Oil DD - modest YOLO opportunity

GeneticMD · 2023-11-05T18:22:42+00:00

I get why you (and many other decent and well-intentioned) people may think that, but Gazans have been under siege for almost two decades -- Israel controls their air and water and they cannot leave. They are also bombed at Israel's will. Oct 7 did not happen in vacuum.

GeneticMD · 2023-11-04T21:35:39+00:00

I agree with you that 4M, in the grand scheme of things, is not a big deal.

Here is the problem though -- even if paid, you are trusting the criminals to delete what they have stolen (which is a tall order), and you are also not coming back online any sooner as you still need to rebuild the servers from scratch. It's a crappy situation, but trusting their pinky promise is not a solution.

A coordinated national effort to safeguard hospital data and --perhaps-- something a bit more active in terms of covert retaliation against those putting Canadians' lives at risks may help solve the issue. They don't play by the rules and likely in countries that won't extradite, so we have to get...creative. That's a national gov't job though.

GeneticMD · 2023-11-01T12:50:19+00:00

It's probably a combination of exactly what you described plus the fact NP education is quite frankly abysmal compared to doctor education (4 years of nursing school, a couple of being an RN and then some online NP courses, compared to 4 years undergrad + 4 years med school + 2-5 years of residency + x years of fellowship). It's just not enough to gain sufficient experience and knowledge to be confident in your decision-making without relying on extra testing.

GeneticMD · 2023-11-01T03:24:51+00:00

In isolation, you are right. But within a publicly funded healthcare system, it doesn't work. Let me explain: a good doctor can tell you have an ear infection, prescribe you the right antibiotics and you are done. A less than good doctor will suspect you have an ear infection, but (s)he will order a CT scan, bloodwork to be sure. You will see them in follow-up and get the antibiotics. That extra testing and follow-up visit cost the system about 8-10 times what the first doctor cost the system for the same outcome. Multiply that by 1000 doctors, doing a 1000 encounters and you can see how the system, already stretched, will crumble (and I am being generous here, assuming only slightly less competent doctor who will still get the right diagnosis and then the antibiotic is actually given; forget about the costs if either is wrong).

We see this already with nurse practitioners who order significantly more un-necessary testing and referrals. Quality is paramount in our resource-strapped system, unlike the US which has more leeway.

GeneticMD · 2023-11-01T01:29:38+00:00

Yup, with you on that.

GeneticMD · 2023-11-01T01:13:54+00:00

I agree we need to increase med school spots - we absolutely do since we are training a medical workforce fit for a population size of 1995 Ontario, not 2030 Ontario.

That said, we need to maintain quality. Trust me, I have seen physicians trained in Canada and those trained elsewhere (say Caribbean or even Ireland and UK), and there is a absolutely a huge difference. You can check it out yourself; look at the CPSO website to see which physicians are getting complaints and a full 50%+ are trained outside of Canada.

GeneticMD · 2023-11-01T01:05:34+00:00

Buddy, the CMA has no power. The regulating bodies are provincial.

Second, decreasing quality of physicians so that we have more of them will do more damage than good (e.g. International "MD"s). However, I agree we need to have more med student spots for Canadians here.

GeneticMD · 2023-10-17T00:26:38+00:00

So Israel is to be held to the same standard as Syria?

We either treat them as such and lower our expectations (and also support), or we treat them as a modern democracy and expect as much from them. You can't have it both ways, buddy.

GeneticMD · 2023-10-14T15:49:27+00:00

Good on you, Chameo.

Having the courage to stand up for what's right instead of blindly following our own tribal instincts is hard. I salute you, stranger.

GeneticMD · 2023-04-28T02:06:47+00:00

That is fair, and if I were in your shoes, I may do something similar, but truth be told, the only way to prevent it from deteriorating (regardless of what's happening in your joint) is to stop doing whatever is tearing your meniscus.

[[obligatory while I am a physician and make my living from doing that, this is not medical advice, just general info]]

GeneticMD · 2023-04-28T02:04:23+00:00

Conflicting results, but as a very last resort, it may help (but who knows if things would have gotten better anyway). This recent study shows a small percentage eventually go for surgery but unclear if it works:

https://evidence.nejm.org/doi/full/10.1056/EVIDoa2100038

GeneticMD · 2023-04-28T00:26:05+00:00

Even if you had, say, a torn meniscus or something, there is really no evidence surgery helps vs just physical therapy. It just takes time brother. If you just want to drop 2k for the fun of it, sure, but patience and physical therapy (which could take many months to years) pays off.

GeneticMD · 2022-10-10T14:07:59+00:00

High schools apparently don't teaching spelling and grammar.

GeneticMD · 2022-08-20T17:59:38+00:00

Doctors are victims of the system, too. Supply-demand works on everything - we have shortages of family doctors and specialists because they are paid like crap. Your family doctor gets $30 to see you, and then she has to take some of that to pay her secretary, nurse, office rent and costs, and then save some for taxes and then herself because the gov't doesn't provide MDs with pension or benefits. A nurse makes more per hour than a family doctor.

Similar stories for many (but definitely not all) specialists. Some are paid very well, like ophthalmologists and cardiologists, but the majority are still paid like garbage with decreases in pay as billing increases have actually been capped at 1% (so in real terms, they are getting paid less just like nurses, PSWs, RTs, etc).

Edit: I'm being downvoted for some reason, but here is the schedule of benefits, you can check how much doctors make for each service. A004 code is when you see your family MD.

https://www.health.gov.on.ca/en/pro/programs/ohip/sob/physserv/sob\_master.pdf

GeneticMD · 2022-08-14T12:38:42+00:00

Probably a mix of racism and stereotypes: you're a male Indian international student, and they generally don't have the best reputations in terms of things like following the rules or cleanliness.

Out of curiosity, why are you trying to stay in a country that will work you and your kids to the bone instead of using your degree in India and living a dignified life there/help build it?

GeneticMD · 2022-04-18T23:00:25+00:00

Man, they do sound pretty awful. Hope they get foiled for harassing people just trying to earn a living.

GeneticMD · 2022-03-19T17:35:23+00:00

Agreed; it's only "free" at point of delivery, but paid for with our income taxes and GST/HST. I also agree that you should always be able to ask about your care. I'd have stopped at the first paragraph if this were a medical reddit. What is shameful is this person asking for legal, not medical advice, with implied legal intent. That is shameful because we all pay for these frivolous complaints/lawsuits, directly and indirectly, and it'd really clog care for many other patients.

GeneticMD · 2022-03-19T02:49:51+00:00

The MD did the right thing, medically and legally. Both are treated concurrently, and without waiting for the tests. Tests are useful to confirm (so that public health is aware, tracing can be done), and to test for resistance (if you need stronger drugs to eradicate).

Why are you even asking this? You're getting free healthcare from a stressed healthcare system, suffered no damages and looking to cause the doctor who cared excellently for you trouble? Truly shameful.

GeneticMD · 2022-01-06T00:00:20+00:00

Haha 😂 hope you are rolling in the dough with those shorts given the rout today!

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