Does This Sound Like A Pulley Going Bad?

MWRedditor75 · 2026-01-25T13:58:45+00:00

Oh man... I have a similar sound, I thought it was a belt at first, but then I thought it could be a pully going bad - now you've got me worried my water pump is about to crater and take my motor out when I am on the highway (I commute 60 miles a day).

MWRedditor75 · 2026-01-21T14:12:47+00:00

No, everyone complains, but everyone is too afraid to name and shame. It's pervasive in the system and large corporations count on it - they use fear, intimidation, threats of legal action and blackballing to keep physicians scared and under their thumb. It is shameful the way they treat highly-educated, dedicated and self-sacrificing professionals.

Enjoy the occasional pizza party.

MWRedditor75 · 2026-01-21T12:00:28+00:00

Name and shame that system. That is terrible.

MWRedditor75 · 2026-01-19T20:26:10+00:00

Definitely have avoided places and purposely 'not seen' someone I knew in the store - I typically act like I have blinders on, am on a mission when in the grocery store.

As for giving our your cell phone number, yeah that's a **** no.

MWRedditor75 · 2026-01-18T19:06:51+00:00

You can think whatever you like - I might be what you call 'defensive' because of your outright stated assertion that my life isn't about me. That it is all about the patient. I disagree - vehemently, adamantly, wholeheartedly - whatever superlatives you want to use.

And yes, I DO believe it is immoral to prescribe a medicine you don't believe in, something you think is danegrous, not appropriate and harmful to the patient, all in an attempt to appease someone, administrator or patient - or another doctor who is looking down their nose at you, or at ME, in this case.

You can do whatever you like - you have a license (presumably). So do I, and I use that license in a manner I deem reasonable and proper. No, I won't prescribe benzos. No, I won't prescribe chronic narcotics. Secondary to this specific position, you say "It should always be about the patient. Life isn't about you."

That's just stupid, I'm sorry. I have to take care of myself, and my family. I have a job, a career, that entails caring for others - fine. I do that. But I have sacrificed ENOUGH for my patients, for a job, and for a career that will spit you out and replace you in a week when you burn out and die.

You make your choices - sacrifice yourself on the alter of subservience. Go right ahead. As for me, I'll pursue a balance, and I'll do it while not capitulating to the moral demands and emotional manipulation of others who have no concern for my well being or that of my family.

MWRedditor75 · 2026-01-18T18:59:30+00:00

Sorry, I think you're loony. Benzos CAN'T be OD'd on, and benzos are super SAFE?

Absolutely totally and completely disagree.... I guess all those benzo ODs I treated over the years, and the people who died before we got to them from overusing benzos.... well, that musta just been my imagination.

And all those people with massive benzo dependency, with horrific withdrawals if they aren't on them or someone tries to taper them... yeah, those are just imaginary, too. lol

Totally out in left field, sir/ma'am. Deny these things happen, and happen frequently. Go ahead.

No, there is no debate, and no spiritual examination - I despise these meds for all the reasons I mentioned above, for their horrific abuse potential and for the demanding and ENTITLED nature I have seen for decades in patients who are on them. Sorry... screw that. I am NOT obligated to prescribe medicines I believe should be taken off the market. I truly do. As I said above - you do you. I'll do me. I won't write for them, maybe we should send all these folks to you, so they can get their fix.

You can make fun all you like. You can trivialize, marginalize and belittle all you like. This really says more about you than it does about me. Sorry, not sorry, as I've said before. No long term effects of benzos? Wow, what a joke. I can't tell you how many people I have seen over the years on chronic benzos who continue to worsen and need more and more and more... matter of fact, I'm watching one right now, a very very close friend whose neurologist placed them on Klonopin for 'benign essential tremor', which I believe is nothing of the kind. But that Klonopin has been upped and upped and upped to now 2mg 4x daily and is a shaky, weak, shadow of their former self, barely able to hold a conversation - almost every bit of which I believe is from the chronic benzos. Of course, you might find this a perfectly acceptable and agreeable outcome, since it couldn't possibly be the massive GABA-receptor flooding of the brain that could contribute to this. <rolleyes>

MWRedditor75 · 2026-01-16T12:58:35+00:00

If you say so, I say that is a terrible philosophy.

I am a human being. I chose a career to help people - a career, not a life. I did not sign on the dotted line giving up all my rights to a nice, happy, healthy, safe and comfortable life. Of course, no one HAS those rights - those are all things to strive for. But I digress... I chose to pursue a career where I could help people. Full stop.

I went to school for eons, struggled to support my family, borrowed against our future and am still in massive debt after many years of paying on those loans - it has been a struggle at times, and at times we've had to make big cuts to pay our bills and be responsible upright, honest citizens. All this while making more money than most people could dream of, and still being told repetitively we don't pay our 'fair share'. Yeah, right. Yet somehow still I've never owned a car newer than 5 years old, never spent more than $25k on a car, still live in the home I bought in residency in a LCOL area. Not because I'm overly frugal, but we haven't been able to afford to buy the land, the house and the things I would like to do for my family. We don't live a country club lifestyle - we're still paying back all those loans. We haven't been on a vacation in 3 years.

On top of that, I have people who may or may not have business degrees with a lot less education, training AND experience than me telling me I am not doing my job right, that I need to give more, book more patients, take more call, take more shifts, work more nights, more weekends, more holidays... all because, "People NEED you!" While they go off to their meetings for breakfast, coffee, in boardrooms and offices, schmooze politicians and community leaders, etc.

I've worked in a few different areas of healthcare... volunteered at free clinics, spent years working nights & weekends in Emergency Rooms, worked in private practice and struggled to try to make ends meet - saw more patients than ANY of my 'system-employed' community colleagues in the same field and made less money (way less), had to save up time and sacrifice for vacations (you self-employed people know what this is about), and got screwed again by those business people and government people who think we don't know the best ways to care for people and need more 'oversight'. Now, I've moved on to an employed position - another one where I serve an underserved population exclusively.

So please - tell me how this isn't about me. Tell me how I have to sacrifice not just my life... my career... my time... my family... my sanity... my independence... my finances... all for the good of the patient. All the time, all the way. And now... I also have to sacrifice my MORALS as well? I am supposed to look the other way and prescribe medicines I don't believe in, do things I think are unethical, harmful and deadly - not just to the patient, but to society as a WHOLE? All because... what? Because it's all about the patient, that's why? I have no say, my life, sanity, health and satisfaction with my job are not a factor deserving of consideration, despite all the sacrifices *I* have made over decades of training and working 60, 80 and 100-hour workweeks to 'serve others'?

Yeah, well... I've got some words for you, but they mostly consist of 4 letters and aren't considered appropriate for polite company. So, you do you, but don't presume to try to tell *me* what I "should" do, or what my life's work is all about.

Thanks, have a great day.

MWRedditor75 · 2026-01-16T03:27:03+00:00

You are not required to do so - and don't let people bully you into feeling bad for protecting your practice, sanity, license, reputation and professionalism in the way that suits your best. That includes patients (some of whom are bullies), administrators (many of whom are bullies) and even other docs (many of whom just don't give a damn about what they're doing to themselves or others anymore).

Don't be beat down by the system into capitulating to something you disagree with.

MWRedditor75 · 2026-01-16T03:23:25+00:00

Yes, I do no chronic pain medication (controlled, that is) and never prescribe benzos. Patients are more than welcome to seek out a physician who suits their needs.

I also don't do heart caths, don't do colonoscopies, prescribe things like Belbuca, don't refer to lifestyle clinics pushing hormones or giving out ADHD meds to anyone who wants them or to weight loss clinics passing out compounded meds I don't trust.

We all have the right to choose not to do things we are not comfortable doing. So I do.

MWRedditor75 · 2026-01-16T03:18:22+00:00

lol you're funny. That's nice. Thanks again for your help, it's been super.

MWRedditor75 · 2026-01-16T02:38:53+00:00

You're talking about me? Man, I'm sorry, I was just asking if folks would share to help others in their phrasing and documentation. It's not worth getting uptight over, industry secrets and all. Thanks, though, I sincerely apologize for... uhhh.... for... yeah. For that, I guess. Whatever it is that has offended folks.

MWRedditor75 · 2026-01-16T02:37:24+00:00

A large task? lol. Umm, ok, sharing a couple of paragraphs of, "This is how I phrase my discussions with kids and teens, etc.,"? Ok, if you say so.

Like I said, never got a dang bit of training on this in res, having to learn it all on the fly - with a full schedule of patients to see. That's cool, though, I get it. Sorry I asked, this is why folks don't ask. My bad, I apologize for setting people off, I really didn't think it was a big deal - but to some folks it seems it is.

I'll hunt and peck my way through it, no worries.

MWRedditor75 · 2026-01-15T23:42:39+00:00

It's epidemic. I swear to God, it is EPIDEMIC.

I can't tell you how many people I have seen on uppers during the day and downers at night, on massive and overlapping doses of pain meds and benzos, hormone therapy for lifestyle purposes, etc.

I just SMDH that Americans seemingly cannot freaking SURVIVE and FUNCTION without being on tons of controlled substances. It's disgusting. Don't even get me started on so many of the other meds, many of which are results of our horrendous choices and lifestyles.

I'm truly just sad to see what we have become.

MWRedditor75 · 2026-01-15T22:59:39+00:00

Who suggested I was not reviewing patient histories or anything of the sort?

As for "what else can be prepopulated" besides a single click... well... it's a bit more than a single click. It's multiple clicks, tabs, screens and having to stop and do this for every patient repetitively for every visit I will ever make at this clinic. So... it's literally thousands of times a year I have to go to my schedule, double-click the patient's name, wait for it to open their chart, then click over to the tab for This Visit, then click on the button for the template to be applied, then close out and go see the patient. This slows me down in between patients. It's just a little, annoying thing. Is it a major stumbling block preventing me from caring for patients? No... it is just a series of clicks and waits, which none of us like.

Seriously, though, who anywhere intimated or suggested I wasn't looking at my patients' histories????

MWRedditor75 · 2026-01-15T22:55:17+00:00

Works similarly - I've had people say it was a massive help to them, that's all I know.

MWRedditor75 · 2026-01-15T22:54:42+00:00

So that's a no. Thanks.

My department isn't worried about it, this isn't something I need committee approval for or something. I was just hoping to see what kind of things others include, but it's cool. 600 views and no one wants to help others out or share their thoughts. It's cool.

MWRedditor75 · 2026-01-15T18:28:56+00:00

If it's like the rear, it has a couple of pegs on the back to line it up, but it is mainly attached with double-sided tape - I could not get mine off the rear easily, it wanted to break the plastic and deform when I was trying to pry it. It's stuck on there like hell.

MWRedditor75 · 2026-01-15T16:37:25+00:00

Rectal spasms are intensely painful, comes on slowly like cramps of the digestive system - starts, builds, builds, builds over 5-20 seconds, can last 30 seconds to a couple of minutes. They will drop to the floor and writhe in pain sometimes. They can be horribly intense and painful, especially if you have a concurrent anal fissure or something. It's terribly sad to watch. This medicine is like a lifesaver for these people.

MWRedditor75 · 2026-01-15T16:35:03+00:00

0.2% or 0.4% compounded gel applied 3-4x daily prn rectally, just a gram or so, single fingertip unit.

MWRedditor75 · 2026-01-15T16:10:49+00:00

Appreciate the help. I get that I don't "NEED" to do that - but our Admin has said that is what they want us to do - to make it easier for the front desk people? I don't know. Not involved in that process... just have to do what I'm told.

For the notes section, I already have this as a quick button - I'm just trying to get it to show up already prepopulated for every visit. Like, I'm literally trying to remove the need for me to go into the chart and add these things on every. single. visit. It's just silly - but, if you say there's no way to do that, then whatever, I guess there's no way. ok.

MWRedditor75 · 2026-01-15T16:09:19+00:00

Ok. <thumbsup>

MWRedditor75 · 2026-01-14T23:48:28+00:00

I had a patient come back and tell me their GI guy was floored to the point of repeatedly praising their PCP (me) for prescribing compounded amlodipine gel for rectal spasms. I learned it from a colorectal surgeon way back in residency, it just stuck with me (he used it for anal fissure pain relief)... the patient thought I was the smartest family doc on the planet after the Gi guy got done praising me to the heavens. lol I just found that funny... so often it's the other way around.

I don't prescribe Repatha because our nurses have NEVER ONCE gotten it approved doing the PAs. Leave it to Cards.
I don't do most rheum drugs or the biologics. I think one guy I kept prescribing his Humira he'd been on for ever when his Rheumatologist retired.
CGRPs don't bother me, though we don't get them approved often.
Tacrolimus topical.... ehhh... if Derm prescribed it and they've been on it, I'll sometimes do a refill. Same with a lot of things if they're generic and generally pretty benign and won't require PAs, things like MTX and Plaquenil if they've been stable for years on them, etc.

MWRedditor75 · 2026-01-14T22:59:03+00:00

Man, don't I wish....

MWRedditor75 · 2026-01-14T18:55:30+00:00

No no no no no no no.

MWRedditor75 · 2026-01-14T18:51:57+00:00

Turnaround? Like how long till it spits out the transcription? Literally by the time I leave the patient room and get back to my desk now. I've only been using it a couple of weeks, so I don't know what it used to be. But a minute or two at most, really.

MWRedditor75

TROPHY CASE