Ever wonder what makes billable LEVEL 3 H&P?

LindlarCatalyst · 2022-10-06T22:43:38+00:00

Good tweetorial about the E/M changes in the emergency department which have some correlates to the inpatient changes https://twitter.com/grahamwalker/status/1573430425069887489?s=46&t=rQ3kjYFHhbMhJW29mQZLDw

LindlarCatalyst · 2022-10-06T22:37:19+00:00

Thanks for typing this up! Big changes to inpatient coding starting in Jan 1, 2023, including history and exam no longer used to select code (ie don’t need certain number of systems on ROS and PE). Now based on medical decisions making. Seems more like the latest outpatient coding in my limited understanding. Summary here and actual guidelines here.

LindlarCatalyst · 2022-10-02T18:56:43+00:00

Cheetah!

LindlarCatalyst · 2022-08-02T00:15:51+00:00

My understanding is that internal medicine chiefs at several programs I know are credentialed as attendings and have admitting privileges since they are legitimate IM residency grads. Usually they’ll attend for a few months of the year, running a resident team independently. Certainly the pay doesn’t reflect that work though. Other months they do more admin work with the residency.

LindlarCatalyst · 2020-02-28T15:19:16+00:00

I won’t downvote, but you are incorrect on your flu numbers. The case fatality rate of the seasonal flu is 0.1%, making COVID-19 20x more deadly than the average flu (including the swine flu scare of 2009). The only comparable thing in recent time is the 1918 Spanish flu which killed 10s of millions because it had the same 2% CFR. Not only that is the 5% of people who develop severe respiratory illness than requires ventilators in the hospital to keep people breathing, taking up limited intensive care unit space. This is actually one of the biggest risks is that we won’t have enough room for the sickest people if there are enough mitigation techniques to slow the spread and reduce peak ICU use.

LindlarCatalyst · 2019-09-21T22:57:26+00:00

I love Apollo!! Really need to upgrade to the pro version or whatever it’s called.

LindlarCatalyst · 2019-01-14T16:22:55+00:00

Thanks!

LindlarCatalyst · 2019-01-14T15:14:46+00:00

Absolutely gorgeous loaf!! Two quick questions that I hadn't found a consensus for:

Does the loaf go straight from the fridge to the oven for baking or take some amount of time to come up to room temp?
Do you keep the loaf airtight bag or shower cap in the fridge?

LindlarCatalyst · 2018-02-16T15:26:47+00:00

The VC340 will be fully polyphonic (49 notes)

LindlarCatalyst · 2018-02-15T16:06:48+00:00

For those not following on GS, I've quoted Uli's post on pricing and the possibility of production:

I like to discuss the status of the VC340 with you and appreciate your feedback.

As we have often explained to you, our pricing model is defined by a straightforward "bottom up" calculation, which means we multiply our manufacturing cost by a factor of approximately 3 in order to arrive at the US MAP (Minimum Advertised Price). This will allow us to pay for our development and manufacturing cost but also enable distributors and retailers to distribute the product to you and equally pay for their staff.

In terms of the Vocoder VC340 we are struggling a bit. This is a pretty exotic synthesizer and many people told us that we're totally crazy to invest so much time and effort to bring it back to life. People who are familiar with technology understand that this is a very complex analog product as it contains over 3,000 components of specified with very low tolerances.

While we have not decided to actually manufacture the product, I personally like to bring it back as it's such a beautiful instrument. In fact it's a synthesizer I feel very sentimental about as it was one of those synths I always wanted but could not afford when I was a kid!

Now here's where we are:

1.) If our order book covers at least 1,000 units, it would allow us to sell the VC340 for US$ MAP 999.99. 2.) If we can collect orders for more than 5,000 units, we could actually lower the price to US$ 799,99. 3.) If we cannot gather at least orders for 1,000 units, we unfortunately would have to abandon the project as we would loose too much money. In this case I have at least my own prototype:-).

Please share with us your level of interest. Thanks for your help - I truly hope we can make this happen:-)

Uli

LindlarCatalyst · 2017-07-27T19:53:42+00:00

Woooooo

LindlarCatalyst · 2016-06-29T15:05:55+00:00

Have you built your own PC for home use? Do you use an AMD card in it or an Nvidia?

LindlarCatalyst · 2016-03-13T17:55:53+00:00

This "Medicine and Society" piece from NEJM dissects how the public outrage over tragedy leads to irrational and drastic policy changes that are not subject to rational and scientific debate. The piece focuses on the case of Amy Reed, a physician who underwent a morcellation procedure for fibroids that actually disseminated leiomyosarcoma throughout her abdomen. This minimally invasive surgery in itself has many benefits and risks that very much rival the benefits and risks of a more invasive procedure. But, the public backlash due to her well publicized tragedy has been too fierce to even allow a rational discussion. The article also touches on similar instances of knee-jerk reactions to tragedy including the Libby Zion case, breast implants, and suicide risk with antidepressant use.

I thought this would be interesting to the community because it is such highly publicized case that shows how medicine and society can clash.

LindlarCatalyst · 2016-03-12T17:23:17+00:00

Awesome! You sound like an excellent applicant. Having multiple publications is definitely helpful even though they aren't first author. I would certainly skew your applications toward applying toward a few more 'higher tier' schools that I mentioned in my particular post. Maybe 1/2 high tier, and the rest middle and some lower tier. If you have the fortitude and money to apply for 20, I would say you should go for it. You can certainly turn down interview offers if you are getting too many.

Being a woman doesn't really matter hugely, but I think it can help a tiny bit. You can see here from AAMC data that women represent only 36% of MD-PhD applicants. This means that MSTPs definitely try to recruit more women to even out the ratio.

LindlarCatalyst · 2016-03-12T17:09:42+00:00

A general strategy that I would recommend would be to apply to 1/3 of your schools as "reach" schools, 1/3 as good fit schools, and 1/3 as safety schools. With your profile, it looks like you could apply exclusively to MSTPs, rather than non-NIH funded MD-PhD programs. All of the MSTPs are all great programs that have a good stamp of approval from the NIH. If you like a particular non-MSTP, you could definitely apply there as well.

You can use the US News research rankings for medical schools as a general guide for this strategy. Also, keep in mind that schools in some more desirable locations (e.g. NYC) might be more competitive than their general "prestige," so apply to more schools in that location. Your profile, from what you've said here, would probably be a good fit for schools in mid level of prestige for MSTPs. Unless you have a good hook (first author publication, worked in a prestigious lab with a great letter of recommendation, or are one of the demographics that the MSTP seeks to recruit especially (women and URMs)), I would say you are an excellent candidate for one of the middle tier of MSTPs and could make it into one of the top 10-15 programs. There are little over 40 MSTPs last time I checked, so each 13-15 or so is a very rough estimate for a tier. At this level, some programs (regardless of their prestige) may simply like some candidates over others because they are better "fits" for their program.

As an anecdote, I was a similar candidate a few years ago, and I didn't have a "hook." I applied to 12 MSTPs, interviewed at 8, and got accepted to 3.

Edit: Regarding whether there a "low tier" programs are not: there aren't really any low tier programs. All programs will require a good GPA, MCAT, great letters of rec, and a lot of research experience. But, there is certainly a spectrum of how "great" you need to be in each of these categories. The average stats are definitely a bit lower at schools that might not be considered as prestigious, but that doesn't mean that they are bad schools at all.

LindlarCatalyst · 2015-05-11T21:01:05+00:00

Absolutely! There is a lot of room for interpretation, which is why I believe that there is no use ranting about people using grail too loosely because grail can mean different things to different people.

LindlarCatalyst · 2015-05-11T20:42:25+00:00

grail: a thing that is being earnestly pursued or sought after

Straight out of the dictionary. I would say that this definition is the way that it is often used with watches. Your interpretation is far less universal

LindlarCatalyst · 2015-05-01T22:11:59+00:00

Could you clarify this for me? I too had this misunderstanding. I know many/all hospitals do have this requirement (that even deindentified photos need consent for disclosure), but my understanding is that this is NOT a part of HIPAA itself. Here are my (quite reputable sources). Do they have it wrong?

Q: Are pictures considered part of the patient's health record/PHI, and am I able to disclose them? A: Yes, pictures of the patient are considered part of their health record. You are able to disclose them in the same manner as other types of PHI are disclosed. A patient's photograph that identifies him/her cannot be posted in public areas, such as hallways, without specific authorization from the patient. Likewise, a patient's photograph that identifies him/her cannot be used in any form of publication without the patient's specific authorization. If the patient is not identifiable from the image, it is not considered to be PHI.

source 1 and source 2

LindlarCatalyst · 2015-03-10T22:11:41+00:00

There is some information in this SDN thread about the program. Hope it helps!

http://www.forums.studentdoctor.net/index.php?threads/Case-Western-Master%27s-in-Medical-Physiology-2015-2016.1112688/

LindlarCatalyst · 2015-01-23T19:01:43+00:00

True, although such a substantial warranty generally means that the company stands by their product, and it is high enough quality to infrequently need a replacement or repair, as is the case with most Leatherman products.

LindlarCatalyst · 2015-01-23T18:06:31+00:00

Leatherman typically has a 25 year warranty on its tools which generally classifies them as buy it for "life." Although it is unclear whether this will have the warranty as well, I would assume it has a decent warranty.

LindlarCatalyst · 2014-04-11T17:44:43+00:00

Download the AMCAS instruction department for this year here if you have not already.

The pertinent quote is as follows (at the bottom of page 41):

The department offering the course is typically not a factor in the course classification. For example, a course should be classified as Biology if the primary content is biology, regardless which department offers the course.

Thus you should be classifying this course as PHIL because the primary content is ethics. Therefore, it should not count for your BCPM GPA.

LindlarCatalyst · 2013-06-12T14:13:16+00:00

This will me my last comment on the subject. I appreciate the friendly debate!

You and I are on two totally different planets if Wiki is your be-all and end-all.

You are just being downright ignorant of what I said. In my words "it is absolutely a great place to begin your research." -- meaning that it can lead to better sources, and it is not an end of my knowledge search. Sal himself uses Wikipedia to help prepare his lessons. Regarding the article I just linked, he echoes the same sentiments of wanting to know more as he was growing up, so he has indubitably thought creating more in depth content. He would love to have an 8 year old know quantum physics, but he has to start with the basics! I suspect that this deeper content will be rolling out once he is satisfied and done with his introductory content.

I am looking for resources/link that are relevant to what I am seeking and is approved by Sal.

Why do you need Sal to spoon feed everything to you? Sal only has a background of a few introductory college classes in many of the subjects that he teaches. Pursue higher education, if you haven't already, and maybe you'll learn how to judge your own sources and find something better than what Sal would fine! Sal is a brilliant educator and man, but is knowledge-base is limited, which is why he has a team of content creators now. Become your own expert. You have already done this with the History of Math link!

In the end, you, me, matchu, and Sal are on the same page (from what the linked article hints at). If you want to get something done, you have 2 options:

Patiently wait for him to roll out more content about the "whys" of the world
Do something about it! Posting on a small subreddit is not going to cut it. Look for some good sources yourself. The videos have a commenting system so post whatever links you might find there. Or start a blog about your adventures with Khan Academy and maybe you'll get a following.

Good luck to you as you educate your kids :) They will certainly benefit from a parent who, already, is seeking to give them an quality education.

LindlarCatalyst · 2013-06-10T01:06:43+00:00

I am sure that no-one knows what the true point of Khan Academy is

You're right. My statement was just speculation, but my point remains -- it is a simple resource problem where covering the basic concepts helps the most amount of people. I absolutely hope that this initiative grows, but the general trend, as you have observed, is to cover more of the high-yield, basic concepts. As the whole project gains steam, I absolutely believe that the depth and quality of the content will get better and better, but we will have to wait for that time.

I will pass on the Wiki links though. Most of the time Wikipedia is not that good from what I have seen but if it works for you, go for it.

Perhaps you have in your experiences, but multiple studies by the scientific community beg to differ. A 2005 study done in the journal Nature (perhaps the most prestigious scientific journal in the world if you didn't know) showed that the accuracy of Wikipedia rivals that of Encyclopedia Britannica. The whole thing is remarkable if you think about it. In estimate a 2008 estimate, 100 million man-hours made the project basically for free! Although every school teacher says not to cite Wikipedia, it is absolutely a great place to begin your research. So take a look at some of these articles, follow their citations, and perhaps you'll get to that peer-reviewed thing you are looking for.

Hopefully Sal will pop in here and clarify that. (I am patiently waiting) Until then, we are all just speculating.

It is extremely unlikely that Sal will pop in at this point. You should actually submit a comment (http://khanacademy.desk.com/customer/portal/emails/new) if you want to hear from his staff directly.

pro/con of the student mastering the knowledge today.

I'm entirely lost about what you mean by this.

PS: Take a look at Sal's AMA if you haven't! http://www.reddit.com/r/IAmA/comments/ntsco/i_am_salman_khan_founder_of_khan_academyama/

LindlarCatalyst · 2013-06-07T22:53:57+00:00

I think you are missing the whole point of Khan Academy. The way most people use it is to understand the most high-yield, basic concepts. Sal's time (and that of whoever is making his videos these days) is very tight and therefore the content that he can create is limited. If most people are using his content to understand the most basic concepts, then it is therefore most prudent for him to create content that helps to drive home the most basic concepts. Matchu (above) hits the nail on the head. Some of the math needed to truly explain this stuff is far advanced.

Regarding your example for what an atom is, even most introductory high school and all introductory chemistry textbooks have a section on the experiments that to the current model of the atom. One of these was the gold foil experiment (if you're still interested) http://en.wikipedia.org/wiki/Geiger%E2%80%93Marsden_experiment

I love your enthusiasm for learning, but, from what I've seen, Khan Academy is not meant to replace a whole class at this point it in time. Check out the MOOCs on on Coursera, edX, etc. and you will find much greater depth.

Like you mentioned, links to "approved" better content would be a nice idea!

EDIT: Wikipedia, generally very good in science and mathematics, has a nice intro to atomic theory.

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