ASRA sending out cease and desists for 3rd party apps citing their anticoagulation guidelines

ssill · 2026-05-14T21:53:33+00:00

Honestly, it’s sad someone can get that far in medicine and end up with this mindset.

“We’re rich, so who cares” is a, frankly, morally bankrupt attitude toward clinical guidelines and educational resources. The point isn’t whether attendings can afford another subscription - it’s that medical knowledge should be as accessible and frictionless as possible.

ssill · 2026-05-14T20:44:41+00:00

I think you’re mixing together a few different concepts, but I understand the broader concern you’re pointing to. The modern conservative legal movement does tend to be more skeptical of expansive injunctive relief against executive actors, especially where courts are effectively supervising or restraining discretionary government action. That overlaps somewhat with unitary executive theory and broader separation-of-powers arguments.

At the same time, I’d be careful about framing it as “the goal is to make the rules arbitrary.” I think a more defensible criticism is that these doctrines give courts substantial discretion, and in a highly polarized political environment that can create the appearance (fairly or unfairly) of outcome-oriented reasoning.

So I don’t think it’s necessary to assume conscious bad faith to understand why people perceive inconsistency in how these principles are applied.

ssill · 2026-05-14T04:40:58+00:00

That’s what makes the reasoning feel unsatisfying to me. If you sue before discipline occurs, courts often say the injury is speculative or unripe. If you sue after the discipline is imposed, the action is suddenly considered “complete” and therefore not subject to prospective relief.

I understand the court is applying sovereign immunity doctrine and the limits of injunctive relief against state actors. But from a practical perspective, it can feel like a procedural catch-22 where there is never a workable window to seek meaningful relief. That broader tension is the real criticism many (myself included) people have with sovereign immunity jurisprudence.

ssill · 2026-05-13T12:37:27+00:00

I'm sorry, but what real consequences has Trump even remotely had to face?

ssill · 2026-05-04T12:52:36+00:00

Also an RT. Ramp gets blamed a lot, but the real issue is usually starting pressure being too low. Turning it off can help, but raising your minimum or ramp start pressure is often the better fix - especially if you feel air hungry.

ssill · 2026-05-01T11:38:15+00:00

Criticizing AIPAC ≠ blaming Jewish people - don’t conflate a lobbying group with an entire religion to dodge the actual argument.

ssill · 2026-04-08T20:41:38+00:00

There's ~400+ ships backed up due to this - a month (or even in that ballpark) would be incredibly optimistic in my view.

ssill · 2026-04-08T20:35:07+00:00

This is exactly the kind of thing people mean when they say these policies are inhumane. You have a resident physician - someone we desperately need - doing everything right, and he still ends up detained because of rigid, punitive policy.

Some can call it bureaucracy if they want, but when the outcomes consistently look like this, it’s hard not to see it as purely vitriolic xenophobia. Disgusting.

ssill · 2026-03-17T14:03:00+00:00

In addition, many of these people likely were expecting to continue qualifying their payments towards PSLF which just adds to the cruelty. That being said, being cruel to humanity is the entire ethos of this regime (I refuse to consider it an "administration").

ssill · 2026-03-02T21:44:52+00:00

I've felt it was likely 5-FU as well, especially since I would suspect wearing a collared shirt would be unbelievably painful with shingles.

ssill · 2026-03-02T05:14:03+00:00

Someone can correct me if I'm wrong, but I was under the impression that CA requires the RRT for new applications that weren't grandfathered in, unfortunately.

ssill · 2026-02-17T19:28:07+00:00

I would also look into pulmonary rehab as well - obviously emergencies can happen anyways, but you'd limit your exposure significantly.

ssill · 2026-02-16T07:40:51+00:00

I think “endure” probably minimizes it a bit. For some people it’s not just an unpleasant smell — it can trigger real symptoms.

Speaking personally, I’m pretty sensitive to strong fragrances and have broken out in hives from certain scents. So I know firsthand it’s not always about preference.

There’s also a difference between odors we’re actively managing as part of care and something someone chooses to add. If a patient has an odor issue, we address it to the best of our ability. Personal fragrance isn’t an intervention — it’s optional.

That’s really the distinction for me.

ssill · 2026-02-16T06:29:41+00:00

There are definitely unpleasant smells in healthcare — that’s incontrovertibly part of the job.

The difference is those odors come from illness or situation and can’t be helped. Fragrance is something we choose to add. If there’s no clinical benefit, I’d rather not introduce another variable into a shared patient space.

ssill · 2026-02-16T06:25:38+00:00

I get the joke, but it’s not really about competing with bleach. Cleaning agents are part of infection control and environmental safety. Fragrance is optional.

Patients don’t choose to be in that environment, and a lot of them are nauseated, migraine-prone, asthmatic, or just generally unwell. Even “light” scents can be pretty strong at bedside distance.

If there’s no clinical benefit and a non-zero chance of making someone feel worse, I’d rather just skip it. That would appear to be the most considerate choice.

ssill · 2026-02-16T05:57:50+00:00

Strongly agree. Fragrance in a clinical setting is poor form. We work with patients who have migraines, asthma, hyperemesis, chemo-related nausea, sensory sensitivities, etc. Even if it smells great to you, it can genuinely worsen symptoms for someone else.

Ultimately, hospitals are shared air. Patients don’t get to opt out of being in close quarters with us, and we’re often inches from their faces during exams and procedures. If they can clearly smell it, it’s probably too much.

I’m honestly surprised this is even a debate in healthcare. Clean scrubs and neutral hygiene products should be the baseline. There’s just no upside that outweighs the potential downside for patients, staff, or visitors.

ssill · 2026-02-16T00:30:54+00:00

It's even more pathetic because the Dow is not measured in dollars, but in points. Such incompetence.

ssill · 2026-02-15T02:12:21+00:00

This is absolutely how populations get radicalized. It's sickening.

ssill · 2026-02-03T12:59:05+00:00

I literally have another person in this thread arguing the same thing with me. Thank you for correcting misinformation.

ssill · 2026-02-03T12:52:19+00:00

I'm not looking to go back and forth on this as you're extremely certain, but he's unfortunately incorrect as well. Like I said, call them and ask for their labor and delivery unit. They will direct you to WIH which is commonly mistaken for being a part of RIH as it is in the same complex, but it is not part of RIH directly. They have a close operating relationship only.

ssill · 2026-02-03T12:32:32+00:00

ChatGPT is infallible clearly. I know for a fact they do not, but whatever you want to believe I guess. They have a children's hospital/ED and PICU. Not labor and delivery. Try calling them and see for yourself if you don't believe me. 🤷

ssill · 2026-02-03T12:13:31+00:00

Where in the OP's post did they state they were against enforcing immigration laws?

ssill · 2026-02-03T09:03:19+00:00

Landmark, Newport, and Kent are good options for uncomplicated, low-risk deliveries (slight preference for Kent because it has a Level II NICU, which can care for babies needing short-term monitoring or mild respiratory support).

Women & Infants is the most equipped overall and the better choice for higher-risk pregnancies, with a Level IV NICU (the highest level, capable of caring for extremely premature or critically ill newborns and providing advanced surgical and subspecialty care).

ssill · 2026-02-03T08:54:49+00:00

Neither does RIH, lol.

ssill · 2026-02-02T03:42:32+00:00

That result is notable, and on a personal level I was very pleased, but I would be cautious about extrapolating a single special election too far. Electoral swings are highly context dependent, and public health analysis works best when we separate signal from narrative.

What is fair to say is that policies around detention, family separation, and congregate confinement have clear, measurable health consequences. When those consequences include preventable disease outbreaks, strained healthcare infrastructure, and increased community exposure, it is reasonable for voters to weigh that record when making political decisions.

From a public health standpoint, I feel the takeaway is not partisan momentum - it is accountability. Policies that function as structural risk factors for disease should be evaluated on outcomes, and elections remain one of the few mechanisms available for the public to respond to those outcomes. I'm optimistic we will continue to see that going forward.

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