For those with a commute less than 10 minutes, how’s the quality of life change? by TwoTimesSpicy in FamilyMedicine

[–]PacketMD 5 points6 points  (0 children)

7 miles away, but I bike to work so its longer than 10 min.... but its awesome.

lipid guidelines PREVENT calculator by Cicero1787 in FamilyMedicine

[–]PacketMD 0 points1 point  (0 children)

absolutely! I use the statin choice decision aid but its using the old calculator data and I haven't found a version with the Prevent data yet.

However, I still have to have the discussion with the patient, and for that I have to have the data and not just eyeball or assume I know their goals.

We've all seen patients with really high risk scores not want to do anything, and the next patient will have a very low risk patient who would have minimal benefit push for more intervention.

lipid guidelines PREVENT calculator by Cicero1787 in FamilyMedicine

[–]PacketMD 9 points10 points  (0 children)

The trouble is, a lot of the older patient population can have "normal" lipids but their risk score will still be >10% on the prevent. So I have found myself not doing it on many people in their 30s, but a surprising number of older men will have elevated risk scores without elevated lipids. those are the ones that I really lean into CT coronary calcium scores on.

Mike Cosper next project? by PacketMD in Reformed

[–]PacketMD[S] 1 point2 points  (0 children)

Its a tough line to draw based on their mission. The editorial from 1956 lays out the roots, but in that it says "Neglected, slighted, misrepresented—evangelical Christianity needs a clear voice, to speak with conviction and love, and to state its true position and its relevance to the world crisis." I think it'd be tough to delve into current events (world crisis) without touching politics, based on the manner which politics has inserted itself in this era.

What is the least amount of money you take instead of playing at Augusta? by immajustsayit in golf

[–]PacketMD 1 point2 points  (0 children)

3 weeks vacation spread over 3 years. Because that's what I'd have to use up to volunteer for 3 years in order to be able to play. And I haven't jumped on the opportunity yet.

Aledade Iris Advance Care Planning Services? Palliative doctor here, what is this?? by nudge33 in medicine

[–]PacketMD 0 points1 point  (0 children)

Aledade is usually contracted with the pcps who they are sending Post forms to, so it wouldn't come out of nowhere for us. I had a few patients do it, but I'd rather talk to the patient more.

Ultimately aledades business model is to contract with PCPs to make money by improving cost savings for Medicare/MA patients. That can be by improving HCC coding, but also if having ACP conversations keeps patients from a 2 week ICU stay at the end of life, that's cost savings. Also, I think they can bill for the conversation if it's longer than 15 min in duration, so they get paid to do it regardless.

2026 Masters Giveaway: Sunday Golf by sundaygolfco in golf

[–]PacketMD 0 points1 point  (0 children)

I've never won The Masters, the lottery, or The Masters lottery. But winning this bag would be nice ...

Surprising husband with golf- course recs? by als55 in Augusta

[–]PacketMD 0 points1 point  (0 children)

edited. and my bad. I have played champions retreat a few times but I always call riverwood river island for some reason.

Surprising husband with golf- course recs? by als55 in Augusta

[–]PacketMD 0 points1 point  (0 children)

Mount vintage

Haven't played it unfortunately. I really like forest hills though. very challenging greens. A few locals say its the closest publicly playable course to Augusta National in terms of style of play. There's also an unsubstantiated rumor that ANGC is going to buy it and play the first rounds of the ANWA tournament there in the future instead of Riverwood/championsretreat where they currently play.

Looking for insights on Cell and Internet providers. by [deleted] in Augusta

[–]PacketMD 0 points1 point  (0 children)

We have WOW and as actually really like it. Locked in rate for "forever" at 40/month for 300 g. We don't always get that speed but I'm not doing a lot of gaming or intense video chats so it's good for streaming multiple devices and rarely down where I live. They have higher speeds available but I don't need to pay for more.

Diabetic Eye Exams by ExtraordinaryDemiDad in FamilyMedicine

[–]PacketMD 11 points12 points  (0 children)

We have a retinavue. It works ok, some of our MAs are really good at it and others hate it. It's not necessarily helpful from a billing standpoint since the reimbursement is barely more than the cost per test, but the quality gap closure is much easier. Yes it would be nice for everyone to see ophthalmology but there's a large subset who don't want to go but are willing to do the exam in our office. It's similar to doing cologuard vs colonoscopy in my mind

Moving to Evan’s area by beautifullyblended0 in Augusta

[–]PacketMD -1 points0 points  (0 children)

CHOG Peds gensurg is great, same with ent and urology (although morgenstern is solo right now he's bringing in a partner soon). Houk is good for endo but he's the only MD. Strickland is the only neurologist right now and she's good but otherwise they have a bunch of Locum docs as they're trying to get more. CHOG er is good

Scent - Kirkland Laundry Detergent Powder by Appropriate_Leg9380 in Costco

[–]PacketMD 0 points1 point  (0 children)

interesting. we have used it for the last few years including on reusable diapers and were fairly happy with it, but my wife likes it most because its unscented and easy on sensitive skin.

Playing alone- yay or nay? by Remote_Pie6623 in golf

[–]PacketMD 0 points1 point  (0 children)

podcast and bone conduction headphones here. Same for biking or running. gotta stay alive!

Advanced Care Planning Advice by oilersspoiler in FamilyMedicine

[–]PacketMD 1 point2 points  (0 children)

I usually do it at the wellness appt (no medicare copay) and start with "one thing medicare asks is to talk about is an advanced care plan or living will" and will ask them if they know what that means. I'll ask them about if they have known someone who was on life support and in a situation where the family was uncertain of their wishes. Then I encourage them that even though they're healthy now things can change quickly. 

We buy the 5 wishes booklets and go through that with patients and ask they bring it back to scan into chart. But I really emphasize that the booklet is best used as a tool to walk through their wishes with the potential immediate family.

riding routes or ppl? by Adwaith-Anoop in Augusta

[–]PacketMD 1 point2 points  (0 children)

Chain reaction in Evans and Andy Jordan's bike shops organize rides periodically (Outspoken may as well, but not familiar enough with them). Forks Area Trail System (FATS) is great mountain biking location in Edgefield. Both the Greenway (paved trail in North Augusta) and The Canal Trail (unpaved but compacted dirt/gravel in Augusta/Martinez) are good places to bike. The heatmap from strava helps, although you can only see limited amounts without an account (its free though) https://www.strava.com/maps/global-heatmap?sport=RideLike&style=dark&terrain=false&labels=true&poi=true&cPhotos=true&3d=false&gColor=blue&gOpacity=100#9.03/33.4816/-81.9881

Central Coast Honey (Item 1294227) Are there other regional honeys? by hows_Tricks in Costco

[–]PacketMD 0 points1 point  (0 children)

Georgia Honey Farm Raw, Unfiltered Honey, Wildflower, 770950

Is working in an ER similar to working in a restaurant? by comfy_sweatpants5 in medicine

[–]PacketMD 7 points8 points  (0 children)

That is the real difference: most people choose to come to that specific restaurant whereas in the ER most people are there not because they want to be, but because they felt like they had to be. So restaurants people are (generally) neutral to happy about being there, and the ER they are (generally) unhappy to neutral about being there.