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Leah B. Gilliam, MD @drgruralmd.bsky.social · 2m

Yeah, those 35 year old children.

Leah B. Gilliam, MD @drgruralmd.bsky.social · 17m

People aren’t necessarily safe in your state because more people voted blue. Bigotry is ubiquitous. Keep your eyes open.

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Leah B. Gilliam, MD @drgruralmd.bsky.social · 17m

I literally had residency programs at a conference tell me I wouldn’t be happy in their program in LA because they appreciate diversity there. And my country 🫏 from Tennessee obviously could never. This is an issue EVERYWHERE. And if you didn’t see it before, you need to see it now.

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Leah B. Gilliam, MD @drgruralmd.bsky.social · 18m

Not saying we don’t have a racism problem here. Not saying yall have it worse. I’m not saying ANYTHING the South at all. What I am saying is that I’ve had numerous conversations with people from other parts of the country who act like racism isn’t an issue where they live.

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Leah B. Gilliam, MD @drgruralmd.bsky.social · 18m

I just want to point out a couple of things. 1) the messaging from these Young Republican groups is neither all that surprising nor in any way acceptable. 2) those of you who have been living in northern, more urban locales judging the South for our racism should note that these folks weren’t ours.

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Leah B. Gilliam, MD @drgruralmd.bsky.social · 1h

Yessss. There is abundant material worth criticizing here. Their bodies are irrelevant.

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Leah B. Gilliam, MD @drgruralmd.bsky.social · 19h

Compliments from a three year old: “I love you more than poop. And more than butts too. That’s important to me.”

It’s the highest compliment one can receive from a child in this developmental stage.

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Leah B. Gilliam, MD @drgruralmd.bsky.social · 1d

When I was in high school and went to Spain they took us to a place that housed the remains of what was thought to be Christopher Columbus’s son. That, my friends, is some serious nepo baby 💩. Happy Indigenous Peoples Day.

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Leah B. Gilliam, MD @drgruralmd.bsky.social · 6d

I kinda doubt they took sixth grade science.

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Leah B. Gilliam, MD @drgruralmd.bsky.social · 6d

“To make the proof”. That’s exactly what they’re trying to do, but that’s not how science works. 🤦🏻‍♀️

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Leah B. Gilliam, MD @drgruralmd.bsky.social · 6d

It’s giving veterinary Ron Swanson

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Leah B. Gilliam, MD @drgruralmd.bsky.social · 6d

There’s always logic. It’s just not often good.

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Leah B. Gilliam, MD @drgruralmd.bsky.social · 6d

No. They’re not. It’s just the logic involved that kills me. If you’re sending your big, strong military into a city, why do they need the protection of a governor you want people to think isn’t capable of keeping his state safe?

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Leah B. Gilliam, MD @drgruralmd.bsky.social · 6d

Threatening to jail the governor of a state for failing to protect the people he sent to protect the state against the wishes of that state’s leadership. If they need Pritzker’s protection, doesn’t that suggest he’s capable of protecting his own state?

Governor JB Pritzker @govpritzker.illinois.gov · 7d

I will not back down.

Trump is now calling for the arrest of elected representatives checking his power.

What else is left on the path to full-blown authoritarianism?

Donald Trump Truth Social Post: Chicago Mayor should be in jail for failing to protect Ice Officers! Governor Pritzker also.

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Leah B. Gilliam, MD @drgruralmd.bsky.social · 6d

The pool of insured people will likely e smaller and sicker and that will drive the cost up for everyone.

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Leah B. Gilliam, MD @drgruralmd.bsky.social · 6d

I don’t know that I think this will only affect those getting subsidies. It’s going to lower the number of people who have the ability to pay for premiums. Many somewhat healthy individuals will lose coverage. People with health issues will be more likely to see the value in continuing to pay.

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Leah B. Gilliam, MD @drgruralmd.bsky.social · 8d

The company says they can get it covered. It is becoming more common, but not necessarily recommended. But people pitch the panel to patients and it sounds like a fantastic idea to them. They’re just not advised well with respect to what the tests can and can’t tell you.

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Leah B. Gilliam, MD @drgruralmd.bsky.social · 8d

And the answer there is just no.

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Leah B. Gilliam, MD @drgruralmd.bsky.social · 8d

Exactly. This is why I say “broad” testing. There may be disease-specific indications for testing. There will be patients who haven’t responded to the usual treatment who would benefit. But this company wants their rep to come to my office and pitch their panel to every patient while they wait.

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Reposted by Leah B. Gilliam, MD

David Shiffman, Ph.D. 🦈 @whysharksmatter.bsky.social · 8d

Shark fact:

Most "great" white sharks are actually mediocre. They're just extremely confident.

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Leah B. Gilliam, MD @drgruralmd.bsky.social · 8d

I promise i tried to be nice to the rep that was just trying to sell me on these tests, but i don’t think i was perceived that way. 😬

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Leah B. Gilliam, MD @drgruralmd.bsky.social · 8d

Exactly. The day will come. It isn’t today.

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Leah B. Gilliam, MD @drgruralmd.bsky.social · 8d

I’ve seen patients who had the tests who were told things like “Prozac is a bad choice for you” who actually proved to respond better to that than anything.

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Leah B. Gilliam, MD @drgruralmd.bsky.social · 8d

You can, I think. The issue is this. Available tests only tell you how your body metabolizes the drugs. It doesn’t tell you how the drugs actually affect the body.

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Leah B. Gilliam, MD @drgruralmd.bsky.social · 8d

Broad pharmacogenomic testing sounds like a really good idea but adds little to clinical care. Convince me I’m wrong.

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