phaedrus441

This is interesting to me. I've done basically no configuring (except frequent use of a "site:reddit.com" lens) and it's been great. Now when I see Google or Bing results it's jarring how bad they seem.

This! I see this all the time in medicine.

Can't wait for the overpriced, late, outdated Oracle to get deployed at the VA! We get to go from one bad EHR to another...

I think you'll see this kind of thing in many professions. Some doctors, who are highly specialized and highly trained in their field, act like they should automatically be great at skills they barely have experience with, and then get frustrated when they don't immediately excel or when people with less impressive credentials end up being better at something.

My family member who taught flying to hobbyist pilots always said physicians were the most dangerous students because of their "know-it-all" attitude.

I completely agree. I've never read a 1-star (to me) book because that implies it's unreadable, and anything good enough to keep my attention room is generally 4-stars and rarely 5-stars. I bet if I look at my Goodreads it's 60% 4s, 30% 3s, and 10% 5s

Late to the party, but I know of at least two highly-paid coworkers that already had plans to retire, but are now just hoping for several months of extra pay (it's essentially the only situation where I would recommend someone take this offer-- if it works out, great for them; if it doesn't, well they were going to leave anyway)

This is such an interesting perspective that I've never thought about. Thanks!

This doesn't change the fact that bidets in the US are only in a vanishingly small percentage of homes. As an example, while not at all scientific, open up Zillow or Redfin and look at any random property and see if there's a bidet.

Wow I was surprised by this figure, so I tried to find the source everyone quotes. It appears to be a 2006 telephone survey of 987 randomly-selected voting age citizens that were then weighted for an underrepresentation of race (so perhaps not that accurate). Anecdotally, I work in a safety net hospital and it is really rare for someone to come in without ID, which is why those numbers seemed so surprising to me...

https://www.brennancenter.org/media/6697/download

I could easily have missed a better or more recent study, so if anyone has one please post it!

You honestly think there are 10s of millions of people wanting a decongestant in the United States without ID? This is ridiculous and I agree with the other commenter, a bit hyperbolic.

This article (and many like it) often mention how intuitive and speedy the Dept. of Veterans Affair EMR is. I can guarantee not a single one of these authors has ever used it. CPRS (the VA's EMR) is easily one of the biggest reasons physicians don't want to work at the VA, and most facilities have fewer patients per team (compared to academic or community hospitals) because of how much extra effort is required to use it. It is just startlingly bad.

I think you are mistaken: https://en.m.wikipedia.org/wiki/Shell_shock

"Shell shock is a word that originated during World War I to describe the type of post-traumatic stress disorder (PTSD) that many soldiers experienced during the war, before PTSD was officially recognized."

Highly recommend the recent Acquired podcast episode about Lockheed Martin. They spend a while discussing the development of the SR-71 (and other Skunk Works projects): https://www.acquired.fm/episodes/lockheed-martin

Interesting feedback. What apps do you prefer?

This looks great! Any other good recommendations like this?

Can you post a link to this study? If true, it's really interesting...

Thanks for this. Worked like a charm! (Though I am another user that switched to Fastmail and so far enjoy it)

Of course it has happened and probably will continue to happen. The key is that this isn't a systemic error, but rather providers going against the government's reporting rules (either mistakenly or intentionally). One could imagine mistakes erring in the opposite direction, though nobody is looking for that (nor would it be an easy thing to discover).

I decided to look into this, because I hear this bandied about frequently (i.e. "these death numbers aren't real because they count even if they incidentally had COVID-19"). Turns out, this isn't correct.

Here's the CDC site with that data: https://data.cdc.gov/NCHS/Provisional-COVID-19-Deaths-Focus-...

Here's the site with information about how a death is counted: https://www.cdc.gov/nchs/nvss/vsrr/covid19/index.htm

In short, for a death to be counted as COVID, it needs to be listed on the death certificate (which only lists diagnoses directly related to the death).

For example, when I write a death certificate (which is a standardized form), it sounds something like this: Cause of Death: Acute Respiratory Distress Syndrome as a Consequence of COVID-19 pneumonia

Guidance from my state (SC) specifically says: "The Coronavirus Disease 2019 or COVID-19 should be reported on the death certificate for all decedents where the disease caused or is assumed to have caused or contributed to death. The preferred term to use in the cause of death is COVID-19." So I can see possibilities where we don't know if it was the MRSA pneumonia superimposed on the COVID-19 or the COVID-19 itself, and we are supposed to report COVID on there, but the idea that a car crash victim would be counted in the statistics seems unlikely.

Patriot is an amazing show and I was looking for someone to post this clip!

Don’t forget Leslie’s original rendition: https://youtu.be/yyfMphjo4t4

Credit cards also provide a nice hack to allow cash deposit for those with only online banks...

Thank you, I had no idea about this! Going to seriously help me "deposit" cash since my bank's closest physical presence is two states away...

Just anecdotal data, but in both my roles as an academic hospitalist and community hospitalist in the US (inpatient internal medicine doc, ie the person that cares for people admitted with acetaminophen overdose if not sent directly to the ICU), I have only seen two cases of intentional acetaminophen overdose (both survived, amazingly) and have heard of an accidental overdose only once (my colleague admitted them; older man taking 8-9 grams/day for about a month because he thought he was doing the right thing by avoiding opiates for hip pain).

Compare that to the three alcoholic cirrhotics I am currently caring for (which is a fairly common number where I work), and I personally don’t think acetaminophen is a very big deal for most people.

Also, we (hospitalists in the US) certainly see far more bad outcomes from OTC NSAID use contributing to GI bleeds and heart trouble (I’d say I care for a couple/month on average).

Upside: there are very few indications for an MRI with contrast, and epidemiological studies have shown current gadolinium-based contrast appears to be well-tolerated (i.e. very low risk of nephrogenic systemic fibrosis in patients with renal failure). Downside: if an MRI protocol calls for contrast, then it’s necessary to use contrast to obtain the information desired (i.e. there’s often little use getting a non-contrasted MRI of the protocol calls for contrast but there is a contraindication).

You're correct. Routine EEG (~30 minutes) can capture active seizures and sometimes patterns that might lead you to think someone is predisposed for a seizure. Often patients need long-term monitoring ("LTM") where they are connected to an EEG for several days to tease out the source of their problems.

Thanks for inadvertently introducing me to Alan Booth. Just picked up a copy of “The Roads to Sata” because of this comment!

In the US, guidelines say people of average risk should have a colonoscopy every ten years, making your point even more salient. To give you an idea, regularly scheduled colonoscopy (ie every ten years unless higher risk) has a specificity of 86%, while stool tests performed annually are in the 90s (FIT is 96.4%, gFOBT is 92.5%)

Did you search for "PMS5003" on aliexpress? I found a few suppliers, and ordered one for $15.81 with shipping (4.9/5 rating; 156 orders)

Don’t neglect osteopathic graduates as well (though I’d imagine that is only several thousand more)

What are you talking about? Residents earn a salary (just google "XYZ university resident salary" to find it...). Medical school (which is prior to residency) is where the debt gets heaped on.

The biggest issue isn't domestic medical school slots, it's a lack of residency training slots (for which federal funding was capped in 1996). If more residency slots were available with adequate funding, these positions could easily be filled with foreign medical graduates that have passed the US's medical boards (USMLE steps 1 & 2, with 3 taken during or after intern year).