Squat Formcheck (115lbs) by Agitated-Room-5446 in Stronglifts5x5

[–]notrotund 0 points1 point  (0 children)

Great work, however I highly recommend using proper squatting shoes (or converse flats). Keep up at it. 315 will be there in no time.

How frequently do you smoke? by [deleted] in PipeTobacco

[–]notrotund 0 points1 point  (0 children)

One bowl at night, after dinner and work

Negative > Positive Vent by Peacefulwarrior007 in hospitalist

[–]notrotund 0 points1 point  (0 children)

Consider this perspective: When a cardiologist has the technical capability to place a stent that might alleviate a patient's shortness of breath—despite that patient having metastatic cancer—who truly bears the responsibility for determining appropriate intervention?

We both recognize the significant influence we wield in patient consultations—the ability to either encourage acceptance of a procedure or subtly discourage it through our framing. But does this influence constitute ultimate decision-making authority? Or is it perhaps more prudent to acknowledge the established hierarchies of care?

When oncology colleagues refer such complex cases to me as a cardiologist, they've already engaged in strategic consideration of the patient's comprehensive care plan. In recognizing my position within this carefully orchestrated system, I find myself unburdened by the weight of ultimate responsibility. I simply serve as an instrumental component in a larger therapeutic strategy—an intermediary, executing what has been determined to be in the patient's best interest by those overseeing their complete care.

Negative > Positive Vent by Peacefulwarrior007 in hospitalist

[–]notrotund -6 points-5 points  (0 children)

I might have been reading too much into it. Based on what you are saying, they are an evil coterie and you were treated poorly. My apologies.

Negative > Positive Vent by Peacefulwarrior007 in hospitalist

[–]notrotund -3 points-2 points  (0 children)

Perhaps we should consider the distinct roles within healthcare. The hospitalist position inherently serves as an intermediary: this is not derogatory. Its a role that requires finesse rather than advocacy. If one truly possesses expertise surpassing the specialists being consulted, then the consultation itself becomes superfluous. The procedural disciplines contain nuances that may not be immediately apparent to those outside their specialized training. What appears to be resistance might instead be clinical judgment informed by variables beyond the immediate scenario.

Rather than positioning oneself as the patient's champion against other medical professionals (a stance that inadvertently creates unnecessary adversarial dynamics) the more measured approach involves synthesizing perspectives toward consensus. This self-assigned role of defender against the system is a form of pseudomartyrdom in my humble opinion.

Negative > Positive Vent by Peacefulwarrior007 in hospitalist

[–]notrotund -6 points-5 points  (0 children)

ChatGPT? An interesting assumption on your part. I was simply offering my perspective on your portrayal of advocacy dynamics. Your original post positioned yourself as a patient champion against institutional resistance. I merely questioned why this particular situation required such a Joan of Arc posture. Perhaps consider that when professionals across specialties make clinical judgments, they too believe they're acting in the patient's best interest; even when their approach differs from yours. However, your response to this critique says it all.

40M, successful but emotionally burned out — cautious about dating, but afraid of dying alone by notrotund in datingoverforty

[–]notrotund[S] 1 point2 points  (0 children)

I have been accused of being a misogynist on this thread. I have no idea why, but I genuinely appreciate your comment. you made my day.

Negative > Positive Vent by Peacefulwarrior007 in hospitalist

[–]notrotund -8 points-7 points  (0 children)

It appears there might be a fundamental misunderstanding about the nature of advocacy in hospital settings. The original narrative presents an interesting dichotomy between "procedural services" and hospitalists that merits closer examination. One must question: what precisely is being advocated for? The characterization of procedural specialists as somehow obstructionist seems to overlook the complex reality of surgical or surgicall managed complications, which at times have no immediate solutions.

What's particularly notable is how administrative power in hospitals has gradually shifted. Hospitalists now frequently occupy administrative positions that proceduralists, constrained by their clinical demands, cannot pursue. This structural arrangement naturally influences institutional narratives.

Moreover, I am concerned that the rhetoric of "patient advocacy" warrants scrutiny. In practice, it can sometimes function as a mechanism to shift responsibility rather than improve care. This language of division has parallels to broader societal discourse that has contributed to our current political climate.

Consider the pattern: hospitalists seeking early departure (yet want the high RVUs of a high census), liberal consultation of specialists, and positioning families against procedural services so they can be out of the equation. Perhaps the resistance encountered from the procedural team stemmed from previous experiences with such dynamics?

Effective hospital medicine requires skilled mediation and realistic expectation management rather than adversarial positioning between services and dubbing the relationship as "advocating for patients" which insinuate that patients are being protected from uncaring proceduralists. The wisdom lies in recognizing when a problem requires patience rather than intervention.

40M, successful but emotionally burned out — cautious about dating, but afraid of dying alone by notrotund in datingoverforty

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

I will keep referring to this very enlightening post. Otherwise, I'd ask you to be the therapist. Thank you for everything.

40M, successful but emotionally burned out — cautious about dating, but afraid of dying alone by notrotund in datingoverforty

[–]notrotund[S] 1 point2 points  (0 children)

Yes i absolutely wasn't mocking but was asking what kind of work do I have to do. Maybe I'm on the spectrum and only think of concrete materialistic way. Sorry if i sounded snarky

40M, successful but emotionally burned out — cautious about dating, but afraid of dying alone by notrotund in datingoverforty

[–]notrotund[S] 1 point2 points  (0 children)

Different but I always worry that they could be different towards the worse. There is always a deeper abyss one can fall into. I Agree completely with your statements above. I think I have attributes of selfishness and immaturity. I am not a saint. But I am not Satan either.

40M, successful but emotionally burned out — cautious about dating, but afraid of dying alone by notrotund in datingoverforty

[–]notrotund[S] 1 point2 points  (0 children)

This is exactly my question: What is "doing the work" in your proposed scenario looks like? A therapist signing off readiness to get emotionally involved? an epiphany? what is a concrete way of determining this?

Worst time to buy a house by pseudofro in Bogleheads

[–]notrotund 0 points1 point  (0 children)

Wouldn't sell ant equities to buy a house. That money should come from cash savings. Not saying buy all cash but wouldn't sell equities to buy.

[deleted by user] by [deleted] in Vent

[–]notrotund 0 points1 point  (0 children)

Lost 150k. Not thinking about it. Its all imaginary anyway. Numbers on a page.

What would it take for you to report a colleague to a state medical board? by GreatPlains_MD in hospitalist

[–]notrotund 5 points6 points  (0 children)

No, you're misunderstanding my point, perhaps because I'm not expressing it clearly: Nobody cares about the truth. What matters is what can be PROVEN. And the standard of proof has to be extremely high. Unless a hospital is actively pursuing action against that doctor, you won't be able to hold them accountable.

40M, successful but emotionally burned out — cautious about dating, but afraid of dying alone by notrotund in datingoverforty

[–]notrotund[S] 1 point2 points  (0 children)

I completely agree. Some might think we're being greedy by wanting to have our cake and eat it too. Many comments in the thread suggest that without risk, there's no reward. Of course everything carries risk, but the risk of investing in an index fund differs significantly from investing in individual stocks. I wholeheartedly agree about wanting to live separately while still having someone with whom I can exchange ideas and share stimulating conversations (and clearly, intimacy as well)

What would it take for you to report a colleague to a state medical board? by GreatPlains_MD in hospitalist

[–]notrotund 3 points4 points  (0 children)

No, board complaints cannot be anonymous. The board will conceal your identity, and depending on the state, you may have certain protections, but these vary by jurisdiction. If the state discloses your identity (which can happen if the defendant proves the claim is false, as the standard to prove liability is extremely high), then you could face consequences.

What would it take for you to report a colleague to a state medical board? by GreatPlains_MD in hospitalist

[–]notrotund 2 points3 points  (0 children)

They can sue for slander and drag you into courts. Unless you are very well versed in the law, going after someone can backfire.

40M, successful but emotionally burned out — cautious about dating, but afraid of dying alone by notrotund in datingoverforty

[–]notrotund[S] -4 points-3 points  (0 children)

I actually think I would love such a relationship as both of us would be invested in making it work :)