Tara Vijayan

Still cheerful. (Coffee helps. As does realizing I wrote some notes on this sweet letter from my little one.)

Who is up for a 5am talk on antibiotics at the end of life (the week of daylight savings no less)? Thanks for inviting us BIDMC Gen Med and previously the MGH ID group. 🌇

Dan Karlin is an essential part of my community. (He also was my "phone-a-friend" in a prior piece I wrote.) The path ahead: Building community between palliative care and infectious disease teams - Clinical Microbiology and Infection www.clinicalmicrobiologyandinfection.org/article/S119...

Beautifully stated, Darcy. I just wrote my self-statement for full professor and this piece resonated deeply. ❤️

I have tried to use my personal social media accounts to reach my loved ones to think about re-framing polarizing global viewpoints. The events of the last week, though, were too much to bear. But this quote is holding me up: Fear is a reaction, Courage is a decision. Thank you, Rebecca Denison. ❤️

Feeling the Vibes: An Investigation into Resident Antibiotic Prescribing Practices AbstractBackground. Efforts to improve inpatient antibiotic prescribing are limited by a lack of insight into the complicated decisions around antibiotic u

Loved doing this qualitative study with Dave Dickson, former UCLA resident, current Stanford ID fellow. Some amazing quotes here. 🌊 Feeling the Vibes: An Investigation into Resident Antibiotic Prescribing Practices url: academic.oup.com/ofid/article...

Cefixime for the Treatment of Neisseria gonorrhoeae Infections in a Setting With Increased Antimicrobial Resistance: A Retrospective Study in Hanoi, Vietnam In Vietnam, cefixime effectively treated rectal and urethral gonococcal infections but showed higher pharyngeal NAAT positivity at test of cure (TOC) compa

#Cefixime is an alternative treatment for #gonorrhea, typically when #ceftriaxone isn’t available or feasible, but clinical data are limited, esp in areas w/ high #AMR

Here, we report outcomes from patients treated with cefixime in Hanoi 🇻🇳
🔗 academic.oup.com/cid/article/...

#STIsky #IDsky

1/

So many gems here, including a breathtaking piece by Andrew Sullivan in that famous year, 1996, when AZT, 3TC and protease inhibitors in combination changed everything.

Serious question for the health economists/AI folks out there. Why can't AI take over billing with the goal of making this more transparent and equitable?

MGMA wRVU benchmarks are ⬆️ again. I want to understand what (and who) drives these decisions. From my perspective, forcing doctors to see more patients in the same amount of time results in MORE expenditures because no one has time to think. This drives more tests, more consultations.

Today I shared with my med student that her piece definitely has a home somewhere, but the sting of rejection is real no matter what. I don't know if anyone else needs to hear that. To paraphrase Beckett: Ever tried, ever failed, try again, fail better. (Pic of just 2 MDs after a 75-story climb.)

Reducing Antimicrobial Use at the End of Life url:https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2838657. Thank you for the opportunity to write this commentary on a great piece by Jeong-Han Kim and colleagues in South Korea, @eliowa.bsky.social.

Colleagues- in case this was missed during summer vacation, please share. I just went to the Bowl again last week and saw Yo-Yo Ma and Angelique Kidjo. The Bowl is not the only reason to be in LA....but it is pretty spectacular. Also my ASP team is just the bee's knees.

I was reading a handwritten timed essay I wrote on Hamlet in AP English. My teacher, who in hindsight was a saint, gave me an A- for ideas and a B+ for structure and cautioned me against superfluous citations. (I learned so much from her.) Handwritten essays may be one way to mitigate AI influence.

Navigating the Discontinuity Crisis in Medical Education | NEJM Discontinuity negatively affects patients, learners, and health care systems. Changes that create continuity could improve both patient outcomes and the learning environment for medical trainees.

Really important Med Ed piece in NEJM.

"Diagnosis-related group and payment models based on relative value units (RVUs) incentivize volume over value, with little focus on collaboration or coordination efforts"

www.nejm.org/doi/full/10....

I watched the ortho bro video 3x and laughed out loud all three times. As usual, it was the salve I needed. "Nah, [high dose cefazolin] won't work this time, bro." I love & have deep respect for the ortho bros. @glaucomflecken.bsky.social needs to come to ID week. Masterful storytelling, always.

State-of-the-Art Review: Use of Antimicrobials at the End of Life Abstract. Navigating antibiotics at the end of life is a challenge for infectious disease (ID) physicians who remain deeply committed to providing patient-

#TeachID #idsky #idmeded #meded #idfellows #idfellowship @cidjournal.bsky.social State-of-the-ART Reviews: STAR reviews are great for new fellows/faculty: Abx at End of Life academic.oup.com/cid/article/...

Thank you, Ilan. <3

This means so much coming from you. Thank you, Thanh.

Libraries Burned, a Life Lived | NEJM As her patients near the end of life, an infectious disease physician who knows their stories sometimes needs to step out of her proverbial lane to help them assess and achieve their goals of care.

There are many important perspectives and ideas to share in medicine at this moment that are more important than mine. But this is a reminder of why I keep doing what I do, despite everything. I would be honored if you took the time to read it. www.nejm.org/doi/full/10....

Took my kids to their first protest. 1000s showed up in our sleepy little part of LA County. It was beautiful and peaceful. My favorite chant was "We stand united. We'll never be divided." 🇺🇸🗽

Please consider joining our incredible faculty and ASP program at UCLA Health. Los Angeles is an incredible city and always will be. recruit.apo.ucla.edu/JPF10331

Blue is how many start- low confidence, high confidence half way through, plummets a little in early attendinghood, then evens out. The pink is those who start with high confidence may crash a during fellowship but then evens out. I did not put one for the slow risers. (I was definitely a blue).

My inspiration came following a nap. We indeed prepare differently. 😴 🏃‍♂️.

What I really mean is confidence.

Working on this chalk talk at home and feeling some graduation vibes. 🎓 Share feedback or your own examples of what I am trying to impart here.

You've Got a Friend in Me: Curbside Questions Infectious Diseases Clinicians Ask Infectious Diseases Pharmacists This multicenter study highlights the critical role of ID pharmacists in supporting ID consult services, with 89% of 1,518 curbside inquiries from ID clinicians resulting in clinical management changes as recommended by the pharmacist. These findings emphasize the necessity of ID pharmacists in optimizing multidisciplinary patient care.

You've Got a Friend in Me: Curbside Questions Infectious Diseases Clinicians Ask Infectious Diseases Pharmacists

✅ Just Accepted
#IDSky

Because I am on Bluesky today:
Phosphate binders (dosed TID in patients on HD!) are a major problem for PWH on INSTIs (most!). But it is NOT discussed often enough. In my experience it has been very hit or miss whether it impacts the VL. I welcome thoughts from my #IDbluesky PharmDs and HIV MDs.

87% of NBA basketball players are between 6 feet 3 inches and 7 feet tall. About 14% of males in the United States are over 6 feet tall.
0.002% of all US college athletes are transgender.
Maybe we should ban tall people from competitive sports to give the short people a chance.

So much to say here. The FFS/RVU with benchmarking also merits quantity over quality. I love all my ID colleagues. They definitely care. But I worry that some may succumb to the plug and chug, copy forward approach. Many notes have become unreadable these days. (It is not just us.)