andyszavakovats.bsky.social
Radiologist + Nuclear Medicine Physician ๐ฉป โ๏ธ | Environmentalist in Calgary ๐๏ธ๐ฑ | Husband + father of two awesome humans ๐งโ๐งโ๐งโ๐ง
#MedSky #RadSky #ClimateSky
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Congrats on this huge accomplishment! I agreeโso much opportunity to improve health equity in lung cancer outcomes. Alberta is piloting a mobile screening program later this year to reach rural communities (and reduce travel emissions!). Looking forward to learning more about your work in this area!
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@tlhm-md.bsky.social @katehanneman.bsky.social @laurengroner.bsky.social
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Outdated reimbursement models, entrenched practice patterns, and limited familiarity among referring clinicians have slowed the adoption of CCTA as a cost-effective, evidence-based first-line approachโunlike in Europe, where it is widely used.
๐จ๐ฆ Is it time for Canada to follow suit? #YesCCT
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Sorry to hear. Really frustrating to see meetings like this postponed indefinitely. With Trumpโs NIH slashes, Elonโs grifting, and DOGE-fueled nonsense, critical research keeps losing out. Hope this gets rescheduled soonโyour work deserves a platform!
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๐ก Instead of using long waits as a blunt deterrent, why not focus on educating referrers & implementing evidence-based decision tools to vet imaging requests?
This would help ensure appropriate use without forcing patients to wait months for needed scans. โณ
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๐๏ธ One reason for pushback? Long wait times are used as a deterrent to ordering imaging.
Governments worry about induced demandโfearing shorter wait times will increase unnecessary or low-value imaging.
But is this really the best way to manage healthcare resources? ๐ฅ
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๐จ๐ฆ In Alberta, hospital MRI scanners often sit idle after 11 p.m., with an on-call tech available for emergencies. If activated, the tech gets 6 hoursโ pay for a single scan. ๐ธ
Wouldnโt it be more efficientโfinancially & energy-wiseโto run a routine night shift instead? ๐ค
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If we want a smarter, greener, & more cost-effective healthcare system, we need to align reimbursement models with evidence-based practice. More CTCA & MRI where it makes sense, less reliance on expensive nuclear studies just because theyโre easier to access. ๐ฑ ๐ฐ
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โ๏ธThe result? Overuse of insured tests, underuse of better ones with access barriers, & higher overall costs. Itโs not that doctors donโt follow evidenceโitโs that policy incentives shape availability, and availability shapes ordering habits.
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๐ฆด This happens outside cardiology, too. In suspected osteomyelitis, MRI is cheaper & better for most cases, yet we often default to nuclear bone/WBC scans, which are more expensive. Why? MRI time is rationed, but nuclear studies are easier to get because they can be billed by clinics.
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๐จ๐ฆ ๐ซ Take cardiac risk stratification in Alberta: MPI is widely available, while CTCA has long wait times. Why? MPI is insured under the SOMB, meaning private clinics can bill the govโt. CTCA, like all CT/MRI, is rationed by hospital-controlled slots. Policy, not evidence, drives access.
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โ ๏ธThe Real Reason ๐จ
Why do they really oppose renewables?
Not reliability. Not costs. Not birds. Itโs about fossil fuel execs protecting their wealth.
๐ ๐ฅ Meanwhile, the planet burns.
โก The good news? Renewables are winning. Letโs push for the transition faster.
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๐ข โThe govโt is picking winners & losers!โ
โก๏ธ Fossil fuels have been subsidized for decades (trillions globally). Renewables are just finally getting support.
๐ธ โLet the free market decide!โ
โก๏ธ If we did, renewables would already dominate. Fossil fuel lobbyists fight to keep their unfair advantage.
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๐ท โFossil fuel jobs will disappear!โ
โก๏ธ Renewables create more jobs per dollar invested.
๐ผ โOil & gas is the backbone of our economy!โ
โก๏ธ Fossil jobs are shrinking due to automation & market shifts, not renewables. Investing in clean energy = more long-term stability.
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๐ โWind farms are ugly!โ
โก๏ธ Beauty is subjective, but massive climate disasters are definitely ugly (and deadly).
๐๏ธ โTourists wonโt come!โ
โก๏ธ Studies show minimal or positive effects on tourism. Many places even turn wind farms into attractions!
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๐ก๏ธ โWe need fossil fuels for national security!โ
โก๏ธ Oil dependence = geopolitical risk (wars, OPEC, price shocks). Renewables = energy independence.
โก โThe grid canโt handle it!โ
โก๏ธ Grids need upgrades, but renewables improve resilienceโdistributed solar & wind = less risk of massive blackouts.
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๐ฆ โWind turbines kill birds!โ
โก๏ธ ๐ข๏ธ Oil spills & climate change kill way more birds. Also: windows, cats & cars kill millions more than wind turbines.
๐ โSolar & wind farms harm ecosystems!โ
โก๏ธ Compared to fracking, pipelines & oil spills? Come on.
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๐ฐ โRenewables will raise electricity bills!โ
โก๏ธ Wind & solar are now the cheapest energy. No fuel costs = long-term savings. Fossil fuels rely on huge govโt subsidies.
๐ญ โWe should focus on fossil fuelsโtheyโre affordable!โ
โก๏ธ Fossil fuel prices swing wildly. Renewables provide stable energy prices.
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โ๏ธ โThe sun doesnโt always shine! The wind doesnโt always blow!โ
โก๏ธ Diversified grids w/ wind, solar, hydro & storage solve intermittency. Offshore wind is very consistent.
๐ โWe donโt have enough battery storage!โ
โก๏ธ Storage tech is advancing fast and rapidly decreasing in cost.
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Didnโt you hear? The real issue isnโt a lack of biodiversityโitโs the rampant ๐ณ๐ฆ๐ท๐ฆ๐ณ๐ด๐ฆ ๐ณ๐ข๐ค๐ช๐ด๐ฎ of so-called โDEIโ programs that disadvantage hardworking monoculture grass lawns and cornfields. Wonโt someone think of the poor, oppressed Kentucky bluegrass?
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๐จ The real question isnโt โhow bad will climate change be?โ
Itโs: โ ๐๐ผ๐ ๐บ๐๐ฐ๐ต ๐๐ผ๐ฟ๐๐ฒ ๐ฎ๐ฟ๐ฒ ๐๐ฒ ๐๐ถ๐น๐น๐ถ๐ป๐ด ๐๐ผ ๐น๐ฒ๐ ๐ถ๐ ๐ด๐ฒ๐? โ
We ๐ธ๐ป๐ผ๐ ๐๐ต๐ฒ ๐ฟ๐ถ๐๐ธ๐. We ๐ธ๐ป๐ผ๐ ๐๐ต๐ฒ ๐๐ผ๐น๐๐๐ถ๐ผ๐ป๐. The longer we wait, the higher the cost.
๐จ๐ป๐ฐ๐ฒ๐ฟ๐๐ฎ๐ถ๐ป๐๐ ๐ถ๐๐ปโ๐ ๐ฎ๐ป ๐ฒ๐
๐ฐ๐๐๐ฒโ๐ถ๐โ๐ ๐ฎ ๐ฟ๐ฒ๐ฎ๐๐ผ๐ป ๐๐ผ ๐ฎ๐ฐ๐ ๐ก๐ข๐ช.
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โ ๐๐ฒ๐น๐ฎ๐๐ถ๐ป๐ด ๐ฎ๐ฐ๐๐ถ๐ผ๐ป ๐ฐ๐ผ๐๐๐ ๐บ๐ผ๐ฟ๐ฒ ๐๐ต๐ฎ๐ป ๐ฎ๐ฐ๐๐ถ๐ป๐ด ๐ป๐ผ๐
โณ ๐ช๐ฎ๐ถ๐๐ถ๐ป๐ด = ๐น๐ผ๐ฐ๐ธ๐ถ๐ป๐ด ๐ถ๐ป ๐บ๐ผ๐ฟ๐ฒ ๐ฑ๐ถ๐๐ฎ๐๐๐ฒ๐ฟ๐, ๐บ๐ถ๐ด๐ฟ๐ฎ๐๐ถ๐ผ๐ป ๐ฐ๐ฟ๐ถ๐๐ฒ๐, ๐ฎ๐ป๐ฑ ๐ฒ๐ฐ๐ผ๐ป๐ผ๐บ๐ถ๐ฐ ๐ถ๐ป๐๐๐ฎ๐ฏ๐ถ๐น๐ถ๐๐.
Meanwhile, ๐ฐ๐น๐ถ๐บ๐ฎ๐๐ฒ ๐ฎ๐ฐ๐๐ถ๐ผ๐ป ๐๐ฎ๐๐ฒ๐ ๐บ๐ผ๐ป๐ฒ๐:
โ
๐ฅ๐ฒ๐ป๐ฒ๐๐ฎ๐ฏ๐น๐ฒ๐ ๐ฎ๐ฟ๐ฒ ๐ป๐ผ๐ ๐ฐ๐ต๐ฒ๐ฎ๐ฝ๐ฒ๐ฟ ๐๐ต๐ฎ๐ป ๐ณ๐ผ๐๐๐ถ๐น ๐ณ๐๐ฒ๐น๐
โ
๐๐ฒ๐๐ ๐ฎ๐ถ๐ฟ ๐ฝ๐ผ๐น๐น๐๐๐ถ๐ผ๐ป = ๐ณ๐ฒ๐๐ฒ๐ฟ ๐ฑ๐ฒ๐ฎ๐๐ต๐
โ
๐๐ป๐ฒ๐ฟ๐ด๐ ๐ฒ๐ณ๐ณ๐ถ๐ฐ๐ถ๐ฒ๐ป๐ฐ๐ ๐น๐ผ๐๐ฒ๐ฟ๐ ๐ฏ๐ถ๐น๐น๐
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โ ๐ช๐ฒ ๐ฎ๐น๐ฟ๐ฒ๐ฎ๐ฑ๐ ๐ธ๐ป๐ผ๐ ๐ฒ๐ป๐ผ๐๐ด๐ต ๐๐ผ ๐ฎ๐ฐ๐
๐ฅ ๐ ๐ผ๐ฟ๐ฒ ๐ด๐ฟ๐ฒ๐ฒ๐ป๐ต๐ผ๐๐๐ฒ ๐ด๐ฎ๐๐ฒ๐ = ๐บ๐ผ๐ฟ๐ฒ ๐ต๐ฒ๐ฎ๐
๐ ๐ ๐ผ๐ฟ๐ฒ ๐ต๐ฒ๐ฎ๐ = ๐บ๐ผ๐ฟ๐ฒ ๐ฒ๐
๐๐ฟ๐ฒ๐บ๐ฒ ๐๐ฒ๐ฎ๐๐ต๐ฒ๐ฟ, ๐๐ฒ๐ฎ ๐ฟ๐ถ๐๐ฒ, ๐ฒ๐ฐ๐ผ๐๐๐๐๐ฒ๐บ ๐ฐ๐ผ๐น๐น๐ฎ๐ฝ๐๐ฒ
๐ ๐๐ป๐ฑ ๐๐ต๐ฒ๐๐ฒ ๐ฎ๐ฟ๐ฒ ๐ต๐ฎ๐ฝ๐ฝ๐ฒ๐ป๐ถ๐ป๐ด ๐ณ๐ฎ๐๐๐ฒ๐ฟ ๐๐ต๐ฎ๐ป ๐ฒ๐
๐ฝ๐ฒ๐ฐ๐๐ฒ๐ฑ.
๐ง๐ต๐ฒ ๐๐ฐ๐ถ๐ฒ๐ป๐ฐ๐ฒ ๐ถ๐ ๐๐ฒ๐๐๐น๐ฒ๐ฑ. ๐ง๐ต๐ฒ ๐ผ๐ป๐น๐ ๐พ๐๐ฒ๐๐๐ถ๐ผ๐ป ๐ถ๐ ๐ต๐ผ๐ ๐ฏ๐ฎ๐ฑ ๐๐ฒ ๐น๐ฒ๐ ๐ถ๐ ๐ด๐ฒ๐.
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โ ๐ช๐ฒ ๐ฑ๐ผ๐ปโ๐ ๐๐ฎ๐ถ๐ ๐ณ๐ผ๐ฟ ๐ญ๐ฌ๐ฌ% ๐ฐ๐ฒ๐ฟ๐๐ฎ๐ถ๐ป๐๐ ๐ถ๐ป ๐ผ๐๐ต๐ฒ๐ฟ ๐ฐ๐ฟ๐ถ๐๐ฒ๐
๐ฆ ๐ช๐ฒ ๐ณ๐ถ๐ด๐ต๐ ๐ฝ๐ฎ๐ป๐ฑ๐ฒ๐บ๐ถ๐ฐ๐ before knowing every mutation.
๐ญ ๐ช๐ฒ ๐ฟ๐ฒ๐ด๐๐น๐ฎ๐๐ฒ ๐๐บ๐ผ๐ธ๐ถ๐ป๐ด before knowing exactly who will get cancer.
๐ ๐ช๐ฒ ๐ฏ๐๐ถ๐น๐ฑ ๐ณ๐น๐ผ๐ผ๐ฑ ๐ฑ๐ฒ๐ณ๐ฒ๐ป๐๐ฒ๐ before knowing if next yearโs flood will be 1m or 3m high.
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โ ๐จ๐ป๐ฐ๐ฒ๐ฟ๐๐ฎ๐ถ๐ป๐๐ ๐ฐ๐๐๐ ๐ฏ๐ผ๐๐ต ๐๐ฎ๐๐
We might see ๐ฎ.๐ฑยฐ๐ ๐๐ฎ๐ฟ๐บ๐ถ๐ป๐ดโor we could hit ๐ฐยฐ๐+. And extreme weather is already exceeding predictions.
โ ๏ธ ๐จ๐ป๐ฐ๐ฒ๐ฟ๐๐ฎ๐ถ๐ป๐๐ ๐ถ๐ ๐ป๐ผ๐ ๐ฎ ๐ฟ๐ฒ๐ฎ๐๐ผ๐ป ๐๐ผ ๐๐ฎ๐ถ๐โ๐ถ๐โ๐ ๐ฎ ๐ฟ๐ฒ๐ฎ๐๐ผ๐ป ๐๐ผ ๐ฎ๐ฐ๐ ๐ณ๐ฎ๐๐๐ฒ๐ฟ. The worst-case scenarios are catastrophic.