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Comment Re:Brazil wasn't far off (Score 1) 322

Yeah, but you understand the reason you're not supposed to eat is that you could be risking your own life if you have food in your stomach while you're under general anesthetic. You can puke and choke on it. (Risk may be doubled depending on origin of meal...)

Hahaha of course I understand the reason for fasting before a surgical procedure. The McDonald's likely congealed in the patients stomach and would not have come up without tearing a hole in their esophagus anyway ;)

Comment Re:My PCP has a "scribe!" (Score 1) 322

Yes, I suppose if you put your mind and wallet to it, you could access all the paywalled medical journals and learn navigate the system of publications to find what's relevant to your particular medical need. If you took that a step further and gave yourself a "full workup" examination, you, too, would have found your hernia - that's standard practice dating back 50 years or more.

The point is, doctors do this daily, they're practiced, and they have a fair idea about common problems and how to spot them - you should go through the "front line" of diagnosis of common problems, like hernia, before digging deeper into the latest research. But, when you fall into the group of people with medical needs that aren't adequately addressed with common, front line diagnosis and treatments, that's where the new stuff becomes valuable. Things that would have gotten a shrug of the shoulders and Rx for some pain killers last year might actually be treatable today. I remember in 1991, a colleague had ulcers, and his doctor was stuck firmly in 1989, telling him to avoid food and drink that irritate the ulcers and basically hope they'll go away on their own - thing was, in 1990 they published the causal connection between H.pylori and common ulcers, making them curable with a short course of antibiotics, which is common practice today, but his doctor wasn't "up on these things" so he was left to suffer.

And how quickly do you expect that research to be available in an expert system? Or are you imagining that these record systems are automatically indexing these journals as they publish?

Comment Re:'Nother reason I want single payer (Score 1) 322

the constant battles on the part of doctors to get paid by insurance companies who's single goal is to not pay. In no other part of my life are my goals (getting care) and the service provider's goals (not paying for that care) so diametrically opposed. I've got family members with nasty health complications from easily treatable problems that were let go because the doctor didn't want to order tests in case they came back negative. If a test comes back negative the doctors never get paid. Come to think of it I see this in one other place. B2B transactions. In so many of them business A won't pay the invoice for business B until A needs B's services again. I read somewhere Don Trump is famous for that, but having worked for small businesses it's so common he could just be going with the flow.

I have this exact problem with multibillion dollar corporations. You literally have to hold their own goals and projects hostage to get paid a $20,000 invoice on some travel expenses THEY required. You ask me to fly across the country last minute (read same day) because you can't schedule something properly and then you want ME to float the $2,000 plane ticket until you need me to save your project again? I don't think so.

Comment Re:Thank you Democrats? (Score 1) 322

No, Democrats thought that electronic records would reduce paperwork, and redundant tests. So, in 2009 & 2010, they passed bills coercing EHR use. So now medical records suck up doctor time. Wise governance?

I don't believe this. For one thing, every doctor now has to ask their patients if they are a drug addict in order to bill medicare. It doesn't matter WHY you're seeing the doctor. You could have a cold and the doctor is still supposed to not only ask whether you smoke pot but if your parents or siblings do. How does that help anyone?

Comment Re:Brazil wasn't far off (Score 5, Funny) 322

Patients are horrendously unreliable. The classic is hospital surgery. "Have you had anything to eat since last night." "No, just a bacon and egg McMuffin on the way in this morning." *

*actual conversation I heard while waiting for surgery. The person didn't think don't eat meant don't eat.

TO be fair to the patient, I would hardly call that food.

Comment Re:My PCP has a "scribe!" (Score 1) 322

Modern practice of medicine absolutely does make doctors into data entry clerks. Big data is telling them what works, what doesn't, improving diagnosis and treatment, the volume of data and pace of discovery are such that no human being could possibly keep up with it in the traditional med school + residency + practice & annual CE fashion. If your doctor isn't "jacked into the cloud," you're not getting the best out of modern medicine.

This is ABSOLUTELY not to say that the best medical care comes from doctors who attempt to practice cloud connected medicine, effectiveness of practitioners varies tremendously, and the best traditional doctors are far far better than the worst "big data" based doctors - but, if you think you might need a procedure performed, it's probably best to consult with an MD who is "up on the cloud" in your area of need, and simultaneously guaranteed NOT to profit from you going ahead with the decision to have an expensive procedure performed.

I'm not sure that I believe this. For one thing, anything that is "in the cloud" I can look up myself. For another thing, sometimes solving a patient's healthcare problem is more about being a good problem solver than knowing the latest and greatest anything. I once had extreme pain when urinating. All of the symptoms pointed towards one of two things: an STD or a kidney stone. An expert system would have said kidney stone since I (being a basement dwelling Slashdot user) was not exposed to any STDs prior to the onset of the symptoms. Did I have a kidney stone? No. It turned out that I had a hernia that was not causing me any discomfort whatsoever. At least, it hadn't for years until it finally pushed against my urinary tract and caused a very serious kidney infection. Not being in the right risk category for a kidney infection, my doctor decided to do a full physical and that is when he discovered the cause of the problem. The expert system could only indicate where there was a symptomatic problem, the doctor found the asymptomatic cause of the entire mess.

Comment Re:Bull Stuff (Score 1) 322

It depends on their tech setup. One heathcare provider has a workstation in every room, and it takes the doctor about 1 minute to review patient records and a couple more minutes to update it after the exam is over. Another heathcare provider takes notes and transfers them all at the end of the day. Yet another still uses paperwork and is very much not organised.

It depends on their tech setup. One heathcare provider has a workstation in every room, and it takes the doctor about 1 minute to review patient records and a couple more minutes to update it after the exam is over. Another heathcare provider takes notes and transfers them all at the end of the day. Yet another still uses paperwork and is very much not organised.

I don't want to use explictives, but they are warranted to the most extreme degree possible. This 1 minute talk, it takes that long to login..if the system is polite, then to open the chart, then to find the actual note, then to load the CT scan... There are multiple hard studies that show 33% reduction in efficiency that cannot be recouped.

Patients just love when you stare at a computer instead of talking to them....

This is crazy, I fight with my nurses every day. They tell me I have to input codes, I have to reconcile X, or Y or whatever.

F. That! I talk to my patients. I deal with them, and I deal with that screaming on the back end, but I'm not typical. I fight to talk to people like I would want to be talked to if I was a patient. I am burnt out, I can't fight forever. They will wear us down, your care will suffer. You let this happen, you asked for it through shitty laws that paid doctors 20% more to be part of a hospital system. You will suffer and you asked for it.

Practicing Surgeon MD

I just recently was consulting with a surgeon (who actually recommended I not have surgery but still took care of my injury with multiple follow ups to see how I was doing) who has his staff come in and prep everything. It looks like their system requires a password to switch charts. So the MA comes in, pulls up your chart and imaging and then leaves it up for the doctor. Of course, I could probably attempt to break into the system but feel like that would be impolite. It might be a HIPAA violation, I am not sure, but it certainly keeps him from looking at the computer instead of me.

Comment Re:Weapons and ammunitions guides? (Score 1) 251

Isn't on the battlefield a little late to be reading weapons and ammunition guides?

These types are usually trained on foreign service weapons in their area of operation. They may be using scavenged weapons and may need to look up a more complicated task that they have not performed on a regular enough basis to have memorized. Same with ammo.

Comment Re: The Republicans want to make everyone work (Score 1) 1126

Bankruptcy doesn't mean what you think it means, It occurs when a person's or Company's cash flow is insufficient to meet it's obligations; a Company can be quite profitable due to the ways capital assets are depreciated, yet have insufficient liquid assets to pay it's bills.

Most truly wealthy people have several bankruptcies; to become that wealthy you have to be much less risk adverse than the average person.

I used to work for a bankruptcy law firm, I am aware that one can be forced into bankruptcy due to a lack of liquid assets. Anyway, we all know that when Trump puts a value on his net worth that he says:

[My networth fluctuates] with markets and with attitudes and with feelings, even my own feelings

Comment Re:Simon says no (Score 1) 259

Are AirBnB rentals going into places that already meet occupancy codes or are they going into permitless new construction?

I would imagine there's a percentage of people willing to rent the cheapest room, which may be a newly converted attic space, which if done to poor standards by a homeowner might be some risk, although it would also be a risk to the homeowner, too, which would seem to mitigate some risk as the homeowner doesn't want to die in a fire, either.

If the majority are going into existing dwelling spaces which already generally meet occupancy codes, where's the construction code risk?

I would imagine the high risk spaces with shoddy construction would get downvoted by potential renters anyway, as if the electrical is so poor as to be a major fire risk, then the rest of its likely to be seriously substandard as well.

There may be different occupancy codes for short term or long term rentals. I believe, but am not positive, that some states require short term rentals to have on-site secure storage in the form of either an in-room safe or a safe at the front desk. I could be wrong, however.

Comment Re:Simon says no (Score 2) 259

You obviously never applied nor got inspected for said licenses. They are just taxes on renovations. I've had 6 permits in the last 2 years, 2 electrical ones, 1 for a repair and 1 for a renovation. The licensing office requires you to have a building permit for the renovation, a building permit for fire sprinkler system, a water permit to connect the backflow preventer for said fire sprinkler system to the pipes, a sewage permit to make sure you don't connect the drain for said fire sprinkler system directly to the sewage, a fire marshal inspection, an electrical permit for the electric. Each permit is ~$120.

The inspections are a joke, I did the work all myself which is permitted as the homeowner, half the inspectors asked me why they were there, They never heard of anyone doing a fire sprinkler system so especially the water and sewage inspector were wondering why they were there, then I had to point it out and they said: well, for residential fire sprinkler we can't test the system, you pass. All inspectors spent 5m looking around and say "looks good" on both rough and finish inspections, didn't even have to show the entire renovation. They do require you to submit plans for ~3 months and then hound each inspector for 3 days to show up and the building inspector I've been calling for 3 weeks now.

You have electrical permits because working with electricity can cause fires and death. You have a sewage permit to make sure that you're not making a change to the line that would cause sewage to spill into the ground. A water permit to make sure that you're not going to cause a water problem for yourself and all your neighbors. A building permit to make sure that you do all of the structural modifications according to code. I've had to get permits to do work before, I know how the process works. When it came time for my inspections the inspectors came by (without being hassled) at the time that I scheduled with them. It took 5 minutes to schedule the inspections. And yes, the inspections only took a few minutes because the first thing the inspectors did was ask me what I did to ensure the work was up to code. Explaining that would take only a couple of minutes. Then the inspector would spend 2 minutes looking to see if I did things exactly the way that I had described. If I had described a situation that sounded dangerous, I have no doubt that the inspector would have been far more thorough. The fact is that the permitting process exists for two reasons: 1) people try to violate the zoning regulations of their community 2) bad contractors and unskilled homeowners do work that is not only dangerous to themselves, but dangerous to future buyers of the property who may not know that shoddy work was done to begin with. If you want the wild wild west that you describe, go back to any time before like 1940 and see just how many people died due to poor workmanship. Especially children in factories.

Comment Re: The Republicans want to make everyone work (Score 1, Insightful) 1126

That's feudalism. In capitalism you have to be smart if you want to keep your money.

Are you suggesting that feudal lords did not have to be smart to get where they were and remain there?

Any company can go bankrupt any day, making your stock worthless. Holding cash will diminish your fortune by inflation. If you are not smart, you lose your money. Lots of aristocrats lost their relevance during industrialisation, because they were not smart. Some invested smartly and kept their riches.

Plenty of aristocrats went bankrupt prior to the industrialization of the west. In fact, the reason that Friday the Thirteenth is unlucky is because a king of France was on the verge of bankruptcy himself.

And look at Donald Trump. That guy is an idiot who has managed to hold on to at least some of his fortune and inheritance despite failed business after failed business. If I failed half as many times as Donald Trump has, I'd be completely destitute.

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