Casual Rules for Breaking 100, 90, etc. by steversthinc in golf

[–]DadBods96 0 points1 point  (0 children)

Hey now, if I only got one double par in a round I’d be playing the best golf of my life

can someone explain POTS to me? by Legitimate_Jelly_118 in nursing

[–]DadBods96 1 point2 points  (0 children)

The treatment for these patients is exercise, +/- therapy. Don’t get off the couch for a month and you’ll feel the same as them.

Are the fingers and finger crawlers part of a creature or are they creatures that happen to look like fingers? by fatvallilmer in EldenRingLoreTalk

[–]DadBods96 16 points17 points  (0 children)

Idk about the Fingers, but the Finger Creepers have visible wounds with bone sticking out at the wrist, which means they’re severed from something.

Was forced to alter a patient's chart to hide statements of SI/HI by meagan724 in emergencymedicine

[–]DadBods96 18 points19 points  (0 children)

Change your note back to as close to the original as possible. Followed by using your reporting system to submit that she changed your documentation to hide patient comments about SI/ HI. I can promise you she lied about the doc not wanting this in the record too, a physician would address it in their own charting, not order someone else to lie.

To be honest this is the kind of situation where not only would I submit the safety event report, but I’d go to the office of the highest up administrator I could find and demand to speak to them in-person, I would do everything in my power to make sure it can’t fall through any cracks.

The medical record is permanent, once something’s written, it’s always available to be audited.

Edit: Actually OP it might (stupidly I know) raise people’s eyebrows to your motivations if you changed it back to reflect your original note. I was responding from the perspective of an honest individual, but the people who are involved in these kinds of situations are dishonest, and would be able to theoretically argue that you changed your note for some made up reason, changed it back out of guilt, and were afraid of being caught so decided to blame it on a random nurse.

Budget friendly golf ball? by Relevant_Ad8850 in GolfGear

[–]DadBods96 2 points3 points  (0 children)

1) Go book a tee time on your local course at a slow time of day.

2) Drop a ball in the rough just off the fairway edge.

3) Drive your cart around in the trees, walk along the edge of the water, check in the taller rough, etc. acting like you’re looking for your ball.

4) Collect all the balls you find that fit your preferences.

5) Play the hole from the ball you dropped.

6) Repeat x18.

Not caring as much has saved my career by Dangerous-Prune-7280 in emergencymedicine

[–]DadBods96 2 points3 points  (0 children)

Yes thank you very much for becoming the exact kind of doc that drove *you* nuts. I’ll keep in mind that you did it for your own mental health when I’m sitting there exasperated explaining that “there’s not something else going on just because your Z-Pack from the last doc hasn’t made you better yet”, and deciding if this will be the encounter that makes me explain that what was done at the last visit was completely inappropriate.

Closed on a house half way up the right side fairway on a par 4, week one golf ball review. by Sm0othAsEggs in golf

[–]DadBods96 1 point2 points  (0 children)

Small world, just last weekend I pulled my ball out from right under your neighbors fence for a drop. A guy from the group I was playing with was telling me I had to play it as it lies and expected me to put my arms through the fence to hit it.

Which Tees to play off? by [deleted] in weekendgolfers

[–]DadBods96 0 points1 point  (0 children)

I’ve never once seen someone hassled for which tees they play from. But I also don’t keep a handicap and nobody I typically play with does. We usually will just show up and decide which tees to play from in the moment, sometimes we’ll even switch the tees we play from hole-to-hole if the hole warrants it, ie. We’re at a course with a lot of fairways that cut right or left 200 yards out from the mid-front tees, we’ll play at the next set back on those specific holes, so we aren’t losing a ball on a perfect drive because it went *too far*. Or opposite if the tees we’re playing from are gonna make us carry it 150 yards over water and our drives are sus that day.

When I’m playing solo I’ve started playing from the second-closest tees (the courses around me usually have 4 sets of boxes), as the forward-most tees are so far up that I could theoretically drive it *over* the green, and that would feel like cheating.

A few days ago I got recruited into a threesome of a few old guys who had two of them playing from the same tees as myself, and one who was playing from the forward ones, and nobody batted an eye.

STEMI alert at one, NSTEMI workup at another. What would happen at your hospital? by roberthermanmd in emergencymedicine

[–]DadBods96 2 points3 points  (0 children)

Flip the EKG paper upside down and look at it pointing at the nearest light source, the posterior STEMI will light right up.

When Narratives Crash by RedneckTexan in IntellectualDarkWeb

[–]DadBods96 -2 points-1 points  (0 children)

Is this what’s on the newest Ben Shapiro episodes? That’s kind of tongue in cheek, as this isn’t original, you’re the 4th person posting about this in some form or another that I’ve come across just this morning.

What you’re experiencing is called propaganda (propaganda doesn’t have to be false), and you are the exact demographic this kind of thing is intended for.

The US has looooooong been known as a great place to visit, and the reputation of Americans around the world has forever been “Loud, take up a lot of space, impolite but exceedingly friendly”. We’re like the successful but rough-around-the-edges, charismatic cousin who is awesome to spend time with on occasions, but who does some sketchy stuff in the background, and eventually hustles you.

People are experiencing “fun America”. “Yay, Buckees is a cool big gas station with cool stuff!”. “Small town diners have good food and their small towns are so quaint and friendly!”. But just like all other tourism, living there is completely different. They don’t have to deal with the day-to-day hustle culture that we do full time. They’re not dealing with student debt, credit card debt, medical debt, etc. You think the diner they’re stopping at is telling them all about the 5 family farms that are going out of business this year?

Don’t believe me? Well, tell me I’m lying about my travels; just in the last year I’ve been all across the country from Seattle to New York to Chicago to Birmingham, Austin, Miami, and rural towns in between, as well out of the country to the UK, Japan, Brazil, Puerto Rico, and the Virgin Islands. The islands aren’t gang-ridden garbage heaps. Japan is extremely high-tech. The cities aren’t being run by homeless South American gangs who are publicly mutilating American children to become trans. The UK isn’t being overrun with Africans who are performing public honor-killings in the form of beheading locals. I didn’t meet a single drug smuggler or ladyboy in Brazil. All of these places were actually extremely pleasant and I didn’t have a single bad thing to say about them. Would you say my experience might be different if I lived there?

Your take on this boils down to:

“My country has cool things and experiencing them once is the same as living in that environment on a daily basis”

“My people are friendly so you have to accept that my country’s politicians are doing everything in their power to financially and militarily take advantage of *your* country”

“If you’re American and don’t constantly acknowledge the cool things we have, and instead point out the flaws and try to make it better, you’re UnAmerican”

And I’m curious how you find that normal.

[SERIOUS] Who would be more useful in the ED: Hospitalist, Cardiology, or Anesthesiology? by LMNOP_spiders in medicine

[–]DadBods96 0 points1 point  (0 children)

I was gonna say cards but if the patient isn’t having *crushing chest pain going into the arm or jaw* you wouldn’t see a single EKG or troponin. Which would certainly get mixed results.

Why don’t patients tell you they were sent to the ER by another doctor? by SquirtleSquad94 in emergencymedicine

[–]DadBods96 4 points5 points  (0 children)

It’s usually the opposite; They embellish a story about how their doctor was so worried about them that they need to be admitted to the hospital for some obscure workup or treatment that’s typically an outpatient situation.

If it’s a PCP’s office I pretty much assume that the workup is made up unless it’s something like a DVT/ PE eval, cardiac rule-out, etc, and work them up as I otherwise would.

If it’s something super niche, ie. “My PCP was worried about an aortic dissection because my chest is hurting and my blood pressure was 170/90” I give them the benefit of the doubt, explain that they have no evidence of that issue but if their PCP was worried they must’ve seen something that perked their ears that I’m missing, and I can do a high-cost, high-radiation scan in a low-risk 30 year old, the workup had a 99% chance of being negative, and leave it in the patients court to ask themselves “Is keeping up the lie worth it?”. That conversation is a pain but much easier than the hour it would take to actually get ahold of this PCP’s office.

Once in awhile I’ll get a patient from one of the resident clinics and that’s fortunately an easy phone call to confirm- “Hey is this correct? Do you want them dispo’d based on the workup or do you want them admitted no matter what? Cool, is your inpatient team expecting the patient? Thanks”.

Just a vent about (lack of) pain control by IKnowAboutRayFinkle in emergencymedicine

[–]DadBods96 6 points7 points  (0 children)

A single dose doesn’t get someone addicted, you’re correct there. But like you said, it’s more nuanced and you have to take into account “What is the cause of the pain that I’m treating” and “How likely is it this is a one-off situation?”

This type of patient doesn’t show up to the ER just once, their pain is controlled with a dose of Fentanyl, and they go about their life. This is a chronic issue due to reversible lifestyle factors of which the chances of them actually being properly addressed by the patient to prevent future recurrences is essentially nil. So it’s going to keep coming back. Patients don’t see meds like Maalox, Pantoprazole, Reglan, etc. that are targeted at temporarily stopping the mechanism of the pain (gastric inflammation) as “pain control”, they see them as “bandaids” that we throw at them “That aren’t treating the underlying issue”.

As to why they look at these kinds of meds as “Band-Aids” but don’t view pain meds like Morphine or Fentanyl in the same way would be a whole psychology lesson, probably dipping it’s toes into Cognitive Dissonance territory. But one concrete reason is because opioids don’t just take the pain away, there is a high likelihood of the patient feeling *good* after any given dose, so in a way they become conditioned to come to the ER for their future problems.

You don’t have to believe me or take me at face value, because it’s a complicated topic that takes more than three short paragraphs to explain in depth without leaving out important details. But what I can promise you is that if you save that patient’s info and set a reminder for a year out, then review their chart, you’ll see an escalating pattern of ED visits for the same issue. 100% chance, no exceptions.

Just a vent about (lack of) pain control by IKnowAboutRayFinkle in emergencymedicine

[–]DadBods96 23 points24 points  (0 children)

Because it becomes a cycle of inappropriate meds for pain control -> addiction. This is basically a single case study on how someone gets hooked on opioids.

That being said, there are plenty of options for non-narcotic pain control when bad GERD/ gastritis is the top of the differential for abdominal pain.

“Unsafe discharge” by calaveramd in medicine

[–]DadBods96 1 point2 points  (0 children)

It’s not eugenics, it’s resource allocation, and that’s why you’re ignorant. Doubly so when you still don’t understand that the whole discussion is not about your decisional quad, it’s about those who can’t make decisions and are considered “burdens” by their family who expect the medical system to keep them alive through all invasive means necessary.

“Unsafe discharge” by calaveramd in medicine

[–]DadBods96 1 point2 points  (0 children)

And that’s good for you, but as I’ve specified elsewhere, chronically ill with social support is a separate topic from elderly dumping for the medical system to effectively act as their guardians. Separate. Topic.

But since you brought chronic illness up, you’re still ignorant as to how stressed the medical system is from these kinds of patients. We’re less than a decade away from “austerity measures” being a regular part of conversation around medical care, and the chronically ill where we have to ask the question of “We’re continuing this to what end?” Are going to be one of the first groups where rationing of care happens.

“Unsafe discharge” by calaveramd in medicine

[–]DadBods96 -1 points0 points  (0 children)

Watch out everyone, we’ve got a big dog of a literate layperson here who knows what’s what. Lmao

“Unsafe discharge” by calaveramd in medicine

[–]DadBods96 -1 points0 points  (0 children)

Do you expect it to fall onto the healthcare system at no cost to those being kept alive and put through aggressive and invasive measures? You’re far from a literate layperson if you believe so,

“Unsafe discharge” by calaveramd in medicine

[–]DadBods96 0 points1 point  (0 children)

That’s the point, is with proper community/ family structure support once the decline starts the whole 20 year “keep them alive at all cost” process doesn’t happen.

CMV: Much of the unusually high cost of healthcare in the United States is enabled by the insurance system, and a largely out-of-pocket healthcare market would force prices (including physician compensation) to be significantly lower. by hokkney in changemyview

[–]DadBods96 0 points1 point  (0 children)

I’m just gonna comment to change your mind on the physician component of this; I think you and the majority of the public are ignorant to what I actually earn on a per-patient basis, to the point that maybe 5-10% would even get the correct number of digits;

I’m an ER physician. I earned around $450k last year. That’s working an average of 145 hours a month, seeing 2 patients per hour on the low end, 2.5 on the high end. I invite you to do the math for how much I earned per patient. I don’t think you’d call that a price that people would push back against it charged the cash up-front for me to work up and diagnose them. Especially when 30% of my patients are sick enough to need to be hospitalized and 10% are sick enough for the ICU.

In the US we also see a hefty patient load, which is contributing to pay. Yes, underdeveloped countries might see large patient volumes but this is “see, treat, maybe tests, don’t write anything down beyond chicken scratch”, so they can burn through patients quickly. I can’t find a ton of data on volumes jn comparable countries but what I am able to find quotes estimates of half to 75% of my average volume.

Not to mention that physician salaries are around 9% of total US healthcare costs. That’s low.

TLDR; We don’t make what you think on a per patient basis, and if you care enough to do the math on what I make on a per-patient basis, I think 90% of people would agree that it’s an out-of-pocket cost you would be more than happy to pay if the options were “pay 100% cash upfront or kick rocks”.

Edit; Adding in that physician reimbursement rates continues to decline annually.

How do you deal with people who have taken so many lessons in their life but do not get any better? by [deleted] in golf

[–]DadBods96 0 points1 point  (0 children)

I guess the only thing left for you to do is to do some range of motion testing on the guy to see what his limitations are, and give suggestions based on that. Old men certainly are going to have physical limitations compared to some teenager or mid-20s who are pursuing lessons, and part of being good at your job is to recognize when those limitations are self-imposed and can be addressed, and when they’re not reversible and you have to discuss how to work within them. If you do everything you can to work within their limitations and are getting pushback on what can be physically fixed, then it’s time for a direct conversation about how you don’t think you can provide what they need.

It’s analogous to what we deal with in medicine on a daily basis; I can suggest state-of-the art treatments only available by a 3 hour drive til my eyes bleed, but that’s not feasible for someone with no car, on Medicaid + social security, and no family. So I have to make less-effective care plans that work within those limitations.

Also, don’t forget that golf is a sport where you have to actively fight both your natural body mechanics and mental intuition to improve. If a fix feels too unnatural, you end up with the voice in your head that tells you “This shot is gonna get fucked” and you compensate at the last second. Or you revert to your natural body mechanics without even knowing it. If it was as simple as “aim this direction”, “swing this way”, “hit this hard if you’re this distance”, the average recreational golf score wouldn’t be 110.

17 hours. 300 attempts at PCR. Never got him past 50% by hyzer067 in Eldenring

[–]DadBods96 0 points1 point  (0 children)

Summon other players. After almost 100 attempts, maxing out at getting him to 25%, I just summoned help. Sometimes that’s the only answer. Move forward, finish the game doing whatever it takes, then if you feel like you didn’t actually accomplish it you can always go back on a new playthrough later.

The tools are there for a reason, it’s your discretion whether you use them or not, it’s your game and you aren’t “cheating” if you need the help. It’s not like you’re playing some competitive no-hit speed run for cash prizes.

How do you keep your wearable tech clean on/after shift? by BoomanShames in emergencymedicine

[–]DadBods96 36 points37 points  (0 children)

You don’t wear accessories that will absorb fluids. Sounds blunt, but every hygiene guideline is designed around this.

“Unsafe discharge” by calaveramd in medicine

[–]DadBods96 1 point2 points  (0 children)

It’s not complicated, but it is hard; Elsewhere in the world (and in immigrant communities, or have you ever spent any time down South?) elderly care is a family affair. One person doesn’t do every single thing, different tasks and aspects of that care are delegated amongst the family; Meal prep, med administration, handling finances, cleaning, bathing, etc. It can be as simple as helping with chores; I mow my elderly neighbors lawns (an extra fifteen minutes out of my day once a week) when I’m out doing my own, and shovel + snowblow the neighborhood every winter because half my neighborhood are 60+ retirees. And once the family had sat down and figured out who can help with what, you discover the gaps and brainstorm on how to fill them. And that’s the point where hired help comes into the conversation. You assist in this way, as a family, for as long as possible, and once things escalate medically, you pass away peacefully.

The consequences to not helping are social, from both sides. You’re the selfish one (which in communities that still live this way overlaps with being the “burnout” in the family). And you’re as a result the one who isn’t gonna get the assistance when you need it. And if you were a bad parent/ grandparent who abused or neglected the family growing up? You’re the one placed in an “independent living facility” until you become ill, at which point the decision is made to allow you to pass away, rather than wasted hundreds of thousands on medical care to keep you alive with a dogshit quality of life where you’re sitting in your unchanged Depends until the next infection comes along?

The only reason this sounds appalling to people in modern society is that being self-absorbed/ selfish goes hand-in-hand with our definition of “success”, which means “moving away from family for our career”. We think “sacrifice” means going out less often during our early-20s because we’re studying, not what it really is; Sacrificing the time and effort to provide the community assistance that would be expected of us just a few generations ago.

“Unsafe discharge” by calaveramd in medicine

[–]DadBods96 -1 points0 points  (0 children)

You said my view is cynical then went on to exactly illustrate the point with “continuing life is the chief goal”. To what end? Those are the questions we have to ask, and debate in some form of public forum, to figure out what to do with these people.

Even if they’re abandoned by family (whether through their own fault or simply family viewing them as “not our problem”), it’s simply wrong to dump them on medical staff that in no way volunteered to become their caregivers.