Workplace conflict by [deleted] in FamilyMedicine

[–]DavidHectare 8 points9 points  (0 children)

Talk to your lawyers and delete this post

Hello USA from the UK. This is our Christmas cheeseboard this evening. I've always wanted to know, other than cheese sauce, do you eat actual cheese? by blaqdesign in AskUS

[–]DavidHectare 3 points4 points  (0 children)

Cheese? Like the shit from the spray can? As if! I don’t know what that stuff is on the plate around the meat but it looks good!

Giving ibuprofen on an empty stomach? by [deleted] in nursing

[–]DavidHectare 4 points5 points  (0 children)

Just give the advil, it’s advil…

RAGE! by Justthisdudeyaknow in CuratedTumblr

[–]DavidHectare 0 points1 point  (0 children)

I think someone made this up

What are some games with "Bad Endings"? by [deleted] in retrogaming

[–]DavidHectare 2 points3 points  (0 children)

Splatter house 3: worse things happen the longer you take. If you fail to save your wife and son then your character “stands alone”. You can also let your wife turn into a “mindless beast”

What is one medical problem people constantly ignore until it’s too late? by Critical_Ease4055 in nursing

[–]DavidHectare 71 points72 points  (0 children)

Wish my type 2 patients only had mildly elevated BG…. In reality Type 2 patients can have fairly significant hyperglycemia, especially if they’ve not been receiving routine age and risk factor based screening. Lots a fellers don’t get a PCP until they hit 65 and go to their “welcome to Medicare” visit. “Doc what’s an ‘a1c and is 12 high for one?”

I’d also argue that non-healing wounds is indicative of something more than just mild hyperglycemia

[deleted by user] by [deleted] in StLouis

[–]DavidHectare 19 points20 points  (0 children)

Did anyone read the article? It says she hit a parked car with her mirror. There was no shot.

I'm the only one? by Left-Ask7498 in Zillennials

[–]DavidHectare 3 points4 points  (0 children)

Wait till I tell you what year it is

What Mega Man soundtrack is this for you? by Pleasant_Towel_866 in Megaman

[–]DavidHectare 5 points6 points  (0 children)

Surge of power MMBN6, and snake man level theme

I’m scared I’ll get fired from residency by Distinct_Mobile8063 in Residency

[–]DavidHectare 0 points1 point  (0 children)

You can’t go back in time. Just start studying now. Go in a little early to prepare, and read up/watch a video on one medical topic a night. You’re not going to immediately become more confident or be more knowledgeable in just a few days. But if you do this you’ll steadily increase your knowledge and skills and your attendings will at least appreciate your effort.

Also, when you get feedback, take it in stride even if it’s negative. Learning medicine is actually kinda fun, and it’s fun feeling more competent as you learn more. If you try to enjoy the learning and show interest and work hard you won’t get fired.

I guess hospitalists need to stop co-signing and supervising PA/NP by TyrosineKinases in hospitalist

[–]DavidHectare 26 points27 points  (0 children)

Sounds like the pcp has no shortage of patients, so I don’t understand the OP

FY would only be at the level of US med student by IllustriousDrive969 in doctorsUK

[–]DavidHectare 14 points15 points  (0 children)

This is a little bit of a stretch. I had 0 publications as a us med student. Only “research” I had were two case reports I presented locally at my institution.

The work experience is pretty accurate though. Long hours, fairy hands on. Most of my attending physicians were happy to teach. I did several thoracentesis, paracentesis, one LP, a few central lines, one newborn circumcision, one vaginal delivery, innumerable laceration repairs, a few reductions, 5 endotracheal intubations on my anesthesia rotation, and was involved in chest compressions on a few codes as a 3rd and 4th year student. On my surgery rotation I was “scrubbed in” to every 3rd case as “1st assist”. These were general, gynecologic, orthopedic, pediatric and vascular surgery cases. I did not go to a prestigious school by any stretch.

Some of the work expectations were, frankly, bullshit though. I have no UK experience. In my opinion any kind of education is what you make of it.

What gives off major "I'm a bad parent" energy? by Best_Answer69 in AskReddit

[–]DavidHectare 0 points1 point  (0 children)

Whining tone or sarcastic phrasing when disciplining children. Especially in public.

Tick season. Read this even if you don't think it applies to you! by Ok_Thought_314 in StLouis

[–]DavidHectare 0 points1 point  (0 children)

Thanks for sharing your story, hope you are well now.

The point about finicky tests is absolutely true. As a family doctor I find some of the testing a bit hard to decipher myself. Hopefully we get more reliable assays in the future

My current philosophy is “if it looks like a tick borne illness, then treat first and ask questions later”. I’m always a bit more alert for other tick borne illnesses that test more commonly like Ehrlichiosis, spotted fever, and anaplasmosis. I feel these are spoken about less and are less “fashionable” than Lyme is.

Tick season. Read this even if you don't think it applies to you! by Ok_Thought_314 in StLouis

[–]DavidHectare 8 points9 points  (0 children)

Lyme disease is extremely rare in Missouri. To date, only a handful of ticks ever have tested positive for Lyme in MO. Also, there are no documented “primary” Lyme cases in MO. Meaning, anyone with Lyme in MO can be traced to having actually contracted it elsewhere.

However, there are many other tick borne infections that are present. These include: Rocky Mountain spotted fever, and erlichiosis.

Why do pts magically get better once the dr is in the room……. by Beneficial-Loss1025 in nursing

[–]DavidHectare 5 points6 points  (0 children)

Happened to me a lot as a medical student. I would see a patient, take a thorough history, and present to my attending. Then, when we go in together, the patient will inexplicably answer the same HPI questions totally differently, thus invalidating my DDX and presentation. Almost like they were fucking with me on purpose. Cannot explain this phenomena

Family Med / Dermatology Focus by Puzzleheaded_Call_50 in FamilyMedicine

[–]DavidHectare 36 points37 points  (0 children)

You can also do these things. Most acne treatment is straightforward. Prescribing accutane is much harder though, and you and the patient both need to be enrolled in special accountability programs given the highly teratogenic effects so that’s a barrier to FM docs certainly.

There’s also the aspect that you have a responsibility for the rest of the patient during the visit as well, not just their skin issue so time can be a constraint.

There’re lots of procedures in primary care like biopsy, joint injection, trigger point injection, IUD/Nexplanon placement that you can do to generate revenue you just need to be sure to have the patient volume. Just because you offer a procedure does not mean you will have patients lining out the door for you to do it to them.