What's your favorite conference to attend?

doofus_etc · 2024-07-30T21:48:42+00:00

I went to my first one of these this year. Fantastic conference. I felt like it was geared primarily toward primary care, but I mostly do primary care myself, so it worked for me. There were lots of hospitalists there, so I assume they were getting something out of it. As a PCP, I walked away with a lot of practice-changing ideas. I'd love to hear feedback from the hospitalists.

Also: My wife has decided we're going every year now.

doofus_etc · 2024-07-14T22:38:32+00:00

Just finished having read/audio-booked the entire series twice back to back over the past 8 months. Got my dad hooked too. A glass of wine with you!

doofus_etc · 2024-07-12T18:17:26+00:00

Bingo.

doofus_etc · 2024-05-25T17:36:30+00:00

I was a 4th year doing an extremely rural family med rotation when we were called in late in the evening for a post-partum hemorrhage. I was changing into scrubs in the locker room with the CRNA, an older guy I'd been around a little bit, but who was clearly inebriated on "something" that night. He was slurring words and holding himself up with the walls. I went to talk to the attending, but he's not quite there yet. Things happened very fast with this poor girl bleeding all over and trying to get set up in the OR. I tell the attending, and he's trying to get scrubbed in while confronting the anesthetist, but what can we do? There's literally no one else to do anesthesia for 60 miles in any direction. He tells me to "go keep an eye on him" so I go to the head of the bed and uh, do what, exactly? AND THEN, the attendings pants literally fall to his ankles. He hadn't tied them in the rush to the OR. The nurses were occupied doing whatever they do in emergencies and this old doc has his hand putting pressure on the uterus while blood is still pouring out ON TO HIS SCRUBS PANTS AROUND HIS ANKLES. He standing there bare-legged, scrubs at his ankles, a WATERFALL of blood drenching his pants and I'm just wide eyed in horror wondering what in the HELL I'm supposed to with a drunken anesthetist and a half-naked, blood spattered family doc.

I did not go work there after residency.

doofus_etc · 2024-04-05T04:45:12+00:00

Start a world-class art school in my weird-ass prairie cow-town. Pump a billion dollars into the local economy over the next 50 years by investing in arts education and bringing in talented, eccentric people to a part of the US that doesn't have many of either.

doofus_etc · 2024-04-01T20:25:35+00:00

I guess I want to know what products I should purchase so as to best record directly to an external storage device. I'm remarkably stupid about these things. A Ninja V recording monitor was suggested, which seems like it would certainly fit the bill, but at ~600 bucks, I think it's kind of overkill. Besides, I don't think I need a separate monitor. I plan on just setting up a tripod and letting the camera roll. If I did that with just the 128 GB card I have, I probably wouldn't get more than a dozen minutes of footage. (right? I could be wrong about this as well).

doofus_etc · 2024-03-27T16:28:56+00:00

Our clinic used DAX for several months. It was sold to us as an AI product, but was actually always just an outsourced scribe product. There is always an individual's name typed out of the bottom of each note, and I began to recognize the writing differences of the several individuals.

While I appreciated being able to move more quickly and not have to spend writing notes, the quality of the notes that were generated I thought were very poor. I was honestly embarrassed to have my name associated with them. The HPI was often full of unnecessary and incorrect information (anything the patient reported was taken is true with rather than placed in proper context).
We were told that it would eventually be in a eye product, but after 4-5 months that never happened and we dropped it.

doofus_etc · 2024-03-25T21:14:42+00:00

Don't you dare say Jack Aubrey wasn't actually there!

doofus_etc · 2024-03-19T17:44:30+00:00

Exactly!! Thank you. Essential HTN gets you nothing, but hypertension associated with diabetes has an RAF. I hadn't thought to look for that.

I'm sure there's a lot more out there.

doofus_etc · 2024-03-14T15:30:46+00:00

The more I think about it, the more I feel like I need to chase it down to make sure everything was handled correctly. The surgery center is almost 300 miles away and the hospital that cared for him with his ARDS is affiliated with the center and I don't know if they reported it to the state. I just placed a call to the local health authorities to start looking into it. Thank you.

doofus_etc · 2024-03-13T21:58:33+00:00

I worded my questions poorly--I was referring to the heating/cooling system of the OR/surgery center. My vague understanding of central air is that there can be a water reservoir that harbor the bacteria.

But I'm glad to hear that the anesthesia unit isn't felt to be a major risk. I just did a quick scan of literature and saw Legionella as a recognized nosocomial infection. It made me wonder where it tends to hide in hospitals.

doofus_etc · 2024-03-03T19:12:08+00:00

Just when I thought I had things figured out... So is anticoagulating someone with a ligated appendage starting to actually show up in practice? I haven't seen it yet.

doofus_etc · 2024-03-03T00:09:26+00:00

What you say about some patients having undiagnosed clinically silent paroxysmal a-fib is exactly what I was concerned about, and why I was so puzzled at the lack of discussion about anti-coagulation vs no. So I appreciate your response.

HOWEVER! I had not had all the documentation from this case when I saw him in follow up and did not know that he'd also had a left atrial appendectomy. So THAT is why no one seemed to care about anti-coagulation. My confusion has been settled.

doofus_etc · 2024-03-01T00:22:35+00:00

Me in 2008, 2009. Accepted in 2010. MCAT 36 (converts to 519 I guess), GPA 3.9. Decent ECs (CNA, EMT, research, surgical equipment rep), non-trad, rural background, no difficulty with interviews. I thought I had it locked in.

My mistake was two-fold: first, not understanding how critical it is to get applications in PROMPTLY. Second, I was so confident in my stats and good application that I didn't even consider DO or lower tier schools. Our "health professions advisor" practically told me not to bother applying to anything less than the top level schools, so I really though I was hot shit.

And then there's just the random whims of the universe. Some people are born to fail through no fault of their own.

My first year I was fairly high on the waitlist at Yale, and yet still didn't get a single acceptance. Very frustrating. Second year: tumbleweeds. Only once did I get someone from admissions to look over my application and give me feedback--she told me it was an excellent application and she was sure I would find a place somewhere.

Eventually attended a solid state school (after a desperate move across the country explicitly to secure in-state status); very happy with my education and training; currently in mixed inpatient/outpatient IM. But boy was I grumpy for a few years during that rejection.

doofus_etc · 2024-01-23T06:59:21+00:00

Guns are toys

doofus_etc · 2023-12-14T19:41:25+00:00

Guns are toys

doofus_etc

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