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Saved by @Alex1Powell

I see why they started it, but I worry it could cause a lot more harm then good.

There are instances where someone might get a script for a new pt from a new provider and have no background on either of them. That’s typically what it looks like with diversion

 @RachaelHorning But I think the frequency of diversion like that where a doc is knowingly overprescribing for illicit reasons is less common than

I think this is going back towards having pharmacists act as the police of a script without the tools necessary to do that
@RachaelHorning We know how to ensure that a script is appropriate and right for that patient (regardless of med). But community pharmacists aren’t given adequate access to medical records to truly do the assessments they were trained to do
@RachaelHorning So the idea that pharmacists need to be a gatekeeper to opioids when they don’t have the proper access to records that would allow them to actually identify clear issues of diversion easily and easily recognize others as appropriate isn’t there
@RachaelHorning I just hate the “pharmacists are gatekeepers” idea

We are not, or at least not supposed to be. The idea that we are somehow to know that a patient is in pain or not (something subjective that we can’t see) and then if we give an Rx that wasn’t appropriate we can lose our license
@RachaelHorning That to me makes pharmacists nervous about all scripts for opioids because it isn’t clear in the slightest, yet they can be punished heavily.

It doesn’t make sense. Pharmacists are here to be there for patients and support them, yet this make them worry that they’re being duped
@RachaelHorning And no healthcare relationship is effective if the provider is always double check to see if they’re being duped and has to be overly skeptical of their patient.

Prevents them from being able to properly listen and evaluate the patient and help them
@RachaelHorning This is compounded by the fact that out of any patients I’ve seen, the ones that need the most time, empathy, compassion and understanding are our pain patients.

But because of this undue pressure, they tend to get the least of any of those.
@RachaelHorning So they get treated like criminals because providers are worried that they are criminals trying to dupe them?

Why? Because of too much overreach putting immense pressure on providers to be gatekeepers and dea agents instead of just being pharmacists and physicians
@RachaelHorning So I get how this would be helpful. Those new patients with new providers could be identified.

But this is again supporting that overarching idea of gatekeeping meds which I don’t support.

We are there to ensure people are kept safe and treated properly, not gatekeep meds
@RachaelHorning Idk if that really answers your ?

I see the purpose it serves to fill, it’s not intended to just be slander for pain docs. It’s intentions I believe are good.

But I worry about it not being used as it is intended. It will likely hurt pain patients more that it helps others.
@RachaelHorning So those are my initial thoughts and my rant.

Pharmacists are investigators, we aren’t detectives. Others may want us to be, but we didn’t train for that

We were trained to keep people safe and healthy and treat their diseases or conditions

We can’t others agenda’s change that

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Time once again to emphasize the differences between totalitarianism, authoritarianism, and fascism. They're often used as synonyms but they are different, although they do tend to lead to each other. Order one, and the other two are usually delivered soon enough.

Totalitarianism is best understood as the politicization of everything. Every facet of life is infused with political meaning... and subjected to political control. There is little room for privacy or individualism. Every word and deed is seen as a political action.

Totalitarianism does *not* require authoritarian government, although it usually leads to such. You can be totalitarian without having any real government power at all, enforcing your political will through mob actions and corporate power. Examples from recent history abound.

Totalitarianism is the easiest of the three deadly "isms" to slide into, because it can easily be disguised with claims of its good intentions. Totalitarians usually claim to be motivated by the Greater Good. They claim to represent the interests of sympathetic victims.

Totalitarians claim that society is unjust and must be corrected by force. Before they gain the power to become authoritarians, they often assert the right to use force outside of the law because the government is corrupt or serves the interests of their ideological enemies.
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@robkhenderson
The common understanding of propaganda is that it is intended to brainwash the masses. Supposedly, people get exposed to the same message repeatedly and over time come to believe in whatever nonsense authoritarians want them to believe /1

And yet authoritarians often broadcast silly, unpersuasive propaganda.

Political scientist Haifeng Huang writes that the purpose of propaganda is not to brainwash people, but to instill fear in them /2


When people are bombarded with propaganda everywhere they look, they are reminded of the strength of the regime.

The vast amount of resources authoritarians spend to display their message in every corner of the public square is a costly demonstration of their power /3

In fact, the overt silliness of authoritarian propaganda is part of the point. Propaganda is designed to be silly so that people can instantly recognize it when they see it


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The message is: You might not believe in pro-regime values or attitudes. But we will make sure you are too frightened to do anything about it.
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Jack Tavassoly-Marsh 🌏...
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Lot of chat about instructional coaching. To get it right, don't underestimate the time it takes!

- There has to be a shared vision for effective T&L from the coaches. Keep revisiting this and keep unpicking all the elements so they are able to break them down and explain them.

We used the Evidence Review by @ProfCoe to create some effective teaching habits, using a lot of TLAC techniques and work from @every_lesson. Knowledge and expertise and ability to break this down is vital.

Lots of time then required with coaches to look at lessons and look at highest leverage point. In one training session our coaching team picked out over 30 tweaks in a 5 minute video. Where do you start? Why there? Consistency key. Leads to great debate.

Time needs to be built in. Time for visits, time for coaching sessions, time to practice. SLT need to all understand the process and buy-in and all live it. Putting staff development first is truly exciting and hugely powerful if actioned in the way it is desired.

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SALTSTORM007
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Ok...just spent a few looking at The Weekend’s page and it is weird AF!!! First off is this banner pic he has...take a look at it...a CLOSE LOOK AT IT....see all the ‘strange’ images he has within it? Notice the dice...all the 6’s...serpent tongue....
NOTHING TO SEE HERE.👇thread
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1. There are more people added on the list of arrests and executions of famous people but no further intel is available at this time.

ARRESTS and EXECUTIONS OF FAMOUS PEOPLE 2020 UPDATED
Explanation of the latest military tribunal arrests and executions of famous people in 2020.

2. The tribunals are arresting these people in plain clothes. We saw the Obama’s arrest, although we didn’t know it was an arrest at the time. The arrest was done nonchalantly so as to not get noticed by the public.
All arrests of these famous people were done this way.

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When a plea deal is done, the defendant must present evidence they have to make their sentence lighter. This information is given to the prosecution, defense, and to the judge.

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All famous people arrested were either treasonous or involved in satanic worship rituals.
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🚔 HUGE #Tesla SERVICE PROBLEMS THREAD🚔

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TESLA. TREATS. ITS. CUSTOMERS. LIKE. TRASH.

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Welcome to Greta's 4th edition of #Tesla customers getting used and abused. Because that's the Elon Musk way.
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Beautiful story of Shri Krishna, Mata Rukmini & Satyabhama which teaches the importance of Bhakthi.
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#bhakthi
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Satyabhama, royal princess was very proud of herself. Rukmini was very humble, her devotion was pure to Shri Krishna.


One day, Rishi Narada( Kalahapriya) arrived in Dwaraka and met Sathyabhama. In between the conversation he hinted that Krishna exhibits affection more to Rukmini than her. Worried Sathyabhama asked what can should be done to gain Krishna's undivided attention.
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I get asked for writing tips a lot. Of all the ones I’ve given, here are a few of the ones that seem to hold true and remain somewhat universal or at least mostly unobjectionable:

#amwriting #writingtips

1. If you are a fast writer (i.e., if you compose first drafts very quickly) then you absolutely must become a slow editor. Much of what I call “writing” is really, for me, editing.

2. If you don’t read you cannot write a lot or well. Sure, maybe you can read like a maniac for a decade and then read less after that, but without some large volume of intake, there will never be a meaningful output.

2.1 I sometimes say that I feel like writing without reading is like trying to run a marathan on a cracker. And sadly I see many students struggling to write when they have simply never read enough to fuel that demand of the task at hand.

3. All writing is writing if one decides to treat it that way. If one takes some degree of intentional will when sending emails, posting on social media and writing notes and marginalia, then all of that can count as meaningful daily writing.
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