I don't disagree with her on the linked discussion but man, she had a hell of a mental breakdown during COVID. And kept all the tweets pinned. Yikes.
CrackaAssCracka
joined 1 year ago
UK narrow boats and canals. YouTube figured out I like nerdy people being passionate and interesting about the nerdy things they nerd about. Do you think I'm gonna go on a canal boat tour when I go to England? You're god damn right I am.
Well shit, I grew one town over from there. Pretty sure that's right by our cliff diving spot on the Croton Falls Reservoir. I never went in it most kids in highschool knew some "facts" about that mine.
Fortunately CMS is rethinking the role of primary care and realizing we can save money if we're able to provide high quality preventive care like we're supposed to. PCP service payments (RVUs) are up 18% since 2020 which has been a long time coming. Unfortunately physician pay is down vs inflation over the last few decades but thank Christ administration salaries are way, way up over the same timeframe.
Reuters 10:09 ET 02/26/2024
UPDATE 1-Intuitive Machines stock plummets after moon lander tips over
Fantastic headline this morning
Just bought a couple of their 4oz coffees, thanks for the suggestion. The Gera Honey dark roast I have high hopes for since I hate light roasts but I don't really understand what the fuck they're taking about on their product pages. All I understood was dark roast so I'll giveit a shot.
And on the total opposite side from the neo-African coffee roaster you suggested, Harrio has the hipsteriest hipster pictured on the Switch product page. Instantly made me hate the product with absolutely no basis for that opinion. Interesting dichotomy of suggestions, 9/10 would look at again.
Schwab app works for me on Graphene and that's my main bank/stocks app. I've found I don't really need all my credit card apps or my other bank app. I check once a day if that and just keep a bookmark. It hasn't been bad at all.
Oof this is definitely wrong. A blood thinner is one of the most important things whether a patient is taking or not. It's the nurses job to let the doctor know whether the patient is compliant not only for medical reasons but for documentation. That's outside the argument about profit in healthcare in US, that's basic medicine. What if that patient falls and hits their head? Do we need to know if they're on s blood thinner? What if they're hemoglobin starts dropping? What if they need a procedure? What tif their platelets start dropping? Etc, etc, etc.
Don't be a dick and not do your job, that makes your coworkers miserable and puts people in danger especially in medicine. I agree with burlit being and issue and chronic understaffing but be an adult and quit or move positions if you don't like it.
What about the 19yo I saw today, with a BMI of 62, who's so far stuck in the cycle of self loathing, inactivity, depression, and pleasure seeking behavior that he can't see a way out let alone start creating himself a new reality? What if I have a drug that I'm pretty confident can help him lose 200lbs? Is it ethical for me to not prescribe it because "he should be able to do it on his own?" How many people do you know who have done that? Out of the hundreds or horribly obese patients I've seems, I have tow that have done it with diet and exercise. We have not evolved for a world where 20,000 calories costs $20 and is available 24/7.
I agree we need to be cautious with these drugs since long-term adverse effects aren't known but the long-term effects of obesity are well documented. I have backed off on pitching these drugs since I learned the companies making them have infiltrated the obesity research community in the US (because of course they did). They're still an amazing tool in the fight against an obesity epidemic which has many, many different contributing factors li ok e trauma, depression, mental health issues, upbringing, genetics, etc, etc. it's not as easy as "just don't eat so much."
It's not that CPR doesn't work, it's that outcomes after resuscitation usually aren't great. The study doesn't disclose ages or neurological outcomes post-rescuscitation so that limits my interpretation but quick rescue and quick CPR is key in those acute, single reason emergencies. That isn't to say in an emergency situation you shouldn't try especially since you don't know that person's wishes. There are good outcomes but usually for underlying healthy people who had one thing go wrong. Think the athlete who's heart stops on the field for some reason.
I've admitted at least a thousand people into a hospital through the ER and I tell everyone that it's not like on TV. If you're older, sick, multiple chronic diseases, don't take care of yourself, etc. the chances of any kind of quality of life after CPR is limited. Death is terrifying and I understand them wanting to try but it's just not realistic a lot of the time. We need better deaths in the US and more in-depth end-of-life conversations with our patients. That should be starting in the PCP's office. Trying to discuss that with a patient in the ER who's already scared isn't ideal. I've seen patients with do not resuscitate/do not intubate orders on file change their mind when they're suffocating and panicking then once they're more stable immediately change their mind back.
An opthalmologist is an eye doctor. They go to medical school and do a residency for extra training. Optometrists have doctorates in optometry meaning they do four more years of school after their bachelor's. They can call themselves doctor because in the US that's the convention for doctorate's (in Europe ony medical doctors use the term). There's avast difference in intensity, depth, bredth, etc. of training between the two. It's easy to miss the difference if you're not familiar with the system.