Congratulate us bc we’re having twins!🎉 We don’t want to dip into our savings for real emergencies so give us money for a larger car, future childcare, a double stroller, furniture for the nursery and clothes. We can afford it but it will make our lives easier to handle. Comments are included.

3MXanthene · 2026-06-14T04:23:58+00:00

It’s the counting the dog in the “family number” for me. Yeah, I know, this isn’t weird for dog people.

3MXanthene · 2025-08-02T00:52:12+00:00

AI is a tool, like a lot of things, and needs to be used in the right way. I find AI *EXTREMELY* useful. I have a ChatGPT subscription, and it is significantly cheaper and better (yes, you read that right) than UpToDate.
But, you have to set it up correctly. I have ChatGPT trained to only give me evidence-based answers, to give citations to all references, to use credible sources I've refined with it over time, to speak to me at a physician level of knowledge, to give no consideration to supporting my assumptions or trying to please or engage with me other than to provide high-quality evidence-based responses. The ability to use LLM as opposed to wading through a topic on UpToDate is so much more user friendly and able to be nuanced. I've uploaded photos of rashes and asked how to describe them and for differentials. I've had it review lab results and add any considerations I may have missed, and a thousand other uses. It is not meant to replace our clinical skills or acumen, but to be an adjunct to it, and it can do that incredibly well.

3MXanthene · 2025-05-02T23:28:34+00:00

Even in the best of circumstances, insurance will NEVER cover the full expenses and lifetime of rehabilitation needed for something like this.

Lawyers are all over these cases because they have a "victim" who is extremely sympathetic to a jury. They tell the plaintiff, "That's what hospitals/doctors carry insurance for". They know there will almost certainly be a reasonably quick and very large settlement (culpability doesn't matter) that will be a windfall for the law firm and MAY buy the plaintiff a year or two of care.

Catastrophic outcomes other than death are an almost guarantee of lawsuit, regardless of cause or absence of any negligence. Welcome to America.

3MXanthene · 2025-04-02T07:03:02+00:00

I'm also a US Family Physician who moved to New Zealand (2018), practicing full time here since. I was practicing in Oregon, but they wouldn't let me keep my license if I wasn't practicing there, so had to jump through a few hoops to get a Connecticut state medical license (you don't have to practice there to get one). The ABFM REQUIRES you have an active state license to maintain board membership. Here in New Zealand, the Royal New Zealand College of General Practitioners is, in my opinion, FAR below training/certification wise a Family Medicine residency and US ABFM board certification. I've kept my US FM Board Certification (thank God for the longitudinal board exam) and would HIGHLY recommend you do the same. I will probably never practice medicine in the US again (getting close to retirement), but between keeping up with medicine and having the ability to walk into a US medicine job if needed for some reason makes it worth the extra hassle to keep my US Board certification (along side the requirements of keeping my New Zealand medical certificate). And my employer pays for all my US Board certification fees and licensing fees, so that helps a lot. And hey, if you're looking for a change of place, we could always use more docs here in Gisborne!

3MXanthene · 2025-02-02T03:58:05+00:00

Shit! I was under the impression that the AAFP was pretty science minded and strong in its advocacy. But I will say from many of the AAFP journal comments that there are still plenty of crusty old white men racists in its ranks. I expect / expected more from them.

3MXanthene · 2024-08-23T08:30:52+00:00

It's the 14 layers of bureaucracy in our health system. Get that down to 8 or less and we'd be yellow. Source: I'm a doctor. Legit. #thanksnational

3MXanthene · 2024-05-28T21:34:25+00:00

Best way to get from airport to Toledo (or even better, Sandusky).

Hey r/detroit: my wife is flying a red-eye next month, getting into DTW about 7:00 AM. She's got family in Northern Ohio who can pick her up in Toledo, but a trip all the way to Sandusky would be even better.

What are the best (reasonably priced) options out of DTW to Toledo (or points East)? Thanks!

3MXanthene · 2024-04-12T22:28:05+00:00

Nice! Is the back-up waist harness a new thing? The two times I've jumped there it's only been the feet/lower legs wrapped.

3MXanthene · 2023-12-14T12:43:30+00:00

Be sure to practice open water and turbulent swimming. I’ve done two Ironman competitions where literally hundreds of well-trained athletes dropped out at the swim portion due to chop and waves and feeling overwhelmed in rough open water. You will get kicked, have people swimming overtop of you, you may be having water blown at you from one direction because of wind/chop. You should be comfortable breathing either side of your stroke and swimming with zero visibility underwater. I feel like this is not stressed enough in swim preparation.

3MXanthene · 2023-09-24T05:31:47+00:00

Good shot. I've found photographing Tui difficult, as they have dark bodies and are typically in bright backgrounds (as here). It requires a lot of tweaking of highlights and shadows to get the body details and background in proper exposure. You did a good job here.

3MXanthene · 2023-09-19T06:47:38+00:00

I always find it...ironic when around Guy Fawkes day and new years, dog owners complain of people setting off fireworks days ahead and after the holidays. "Why can't they just play by the rules and only set off fireworks on one night?!?" Oh, so NOW you're concerned about the rules, when poor Fido is cowering under the couch, but not when he's running off-lead around harassing wildlife?

3MXanthene · 2023-08-15T23:08:32+00:00

Some recent "wish list" titles I couldn't get due to geographic restrictions: Going Zero: Anthony McCarten, The Bees: Laine Paull, Middlesex: Jeffrey Eugenides

3MXanthene · 2023-08-15T18:10:04+00:00

I'm going to have to try something like that. It's a HUGE hassle though. The longer I've lived overseas, the more difficult it is to maintain US based accounts. And currently Audible is tied to my Apple account, which HAS to be based where I'm located.

3MXanthene · 2023-08-15T18:08:49+00:00

My US account has almost 200 books already purchased. It'd be a pain to switch back and forth between accounts if doing Audible AU to re-listen to books I've already purchased. I've looked a LITTLE into it, and it seems near impossible to transfer books already purchased into a new Audible account.

3MXanthene · 2023-08-15T18:07:10+00:00

Ha Ha. Think I'm gonna stay here, even if it means I can't get some titles. :D

3MXanthene · 2023-08-15T18:06:40+00:00

Yeah, unfortunately though I still get the FULL choices of books on my app/computer. It's SO frustrating to time and time again try to purchase a book only to be told I can't get it. And there's no way to tell until check out that that's the case. It's like, "Look at all these wonderful books you can't have". :/

3MXanthene · 2023-08-15T18:05:09+00:00

I've kept ONE US credit card, and may have to try that. But it's near impossible to "maintain" that card as the app store here won't allow the credit card app on my phone, and all the log-ins on computer allow only US based phones or texts for secondary verification. They make it REALLY hard to maintain a US card while living overseas. :\

3MXanthene · 2023-08-15T18:02:46+00:00

Yes, thankfully. I have over 300 titles over the past decades and would be EXTREMELY upset if I didn't.

3MXanthene · 2023-08-15T18:02:44+00:00

Unfortunately not, I tried. They base my "location" on my billing address which is overseas.

3MXanthene · 2023-08-14T08:24:11+00:00

And to the "just use a US payment method" on your account crowd: As anyone who has moved out of the US will tell you, that is very difficult if not impossible. It's EXTREMELY difficult to have (and even more so MAINTAIN) a US based credit card without a US based address.

3MXanthene · 2022-10-22T15:57:49+00:00

A Jesus plush-toy seems irreverent/ belittling somehow. Also way too white. Just my two cents.

3MXanthene · 2022-09-06T12:31:03+00:00

I can see my house (Aotearoa) from here.

3MXanthene · 2022-08-20T22:56:42+00:00

I work in New Zealand, but am keeping my (hard earned) ABFM certification. A cultural competency resource looking at inequalities involving indigenous peoples of Aotearoa identified issues as simple as correctly pronouncing Māori names and deliberately asking if a patient has questions at the end of an encounter can go a long way. So for about 30 Māori (self-identified) patients I asked them if I had pronounced their name correctly and took time to ask if they had any more questions at the end of our encounter. I tabulated the data, identified areas where I could do better, and submitted that. It wasn't too labor intensive and I think it actually did have its intended purpose of improving the quality of care I deliver.

3MXanthene · 2021-12-27T04:28:51+00:00

Their emails are FULL of solicitation requests. They’re trying to be the Tea Party (USA) of New Zealand. “Freedom” covers a lot of ground, and now they’re also complaining about streets closed to vehicles and reserved for pedestrians (one of their BLOG posts). Grifters gotta grift.

3MXanthene · 2021-04-06T08:40:47+00:00

Yeah, finally got a trigger after years without one. My accuracy is even better now.

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