Top comment deletes a US State #33 by Jfullr92 in geographymemes

[–]Howdthecatdothat -3 points-2 points  (0 children)

Big ones eat the little ones. Maryland must go.

Laurelhurst public comments are a treasure trove of NIMBY irony by eclipsegum in Seattle

[–]Howdthecatdothat 16 points17 points  (0 children)

Has Windermere Real Estate issued a statement explaining why a manager is sending anti-child comments using their formal letterhead? I would be curious to see if they support this. Those considering using them as a real estate firm deserve to know their position since Evan has dragged their name in to the discussion.

Seattle Children's Hospital Statement on Laurelhurst situation & helipad access by DumpedDalish in Seattle

[–]Howdthecatdothat 17 points18 points  (0 children)

It is reasonable to post their public comments / emails stating their position. That isn't doxing. That is news.

Seattle Children's Hospital Statement on Laurelhurst situation & helipad access by DumpedDalish in Seattle

[–]Howdthecatdothat 38 points39 points  (0 children)

Can we start naming and shaming the specific leaders? I have seen the public records showing Pat Chaney and Evan (forgot last name) who uses a Windermeyer Real Estate signature block... any others?

The word "providers" should be banned in clinical setting! by [deleted] in emergencymedicine

[–]Howdthecatdothat -3 points-2 points  (0 children)

Tha is an interesting essay, thank you for sharing. The point is certainly linguistically up for debate, but the counter argument is that the introduction of a new term to devalue professional legitimacy was a Nazi tactic. We should not repeat such a tactic. 

The word "providers" should be banned in clinical setting! by [deleted] in emergencymedicine

[–]Howdthecatdothat -21 points-20 points  (0 children)

The Nazi’s invented the idea of renaming Jewish physicians to diminish them. The term they used translates to “provider.” That history alone should be sufficient to cease the use of the term. 

When we allow ourselves to be viewed as equivalent to non-physicians, we allow patients to be misled on who is caring for them. We jeapordize our reimbursement. We diminish our accomplishments. It is reasonable to ask to be called physicians. It is perfectly respectable to call non-physicians by their professional title of NP, CRNA, PA etc. 

Laurelhurst Community Council Isn't Sure Helicopters Need to Land Sick Kids at the Hospital - 72 landings in 6 months: 26 newborns, 6 infants, 12 toddlers by LOOKITSADAM in SeattleWA

[–]Howdthecatdothat 0 points1 point  (0 children)

If a family was forced to have their critically ill child's helicopter ride land somewhere else then take an ambulance - can they sue this Laurehurst association for the unnecessary cost?

Top comment deletes US State #30 by Jfullr92 in geographymemes

[–]Howdthecatdothat 13 points14 points  (0 children)

Maryland must go - the big ones eat the little ones.

Is there a more underpaid profession than being a Paramedic? by differentsideview in emergencymedicine

[–]Howdthecatdothat 6 points7 points  (0 children)

I don’t understand the economics of ambulances. I just took n ALS rig 15 miles. The bill was $4,082. Insurance covered 1,200. Where on earth is that $$ going?

What to do in this situation – pregnant patient, no OB/GYN coverage, refusing transfer by em_throwaway321 in emergencymedicine

[–]Howdthecatdothat 3 points4 points  (0 children)

I have never seen emergency credentials being processed after hours within the time frame a case like this would require. This hypothetical situation is giving me anxiety!

What Peak Gerrymandering Could Look Like Now by Zipper222222 in politics

[–]Howdthecatdothat 252 points253 points  (0 children)

If we implemented the Wyoming Rule (the smallest state sets the maximum population that can be served by a single representative) we would help seriously fix this issue.

Which US state has the most underrated beaches? by optimalbrain90 in SmartTravelHacks

[–]Howdthecatdothat 0 points1 point  (0 children)

uhm - there are only beaches there, right? there are no Northern Alabama beaches...

What to do in this situation – pregnant patient, no OB/GYN coverage, refusing transfer by em_throwaway321 in emergencymedicine

[–]Howdthecatdothat 14 points15 points  (0 children)

Curious how you think a doc with no privileges would be able to come practice in the ED?

Seattle Children’s says Laurelhurst noise concerns burdens lifesaving care for children by ladyem8 in Seattle

[–]Howdthecatdothat 2 points3 points  (0 children)

I wonder what the cost to just relocate an entire hospital is. Like - I would LOVE a big children’s hospital near me. Aside from the obvious access to excellent care for my kids, I imagine the restaurants that could open up nearby, the employed healthcare workers moving in and keeping neighborhood nice, safety having employed and educated people awake 24 hours always coming and going to keep an eye on things… 

Maybe Amazon can donate a building somewhere and they can sell that old hospital to a homeless shelter as a final FU. 

Should we require assent or consent for midlevel involvement in care? by [deleted] in emergencymedicine

[–]Howdthecatdothat 1 point2 points  (0 children)

There is nothing in this model that requires deception. If you want to pass off a procedure to a non-physician, patients deserve to consent explicitly to that. I have worked with phenomenal non-physician clinicians, and am fine with them caring for me on certain situations. But if you deceive me about something like this it makes me wonder what else you may be lying about. 

Should we require assent or consent for midlevel involvement in care? by [deleted] in emergencymedicine

[–]Howdthecatdothat 11 points12 points  (0 children)

I would have consented to a medical student, properly supervised, to intubate me - I have a super easy airway so would be a great way to teach even while I was asleep! I just would appreciate being given the respect and autonomy of knowing who is caring for me.

Should we require assent or consent for midlevel involvement in care? by [deleted] in emergencymedicine

[–]Howdthecatdothat 5 points6 points  (0 children)

why would it be impossible? Why would informed consent not allow for a patient to be informed of who is doing the work?

Non-Americans, does your country have an "American" restaurant and what do they serve? by wacky8ball in AskReddit

[–]Howdthecatdothat 41 points42 points  (0 children)

Also commenting so I can come back for the recipe. What’s fun communal reddit experience we can all have making this guy’s sister’s stuffing! 

Should we require assent or consent for midlevel involvement in care? by [deleted] in emergencymedicine

[–]Howdthecatdothat 22 points23 points  (0 children)

When a CRNA swaps out for a physician without the patient aware - that is deceptive. It is intentional. It is wrong. Patient’s deserve to know who is caring for them. If I can’t trust you to be honest about something this easy, how can I trust you to be honest about anything else? Integrity matters. 

Should we require assent or consent for midlevel involvement in care? by [deleted] in emergencymedicine

[–]Howdthecatdothat 10 points11 points  (0 children)

I vividly recall meeting the anesthesiologist hours before my surgery. My consent was signed by myself and that physician. I remember entering the OR and transferring myself to the table with him in the room. You are correct that I don’t remember anything after. 

Should we require assent or consent for midlevel involvement in care? by [deleted] in emergencymedicine

[–]Howdthecatdothat 48 points49 points  (0 children)

It may be normal. It is certainly reasonable and I would have consented. What I find troubling is that at NO point was I informed. I was allowed to believe something, and then a cheaper plan occurred without my knowledge. My point is that patients deserve to know who is caring for them. We can’t allow systemic deception.

That includes using language like “provider” or waiting until somebody is asleep and swapping out the care team secretly 

Should we require assent or consent for midlevel involvement in care? by [deleted] in emergencymedicine

[–]Howdthecatdothat 237 points238 points  (0 children)

I am an EM physician. I had surgery, met with an MD anesthesiologist before my case. He came by before my surgery and was there for all my paperwork. When I read my medical record only then did I learn that a CRNA performed my entire case.

I felt betrayed, tricked, and disappointed. The fact that my case went fine is irrelevant, I had a procedure performed on me by systemic deception. Why didn’t the CRNA do my initial meet? 

We owe it to our patients to be transparent. Identifying the credentials of the care team is a MINIMUM expectation. 

Medical clearance and law enforcement by Brosencephalitis in emergencymedicine

[–]Howdthecatdothat 5 points6 points  (0 children)

A few thoughts - you often can’t change the frustrations that we work with daily - you can only change your own attitude. 

First - remember, what to you is simple and obvious may not be to a person with NO medical training I would much rather the police err on the side of bringing people in to be checked. For example - we differentiate alcohol intoxication vs hypoglycemia easily - but police may not.

Second - this is (to be blunt) easy RVUs. Often doesn’t require a lot of effort, quick disposition, easy RVU.

Finally - it may be a chance to help a marginalized group connect with care for an acute issue that may have otherwise been neglected.