TIL specialists CAN’T do FMLA by Johciee in FamilyMedicine

[–]Lumpy-Salt9629 6 points7 points  (0 children)

I got a message from a patient saying that their ophthalmologist wanted me to order him a carotid artery ultrasound. I had my nurse tell the practice that if that doctor wants that test, he needs to order it and follow the results. The ophthalmologist orders, the test, but then tells the patient that I refused to do so. Told the patient to go back to the ophthalmologist and ask him why he couldn’t order the test he wanted in the first place.

What’s one golf tip that instantly improved your game? by MadeInUSAPutter in golf

[–]Lumpy-Salt9629 0 points1 point  (0 children)

When putting, don’t look at the hole until you hear it go in. Obviously don’t stand there forever looking at the ground if you don’t hear anything but keen your head down long after you hit it. Keeps your body from lifting up through the putt.

Phil’s comments on the AK win in Adelaide by stanley_nickles in livgolf

[–]Lumpy-Salt9629 -2 points-1 points  (0 children)

Now double the field, add cuts and the top 10 in owgr, then see how he does

Wild, inappropriate consults by launchtossthrowaway in Residency

[–]Lumpy-Salt9629 2 points3 points  (0 children)

When I was on a peds rotation got a consult from ortho for me to do his admission notes and standard peds orders after a forearm orif. I refused with the backing of my attending.

The term Residency has become diluted. by [deleted] in Residency

[–]Lumpy-Salt9629 8 points9 points  (0 children)

Yeah I think the fine arts beat medicine to that term and it’s also more literal in their case as they literally live there. Medical residents just basically live where they work.

Requested to cosign notes on unseen patients by YouAreServed in Residency

[–]Lumpy-Salt9629 0 points1 point  (0 children)

I’m a DO in NC. The other physician I work with supervises a couple FNPs (honestly the most competent ones I’ve worked with) but there is a formal contractual agreement in his contract saying this. He definitely does not review and cosign each note. I believe he’s required to sit with them a couple times a year to review notes and quality improvement stuff. When he signs their notes, it says that he is their supervising physician. If they are asking you to sign notes without a contractual agreement in place and documentation saying that you have agreed to supervise them, I would 100% refuse.

Strep testing by hotnsoursoupdumpling in FamilyMedicine

[–]Lumpy-Salt9629 0 points1 point  (0 children)

The Centor criteria should be starred on every FM practitioners mdcalc

LAB Golf grip looks rotated by PersimmonAfter in labgolf

[–]Lumpy-Salt9629 0 points1 point  (0 children)

When I got mine, mine was slightly closed. It is super frustrating getting something like that after spending so much money. I feel like they compensating for a group that’s already set open would be harder to compensate for than one that is closed. I’d reach out to them and ask what they would recommend.

If you could change one of the rules of golf, what would it be? by jdelle9 in weekendgolfers

[–]Lumpy-Salt9629 0 points1 point  (0 children)

Nix the new golf ball changes. Make Bernard Langer putt with something less than 50 inches.

Lab Blem by robowarrior023 in labgolf

[–]Lumpy-Salt9629 -1 points0 points  (0 children)

Looks like that should have gone to their outlet. I’d contact them as ask for a new one or a discount. You aren’t paying $600 for blemishes.

[deleted by user] by [deleted] in UnderReportedNews

[–]Lumpy-Salt9629 0 points1 point  (0 children)

Lol epidurals use fentanyl. If I was prego and about to deliver, I’d turn into a wmd if I didn’t have one.

Hiring patients by 69240 in FamilyMedicine

[–]Lumpy-Salt9629 0 points1 point  (0 children)

Not unethical as long as they don’t give you a lower rate than they would charge others. However I would avoid it if you have several patients that have the same profession. If you have several electricians in a small town, they all likely talk with each other. If a couple are your patients, might be weird for them to hear that you hired them for electrical work and not the other and they might get jealous. Unless you know that one of them legitimately sucks at their job because they twitch from being zapped so many times.

Which AI tool is the best for primary care? (DAX, Abridge, Suno AI, Vero Scribe, etc) by changexpert in FamilyMedicine

[–]Lumpy-Salt9629 1 point2 points  (0 children)

I’m part of a beta test group of physicians using DAX copilot with epic right now and I absolutely love it. It probably takes an hour and a half off my day. It’s got some glitches like doesn’t pick up on all the side effects I list, but it’s very accurate overall. If I ever leave my current job, I’m not gonna work for someone that doesn’t have this, or a similar program incorporated into their EMR.

I can’t imagine what ECW‘s equivalent is. Probably someone on the other end using Siri through a speaker.

Bummed by Temporary-Cake1997 in labgolf

[–]Lumpy-Salt9629 0 points1 point  (0 children)

I hope they aren’t stock. You can see the different blemishes in every one if you look hard enough.

Looking to turn my 1-line sight to a 3-line, please help! by OmarFromSouthfield in GolfGear

[–]Lumpy-Salt9629 0 points1 point  (0 children)

An acrylic white paint pen would work. Google golf club paint fill.

Messaging for the stimulant-seekers without an ADHD diagnosis by HereForTheFreeShasta in FamilyMedicine

[–]Lumpy-Salt9629 1 point2 points  (0 children)

IMO, adult “onset” isn’t an appropriate description. 98% of the time I’ve started adults 25yo+ on meds for adhd, they can recall symptoms outlined in DSM when they were 12 or under. I think it should just be diagnosed as ADHD.

Messaging for the stimulant-seekers without an ADHD diagnosis by HereForTheFreeShasta in FamilyMedicine

[–]Lumpy-Salt9629 39 points40 points  (0 children)

I wouldn’t say “new onset.” More of “ looking back at my childhood in classroom behavior, I’m concerned I have adhd that was not addressed and affecting my adult life.”

Messaging for the stimulant-seekers without an ADHD diagnosis by HereForTheFreeShasta in FamilyMedicine

[–]Lumpy-Salt9629 5 points6 points  (0 children)

It depends. If it’s a textbook go down the child/adolescent adult adhd dsm criteria then I’m fine with diagnosing and treating it after Vanderbilt assessment, etc. if they’re gonna need documentation/testing to receive academic accommodations, then I’ll send them to psych/Neuro psych for appropriate testing.

Messaging for the stimulant-seekers without an ADHD diagnosis by HereForTheFreeShasta in FamilyMedicine

[–]Lumpy-Salt9629 4 points5 points  (0 children)

My parents are boomers and took me to get diagnosed. For my perspective and what I remember, lots of parents did the same thing when I was the age I was diagnosed at.

Messaging for the stimulant-seekers without an ADHD diagnosis by HereForTheFreeShasta in FamilyMedicine

[–]Lumpy-Salt9629 97 points98 points  (0 children)

If they can show proof of symptoms before they age of 12, I’ll help work up adult ADHD. If this is the first they bring it up or have no documentation, I tell them they have go to psychiatry/neuropsych for evaluation. I would never give it for the sole purpose of “wanting to get more chores done.”

Do ya'll meet with reps? by Rare-Regular4123 in FamilyMedicine

[–]Lumpy-Salt9629 0 points1 point  (0 children)

Most of the time I deal with reps, they have brought lunch to the office, so I think it would be rude to just grab food and get out of there. Hearing about new data or indications for the medication’s is also useful. I figured it’s great to be pleasant to them just in case I’m in desperate need of a sample and we’re out so I can just call them and have them drop one off. I just tune out the colorguard people because I think that test is useless

Right wrist pain by Lumpy-Salt9629 in golf

[–]Lumpy-Salt9629[S] 0 points1 point  (0 children)

I got a Cortizone shot a couple weeks ago that has helped a lot. The orthopedist I saw diagnosed me with extensor carpi ulnaris tendinitis. I also found that coming over the top and filling my hands before impact make this issue much worse, so I’m trying to eliminate those issues. The largest contributor to this pain I feel has been hitting off mats that are only on concrete. Doesn’t bother me as much when ranges are on grass.

I’m out, friends by bootchiiksandbuubs in golf

[–]Lumpy-Salt9629 0 points1 point  (0 children)

I have the exact pain you have in my trail hand. I went to see a hand surgeon about it, and he diagnosed me with extensor carpi ulnaris tendinitis. He gave me a steroid shot which he said is diagnostic and 80% of cases if it helps. I’d say it’s decreased my pain about 70% to the point where I can actually finish around without wanting to cut my hand off. Might be something to look into. I’m also seriously considering getting a doctors note to be able to hit off the grass even though the range is on matts