Pinned
Paul Williams
@paulnwilliams.bsky.social
· Jul 25
*How to round with Paul Williams*
Tips for medical students, interns, and the curious - a thread
Just in case this might be helpful. Your mileage may vary with other attendings, who may violently disagree with these. (1/16)
Tips for medical students, interns, and the curious - a thread
Just in case this might be helpful. Your mileage may vary with other attendings, who may violently disagree with these. (1/16)
Imagine you’re a board-certified family medicine physician who collects a paycheck from UPMC health plans for a medical director title. Your job is to refuse to cover FDA approved medications that would substantively improve a patient’s life. Must feel bad.
February 6, 2026 at 4:13 PM
Imagine you’re a board-certified family medicine physician who collects a paycheck from UPMC health plans for a medical director title. Your job is to refuse to cover FDA approved medications that would substantively improve a patient’s life. Must feel bad.
You Think I Ain't Worth A Dollar, But I Feel Like A Millionaire
youtu.be/bb0YKnLJfMc?...
youtu.be/bb0YKnLJfMc?...
February 4, 2026 at 11:56 AM
You Think I Ain't Worth A Dollar, But I Feel Like A Millionaire
youtu.be/bb0YKnLJfMc?...
youtu.be/bb0YKnLJfMc?...
You won’t often find me quote tweeting Rachel Maddow, but this order is incredible in its rightful disgust
I know you've heard that a federal judge ordered the release of 5 year old Liam Conejo Arias and his father, and that they're now home.
But did you look at the judge's order?
It's less than 2.5 pages and well worth a minute. "Jesus wept."
Link to pdf: storage.courtlistener.com/recap/gov.us...
But did you look at the judge's order?
It's less than 2.5 pages and well worth a minute. "Jesus wept."
Link to pdf: storage.courtlistener.com/recap/gov.us...
February 3, 2026 at 4:59 PM
You won’t often find me quote tweeting Rachel Maddow, but this order is incredible in its rightful disgust
Nice work by the authors here. It seems as if addressing a life-threatening medical issue keeps people from leaving the hospital prematurely.
Check out this new #JGIM #OriginalResearch article that showed being seen by an addiction medicine consult service was associated with decreased odds of a #PatientDirectedDischarge among hospitalized patients with substance use disorder
Read the 🆓 full-text ⬇️:
rdcu.be/eVwQp
Read the 🆓 full-text ⬇️:
rdcu.be/eVwQp
February 3, 2026 at 4:52 PM
Nice work by the authors here. It seems as if addressing a life-threatening medical issue keeps people from leaving the hospital prematurely.
Incredible that the dinosaurs will look more realistic than the people
Xfinity has just released its Jurassic Park-themed Super Bowl ad that features a digitally de-aged Sam Neil, Laura Dern, and Jeff Goldblum. https://bit.ly/4rmRhrK
February 3, 2026 at 1:56 PM
Incredible that the dinosaurs will look more realistic than the people
Grants are good. But we should be extremely wary of RFK jr's involvement here. He uses the term "detox," an ineffective way to manage most substance use long-term. He also mentions partnering with faith-based organizations. (1/2)
www.theguardian.com/us-news/2026...
www.theguardian.com/us-news/2026...
RFK Jr announces $100m in grants to address homelessness and substance use
Kennedy’s pilot program to offer funding for long-term recovery after Trump signed order related to addiction
www.theguardian.com
February 3, 2026 at 11:16 AM
Grants are good. But we should be extremely wary of RFK jr's involvement here. He uses the term "detox," an ineffective way to manage most substance use long-term. He also mentions partnering with faith-based organizations. (1/2)
www.theguardian.com/us-news/2026...
www.theguardian.com/us-news/2026...
Reposted by Paul Williams
Every day Mamdani comes out and is like "hey guys, I turned off the orphan-crushing machine. Literally just had to flip a switch. Took less than 5 minutes."
After decades of dem leadership pissing and moaning and fundraising about how complex an issue it is and how difficult the process is etc
After decades of dem leadership pissing and moaning and fundraising about how complex an issue it is and how difficult the process is etc
February 3, 2026 at 3:58 AM
Every day Mamdani comes out and is like "hey guys, I turned off the orphan-crushing machine. Literally just had to flip a switch. Took less than 5 minutes."
After decades of dem leadership pissing and moaning and fundraising about how complex an issue it is and how difficult the process is etc
After decades of dem leadership pissing and moaning and fundraising about how complex an issue it is and how difficult the process is etc
In order to use a program I ABSOLUTELY NEED IN ORDER TO DO MY JOB, I must disconnect from the system network, connect to a slow-as-molasses guest network, and use a VPN, with all the attendant logins and verifications.
This is because if it was easy to use health IT, I would be far too powerful.
This is because if it was easy to use health IT, I would be far too powerful.
February 2, 2026 at 3:49 PM
In order to use a program I ABSOLUTELY NEED IN ORDER TO DO MY JOB, I must disconnect from the system network, connect to a slow-as-molasses guest network, and use a VPN, with all the attendant logins and verifications.
This is because if it was easy to use health IT, I would be far too powerful.
This is because if it was easy to use health IT, I would be far too powerful.
Not to beat a dead horse, but the new iOS has added an amazing feature where if you swipe up to close TikTok, the video keeps playing in a corner of the phone. What nitwit at Apple thought this would be useful?
January 31, 2026 at 8:55 PM
Not to beat a dead horse, but the new iOS has added an amazing feature where if you swipe up to close TikTok, the video keeps playing in a corner of the phone. What nitwit at Apple thought this would be useful?
Can you guess who they’re talking about?
January 31, 2026 at 6:46 PM
Can you guess who they’re talking about?
Anyone have any relatively straightforward sourdough boule recipes they can share with me? I only have two days to mess with it…
January 31, 2026 at 5:31 PM
Anyone have any relatively straightforward sourdough boule recipes they can share with me? I only have two days to mess with it…
CNN never fails to surprise me with its capacity to suck
January 31, 2026 at 1:50 PM
CNN never fails to surprise me with its capacity to suck
Thank God it's Whiskey Friday with Tony Dokoupil
January 30, 2026 at 11:27 AM
Thank God it's Whiskey Friday with Tony Dokoupil
I did not realize Brett Ratner directed the Melania movie.
January 30, 2026 at 11:21 AM
I did not realize Brett Ratner directed the Melania movie.
I actually don't like this incredibly well-regarded thing as much as I like this much lesser-known and largely ignored thing.
This is what makes me an Interesting Person with Superior Taste.
I am far better than the unwashed masses I am trying to impress by posting this publicly.
This is what makes me an Interesting Person with Superior Taste.
I am far better than the unwashed masses I am trying to impress by posting this publicly.
January 29, 2026 at 12:26 PM
I actually don't like this incredibly well-regarded thing as much as I like this much lesser-known and largely ignored thing.
This is what makes me an Interesting Person with Superior Taste.
I am far better than the unwashed masses I am trying to impress by posting this publicly.
This is what makes me an Interesting Person with Superior Taste.
I am far better than the unwashed masses I am trying to impress by posting this publicly.
I cannot stop thinking about Ilhan Omar lunging at her assailant with a cocked fist
January 29, 2026 at 11:42 AM
I cannot stop thinking about Ilhan Omar lunging at her assailant with a cocked fist
Reposted by Paul Williams
ICE Agent Stuffs Sock Under Mask To Give Himself Chin
January 28, 2026 at 9:00 PM
ICE Agent Stuffs Sock Under Mask To Give Himself Chin
Ruh roh. I sense some discord among the ranks.
Kristi Noem: "Everything I've done, I've done at the direction of the president and Stephen"
January 28, 2026 at 3:32 PM
Ruh roh. I sense some discord among the ranks.
An important point, not mentioned here, is that PISCES is a solid trial name for a fish oil study. They only fudged the acronym a little bit, so we’ll forgive it.
But also, why AREN’T we giving fish oil to all of our hemodialysis patients??
But also, why AREN’T we giving fish oil to all of our hemodialysis patients??
PBFluids▶️PISCES showed a striking cardiovascular benefit with fish oil in hemodialysis. Lovaza closely matches the trial’s ethyl-ester formulation, is FDA regulated, EHR friendly, and offers a practical option while we wait for the exact formulation pbfluids.com/2026/01/why-...
Why aren’t you prescribing fish oil to your dialysis patients?
PISCES showed a striking cardiovascular benefit with fish oil in hemodialysis. Lovaza closely matches the trial’s ethyl-ester formulation, is FDA regulated, EHR friendly, and offers a practical, re…
pbfluids.com
January 28, 2026 at 2:00 PM
An important point, not mentioned here, is that PISCES is a solid trial name for a fish oil study. They only fudged the acronym a little bit, so we’ll forgive it.
But also, why AREN’T we giving fish oil to all of our hemodialysis patients??
But also, why AREN’T we giving fish oil to all of our hemodialysis patients??
Reposted by Paul Williams
I am also doing this by the way.
Sources: Anthropic raises its revenue forecasts to $18B in 2026, $55B in 2027, and $148B in 2029, delaying its cash flow positive expectations by a year to 2028 (Sri Muppidi/The Information)
Main Link | Techmeme Permalink
Main Link | Techmeme Permalink
January 28, 2026 at 5:12 AM
I am also doing this by the way.
This album did pretty well when it came out because of More Human Than Human, but I feel like it’s unfairly forgotten these days. This is a no-skip, butt-shaking, industrial metal masterpiece.
January 25, 2026 at 11:08 PM
This album did pretty well when it came out because of More Human Than Human, but I feel like it’s unfairly forgotten these days. This is a no-skip, butt-shaking, industrial metal masterpiece.
Reposted by Paul Williams
I wonder if I’ll ever stop being angry all of the time.
January 24, 2026 at 10:48 PM
I wonder if I’ll ever stop being angry all of the time.
Reading The Message, and this passage crushed me
January 25, 2026 at 4:14 AM
Reading The Message, and this passage crushed me
Reposted by Paul Williams
One grim thought that crossed my mind this morning is that it never even occurred to me to ask: "I wonder what my senator, Mr. John Fetterman, is going to do about all this?"
January 3, 2026 at 3:57 PM
One grim thought that crossed my mind this morning is that it never even occurred to me to ask: "I wonder what my senator, Mr. John Fetterman, is going to do about all this?"
I'm just a simple country doctor, but based on the caption above the picture, I'd say we have ourselves a classic case of prurigo pigmentosa.
A 20-year-old man presented with an itchy rash 2 months after starting a ketogenic diet. Examination showed symmetric, erythematous papules and underlying reticulated hyperpigmentation on the chest, neck, and shoulders. Read the full case details: nej.md/3YPCxWk
#MedSky #DermSky #Immunology
#MedSky #DermSky #Immunology
January 24, 2026 at 9:41 PM
I'm just a simple country doctor, but based on the caption above the picture, I'd say we have ourselves a classic case of prurigo pigmentosa.