MR_Bulldops

Do you have an example that doesn't involve an objective metric? Of course objective metrics won't turn bad. They're more measurements than metrics, really.

Can you provide any proof of this?

Doctors, especially young doctors, are not the wildly greedy people you paint them to be. There are dozens of easier paths to riches these days than medicine and we all know it. My medical school is "cheap" and tuition + cost of living is ~$90k/year. Then, we have 3-7 years of residency before we start making the real money which is less than any generation of doctors in 100 years. I could become a senior software engineer at a Fortune 50 company in less time than it takes to graduate medical school and be better off financially than most doctors. Ask me how I know.

"But even a very small percentage of wildly greedy people can damage a system severely."

You are close to placing the blame in the correct place. My emergency department was just bought by a private equity group. There were 28 doctors. Most of whom worked there because they could spend adequate time with patients and work a reasonable schedule. After the PE company bought us, they mandated less of EVERY position from CNA to MD. The MD headcount is now 11, and the 17 physicians who are looking for jobs are having a tough time (relatively) because most other emergency departments in the area are also owned by PE firms who care about money over health outcomes. Those are the greedy people damaging the system you are looking for.

I have found the biggest commonality in otherwise intelligent Trump supporters in my life is deep-seated insecurity issues.

The second biggest is a life that hasn't gone how they had envisioned and, rather than take accountability, they blame anything but their choices. Though, I think lack of accountability is a symptom of insecurity, so it is wrapped up in the first issue.

Let's have a conversation about leaking tax dollars. How do you feel about our tax dollars directly enriching the sitting president? How do you feel about our tax dollars leaking into a military parade to celebrate the president's birthday? If you don't address those leaks, how can we be expected to take people like you seriously when you defend authoritarian policy as fiscally responsible?

Hey. I am not a migraine guy but a paroxysmal, full-body, painful hives type of guy. Like some migraine people, my symptoms eventually stopped happening after trying all sorts of things for years, and I can't say precisely what the "cure" really was. Or if I am not just in a 7-year-long remission.

Anyway, I experienced this fatigue you speak of. I am not sure this will help you since your fatigue appears to come from blood tests/medical treatments, but hopefully it helps somebody. What helped was when the suggestion was something I could do that was healthier/cheaper/more beneficial than what I was currently doing, I would frame it as, "This might not fix my debilitating problem, but it will improve my life in some way. So, worst case scenario, I'm in the green."

Examples (I am not suggesting these as migraine silver bullets, but I am trying to clarify what I mean):

- Someone in this thread mentioned cutting out xanthan gum and other thickening agents has helped. Will that cure you? Probably not. Is it a healthy lifestyle change? Probably. Why not try?

- I cut out processed food, which helped me realize that I was eating 1-3 frozen Trader Joe's meals per day. - I got an air quality monitor that made me realize the brain fog I felt at night was due to worsening air quality in my home. - I switched to unscented soap and laundry detergent, which was cheaper. (Artificial laundry scent now smells sickly and synthetic to me, which may be a downside.) - I set up reminders for change-by dates for furnace/car filters, vacuuming, dusting etc.

I don't know if any of this is why I don't experience symptoms anymore, but I don't regret any of it, and have long-term positive effects regardless.

Lastly, after several creams & allergy pills, I stopped getting my hopes up that anything would fix me. Expectation management is essential for avoiding fatigue.

Hope this helps you or somebody else. I am sorry you have suffered for so long.

Strava has (rightfully) received no blame, so they were accidentally right!

I had it done 2 years ago and started taking it for granted about 4 days after the operation. I have perfect sight with no complaints and almost never think about it.

I was 30 years old and wore -4.0 lenses.

It should inspire confidence that we have moved beyond that for many types of cancer. And if it can be done with cancer treatment, we are closer to doing it with autoimmune and anti-virus treatments.

I am here to restore your confidence about autoimmune issues.

Recently (and still in many cases) "turn down the immune system" was the treatment for most cancers. Of course, the purpose of anti-cancer drugs isn't to turn down the immune system. It just happens that the side effect of drugs that target cancer cells also target other rapidly-dividing cells like hair, endothelial, and immune cells.

In fact, chemotherapy drugs like Methotrexate are prescribed - at lower doses than for cancer patients - to people with Lupus and other autoimmune diseases.

There are similar challenges with cancer and autoimmune diseases, so progress in one might help progress in the other.

From the article: "They are now working to find ways to deliver these molecules safely and effectively to people." This is a challenge for many potentially effective cancer treatments as well.

"I presume." There is a famous saying about assumptions that applies to you.

I've been wrestling with this decision for a couple years now. I've slowly knocked off remaining pre-reqs, but haven't fully dived in - which would be leaving my job and becoming an MA or ED tech and doing dedicated MCAT studying.

I work for a tech company that you and your fellow classmates have no doubt used during medical school.

The massive financial hit is one of the big reasons I haven't made the jump. It doesn't feel fair to my wife to uproot our life. I always say if I won the lottery, I'd go to medical school.

Congrats on graduating and matching! I hope residency treats you well.

Going on an adventure and finishing back where you started is not a bad result.

Going on 2 years it's the best bed I've had. Completely silent and sturdy.

I did this last year and it was incredibly satisfying. If I amrunning errands and near a nursery I'll stop by and get a new plant or two. Slowly filling it in and watching all the nature is nice.

Our back yard is about 4x bigger, but I'll be tackling that shortly too! Our neighborhood is a mix of lawns, manicured landscaping, and natural gardens. Lawns are slowly becoming less frequent.

"beyond the desire not to introduce a plant or creature that would monopolize their environment"

That is reason enough to avoid non-natives and invasive species.

They reduce biodiversity making a habitat more brittle and boring. And they may spread beyond the bounds of your property, negatively affecting others.

Yeah, okay.

What's with the attitude? Do you think it's ED staff that created those training documents?

Do you think ER physicians who spent years jumping through hoops to get accepted into medical school, then spent 4 years in medical school followed by 4 years working 100 hour weeks for minimum wage as a resident do all of that so they can gouge patients for money?

Do you think RNs who jump through years of hoops and school, who sign up to help people during the worst times of those people's lives get off by upselling them on treatment?

There is a massive amount of misplaced vitriol toward medical providers that should instead go towards hospital admins and their profiteering ways.