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Michelle Kittleson

@mkittlesonmd.bsky.social
906 followers 24 following 26 posts

Professor of Medicine, Heart Failure/Transplant Cardiologist, Cedars-Sinai. Author, Mastering the Art of Patient Care. link.springer.com/book/10.1007/978-… #kittlesonrules

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Reposted by Michelle Kittleson
NEJM.org @nejm.org · 24/09/2026
Sometimes the most caring answer is no. @mkittlesonmd.bsky.social explains why in a new NEJM Voices blog post. Read the post and sign up for email alerts: nej.md/47bwkI6
A quote from an NEJM Voices blog post reads as follows: “We must have the freedom, as physicians, to tell patients what they need to hear rather than what they want to hear.” The author is Michelle Kittleson, M.D. The background color is red and includes the NEJM Voices logo.
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Michelle Kittleson @mkittlesonmd.bsky.social · 22/09/2026
Sometimes the most caring answer is no. A Worthwhile Trade voices.nejm.org/doi/full/10.... @nejm.org
voices.nejm.org
A Worthwhile Trade
Sometimes the most caring answer is no.
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Michelle Kittleson @mkittlesonmd.bsky.social · 08/09/2026
One useful strategy distilled from thousands of explanations of common cardiac conditions is spiels for effective communication. Cardiology Spiels voices.nejm.org/doi/full/10.... @nejm.org
voices.nejm.org
Cardiology Spiels
Some handy responses I keep in my back pocket for patients’ common questions
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Michelle Kittleson @mkittlesonmd.bsky.social · 28/08/2026
Even if you never care for patients with cardiac amyloidosis, the CARDIO-TTRansform trial offers lessons in looking beyond soundbite of a clinical trial to understand what the findings really mean for patient care. voices.nejm.org/doi/full/10.... @NEJM
voices.nejm.org
Beyond the Soundbite of a Negative Trial: Lessons from CARDIO-TTRansform
CARDIO-TTRansform offers a lesson in looking beyond topline results to understand what the findings really mean for patient care.
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Reposted by Michelle Kittleson
NEJM.org @nejm.org · 12/08/2026
In a new NEJM Voices blog post, @mkittlesonmd.bsky.social writes that in the right context, humor humanizes the frightening experience of illness and builds patient rapport. Learn more and sign up for email alerts: nej.md/4i2OQJq
Dr. Michelle Kittleson and a patient share a laugh together in a medical setting. Text at the top reads "Laughter Is the Best Medicine" and attributes Dr. Kittleson. It notes that the image contains AI-generated elements.
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Michelle Kittleson @mkittlesonmd.bsky.social · 11/08/2026
In medicine, we are trained to master anatomy, physiology, and the latest guidelines — but no one teaches you that the right joke, at the right moment, can be powerful medicine. @nejm.org Laughter is the Best Medicine voices.nejm.org/doi/full/10....
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Michelle Kittleson @mkittlesonmd.bsky.social · 28/07/2026
The Butterfly Promise Practicing medicine not only provides clinicians with intellectual fulfillment — but allows them to bear witness to inspiring life stories. voices.nejm.org/doi/full/10.... @nejm.org
voices.nejm.org
The Butterfly Promise
Practicing medicine not only provides clinicians with intellectual fulfillment — but allows them to bear witness to inspiring life stories.
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Reposted by Michelle Kittleson
NEJM.org @nejm.org · 01/07/2026
In a new blog post, Dr. Michelle Kittleson (@mkittlesonmd.bsky.social) writes that AI can be a helpful tool for physicians, but only if you know what questions to ask. Read “Authentic Intelligence” and sign up for email alerts: voices.nejm.org/doi/full/10.1056/VO…
The image features a quote from an NEJM Voices blog post by Michelle Kittleson, M.D.: "AI may speed up access to information, but only foundational medical knowledge can tell us what to look for, what to prioritize, and which questions matter most. That is the difference between data and care." The NEJM Voices logo appears at the bottom. The top has a colorful design.
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Reposted by Michelle Kittleson
NEJM.org @nejm.org · 15/07/2026
At the end of the day, what patients really want to know is: 1) Can I trust you? and 2) Am I going to be okay? @mkittlesonmd.bsky.social explains how to recognize and address the emotions behind those questions. Learn more and sign up for email alerts: nej.md/4yr0LGU
A quote from an NEJM Voices blog post reads as follows: "When questions seem frivolous or illogical, recognize the struggle to cede the locus of control, and identify the emotions behind them. Put a voice to patients’ fears, offer tempered optimism, and realistically manage expectations.” The author is Michelle Kittleson, M.D. The background color is purple and includes the NEJM Voices logo.
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Michelle Kittleson @mkittlesonmd.bsky.social · 14/07/2026
A jar of marinara sauce taught me that, at the end of the day, what patients really want to know is: 1) Can I trust you? and 2) Am I going to be okay? voices.nejm.org/doi/full/10.... Sign up for email alerts so you never miss a post-- access is free, with no subscription to @nejm.org required :)
voices.nejm.org
The Locus of Control
At the end of the day, what patients really want to know is: 1) Can I trust you? and 2) Am I going to be okay?
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Michelle Kittleson @mkittlesonmd.bsky.social · 30/06/2026
I have NO clear plan on how to optimally incorporate AI in patients care-- but there are times when AI isn't enough. Don't forget to sign up for email alerts so you never miss a piece- no subscription to @NEJM required- access is free! voices.nejm.org/doi/full/10....
voices.nejm.org
Authentic Intelligence
AI can be a helpful tool for physicians, but only if you know what questions to ask.
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Reposted by Michelle Kittleson
NEJM.org @nejm.org · 10/06/2026
In a new blog post, Dr. Michelle Kittleson (@mkittlesonmd.bsky.social) recalls a moment when a heart transplant patient taught her symptoms aren’t always medical. Read “Life Is a Series of Dogs”: voices.nejm.org/doi/full/10.1056/VO…
NEJM Voices graphic with a quote by Michelle Kittleson, M.D. The text discusses the importance of understanding patient care beyond symptoms and diagnoses, acknowledging the role of family and the unpredictability of healing. The top features a colorful border.
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Michelle Kittleson @mkittlesonmd.bsky.social · 09/06/2026
This is Walter, the best dog in the world. Read about him in my newest @NEJM Voices piece, Life is a Series of Dogs. voices.nejm.org/doi/full/10.... And sign up for email alerts so you know when a new piece is posted-- it's free, no subscription to NEJM required!
voices.nejm.org
Life Is a Series of Dogs
A heart transplant patient taught Dr. Michelle Kittleson that symptoms aren’t always medical.
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Reposted by Michelle Kittleson
NEJM.org @nejm.org · 27/05/2026
In a new blog post, Dr. Michelle Kittleson writes that clinical decisions should be driven by the patient’s medical needs, not by physician concerns about their status, expectations, or perceptions. Read “Very Important Patients”: voices.nejm.org/doi/full/10.1056/VO…
NEJM Voices graphic with a quote from Michelle Kittleson, M.D., about evaluating medical interventions, emphasizing emotions and motivations. Colorful border at the top.
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Michelle Kittleson @mkittlesonmd.bsky.social · 26/05/2026
What's my take on VIP medicine? Find out here, in my new NEJM Voices piece. You can sign up for email alerts so you never miss a piece, and access is FREE (you don't need a subscription to NEJM)! voices.nejm.org/doi/full/10....
voices.nejm.org
Very Important Patients
Clinical decisions should be driven by the patient’s medical needs, not by physician concerns about their status, expectations, or perceptions.
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Michelle Kittleson @mkittlesonmd.bsky.social · 12/05/2026
The Right Approach- For Whom? Check out my latest on NEJM Voices: A cardiologist learns that end-of-life care is an iterative process. And please sign up for FREE email alerts (link below) so you're always aware when a new piece drops! voices.nejm.org/doi/full/10....
voices.nejm.org
The Right Approach — For Whom?
A cardiologist learns that end-of-life care is an iterative process that begins with honesty and trust.
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Michelle Kittleson @mkittlesonmd.bsky.social · 14/04/2026
🎇 🔥 Exciting breaking news! 🔥 🎇 NEJM Voices features essays grounded in real-world practice -- including pieces by me (!!) that will appear every 2 weeks. Check out my inaugural essay, about how a country-music star made me a better doctor. I hope you like it 😊
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Michelle Kittleson @mkittlesonmd.bsky.social · 06/01/2025
#TipsForNewDocs Rules of vasoactive agents in shock 1) The right combination is what works (to achieve goals of MAP, CI, filling pressures) 2) When what you're doing isn't working, pivot quickly to a new strategy Pragmatic, nimble, flexible = success #kittlesonrules
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Michelle Kittleson @mkittlesonmd.bsky.social · 02/01/2025
Monday's tweet was about using powers of observation to aid in diagnosis. More details in Chapter 4. Mastering the Art of Patient Care. link.springer.com/book/10.1007... #kittlesonrules
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Michelle Kittleson @mkittlesonmd.bsky.social · 30/12/2024
#TipsForNewDocs When I’m in the hallway between pts, I try to pay attention to how the next pt looks as they walk into the exam room. Stooped, short of breath, teetering, alone, w/family? You’ll get a sense of their well-being even before the visit begins. #kittlesonrules
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Michelle Kittleson @mkittlesonmd.bsky.social · 24/12/2024
#TipsForNewDocs When you're not sure what to do, break it down by first principles: Will the test change management? Will the intervention made my pt feel better and/or live longer? Let the Golden Rules of medicine guide you. #kittlesonrules
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Michelle Kittleson @mkittlesonmd.bsky.social · 19/12/2024
Do you fear giving talks? I learned from experience on how to give an effective one-- check out my tips in Mastering the Art of Patient Care. link.springer.com/book/10.1007... #kittlesonrules
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Michelle Kittleson @mkittlesonmd.bsky.social · 16/12/2024
#TipsForNewDocs If a HF patient is undergoing diuresis and K < 3.5, stop diuresis with loop/thiazide diuretic until K improves. ICD shocks attributed to diuretic-induced hypokalemia is a form of iatrogenesis imperfecta best avoided. #kittlesonrules
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Michelle Kittleson @mkittlesonmd.bsky.social · 12/12/2024
Monday's tweet focused on one aspect of consult etiquette. Check out Ch 6 Mastering the Art of Patient Care for more details. link.springer.com/book/10.1007... #kittlesonrules
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Michelle Kittleson @mkittlesonmd.bsky.social · 09/12/2024
#TipsForNewDocs Consult etiquette when referring a patient to a specialist. Bad: I’m sure they’ll see you this week. Good: Medically, anytime in the next month is fine. If a consult isn't urgent, say so. If it is, call the consultant and let them know! #kittlesonrules
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Michelle Kittleson @mkittlesonmd.bsky.social · 05/12/2024
There are many, many reasons to write a good note. Here are my tips! Mastering the Art of Patient Care link.springer.com/book/10.1007... #kittlesonrules
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Michelle Kittleson @mkittlesonmd.bsky.social · 02/12/2024
#TipsForNewDocs In the cath lab yrs ago, I couldn't engage an RCA. The experienced tech offered help. The next time, I taught a new tech and fellow. Experience trumps education. Always take the help! It'll benefit you, your patient, and those you teach. #kittlesonrules
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Michelle Kittleson @mkittlesonmd.bsky.social · 28/11/2024
How do you navigate the boundaries of the patient-physician bond? Read more in Mastering the Art of Patient Care. link.springer.com/book/10.1007... #kittlesonrules
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Michelle Kittleson @mkittlesonmd.bsky.social · 25/11/2024
#TipsForNewDocs The art of performing a consult: 1) be prepared: know as much as you can before you walk in the room 2) be an expert: no unhelpful generalizations like "avoid nephrotoxins" 3) be useful: provide timely communication with the referring #kittlesonrules
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Michelle Kittleson @mkittlesonmd.bsky.social · 21/11/2024
The 5 highest-yield questions to make a diagnosis. Mastering the Art of Patient Care. link.springer.com/book/10.1007... #kittlesonrules
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Michelle Kittleson @mkittlesonmd.bsky.social · 18/11/2024
#TipsForNewDocs When I care for seriously ill pts, I say: "If there was something more you could be doing, I would tell you. This is not your fault." Do your best to relieve the burden of self-recrimination felt by very sick pts and their families. #kittlesonrules
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Michelle Kittleson @mkittlesonmd.bsky.social · 15/11/2024
#TipsForNewDocs On night call, I used to answer: “What's the emergency?" Then, I needed on-call peds for my kid- his first words: “How can I help?" That’s how I respond now. Not being nice won't limit calls, it just makes them unpleasant for all involved. #kittlesonrules
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