1) not required to report unexplained loss of consciousness like seizure or fainting to Dept Motor Vehicles in NY State. In fact, if I did so, I would be in violation of patient privacy 2) yes, a physician is a mandated reporter of child abuse, so are nurses, teachers, and several other professionals. You have a problem with that? --JSt

I'm sorry about your friend. But you don't see the flip side of this. If every tiny white dot lead to a massive investigation, we'd kill more patients. It goes like this. Every tiny questionable finding white dot would lead to big investigation with endoscopy (garden hose scope down your throat) with biopsies to get the truth about the terrifying "white dot". Every now and then the procedure and the anesthesia would lead to a patient breathing in mouth saliva or gastric juices and catching a wicked pneumonia, a few might die. Every now and then the biopsy would perforate the stomach and a few might die. Every now and then the biopsy would nick a blood vessel in the stomach causing massive bleeding, leading to emergency surgery, blood transfusions and blood bourne infections and transfusion reactions, surgical wound infections, and a few would die. Or the white dot would be further evaluated not by scope but by CT scan, and every 1100 CT scans cause 1 additional case of cancer from the high dose of radiation, and so a few people would die. Get it? It takes experience and judgment to notice a tiny abnormality and decide whether it warrants further investigation. Mostly we get it right. Sometimes we get it wrong. But don't imagine that every white dot overlooked goes on to be bad just because it happened to someone you know, and that every white dot investigated improves the health of those lucky enough to not to be overlooked. Again, same reason why you folks should not look at your records: you won't know what you're looking at and you won't be able to make useful sense of them to improve your health. --JSt

Not quite true. Doctors are supposed to look for highest probability diagnoses and most dangerous diagnoses first. Common because that's probably the correct diagnosis, and dangerous ones because those cannot afford to be missed, even if they are less likely. --JSt

this is so silly. If you complain to me that you have explosive diarrhea, I write down "patient had explosive diarrhea". My medical notes are just that -- notes to help me remember and understand what I heard, what I examined, and the plans I made. You people are a bit prudish if you think that explosive diarrhea is titilating to a physician. It is not. We deal with complaints of vaginal discharge, anal bleeding, coughs with nasty phlegm, rashes with putrid oozes, everything which can be vomited, and all manner of intimate stories from our patients over their sexual indiscretions, their substance abuse, their crushing sadness from social estrangement or divorce or death of a loved one, and everything else which causes suffering in the human condition.

Doctors are deputized agents of the State? You need to go see your doctor for some psych meds to make those delusions stop haunting you...

Stuff you don't understand that only doctors understand like a zillion test results that to you might look concerning but to a doctor look fine

As amazing as this is (and it IS friggin' amazing), remember that the human brain does this throw, catch, reposition, recalculate, and respond stuff effortlessly. Just play catch with a ball and your 5 year old child. Animals with pea-sized brains do it great, too! -- Josh

Obama is taking mediocre expensive American medicine and getting it to more people. More expense. More mediocrity. More, frankly, crap. If he were really a liberal, he would have sought a govt based solution like single payor and been done with the atrocious 3rd party employer linked private insurance that we put up with now. But no, he gave in, compromised or caved at every turn, and thus we have more crap for more people when we could have had transformative change. Not a Democrat, not a liberal. --JSt

Yeah, I guess bagging college works for the rare 1-in-a-billion future billionaire. But for everyone else, college is a place of great growth of knowledge, breadth of mind and experience, social maturation, and preparation for anything and everything. Yeah, college does not guarantee success. But not going to college virtually assures lack of success. Don't listen to this drivel. --JSt

I'll help all you folks out who are insecure. I am an amateur software cobbler, able to make Hello World work only during full moons. I tip my hat to all of you, whether you are developers or engineers. Cheers, --JSt (fortunately, software tinkering is not my day job)

One reason I've heard cited that makes sense to me is that education, whether 2nd grade or second year of med school, is one of those human endeavors that requires person-to-person interactions that resists the general industrialization that occurs in so many other fields of work. You can't outsource classroom teaching. You can't replace a teacher the way you can replace secretaries with word processors and calendar apps and automated phone answering systems. I don't know whether this idea stands up to scrutiny, tho'... --JSt

"Why should college necessarily be a "fond personal experience"? You're there to learn, are you not?" You're there to do a lot of things. Learn is one of them. But get real for a moment, nearly everything one learns in a college classroom one forgets within weeks, months, and certainly years. This is not cynicism, this is fact. If you take an Econ course or a Psychology course, months or years later former students can't recite lots of facts learned. College is about learning facts, learning discipline, learning teamwork, learning about other people, broadening your mind, transitioning to being an adult. All the goals are important. For some certain goals will be more important than for others. For some, the stuff one learns will be highly aligned with the work they do in the workplace in 2, 5, and 20 years, for others the stuff they learn will have little to do with future work, and that's ok. Anyway, with a broader view of what one could and should get from college, I think college can and should be a fond personal experience. --JSt

Um, I'm a doctor. It amazes me that people do not care about how these marvelous machines work, namely the human body, but they don't. They just keep using them without paying attention to them or keeping them in good shape and then wonder why they break down. Creepy when you think about it, but it pays the bills : ) -- JSt

No, never ethical, never appropriate. Leave drugs, their costs, their risks, their side effects, to those who have diseases. --JSt