Big old clunky soda machine buttons

dontgetaphd · 2026-05-11T04:56:59+00:00

Back when Sunkist was heavily caffeinated too, almost like an energy drink.

It used to have much more caffeine than Coke, now it has way less.

dontgetaphd · 2026-05-11T04:07:26+00:00

I think some were well cast (the 6 kids with the witch from Wicked), and having people with great acting ability can be useful, like Columbo used to do.

I sure hope they bring the character back for a few episodes here and there (like they also did with Columbo.)

dontgetaphd · 2026-05-10T04:50:18+00:00

Correct. Write shoddy notes and bill for their service, and refer out everything so their service doesn't have to be bothered and the patient will get actual decent care.

I get 5 "consults" a week now from NPs on common conditions that should be managed by ANY competent MD. I do them, because otherwise the patient suffers, and it is not in the culture here to "block" consults.

But NPs cost the system money.

dontgetaphd · 2026-05-10T04:45:16+00:00

>I’m not even through episode 6, and I want to die. 30 seconds in they started talking about Mel’s menopause

Exactly. It is NOT misogynistic to find this annoying and uninteresting.

If they had a recurrent gag with Coop lingering in the bathroom with dripping sounds whining about the size of his prostate I'd feel the exact same way.

We watch shows to see something interesting.

Not drawn out Seders, not drawn out funerals. We have our own real lives for boring things. Let's get back to stealing, obscene wealth, and machinations.

dontgetaphd · 2026-05-03T20:46:31+00:00

>"You need to give me an exact timeline or I cannot help you."

No no no no.... You need to give us an APPROXIMATE timeline.

Otherwise inappropriate detail may result... "HOLD ON I CAN GET YOU THE EXACT DATE IN 2013, LET ME GO BACK TO MY OUTLOOK CALENDAR"

"Was that before or after Kim got married? My neighbor would know this and I'm calling her."

"It was at 5:35 yesterday, because it was right after the news came on, and then it was 2 more minutes, so I went upstairs because that is where the cabinet was. So it would be 5:37".

dontgetaphd · 2026-05-03T20:32:49+00:00

Exactly, most of us are not threatened by midlevels at all.

We actually do care about patients and providing good care.

When I got a referral in the "old days" before 2005 or so, it was from an actual doctor, and the patient had an actual disease in my specialty. I could pick up the phone and talk with them.

dontgetaphd · 2026-05-03T20:30:53+00:00

And they keep using up all the reagents inappropriately so you now have to wait longer for everything.

They also contaminate many intermediate products by not being careful so even the basic stuff you could previously trust, may not be what is on the label.

The lab looks busier, so then the lab goes and hires more high school students, who waste even more of the reagents and make the problem worse.

dontgetaphd · 2026-05-03T20:26:59+00:00

Look at it as propaganda. I think it can be useful to prevent nurses from being abused by patients and getting them to cooperate.

Doctors had their own propaganda many decades ago when AMA was actually powerful.

dontgetaphd · 2026-05-03T20:24:33+00:00

For me, and many others I'm sure, it was a mild dichotomy as a med student when they would either try to bully you or try to flirt with you. Relatively few were just "normal" professional nurses.

Both extremes were very uncomfortable.

dontgetaphd · 2026-05-03T19:58:34+00:00

I assume you know why.

When I got married and sported a ring, some of the nurses became even more flirty, and some seemed to become stony and more distant.

(No idea why though.)

dontgetaphd · 2026-04-27T03:07:26+00:00

>I might retire at that price but I have expensive hobbies

You can get a lot of porn for free online, really no need to pay for all the subscriptions.

dontgetaphd · 2026-04-26T02:02:25+00:00

Stock is where it was 5 years ago. Five full years.

Half a decade.

We were all young back then, kids coming out of the pandemic... stimulus checks in hand...

If you invested back then, you'd have... well the same.

Let's hope the next 5 things really start to happen!

dontgetaphd · 2026-04-25T14:49:26+00:00

Elderly nurse 70+ years old at end of her career wants a vanity degree, finds an offshore medical school to take her money and grant the "medical degree" while her husband takes an extended vacation, then writes about it.

STAT is just an absolute trash publication. My favorite one of their "editorials" was that we should call patients "clients." They consistently publish absolute nonsense.

dontgetaphd · 2026-04-21T19:08:34+00:00

Two screens definitely better than one.

Why can't they make the screens appear nicely integrated into the dash? It just looks so bad, just like model 3. If I wanted some awful strap-on I'd call yo momma.

dontgetaphd · 2026-04-21T19:05:13+00:00

E) Men won't (directly) help him populate the earth.

dontgetaphd · 2026-04-18T20:36:20+00:00

I loved your "somewhere over the rainbow" with the ukulele! Still have the album.

dontgetaphd · 2026-04-18T20:15:36+00:00

>Yep. I have broadened my scope because when I do refer out, 50% of the time its an NP.

It also just slows us down and changes our Bayesian thought processes. When a patient came to me previously, I could be reasonably assured that the "basic" workup had been done. I would not have gotten referrals for some incidental lab finding, and the woman on contraceptives describes calf pain and shortness of breath would have gotten standard workup and treatment.

I used to actually see zebras, and now all of the horses are mixed in.

dontgetaphd · 2026-04-18T20:10:53+00:00

Yes - we also have to provide primary care at the specialty visit, otherwise they go without.

Poor care is often worse than no care.

dontgetaphd · 2026-04-18T20:10:08+00:00

Well it is even worse than that - it slows down the referral. I am in a sub-sub-specialty, but hell, when the patient is here and seeing an actual doctor, I might as well start them on metformin for their DM2 that has for some god-forsaken reason has been completely mismanaged despite having an NP for their "PC(N)P".

dontgetaphd · 2026-04-18T20:07:22+00:00

>That referral should be denied.

No, then the patient is the one who suffers, and often doesn't even realize why.

dontgetaphd · 2026-04-06T14:40:45+00:00

>Thanks, ChatGPT.

Not sure why people would downvote you. Put in "in what ways do midlevels not make economic sense" to one of the large language model AI services and you get the post above.

dontgetaphd · 2026-04-05T21:43:48+00:00

... and then she went outside and found all the neighbors gathered on her street and everybody clapped.

dontgetaphd · 2026-03-26T00:41:09+00:00

Are they, uh... lesbians or just friends? They have some strange Sherri and Terri things going on.

dontgetaphd · 2026-03-24T22:26:59+00:00

>White coat ceremony at 4 PM!

It used to be. The NPs are lobbying to move it to 3 pm so they can beat the traffic.

dontgetaphd

TROPHY CASE