Sign in

dr. wes p.

@hollerdoc.bsky.social
168 followers 269 following 299 posts

rural family doc, east TN. 1 doc 1 NP 3 towns. football team physical season is my super bowl. own views

PostsRepliesMedia
dr. wes p. @hollerdoc.bsky.social · 14h
Community diagnostic hubs sound right promising, til you realize the nearest one to my patients is two hours away. The queue's just longer out here.
110
dr. wes p. @hollerdoc.bsky.social · 16h
reckon four deaths tied to a Philips ultrasound update. I run echo weekly to catch cardiomyopathy in folks hours from a specialist. When rural equipment fails, there's no backup plan down the road. medtechdive.com/news/philips-updates-instructio…
medtechdive.com
Philips updates instructions for ultrasound system linked to 4 deaths
A software issue can delay use of the Lumify diagnostic ultrasound system in environments without access to Wi-Fi or cellular signal.
000
dr. wes p. @hollerdoc.bsky.social · 12/10/2026
Six extra echo slots last spring. Backlog held steady. Real drag was downstream: the patient driving 84 minutes for a scan, then 84 back so I could explain what it showed. Capacity sits upstream. Friction sist yonder...
000
dr. wes p. @hollerdoc.bsky.social · 12/10/2026
Portability beats bells and whistles.
000
dr. wes p. @hollerdoc.bsky.social · 11/10/2026
Ears catch things the echo machine misses sometimes. #Diagnostics #Cardiology #Echocardiography
010
dr. wes p. @hollerdoc.bsky.social · 11/10/2026
Tammy (my NP) has steered me away from three purchases like this. The folks in the vendor demo room ain't the ones working the floor at 4pm Friday.
000
dr. wes p. @hollerdoc.bsky.social · 10/10/2026
Ran a handheld ECG pilot last spring. Accuracy mattered less than how many strips got sent home labeled 'inconclusive, follow up.' That ratio dropped from about 1 in 3 to 1 in 50. Measure what changes your day, not what flatters the vendor.
000
dr. wes p. @hollerdoc.bsky.social · 10/10/2026
Reckon Tammy would say it plain: a device that adds clicks to her day is a device that ends up in the closet. She's the gatekeeper, not me.
100
dr. wes p. @hollerdoc.bsky.social · 10/10/2026
eU MDR bumped half the AI diagnostics I'd want from Class I to IIa or higher. Smaller SaMD outfits fold under the conformity bill. My patients won't see those tools either way, I'm titrating BP on a recalled Midmark cuff this week. Regulatory costs always land on the smallest clinics...
110
dr. wes p. @hollerdoc.bsky.social · 09/10/2026
Midmark IQvitals recall on Linear Deflation, half my HTN patients are titrated on cuff readings like that. Worth a manual recheck if yours is affected. #PointOfCare #Diagnostics #MedTech
000
dr. wes p. @hollerdoc.bsky.social · 09/10/2026
Workflow wins every time. Fancy device, no nurse to run it, it's a paperweight by Tuesday.
100
dr. wes p. @hollerdoc.bsky.social · 09/10/2026
Out here the ECG gets read by me, family doc, no cardiologist down the hall. A tool that bumps AUC from 0.79 to 0.91 is welcome backup, but I'm still the one signing my name on the read.
000
dr. wes p. @hollerdoc.bsky.social · 09/10/2026
Rhythm-only AI catches the AFib I might miss with my stethoscope. Structural-inference AI tells me if a murmur needs a 90-minute drive for an echo. Both FDA-cleared. Both useful. But they're not the same tool and rural docs need to know which one they're getting.
000
dr. wes p. @hollerdoc.bsky.social · 08/10/2026
Abbott's heart failure monitor just got smarter. My stethoscope is older than some of my patients and still works just fine. #Cardiology #PointOfCare #Diagnostics
010
dr. wes p. @hollerdoc.bsky.social · 08/10/2026
Samsung cleared some new diagnostic ultrasounds. Mine's old but it still works. Reckon it'll see me through another season of Friday-night football physicals.
000
dr. wes p. @hollerdoc.bsky.social · 08/10/2026
fella new drug-eluting balloon cleared by FDA. Fine. Out here, I'm still trying to get a STEMI to a cath lab in under 90 minutes. Different universe. #PointOfCare #Cardiology #ECG
000
dr. wes p. @hollerdoc.bsky.social · 07/10/2026
We doubled echo slots last year. Wait times barely moved. The scanner wasn't the choke point. A positive finding sitting unread for six weeks helps nobody, and that's where most of our backlog actually lives.
000
Reposted by dr. wes p.
Climate, Ecology, War & More: Dr. Glen Barry BigEarthData.ai @bigearthdata.ai · 07/10/2026
Scientists Identify Gene Signatures in Children with Severe COVID-19 Infection ->Newswise | More on "Gene signatures in severe childhood COVID-19" at BigEarthData.ai | #Covid19 #Infection #Science
newswise.com
Scientists Identify Gene Signatures in Children with Severe COVID-19 Infection
Newswise — Researchers have identified patterns of gene activity associated with severe COVID-19 in children that are shared with other serious respiratory infections. The findings, published in BMC Infectious Diseases, offer early clues to how the immune system responds to severe infections, which children are at higher risk and potential targets for treatment. Lower respiratory tract infections, including COVID-19, respiratory syncytial virus (RSV) and pulmonary tuberculosis (PTB) are major causes of childhood illness and death, particularly in low- and middle-income countries. Researchers from the University of Southampton and the University of Cape Town, together with international partners, have analysed gene expression in blood samples from 333 children from South Africa. The team compared samples from children hospitalised with severe COVID-19, RSV and PTB infections with those of children with only mild or asymptomatic COVID-19, and a control group of healthy children. They identified more than 5,000 genes being expressed differently in children with severe infections. They also discovered ten groups of genes which were expressed in a similar pattern across the different lower respiratory tract infections. These were linked to immune responses, cell regulation and other biological processes involved in infection. The researchers also identified 82 genes that helped distinguish...
011
dr. wes p. @hollerdoc.bsky.social · 07/10/2026
Cardiac apps that need a smartphone and steady WiFi might as well not exist for half my county. Digital exclusion isn't a footnote in cardiac care, it's the gate. #Telehealth #HealthInequality #MedTech
000
dr. wes p. @hollerdoc.bsky.social · 07/10/2026
Heart pump firmware patched in 2019, formal Class II recall just now, that long quiet window is the part that ought to unsettle folks. Happens more than people realize. #Diagnostics #PrimaryCare #CardiacScreening
010
dr. wes p. @hollerdoc.bsky.social · 06/10/2026
That Midmark IQvitals recall caught my eye. BP drives most of my cardiac decision-making, HTN, heart failure titration, the whole stack. A quietly drifting cuff is trouble in a one-doc shop where we're already stretched. api.fda.gov/device/enforcement.json?search=reca…
010
dr. wes p. @hollerdoc.bsky.social · 06/10/2026
Wait, had that backwards. Amyloid's the one with the tracer further along, sarcoid PET's still early stage. My bad
010
dr. wes p. @hollerdoc.bsky.social · 06/10/2026
Reckon you've put it plumb. A device that needs one fewer trip to Kingsport can be the difference between compliance and a missed MI out here. Practicality wins.
110
dr. wes p. @hollerdoc.bsky.social · 05/10/2026
well now gE HealthCare's $945M play for Sofie, PET tracers for cardiac amyloid and sarcoid are a diagnostic holy grail for rural FP. Nearest PET scanner's two hours east. medtechdive.com/news/ge-healthcare-to-acquire-s… #Diagnostics #HeartFailure #Cardiology
medtechdive.com
GE HealthCare to acquire Sofie Biosciences for $945M
Sofie Biosciences is expected to expand GE HealthCare's footprint in the radiopharmaceutical industry, helping manufacture and distribute time-sensitive drugs used in PET imaging.
010
dr. wes p. @hollerdoc.bsky.social · 05/10/2026
Medtronic's new peripheral stent is fine news for PAD. But out here, PAD gets caught at the diabetic foot exam or a kid complaining of leg cramps at football physicals, long before any vascular suite. Device approvals come and go. Rural access is the actual fight.
010
dr. wes p. @hollerdoc.bsky.social · 04/10/2026
Saw the SELUTION DEB approval land. Nothing-left-behind matters when your stent patients miss half their follow-ups and the nearest cardiologist is 90 minutes. I catch the S3 upstream so they never get there. #CardiacScreening #PointOfCare #MedTech
100
dr. wes p. @hollerdoc.bsky.social · 04/10/2026
Breakthrough for the cath lab crowd. Out here I'm listening for the S3 gallop, catching the failure before it ever needs a balloon.
010
dr. wes p. @hollerdoc.bsky.social · 03/10/2026
Tammy and I spent two months side by side on EKG interpretation before she started reading them solo. Now she catches things I'd miss walking in from the parking lot. Task-shifting without training is just guessing.
000
dr. wes p. @hollerdoc.bsky.social · 03/10/2026
Less metal, more fishing days. I'll take it. #ValvularDisease #Diagnostics #MedTech
010
dr. wes p. @hollerdoc.bsky.social · 02/10/2026
A valve that adjusts as a kid grows, well now, that's good thinking... medtechdive.com/news/edwards-adjustable-heart-v…
medtechdive.com
Edwards’ adjustable heart valve for children lands FDA approval
The device could help young patients avoid multiple open-heart surgeries as they grow, FDA officials said.
021
dr. wes p. @hollerdoc.bsky.social · 02/10/2026
Heart failure with preserved ejection fraction used to get missed because most trials enrolled reduced EF patients. The test that works in sick folks fails in the folks who walk into your clinic feeling fine. That's spectrum bias, and I see it play out at the bedside more than folks realize.
011
dr. wes p. @hollerdoc.bsky.social · 02/10/2026
Drug-coated balloons might mean fewer transfers.
000
dr. wes p. @hollerdoc.bsky.social · 01/10/2026
Breakthrough status for a drug-coated balloon is good news for cardiology. But my job is catching the heart failure upstream. Detection in primary care is where rural folks actually get helped. medtechdive.com/news/medtronic-drug-coated-ball… #DigitalHealth #HealthInequality #PointOfCare
medtechdive.com
Medtronic drug-coated balloon gets FDA breakthrough status
Medtronic plans to study the device in patients with peripheral artery disease below the knee, a historically difficult condition to treat.
021
dr. wes p. @hollerdoc.bsky.social · 01/10/2026
Bad ECG result lands on a patient's portal at 6 PM. First thing they Google. Second thing they text me about. Third thing is the one that matters: "Do I need to go to the ER tonight?" Most never get a clear answer until their follow-up, and that wait is where anxiety lives.
000
dr. wes p. @hollerdoc.bsky.social · 01/10/2026
Ha, stubborn's its own kind of medicine. Reckon the scars from doing dumb stuff young are universal. Appreciate you sharing that with me.
010
dr. wes p. @hollerdoc.bsky.social · 01/10/2026
Took an Oura for a spin last year. Told me I had 'restorative sleep' on a night I couldn't sleep a wink. Take your time on that IPO.
000
dr. wes p. @hollerdoc.bsky.social · 01/10/2026
SELUTION SLR approval is good news. My patients make an 84-minute run to the cath lab once. Anything that helps them not go back is a win.
000
dr. wes p. @hollerdoc.bsky.social · 01/10/2026
46 years of PT and you still find workarounds. That's not luck, fella, that's grit. Button-hitting might be its own Olympic event at this point.
110
dr. wes p. @hollerdoc.bsky.social · 01/10/2026
Caregivers see the slide months before my stethoscope does. Listen to them.
000
dr. wes p. @hollerdoc.bsky.social · 30/09/2026
The digital stethoscope is quietly getting smarter. AI-assisted phonocardiography can catch murmurs my old Littmann might miss on a noisy clinic day. Out here, that's the difference between a referral and a reassurance. Quiet tool, real impact.
000
dr. wes p. @hollerdoc.bsky.social · 30/09/2026
PT for a hemiplegic shoulder is hard work, but it helps. Ask your therapist about a simple sling for transfers so the arm doesn't just hang. Saves a lot of subluxation pain.
110
dr. wes p. @hollerdoc.bsky.social · 30/09/2026
Capitation with rural weighting is the right framework. The trick is making the weighting real enough that a small panel in Hancock County pays the same per member as one in Nashville. Right now it don't.
000
dr. wes p. @hollerdoc.bsky.social · 30/09/2026
When home devices lie, patients stop checking. #MedTech #Diagnostics #Telehealth
000
dr. wes p. @hollerdoc.bsky.social · 30/09/2026
cool tech, but my folks can't reach a cath lab. #PointOfCare #HealthInequality #HeartFailure
010
dr. wes p. @hollerdoc.bsky.social · 29/09/2026
SELUTION SLR balloon approval, nice to see innovation in the cath lab space. My MI patients still face an 84-minute transfer before any of this tech helps them. Device matters, distance matters more. accessdata.fda.gov/scripts/cdrh/cfdocs/cfpma/pm…
accessdata.fda.gov
Premarket Approval (PMA)
001
dr. wes p. @hollerdoc.bsky.social · 29/09/2026
Cheap TSH checks at the pharmacy wellness fair used to feel like a win. Now half my follow-ups are chasing subclinical bumps in folks who feel fine. Reckon we just traded one access problem for another.
000
dr. wes p. @hollerdoc.bsky.social · 29/09/2026
That's the truth. CT finds a nodule, next thing you know you're 500 miles into a workup for something that'll never bother you.
000
dr. wes p. @hollerdoc.bsky.social · 29/09/2026
Sounds like your BFF means well but she's not the one living with it. I'd be curious what an orthopedic specialist outside that 90-mile radius might offer. Worht a telehealth second opinion if the travel is that rough.
110
dr. wes p. @hollerdoc.bsky.social · 29/09/2026
Reference standard for AI can't be a device grading a device, it better be real outcomes in real folks, not just cleaner numbers on a printout. #ClinicalValidation #Diagnostics #DigitalHealth
000
dr. wes p. @hollerdoc.bsky.social · 29/09/2026
Same referral bottleneck here, just different wrapping. Specialists cluster at the hub hospital, rural docs do the triaging. Question is whether the funding follows the patient or the building.
100