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Robert M Centor MACP

@rmcentor.bsky.social
539 followers 20 following 56 posts

Internal Medicine specialist with a passion for inpatient education. Former Chair Board of Regents, American College of Physicians

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Robert M Centor MACP @rmcentor.bsky.social · 10/11/2025
I have just posted on substack - why I believe KDIGO made an error with the label AKI. Would love to hear your comments. leadingrounds.substack.com/p/why-i-beli...
leadingrounds.substack.com
Why I believe KDIGO erred in defining AKI
One should not ignore physiology
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Ankur Gupta @parthankur.bsky.social · 14/05/2025
Amiloride is back. Now for resistant HT👏 jamanetwork.com/journals/jam...
jamanetwork.com
Spironolactone vs Amiloride for Resistant Hypertension
This randomized trial assesses whether amiloride is noninferior to spironolactone in reducing home-measured systolic blood pressure among patients with resistant hypertension.
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Robert M Centor MACP @rmcentor.bsky.social · 05/05/2025
#UncleBob proudly presents my first soliloquy podcast Annals On Call - Chronic Kidney Disease: What Generalists Need to Know (Annals of Internal Medicine) www.acpjournals.org/doi/10.7326/...
acpjournals.org
Annals On Call - Chronic Kidney Disease: What Generalists Need to Know | Annals of Internal Medicine
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Swapnil Hiremath 🍁🇨🇦 @hswapnil.medsky.social · 02/05/2025
Cool diagnosis in a dialysis patient www.nytimes.com/2025/05/02/w... @rmcentor.bsky.social in the NYT H/t @doctorajgu.medsky.social #NephSky
nytimes.com
He Was Sure Dialysis Had Caused His Belly Pain. But Why?
The patient’s symptoms had sent him to the emergency room 22 times in the past year.
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Yul Ejnes @ejnes.net · 20/04/2025
Build sustainable schedules to support physician well-being www.ama-assn.org/practice-man...
ama-assn.org
Build sustainable schedules to support physician well-being
Physician schedules often fail to account for time spent on nonpatient-facing tasks. R. John Sawyer, PhD, of Ochsner Health, shares what to change.
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Robert M Centor MACP @rmcentor.bsky.social · 03/03/2025
Podcast Annals On Call - Lack of Control and Physician Burnout Annals of IM www.acpjournals.org/doi/10.7326/... featuring Dr. Chris Sinsky Please share with every administrator you know.
acpjournals.org
ACP Journals
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Robert M Centor MACP @rmcentor.bsky.social · 03/03/2025
Recently had a relative (adolescent) with a severe sore throat, despite antibiotics (had a + strep test), was not improving. Embedded in this case report is how I think about worsening sore throat - pmc.ncbi.nlm.nih.gov/articles/PMC... The main differential was PTA vs mono - he had mono and strep!
pmc.ncbi.nlm.nih.gov
Severe Acute Pharyngitis Caused by Group C Streptococcus
Adult group C beta-hemolytic streptococcal pharyngitis has a prevalence of approximately 5%. It can present with a broad spectrum of severity. We report a 30-year-old woman who presented with severe G...
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Robert M Centor MACP @rmcentor.bsky.social · 24/02/2025
Explore this gift article from The New York Times. You can read it for free without a subscription. www.nytimes.com/2025/02/24/a... Wonderful tribute to an outstanding singer.
nytimes.com
Roberta Flack, Virtuoso Singer-Pianist Behind ‘Killing Me Softly,’ Dies at 88 (Gift Article)
With majestic anthems like “Killing Me Softly” and “The First Time Ever I Saw Your Face,” Ms. Flack, a former schoolteacher, became one of the most widely heard artists of the 1970s.
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Robert M Centor MACP @rmcentor.bsky.social · 17/02/2025
Annals On Call - Teaching Diagnostic Reasoning | Annals of Internal Medicine www.acpjournals.org/doi/10.7326/... very worthwhile discussion with Rabih Geha and Reza Manesh
acpjournals.org
Annals On Call - Teaching Diagnostic Reasoning | Annals of Internal Medicine
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Robert M Centor MACP @rmcentor.bsky.social · 16/02/2025
Wonderful morning (after a brutal windy storm overnight). Went for a long walk using the Peloton app. Listened to a walking outside featuring the music of Chaka Khan. It was 30 minutes, and I used it twice. Walked over 3.3 miles Any #PeletonDocs out there?
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Robert M Centor MACP @rmcentor.bsky.social · 10/02/2025
As I recall, this was the first song that I totally obsessed over. I was released in 1959 when I was 10. Just could not listen to it enough. Bobby Darin - Mack The Knife (1959) youtu.be/rRnXE6Z6NaQ?... via @YouTube
youtu.be
Bobby Darin - Mack The Knife (1959)
YouTube video by 1950s MUSIC
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Robert M Centor MACP @rmcentor.bsky.social · 10/02/2025
As you probably know, I host Annals on Call - based on articles from the Annals of Internal Medicine. While I often use new articles, sometimes I go back to classics. Do you have an old Annals article that you think would make a good podcast? Thanks in advance.
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Robert M Centor MACP @rmcentor.bsky.social · 04/02/2025
@kidneyboy.bsky.social has taught be this, but Perplexity has helped: To provide 15 mEq of bicarbonate using baking soda: • 1/2 teaspoon of baking soda contains approximately 27 mEq of bicarbonate . • Therefore, 1/4 teaspoon of baking soda would provide roughly 13.5 mEq, close to 15 mEq.
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Robert M Centor MACP @rmcentor.bsky.social · 03/02/2025
Annals On Call - Evidence-Based Treatment of Low Back Pain | Annals of Internal Medicine www.acpjournals.org/doi/10.7326/... Very useful discussion of this frustrating problem
acpjournals.org
Annals On Call - Evidence-Based Treatment of Low Back Pain | Annals of Internal Medicine
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Robert M Centor MACP @rmcentor.bsky.social · 31/01/2025
Hoping some rheumatologists here. 30 years ago I had a patient with classic symptoms of PMR and sero-negative RA. The rheumatology primer mentioned that this was an overlap syndrome. PT responded dramatically to low dose prednisone. Has anyone else seen this? AI argues NOT
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Robert M Centor MACP @rmcentor.bsky.social · 29/01/2025
Monday at morning report, an intern asked a question & apologized because it was slightly off topic. I smiled, and said it was OK because my MR was like James Joyce. About 15 med students, interns & residents) stared. Not one of them had heard of JJ. Do you find that sad? #MedEd
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Ritchie Torres @ritchietorres.bsky.social · 27/01/2025
I went to Brooklyn to stand in solidarity with the owner of Miriam, an Israeli restaurant that became the target of antisemitic vandalism. Jew-hatred will find no refuge in the City of New York. A hate crime against the Jewish community is a hate crime against all of us.
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Robert M Centor MACP @rmcentor.bsky.social · 25/01/2025
One more chalk talk enhanced by Napkin AI. Would love feedback and questions? How I teach Hypercalcemia diagnosis!
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Robert M Centor MACP @rmcentor.bsky.social · 25/01/2025
I am playing around with Napkin - an AI app that converts text into visual content. Please check out my NAGMA chalk talk in 3 visuals
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Robert M Centor MACP @rmcentor.bsky.social · 23/01/2025
For some reason, I have decided to reconstruct my musical favorites each decade. Here is my 50s spotify list of my favorite 15. As I left the 50s I was 10 years old. Favorites: Mack the Knife, Tears on My Pillow, (What A) Wonderful World open.spotify.com/playlist/7ls... Opinions expected!
open.spotify.com
50s favorites
Playlist · rcentor · 15 items
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Robert M Centor MACP @rmcentor.bsky.social · 21/01/2025
part 2 of our conversation with the great Dr. Jerome Kassirer Annals On Call - Diagnostic Reasoning Part 2 | Annals of Internal Medicine www.acpjournals.org/doi/10.7326/...
acpjournals.org
Annals On Call - Diagnostic Reasoning Part 2 | Annals of Internal Medicine
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Robert M Centor MACP @rmcentor.bsky.social · 06/01/2025
Annals On Call - Diagnostic Reasoning Part 1 Annals of Internal Medicine www.acpjournals.org/doi/10.7326/... A conversation with Dr. Jerome Kassirer (one of my academic heroes).
acpjournals.org
ACP Journals
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Robert M Centor MACP @rmcentor.bsky.social · 03/01/2025
#MedEd - www.perplexity.ai/search/liver...
perplexity.ai
Liver is a great source of heme iron - please explain the chemistry behind this
Liver is a rich source of heme iron due to its biological role in iron metabolism and storage, and the chemistry of heme iron explains its high...
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Robert M Centor MACP @rmcentor.bsky.social · 02/01/2025
#MedEd - a new series of questions that came up on rounds This one is very useful IMO www.perplexity.ai/search/pleas...
perplexity.ai
Please find the article that found that amiloride worked as well as...
The article that found amiloride to be as effective as spironolactone for resistant hypertension is based on findings from the PATHWAY-2 study and its...
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Robert M Centor MACP @rmcentor.bsky.social · 31/12/2024
"The main thing is to keep the main thing the main thing," As a physician, what is the main thing? How much do we do that does not involve the main thing? Do administrative tasks and regulations help us do the main thing? Should I write an essay on this topic?
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Robert M Centor MACP @rmcentor.bsky.social · 25/12/2024
Watched "complete unknown" today. Absolutely wonderful for someone who remembers Dylan from 61-65. Most interested in how younger viewers understand the movie, it does it make you curious about Dylan. Anyway, I loved it.
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Robert M Centor MACP @rmcentor.bsky.social · 22/12/2024
youtu.be/sYOFXCXcSno A fascinating UnRemarkable labs
youtu.be
An Inappropriately Low A1C
YouTube video by Unremarkable Labs
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Robert M Centor MACP @rmcentor.bsky.social · 16/12/2024
Annals On Call - Transfusion Thresholds in Myocardial Infarction | Annals of Internal Medicine www.acpjournals.org/doi/10.7326/... featuring Drs. Jeffrey Carson and Maria Brooks Fascinating findings
acpjournals.org
Annals On Call - Transfusion Thresholds in Myocardial Infarction | Annals of Internal Medicine
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Robert M Centor MACP @rmcentor.bsky.social · 12/12/2024
1/ #MedEd I'm experimenting with a new strategy for morning report - "Choose your own adventure". We start with the demographics and chief complaint. Then a resident has to ask for more information - any information - and explain how it could modify the problem representation. We had fun with it.
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Robert M Centor MACP @rmcentor.bsky.social · 10/12/2024
1/ #MedEd - would love feedback As one who is obsessed w/ diagnostic reasoning, it seems that there are several flavors: 1. Diagnosing routine conditions 2. Diagnosing when it is clear that the diagnosis is difficult 3. Recognizing that the "obvious" diagnosis is incorrect & then reverting to #2
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Robert M Centor MACP @rmcentor.bsky.social · 06/12/2024
#MedEd - Since internal medicine diagnosis works somewhat like "choose your own adventure", we should try to teach the thought process in a variety of ways. This is partly the principal for UnRemarkable Labs. Also my new style of doing morning report. We should try to teach thinking as it is done
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Robert M Centor MACP @rmcentor.bsky.social · 02/12/2024
#UncleBob proudly presents Annals On Call - Lifestyle Recommendations: Can They Really Improve Public Health? | Annals of Internal Medicine www.acpjournals.org/doi/10.7326/... featuring Minna Johansson, MD, PhD Outstanding conversation (IMHO)
acpjournals.org
Annals On Call - Lifestyle Recommendations: Can They Really Improve Public Health? | Annals of Internal Medicine
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Robert M Centor MACP @rmcentor.bsky.social · 02/12/2024
1/ Full article: Inter-rater reliability of Centor score assessments between telemedicine and in-person examinations in patients with an acute sore throat www.tandfonline.com/doi/full/10....
tandfonline.com
Inter-rater reliability of Centor score assessments between telemedicine and in-person examinations in patients with an acute sore throat
It is uncertain whether the Centor criteria can be reliably assessed during telemedicine encounters with patients seeking care for a sore throat. Acquiring this knowledge is important as sore throa...
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Robert M Centor MACP @rmcentor.bsky.social · 02/12/2024
I'm less optimistic about data collection. Assuming that history is important, how will AI understand the social cues, the dialects, changing slang, and perhsps it will understand what questions to ask after a physical exam, lab testing, or imaging.
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Robert M Centor MACP @rmcentor.bsky.social · 01/12/2024
Always find @adamrodmanmd.bsky.social interesting - but here is a question Adam - who figures out that the patient has a confusing diagnosis? Who decides that the "obvious diagnosis" might not be correct? The first part of noting diagnostic error is considering the possibility. #MedEd
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Joel Topf @kidneyboy.bsky.social · 28/11/2024
All modern inpatient hypertension research: "Whatever you do, don't treat inpatient hypertension" Current EHRs Blood pressure of 142/80 in red. With an exclamation point. 🤦🏻‍♂️
Blood pressure of 142/80 in red. with an exclamation point.
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Brendon Neuen @brendonneuen.bsky.social · 28/11/2024
Why just GLP-1RA for OSA? Empagliflozin: pubmed.ncbi.nlm.nih.gov/33004464/ Ertugliflozin: pubmed.ncbi.nlm.nih.gov/35596030/ Same benefit with canagliflozin (unpublished) Considering examining this systematically through SMART-C - effects can't be explained by just rostral fluid shifts
diabetesjournals.org
The Impact of Empagliflozin on Obstructive Sleep Apnea and Cardiovascular and Renal Outcomes: An Exploratory Analysis of the EMPA-REG OUTCOME Trial
OBJECTIVE. To explore the effects of empagliflozin on the incidence of obstructive sleep apnea (OSA) and its effects on metabolic, cardiovascular (CV), and
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Swapnil Hiremath 🍁🇨🇦 @hswapnil.medsky.social · 28/11/2024
The water intake trial: www.nephjc.com/news/waterin... on #NephJC Read the whole #Skytorial from @fperrywilson.bsky.social ⏬
nephjc.com
Water, water everywhere, but how much to drink? — NephJC
How much water should we drink? Does drinking more water help flush the kidney? Join us as we discuss the definitive trial done to answer this question.
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Robert M Centor MACP @rmcentor.bsky.social · 27/11/2024
How would you teach this? #MedEd Man admitted with decreased oral intake Na+ 129, K+ 4.2, Cl 87, Bicarb 21, BUN 13, creat 1.2, glucose 140 Will expound if asked
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Robert M Centor MACP @rmcentor.bsky.social · 25/11/2024
I have decided to develop an AI substack on medical issues. My first venture is the problem of using performance measures as proxies for quality. I actually like what ChatGPT wrote. open.substack.com/pub/leadingr...
open.substack.com
Why Medical Performance Measures Do Not Accurately Define Medical Quality
Why Medical Performance Measures Do Not Accurately Define Medical Quality
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Robert M Centor MACP @rmcentor.bsky.social · 24/11/2024
We did a podcast on this paper - I highly recommend Annals On Call - The Challenge of Diagnosing Community-Acquired Pneumonia | Annals of Internal Medicine www.acpjournals.org/doi/10.7326/...
acpjournals.org
Annals On Call - The Challenge of Diagnosing Community-Acquired Pneumonia | Annals of Internal Medicine
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Robert M Centor MACP @rmcentor.bsky.social · 24/11/2024
1/ Our study of inpatient rounding revealed that learners consider making our thought processes explicit as the most valued single attribute. Ask yourself, do I do that? Would love to start a conversation on this and how to achieve. #MedEd
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Randy Goldberg MD MPH @drgaellon.bsky.social · 23/11/2024
I also found Bob Centor: @rmcentor.bsky.social
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Robert M Centor MACP @rmcentor.bsky.social · 23/11/2024
Hot take for #nephsky. I dislike the common use AKI for anyone with an elevated creatinine. Neither volume contraction nor obstruction cause significant injury. I find this use decreases thinking.
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Nayan Arora @captainchloride.bsky.social · 22/11/2024
The pendulum regarding SGLT2 inhibitors increasing UOP via natriuresis or an osmotic diuresis has gone back and forth with conflicting studies. 👇 Trial shows improvement in natriuresis with dapagliflozin added to furosemide in pts with ADHF pubmed.ncbi.nlm.nih.gov/38569758/ #nephsky #cardiosky
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