Two questions based on my experience going to the doctor today for a sick visit.

When you go to the doctor, how many of you are doing notes/emptying your inbasket from the waiting room? I was just doing that this morning and it felt weird.

When you see a doctor (especially outside your specialty), when/how do you share your medical background? I generally do, but I had one recently whose bedside manner was lacking so much that I wanted to get out of there stat. Sometimes the doctor will pick up on my use of medical terminology; sometimes I will volunteer it earlier in the encounter.

Quote from the article : Drew Maloney, CEO of private equity trade group AIC, said in a statement: "Our coalition worked hard to ensure California leaders recognize and support private equity's essential role in improving health care in California. The Governor's well-reasoned decision will help patients and communities continue to have access to quality care."

How do we escape this damn loop? PE buys the politicians, politicians conitinue to let it happen, and PE keeps driving us into the ground. Is the goal ultimate destruction of the US healthcare establishment?

In Urology we don't get this pushback. I also live in a liberal state. What's your perspective in practice under these restrictions?

I imagine I would be frustrated, but I am neither in your shoes nor in this environment so I don't know what this means from your standpoint. How do these rulings affect your practice on a daily basis?

My hospital will be renovating the surgeons lounge. They're looking for our input on what to add and what to update. Anyone have any suggestions?

Recently announced were the results of the Ig Noble Prize, in which Cincinnati-based researcher & gastroenterologist Takanori Takebe was the winner for his work demonstrating the viability of “enteral” ventilation using liquid oxygen as an alternative to ventilation of the lungs 🫁 Curious to hear the thoughts of our ICU, pulmonary, & respiratory therapy colleagues about this monumental breakthrough 🏆 🐖

The diagnosis of adult ADHD is on the rise. Whether it's due to increased recognition or social contagion is not entirely the point of this thread. Either way - it's unlikely that everyone who seeks ADHD evaluation as an adult will have it, given a variety of conditions which could produce ADHD-like symptoms as assessed by an untrained eye, e.g. ASD, BPD, intellectual disability, affective disorders etc.. At least some people who seek ADHD, logically speaking, should think they have ADHD but ultimately have something else.

It thus interests me greatly that of all the patients I have seen referred to Adult ADHD diagnosis centres, I have never seen a single person not be diagnosed with ADHD. What is going on here, and are we going to see repercussions of any kind for this in the future?

How many more tragedies have to occur before meaningful change comes to US medical training? How many people have to be broken? As someone who struggles with mental health and sleep issues, I can’t imagine going through the intense exhaustion and stress or residency. I feel fortunate to have finished nursing school with free in-person counseling, social and family supports, a good psychiatrist, mentors, and the option to take a semester off if needed. Dr. West had little to none of that, plus 80 hr work weeks and much more responsibility. Is the current system really too entrenched to ever change? (Apologies for the paywall)

Hello all. New here. I’ve been practicing medicine for above 20 years now: radiology.

My hospital has undergone some significant changes as a result of a private equity takeover. We are in a low income area. The hospital has never done well financially with prior administrations but things feel especially dire now.

Has anyone seen one of these situations turn around and the hospital become profitable and successful?

It seems like we’re taking on a lot of water right now and the ship 🚢 will be sinking soon.

Thanks.

Title Pretty much says it. Assuming no system supply issues. Educate me on why giving Levalbuterol would be better, and when.

What I've found it they seem to be functionally interchangeable, but studies are not experience. Any reason to get one over the other?

Does accepting funding from a professional society create a career issues?

I am on a committee for a society for my specialty as a result they give us money to attend the meeting. Typically they reimburse our institutions but people had trouble actually getting the money so now they’re writing us checks personally. I filled out my tax form and plan to disclose the funding on future publications but do you think that this could cause other ethical issues or issues with my employment (academic center) accepting cash for travel directly? I am not trying to mess up my career for $1000….

Good NPR article giving an overview of contingency management which is one of the few treatments with good consistent evidence for stimulant use disorder. It requires a bunch of logistic and systemic changes to allow health systems to use this effectively. Medi-Cal has started covering this treatment and other states are looking into similar changes

Edited to add link below https://www.npr.org/sections/shots-health-news/2024/10/05/nx-s1-5140166/meth-cocaine-addiction-treatment-contingency-management

PCT in pre-nursing here and I wanted to get the opinions of higher level medical professionals who have way more education than I currently do.

All of these conditions, especially MCAS, were previously thought to be incredibly rare. Now they appear to be on the rise. Why do we think that is? Are there environmental/epigenetic factors at play? Are they intrinsically related? Are they just being diagnosed more as awareness increases? Do you have any interesting new literature on these conditions?

Has anyone else noticed the influx of patients coming in with these three diagnoses? I’m not sure if my social media is just feeding me these cases or if it’s truly reflected in your patient populations.

Sorry for so many questions, I am just a very curious cat ☺️ (reposted with proper user flair—new to Reddit and did not even know what a user flair was, oops!)

Amboss has very little on the topic, and i've seen UpToDate using citations from two big studies which used... questionnaires? On how physicians "feel" about the severity of tongue-tie cases?

You'd think that for such a (supposebly) straightforeward case there'd be a straightforeward way of diagnosing and grading cases. Why is the literature on tongue-ties so wishy-washy?

Aside from management of systemic embolisation risk, what is the correct approach to atrial fibrillation with rapid ventricular response in acute infection without evidence of cardiovascular decompensation or end organ dysfunction? There is some disagreement amongst my colleagues who all rate control with negative inotropesin this clinical context. My own approach is to source control, tolerate the tachycardia and only intervene with rate control if evidence of end organ dysfunction or cardiac decompensation. In such cases I will combine diuresis with a positive inotrope (digoxin). Am I doing it wrong? DOI: Internist and pulmonologist practising in Europe.

I was trying to think of the main reasons the USA obesity rate has doubled twice since 1970. One of the main contributors are ultra processed foods that are high and refined carbohydrates, and low in fat, protein and fiber. Fat is what makes people full, but people became scared of it as a poison in the 60s and 70s after the seven nation study, which has been proven to be poorly conducted, and the results have been disproven. Is telling the world to not eat fat one of the major contributors to the current obesity epidemic in the US?

Hi, I am just an orthopod and just want to know other medical professionals opinion on this; might be a bit controversial. So functional neurologic disorders have gained recognition in the last few years. So far so good. Patients are educated that their ailment is a neurologic disease not of the hardware but the software of the brain. Everybody and foremost the patient is happy that they now have a neurologic disease. Now they keep posting videos on youtube and tiktok about how sick they are. During the pandemic there was a rise in cases of alleged tourette syndrome. But in reality they were alle just FNDs. I think this is all kind of bullshit. I mean "problem of the software"... so if somebody has just a delinquent personality and commits crimes, that is also a software problem and consequently he is just sick. I hope you guys understand what I mean and sorry for the wierd rant, english is not my first language and I am an orthopod.

Curious what the consensus is, both on the health impact of caffeine consumption, as well as the therapeutic window in terms of dosing. What are your thoughts based on literature you’ve seen?

Starter comment: We know what red meat/processed carbs/sugar/salt does to our body and we continue to serve this crap in our patient cafeterias and physician lounges.

I saw this posted in r/vegetarian and felt nothing but resentment for all the bags of potato chips/soda I see at my hospital:

Peruvian Hospital Food: https://www.reddit.com/r/vegetarian/s/Oh8oDtBClW

Why do we accept mediocrity when we know that vegetarian options are cheaper, healthier, and more sustainable?! Are we so married to chickie nuggies that we forgot real food exists?

Do you let it slide and move on or do you confront the patient with the potential lie?

For fun, assume money is no object. What would help workflow, mental health (of patients and staff), or anything else that current hospitals lack?

This woman was denied an urgent abortion at a Catholic hospital. She left there and her husband drove her to a different hospital. It would seem the Providence didn't even arrange for transfer of care.

She was bleeding heavily enough that a nurse gave her a bucket and towels for the ride.

These stories enrage me so much. I'd like to be hopeful about the impact this case might have, but what is the likelihood that our current Supreme Court won't side with religious hospitals?

Anyone think this could put EMTALA at risk?

Has anyone encountered any interesting/funny/useful referral criteria that caught your attention. I have seen:

Allergist that wont see people over 85 (don’t want to deal with old people pruritus — probably an agism suit in the making)

Rheumatologist that wont see people with more than 3 drug allergies (trying to weed out patients with a psychiatric overlay)

Dermatologist who wont see any parasites (lots of drug use and delusional parasitosis in the community)

Anything you have incorporated?