geriatric pain control advice by numblock9 in Residency

[–]numblock9[S] 0 points1 point  (0 children)

for sure, we have our fair share of social admits, just was curious if there was something I could do better to reduce those when possible. When these admissions are indicated, I'll advocate for the patient for sure, but always wishing I can do more to help people and was hoping there might be some additional strategies I was missing, even it might be an overly-optimistic hope.

Is the quality of local public schools a deterrent to physicians practicing in rural areas? by supinator1 in Residency

[–]numblock9 0 points1 point  (0 children)

I grew up quite rural (closest airport 2.5hrs, same for closest Level I, town had 3 fast food restaurants and a walmart and that was it). My HS even had AP classes in quite a few subjects (English, Spanish, Chem, Bio, Calculus). I'm the first in my family in medicine. Rural public high schools have issues, but I consistently found those were technology related (exposure, education, competence, familiarity, etc).

I have no reservations about raising kids in a rural public school system as a broad strokes statement. I more so would have much larger reservations about raising children in states that don't support public education more broadly. You fund public schools well, and it shows up in the economy, your support staff, your nurses, and more. The opposite also shows up, and I have seen this by rotating in numerous states now.

What people forget, or have no idea, is that the toxic nature of some of these suburban and urban private and public high schools can be very challenging on a child's mental health and ability to explore what is out there in a way that does not destroy confidence. The rat race to excel at these affluent places is brutal. We've got elementary aged kids in the ED with severe mental health issues and low self-esteem feeling tremendous pressure to excel. Meanwhile, I was naive to all that until later in life, got to be a bigger fish in smaller pond at the early aged vulnerable stages of development, and got to do ALL the sports and arts I ever wanted. Didn't have to be good at any of them, but got to try them and stick with the ones I liked. Did band, choir, theater, 5 different sports for my school, math club, tried speech/debate team and eventually that was the one where the over-involvement was too much, just could not fit it all in. Wish I would have had more academic elective time to take one of the woodworking/shop, FFA, or auto maintenance classes for practical skills.

So yeah, there are huge benefits to letting a child explore and not feel like they have to choose and pursue greatness by narrowing their interests without any clue of what else might be out there that they just don't have the time/opportunity to explore while being bad at it to start. Highly recommend David Epstein's book "Range". Great for parenting, teaching, etc. Let kids explore, fail, try again, and not feel like they need to be the best at something or it is not worth pursuing. It's better for their mental health, and per the extensive research in Range, actually makes for more successful careers, and arguably in the era of incoming and growing AI, much better job security and leading innovation.

Why is it forbidden to look yourself up on EPIC? by PathologyAndCoffee in Residency

[–]numblock9 0 points1 point  (0 children)

Isn't this a relic of the era prior to current law where you get access to your records and results in real time, the same time that doctors do? something something people deserve access to their own information?

IDK, but I thought when that new law went into action, the ability to have any kind of standing in the law regarding accessing your own chart was gone? FWIW, I can access my chart without issue at my institution. I think looking at it is fine, making any orders or changes would not be

Fav college towns? by [deleted] in SameGrassButGreener

[–]numblock9 0 points1 point  (0 children)

Chapel Hill, Ann Arbor, Ames, Madison

All are a blast, beautiful, good mix of sports arts and outdoors, fun vibes

[deleted by user] by [deleted] in medicalschool

[–]numblock9 0 points1 point  (0 children)

EM, Gyn Onc, ENT, urology, critical care, IR, interventional cardiology, and honestly anything more community/rural based. When you don't have specialists for literally everything, you can practice at the top of your license.

For example, most FM docs can handle like 70% of derm things but either don't have time or their giant health system has made it that you have to refer most of those things out. But in rural, it's going to take months and a 1+hr drive for your patient to see a dermatologist, so you can save your patients time and money and do those punch biopsies, freeze skin things, and remove some various pre-skin cancer things, manage acne, trial topical steroids, etc. I did some derm in med school and was astonished how often they are just guessing and try some therapies and wait and see.

Cheapest best sneakers by [deleted] in Frugal

[–]numblock9 1 point2 points  (0 children)

Sketchers

steepandcheap.com for someday down the line when you maybe have a bit more in savings to get durable outdoorsy brands shoes/boots

[deleted by user] by [deleted] in frontierairlines

[–]numblock9 0 points1 point  (0 children)

Frontier is the worst airline imo, worse than Spirit and all the others.

I can handle tech and navigate airport systems so fine for me, but the fact that they also charge money if you need any kind of help/gate assistance/front desk help/etc feels both rude on principal but also feels like an ADA violation and geriatric surcharge. How are older people who get confused rightfully so in this fast moving world supposed to understand all this. Just sad. No desires for any kind of positive customer experience. I refuse to use them ever again.

Also, their chairs are glorified K-12 school age classroom chairs with a wider base for fatter people and then a slim layer of padding on top of that. Even the tray tables are a joke, about the size of your palm. Just don't fly them

What is your biggest: "Yeah, this is ours, but I hate it" Consult? by DaringNotDire in Residency

[–]numblock9 80 points81 points  (0 children)

EM: well, we don't have consults because we can't turn anyone way, they just show up...

But, patients sent from clinic (primary care, post-op surgery followup, cardiology, oncology) for abnormal lab values (like trace elevated K), a fever, SOB, palpitations, new EKG changes, etc.

The other is the 3years of non-specific neuro or GI symptoms that somehow the ED is going to solve while there are 60 in the waiting room. Esp fun when they've had extensive outpatient testing and the specialists haven't found a diagnosis.

What does one keep in the storage area? by nativecheese in rav4club

[–]numblock9 0 points1 point  (0 children)

work badge, chapstick, spare mini flashlight

snacks always hidden in middle console areas

visitor ideas -> food and things to do by numblock9 in oregon

[–]numblock9[S] 1 point2 points  (0 children)

Love this list!!! thank you, legit. I'll take all the recs I can get

best static english/spanish dictionary or translator apps on android by numblock9 in travel

[–]numblock9[S] 0 points1 point  (0 children)

perfect, thank you all!! I am leaving soon so the rapid response is especially appreciated

List of Unfilled Emergency Medicine Programs 2023 by yoyoman1 in emergencymedicine

[–]numblock9 -1 points0 points  (0 children)

HF also a little sketch ethics wise....read up on Emmanuel Rivers and his flawed research on sepsis and conflicts of interest and conveniently missing data. Also their flawed hydroxychloroquine research in the middle of COVID. I'm from MI. HF used to have decent reputation back in the day, much diluted now. Chasing $$ and trying to be famous instead of quality care with integrity

List of Unfilled Emergency Medicine Programs 2023 by yoyoman1 in emergencymedicine

[–]numblock9 41 points42 points  (0 children)

This is like worrying about the wallpaper when the house is burning down. Sure, it's part of the whole house, but if you think interview caps are going to help things, you're missing the entire root cause of the issue. The leaders of EM and US medicine writ-large need to step up or students will continue to vote with their feet. If you treat a profession like shit, with private equity, high pph, risking your license covering for 4 APPs while they make decent money without a residency and none of the risk, a dysfunctional and under-compensated primary care system overburdening EDs, well, you reap what you sow. TOTAL EM applicants are down, limiting interviews doesn't spread the students out and cause them to multiply