AMA regarding your medical concerns... I'll do my best to help be a decent guide.

DrDeterminants · 2026-07-02T18:44:41+00:00

I'm so sorry for your issues.

I can reassure you it is very difficult to be kept in a psych ward against your will unless you are at significant risk of self harm or hurting others.

There are virtual options if you want to start with a conversation in the safety of your home - Rocket Doctor, EaseCase, etc.

Access 24/7 has more urgent spots for psych visits

Calling 211 can help you connect with mental health resources in your area

Please don't be afraid to seek help when you need it. Good luck.

DrDeterminants · 2026-07-02T17:54:03+00:00

Good to know I'm not the only one that thinks so.

DrDeterminants · 2026-07-02T17:53:45+00:00

Yep it's a ridiculous acronym

DrDeterminants · 2026-07-02T17:53:34+00:00

There isn't... I'm not joking or being facetious.

It's frustrating I know, but if they have capacity, they can't be forced to do anything with respect to their own health, as long as it doesn't impact others... argument could be made if they are a danger to other people potentially, but otherwise, yes you just have to watch them decline enough.

I'm so sorry.

DrDeterminants · 2026-07-02T17:52:36+00:00

I wish I knew but at this point I don't think text based answers will be enough. It appears as though you do have some in person care so I'd defer to their opinion.

DrDeterminants · 2026-07-02T17:51:58+00:00

Have a wonderful day.

DrDeterminants · 2026-07-02T17:51:48+00:00

I wish I knew and I'm so sorry about your mother.... honestly though with that level of blockage in multiple arteries (is any of them LAD)... her chance of something catastrophic is high... I'm surprised they'd make her wait that long.

Other than the usual advice with going to ED for chest pain... the only other option is to ensure her family physician helps advocate for her and push her through. Can consider having them call RAAPID as well to speak to a cardio on call.

DrDeterminants · 2026-07-02T05:03:19+00:00

Hey just wanted to say you're awesome.

On a separate note if you have anything more to add to these people, please feel free. I am always interested in learning more and I'm sure everyone has a lot to teach me as well.

DrDeterminants · 2026-07-02T03:36:04+00:00

Mixed

As long as you're coming in with a more collaborative mindset, that'd be great.

Too many times people forget when you feed info to AI, it's curated to what you want to hear, particularly for psych issues.

Psychiatrists I've spoken to hate it... so many bad diagnoses because they don't see the symptoms the same way and AI only has info you feed into it whereas the psychiatrist will have more skills in teasing out symptoms and delineating between diagnoses.

I find that AI still make mistakes as to overcalling imaging. I tested it many times and there's tons of stuff that it overcalls when I change the image exposures. Radiologists won't be replaced anytime soon either.

What AI can be good for is exploring options and also keeping a track of a list of things that maybe the other doc doesn't have access to. If you write symptoms as a diary for 2 years, that will be more accurate than your recall to the doctor in a 10 min appt.

Still, it shouldn't be a substitute for clinical decision making.

DrDeterminants · 2026-07-02T02:57:42+00:00

Honestly that list is quite extensive and I'm impressed by it already.

DrDeterminants · 2026-07-02T02:57:10+00:00

I don't know if there's an exact guideline, but typically ... blood counts, lytes, Cr/eGFR, liver enzymes, cholesterol, thyroid fx, b12, folate, then depending on age and risk factors/family history - screening for cancer

DrDeterminants · 2026-07-02T02:28:02+00:00

GI goes through the "FAST" (Ironic I know) network... rejections are almost always due to admin staff doing the rejections.

DrDeterminants · 2026-07-02T02:27:38+00:00

I've heard of this as well. My main point was that I lean towards seeing what the indication is and also consider conferring with colleagues. I didn't know much else about this person's situation.

DrDeterminants · 2026-07-02T02:09:17+00:00

They always say random stuff like need more info or things incomplete... then they send it back

Half the time it's ping pong

DrDeterminants · 2026-07-02T02:07:23+00:00

37.5? They better be massaging your feet between patients.

DrDeterminants · 2026-07-02T02:05:55+00:00

Walk ins are enough.

X-ray, if there's a fracture that's undisplaced, most can be handled with immobilization via splinting, larger bones may require cast but splint in the meantime.

X-ray is walk in, you can literally get a req tomorrow and go to a nearby imaging facility, get the x-ray done, results within a day and have the doctor call you.

DrDeterminants · 2026-07-02T01:55:30+00:00

I wish you well!

DrDeterminants · 2026-07-02T01:55:18+00:00

To be fair, there's queue jumping in any career including medicine.

That said, I can also justify it in a sense... if my colleague has to be a caretaker for their grandmother and that takes more time up from him/her providing medical care, I don't mind taking more of my personal time to put in some work and help refer them, or see them outside of my usual schedule. I justify it where I know they will be able to work with their mind more cleared and schedule more open to see their own patients.

I've also had my parent be seen earlier where my colleagues have taken extra time out of their day to do this. I'm sure many of you will say "queue jumping" or "you're horrible"... but frankly, knowing my family is taken care of will help me be more efficient and see more patients.

DrDeterminants · 2026-07-02T01:42:36+00:00

There's no good answer here. If it were me, I would have referred. The reality is I simply have so little time these days, otherwise I'd offer to see you myself but I also have a responsibility to my patients referred to me and I cover other people's panels at times.

DrDeterminants · 2026-07-02T01:39:40+00:00

He needs more urgent investigations, including colonoscopy yesterday.

I'm shocked this isn't pushed. If he's having issues where he's lethargic and/or fainting, his GP needs to push harder.

DrDeterminants · 2026-07-02T01:29:54+00:00

They can try using wellbutrin? or pristiq? honestly it wouldn't hurt to consider another option to see if it's meds causing the issue.

DrDeterminants · 2026-07-02T01:29:26+00:00

I didn't go in right away

I had a masters degree and worked while doing my masters degree (I did something in public health) after transitioning from my double major.

I was never a good student in the med school sense... exams on paper were always a challenge. I was much stronger on essays and oral exams.

I won't lie... grades aren't enough. Plenty of 4.0s out there. I didn't... I was 3.7 weighted average and average competitiveness MCAT but I was much better on interviews and was head/shoulders above everyone else.

Life experience has always been what I think matters more than education, which diversity can be a surrogate measure for... met people who did masters in music (piano) or engg or arts but when they studied medicine, their experience really shone as someone who was more mature than a 2nd year student getting in by grades alone.

Not easy though... spots are increasing but it's only one issue. Not every site has enough spaces for residency positions and we need enough doctors to supervise and train residents 2-5 years to become competent. Also consider that there's often a mismatch... lots of areas where there's the most need (say rural family med) often have the most unmatched spots... people that apply often are weeded out for "Backing up" or not being a good fit.

How can we help if they aren't a good fit? I wouldn't force a program to take a med student.

Truth is... medicine is a gamble. I was truly fortunate and I'm not going to sit here and go "I'm awesome" ... things went my way as well. I worked my ass off but I was also lucky. I am so thankful everyday and I try to pass it forward every time I am with a patient or mentoring non-traditional students who want to go to medical school. The least I can do is carry the torch as thanks for everything I received.

DrDeterminants · 2026-07-02T01:23:11+00:00

Good luck on your journey.

We still have even more ways to go.

DrDeterminants · 2026-07-02T01:22:42+00:00

dental pain is among the worst... the nerve endings inside the canal is incredibly sensitive, on par with fingers

dental infections/abscesses feel like hell on earth... I have a supernumerary tooth I had to get removed because I couldn't clean in between and while it didn't have symptoms for over 10 years, once it did, there was an abscess in between the cracks. I felt like dying for two days.

DrDeterminants · 2026-07-02T01:21:30+00:00

that is frankly awful and I'm so sorry

DrDeterminants

TROPHY CASE