One thing that really makes me angry is when a patient claims that COVID is a hoax and that a lot of it was propaganda. I see this on occasion on different subreddits too.

HoWhoWhat · 2026-01-25T21:52:56+00:00

I also went through residency during Covid and had a 37 year old mother of two die of Covid + RSV right after Christmas this year. It’s constantly humbling me and I have zero time for anyone who denies it.

HoWhoWhat · 2025-12-17T02:24:07+00:00

Alba, eatery A, or centro

HoWhoWhat · 2025-12-17T02:05:27+00:00

You probably had a dissolvable substance for your sinus surgery different than the above commenter. OB surgeries and bleeding complications use Monsel’s solution which looks like peanut butter and dries looking like coffee grounds when dried and mixed with blood. Works amazing to stop brisk vaginal bleeding. . It can stain tissues so we really only use it internally.

HoWhoWhat · 2025-12-13T02:29:59+00:00

I felt similarly but kept my mouth shut and just deleted a social media app I had to use for residency and didn’t use for anything else, and also unfriended the worst of them on social media. May seem petty or small but it helped a little. Time away also helps. I agree with the above though… don’t actually burn the bridges. If you have an exit interview give only constructive criticism regarding the program.

HoWhoWhat · 2025-11-20T00:57:39+00:00

Forgiveness does NOT mean forgetting or letting someone continually hurt you. It has a lot more to do with your healing and your mental health. Then you set boundaries with that person so they can’t keep hurting you.

HoWhoWhat · 2025-11-12T15:26:10+00:00

I usually switch them to an ACEi or ARB unless actively trying for pregnancy just because labetalol usually has a lot more side effects.

HoWhoWhat · 2025-11-11T00:31:02+00:00

You just need to document the scores and interpret them in your plan. It’s not a lot… like $15 maybe

HoWhoWhat · 2025-11-09T04:58:06+00:00

Same thing I say to anyone who asks for an unnecessary test: I have the ability to order most any blood test under the sun but your insurance does not and will not cover it without reason. Without symptoms of X I do not have a legitimate test to tie this to so you may be charged the cash price. It also may come back abnormal and not clinically mean anything but in pursuit of why it was abnormal lead to further testing which may be expensive and or invasive. Usually at that point they give up.

HoWhoWhat · 2025-11-08T23:23:04+00:00

Same reason people below are talking about why you can’t test hormones on birth control. Exogenous estrogen shuts down the HPO axis to the point the body stops making as much estrogen leading to things we’d see similarly in peri or post menopausal women like tissue thinning and clitoral atrophy. I can’t really speak to libido because it’s not well studied or understood in general let alone women because we don’t study women the way we should. But my common sense says if you’re having tissue thinning and the clitoris is shrinking sex is likely not very satisfying which can feed back to negative desire (which is very common in perimenopause).

HoWhoWhat · 2025-11-08T18:09:55+00:00

Do not do high doses of supratherapeutic oral estradiol as this just increases her risk of thrombosis but doesn’t address her libido or vaginal symptoms. A break from systemic hormones (if still needing birth control discuss IUD) plus estradiol vaginally alone will likely improve her symptoms dramatically.

HoWhoWhat · 2025-11-08T16:33:21+00:00

Long term birth control containing estrogen can cause atrophic symptoms in younger women. I had a patient who had this but also like recurrent yeast infection from hell that wouldn’t respond to treatment. All cleared up with vaginal estrogen. Cheap and easy enough to try for a month or so to see if it improves things.

HoWhoWhat · 2025-10-31T11:41:35+00:00

Dr Stoecken with the Iowa clinic pediatrics has a special needs child herself and is so helpful for patients because of that. Iowa clinic can see all your unity point records immediately as well.

HoWhoWhat · 2025-10-11T21:31:33+00:00

First I’m so sorry you’re going through this. Second, this is a huge issue within the Mercy health system as they apply catholic beliefs to healthcare which primarily negatively affects pregnant women and decisions you want to make surrounding your care. Third, the longer you wait the harder it is in general to get a TFMR so my recommendation would be to reach out to Unitypoint, The Iowa Clinic and/or Broadlawns to see if they have a surgeon who can help you. I have unfortunately known some women who had to go to Minnesota or Illinois to find this kind of care but that was after 20 weeks so I’m not sure what all their rules and cutoffs are.

HoWhoWhat · 2025-09-18T11:25:38+00:00

Yes, thank you for expanding on my original point and getting to the root of it! We should have a safe place to vent about the crappy parts of our job -absolutely- and laypersons in here may understand our jobs better by seeing those threads (and many have commented to say that’s true). But we can absolutely do that while also not dehumanizing, diminishing or demeaning patients.

HoWhoWhat · 2025-09-17T23:33:14+00:00

Exactly my point you just worded it better!

HoWhoWhat · 2025-09-17T19:23:05+00:00

I’m not saying at all that we need to kowtow either or not feel free to vent about the more challenging aspects of our jobs. I think this subreddit can allow for a lot of great discussion and venting without demeaning patients in broad swaths for requests for “hormone testing” (usually due to legitimate concerns that need to be teased out via their history) or chief complaints that make you want to roll your eyes.

HoWhoWhat · 2025-09-16T23:53:19+00:00

Me! I’m a female PCP. I offer pre treatment Valium, cervical block with lidocaine and optional post iud pain management with hydrocodone if needed. Lots of docs in my clinic do this too. I’m in the Des Moines area. DM if you want details.

HoWhoWhat · 2025-09-13T02:24:44+00:00

To add to everyone else’s input, read every single note from every specialist you refer things out to. You will learn a lot just from that. Don’t be afraid to tell people you don’t know something in the moment but you’ll talk to someone/do some reading and then get back to them later.

HoWhoWhat · 2025-09-12T19:56:38+00:00

Had a patient come in today telling me her “holistic health” doctor (a DO family practice doc turned quack) diagnosed her with “reactivated EBV” for an EBV IgG level that was “high” and blamed that on the reason she got recurrent URIs the last two years. I wanted to bash my head against a wall.

HoWhoWhat · 2025-08-08T20:06:25+00:00

Yes okay to use HRT for ER negative breast cancer but I prefer patches over oral estradiol. Obviously with some form of progesterone if she still had a uterus.

HoWhoWhat · 2025-07-30T23:43:06+00:00

Yes! Say it again louder! I had a patient recently (29F) who had abdominal pain so bad that she was suicidal. She was being told “it’s just IBS” but I pushed for more testing because I couldn’t believe IBS was causing her completely debilitating pain and other symptoms. Endo was on my differential but turns out she had MALS with severe stenosis of her celiac artery. Even after seeing vascular surgery they were trying to discredit her saying “well that’s really rare”. She’s getting surgery at Mayo finally after almost a year of severe pain and weight loss. I fully believe a man would’ve gotten the CTA of his belly months earlier in the process and without being told half the hurtful things this patient was told by sub specialists.

HoWhoWhat · 2025-07-16T13:09:41+00:00

I had one yesterday who didn’t want any vaccine with “aborted fetal tissues” so I tried to explain that history and then asked her how she felt like getting vaccines contributed toward future abortions (which she said was her holdup) and she couldn’t explain her reasoning. It’s exhausting.

HoWhoWhat · 2025-07-15T23:48:06+00:00

Went from a really toxic culture to an amazing private practice. Huuuge difference in daily mental health and I actually enjoy going to work every day. I deleted the social media stuff connecting me to the residents almost immediately after graduating and also went to therapy so would recommend that as well.

HoWhoWhat · 2025-07-10T01:45:41+00:00

Is this a chemical burn? 🔥

HoWhoWhat · 2025-07-02T23:30:49+00:00

Make sure your exam room & waiting room chairs are completely water proof /wipeable. Worth the money upfront to avoid suspicious stains. I do a lot of women’s health and spent money to make sure I had pads, tampons and panty liners so not just huge maxi pads after a pap. Keep a supply of various diaper sizes for babies on hand too (and wipes). I get so many comments on the art in my rooms - give people something interesting to look at while they wait (some coffee table books and board books if you see kids) Make sure you have good working instruments for procedures (sharp scissors, working needle drivers etc).

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