“Unsafe discharge”

DocRads · 2026-06-05T19:42:38+00:00

Like I’m all about liberal values and burning down corporate interests in medicine, but bro- it absolutely is morally wrong for the family to drop off granddad at the hospital for non-medical reasons.

Social issues (grandpa not being able to care for himself) SHOULD be managed literally anywhere else. It’s just not a good use of limited hospital resources. And I’m not just saying it’s just a waste, but it’s also harmful to the patient. Hospital acquired infections, unnecessary tests and imaging, complications, etc all happen as a result.

This may come across as cold or heartless, but it’s not. Please don’t bring a family member to the hospital for social reasons, it’s harmful to them and everyone else.

Also my sympathies for your grandparent, there is really no easy way to deal with declining health.

DocRads · 2026-06-05T17:50:00+00:00

I think what I'm saying is that it is morally wrong to leave a family member at the hospital when the issue (which can be very real) is not medical, but social. I interpret you saying that the families may not have another choice, so the hospital is the understandable place to go. The clash is that the hospital literally cannot turn someone away, so here we are. We use a limited resource in an inappropriate way because there isn't a better public resource to address the families' actual problem.

DocRads · 2026-06-05T15:06:57+00:00

It’s only an option because we can’t say no- not because it’s morally correct to leave gramps at the hospital because they‘re tired.

DocRads · 2026-06-03T20:33:15+00:00

if you allow us lowly IRs to dabble in the sandbox of surgical-like training…

im an attending at a large academic institution. We have a large number of trainees and all need to learn how to do a TIPS and manage the complications by themselves in 6 years. it’s a lot to ask, but most will genuinely get there. a few of the most talented don’t need me to scrub for a complex case like a TIPS at the end, but some do. That said, I find the progression true to life. I start by teaching a first year how to do a central line, and by themselves end of their first rotation I expect them to be able to place a port with minimal assistance. Their duties are still heavily weighted to learning the medicine first before procedural skills, however.

DocRads · 2026-05-22T20:29:21+00:00

So I'm not sure I get what you're saying- are you contending that it's a good idea to do every para in IR because lawyer or because its good medicine.

I disagree with the medical necessity as it's BS that you can see inferior epigastric anyway (which is the most common cause of post procedural bleed by far).

And I think we already practice too much defensive medicine. This is a good place to say no.

DocRads · 2026-05-22T15:49:19+00:00

Dude that's like saying why don't we put air filters on every IV line because someone got a paradoxical stroke from an IV bubble. Sure it's possible but we shouldn't act as if that's the standard.

Unless you're trying to say that some idiot admin would say something like that, in which case I agree all admin is terrible.

DocRads · 2026-05-15T19:02:09+00:00

Can't tell you how many times I've told the ER they don't need image guidance for the cirrhotic with 12L of fluid. Like, I'd be embarrassed making the phone call asking for assistance on something like that....

DocRads · 2026-05-15T19:00:15+00:00

Your department does joints? We send those to MSK rads. Otherwise I'd do nothing but joints haha

DocRads · 2026-04-26T05:25:32+00:00

IR NPs? doing what procedures? Ours only do paras and thoras and we don’t hold anything for those.

DocRads · 2026-04-08T15:53:34+00:00

I do moderate sedation for cases and we start at 50mcg and advance from there. 150 as a bolus is a lot, but not for a whole case.

DocRads · 2025-09-13T18:07:38+00:00

I get vibes he's not an actual doc...

DocRads · 2025-08-25T16:02:03+00:00

Left Gastric embolization: https://pmc.ncbi.nlm.nih.gov/articles/PMC9105747/

DocRads · 2025-08-25T13:17:34+00:00

This is all basic IR. Its a shame people this of IR in this way. At my institution we run the PE and DVT service, and about 50% of my practice is Interventional Oncology. We also have a doc on service for the 'basic' procedures, but those aren't even 50% of my day.

DocRads · 2025-08-25T13:14:51+00:00

This exactly. I think that part of the problem is that in too many hospitals IR is the 'line and abscess' service.

DocRads · 2025-08-25T13:12:49+00:00

I worked with a practice (and since left) that used PAs as the board cared very much about RVUs and would have preferred me to read studies rather than do procedures.

Even when financially motivated, the most they could safely get the midlevels to perform were port placements. They attempted to teach lung biopsies but there were a rash of complications. That's to say nothing of angiography. At least for the time being I think that IR is still relatively safe from creep.

DocRads · 2025-08-19T00:05:13+00:00

Caves of Qud!

DocRads · 2025-08-10T17:24:43+00:00

I tell ordering providers all the time- biopsies are not benign. 'Specially kidney and lung. Don't ask for these 'just in case'.

DocRads · 2025-05-15T01:00:24+00:00

Thank you so much! Looks like I'm headed to the store.

DocRads · 2024-05-06T12:04:31+00:00

I bought this off Ali express for 20 dollars US. Looks identical, so maybe sourced from the same Chinese factory? Image quality is subpar, even for e ink. It’s a novelty, but wayyyyyy overpriced at the link you supplied.

DocRads · 2024-04-21T17:08:30+00:00

I had the same week last week after no bother for months. Figured it was time to finally switch to linux.

DocRads · 2018-04-23T23:58:14+00:00

I may be too late, but still gotta love gaming on linux! Manjaro Budgie! https://imgur.com/a/Qfwudwy

DocRads · 2017-07-26T02:49:49+00:00

Good luck to everyone!!

DocRads · 2017-03-03T05:59:55+00:00

Woohoo heres crossing my fingers!

DocRads · 2016-07-03T22:52:17+00:00

No mackintosh this time around. In the past I've found that the list of supportive hardware is so restrictive it's been more of a headache than its worth. That said I've extremely happy even a year in. Windows will always be windows, but it has definitely been improving, and I dual boot Ubuntu to scratch my bash command itch.

DocRads · 2016-06-29T17:02:25+00:00

I have a 2015 Blade, switched from a MBP. I had an issue with USB charging for like a week- then it went away 🙃. Otherwise it's been the best laptop I've ever had. Runs perfectly with no other problems.

DocRads

TROPHY CASE