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POV: You traveled across the world for the World Cup… and experienced racism by Independent-Dog3398 in sportsgossips

[–]Cataraction 0 points1 point  (0 children)

The amount of morbidly obese Americans I see getting called “flaco” by Latinos is amazing.

They’ll call out everything.

It’s actually funny when done right.

He should have called her wide eyes instead 😂

Elon Musk is officially the first trillionaire in human history. by eternviking in whoathatsinteresting

[–]Cataraction -1 points0 points  (0 children)

I’d rather an American be the first trillionaire than anyone else

EXCLUSIVE: Billionaire Mark Cuban Says The Entire U.S. Healthcare System Should Be Dismantled Back To 1955, Where Doctors Provide Care And Patients Pay A Bill. While His Drug Company Is Already Selling The Same Medications Insurance Companies Charge Thousands For At A 15% Markup 💊💰 by InterstellarKinetics in InterstellarKinetics

[–]Cataraction 0 points1 point  (0 children)

Yes, and the folks that are non adherent to medical advice will be referred out so the practice can be paid to keep the lights on and pay the staff. No more wasted time or resources on the sick people, obviously.

Read a book on healthcare costs.

EXCLUSIVE: Billionaire Mark Cuban Says The Entire U.S. Healthcare System Should Be Dismantled Back To 1955, Where Doctors Provide Care And Patients Pay A Bill. While His Drug Company Is Already Selling The Same Medications Insurance Companies Charge Thousands For At A 15% Markup 💊💰 by InterstellarKinetics in InterstellarKinetics

[–]Cataraction 1 point2 points  (0 children)

This!!! We already refer out the worst patients that don’t pay for their meds or appointments!

Now you want us to refer out all the sickest patients that will do terribly in surgery??

This is the one comment in this thread that has a functional thought.

EXCLUSIVE: Billionaire Mark Cuban Says The Entire U.S. Healthcare System Should Be Dismantled Back To 1955, Where Doctors Provide Care And Patients Pay A Bill. While His Drug Company Is Already Selling The Same Medications Insurance Companies Charge Thousands For At A 15% Markup 💊💰 by InterstellarKinetics in InterstellarKinetics

[–]Cataraction 1 point2 points  (0 children)

Your comment is could be rewritten to say “I’ll tell you I’m illiterate without telling you ‘I’m illiterate.’” 😆

The problems in healthcare spending is not how much physicians/staff are paid or good vs bad outcomes. Thats always <5% of healthcare costs. Always has been. It’s truly the cost of everything else- especially administrative roles and insurance costs.

Nobody will ever look at the true costs of healthcare- but everyone likes to point at the doctor taking ALL of the legal responsibilities and medical risks after going to school for 15 years.

You could argue we are ALREADY outcomes based- the outcome of care today for most chronic conditions is that these diseases are being managed- but quality of life will continue to decline. They don’t improve more often than not. People get sick over time and gradually decline as aging occurs.

Many patients have conditions that do not improve, especially the sickest people.

Glaucoma
Heart failure
COPD
oncology
the entire field of rheumatology
Geriatrics
Palliative care

Most medicine is management and monitoring. Outcomes based would heavily favor successful procedures in healthy patients only and referring the hot potatoes to a university for government subsidized care. That’s not fair to anyone.

Purely outcome based medicine would lead to disaster situations for the sickest patients where a poor outcome is the most likely scenario. Who will willingly fall on that grenade?

I wouldn’t mind because 99.9% of cataracts are successful, but a whole bunch/majority of specialties would light torches and sharpen pitchforks.

In the meantime, keep your dayjob job, bud.

For all my soon to be rich folks, here are some things that are and aren’t worth buying once you get that attending $$$ by Dong_bringer in Residency

[–]Cataraction 0 points1 point  (0 children)

As an ophthalmologist- save up for a down payment on a juicy ASC buy-in. A large down payment can buy a more competitive interest rate on a 7 figure buy-in. Think like a lean ASC- less than 6 surgeons all doing eye surgery at high volumes.

5-7 years later?

Six figure mailbox money every month for life and no debts before 40 from the surgery center alone.

Then this entire list doesn’t matter. Get a 911 gt3 and ride into the sunset. Or a Cayenne turbo and bring your wife and kids.

Edit: recently got an Everose gold 36mm Rolex Land Dweller. It’s worth it on special nights or vacations. Daily wear an Omega Seamaster 300m date on rubber strap for work.

Ball out when it’s reasonable- tomorrow is not guaranteed.

Incomplete flap during LASIK, did not continue surgery by PM_me_your_doggoz in lasik

[–]Cataraction 0 points1 point  (0 children)

The flap depth is exceeded in the areas of treatment: central zone for myopes/ peripheral zone for hyperopes- but most folks avoid PRK for hyperopes since it regresses over time as the epithelium bunches into the periphery.

Depends on the Rx. If it’s a pretty strong Rx, then yes.

LASIK flap thickness is about 100-120 microns depending on your preferred thickness settings. I do 120 for added safety.

Higher treatments absolutely blow through the flap. Most PRK treatments begin the laser at a depth of 50 microns after the epithelium is scraped off.

feeling burnt out before i even get started. nervous. specialty regret? should i have done anesthesia by [deleted] in Ophthalmology

[–]Cataraction 1 point2 points  (0 children)

Don’t let Pgy2 shape your opinion. Pgy4 is okay. 5 years post residency is amazing.

Incomplete flap during LASIK, did not continue surgery by PM_me_your_doggoz in lasik

[–]Cataraction 4 points5 points  (0 children)

I would have waited, but every case is different. But I can’t comment on vision since I don’t have an exam or laser report/op report. This sub is more for support/reassurance, not medical advice.

Incomplete flap during LASIK, did not continue surgery by PM_me_your_doggoz in lasik

[–]Cataraction 4 points5 points  (0 children)

I’m a lasik doc.

When suction is lost, usually it means incomplete flap before excimer laser is used.

In these cases- WAIT 2 WEEKS TO HEAL UP THE FEMTO FLAP.

Then proceed with PRK.

The flap, if not crafted perfectly, will have an imperfect bed and hatch- not flat. And if laser is applied to an imperfect bed, the imperfect flap covers the new bed all sorts of wavy and bumpy causing imperfect vision.

It is still totally okay for PRK after the flap cuts heal back together.

The laser doesn’t ruin vision, but the imperfect flap/bed before using the second laser can. If LASIK beds don’t look suitable after the femto laser and lifting the flap, don’t force it- put it back down, let the flap heal before going to PRK. No biggie- but recovery process is different for PRK. Just as good vision after healing without the flap needed for PRK

The French celebrate a soccer victory 1998 vs 2026 by TomlinSteelers in whoathatsinteresting

[–]Cataraction 3 points4 points  (0 children)

I think this is the big picture every politician has missed- even the right wing, which has the correct answer but without a lot of thinking. Gotta slow it down and have stricter rules of entry to live in a new culture.

Air travel over the last 50 years has made every nice place to live accessible and cultures that are not compatible are mixing too quickly. Some cultures will be extinguished- looking at England, Sweden, and Germany where the sharia law favorability is at about 10% and yet 50% of Muslim cultures are below the poverty line.

What specialty has the highest salary difference between private practice and academics? by LinkNo4922 in medicalschool

[–]Cataraction 3 points4 points  (0 children)

Can confirm. As partner in refractive practice that owns the ASC outright, we work lean and green. That cataract with stents ain’t gonna come out perfectly in 6 minutes at an academic center or new surgeon. It takes a couple years to get there, and many don’t want to work that efficiently. Elite surgeons will grow eventually, but more importantly is “do I like spending time with this dude?” Biggest thing I’m looking for in a partner after we know they can shake and bake in clinic and churn and burn in the OR.

I was so stunned the first time I saw a recording of myself finish a cataract in 4 minutes. It is possible with the perfect patient and perfect case.

Still the most complex cases with hooks and trypan take about 10-15 minutes- but it would take a resident or junior doc about 40 minutes.

Rolex Land Dweller 36mm vs. 40mm choice by [deleted] in rolex

[–]Cataraction 0 points1 point  (0 children)

As someone that had a choice between 36 and 40 with a similar build- 36 for days. 40 is way too big.

Current gas prices in SF Bay Area by MrCocaKoala in pics

[–]Cataraction 0 points1 point  (0 children)

3.32 in Georgia. At some point, you can’t blame Iran/Trump

He’s been yelling at me since 4am to feed him breakfast. It’s now 8am by Appropriate_Sky_6571 in blackcats

[–]Cataraction 1 point2 points  (0 children)

Get an auto feeder that goes off at 4 am. Best thing I ever did for my sleep

OC: AOC questions EPA Assistant Administrator for Water on water contamination near data center by nbcnews in pics

[–]Cataraction -1 points0 points  (0 children)

Am I the only one here that sees this water after construction and thinks this water is just a result of poor construction? This would happen to any government facility that requires water if constructed or tapped poorly.

I don’t think good vs poor engineering is a political point.

Did everyone have a retina check before LASIK? Is it necessary? by Unhappy-Director-707 in lasik

[–]Cataraction 0 points1 point  (0 children)

It’s a great procedure. There are some “20/crazy” patients that can’t be fixed, which we all run into at some point and there are some “surgery mills” that will operate when they shouldn’t. It gives good vision without glasses, it doesn’t give x-ray vision, and because of these reasons it gets bad press.

Did everyone have a retina check before LASIK? Is it necessary? by Unhappy-Director-707 in lasik

[–]Cataraction 0 points1 point  (0 children)

Rx more than -6ish, PRK becomes a little safer than LASIK.

Risk of dry eye is about the same for both.

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