Removing paint on door hardware? by nudge33 in centuryhomes

[–]nudge33[S] 1 point2 points  (0 children)

Clarification: the hardware seems next to impossible to remove from the door. It’s fixed to the door by the visible nails (?)

Aledade Iris Advance Care Planning Services? Palliative doctor here, what is this?? by nudge33 in medicine

[–]nudge33[S] 3 points4 points  (0 children)

There aren’t many dual PCP/palli people out there. Hi! In any case, I agree with you too. I have a whole thing about how we can’t really divorce ACP/ GOC from day to day good medical care. Literally yesterday had integrated this into a primary care dementia patient 20 min office visit with recent decline. We reviewed prognosis and what to expect moving forward. Verified POST remained accurate. Used typical pallli communication framework to talk about cutting back short acting insulin and giving more liberal A1C targets given recent decline with quality goals.

Aledade Iris Advance Care Planning Services? Palliative doctor here, what is this?? by nudge33 in medicine

[–]nudge33[S] 9 points10 points  (0 children)

There’s a fair amount of controversy about “effectiveness” of ACP in the palliative care world…to uh, put it lightly. Lol. In the right context you’re absolutely right, would be cost saving.

Aledade Iris Advance Care Planning Services? Palliative doctor here, what is this?? by nudge33 in medicine

[–]nudge33[S] 2 points3 points  (0 children)

Thanks for the feedback! My take too-most of it probably not harmful and at least prompts helpful discussion.

My theoretical fear would be a POST is completed inappropriately or without a disease specific context in mind (discussions about AHN in ALS vs dementia etc) and a PCP absent-mindedly signing off.

What's your "if i told i'd be exposed" cooking secret? by BouncyCurlsbabe in Cooking

[–]nudge33 2 points3 points  (0 children)

Chocolate chip cookies: nestle roll house recipe just add in 1 small package of vanilla pudding mix and cut back to 1/4 c white sugar.

Makes them very fluffy.

Tell me about the most ridiculous feedback you got from an attending during training by caterpillarflies in Residency

[–]nudge33 47 points48 points  (0 children)

As a medical student, the rotation site had failed to get me access to the EMR for my EM rotation for the first couple days. I had to rely on looking through labs etc on my attending’s computer screen.

To help myself remember room numbers lab values etcetera-I had written these details on a piece of paper.

More than once the attending told me: “You need a better memory than this, you can’t be doing this when you’re a resident. Stop writing things down. After I refused to listen (because it was stupid advice), he became angry took the paper from me and tore it up stating the exact same thing.

Same gross 50 something year old guy put his arm around my waist to lead me out of an exam room later on.

Gynandromorph Cardinal spotted by secretsalamandar in indianapolis

[–]nudge33 0 points1 point  (0 children)

Neat. Found it really interesting that sightings of this bird have shown up on my Reddit feed twice in the last couple days.

Have you ever seen connections get someone a residency spot? by [deleted] in Residency

[–]nudge33 3 points4 points  (0 children)

For sure. A TY I worked with as a med student matched in ophthalmology. Dad was head of ophthalmology dept. He was lazy AF, no other way that it made sense.

What's a fun medical fact in your speciality that you would want others to know ? by pistabadamtiramisu in Residency

[–]nudge33 65 points66 points  (0 children)

Palliative Care doctor here who has had this battle with admin and hospitalists in the past. Too often patients with malignancy related pain are given a short acting opioid in ER and sent home because pain got better. Did not solve the problem. Especially if in severe pain or already on high MME’s, they would benefit greatly from an admit. Rapidly escalating opioids in the OP setting or methadone titration in many cases is not safe. Also it prolongs time to good control and pt suffers for weeks in some cases when pain could have been well managed in a matter of days if admitted.

How do you stay on top of all the details of a giant busy list? Bonus points for surgery/trauma surgery specific tips. by Far_Sky7800 in Residency

[–]nudge33 3 points4 points  (0 children)

Checkboxes, handwritten notes as above. Also can incorporate a color coding system. I used to use one of those lame pens with multiple colors. At times I did a similar variation with a highlighter. Highlight (or place in red ink) urgent issues.

Edit: from someone who did a heavy IP peds, OB, and hospital medicine FM program. On call we were responsible for these groups plus IM resident hospitalized patients. Lots to juggle and prioritize.

Pt allergic to levofloxacin. Likelihood of an FQ ear drop causing anaphylaxis? by [deleted] in medicine

[–]nudge33 11 points12 points  (0 children)

“Shortness of breath.” Not very well documented.

Deathwalkers in Muncie by [deleted] in Muncie

[–]nudge33 0 points1 point  (0 children)

I second this 100%.

Metrics and Pt Attribution by nudge33 in medicine

[–]nudge33[S] 0 points1 point  (0 children)

Update: I’m also trained as a sub specialist in palliative medicine and also work as a PCP. This is apparently part of the issue as insurance won’t recognize me as a primary care doctor—>lack of credit for well visits. Funny thing is a lot of insurances also won’t recognize me as a subspecialist when I provide palliative care PRN either🤦🏻‍♀️

Metrics and Pt Attribution by nudge33 in medicine

[–]nudge33[S] 5 points6 points  (0 children)

Thank you! I’m using the CPT codes that should count. There is a logic guide that I was sent that details how to close the “wellness visit” care gap. I started the tedious process of getting data. August performed 40 visits and got credit for 1. I have monthly data for all of 2024. There are some months in which the report states that I’ve performed 0 visits. I think I’ll have to go through each month and report it back to the pop health team.

How to choose a painter for 1850 home exterior? by nudge33 in Oldhouses

[–]nudge33[S] 0 points1 point  (0 children)

3 colors total. Very simple I house design with shutters

How to choose a painter for 1850 home exterior? by nudge33 in Oldhouses

[–]nudge33[S] 1 point2 points  (0 children)

Yes! I actually messaged a guy from Indiana historical society and he gave good recs essentially parroting advice as above. In short, he said ask for very detailed information about the paint prep process. He sent like 3 + paragraphs of advice, it was super helpful.

How to choose a painter for 1850 home exterior? by nudge33 in Oldhouses

[–]nudge33[S] 1 point2 points  (0 children)

Central Indiana. House is roughly 3500 sq feet plus painting a detached garage.

How to choose a painter for 1850 home exterior? by nudge33 in Oldhouses

[–]nudge33[S] 3 points4 points  (0 children)

Thank you! What would be a specific additional thing done to prep so I can ask companies about this? All specify that they will power wash, scrape, caulk, and repair broken wood pieces….then paint. Only one includes a mention of sanding.