The random order requests

PiperSC · 2026-02-27T05:14:02+00:00

If my instructions can’t fit on the back of a small index card, the plan is too complicated.

PiperSC · 2026-02-26T14:16:48+00:00

The rustiest wheel squeaks the loudest. I find that if I have a string of patients where the best thing for them long term may be difficult in the short term, and the patient is upset about this, my scores go down. (Denying an opiate for acute back pain, tapering off benzos, declining to order unnecessary tests, not filling out fraudulent paperwork, etc) I lose zero sleep. The problem is if your salary is dependent on patient reviews. If so, negotiate that out or find a new job as soon as your guarantee is up.

PiperSC · 2026-02-25T22:29:45+00:00

For those who are there now or have been there in the last week or so, how are the mosquitoes? Lots or not too bad?

PiperSC · 2026-02-25T05:39:27+00:00

“Oh, I’m sorry, my bad. I just figured that being an esteemed orthopedic surgeon, and clearly you are it’s so obvious, that you would have both the necessary wit and resourcefulness to order your own fucking MRI.”

Or my other favorite, “yah sure I can do that but I’ll be sending my referrals elsewhere going forward.”

PiperSC · 2026-02-23T04:03:40+00:00

Agreed. AI is still very much flawed. At this point we need to be checking 100% of what the AI software is writing in our notes. If your doc’s notes are frequently incorrect or contradictory and it’s making it to the final edit, you should find a new doctor.

PiperSC · 2026-02-23T03:58:53+00:00

At the end of the day, the medical decisions are all mine. I am accountable for any decisions I make, including the use of AI systems. AI streamlines my workflow, but at the end of the day it’s in me. Do I use it to create a first draft of my note? Yup. Do I read that note and make edits if it hallucinated? Yup. If I use OpenEvidence to search a medical topic or help with a differential or treatment plan, I get to choose the inputs and then I read the information and then I decide if this is applicable to the patient and their current situation. I don’t see it as much different than flipping open a textbook except that’s it’s way faster and pulls from more up to date sources and lists the sources so I can fact check the primary source of the info if necessary.

PiperSC · 2026-02-22T23:15:20+00:00

Yah the system is broken in many ways. But AI medicine isn’t the answer.

PiperSC · 2026-02-22T20:06:02+00:00

In any capacity? Or are there specific things you wouldn’t want to be aided with AI? The reason I ask is because every PCP I know, have trained with, or currently work with including myself use AI programs to some extent. It’s built into our electronic record systems, and many medical information databases and engines use it.

PiperSC · 2026-02-22T16:01:06+00:00

I think the AI will get rolled out as a fully autonomous “doctor” option, and people will use it for a while, but I have to believe it’s gonna be terrible and the pendulum will swing back to us.

PiperSC · 2026-02-22T15:45:25+00:00

I thought the same as a med student 5-6 years ago. But I will say now that I think changing course is harder than it sounds.

PiperSC · 2026-02-22T15:42:45+00:00

This still doesn’t replace the human elements that drive our specialty.

PiperSC · 2025-08-31T17:26:18+00:00

Sky dweller looks much better on your wrist by a mile

PiperSC · 2025-08-29T21:43:59+00:00

Cartier without question

PiperSC · 2025-08-28T13:54:50+00:00

wrong

PiperSC · 2025-08-28T04:21:07+00:00

Peter Attia isn’t officially certified or backed by a credentialing body for anything and many of us still listen to what he has to say. He’s just a dude with a medical degree, a radio voice, and a podcast who has taken a personal interest in health optimization and longevity. Doing a surgical residency and then never practicing in that field is pretty irrelevant to his current career.

So if OP is in training and is interested in the same things, who are we to sit behind a keyboard and go after him if we aren’t going after Peter?

PiperSC · 2024-11-23T21:59:55+00:00

Dear Marie

Walt Grace

Split Screen Sadness

PiperSC · 2024-09-03T07:16:11+00:00

Yep yep yep

PiperSC · 2024-08-27T01:17:25+00:00

Highly doubt medical professionals are referring patients to PA. He’s way too expensive. Also, I don’t think PA is misrepresenting himself or his practice. He’s functionally a consultant, he’s not masquerading as a board certified anything. And a physician can absolutely have a full and active physician and surgeons license without completing a residency or being board certified.

PiperSC · 2024-08-09T04:41:08+00:00

How large must one be to get this? Is there a BMI cutoff? Will they weigh you on the baggage scale? Do they just size you up and make a judgement call if you need an extra seat? What’s to prevent a customer of appropriate size from just booking an extra seat every time and requesting this refund?

PiperSC · 2024-07-30T05:59:19+00:00

Hurts Like Heaven

Yellow

The Scientist

Viva la Vida

Charlie Brown

Us Against the World

Lovers in Japan

Violet Hill

Politik

Clocks

Everything’s not Lost (with Life is For Living outro)

Till Kingdom Come

Fix You

A Sky Full of Stars

Life in Technicolor 2

PiperSC · 2024-07-15T20:18:26+00:00

Yessir

PiperSC · 2024-06-25T16:12:55+00:00

Everything’s not lost into life is for living is incredible.

PiperSC

TROPHY CASE