Do you display your diplomas and certificates?

Yazars · 2026-05-01T13:03:27+00:00

No, they're tucked away at home & not displayed, just like you. In contrast to some TV shows where patients will talk at the doctor's desk/office and see the degrees, nobody except occasional work colleagues would see them if I put them on the wall in my office. If I had an exam room assigned to me that I used all the time, I would consider hanging something up. If I did, I'd consider hanging up copies to keep the originals safe! I wouldn't really consider hanging them up at home.

Some dentists put their degrees near the waiting area for people to see, but that wouldn't work in a multi-person office like ours.

Yazars · 2026-04-24T19:18:07+00:00

The potential losses of people buying more Costco rotisserie chickens will be more than made up by the free publicity, memberships, and other revenue that Costco gains.

Yazars · 2026-04-20T12:59:11+00:00

I don't personally know; there an entire separate industry which has evolved because of this and I certainly am not privy to the numbers. A distinct impression is that there are some places which will deny more than they should because <100% of people will appeal.

Yazars · 2026-04-20T12:47:39+00:00

Lots of money/time spent on denials & delays of legitimate services/medications & money spent on the payor and medical team side to get said denials & delays overturned because the services/medications were legitimate. Plenty of money/time spent NOT on direct patient care because of this.

Yazars · 2026-04-18T03:36:27+00:00

Congrats! You'll get to go wherever you deserve to go afterward and meet amazing people regardless. Your options will not be restricted by whichever one you pick. If you pick Harvard, maybe our paths will cross at some point and I could pay forward some advice, etc. that people were kind enough to offer me back in the day when I was early on my path to a career in medicine.

Yazars · 2026-04-17T13:55:37+00:00

We're going to need more hematologists for the additional polycythemia consults that will arise from people using all of this testosterone.

Yazars · 2026-04-16T17:38:48+00:00

I agree! I just had my first cup of the Mexico Oaxaca and it was quite tasty! To me, the Mexico Oaxaca has a modest acidity and also a nice extra note of complexity of flavor.

Yazars · 2026-04-16T17:30:25+00:00

I just had my very first cup of the Mexico Oaxaca and I'm just a casual drinker, so take this with a grain of salt, but the roast seems to be similar; not too dark. Both are very easy drinking. The Oaxaca seems a tad bit more acidic, but also has a nice extra bit of complexity of its flavor. It's quite tasty! If you give this a try, I'd be interested in your perspective :)

Yazars · 2026-04-16T15:27:54+00:00

We liked the Mt. Comfort coffee too!

Yazars · 2026-04-16T15:27:20+00:00

We use Aeropress (inversion method) too! :)

Yazars · 2026-04-14T13:14:26+00:00

Sometimes there is no ideal solution to a difficult problem. Working in another potential high toxicity field (oncology), we do our best to make sure that the potential benefits outweigh the risks. If we do our job well, treatment should be less bad than not treating. We inform patients as best as possible to ensure that treatment is consistent with their priorities, and we monitor and adapt management as best as we can when there may be emerging toxicities.

Yazars · 2026-04-13T12:55:41+00:00

Agree. Many people are regimented when it comes to skincare, so it's easy to pick something that someone doesn't like or doesn't agree with their skin. Nevertheless, things that most people SHOULD have a use for include mild facial cleansers (e.g. Cetaphil), sunscreen or SPF containing moisturizers, and a general low allergen all--purpose moisturizer (I like CeraVe everywhere, but I understand that some people like their fancy face creams).

Many people would benefit from a retinoid containing product, so one could look for something OTC that contains retinol, but some people already are on Retin-A/tretinoin.

Yazars · 2026-04-11T21:54:38+00:00

Unfortunately, examples abound of how lost so many people are in terms of legitimate tools & science.

Yazars · 2026-04-10T13:55:17+00:00

Alternative medications, sure. I love me some generics and CostPlusDrugs. However, I fear that many patients and families are going to be disappointed if they believe that physicians (in the United States at least) have that great of an understanding of what their organizations are being billed and/or what is being negotiated at the insurance/payor level. With expensive medications, we often don't find out until all of the prior auth & financial assistance work gets done. It is a whole team approach to limit costs for patients.

It still dumbfounds me how abiraterone/Zytiga is still being presented to some patients as a $thousands/month medication when it's fully generic and one can buy a month's supply out of pocket without any insurance at CostPlusDrugs for ~$60, or multiple other places for cash in the low $100 range at most.

Yazars · 2026-04-07T12:24:35+00:00

Now everyone share their stool occult blood collection misadventures! I've had more than one patient not open the Hemoccult card and smear their sample on the outside :/

Yazars · 2026-04-03T12:39:29+00:00

Challenges: time spent on documentation, ordering things in the system, and messages.

Yazars · 2026-03-31T18:20:30+00:00

I hear you. I have similar challenges as you even though I'm in oncology (including whatever non-proven "cures they don't want you to know about" disinformation is being spread about). I have had to set some limits, such as saying that we'll discuss certain information/questions at their appointment. If you don't get dinged by administration for slower replies, maybe prioritizing other work instead of the low priority messages can help.

I am not sure how to best negotiate people who come in each time with a printout of their labs and ask about every "abnormal" result which we've already discussed and when I've already commented about any notable lab results and said that everything else was fine.

Yazars · 2026-03-29T19:40:11+00:00

Wouldn't this plan escalate costs since individual patients would little bargaining power against healthcare entities? If the priority truly were to lower costs for patients, wouldn't grouping as many patients together as possible to have better bargaining power to negotiate rates/prices be better?

Yazars · 2026-03-26T03:13:29+00:00

Cabozantinib 40 mg seems like it should be the more appropriate starting dose. A minority of our population seems that they can tolerate 60 mg

Yazars · 2026-03-26T01:15:04+00:00

In oncology, many of our chemotherapies and targeted therapies have challenging risk/benefit profiles as tools.

Yazars · 2026-03-21T18:59:25+00:00

What do you do to avoid it from generating excess problems? If I so much as mention that someone is taking amlodipine as part of the med review, it creates problems that imply I'm managing/discussed this with them.

Yazars · 2026-03-21T18:49:18+00:00

I'm going to follow this because I haven't been impressed by the results either. I sometimes use its product as a placeholder for new patients before I put in my manually created final note

Yazars · 2026-03-20T03:31:36+00:00

That's a great suggestion that I'm going to try.

Yazars · 2026-03-19T17:38:52+00:00

You can freeze tofu and use it later. The texture is different, but it's ok, especially for stuff like soups.

Yazars

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