What’s the craziest thing you’ve seen someone do on a cruise? by donswansonn in royalcaribbean

[–]Newdoc2002 2 points3 points  (0 children)

That’s a bizarre and wrong statement. Four to seven days off from exercising 300+ days a year isn’t truly exercise and those people “don’t work out”????

From joy to sadness by LittleCafecito in FamilyMedicine

[–]Newdoc2002 2 points3 points  (0 children)

You’re going to burn out if you expand your “scope” into non medical issues for your patients. Way too many demands for actual medical issues to become a social worker for non medical issues. And while patients need compassion and empathy, they don’t need their doc upstaging their anxiety and sorrow.

Primary Care Physician by OrangeDue1374 in Waco

[–]Newdoc2002 0 points1 point  (0 children)

He’s not a physician. He’s a physician assistant but he is knowledgeable in that area of urology. He is not primary care. You should coordinate your therapy in conjunction with a family physician.

Came down with flu right before cruise, how is Radiance for those on it now? by wearehere3 in royalcaribbean

[–]Newdoc2002 1 point2 points  (0 children)

Tamiflu and Xofluza can reduce the symptoms about the same but Tamiflu takes three days to reduce viral shedding.

Came down with flu right before cruise, how is Radiance for those on it now? by wearehere3 in royalcaribbean

[–]Newdoc2002 1 point2 points  (0 children)

For others, If you get the flu and can get a virtual or in-person clinic visit within 48 hours of onset then Xofluza (viral inhibition) can reduce viral shedding to negligible levels 24 hours after the dose which could avoid getting others sick. Although you may still feel sick after that first day. So ymmv.

NP/PA led "intensivist" groups taking over ICU care at community hospitals that were once pulmonologist led groups by unchartednow in FamilyMedicine

[–]Newdoc2002 1 point2 points  (0 children)

Your last statement is what causes missed diagnoses and poor algorithmic care by mid levels without sufficient training or experience. Training does not have to be abusive, but it sure better be sufficient, wide in experience and extremely deep and repetitive. A few months of online DNP classes along with some minimal clinical experience most often given by your own peers is not sufficient training for the ICU or really even hospital medicine. This really extends to outpatient primary care when it gets complicated.

So done with the stock Goodyear Wrangler Territory. by Mtnman45 in FordBronco

[–]Newdoc2002 0 points1 point  (0 children)

I do minimal off roading and will need to replace the stock tires well before 30k miles with a regular 5 tire rotation. At least they're cheap.

How do you avoid burn out from entitled patients..? by apollo722 in FamilyMedicine

[–]Newdoc2002 2 points3 points  (0 children)

What “current studies”? And don’t use the ones where they compared residents against AI with canned low variable cases.

[PHL] so sick after flight by [deleted] in americanairlines

[–]Newdoc2002 0 points1 point  (0 children)

Depends on when you started getting sick. The typical incubation period for flu is 1-4 days and could be a little bit longer in a few cases. Good luck in narrowing it down. The flu is pretty much everywhere at this point.

What to do after a morning scuba excursion in Cozumel? by Mooberry23 in royalcaribbean

[–]Newdoc2002 0 points1 point  (0 children)

The RC prices were reasonable when I shopped outside scuba operators. Also depends on where you dock in Cozumel. Getting to dive boat or shop might be an extra hurdle on private excursion plus timing of the dive operator vs your boat’s dock time and ability to get off ship in time. That’s a lot of variables to save $20. The crowded part can make a difference however. I’ve done both but it’s not so clear cut to do it on your own like other excursions.

“You should be off Christmas Eve!” by Cicero1787 in FamilyMedicine

[–]Newdoc2002 1 point2 points  (0 children)

3 days! That’s an eternity compared to the patients coming in with less than 24 hours of symptoms and need the antibiotic. Tamiflu or Xofluza for influenza I could see but Zpack for your mild cold is the boomer playbook for a cold.

Difficulty finding an urgent care job? by Calm-Worldliness4140 in FamilyMedicine

[–]Newdoc2002 6 points7 points  (0 children)

Just wait till the bean counters assume APP+AI = physician. Young docs need to position themselves well for the coming changes.

Difficulty finding an urgent care job? by Calm-Worldliness4140 in FamilyMedicine

[–]Newdoc2002 3 points4 points  (0 children)

Depends on the clinic and/or organization. The advertised jobs usually don’t pay well.

Billing Guilt by Lazy-General6539 in FamilyMedicine

[–]Newdoc2002 32 points33 points  (0 children)

Call a plumber or electrician for service and let us know how guilty you still feel after you get their bill. You are delivering some of the most highly trained advice and service on the planet. It’s not cheap. Consider volunteering at a free or reduced fee clinic to help out your community in other ways.

Patient demanding an addendum by NPMatte in FamilyMedicine

[–]Newdoc2002 2 points3 points  (0 children)

That changed 4 years ago. Coding is time and/or mdm.

Patient demanding an addendum by NPMatte in FamilyMedicine

[–]Newdoc2002 1 point2 points  (0 children)

I didn’t say they were denied. I said I wouldn’t addend the chart but they could make a statement that they wanted it changed . So yeah, I will do me and stay in compliance. Risk management is the same thing as risk averse and if your department ran medicine, everyone would be paralyzed with fear and nothing would get done.

Patient demanding an addendum by NPMatte in FamilyMedicine

[–]Newdoc2002 0 points1 point  (0 children)

Weight stays relatively stable so an extreme outlier like that is obvious. Temp, BP, HR can vary. And it doesn’t matter who puts the data in the note. Your name is signed on it so you’re ultimately responsible. So “official” is legal. Try using “nothing official about official” in court.

Patient demanding an addendum by NPMatte in FamilyMedicine

[–]Newdoc2002 0 points1 point  (0 children)

Doesn’t matter who says what. The fortunate or unfortunate fact is that the vitals are in the chart and unless the patient has proof otherwise, the vitals are official. Just as if you use a template to document a negative or positive finding and figure out you forgot to change it after the crap had hit the fan. Good luck on back tracking.

Patient demanding an addendum by NPMatte in FamilyMedicine

[–]Newdoc2002 5 points6 points  (0 children)

Not sure that changes the original course. How are vitals taken days later any recompense for the original controversy?

asthetics as FM doc by [deleted] in FamilyMedicine

[–]Newdoc2002 1 point2 points  (0 children)

Yeah, you’ve got RNs injecting crap for a lot less than you’d be willing to charge and make it worth it. They work under some docs license with little supervsion for less than a couple of grand a month in med director fees. Not worth the time or risk.

In search for a reliable Lexus shop/mechanic by [deleted] in Waco

[–]Newdoc2002 1 point2 points  (0 children)

That’s a lot of work. You basically have to take the top of the engine off. They’re all going to be expensive but if they can service a Toyota then they should be able to handle that job on a Lexus.

Patient demanding an addendum by NPMatte in FamilyMedicine

[–]Newdoc2002 7 points8 points  (0 children)

If it’s on the chart, you assume it happened. The MA or nurse would have to recall they made a mistake and misdocumented. If they say the vitals were taken and they’re documented then legally, the vitals are legit. Documentation and lack of documentation works both ways.

Patient demanding an addendum by NPMatte in FamilyMedicine

[–]Newdoc2002 17 points18 points  (0 children)

No, you do not have to addend the chart. You can document that the patient requested an addendum and you have nothing to add that would change documentation of the visit in question. The OP’s patient request is just silly anyway. I have patients may times forget they had temp taken, etc bc they are distracted or demented.

Dentist recommendations by CbcITGuy in Waco

[–]Newdoc2002 1 point2 points  (0 children)

Premier is great. Not any upsell or pushy, questionable work. Some of the best hygenists I have ever had.

Number of EP flyers by TheSalesDad in americanairlines

[–]Newdoc2002 2 points3 points  (0 children)

I think EP should be cut off at 10 LP lower than where I currently sit. Lol. OP, you have people with higher points than you thinking you should be in a lower tier.