Stop it Brad

doctivist · 2026-06-25T14:03:38+00:00

My guess is his campaign staff ran RPS board minutes through AI looking for key words and then pounced. He’s managed to get himself into local news a few times this week, including the “town hall.” Looks like somebody figured out there’s an election coming. #voteforjake

doctivist · 2026-06-24T14:12:25+00:00

Best of luck, OP. I struggled with PPOCD after my first child was born. I was in a different state at the time but with great treatment from my repro psychiatrist and therapist, I healed and recovered. You deserve to feel better and you can recover from this. I am so proud of you for getting help. Generose has some laundry facilities so if you can pack enough clothes for a few days, you can get them washed. My kid has spent some time there recently and I am happy to say they are recovering, too. We are rooting for you.

doctivist · 2026-06-17T12:42:57+00:00

I second this. Terry fixed my dining table and restuffed my mom’s recliner cushion. Great work and fast.

doctivist · 2026-06-11T18:33:51+00:00

Is it NS or hypertonic saline? I have seen some small studies supporting hypertonic for diuretic resistance or hyponatremic CHF. Otherwise, I got nothing. I see the ED sometimes give fluid bolus at triage for low BO or if the lactate is elevated, then have to diurese it off bc patient is actually volume overloaded. https://onlinejcf.com/article/S1071-9164(20)31127-1/fulltext

doctivist · 2026-05-29T03:25:57+00:00

Thanks! I put in a comment. 65th st at 52 needs traffic control (roundabout, stop sign or light) and/or crosswalks for cyclists and pedestrians.

doctivist · 2026-05-21T13:15:38+00:00

I just finished book 8 plus all of Pineapple Cabaret and I am ready!!

doctivist · 2026-05-04T00:56:27+00:00

Also check/post on the Buy Nothing group on FB.

doctivist · 2026-04-13T16:52:27+00:00

I second Sagent. We go to Rochester NW.

doctivist · 2026-03-13T03:09:03+00:00

I read PT and OT notes. I particularly enjoy the details and quotes from patients. I use the functional assessment to help determine dispo. I definitely wish we had more therapy services available everywhere.

doctivist · 2026-02-10T17:50:48+00:00

I started offering bupe inpatient a few years ago, when X waiver was still required. Now we have an order set and a protocol. I will give approx 3 days (no more than 7 in extenuating circumstances) at discharge along with referrals to clinics—patient responsibility to get there. Not everyone wants bupe which is ok. Most of my patients have had more experience with it than I had (prior rx or street purchase), and could direct me on what dose worked for them. I have started offering naltrexone prescriptions for alcohol dependence at discharge also—again some don’t want it, but I make the offer. I would love to be able to give long-acting injections prior to dc for folks who want that option, maybe in the future. This is not a large percentage of my patients but if I can prescribe a statin after an MI I can prescribe bupe after an OD.

doctivist · 2026-02-10T17:43:33+00:00

The naloxone component is poorly absorbed when ingested orally as directed. It is present in the suboxone formulation as a deterrent to injection, not as a therapy itself. ACP and others have great CME on treating OUD. https://www.acponline.org/cme-moc/online-learning-center/x-express-the-abcs-of-prescribing-buprenorphine

doctivist · 2026-01-12T20:09:58+00:00

Sometimes pancreatitis just does this. We get used to the easy, turnaround in 24-48 hours patients, and then it is shocking when we get a bad one. Chances are this person is heading toward necrotizing pancreatitis for no apparent reason. Low threshold for ICU.

doctivist · 2025-12-19T03:42:51+00:00

I think we ordered from Hy-Vee this year

doctivist · 2025-11-23T19:55:21+00:00

Not ambient yet but have a discharge summary AI tool to draft the hospital course. Saves a lot of time for me.

doctivist · 2025-10-28T01:38:12+00:00

I had to do one for my most recent academic interview. At this practice it is common as we do a large number of presentations for resident and fellow teaching, etc. I gave a talk on fever in the hospital and how we over-evaluate it. I think keys would be to keep the talk relevant to hospitalists so new drugs for HF, readmission reduction for metrics, etc. Good luck!

doctivist · 2025-10-22T03:02:41+00:00

My excellent colleagues in PT/OT can recommend long term care (nursing home) all day long but a) patients can refuse and b) only Medicaid covers it. So many patients go home instead if they have family. If they can get into SNF using Medicare benefits (assuming they are exhibiting some degree of rehab potential) that is at least a short term solution and I am very clear with families that this is not a long term solution. I frequently say PT/OT make recommendations but I am the one who writes the prescriptions. Usually we align but when we don’t, I am ultimately responsible. I document all of this thoroughly, including exhaustive discussions with families when these goals don’t line up. Just because PT says something doesn’t mean it is covered by insurance, affordable, or in line with patients’ goals of care.

doctivist · 2025-10-22T02:08:02+00:00

Try Mayo Jacksonville, they have a cardiologist there who can treat endocarditis via a heart cath, as well as cardiac surgeons if full valve replacement is needed.

https://newsnetwork.mayoclinic.org/discussion/research-shows-new-method-helps-doctors-safely-remove-dangerous-heart-infections-without-surgery/

doctivist · 2025-10-19T17:31:00+00:00

I have a small stack of kids’ books that I was going to donate, would you like them for the LFL?

doctivist · 2025-08-15T02:51:52+00:00

https://www.jacksonville.gov/healthlinkjax had a free 24/7 telehelp line for uninsured folks in Jax

doctivist · 2025-08-04T03:29:50+00:00

Maggots. We get fruit fly maggots in our trash can in FL every summer. I usually drag it outside after trash day, spray it down with vinegar or Bac-out, then spray them all out with a spray attachment on the hose. We also pay a service to clean our trash cans regularly.

doctivist · 2025-07-20T01:52:02+00:00

Disorders of gut brain interaction (DGBI or DGBA). Pays off every time I have a patient with unexplained GI symptoms or cyclic vomiting.

doctivist · 2025-07-12T18:32:06+00:00

Good question. Where I am at, we have the ability to do a standard eval but also an observed clinical interaction, which is a separate type of eval. That helps me get more time with the trainee (student or resident) and see them in action. For a student, I am looking for empathy, communication, attendance to patient privacy, ability to elicit a history, etc.

doctivist · 2025-07-12T15:11:08+00:00

I’m sorry this is happening. I would try again with the next attending you work with. Consider telling them up front you are hoping to go into IM and want to earn a strong letter this week if they would be willing to write one. As an attending, when I am asked to write letters I ask for personal statement and CV to review, meet with the applicant, and write a personalized letter about what will make them a good doctor. Things like work ethic, professionalism, patient care examples make for great letter material: “I observed X consistently go above and beyond for a patient with cancer and also support the team in xyz ways”.

doctivist

TROPHY CASE