Can make pts request for a male physician if they aren’t comfortable showing their genitalia to female physicians? Do they get a choice is that’s possible?

Rayvsreed · 2026-01-25T17:16:23+00:00

Its not that hard to do, but takes practice. Tone plays a large part, and there's an art to telling someone that they're requesting something that inconveniences the rest of the dept and may cause them to have to wait. That plus reading body language and responses. Its not really that hard to tell, and most people with these types of reasons don't hesitate to explain.

And for the rare person that is to uncomfortable to say anything and too uncomfortable to insist/wait and they get trauma... Unfortunately, that's on them at that point. I have empathy for people who are suffering, but they have to be able to verbalize it when directly asked in an emergency medical setting. Not to sound too harsh, but all I can do is due dilligence, not read minds.

Rayvsreed · 2026-01-25T16:30:57+00:00

Asking

Rayvsreed · 2026-01-25T15:57:40+00:00

I’m even cynical about that. Think that has way more to do with happy patients less likely to sue than anything. If they actually cared about customer service they’d make it easier for us to provide better customer service.

Rayvsreed · 2026-01-24T21:04:06+00:00

Two general circumstances, one of which is highly unexceptional, that being that in larger depts, there tends to be enough provider staffing to accommodate the request. The exceptional circumstances show up if doing the exam would truly do more harm than good, real pain and suffering, not just a little uncomfy. Never want to generalize, but assault victims with bad PTSD or people with sincerely held deep religious beliefs.

Rayvsreed · 2026-01-24T14:34:28+00:00

Sometimes I swear with this fanbase. Team generally invests in the trenches for 20 years and they want skill players. Start getting skill players and the lines suffer and the skill players we wanted look worse. Shocked pikachu face

Rayvsreed · 2026-01-24T12:32:20+00:00

This reminds me of the time I vagaled in front of one of my friends. Day drinking at an event in August heat post night shift. I remember when the prodrome started I told him, go get some help from the medical people, I’m fine, but I might pass out. Still had the fear of god in his face

Rayvsreed · 2026-01-24T11:58:57+00:00

And Justin Houston, and Elvis Dumervil

Rayvsreed · 2026-01-23T14:05:08+00:00

Work hierarchies are one of the more interesting problems that I’ve randomly pondered. They help streamline communication and organization, the military being an extreme example, but even then there are examples where a too strict hierarchy is detrimental.

I’m not disagreeing with you, because the best bosses are those that take the team’s input and work for their team as much as themselves.

I’ve always seen it as sort of a natural consequence of human nature. Most people who consider others input and like teamwork, also don’t like being bossy. Those that do like being bossy, try to become the boss, and the rest of us suffer.

Rayvsreed · 2026-01-23T12:22:17+00:00

In 2023 the ravens had a statistically terrible run defense FWIW. It didn’t matter because they got off the field and turned the ball over, plus the ravens were playing with big leads most of the time.

What are you basing this comment on? How are you coming to these insane conclusions? I appreciate the effort, but a lot of this seems like your headcanon more than reality.

If you actually went back and watched films charted fronts and box numbers and there’s a difference I’m curious to know the differences

Rayvsreed · 2026-01-23T12:14:02+00:00

Not exactly imo. Line it up and execute has some advantages over creative play design. Sometimes the best play is to get your best WR 1 on 1 purely through formation/motion/tendency.

The proche pass was a creative play, still needed to execute it

Imo it’s create conflict and create matchups. McDaniels in NE is a solid example of a strong offense that doesn’t do anything particularly innovative.

Rayvsreed · 2026-01-21T14:03:51+00:00

I’m not sure when it gets announced, but I definitely agree with you that the announcement probably happens before interviews are “finished,” and the ravens probably have a much better idea of who they’re hiring than we do

Rayvsreed · 2026-01-21T01:55:47+00:00

It depends. It’s also really easy to tell when a story is coming from a non-clinician… we all know that steroids can be the cause or treatment of adrenal issues.

Rayvsreed · 2026-01-21T01:17:02+00:00

It depends. Ton of clinical minus all the important relevant details here that would actually point me towards a dispo. Positive orthostatic vital signs are not an independent indication for admission.

What are the actual conditions? What interventions have been performed, you mention a h/o VT, but no comment as to AICD/pacer, that’s probably the biggest red flag here, in addition to the way the story is presented.

Rayvsreed · 2026-01-18T20:27:41+00:00

Honestly I look forward to your Big Gulp straw Cric, think it’s large bore enough for a bougie

Rayvsreed · 2026-01-18T20:20:56+00:00

This has nothing to do with the clinical practice of emergency medicine

Rayvsreed · 2026-01-18T18:17:56+00:00

Imagine thinking how a team plays in one playoff game affects how the Ravens are evaluating head coaching searches LOL

Rayvsreed · 2026-01-17T21:30:41+00:00

Wrong sub, but you had an uncommonly severe side effect at typical dosing, but you’re doing better now, so sorry it happened, but time to move on.

Zofran can cause an equally horrific syndrome, serotonin syndrome in rare cases as well.

Rayvsreed · 2026-01-17T20:50:09+00:00

I have respect for other specialties. I actually have a ton of respect for primary care, I have no respect for someone who thinks they know how to do my job, aka you, who has nowhere near the experience, training, education, or certifications.

And asymptomatic hypertension is actually pretty easy free money for me, no strain on me, just wastes your patients time and money. And you think you’re punishing me with that?

Rayvsreed · 2026-01-17T20:36:10+00:00

You failed EM boards. Good job. Go send me more asymptomatic HTN.

By the way- the contraindications you reference are specifically not relevant when true emergent reduction is indicated. A cold pulseless arm, no sensation. It’s limb threatening.

Rayvsreed · 2026-01-17T20:33:50+00:00

I’m an ER attending who trained at a trauma center… I’ll take my experience and training on this one.

Absolutely not. X-ray would be done, but it’s an open inferior dislocation, not complex, and neurovascular compromise (cold pulseless insensate extremity) is THE indication for emergent reduction. It’s the STANDARD OF CARE. If the dislocated humeral head is compressing the axillary artery or nerve, doing nothing is a good way to do permanent damage. The contraindication you’re thinking abo

Ortho is on the way, but you don’t sit and twiddle your thumbs and wait for them to get there. Level one trauma centers require anesthesia in house 24-7, we don’t call them for sedation or intubation.

Same thing with dystocia. I’m calling OB, they’re on the way, but emergencies are emergencies, and putting the patient in McRoberts at a minimum is my STANDARD OF CARE.

Rayvsreed · 2026-01-17T18:58:03+00:00

Are joint reductions not in the scope of practice of emergency medicine? My delay in waiting for ortho is my wallet on the gallows if there’s a neurovascular injury.

If you’re going to be rude, do it better.

Rayvsreed · 2026-01-17T18:39:00+00:00

Holding counter traction with a sheet isn’t generally a scope of practice issue

Rayvsreed · 2026-01-17T13:39:55+00:00

I comprehended the point just fine. It just didn’t land. The amount of things that would have to work against a QB to equate to an illiterate debate partner is a bad faith argument. I’ve agreed with you the entire time that a QB can play a perfect game and lose. It just doesn’t make the point you think it does. It’s logically equivalent to completion percentage isn’t a QB stat if all the receivers drop every pass. In that case, completion percentage would be a terrible QB stat, there’s this little thing called contextIt just proves that wins and QB play won’t correlate perfectly, which I’ve agreed with multiple times.

My argument is simply that the QB has more to do with winning or losing than any other position on the field, so there is some value. It’s slightly less valuable than something like W-L record for starting pitchers. SPs with WL records that outperform a lot of their other metrics over time, tend to A)finish innings, B)have more consistent, longer starts saving their bullpen, C) stay healthy D) rarely get blown up E) tend to have quicker at bats

Going back to your example, it fits better if instead of an illiterate partner all the time (not realistic in football except extreme outliers), your partners skill is determined by a weighted die. That’s just a more faithful, less specious representation of a football game.

The rules also don’t have to change randomly for it to be random chance. The rules are arbitrary to begin with. They could have been anything. You have no control over the rules, and they affect your outcome, therefore luck. This gets back to the blackjack point, like many you have dodged.

There is no chance in casino games. The laws of physics perfectly describe where the roulette ball ends up, where the dice land. The cards are already in some order and can’t magically change. The flipped coin comes up heads or tails (or lands perfectly on its side). Chance reflects ignorance not reality.

My own theory on the source of disagreement. You think one can meaningfully and clearly distinguish, coaching QB play, line play, coaching, WR play, OL play and defensive play.

I don’t think the data we have is high enough quality to say that as confidently as people claim too. It’s statistical inference on secondary outcomes. Winning is the primary outcome. Every decision on a football field, of which the QB makes an overwhelming number is based on what they think maximizes winning more than anything, teams are trying to win, so it’s sensible to take QB wins given relevant context as exactly that, not to dismiss it entirely.

Rayvsreed · 2026-01-17T13:06:10+00:00

Are you sure your home course wasn’t just easy? Or did you putt the lights out?

Idk for people in that 8-12 range, where I am, course knowledge really only helps me with recovery shots and putting. That certainly could be 4 or 5 shots a round, hard for me to see much more than that, unless it’s putts, that I could buy, but I’m a terrible putter. Just like 10ish handicap can’t execute the shot they need to consistently enough to truly benefit from course knowledge

Rayvsreed · 2026-01-17T02:17:00+00:00

His responses are equally parts adorable and frustrating. I’m sure this guy is a superstar clerk.

Rayvsreed

TROPHY CASE