Brett Biebelberg, MD
@bbiebelberg.bsky.social
IM PGY1 @ Penn, researching sepsis @MGH/BWH, gun violence prevention advocate, EMT, via Harvard. 🗣evidence-based medicine, QI, public health, humanity in medicine.
Career changer & proponent of physician leadership.
#medsky #emimcc #pccm 🫀🫁
Career changer & proponent of physician leadership.
#medsky #emimcc #pccm 🫀🫁
Pinned
🦠We call a lot of things “sepsis”
🔎Our #AnnalsofIM study examined how broad this grab bag really is
⚠️Among ~75,000 patients with sepsis, we found remarkably wide spectrum of presentations & outcomes across infection source & organ dysfunction patterns
Thread ⬇️
#medsky #emimcc #idsky #pharmsky
🔎Our #AnnalsofIM study examined how broad this grab bag really is
⚠️Among ~75,000 patients with sepsis, we found remarkably wide spectrum of presentations & outcomes across infection source & organ dysfunction patterns
Thread ⬇️
#medsky #emimcc #idsky #pharmsky
Reposted by Brett Biebelberg, MD
The word physician is essentially not used in the hospital anymore. Not even 'clinician.' We're 'providers.'
Yes, not everyone making care decisions is a physician, and APPs are important too! But the word provider is so devoid of any relation to medicine that we might as well just be called doers.
Yes, not everyone making care decisions is a physician, and APPs are important too! But the word provider is so devoid of any relation to medicine that we might as well just be called doers.
October 17, 2025 at 11:24 PM
The word physician is essentially not used in the hospital anymore. Not even 'clinician.' We're 'providers.'
Yes, not everyone making care decisions is a physician, and APPs are important too! But the word provider is so devoid of any relation to medicine that we might as well just be called doers.
Yes, not everyone making care decisions is a physician, and APPs are important too! But the word provider is so devoid of any relation to medicine that we might as well just be called doers.
The word physician is essentially not used in the hospital anymore. Not even 'clinician.' We're 'providers.'
Yes, not everyone making care decisions is a physician, and APPs are important too! But the word provider is so devoid of any relation to medicine that we might as well just be called doers.
Yes, not everyone making care decisions is a physician, and APPs are important too! But the word provider is so devoid of any relation to medicine that we might as well just be called doers.
October 17, 2025 at 11:24 PM
The word physician is essentially not used in the hospital anymore. Not even 'clinician.' We're 'providers.'
Yes, not everyone making care decisions is a physician, and APPs are important too! But the word provider is so devoid of any relation to medicine that we might as well just be called doers.
Yes, not everyone making care decisions is a physician, and APPs are important too! But the word provider is so devoid of any relation to medicine that we might as well just be called doers.
Me hyping myself up to try, again, to place an ultrasound–guided IV
September 28, 2025 at 4:32 PM
Me hyping myself up to try, again, to place an ultrasound–guided IV
Reposted by Brett Biebelberg, MD
This is intern year except every 2 weeks you go back to rolling a wooden box filled with patients you know nothing about, subspecialty services you have no experience in, new attending and senior resident preferences, and
bathrooms you don’t know the codes for 😀
bathrooms you don’t know the codes for 😀
September 15, 2025 at 10:36 PM
This is intern year except every 2 weeks you go back to rolling a wooden box filled with patients you know nothing about, subspecialty services you have no experience in, new attending and senior resident preferences, and
bathrooms you don’t know the codes for 😀
bathrooms you don’t know the codes for 😀
This is intern year except every 2 weeks you go back to rolling a wooden box filled with patients you know nothing about, subspecialty services you have no experience in, new attending and senior resident preferences, and
bathrooms you don’t know the codes for 😀
bathrooms you don’t know the codes for 😀
September 15, 2025 at 10:36 PM
This is intern year except every 2 weeks you go back to rolling a wooden box filled with patients you know nothing about, subspecialty services you have no experience in, new attending and senior resident preferences, and
bathrooms you don’t know the codes for 😀
bathrooms you don’t know the codes for 😀
1/ Last October, 85 people ages 1-91 developed dizziness, drowsiness, anxiety, and/or memory distortion. Some went to the ED. They'd all recently eaten at a Wisconsin pizzeria.
Local public health officials investigated. As reported in last week's CDC MMWR, they found
Local public health officials investigated. As reported in last week's CDC MMWR, they found
August 1, 2025 at 6:08 PM
1/ Last October, 85 people ages 1-91 developed dizziness, drowsiness, anxiety, and/or memory distortion. Some went to the ED. They'd all recently eaten at a Wisconsin pizzeria.
Local public health officials investigated. As reported in last week's CDC MMWR, they found
Local public health officials investigated. As reported in last week's CDC MMWR, they found
Case-control study in @jamanetworkopen.com suggests living in close proximity to a golf course substantially increases the risk of developing Parkinson's Disease, likely related to pesticide use.
Proximity to Golf Courses and Risk of Parkinson Disease
This case-control of older US adults examines risk of Parkinson Disease by proximity of residence to a golf course.
jamanetwork.com
July 30, 2025 at 2:38 AM
Case-control study in @jamanetworkopen.com suggests living in close proximity to a golf course substantially increases the risk of developing Parkinson's Disease, likely related to pesticide use.
Reposted by Brett Biebelberg, MD
It's that wonderful time of year when new residents are joining the ICU team!
Here are a few of my favorite @criticalcaretime.bsky.social infographics to help you understand key concepts:
⚡️Undifferentiated shock
💉 Vasopressors
😮💨 The physiologically difficult airway &
🧪 Metabolic acidosis
Here are a few of my favorite @criticalcaretime.bsky.social infographics to help you understand key concepts:
⚡️Undifferentiated shock
💉 Vasopressors
😮💨 The physiologically difficult airway &
🧪 Metabolic acidosis
June 30, 2025 at 2:09 AM
It's that wonderful time of year when new residents are joining the ICU team!
Here are a few of my favorite @criticalcaretime.bsky.social infographics to help you understand key concepts:
⚡️Undifferentiated shock
💉 Vasopressors
😮💨 The physiologically difficult airway &
🧪 Metabolic acidosis
Here are a few of my favorite @criticalcaretime.bsky.social infographics to help you understand key concepts:
⚡️Undifferentiated shock
💉 Vasopressors
😮💨 The physiologically difficult airway &
🧪 Metabolic acidosis
First week of residency down.
June 27, 2025 at 10:59 PM
First week of residency down.
Reposted by Brett Biebelberg, MD
ZODIAC trial: For ischemic stroke patients who are awaiting thrombectomy, flat positioning reduced the risk of neuroworsening or death
Premature termination but seems reasonable
Statistically robust results
Best available evidence; should change practice
pubmed.ncbi.nlm.nih.gov/40465238/ #EMIMCC
Premature termination but seems reasonable
Statistically robust results
Best available evidence; should change practice
pubmed.ncbi.nlm.nih.gov/40465238/ #EMIMCC
June 9, 2025 at 4:33 PM
ZODIAC trial: For ischemic stroke patients who are awaiting thrombectomy, flat positioning reduced the risk of neuroworsening or death
Premature termination but seems reasonable
Statistically robust results
Best available evidence; should change practice
pubmed.ncbi.nlm.nih.gov/40465238/ #EMIMCC
Premature termination but seems reasonable
Statistically robust results
Best available evidence; should change practice
pubmed.ncbi.nlm.nih.gov/40465238/ #EMIMCC
Reposted by Brett Biebelberg, MD
when perfusion falls, the most vulnerable tissue suffers first.
so for someone with a chronic carotid artery stenosis, urosepsis can manifest with focal neuro symptoms.
so for someone with a chronic carotid artery stenosis, urosepsis can manifest with focal neuro symptoms.
a rabbit from the secret life of pets is angry and says `` i 'm sorry ... what ? ''
ALT: a rabbit from the secret life of pets is angry and says `` i 'm sorry ... what ? ''
media.tenor.com
June 2, 2025 at 8:49 PM
when perfusion falls, the most vulnerable tissue suffers first.
so for someone with a chronic carotid artery stenosis, urosepsis can manifest with focal neuro symptoms.
so for someone with a chronic carotid artery stenosis, urosepsis can manifest with focal neuro symptoms.
My palliative care elective in med school was my most impactful rotation. I’m eager to rotate on PC as a resident.
It felt like another world of medicine. A reprieve from the cog-in-the-wheel, task-rabbit medicine we practice. A version that prioritizes patients, dialogue, and bedside care
#medsky
It felt like another world of medicine. A reprieve from the cog-in-the-wheel, task-rabbit medicine we practice. A version that prioritizes patients, dialogue, and bedside care
#medsky
Spending 3 weeks with my palliative care colleagues is such a refreshing and validating experience. To watch and learn from these experts while navigating difficult EoL questions with such patient centeredness is incredible. If you're in training, please consider spending dedicated time with them.
May 18, 2025 at 5:09 PM
My palliative care elective in med school was my most impactful rotation. I’m eager to rotate on PC as a resident.
It felt like another world of medicine. A reprieve from the cog-in-the-wheel, task-rabbit medicine we practice. A version that prioritizes patients, dialogue, and bedside care
#medsky
It felt like another world of medicine. A reprieve from the cog-in-the-wheel, task-rabbit medicine we practice. A version that prioritizes patients, dialogue, and bedside care
#medsky
Could it be that simple?
Hanging a folding chair on the wall in patient rooms increased the patient-reported likelihood that physicians sat at the bedside, spent enough time, and checked for understanding.
shmpublications.onlinelibrary.wiley.com/doi/10.1002/... @jhospmedicine.bsky.social #medsky
Hanging a folding chair on the wall in patient rooms increased the patient-reported likelihood that physicians sat at the bedside, spent enough time, and checked for understanding.
shmpublications.onlinelibrary.wiley.com/doi/10.1002/... @jhospmedicine.bsky.social #medsky
Wall‐mounted folding chairs to promote resident physician sitting at the hospital bedside
Click on the article title to read more.
shmpublications.onlinelibrary.wiley.com
May 14, 2025 at 2:54 PM
Could it be that simple?
Hanging a folding chair on the wall in patient rooms increased the patient-reported likelihood that physicians sat at the bedside, spent enough time, and checked for understanding.
shmpublications.onlinelibrary.wiley.com/doi/10.1002/... @jhospmedicine.bsky.social #medsky
Hanging a folding chair on the wall in patient rooms increased the patient-reported likelihood that physicians sat at the bedside, spent enough time, and checked for understanding.
shmpublications.onlinelibrary.wiley.com/doi/10.1002/... @jhospmedicine.bsky.social #medsky
Reposted by Brett Biebelberg, MD
A 25% reduction in research funding in the US would lower GDP by 3.8%— a decline similar in magnitude to that in the Great Recession.
A 75% reduction in research funding would lower GDP 11% — a larger decline than in any recession since the Great Depression.
www.nytimes.com/2025/04/30/b...
A 75% reduction in research funding would lower GDP 11% — a larger decline than in any recession since the Great Depression.
www.nytimes.com/2025/04/30/b...
May 1, 2025 at 12:44 PM
A 25% reduction in research funding in the US would lower GDP by 3.8%— a decline similar in magnitude to that in the Great Recession.
A 75% reduction in research funding would lower GDP 11% — a larger decline than in any recession since the Great Depression.
www.nytimes.com/2025/04/30/b...
A 75% reduction in research funding would lower GDP 11% — a larger decline than in any recession since the Great Depression.
www.nytimes.com/2025/04/30/b...
Reposted by Brett Biebelberg, MD
Takeaways from @nejm.org acute abdomen review:
➡️ Don’t withhold analgesia
➡️ CT angio abd/pelv w/ IV contrast is usually ideal image; ultrasound for others but high performance variability
➡️ Consult surgery ASAP
➡️ Beware of cognitive bias
www.nejm.org/doi/full/10....
#medsky
➡️ Don’t withhold analgesia
➡️ CT angio abd/pelv w/ IV contrast is usually ideal image; ultrasound for others but high performance variability
➡️ Consult surgery ASAP
➡️ Beware of cognitive bias
www.nejm.org/doi/full/10....
#medsky
April 20, 2025 at 4:48 PM
Takeaways from @nejm.org acute abdomen review:
➡️ Don’t withhold analgesia
➡️ CT angio abd/pelv w/ IV contrast is usually ideal image; ultrasound for others but high performance variability
➡️ Consult surgery ASAP
➡️ Beware of cognitive bias
www.nejm.org/doi/full/10....
#medsky
➡️ Don’t withhold analgesia
➡️ CT angio abd/pelv w/ IV contrast is usually ideal image; ultrasound for others but high performance variability
➡️ Consult surgery ASAP
➡️ Beware of cognitive bias
www.nejm.org/doi/full/10....
#medsky
Reposted by Brett Biebelberg, MD
Diuresis and fluid status comes up on almost every single ICU patient (especially in a cardiac ICU🫀)
It’s very important to understand how each diuretic works, how they can be combined to augment urine output & their limitations
Check out my starter guide for diuresis in the ICU
#MedSky #Nephsky
It’s very important to understand how each diuretic works, how they can be combined to augment urine output & their limitations
Check out my starter guide for diuresis in the ICU
#MedSky #Nephsky
March 29, 2025 at 2:05 PM
Takeaways from @nejm.org acute abdomen review:
➡️ Don’t withhold analgesia
➡️ CT angio abd/pelv w/ IV contrast is usually ideal image; ultrasound for others but high performance variability
➡️ Consult surgery ASAP
➡️ Beware of cognitive bias
www.nejm.org/doi/full/10....
#medsky
➡️ Don’t withhold analgesia
➡️ CT angio abd/pelv w/ IV contrast is usually ideal image; ultrasound for others but high performance variability
➡️ Consult surgery ASAP
➡️ Beware of cognitive bias
www.nejm.org/doi/full/10....
#medsky
April 20, 2025 at 4:48 PM
Takeaways from @nejm.org acute abdomen review:
➡️ Don’t withhold analgesia
➡️ CT angio abd/pelv w/ IV contrast is usually ideal image; ultrasound for others but high performance variability
➡️ Consult surgery ASAP
➡️ Beware of cognitive bias
www.nejm.org/doi/full/10....
#medsky
➡️ Don’t withhold analgesia
➡️ CT angio abd/pelv w/ IV contrast is usually ideal image; ultrasound for others but high performance variability
➡️ Consult surgery ASAP
➡️ Beware of cognitive bias
www.nejm.org/doi/full/10....
#medsky
Wellness will be when I don't have to do a module on how to use hand sanitizer
April 19, 2025 at 5:38 PM
Wellness will be when I don't have to do a module on how to use hand sanitizer
Ah, yes. Just a little mistake.
Trump Officials Blame Mistake for Setting Off Confrontation With Harvard
An official on the administration’s antisemitism task force told the university that a letter of demands had been sent without authorization.
www.nytimes.com
April 19, 2025 at 2:10 AM
Ah, yes. Just a little mistake.
I'm thrilled to have matched in internal medicine at Penn! @pennmedicine.bsky.social
Endlessly grateful for my family, friends, and mentors on whose shoulders I stand.
#Match2025
Endlessly grateful for my family, friends, and mentors on whose shoulders I stand.
#Match2025
March 21, 2025 at 7:24 PM
I'm thrilled to have matched in internal medicine at Penn! @pennmedicine.bsky.social
Endlessly grateful for my family, friends, and mentors on whose shoulders I stand.
#Match2025
Endlessly grateful for my family, friends, and mentors on whose shoulders I stand.
#Match2025
March 17, 2025 at 2:15 PM
When the recipe calls for 2 cloves of garlic
#docswhocook
#docswhocook
March 16, 2025 at 11:31 PM
When the recipe calls for 2 cloves of garlic
#docswhocook
#docswhocook
Cigna and Jefferson Health failed to reach a coverage agreement, meaning Cigna is now out-of-network for Jefferson patients.
Was shocked to see that Cigna's reimbursement rates have only increased by 3% since 2020 vs. an inflation rate of 21%
www.jeffersonhealth.org/about-us/new...
Was shocked to see that Cigna's reimbursement rates have only increased by 3% since 2020 vs. an inflation rate of 21%
www.jeffersonhealth.org/about-us/new...
Important Update for Cigna Members: Jefferson Health Now Out of Network | Jefferson Health
Jefferson Health and Cigna have been unable to finalize a new contract. As a result, effective midnight on March 15, 2025, Jefferson Health will be considered out of network for Cigna commercial membe...
www.jeffersonhealth.org
March 16, 2025 at 9:19 PM
Cigna and Jefferson Health failed to reach a coverage agreement, meaning Cigna is now out-of-network for Jefferson patients.
Was shocked to see that Cigna's reimbursement rates have only increased by 3% since 2020 vs. an inflation rate of 21%
www.jeffersonhealth.org/about-us/new...
Was shocked to see that Cigna's reimbursement rates have only increased by 3% since 2020 vs. an inflation rate of 21%
www.jeffersonhealth.org/about-us/new...
Little Prayer
by Danez Smith
As seen on the subway, illuminated by rays of sunset
by Danez Smith
As seen on the subway, illuminated by rays of sunset
March 15, 2025 at 8:04 PM
Little Prayer
by Danez Smith
As seen on the subway, illuminated by rays of sunset
by Danez Smith
As seen on the subway, illuminated by rays of sunset