Alison galvan

@jimmybeansx @pgipe But then there’d be no one to sue when the shit hits the fan

@pgipe Also throw in the fact the doctor will spend AT BEST 5 min with the patient all day. If you ask me, the nursing staff could handle these patients all by themselves and do a better job at it. Yall think way too highly of yourselves

This has really stirred up the hornets nest of those with very little understanding of healthcare costs or basic economics, AI, etc-but LOTS of confidence. As usual on here, the dumbest are the loudest.

@JebraFaushay You know what’s coming? We are going to have to enter height and weight when we go to buy a plane ticket, let it calculate BMI, and over a certain bmi will have to buy 2 seats

South West airlines is singling out fat people and it’s not fair.

@dolores_road @telyhouse lol, my husband is a gen internist, just had a new pt. Physical exam shows hyperreflexia. He reviewed neurology PE from 10/25 “hyporreflexia”, then from 11/25 “dtr’s wnl throughout”. Worthless

@telyhouse Symptom + symptom + symptom + really weird symptom = diagnosis and treatment for the real issue. Reality: Symptom = prescription Symptom = prescription Symptom = prescription Really weird symptom = referral to neurology Neurology can’t find anything = rinse and repeat

What's the most unrealistic thing about House?

@violinjen8 @courtneyellis However, if you had several chronic diseases, see numerous doctors who you can’t get to call you back, are on 10+ meds, and no one can figure out what’s wrong with you, it may be worth it.

@courtneyellis That is a ridiculous amount. It is more than our individual deductibles and we do not see our PCP enough — only two to three times a year — for that to make one ounce of sense financially.

My longtime family doc in Nov: Exciting news! I am moving to concierge medicine! For an annual fee of $5,000 I can remain your primary care physician. (Sick visits extra.) My longtime family doc in March: So… I still have a few open spots, in case you want one.

@SaltyB15 @lady_dy_stl @TaraBull I utilized the neck pinch, or the one right behind the upper arm, over the triceps. Good times!

@lady_dy_stl @TaraBull My Mom always did the look accompanied with the Vulcan neck pinch 🤣🤣🤣 We would legit just be paralyzed with her staring us dead in the eyes with the look of death lmao

She has lost control of her 3 year old and doesn't know what to do

@gruntdoc @BrentAWilliams2 How did we get here? Primary care used to treat basic chronic ds, but as reimbursement dropped we had to increase volume to stay afloat. Can’t tx everything in a 10 min visit. So we started referring out even basic stuff.

@BrentAWilliams2 We agree, specialization improves treatment, generally. The biggest current problem is a serious lack of coordination of specialists and a 'bigger picture' for a whole lot of patients.

This is one of the dumbest posts that I've ever seen. Seriously. Specialization is one of the overwhelming strengths of American medicine.

@hfp91 @oatsdoc Used to be that way, all docs had each other’s cell phone numbers and would call and discuss patients. But I’m old, rarely happens now.

@oatsdoc Do you lot ever speak to each other ? What has happened to Local Medical Meetings where these issues are discussed & sorted ?

To my specialist colleagues, Please plz plz don’t order labs/imaging and then tell patients to “just follow-up with your primary care doctor to discuss.” He who doth order, doth interpret and communicate to patient. That’s the rule 🤝🤗

@AmiriKing We will all die one day, and have to go through a life review. Both men will have to relive this moment through the other’s eyes.

A bunch of blacks cut a Vietnam veteran in the name of black history month. Instead of giving them the reaction they want, the veteran tells jokes and introduces himself. You don’t hate these people enough.

@gorilla_rape I’m old, graduated med school in 1989. At that time anyone could get into a residency-maybe not your first choice of lication and specialty, but it was easy to get something! Not now, and it’s a travesty

this should be the biggest scandal in the country right now we cant allow the US to become something like the NHS

@olsonplanner Female physician here. When I was finishing residency I asked for a part time staff position, because I had 2 babies in residency. I was denied. Took a part time position at a private lab, 2 days a week. Maybe this is why I was paid less

Not surprised. But wow this sucks.

@Clutch_DWG @naomirwolf Baloney. In college my roommates and I managed to cobble together basic cheap meals. Red beans and rice with the recipe on the package of beans. Spaghetti with a jar of marinara and ground beef. Quit making excuses

I can see both sides. I've met people who didn't know how to cook, who had to work from recipes. They didn't have the foundation to be able to casually throw anything in a crockpot and know it'd be edible in 8 hours. They weren't skilled at meal planning or portioning. I mastered the 3 meals in 20 min thing a long time ago, but it's cause I know how food works. I've put out my "recipes" and coached a couple folks but they still feel overwhelmed. Maybe home ec needs to be two years, mandatory for all, and include real cooking not the BS my classes had us doing? I got a low grade for making juevos rancheros. "It's just eggs." Other students were making carrot cake from scratch. Guess who isn't 400lbs and still eats eggs....

I just do not agree with you. Rice and beans in a crockpot take the same amount of time as heating a frozen meal. Scrambling eggs takes 5 minutes. Slicing an avocado on toast, 5 minutes.

@nolapatriot3 @houmanhemmati Female physician here. Retired when youngest started kindergarten

@houmanhemmati And… medical schools have been doing this for the last couple of decades, & is why we have a doctor shortage. Many female Drs retire after baby #1, or part time schedules! Male Doctors work around the clock! You would’ve thought medical schools would’ve corrected this by now!

@houmanhemmati Damn! No blondes in this year’s class

@xereeto @crackpops @justalexoki @cmd_14_88 Reading these comments makes you realize women should lose the right to vote

@crackpops @justalexoki @cmd_14_88 i'm right. doctors prioritize a potential fetus even when the woman is not even likely to be pregnant. women are not treated as human beings by the medical system, but incubators.

i'm not gonna lie, women complaining about "having to take a pregnancy test" to prove they're not pregnant when seeking medical aid is not making women look good

@queenchonkula @DrDiGiorgio You don’t get it - getting the pregnancy test IS the standard of care. It is not an unnecessary test. Not getting the pregnancy test would be malpractice.

@DrDiGiorgio Ok. Doctor ordering unnecessary tests can be fraud. Different kind of court. Pretty sure your malpractice insurance doesn’t cover it. If you want a test to CYA then YOU pay for it.

Because of the medicolegal environment, everything is a hedge until it’s confirmed. Writing “patient claims X” gives the doctor room to navigate in court. Patients misremember things, they lie, or they are incorrect. Until we confirm a thing, we will always hedge.

@Spikels @chamath If you thoroughly investigate the patient chart, you will be able to find “malpractice “ after the fact. But patients and attorneys usually sue the wrong person

@chamath FYI - Malpractice lawsuits have little to do with a doctor quality. Doctors get sued because for subjective reasons like "patient rapport" or because they work in high-risk areas or on children. Lots of doctors get sued and doctors make lots of mistakes but it's not correlated.

is there a way to do a regression on doctor quality and mcat score? one could also look at malpractice claims vs mcat score as well...

@Melo_Malebo 73-year-old male, annual PSA mildly elevated at six (normal is <5). Treated with antibiotics, repeat PSA in four weeks. PSA increased to 11. MRI and pet scan show cancer with mets to nodes and bones. Bad Cancer moves FAST

Medical experts : how do people develop stage 4 cancer without noticing until it’s too late ?

@Melo_Malebo Never smoker developed hoarseness, work up discovered and enlarged lymph node, pressing on the nerve to the vocal cords. Diagnosis: small Cell lung cancer, meds to liver, lymph nodes, brain. The first sign of cancer was hoarseness.

@Iamjaneezy @Keystones943 @JDoza1 @CynicalPublius Repeat this when someone asks your opinion on reparations

@Keystones943 @JDoza1 @CynicalPublius Accountability belongs to the people who did the crimes and the systems that failed to detect it not to everyone who shares their ethnicity.

RE: Fraud in Minnesota I’m not sure that most Americans understand that in large swathes of humanity, there is no actual concept of “fraud,” particularly fraud against the government. Instead, there is a belief in the virtue of getting away with what you can to help yourself and your tribe. I spent a lot of my life in the Middle East and Central Asia, working closely with foreign contractors and foreign governments to provide support to American military operations. As a US Army officer with a big checkbook courtesy of Uncle Sam, I can’t really count the sheer number of times I was offered bribes to award a contract, or falsify records to do things like create larger (fake) headcounts at places like dining facilities, or to just simply be on the take for future illegal requests. Of course I had enough sense to never comply with such requests. Moreover, they were never explicitly structured as “bribes”; instead it was usually along the lines of “Here I have these Rolexes as gifts for you and your wife to show our friendship.” (Unfortunately, too many US officers and NCOs succumbed to this siren song and ended up breaking rocks in Leavenworth.) The weird thing about this to me was that whenever I turned down such an offering, it was treated as a grave insult. I was the one in the wrong, and not the fraudster trying to bribe me. They considered it rude that I was in their country and refused to accept how things got done. After all, why did I not want to help my tribe by helping their tribe? Let me repeat: in these cultures, FRAUD IS NOT EVEN A CONCEPT. There is only what helps your tribe. Such thought processes are so alien to Americans and much of the West. We are raised on the presumption that our institutions are valid, that the rule of law always prevails, and that integrity is universal. We need these presumptions to have working governments and economies, and without those presumptions—without the mental barrier that causes us not to accept outright fraud—our nation would quickly descend into the economic and social hellscape of countries like…. ummm… you know…. SOMALIA! So when we import people en masse from cultures that accept bribery and fraud as routine, acceptable ways to advance one’s tribe, we should not be surprised that things like the $8 BILLION fraud schemes of the Somali population in Minnesota happen so easily. Introducing a fraud-based culture based on tribalism into America is like introducing some sort of lethal virus into a population that has no natural immunity. The virus will spread and grow, unchecked, because it is so alien to the host. Similarly, a culture of fraud is anathema to American thinking, and it must be cut out before it consumes the host. So when you see and hear patriotic Americans decrying what is happening in Minnesota or elsewhere, and when they seek deportation of the offenders, it is not “racism,” it is not “bigotry,” it is not “xenophobia”; instead, it is preserving the American tradition of responsible institutions and national integrity.

@ThatEricAlper 2008 Crosby Stills and Nash

What's the favorite concert you're glad to have caught before an artist died/band broke up/key member left?