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Medical staff being rude/arrogant in Health · Aug 11, 2006

censored by Jose Miller3. Look, I really need everyone to get it through their heads—I’m just not going to tolerate people attacking each other on this subforum!

Wait, hold on... maybe you should take another look at what I actually wrote. I wasn't insulting anyone here; I was just talking about a hypothetical patient mentioned in the post, I guess.

Medical staff being rude/arrogant in Health · Aug 10, 2006

Justin Fox said:They act like they're running a business, but they really just love having a monopoly.

I mean, if we were actually a for-profit outfit, maybe we could finally charge all those idiots who think it's totally fine to roll into the ER at like 3 AM because they've been nursing some random ache for two or three weeks...🙄 😕

And then when you tell them to go see their regular doctor first, they start threatening to sue you or call the local news... honestly, be my guest. censored by Jose Miller3. Please understand, I really don't allow any personal attacks between members on this subforum!

Metacarpal fracture/broken hand bone in Health · Mar 20, 2006

McQueen said:In my case, it was what they call a fifth metacarpal mid-shaft fracture—basically, the bone snapped right in the middle, and I think I read somewhere that you have way less wiggle room for angling with that kind of break. My ultrasound showed it at 27 degrees.

Not to be repetitive, but honestly, 20 to 30 degrees is usually fine. I'm just curious about the specific threshold where you read it was unacceptable. And as for using ultrasound to diagnose bone structures... 🙄
Well, if you really want to know, someone definitely took your money without even blinking... since you're basically picking at my words here.

McQueen said:The physiatrist just sort of shook her head when she saw the X-rays from before and after the cast was applied. She mentioned that they probably should have performed an open reduction immediately after the break and set it with a plate and screws, and then it would've been all settled...

It’s the same story here, unfortunately—pretty typical for the medical system in America. You see specialists who don't really know what other departments do, yet they feel the need to comment on everything loudly right in front of the patient. If she had just called her colleague to ask why things weren't handled differently or why a certain procedure wasn't done... instead, she just talks. I can't tell you how many times I've called colleagues to ask for advice, point out a slip-up, or maybe just yell a bit when they start getting too arrogant. But I'm not going to act surprised in front of a patient and wonder which technician messed up; I'll just do whatever I can for the patient, and eventually, those mistakes catch up to people.

Are you guys feeling okay? in Health · Mar 12, 2006

Susan Martin24 said:Jose Chase2, if we’re actually going by that official CDC definition where being healthy isn't just about not being sick, but also means total physical, mental, and even social well-being, are you even sure you're healthy? Or honestly, 🙂 do you even know anyone who actually is?!? 😈

I mean, this whole country is supposedly full of healthy people, right?

Metacarpal fracture/broken hand bone in Health · Mar 10, 2006

I guess an angle somewhere between 20 and 30 degrees is probably considered acceptable

Surgical excision for under $100??? in Health · Feb 12, 2006

Honestly, it was just a joke. I’m not really out here expecting anything, though I guess I wouldn't say no to a glass of some good old Bourbon—you know, maybe a double if we're being fancy. I don't want anyone thinking I've got a drinking problem or anything, but man, one of these days I might actually lose my cool and snap at someone. It's just weird when people think they can buy you off or act like they're doing you a huge favor by tossing stuff your way...🙄 🙄
I'd much rather you just be real with me and say thanks, or honestly, just don't bother at all if you don't feel like it, depending on how you think I've earned it

Surgical excision for under $100??? in Health · Feb 11, 2006

@Susan Martin24/">@@Susan Martin24 - honestly, you should probably run the labor unions, maybe? I mean, these rookies just don't speak plainly enough—or at least, from what I’ve gathered through some high-level union circles, they say what they want to say, but they're way too soft about it.
It reminds me of this one blog post I saw, reacting to some guy saying he’s doing the exact same job over in Switzerland making $60 $0.00 instead of $8 $0.00 a month, where he actually got the hourly rates right for doctors $12, lawyers $167, and mechanics $50... and people were all like, "what do we even want? You're looking at health through such a materialistic lens, where's the humanity, life is the most precious thing..." Well, if my health is supposedly worth more than my car, why on earth would I trust it to someone who's totally underpaid and basically incompetent just because they spent 25 years in school???

Same goes for the OP here... either pay a fair price or just take a referral and deal with whoever you end up with.
Just pay Susan Martin24 $133 and bring a referral slip, then it'll be smooth sailing 😁 😁

Searching Mayo Clinic in Health · Feb 11, 2006

Susan Martin24 said:Sorry, this might be a little too heavy for a forum discussion... but I'm pretty sure Casey Cook10 will get what I'm getting at... 😍

I guess we drifted a bit off-topic here. We actually started out talking about gallbladder cancer with liver infiltration/metastases...
It’s true that the prognosis changes things, but just looking at what was mentioned for this specific case, I think the whole reason for doing an ERCP is still kind of fuzzy—especially if they already know the tumor is in the gallbladder. And if it's primarily gallbladder cancer that's hitting the ducts or the pancreas... then we're looking at Stage IV, where you really just have to see what kind of resection or palliative care is even possible, which would make the ERCP necessary.
Anyway, I don't want to overwhelm everyone 🙂

The thing is, in our healthcare system, whenever you ask for more differential diagnostics just so you can map out a precise procedure—or even just a Plan B or a bailout option—everyone seems to act like it's weird. And while the patient is busy jumping from one hospital to another trying to get all those tests done, who knows how much their initial condition has changed in the meantime.

Searching Mayo Clinic in Health · Feb 10, 2006

Susan Martin24 said:It's pretty essential when you're trying to figure out if the cancer started in the bile ducts or the head of the pancreas.

But honestly, I feel like when a patient has disease this advanced—and they mentioned an angiography too, so I'd say it's pretty locally widespread—knowing whether it originated in the ducts or the pancreatic head feels more like an academic distinction at this point.

BTW, they've been doing routine ERCP procedures at hospitals like Mount Sinai for years now, so your operator could have easily coordinated that (just like the GP suggested), you know, just getting the patient admitted and handled before surgery. Inpatient cases don't usually have to wait around for tests the way outpatient folks do.

Searching Mayo Clinic in Health · Feb 8, 2006

Scott Allen10 said:I mean, it's hard to say for sure since we're all just guessing here, but I'm thinking maybe the Mayo Clinic procedure isn't really the main goal for the head itself. Just spitballing, though... maybe they're using the Mayo Clinic procedure to see if the process has spread to the bile ducts, other channels, or the pancreas, just so they can figure out which surgery is actually best—especially considering age, whether it's something radical like a Whipple with a liver segment resection, or just palliative stuff to get the bile and pancreatic juices flowing into the small intestine again.

That’s probably what's happening... trying to plan out a bile diversion during surgery (depending on where those secondary spots are in the liver, like if they're near the hepaticus or not).
BTW... how did they even catch the gallbladder tumor in the first place?? Usually, these patients end up with jaundice, so by then it's often way too late for radical surgery. Or they find it in the pathology after a gallbladder removal. Now, the only way it would make sense to do a Mayo Clinic procedure is if they can't tell if it's the gallbladder or a Klatskin tumor at the junction of the liver ducts... so that's why they'd go that route...

Excel - time calculations in Software · Feb 6, 2006

So, it’s giving me the results for cells A1 and B1, but I was wondering if there might be some way to just format the entire column so it automatically spits out that difference whenever I fill in those first two columns?

Doctors held liable for patient's death in Health · Feb 5, 2006

I guess it’s kind of funny how this old case is suddenly being dragged back into the spotlight right when everyone is fighting about doctor salaries again—you know, since the administration basically backed out of that deal to bump pay by 10% annually over four years to match what judges make.
At the same time, I don't think anyone really pointed out from that article that our "famous" lawyer actually suggested the mother sell her house just to cover his fees and the legal costs....

Look, I'm not trying to defend the doctor's mistake, whether it was a technical error or just being unprepared or whatever... but this whole thing is ancient news, so I'm wondering why it's suddenly being resurfaced now. Like, what's actually new here? Why is this even a headline today??

Excel - time calculations in Software · Feb 5, 2006

I was wondering if anyone could help me figure out how to make an Excel column show the difference between two previous cells when they're both using an hh:mm time format? I'd really love for the result to stay in that same hh:mm format too, if that's even possible.

Thanks!

Why are fewer and fewer young people choosing to become doctors? in Health · Jan 25, 2006

I don't know, I guess I wouldn't say it was any easier to land a residency twenty or thirty years ago... I mean, it's probably not that hard nowadays unless you're being super picky about which hospital or clinic you aim for, and honestly, things might get even tougher in a year or two if those grim projections from the AMA actually come true regarding the shortage of about 300 surgeons and internists (which, let's be real, is just the fallout from some pretty questionable staffing decisions made back in the day)

Just as a little side note though, I've been noticing who's actually enrolling in med school these days... it's mostly women, which I totally don't mind because you kind of need that hyper-focused, perfectionist streak that a lot of women have, but I feel like I haven't seen a guy at training in the last four or five years who wasn't some totally feminized dude with perfectly coiffed hair and a stethoscope draped over his shoulder looking all polished 🙄 🙄 🙄

Are doctors more prone to "negative careerism"? in Health · Jan 12, 2006

Susan Martin24 said:So, Lastane, does that basically mean I'm just some dirty, corrupt, evil vampire doctor out for blood? 😍
Should I just go get bitten by a mosquito or is sprinkling some ash on myself enough... because, honestly, what I did was pretty terrible. 😈

I guess it doesn't really mean that. Because if you actually were, you wouldn't even be getting paid in dollars. I mean, what happens when people don't know the standard rate and they end up overcharging you anyway? 😁

Scott Allen10 said:Any kind of continuing education—symposiums, national conferences, workshops... travel costs, registration fees, hotel stays—none of that should come out of your own pocket. It’s either covered partially by hospital funds or, more likely, heavily subsidized by various sponsors.

Regarding that, I think anyone would be lucky if their hospital covered all those training sessions, or better yet, if they could pay for them themselves. It's like you're totally forgetting about recertification, which requires similar investments just to chase those famous "credits." And if you're in a specialty where there isn't much left to discover at national conventions (or if they aren't even happening lately), how are you supposed to stay up to date? Sure, in this age of the internet and endless medical journals, a conference isn't some magical way to gain knowledge (which the boss then reports to the board), but it at least lets you refresh things or make some new connections. Plus, it gives you a chance to get away for a week and just relax. There's a decent amount of money involved, though obviously still less than the big capital investments or equipment upgrades, which a department head like you or me couldn't touch even if we wanted to (and I don't really care about that part anyway). And nobody calls you out for that stuff either; they'll just whisper that Company X took Doctor YZ on a trip to Malibu—as if!

Post-op recovery: How is everyone doing? in Health · Dec 22, 2005

So I see your surgeon was basically an artist, what with how they closed up that wound using those extended stitches.
Like everyone else here keeps saying, maybe patience really is the key to getting through this.

Organ donation after death: thoughts and experiences? in Health · May 8, 2005

It’s true that America used to be part of the Eurotransplant network, but we lost that status mainly because there just weren't enough organs being added to the shared pool compared to how much demand there was.

Things have actually been looking up lately, probably thanks to a lot of positive PR, the success they've had with liver transplants at Mayo Clinic, and—this is huge—a whole new generation of dedicated doctors popping up all over the US. These folks working in ICU units are where most potential donors are identified, and they step up as hospital coordinators who are incredibly on top of things. Though, I guess, like a lot of stuff in this country, it still relies heavily on specific people just being passionate about their jobs, so it might only last as long as that enthusiasm does. It's such demanding work, both physically and mentally, especially when you're having those heartbreaking conversations with families during their worst moments.

Scott Allen10, I can't help but mention some of your points; you clearly know how the system works, but I feel like, just like with other healthcare topics, your tone gets a little bit bitter sometimes. Having a full transplant team on standby is absolutely essential to actually making use of the organs being harvested, and there really aren't any members of those teams who just "don't feel like working" when the moment hits. Since there are so few specialists like this in the US, if even one person is missing for any reason, it could seriously mess up the outcome, so sometimes it's honestly better not to even start the procedure.
I think way more organs get wasted simply because someone was too lazy or just didn't want to deal with the hassle of managing a potential donor, finding it easier to just pull the plug and call it a day.

Doctors' strike in Health · Apr 13, 2005

I'm honestly just glad things have cooled down a bit and the conversation has moved into slightly calmer waters, I guess.

It seems like there's a bit of a misunderstanding about how the healthcare system actually works here, and yeah, there's definitely a need to fix things so that a handful of parasites don't end up ruining it for the honest majority—you know, the people who, believe it or not, actually rely on a steady paycheck...

And just one more thing that maybe people don't quite realize: when someone hands a nurse or a doctor a little gift or buys them a coffee, that’s still money leaking out of the system, I suppose.

I'm pretty sure half those users giving out little gifts would probably lose their minds if they were told they had to pay full price for an exam or a checkup (like $50-$20) just because they gave a tip; they’d immediately start complaining about how expensive everything is... even though they might not realize they’ve already indirectly paid for it by not contributing to the actual fund that pays for the services and all those doctors' salaries in the first place...

Doctors' strike in Health · Apr 10, 2005

Scott Allen10 says:>
I mean, if a doctor isn't feeling the pay within the Medicare system... well, guys... you've got options. You could always just go private, be your own boss, and if you actually manage to make some real money doing that $33333 then honestly, good for you...

it's not like every single private doctor just fell out of the sky, you know? Most of them were specialists who spent years grinding away in the public system, and they somehow scraped together enough from those tiny, pathetic salaries to afford their offices and equipment. Yeah, right.....
Or maybe they just graduated and jumped straight into private practice? I'm really curious to see what kind of legacy those top-tier experts left behind in the public sector. Like, who did they actually mentor or teach anything to...
One of the best examples is this one private doctor who was a guest on Open one evening...

The real issue, I guess, is this lingering, old-school perception of healthcare we have here. Americans have gotten pretty used to all the perks of capitalism, except when it comes to healthcare—they somehow think that should stay totally free. And even then, people barely take care of themselves. So when things get tough, they want everything, they want it now, and they want it for nothing...
And honestly, if you want to see what kind of Federal Government we're dealing with, just look at how they announced co-pays for basically everything in healthcare right on the eve of a strike, just so they could shift all that public anger onto the doctors again.

As for your little salary "calculations"—man, I’d probably be the first one happy to see those numbers sitting in my paycheck at the end of the month.

And regarding those comments about working night shifts—I really hope you run into the exact kind of doctors you're describing if you ever find yourself needing emergency help in the middle of the night. But hey, being a "subject of Hebrang," I'm sure you can just bend heaven and earth to get whatever you need through the system without waiting like the rest of us—the people whose posts you claim to understand so much, you hypocrite.

Doctors' strike in Health · Apr 8, 2005

I feel like I just have to say something about these random claims

Earning a guaranteed monthly salary of $1,500 or more in America

So, if you look at that $3333 from a senior specialist doctor's base pay $2267 (which the Secretary tends to conveniently forget whenever it suits them), they’re actually pulling an extra $500 or so from maybe four or five on-call shifts. That means being stuck in a hospital for four or five 24-hour stretches, away from family, through holidays, weekends, and everything else. If you calculate the hourly rate for someone who spent ten years in medical school and keeps studying their whole life—mostly out of their own pocket, even though it's legally required—it ends up being about $10 per hour. Meanwhile, kids making money through campus jobs can pull in $10 for some gigs. Not to mention the endless overtime and all those unused vacation days basically gifted to the government that nobody ever compensates them for...

Refusing a 10% raise and asking for more, more, more... hiding behind notions of dignity or feeling undervalued and pleading for empathy... honestly, it seems totally irrational and wrong to me.

Nobody is really asking for anything beyond what THIS specific administration signed off on and allocated funds for—so there's no point blaming whatever unrepresentative previous government was in charge. Besides, a doctor's rights are all regulated by the signed professional agreements, so right now, even old earned rights aren't being met because only the branch collective agreement is active.

Like one doctor put it—we'll all just hop into our Mercedes-Benzes, Audis, and BMWs and honk through town complaining about how we're underpaid and undervalued.

Pretty much. Everyone's driving high-end cars and suddenly doesn't know where all that cash went.

And I guess nobody wonders why certain legal matters get dragged through the Supreme Court (where, by the way, judges have salaries that doctors try to match), yet when the state goes against a union, things move from lawsuit to verdict in a single day. It seems they definitely know how to use those high judicial salaries to ensure the courts stay on the state's side when necessary.

Just a quick side note: when people start talking about medical humanitarianism, they should remember that a doctor shouldn't be filling up their Mercedes-Benz at the gas station on the taxpayer's dime in the name of compassion, nor do their kids live off of being "humanitarian."

And honestly, I'd trade my $10,000 for any programmer, manager, or consultant's $10,000 $0.00 in a heartbeat.