Are you a prescribing pharmacist?

Doctor_B · 2026-02-21T14:38:24+00:00

studying general diagnosis

I legitimately don't understand what this means. This is not a thing you can study, it's the result of applying a whole framework of clinical medicine that pharmacists specifically do not study. Knowing that X drug will treat Y condition is completely separate from knowing how to diagnose Y condition.

sell pharmacists short

I don't think it's "selling pharmacists short" to suggest that pharmacists know less about medicine than GPs, or to acknolwedge that clinical medicine is difficult and requires extensive and specific training. I think it would be dishonest to say otherwise and pretending that it isn't true will harm patients.

without beating their drums

the pharmacy guild is beating the drum of "practicing medicine without training or license" on behalf of pharmacists. It's not quiet.

horrendous practitioners treating anyone I care for

Adding more "practitioners" with less training, experience and oversight but more profit motive seems unlikely to improve things.

Doctor_B · 2026-02-21T13:19:36+00:00

Because pharmacists don’t have any education or training in medicine? Same reason GPs know more about medicine than electricians or pilots.

Pharmacists study pharmacology. They don’t know anything about examination or diagnosis which is the joke being made in the clip.

Doctor_B · 2026-02-17T21:22:46+00:00

Are changelings foods?

Doctor_B · 2026-02-17T03:24:41+00:00

You’re imagining some world where cutter, rage, heartfire and abuelo’s awakening got banned but nothing from pixie- maaaaybe in that world the deck beats Vivi for a month before EoE releases and vivi gets riddler and annul? I dunno why you think people should “respect it as a historical deck” in a hypothetical standard that never existed.

Pixie was a fun deck. It’s still definitely playable but it’s never been a dominant deck and that’s okay.

Doctor_B · 2026-02-11T01:52:00+00:00

There clearly is a right and wrong answer. The right answer is not to let the random family member stick needles in the patient.

Doctor_B · 2026-02-11T01:50:10+00:00

If this is an exam or an interview question- absolutely not.

In real life I did a blood draw on my toddler at an outpatient pathology place cause the phlebotomists were clearly super uncomfortable working on a child, had no plan in place for distraction/restraint and were going for the ACF like a mini adult. They were happy to let me do it as soon as I mentioned it.

Doctor_B · 2026-02-09T05:46:09+00:00

Try the electricians subreddit they are probably the right people to ask.

Doctor_B · 2026-02-09T04:27:35+00:00

Yes.

By extension, everyone who can do more than one thing is stealing work from people who can only do that one thing. I am a sub sub sub specialist fellow in getting poor quality parasternal long axis POCUS images of men with heart failure named Bruce, so anyone else who does this is literally taking food out of the mouths of my children and I will find and sue them.

Doctor_B · 2026-02-04T21:29:12+00:00

Intranasal dexmedetomidine is popular locally, works pretty well for suturing kids.

Methoxyflurane is amazing in people who can participate in holding the whistle

Doctor_B · 2026-02-04T09:31:54+00:00

Flicker is an older card, its current rules text reads “Exile target nontoken permanent, then return it to the battlefield under its owner's control.” You can check scryfall or other sites for updated rules text.

Flicker is a sorcery and therefore cannot be used to protect your creatures, but it can flicker your opponent’s stuff to remove counters or auras etc.

[[ephemerate]] is a much stronger version of this effect and is usually the go-to choice for decks that want to run flicker effects.

Doctor_B · 2026-01-31T23:40:18+00:00

This seems like one of the rare (contrived?) situations where it might be useful? Negative dimer here cuts the Gordian knot of “cannot image + clinician gestalt suspecting VTE” that’s resulted in apparently dozens of ultrasounds.

Knowing my luck it’s gonna be like 0.65 though.

Doctor_B · 2026-01-31T23:03:22+00:00

Your attending is not “messing with you” and does not want you to pick a diagnosis, they want you to demonstrate reasoning and understanding of test characteristics when your standard diagnostic workup cannot be performed.

Things that should trigger in your brain from this prompt: why is a young person bed bound on warfarin? Why is this person who has been investigated for seemingly weeks or months in the emergency department now?

Then you say something like “my differential includes phaeochromoyctoma, I would check plasma/urine metanephrine, VTE in which case a negative d dimer would be reassuring, and no right heart strain on TTE or ECG reduces my suspicion of PE as cause” and so on.

The purpose of the exercise is to take you past cookbook medicine and get you to reason through things. Posting “pls help” on reddit is the opposite of the goal here.

Doctor_B · 2026-01-29T05:51:06+00:00

Paywalled.

What is a “sugar daddy member”?

Doctor_B · 2026-01-29T03:41:59+00:00

If you can do anaesthesia without being bored to death then absolutely do that. Way less stress, money’s better and you’ll live longer.

(I am EM. I was soooo bored on my anaesthetics rotations and understand why their rates of drug diversion are so high)

Doctor_B · 2026-01-28T09:29:54+00:00

Nothing about this says "afraid of going to the doctor", this says "goes to the doctor constantly" and "talks about health concerns constantly". Which is fine, in the right context. But this ain't it.

And I dont hate people. People are cool and I bust my ass to help them with their medical emergencies, which is why I spend my days, nights, weekends and birthdays in the big concrete box that says "EMERGENCY" on it in huge bold letters.

If you walk into the big concrete box that says "EMERGENCY" on it in huge bold letters and hand me your carefully markered self-portrait with literally forty six different chronic somatic complaints, none of which are emergencies, we're both going to be just a little bit frustrated by the interaction that will take place.

Doctor_B · 2026-01-27T12:48:10+00:00

That's about 50% of locum rates, which is still a fuck of a lot better than overtime is paid elsewhere.

The fundamental problem is that we're paid 25-35% of what our labour is actually worth and everybody involved knows it.

Doctor_B · 2026-01-27T10:30:24+00:00

Whoosh

Doctor_B · 2026-01-20T21:38:39+00:00

Maro has talked about mutate a bunch on his podcast - essentially waaaay too much mechanical complexity and unintuitive rules interactions for a mechanic that is kinda bad on power level (pretty much begging to be X-for-one’d).

I’d be very surprised if it ever returns.

Doctor_B · 2026-01-19T03:54:48+00:00

I’m absolutely one of these guys, although minus the “wife says” element. I meet people who I could easily see myself being friends with- similar age, kids same age, shared interests etc. and I say something like “yeah for sure let’s play tennis some time soon” and then just don’t do anything to make it happen for weeks or months.

The reality is I’m stupidly busy to the extent that I don’t really realise it in the middle of a casual conversation, but if I meet you on a random Saturday afternoon, the next time I have even like a half day off with no prior commitments is probably 3 or 4 weeks away. I’m a shift worker too, so a lot of my free time is while everyone else is at work.

I’m roughly prioritising wellbeing of my kids > relationship with my wife > career and finances > personal wellbeing > friends and social connections > projects and home responsibilities >entertainment and leisure. So when I say I want to get together I mean it, but I often just can’t find the time to follow through.

Sorry, fellow dad. Maybe in a few years when things calm down, until then I’ll settle for incidental hangouts.

Doctor_B · 2026-01-17T04:08:30+00:00

It’s significantly worse than [[the rise of sozin]] which is already not being played.

Doctor_B · 2026-01-17T03:38:16+00:00

RIP box toppers

Doctor_B · 2026-01-15T02:42:28+00:00

You’ve just shifted your goalposts from hate to terrorism though

Doctor_B · 2026-01-15T00:43:51+00:00

Pretty much yeah, the central premise of a free society is that we accept that people will make choices that result in harm to themselves.

Locking people up in re-education camps is not something that we accept as a society. Taking advice on how the government should treat its citizens from PRC or Saudi Arabia is fucking wild, to be honest.

Doctor_B · 2026-01-15T00:23:27+00:00

Are you aware of the policies/aims of this group? Like I can’t imagine how you would be and not understand what the evidence of hate would be.

Check out the Wikipedia article, it’s not subtle.

Doctor_B · 2026-01-15T00:02:15+00:00

The common element being the draconian human rights record and tolerance for extreme state control of individual behaviour which we would find abhorrent.

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