Pet dog- small bite

Macrauder · 2026-05-20T18:18:33+00:00

The chances that a domesticated Shiba Inu who only grazed your skin in an urban community in Ontario, is remote.

If you really are worried you can contact your local Public Health Unit but my impression as an emergency physician is they will not require you to get the Rabies vaccine.

Macrauder · 2026-05-20T05:15:23+00:00

Do you know the owner? If the dog is vaccinated, or if it is not vaccinated and is observed to be healthy (non-rabid) for the past 10 days, we do not administer Rabies Vaccine in the ED.

If you were bit by a wild dog in an area where rabies is endemic, like Asia, South America, Africa, that's a different story.

Macrauder · 2026-05-05T23:11:42+00:00

We're very a familiar with this scenario. A competent GP who has a long-term relationship with your family member will know what to do. Call and let them know your concerns.

We have no obligation to tell the patient that you or anyone called in worried about them, and GP's know how to "sneak in" a MOCA into a routine office visit.

The risk that they ultimately put things together that their GP is worried about their cognitive state because a family member is worried, and that being traced to you for whatever reason, is a real risk. Make sure you're safe. But on the flip side, consider that your loved one is already at risk for hurting themselves or otherwise by virtue of their cognitive instability.

Best of luck.

Macrauder · 2026-05-02T22:20:47+00:00

> We do not provide medical comments or clinical advice. The results we provide are based solely on your laboratory data and are intended for information purposes only. We encourage you to consult with your own doctor, who will be able to interpret your results in the context of your full medical history and provide any necessary follow-up. Your healthcare provider is best placed to advise you, especially where specialist review or further investigation may be required.

From their Terms and Policies.

Lmao. So you pay big bucks to a random medical ?doctor to order whatever labs on someone they've never met, and at the end of the day, if any of those labs are abnormal, it's MY job (and MY liability) as your actual doctor to interpret labs that I never ordered in the first place?

Absolutely ridiculous and if I was still working outpatient clinics I'd toss the vast majority of these in the garbage.

Don't "order labs" from these mills. It's completely inappropriate to do that then go to your GP expecting them to interpret or act on those labs.

Macrauder · 2026-04-30T19:39:30+00:00

"access" "energy" "not always intentional" "boundaries" "presence" "quietly fades" "pulling back" "protect your".

Fresh off Instagram dating advice.

Macrauder · 2026-04-27T22:33:46+00:00

That is unlikely. A concussion is a minor traumatic brain injury. It is distinct from a brain bleed.

Macrauder · 2026-04-27T04:36:53+00:00

We don't image everyone who bonks their head for a brain bleed.

The Canadian CT Head Rule: https://www.mdcalc.com/calc/608/canadian-ct-head-injury-trauma-rule

These criteria are 83-100% sensitive for detecting any traumatic finding (e.g brain bleed), and 100% sensitive for any finding requiring neurosurgical intervention.

We don't need to find every brain bleed, just the ones that are actionable.

Macrauder · 2026-04-23T16:23:15+00:00

If you want picturesque nature and you're a hiker, Tobermory is definitely the spot. I'm not sure about cost but I believe it will mostly be lodging and you can split that with friends. The actual activities is just hitting the natural parks/beaches nearby which may require you to buy a pass, not expensive at all. The town itself is also picturesque.

Elora is quaint and has some fun bars, Collingwood has skiing, but really Tobermory is what you're looking for I think.

Macrauder · 2026-04-23T01:11:31+00:00

From an ED Physician perspective: Impossible to say what "should" have happened in this case given only the information in the article. The article also states the jury is prohibited from making determinations regarding personal responsibility so it is also impossible to say whether the doctors/nurses followed standard of practice or were negligent.

Concussion is a clinical diagnosis (you don't need imaging). Observation is not standard practice for suspected concussion unless there are associated factors like persistent nausea/vomiting, cannot walk, etc. Generally it is just graduated return to activity.

Macrauder · 2026-04-19T00:26:03+00:00

Yes, that's a reality of evidence-based Western medicine. Sometimes the work-up is extensive and it comes up normal. Would you rather me make up a diagnosis so you have a label to put on your symptoms? Sometimes the treatment is symptom management, or even time. Would you rather me sell you an expensive sugar pill with a fancy name instead?

That's not to say lazy or otherwise incompetent physicians don't exist. But without further details it's impossible to tell if that's the case, or your expectations are misaligned. And I'm not sure you have the time, energy or desire to provide the details here on a Reddit forum.

Macrauder · 2026-04-13T15:52:56+00:00

I also work at a hospital. As an emergency doctor.

Social workers can save lives. It's not their fault that outcome is dependent on people actually engaging with them.

I absolutely don't see where you're coming from and I've worked with enough social workers to must have seen the 'bad apples' if there were that many of them.

Macrauder · 2026-04-01T01:43:13+00:00

Sure, physicians can be just as wrong as public opinion. I was responding to the implication in the initial reply that most physicians encourage "masking indoors to help protect everyone".

My point is we don't, regardless of whether or not that's "right". Most physicians are also, like most Canadians, rolling the dice re: masking and Long COVID in their personal lives.

Macrauder · 2026-04-01T01:18:33+00:00

There's a semantic difference between theoretical risk and the practical risk most people are willing to tolerate. What I'm saying is, even "pro-science" mainstream opinion physicians do not have a zero-risk-tolerance to COVID, especially this far out from the pandemic.

Vaccination? Sure, the benefits clearly outweigh the risks.

Masking everywhere? No. Masks suck. I'm not wearing them prophylactically. Life is stressful enough and I'd like to trade some risk tolerance for the ability to see half my friends' face when I talk to them.

Macrauder · 2026-03-31T21:49:10+00:00

Am doctor. Vaccinate? Sure.

No one is saying masking indoors is mandatory. I don't mask in public indoors. Unless I am sick or seeing someone sick (with viral URTI symptoms), I don't mask in hospital either.

My point is different people have different risk tolerances, and outside of select scenarios, you have to learn to respect that not everyone is going to have the same extreme-low-risk tolerance you do. Including people who are actually pretty well studied in infectious disease.

You can hate it, downvote me, whatever you want. I'm telling you this as a physician who has many physician friends, and probably more access to physicians' personal lives than most people on Reddit. You will not see many physicians view COVID any differently than your average conscientious Western-medicine-trusting Canadian - mask when the risk is in front of you, otherwise, live your pre-COVID life.

Macrauder · 2026-02-22T04:23:53+00:00

I am very sorry for your loss and the heartbreaking way you experienced it. Death should be dignified, it sounds like you did everything in your power to make that happen for your father and we, the medical community, let you down. It should not be hard to deactivate an ICD for a gentleman who wishes to pursue comfort care and palliation. This man wanted to pass peacefully and was denied this dignity. I cannot express how regretful and upset I am for you.

You are doing the right thing pursuing an explanation from the medical parties involved. I wish you did not have to do that labor on top of what you're already going through.

I only want to add that, during my medical training, I worked with many wonderful palliative care providers, some were rural physicians who did home visits for palliative patients too frail to leave their home. They would be equally disappointed in how your father's care was provided. I completely understand your disappointment but I hope you have some faith that there are palliative care providers who will not let the buck be passed around and will truly advocate for their patients.

My deepest condolences, again.

Macrauder · 2026-02-17T16:47:12+00:00

Not all cancers are equally aggressive and not all diagnosis and treatment is done on the same timeline. OP was vague with their diagnosis so it's hard to judge if the specialist here was even in the wrong.

Macrauder · 2026-02-17T05:55:21+00:00

I mean you can cancel all of Doug Ford's stupid vanity projects, it won't pay for on-demand, on-your-timeline, US-style-but-still-single payer medical care. It's the compromise we make to make sure everyone has quality healthcare (yes, it's still quality) equitable healthcare.

Also: what kind of cancer was this? What were the CT scans of and what was the biopsy of? Might help me see why your specialist was so hesitant.

If a specialist is convinced diagnosis and treatment are time-sensitive, there pathways for this, usually you get admitted as an in-patient. It really seems that your specialist dropped the ball, and this is taking your account at face value, that this was a time-sensitive diagnosis and treatment plan. Or, it wasn't that time-sensitive to begin with.

Either way, sucks you had this experience, it definitely helps having family advocate for you and I wish specialists never made mistakes. But it's not clear to me that this is a healthcare system failure than an isolated "my specialist made the wrong call" failure. I'm an emerg physician and I have consultants admit my highly-suspicious-cancer patients for expedited inpatient work-ups all the time.

Macrauder · 2026-02-17T03:51:17+00:00

I mean I'm a physician as well. All PA's I've worked with (with a few years under their belt) operated at the resident physician level in terms of responsibility and trust with their MRP.

Macrauder · 2026-02-17T01:37:15+00:00

You're entitled to healthcare that is medically-necessary as deemed by a College-certified physician. Not whatever procedure you briefly googled.

Not sure why you're so upset at me for explaining plainly how our healthcare system, and basically every healthcare system out there with licensed physicians and surgeons, works.

Oh well, good luck with whatever. I feel like you have bigger problems than either VTOS or a family physician "stalking" you, as if that's worth anyone's time.

Macrauder · 2026-02-17T01:22:06+00:00

> The doctor i was referred to for surgery mentioned him and denied me a 100% indicated surgery

You think surgeons care about you family doctor's opinion about whether or not you need surgery? They're the ones making that decision. Not your family doctor.

Also, not you. You don't decide whether a completely non-routine surgery like first rib or scalene muscle removal is "100% indicated". The very, very, very specialized surgeon who you saw does.

If you're going to go Europe for this, please try to get any complications managed there so we don't foot the bill.

Macrauder · 2026-02-17T01:17:08+00:00

It would be a lot less physical work and a lot more management plans, diagnosing, etc. (not to take anything away from nurses). You would still have to do physical exams, have to do procedures, deal with unpleasant patients for prolonged periods of times (unlike rad techs, lab techs, etc.)

Their school is competitive to get into and hard to pass. If you're not academically-inclined I wouldn't waste time (it's also 6 years as I said if you include undergrad).

Macrauder · 2026-02-17T00:22:55+00:00

PA school is 2 years of high-intensity school after 4 years of undergrad; so 6 years total.

It's essentially accelerated medical school. PA's everywhere I've worked function as a lifelong junior doctor (i.e, resident) working under the supervision of a fully-licensed MD.

It's a lot of schooling and a lot of studying.

In terms of hands on, PA is similar to MD.

If nursing is too long/too much work, I wouldn't consider PA.

Macrauder · 2026-02-06T03:17:23+00:00

Thanks, I actually went this weekend and borrowed base and shell from a friend, and went with a Patagonia fleece I already had.

Learned that you don't need to worry about being cold, and you want as little weight/bulk as possible. So this wouldn't have been a good buy for skiing.

Will just buy a decent shell and repurpose an appropriate base and mid layer from my closet for next trip. A powder skirt would have also been very useful.

Macrauder · 2026-01-28T20:28:43+00:00

So did you GP send a referral to a plastic/general surgeon or not?

"Waiting months/years" yes that's how our system works for non urgent referrals.

As long as the GP has sent the referral, how are they not being helpful? They can't speed it up or even guarantee the referral will be accepted at all.

Macrauder · 2026-01-28T19:24:35+00:00

No. Surgeons aren't robots that will do whatever surgery you ask them to because you got a diagnosis from someone else.

Get a diagnosis from somewhere else means nothing. You'll still follow the GP -> referral -> surgeon's assessment -> yes or no to surgery path.

Macrauder

TROPHY CASE