 2012

Kamiyamay @schwartzbrown#hpm U are right some need to hear via written word or phone forprivacy or comfort (personal choice like @jfcleary said)

Wed Aug 1 18:32:50 PDT 2012

jfclearywisc @ravipm2000 YEs watching my mistakes!!! LOL #hpmWed Aug 1 18:32:52 PDT 2012

aliciabloom @AnkurB_MD listening is crucial. love to ask open ended ?: what are you mostworried about? what do you understand about your illness? #hpm

Wed Aug 1 18:32:59 PDT 2012

Kamiyamay RT @jfclearywisc: Credit where credit is due It was @ravipm2000 at his #hpmFellowship grad. "Most impt tool in medicine, a chair and b ...

Wed Aug 1 18:33:30 PDT 2012

aliciabloom for T2: from @Kevin MD by Alex Smith, MD: "Psychological factors influence howpatients interpret information" (http://t.co/2beaEQde) #hpm

Wed Aug 1 18:34:46 PDT 2012

AnkurB_MD Imp Qs! RT@aliciabloom: Love to ask open ended: what are you most worried about?what do you understand about your illness? #palliative#hpm

Wed Aug 1 18:35:07 PDT 2012

ravipm2000 @jfclearywisc If you made any mistakes, I couldn't perceive them! Lol #hpmWed Aug 1 18:35:41 PDT 2012

kilani19 @aliciabloom@ankurb_md I like the "what are you hoping for"... #hpmWed Aug 1 18:36:23 PDT 2012

theyoganurse @jfclearywisc yes a template, a framework based in the heart:)


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ravipm2000 T2: I've seen many patients open up and touch on difficult topics unassisted once theywere "allowed to drive" the discussion. #hpm

Wed Aug 1 18:36:47 PDT 2012

WaywardChad MT @jfclearywisc: Credit where due: was @ravipm2000 at his #hpm Fellowship grad."Most impt tool in medicine: chair and box of tissues" #hpm

Wed Aug 1 18:37:37 PDT 2012

aliciabloom T2: we know that language matters, but what about perception? how do we ensurepatients understand the meaning of what we communicate? #hpmWed Aug 1 18:37:57 PDT 2012

ggramels @aliciabloom Gave grand rounds on this topic 2day & abandoned the Power Point fortwo chairs & role play. Great audience participation.#hpm

Wed Aug 1 18:38:24 PDT 2012

jfclearywisc @aliciabloom T2: Have seen the results of study but see my role to assist in transition.Teach back; "what did u hear I said" v impt #hpm

Wed Aug 1 18:38:29 PDT 2012

Kamiyamay @kilani19@aliciabloom@ankurb_md#hpm Also...asked pt today..what goals can Ihelp u achieve...where do you think this ship is headed?

Wed Aug 1 18:38:37 PDT 2012

aliciabloom @kilani19@ankurb_md such a great question! reminds patients they can still hope forthings, even if the face of life-limiting illness #hpm

Wed Aug 1 18:38:48 PDT 2012

Kamiyamay @ggramels@aliciabloom#hpm excellent!Wed Aug 1 18:39:25 PDT 2012

jfclearywisc MT @ravipm2000: T2: I've seen many patients open up &touch on difficult topicsunassisted once "allowed to drive" the discussion. #hpm

Wed Aug 1 18:39:37 PDT 2012

kilani19 @ggramels@aliciabloom yup that's the best way to do it! #hpm video or role play aregreat tools.

Wed Aug 1 18:40:00 PDT 2012

ravipm2000 T2: I like the "teach back" method too..e.g. "What have your doctors been telling you?"

#hpmWed Aug 1 18:40:03 PDT 2012

schwartzbrown I hate discussions of percentages. How many people really understand math? It's adefense that doesn't work. #hpm

Wed Aug 1 18:40:08 PDT 2012

aliciabloom like to use the ask - tell - ask sandwich with patients & families: see where they are,offer education, check understanding. #hpm


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Wed Aug 1 18:40:18 PDT 2012

jfclearywisc MT @aliciabloom: like "ask - tell - ask" sandwich w patients & families: see where theyare, offer education, check understanding. #hpm

Wed Aug 1 18:41:04 PDT 2012

kilani19 @aliciabloom very important to remain clear of jargon, be di rect and not vague, havethem repeat back what they understand you've said. #hpm

Wed Aug 1 18:41:38 PDT 2012

Kamiyamay @ravipm2000#hpm absolutely never assume they know!!Wed Aug 1 18:41:58 PDT 2012

jfclearywisc @schwartzbrown: I ask if they are percentage type folks. Some say know. Some sayuse. But "% apply to populations not individuals #hpm

Wed Aug 1 18:42:18 PDT 2012

WaywardChad RT @aliciabloom like 2 use the ask - tell - ask sandwich w/ pts & families: see where

they are, offer education, check understanding. #hpmWed Aug 1 18:42:25 PDT 2012

AnkurB_MD RT @aliciabloom: like the ask - tell - ask sandwich with patients & families: see wherethey are, offer education, check understanding. #hpm

Wed Aug 1 18:42:42 PDT 2012

ravipm2000 @Kamiyamay Agreed. #hpmWed Aug 1 18:42:51 PDT 2012

schwartzbrown@jfclearywisc Exactly #hpm

Wed Aug 1 18:43:01 PDT 2012

aliciabloom assess how the patient/family prefer to receive information & then deliver it in a waythat they'll be able to understand #hpm

Wed Aug 1 18:43:23 PDT 2012

kilani19 @aliciabloom great technique! Also I like to give patients and families time to process -moments of silence... #hpm

Wed Aug 1 18:43:39 PDT 2012

theyoganurse @schwartzbrown Agreed math/percentages are lost when the mind is gripped in fear+ chaos. Simplify. As in will a 9 year old understand. #hpm

Wed Aug 1 18:43:40 PDT 2012

schwartzbrown Many people tend to want to doctor-please, feign understanding. I used to meet withthem after doc left & review discussion. #hpm

Wed Aug 1 18:43:56 PDT 2012

AnkurB_MD T2: Agree with @AlexSmithMD re: value of "Optimism"! V.imp to keep the "HOPE" alive


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during these conversations.. #hpm

Wed Aug 1 18:45:07 PDT 2012

ravipm2000 T2:Throw the test back at ourselves e.g. " to make sure I explained i t well, what did Ijust explain to you?" #hpm

Wed Aug 1 18:45:14 PDT 2012

Kamiyamay #hpm Make no assumption re: wealth, race, or poverty level. Some much wiser than

healthcare peeps thinkWed Aug 1 18:45:17 PDT 2012

aliciabloom RT @kilani19: great technique! Also I like to give patients and families time to process- moments of silence...


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jfclearywisc RT @aliciabloom: hope is powerful, driving force. impt to understand what it means topatient & sometimes need to help them reframe it. #hpm

Wed Aug 1 18:49:17 PDT 2012

kilani19 @aliciabloom@ankurb_md@jfclearywisc I always try to find things to hope for-redefine hope and strive for it :) #hpm

Wed Aug 1 18:49:26 PDT 2012

aliciabloom recommended reading: "The Anatomy of Hope" by Jerome Groopman, MD #hpmWed Aug 1 18:49:38 PDT 2012

ravipm2000 Hope can transition over time.."hope for cure" to "hope for time" to "hope for comfort" to"hope for a good death." #hpm

Wed Aug 1 18:49:59 PDT 2012

WaywardChad Think it's important to try to understand what hope means to each individual. Can theybe hopeful even with downsides? #hpm

Wed Aug 1 18:50:18 PDT 2012

aliciabloom there are always things to hope for, just as there is always something we can do.#hpm

Wed Aug 1 18:50:27 PDT 2012

jfclearywisc @Kamiyamay Tulsky writes about hope as "trust and reliance" rather than expectation!JPM "Hope or hubris" #hpm

Wed Aug 1 18:50:31 PDT 2012

aliciabloom RT @ravipm2000: Hope can transition over time.."hope for cure" to "hope for time" to"hope for comfort" to "hope for a good death." #hpm

Wed Aug 1 18:50:45 PDT 2012

AnkurB_MD .@jfclearywisc HOPE is always ALIVE! Whether for CURE, or for CONTROL, or forCOMFORT! It is the very essence of any conversation.. #hpm

Wed Aug 1 18:50:54 PDT 2012

Kamiyamay #hpm Hope very personal thing - hope 4 better on the other side. Hope it's overquick....hope very individual meanings 4 each like goals.

Wed Aug 1 18:51:11 PDT 2012

WaywardChad RT @ravipm2000: Hope can transition over time.."hope for cure" to "hope for time" to"hope for comfort" to "hope for a good death." #hpmWed Aug 1 18:51:46 PDT 2012

jfclearywisc @AnkurB_MD Really worth reading @jatulsky. Changes the whole situation when itsnot about expectations, even for pain free. #hpm

Wed Aug 1 18:52:08 PDT 2012

Kamiyamay RT @jfclearywisc: @Kamiyamay Tulsky writes about hope as "trust and reliance"rather than expectation! JPM "Hope or hubris" #hpm


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Wed Aug 1 19:06:44 PDT 2012

ravipm2000 @aliciabloom Great chat...as per usual! #hpmWed Aug 1 19:07:15 PDT 2012

aliciabloom @AnkurB_MD yay! we're glad to have you back #hpmWed Aug 1 19:07:18 PDT 2012

aliciabloom @ravipm2000 thank you! always appreciate your perspective & will be quoting you inmy next goals of care lecture. #hpm

Wed Aug 1 19:08:06 PDT 2012

Kamiyamay #hpm 'Don't B afraid 2 talk 2 me,no right & wrong. Johns&Johns wrote babies but noone wrote this book. Each is different like snowflakes!

Wed Aug 1 19:08:24 PDT 2012

ctsinclair RT @Kamiyamay: @ggramels@aliciabloom#hpm "I don't know how you feel but I willbe glad to listen and care" - no right or wrong questions

Wed Aug 1 19:08:47 PDT 2012

ggramels @theyoganurse@aliciabloom Eliot "I said to my soul, be still, and wait without hopefor hope would be hope for the wrong thing.." #hpm

Wed Aug 1 19:08:49 PDT 2012

Kamiyamay RT @ggramels: @theyoganurse@aliciabloom Always good to remind ourselves thatwe haven't a clue (even when we do). #hpm

Wed Aug 1 19:08:56 PDT 2012

Kamiyamay #hpm night all - learn so much from UWed Aug 1 19:10:01 PDT 2012

ggramels @theyoganurse@aliciabloom and TS Eliot concludes "So the darkness shall be thelight, and the stillness the dancing." #hpm

Wed Aug 1 19:10:37 PDT 2012

aliciabloom great group for #hpm chat tonight, including some first timers. hope to see you al l backagain next week! #hpm

Wed Aug 1 19:11:27 PDT 2012

ravipm2000 RT @aliciabloom: great group for #hpm chat tonight, including some first timers. hopeto see you all back again next week! #hpm

Wed Aug 1 19:12:00 PDT 2012

aliciabloom RT @ggramels and TS Eliot concludes "So the darkness shall be the light, and thestillness the dancing." #hpm#hpm

Wed Aug 1 19:12:29 PDT 2012

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8:1:12 #Hpm Transcript