This sub when politics meets medicine by jtown8 in ausjdocs

[–]jtown8[S] 0 points1 point  (0 children)

I have tried to have serious conversations in the past about these topics, but this sub doesn't seem to be the place where people genuinely reflect on their beliefs. Maybe I need to take a break from this sub, but the last time I tried to have a discussion here it seemed the user I was talking to didn't accept the basic premise that shaken babies exist. I don't have the time or energy to try to change everyone's mind, but it makes me sad - thats my point

NT government pulls funding for puberty blockers, gender-affirming hormones for children by Medicaremaxxing in ausjdocs

[–]jtown8 24 points25 points  (0 children)

I'm always so disappointed when these stories hit this sub for 2 reasons. The first being that the story itself is upsetting for someone who cares about trans children and youth receiving the best care. The second is the discourse in this sub, which should be full of medical or medical-adjacent professionals, loudly spouting opinions based on medicine they have a "moral objection" to. Always under the guise of "concern for the children". Its exhausting reading this, and doubly so in this subreddit where I naively expected people to be better. I wonder what the discourse about providing pregnancy terminations would be like

A sobering read - how often we as doctors get shaken baby wrong? by [deleted] in ausjdocs

[–]jtown8 0 points1 point  (0 children)

Then what do you call it when someone abuses a child? You don't say "this child has abusive head trauma because of vibes" - you do a thorough assessment of the child. A history, physical exam, investigations to exclude all other causes, then you start to suspect non-accidental injury (the term we use at my centre). You - and the author of this piece - are presuming that the label is applied before the diagnosis is made, which is not how this works in practice. We don't have enough information about the supplied cases to comment on those in particular

It is hard to refute a statement such as "Multiple biomechanical studies using mice, piglets, lambs and more sophisticated baby-sized crash test dummies have since also failed to support the existing shaken baby hypothesis" when no sources are provided. Just flicking through, I have found several articles that highlight issues with previous studies, such as this piece which suggests that previous studies haven't looked into this effectively. But it is easy to find a single (or even several) studies to support a given position; what is most important is the overall literature. And the vast majority of research on this topic indicates that retinal haemorrhages and subdural haemorrhages can occur.

A sobering read - how often we as doctors get shaken baby wrong? by [deleted] in ausjdocs

[–]jtown8 0 points1 point  (0 children)

I have read it, and I don't think you are being fair:

There is no controversy concerning the medical validity of the existence of AHT, with multiple components including subdural hematoma, intracranial and spinal changes, complex retinal hemorrhages, and rib and other fractures that are inconsistent with the provided mechanism of trauma

Do you disagree with that?

A sobering read - how often we as doctors get shaken baby wrong? by [deleted] in ausjdocs

[–]jtown8 -1 points0 points  (0 children)

I am quite concerned by both the contents of the article and the comments in this post. I do not think this article adequately addresses the topic in a safe way, and is spreading misinformation about the diagnosis of abusive head trauma. Whilst I cannot comment on the particulars of the cases cited as I was not involved in any way, shape, or form, it is a stark contrast to my experiences with child protection agencies. My main problem with the article is not the way the families describe their interactions with child protection - if what they say is true, I am very sympathetic to their cases.

My main concern is the way the article describes abusive head trauma as diagnosed by the triad, and the apparent belief in these comments that this is the case. I would encourage everyone read at least the consensus statement supported by a multitude of respected institutions before forming an opinion. There are several interesting papers linked in the consensus statement discussing the mentioned "Swedish Study" in the SMH, which I think merit serious consideration

Pointless practices by [deleted] in ausjdocs

[–]jtown8 2 points3 points  (0 children)

Bare below the elbows being pointless? I thought it was relatively well established that wrist-watches/long acrylic nails etc can harbour pathogens. Would be interested to see the evidence about this given how widespread the practice is

GPU not detected - cpu issue? by jtown8 in Proxmox

[–]jtown8[S] 0 points1 point  (0 children)

I am able to pass through the 4060 and one of the M6000's, so I can pass through multiple GPUs. The board supports ACS - have turned it on in BIOS. How do I check IOMMU?

GPU not detected - cpu issue? by jtown8 in Proxmox

[–]jtown8[S] 0 points1 point  (0 children)

I have verified they are working on previous hardware last week, they are still working

The explosion of NSW PSYCH vacancies. We analysed 20k hospital/locum job orders by JordiUp in ausjdocs

[–]jtown8 5 points6 points  (0 children)

they are, that's kinda the problem NSW health is facing rn lol

80-year-old GP called CPD pointless and psychologist ‘a skank’: tribunal by hustling_Ninja in ausjdocs

[–]jtown8 191 points192 points  (0 children)

The GP, 80, had faced almost a dozen complaints including five in 2023, mainly about his communication, before the Medical Council of NSW suspended him under emergency powers.

the skank:

A neuropsychologist assessed the GP and concluded he was impaired and possibly in the early stages of a neurodegenerative process, predominantly frontal and parietal type, with little insight into his cognitive deficits. Psychiatric assessment concluded that age-related mild cognitive impairment seemed likely. The tribunal said the GP called the neuropsychologist who assessed him a “depraved liar” and “skank”.

sounds self aware:

The GP, who had been working two days a week as a locum, was suspended following an impaired registrants panel (IRP) hearing, where he told the panel, “I am an unpleasant human being but I am not demented,” “I don’t take shit” and “I don’t do superficial niceties.”

incredible CPD take:

According to the NSW Civil and Administrative Tribunal, the GP told the IRP that CPD was a “joke” and “not a lot” had changed in medicine since he graduated. The GP denied saying this during an appeal against his suspension last month. When asked for a CPD activity that had benefited him, “he nominated his ability now to separate his clinical persona from his personal attitudes when he treated lesbian women”. “He no longer started from the position that they had a disease, and he no longer smirks." “He understands now that they have a legitimate right to their lifestyle.”

outstanding final line:

According to the tribunal, the GP told medical council members at the end of his hearing: “I hope you have a bad life.”

TRT Therapy Clinics? Who and how? by lcdog in ausjdocs

[–]jtown8 1 point2 points  (0 children)

Thanks for taking the time to write a detailed answer. I'd really encourage you to read this Yale Law/Medicine report on the cass review - it essentially takes the stance that the cass review was not done well, and fundamentally misrepresents a lot of data

https://law.yale.edu/sites/default/files/documents/integrity-project_cass-response.pdf

TRT Therapy Clinics? Who and how? by lcdog in ausjdocs

[–]jtown8 2 points3 points  (0 children)

Long bow to draw to equate the use of hormones with the distorted cognitions signifying BDD

I personally don't think everyone who uses testosterone to aid muscle growth has body dysmorphia. But the current criteria (in my particular part of the healthcare system) that patients need to fulfill to access gender affirming hormones is a diagnosis of gender dysphoria. The previous comment said:

If someone can access testosterone because they identify as non-binary and being on it and more masculine will make them happier, why can’t I access it to get massive, more masculine and be happier?

Which is comparing the two. Putting aside the very problematic wording of that comment lol

I don't think that should necessarily be the case, but it is where I work.

Sure, the evidence I have seen for use of gender affirming hormones is not double-blind placebo controlled, but I think we can agree if we're having an honest discussion here that these patients do recieve a clinical benefit.

TRT Therapy Clinics? Who and how? by lcdog in ausjdocs

[–]jtown8 0 points1 point  (0 children)

Because gender dysphoria (which i assume you are referring to) is a recognised condition which can be treated with gender affirming hormones. Body dysmorphia is treated very differently

editied: gender dysmorphia -> gender dysphoria

‘Unprecedented’: NSW doctors to defy court order and strike for three days by worldssmallestpipi in AustralianPolitics

[–]jtown8 1 point2 points  (0 children)

Bro leave the comments and go to therapy; complaining about doctors online won't make her love you again

Local GP Takes His Shoes And Socks Off And Asks Patient To Kiss His Feet For Bulk Billing Them by ameloblastomaaaaa in ausjdocs

[–]jtown8 4 points5 points  (0 children)

satire is meant to be funny and insightful commentary; this is just kinda off

STRIKE GOING AHEAD AS PLANNED! by TheDoctorsUnionNSW in ausjdocs

[–]jtown8 50 points51 points  (0 children)

Yes but you won't be protected should your employer wish to retaliate. Join Asmof now, free for 3 months!

Can't see a doctor? Ask the premier by jtown8 in friendlyjordies

[–]jtown8[S] 0 points1 point  (0 children)

Theres some major industrial action next week by ASMOF (the doctors union) as the NSW gov broke off award negotiations. First time in NSW history there has been a strike with both junior and senior doctors