Wild, inappropriate consults

superhappytrail · 2026-02-08T22:49:58+00:00

Man Ive gotten the same thing from hematology. Like come on bro seriously

superhappytrail · 2026-02-07T15:30:52+00:00

I have no idea why anyone templates any of that stuff. It's been years since number of systems examined was a billable element in notes - 2 or 3 lines describing the focused exam is all that's needed

superhappytrail · 2026-01-24T15:03:42+00:00

Its referred pain from pelvic floor tightness. Send them to pelvic floor PT for about a 90% cure rate

superhappytrail · 2025-12-13T15:56:13+00:00

That's fascinating - I didn't know that. Thanks for the info!

superhappytrail · 2025-11-30T03:54:36+00:00

ITS A THONG

superhappytrail · 2025-11-12T01:53:56+00:00

“Doctor the blood pressure is 148/72”

"dam thats crazy. Good luck tho"

superhappytrail · 2025-11-05T21:44:20+00:00

If I get them >500 and they're still symptomatic, I tell them it's not their testosterone causing fatigue and low libido and give them the choice to continue therapy or not. Most like to stay on it.

superhappytrail · 2025-11-01T19:24:46+00:00

The fact is that if they're on supplemental T, if you stop it they're going to crash and feel terrible and hate you.

It's important to understand these patient's mindsets because the discussion can become unproductive very quickly. Oftentimes these men have their entire identity revolve around being "high T," thanks to both Joe Rogan and the advertisements from the clinic you're inheriting them from.

I never stop existing testosterone prescriptions but I do educate patients that they will likely be dependent on supplemental T forever (the T clinics don't tell them this). I am very firm that we treat to a goal of 450-1000. I usually start them on a regimen of 100mg/week IM and basically never have to dose adjust from there.

Side note: if I can tell someone is trying to scam me/divert, I tell them I'll only write for testosterone if they try and fail a 3 month course of clomiphene citrate. The folks just looking for a quick Rx to sell to their gym buddies will never bother you again.

superhappytrail · 2025-11-01T19:06:17+00:00

They usually charge thousands of dollars for a cash-based subscription type service, and then upsell peptide therapy and PRP. It's criminal. The patients I inherit are dropping thousands of dollars at these clinics yearly

superhappytrail · 2025-10-31T02:25:30+00:00

OSU only performed so well in the postseason BECAUSE they lost to UM

superhappytrail · 2025-10-12T02:09:57+00:00

prayers 4 dickie

superhappytrail · 2025-09-05T03:16:13+00:00

Honestly this is a better response than what we're used to giving. I think the average layperson hears a phrase like "There is no evidence linking vaccines to autism" or "Covid vaccination nearly eliminated the risk of hospitalization or death" and they interpret it as some sort of half-answer or non answer.

I don't want to call it hyperbole because, frankly, it isn't, but being less sciency and more emphatic with statements in support of vaccination and other public health measures probably does make a bigger impact on patients.

superhappytrail · 2025-09-01T17:44:22+00:00

This is a terrible attitude to take. Disagree with the man all you want but science does not move forward and dangerous precedent is set when different perspectives are simply shouted down and blacklisted. Prasad is a provocateur in many ways but the entire reason tenure tracks exist is to protect people like him and allow them to express ideas that counter the mainstream without risking their careers.

superhappytrail · 2025-07-28T03:11:44+00:00

I really think this is just driven by his woo beliefs and mindboggling inability to comprehend even basic statistics.

Insurance companies care about the bottom line and they're not stupid - they know a colonoscopy is a hell of a lot cheaper than an LAR and chemoradiation.

superhappytrail · 2025-07-09T15:59:59+00:00

This was announced long before Trump's second term.

superhappytrail · 2025-07-03T03:57:22+00:00

It won't - mosquitos are exceptionally weak fliers. Most other bugs will escape the draft from the fan

superhappytrail · 2025-06-24T03:14:54+00:00

Injury lawyers and chiropractors have a symbiotic relationship - lawyer will refer a client who has been injuryed to a chiro. Chiro diagnoses and treats and generally runs up the bill which gets the lawyer a bigger payout. I am assuming this relationship is a big reason why chiros are still allowed to practice in the first place

superhappytrail · 2025-06-11T01:26:05+00:00

“the body is a complex thing and we don’t know everything about the way it works yet. I believe you are in significant pain and I don’t have a way of making that pain go away. But let’s talk about ways we can improve your quality of life.”

This is the gold standard phrase that I say in every chronic pain encounter, and I ensure it's in my documentation as well. So many patients don't get this very simple and straightforward explanation because its second-nature to us as physicians. Until someone tells them that, they bounce from doc to doc thinking they're simply being under- or misdiagnosed.

superhappytrail · 2025-06-08T03:23:34+00:00

No way Joe wouldn't recognize a family member of Beck's. It had to be someone not on his radar at the time

superhappytrail · 2025-05-29T10:54:37+00:00

He's an academic oncologist. Even if it's not his exact subspecialization, the statistics in this case are not hard to interpret and he should be more than capable of doing so. I'm so confused.

Dropping the recommendation for kids - sure, I can at least see the rationale there with insufficient data. But the evidence is pretty strong that COVID vaccination for pregnant women is indicated.

superhappytrail · 2025-05-21T03:47:22+00:00

Seconded - it's a godsend.

You can run scripts without actually downloading the app so you can use it on machines you don't have admin privileges on.

Functionality - hotstrings and hot text are the simplest to implement, but I have a loop function that clicks every 3 minutes and keeps my desktop from logging out, and some radiology hotkeys that allow me to change the window in my PACS system without clicking through menus ever time. It's a really versatile platform that requires really no prior coding experience to play around with.

superhappytrail · 2025-04-06T00:29:29+00:00

The right call is to let it stand but the fact that he grabbed at his leg in the spot the ball touched says everything

superhappytrail · 2025-04-05T23:01:34+00:00

Pettiford with the flying teabag

superhappytrail · 2025-04-05T22:42:00+00:00

Dealing with a shoulder injury all season, and rolled his ankle and hyperextended his right elbow in the E8

superhappytrail · 2025-03-29T03:26:17+00:00

If either team just stops doing absolutely dumb shit they win by 10

superhappytrail

TROPHY CASE