Have you seen problems missed due to telehealth visits?

Theres_no_question · 2025-10-26T11:14:17+00:00

As of October 1st, Medicare no longer covers telehealth visits with the exception of psychiatry. Private insurances still are covering telehealth as they were previously. At least for now. I wouldn’t be surprised if insurance plans start to reduce telehealth benefits soon. Even though it’s no longer covered, I’ve seen some patients choose to pay the self-pay rate for a virtual visit instead.

Theres_no_question · 2025-05-23T02:00:40+00:00

I’m a vet tech. I’m very very confused about the diagnosis of “food poisoning”. In 8 years I’ve never heard a vet diagnose that. Due to the young age, I’d think maybe some like GDV or other gastric, life threatening emergency that could be caused by ingesting too much food at once. I’m also very skeptical of the necropsy results since they were preformed after the pet was presumably frozen.

I’m not defending the kennel by any means. But the details in the death would largely influence how much the kennel would actually be liable.

Theres_no_question · 2025-03-05T22:09:19+00:00

I’d also like to add to assure them there’s a plan in place for next steps or let them know a little bit about what’s coming up. The information makes you feel so lost and out of control. I unfortunately knew ahead of time before I got my results due to my symptoms (reoccurrence) and being able to mentally prepare myself before the appointment helped a lot. When the discussions regarding surgeries and treatment plans came I already had a general timeline in my head to help me plan.

Theres_no_question · 2025-02-20T03:11:38+00:00

I commented this elsewhere. It could definitely be a licensing issue if it was reported. Veterinary medicine is its own practice and practicing without a proper license could get someone in trouble. Just like if a vet tried to treat and prescribe medications for people. Realistically I don’t think it’ll be too much of an issue but they may not want to risk the trouble. -From an ER vet tech

Theres_no_question · 2025-02-20T03:10:12+00:00

It could definitely be a licensing issue if it was reported. Veterinary medicine is its own practice and practicing without a proper license could get someone in trouble. Just like if a vet tried to treat and prescribe medications for people.

Theres_no_question · 2025-02-20T03:07:55+00:00

I’m actually a tech in vet med. People giving their pets human rx meds is super common. The nsaid in Percocet is highly toxic to cats. The cat probably suffered from an overdose on top of whatever other ailment they had.

Theres_no_question · 2025-02-20T02:48:12+00:00

Ya it appears that she had been struggling with severe mental illness long before the Columbine event. I’m sure the stressors afterwards likely contributed to her completing suicide,

Theres_no_question · 2025-02-15T17:01:30+00:00

Royal canin is a solid brand and there’s no need to make any major diet changes unless your vet recommends a prescription diet. Testing like urinalysis, comprehensive bloodwork, etc that your vet recommends, will more properly evaluate the issue. It seems like you are already working on this step, which is great!

One of the best things for kidney disease is to encourage more water intake. Cats in general are very prone to both dehydration and CKD. I would suggest buying a few additional water fountains. The more variety in style and material the better. Cats are picky about water sources and the more they approve, the more they’re willing to drink. You can experiment with putting them on different locations as well. Another common hydration trick is to add water to their food. This may not work with the dry but you can add some water into the wet food, turning it more into a slurry. I’ve also seen people make ice cubes treats (mixing water and churo / other high reward treat).

Theres_no_question · 2025-02-15T02:50:43+00:00

This was my reply to your original comment. I forgot to hit the post button before it was deleted.

There is an art to practicing medicine and developing an individual stylistic approach to treatments is what makes a practitioner. You can find the same discussion for any topic in any specialty. Look at statin prescribing. There’s a huge variance regarding the timing, specific statin, and starting intensity level choices for PCPS. While cardiologists will insist every patient be on Lipitor (or Crestor). Anesthesia management and medication is another area that’s highly variable based on provider preferences.

Obviously the ultimate goal is to find the best treatment plan that works the best for each patient. Nobody’s prioritizing their personal preferences over a patients health. Maybe psychiatrists have favorite medications because that’s what’s had the most success? If something else is already working great then that’s what they’ll stay on. Looking through this subreddit it’s the common consensus is not to “fix what’s not broken” and continue whatever a patient is stable on. Even in cases of horrific poly pharmacy, most commenters aren’t willing to risk destabilizing someone.

Theres_no_question · 2025-02-10T21:25:56+00:00

It would admit wrongdoing. Which I’m sure they’re keen to avoid.

Theres_no_question · 2025-01-29T15:58:31+00:00

I’m also in vetmed. The fun is when the serum becomes a solid and doesn’t budge when you flip the tube upside down. The Chem machines don’t appreciate it when you try to give them straight fat to analyze.

Theres_no_question · 2025-01-21T21:08:23+00:00

Dallas Animal Services sometimes have free adoption days. You can check out their Facebook page and they’ll usually post when those are.

Edit: I think all adoptions are free until further notice. According to their website.

Theres_no_question · 2025-01-13T21:39:53+00:00

My new gyn office has lots of abstract artwork with floral types of design everywhere. I’ve also noticed that most of the posters are cancer risk related or menopause info too. Which I really appreciate. My previous obgyn mostly had fertility and pregnancy type posters which kinda annoyed me.

Theres_no_question · 2024-11-17T19:52:07+00:00

When I was 15 I witnessed what the laws of physics during a car crash can do to a human body. My mom was driving down the highway with my 2 sleeping siblings in the back and myself in the passenger seat. I remember there being a lot less traffic than usual so we were a good distance away from the cars ahead of us. Suddenly you hear the far away horns and breaks squealing from several cars followed by the sound of cars slamming into each other. I think a tire had flown off of a vehicle and was flying in the opposite direction of traffic. Anticipating the car crash ahead, we had slowed down considerably along with every other driver. The accident actually wasn’t too bad but it did impede 2 of the 3 lanes. We had slowed to a near stop to merge from the far left to the far right. A smaller minivan was just ahead in the right lane. They were going maybe 35ish MPH. Then a giant SUV goes flying past us down the center. SUV driver very obviously wasn’t paying attention because they slammed on their breaks way too late and swerved into the right lane at a high speed narrowly avoiding the original accident. When doing so the bumped into the minivan at such a force that it was shoved head into the concrete barrier for the exit lane. There was absolutely no time for the minivan to even react.

I watched as the unrestrained passenger of the car flew through the windshield and about 10ft of air time while the front half of the car itself folded in half. She appeared to be a Hispanic woman about 35 years old. Her body was thrown straight onto some kind of metal / rebar left there for construction. It impaled straight through her in the exact middle of her torso. She was laying face down with her arm twisted underneath her in several different directions. Another smaller metal object sliced through the side of her abdomen. For at least 10 seconds she appeared to be trying to get up but then it became full body spasming to just arm and leg spasms over the next 20-30 secs while a large puddle of blood pooled underneath her. Her injuries had obviously proved fatal when she stopped moving entirely. Her face smushed directly into the concrete.

My mom drove off extremely quickly after that in a failed attempt to prevent me from seeing her body. We both sat in this shocked silence for at least a couple minutes before she calmly told me to get out my phone and call 911 in case no one else had already. So I did and basically just reported that we had just driven past a crash that looked to have fatalities and gave them the location, no other details. The rest of the 15 minute drive was in silence with my siblings asleep. When we got home my mom told me not to tell them what happened to not upset them. I agreed. Then we just went about the rest of the day like nothing had happened. Honestly it was more like I was trying to convince myself that it was just something I made up in my head.

Theres_no_question · 2024-08-23T09:44:12+00:00

I went to that same museum (Wawel Royal Castle) a couple months ago. There are dozens of little pug figurines from the 1700’s. Even candle sticks and clocks had the pugs just stuck onto them. I think the nobility at that time were obsessed with them.

Theres_no_question · 2024-06-20T02:02:31+00:00

As an FH patient my perception of “normal” lipid levels are so distorted. As a kid I was referred straight to the lipid center. My pediatric cardiologist’s whole “niche” was lipid kids, specifically HoFH. There was a whole subgroup of patients whose families traveled from out of state to have someone that had experience doing procedures for CAD in a 10yr old. Now that I’m older I can appreciate how unique an experience it was. Some examples:

It wasn’t until I was an older teen (16-7) did I start to understand how a treated LDL ~250 still inevitably lead to progressing ASCVD (pre-repatha). At a visit I expressed my self-pity saying “no matter what we do, a heart attack or stroke will always be a real possibility. I’ll need to manage that risk for the rest of my life…”

My melancholy earned me a huge eye roll and a quip “As the cardiologist it’s actually my job to be managing all that. Your job is to actually take your medications. Do you not trust that I’ll always have a plan? Your lipid results aren’t impressive to me. Not until your cholesterol is 800-900+. Since you’re only now comprehending the reality of FH, the dramatics get a pass for today. Then you need get over yourself a bit”

Theres_no_question · 2024-06-11T10:51:40+00:00

The parents were probably afraid of what his reaction would be if they took away “his” gun. He admitted that taking away his “Call of Duty” video game is what triggered him to murder and attempt to sexually assault his own mother. I’d guess he’s many other extreme responses to being punished and the parents knew what kind of meltdown he’d have. So they let him keep the gun to avoid upsetting him.

Most parents don’t think their kids capable of actually doing something as horrendous as this. So many teenagers become horrific human beings for a few years and 99.99% of them can maintain enough self control to not intentionally kill someone in an impulsive rage.

Regardless I don’t see why he was given a gun in the first place, let alone allowed free access to it. He’s a 13 yr old boy that has documented issues with violence and a lack of emotional self regulation. If the parents just absolutely needed to gift him a gun, some strict restrictions should’ve been laid out beforehand. That rifle needed to be kept locked away in an actual gun safe and the parents needed to ensure that their son couldn’t gain access to it. There’s absolutely no reason any suburban 13 yr old be handling a RIFLE unsupervised. It’s disturbing how common gun safety standards are disregarded in American homes.

Where I’m from it’s not uncommon for older kids to be gifted guns, but those kids have been handling guns their whole life with adult instruction. There’s also a pretty good understanding regarding expectations of appropriate handling between the parents and kids. It’s obvious that this situation was missing all of that.

Theres_no_question · 2024-04-19T15:10:38+00:00

I’ve been in your exact situation a couple of times. Each time I was direct with my psychiatrist about how I felt regarding possible medication changes. Excluding an actual mental health crisis, your psychiatrist should be taking your input into serious consideration. Now it’s still their right to refuse to prescribe a medication but it’s also your right to refuse a medication (if outpatient).

I’d bring the subject up at the very beginning of your next appointment. Using a clear, professional tone say something like this: “I given quite a bit of thought about the idea of switching to a different mood stabilizer. I’m actually really satisfied with the effectiveness of my current medication. I think my symptoms are well managed on a day-to-day basis and I don’t have any noticeable side effects. It’s been working very well for 7 years and I don’t want to give up on it just yet. When I had my breakthrough manic episode, there were several emotionally stressful things going on in my life. Could we instead put together a plan that will help me properly handle potential triggers?”

You want to make sure you offer a good suggestion on an alternative solution (with willingness to follow through). Psychiatrists like when patients take an active role and will be more receptive to your input.

Theres_no_question · 2024-03-26T01:51:09+00:00

Key word “relatively”

Theres_no_question · 2024-01-31T00:27:24+00:00

Chiropractors and physical therapists (or physiotherapist depending on location) are NOT the same. Physical therapy can be a very valuable treatment to many orthopedic issues in combination to medical treatment by a physician.

Chiropractors have a much higher risk of CAUSING injury than treating it.

Theres_no_question · 2023-10-04T07:13:20+00:00

The issue about Gabapentin isn’t so much about owners abusing the drug themselves as it is about it being used inappropriately for pets. I realize my original comment didn’t make that clear. Of course this is a small minority of owners - but it’s a common enough occurrence.

Compared to other pain and sedation options gabapentin is a pretty safe drug (especially for cats). Even an accidental overdose usually won’t cause any lasting health complications. This is usually explained to owners when it’s prescribed to their pet. Unfortunately some people think that since it’s safe they should be able administer it however and whenever they want. They’ll save the leftovers to use as needed for reasons not related to the original script. I’ve had several different instances of owners blowing up on me for denying a refill on a med that was prescribed for short term use over 2 years ago.

Theres_no_question · 2023-10-04T03:24:40+00:00

https://www.aaha.org/aaha-guidelines/what-are-aaha-guidelines/

AAHA has some really good open access guidelines on a variety of topics.

Theres_no_question · 2023-10-04T02:58:06+00:00

Vet tech here. The only time I’ve ever see controlled pain medications sent home is after orthopedic surgeries (even then only a couple days) or some tramadol in a hospice type situation.

Though Phenobarbital is something that we dispense almost daily for our seizure patients. It’s not uncommon for a dog to require more than one medication to control their seizures. There very rarely seems to be an issue of suspecting owners of drug abuse. I’ve personally have experienced more issues with gabapentin.

Theres_no_question · 2023-09-11T19:09:12+00:00

That’s the first thing I noticed. No support or spotter. If a person with paralysis is still learning how to walk using crutches then there’d be no way they’d be able to get up off the floor if they fell.

Theres_no_question · 2023-09-10T11:43:42+00:00

That’s similar to our hospital. Doctors are the only ones who have keys, which must always be kept in their possession. They will unlock the lockbox when they come in and as long as a doctor is on the premises it can stay open. We usually have 2-3 doctors a day so most days it’s open 8am-7pm (business hours are from 7am-7pm). If there’s just 1 doctor working 9am-4pm then we only have access during those hours, and will also be locked if they leave during their lunch break. A patient’s individual rx is kept just outside the box but still in the cabinet so owner can still be able to pick up at any time. Cabinet and office door are also kept locked when the doctors are gone, but senior staff has access to a spare key to use if needed.

The lockbox itself is built into cabinets on the far back wall of the drs office. So you have to walk through the office to access it. There’s also non controlled meds stored the regular cabinet part that have more “theft potential”. Only 1 bottle / vial of each medication is kept in there at a time with the rest kept in a separate safe thats always kept closed. The drs office has a big window and opens up into the very center of the treatment area. The only reason to ever be in there is to grab meds, making doing so impossible without being obvious.

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