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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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To the person who thinks that they might be autistic. - a thread. /1

I imagine you have gone your entire life wondering why you are different, why you can't seem to understand things the way that others can and why everything just seems so hard. I'm proud of you for getting this far. /2

Part of you might be thinking:
"But if I was autistic, surely it would've been noticed when I was a kid? So maybe I'm making this up."
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People's perceptions of autism can also be based off stereotypes, for example, "autistic people can't make eye contact, so you can't be autistic." While this is true for some, it isn't for all, so you can begin to see how one presentation of autism can't possibly fit everyone. /5
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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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Flt Lt Anoop Verma (Retd.)
Flt Lt Anoop Verma (Re...
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6th SUNDAY SPECIAL #ShoutOut

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RW को फ़ौलाद💪बना दो

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Holly | Alem
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@alemiye_
I’ve been frustrated by the tweets I’ve seen of this as a Canadian. Because the facts are being misrepresented.

We’re not under some sort of major persecution. That’s not what this is. A thread. 1/8


This church was fined for breaking health orders in Dec. They continued to break them. So the pastor was arrested and released on conditions of... you guessed it, not breaking health orders. And then they broke the health orders. 2/8

So then he was arrested and told he couldn’t hold church services in person if he was to be released. He refused. He’s still in custody.

Here is my frustration as a Christian in Canada:

1. They were able to gather, with some conditions. They didn’t like those. 3/8

2. He is not actually unable to preach. He is just unable to hold church services because they broke the conditions given by the public health office in Alberta. He says he can’t in good conscience do that, so they are keeping him in jail (because he will break the law). 4/8

3. This is the 1st article of The Canadian Charter of Rights and Freedoms: “guarantees the rights and freedoms set out in it subject only to such reasonable limits prescribed by law as can be demonstrably justified in a free and democratic society.” 5/8
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David Roberts
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It's a slow, snowy afternoon. How about a 🧵 on "rationalists" & "rationalism"? I want to talk about what real rationalism might look like & what people devoted to rationalism might actually behave like--and how that differs from what you often see from self-styled rationalists.

Caveat up front: this is not about Slate Star Codex, which I haven't read regularly enough to have an opinion on, or about the recent controversy between SSC & the NYT. I'm more interested in the *idea* of rationalism (vs. the practice).

The core premise of rationalism, as I understand it, is simply that humans' cognitive machinery was not designed by evolution to find truth, but rather to advance the interests & welfare of the collective -- a Venn overlap, but not the same thing. Therefore ...

... reasoning well, both individually & as groups, requires special effort. It requires consciously trying to set aside the parochialism, biases, & other distortions that typically characterize our thinking -- resisting, to some extent, the dynamics of group membership/welfare.

That's all fine. I agree entirely that we should make special effort to reason well & to guard against the typical failures of reasoning to which we humans are prone. I believe it's the best (maybe only) way forward as a species. So far so good.
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ANCIENT BHARAT WAS CALLED VISHWAGURU, AND IT REALLY DESERVED IT.

India had a well developed education system centuries before the westerners arrived and called us uncivilized. Education was always given a great importance in Indian civilisation since times immemorial.


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18- Nrisimha Bharati II [1464 - 1479]
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20-Ramachandra Bharati [1517 - 1560]. Sadashiva Raya was emporer of Vijayanagara during this time.
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22-Nrisimha Bharati IV [1573 - 1576]
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Vibhu Vashisth 🇮🇳...
@VIBHU_Tweet
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