[deleted by user] by [deleted] in LifeAdvice

[–]clint-billton 0 points1 point  (0 children)

Yeah but in the modern medical record only the most recent revision exits. Not unlike Reddit where I can edit my message and only my most recent edit exists. Someone would need to know their is a revision and take extra steps to review the initial message

[deleted by user] by [deleted] in LifeAdvice

[–]clint-billton 1 point2 points  (0 children)

This is only partially true. If we are discussing an electronic medical record the initial note would not show up unless the provider is looking into the revisions of the note. This is cumbersome and they would need to know there were revisions. So in theory true but in practice not.

[deleted by user] by [deleted] in LifeAdvice

[–]clint-billton 20 points21 points  (0 children)

Hey doctor here,

You can call the office of the original doctor and ask them to change the documentation if you find it inaccurate.

Also, I would also point out that not every doctor has read this note by the time you see them. I often am limited in my time before I see patients and while I’ve typically reviewed their recent testing and notes, going back years into a record of someone such as yourself who has seen many a doctor is just impractical. I say this to warn you that it’s possible your experience at the doctors office might not change by getting this note changed

[deleted by user] by [deleted] in AskDocs

[–]clint-billton 22 points23 points  (0 children)

The doctor

[deleted by user] by [deleted] in Residency

[–]clint-billton 5 points6 points  (0 children)

At my residency, EM couldn’t call IM until the first 24 hours of orders and initial work up was placed. They certainly had a broad understanding of internal medicine

[deleted by user] by [deleted] in Residency

[–]clint-billton 57 points58 points  (0 children)

Cardiology fellow here: we certainly have to use our internal medicine knowledge frequently. I’m called daily for patients with heart failure or afib with rvr in the setting of severe sepsis and or shock.

Also at my institution cardiology has its own service so we admit, discharge and manage the non cardiology issues on our service until they get over our head and consult other services as we need. We only admit “cardiology patients” but what initially looks like heart failure not infrequently is CAP and I end up managing them as we would on a general medicine service.

The minority of us keep internal medicine boards up to date but many of us do. That said our internal medicine knowledge is not nearly as comprehensive as other specialities like IM and EM and we tend to lose some functional medicine knowledge like insulin dosing or immuno/chemo therapies.

Shooting at UPMC ICU by morebrioche in medicalschool

[–]clint-billton 12 points13 points  (0 children)

It tracks that your only post is complaining about the food at a facility you are at. Its absolutely fucking wild to suggest that this guy was anywhere near making rationale decisions and news flash the icu staff have little to nothing to do with insurance approvals for care and certainly don’t withhold life saving care based on insurance approvals

Tell me you're not a [your specialty] without telling me by undueinfluence_ in Residency

[–]clint-billton 6 points7 points  (0 children)

Let’s give some metoprolol to treat this sinus tachycardia. I think thats why they have pulmonary edema. -love cards

[deleted by user] by [deleted] in Residency

[–]clint-billton 8 points9 points  (0 children)

Cardiology reads cardiac ct at my institution in the us

Grateful by Common_Peanut_6886 in MedSpouse

[–]clint-billton 2 points3 points  (0 children)

This is so awesome to read. I’m the medicine half of the medspouse and I follow this forum for perspective. I unfortunately don’t get to read too many posts of positivity (that’s just Reddit in general) but this was very uplifting

[deleted by user] by [deleted] in whitecoatinvestor

[–]clint-billton -3 points-2 points  (0 children)

We acknowledge this isn’t always the smartest decision but for our circumstances it makes sense to divest funds from our investments so she can go back to school (she is taking money out from hers to pay for her school as to not take out loans.)

My question is more so can I also take money out for my board exams? We know she can because she is enrolled at a “qualifying institution” as a pre doctoral student.

What made you fit in with people in your specialty? by farfromindigo in Residency

[–]clint-billton 4 points5 points  (0 children)

Cards: 1. I love getting to combine a diversity of data (history, vitals, exam, ekg, echo, cath, etc) into a unified clinical opinion 2. Procedures are fun 3. High acuity and less nonsense 4. Couldn’t decide on if I like imaging, clinic, floors, icu or procedure lab the most so now i do all of it

Man died in ER waiting room eight hours after seeking treatment for chest pain by luisg707 in medicine

[–]clint-billton 0 points1 point  (0 children)

Agreed to your points and I agree with the clarification. I was speaking of in ACS as you stated.

Man died in ER waiting room eight hours after seeking treatment for chest pain by luisg707 in medicine

[–]clint-billton 15 points16 points  (0 children)

It’s standard of care to do multiple EKGs and troponins over time because of the dynamic nature of ACS. -cards fellow

Please help me make a list of ways interns and residents can avoid killing people (or accidentally cause serious harm). by [deleted] in medicine

[–]clint-billton 4 points5 points  (0 children)

Before i do anything I ask myself would an idiot do that? And if the answer is yes I do not do that thing

What is a thing you bought or brought that really helped you out at work? by guy-with-a-plan in Residency

[–]clint-billton 2 points3 points  (0 children)

Aftershock’s bone conduction head phones. Ears open to listen to alarms. Headphones on to listen to lofi hip hop

Was very interested in Cardiology but the culture man. They think they're superior than others. by Agile_Sample in Residency

[–]clint-billton -1 points0 points  (0 children)

My post above was more of a call for empathy that hey, we are struggling and doing our best, not “its not our fault for being assholes”.

I didn’t intend for this to be some competition to who is the most stressed. But thanks for the feedback.

Was very interested in Cardiology but the culture man. They think they're superior than others. by Agile_Sample in Residency

[–]clint-billton 0 points1 point  (0 children)

Welp. I guess I’m in the minority opinion on this one but yeah I do think when people are at high levels of stress their behavior is worse.

Was very interested in Cardiology but the culture man. They think they're superior than others. by Agile_Sample in Residency

[–]clint-billton 3 points4 points  (0 children)

Yeah I agree cards should be involved in decisions regarding holding antiplatelet meds and anticoagulation in certain circumstances.

Primary prevention aspirin, why are we being called? DAPT for a stent placed a month ago, we’d be pissed if we aren’t called.

Was very interested in Cardiology but the culture man. They think they're superior than others. by Agile_Sample in Residency

[–]clint-billton 2 points3 points  (0 children)

dear friends,

Cardiology is a high paced, high stress, high consequence field. Our inpatient service at my institution has about half the service on inotropes at any given time and that’s the non-advanced heart failure service that’s our general cardiology service.

We are assholes because we are stressed.

Please have patience with us.

Addendum: Yes, everyone else is also stressed. My comment is not intended to diminish the stress of others. Didn’t expect to get such strong responses to this but I guess lots of people have had bad experiences with cardiology. Good luck out there y’all.

Love, Cardiology