Throwaway05
3mo ago
AMA limiting medical seats and residencies than it has to do
Sir!
I expect better from you, that's not how it works at all. ;_;
What have my rants been for!
Throwaway05
3mo ago
Sounds like you are talking about outside the US - the US is usually different in medicine when it comes to a bunch of stuff. However it seems pretty similar on this issue. Yes male doctors are more "normal" now but you are still significantly more likely to find the population we want in men over women.
Doctors in the US also avoid rural areas but its a bit thornier because the US has a ton of them, the salaries involved can be eye popping in some places (like Alaska) and because a good chunk of the problem is downstream of politics. Since the student population is overwhelmingly leftist and feel like they are giving up good leftist opportunities by learning in Iowa City or Scranton, once given freedom they centralize on big blue cities much harder (especially since many are non-white and have racism fears in white places).
At this point we've spent decades farming poor and rich minorities and made no effort at all to grab people who are likely to return to Iowa after graduation. It's a problem.
Also it seems like night shifts in the U.S are increasingly done as part of part time money farming, poor resident staffing, and shit mid levels.
Throwaway05
3mo ago
Yes female doctors hire nannies, and they are more likely to drop out of residency, have shorter careers, take more vacation, work less hours, and take on more administrative roles.
The absolutely huge gender disparity in medicine is a complete disaster because you need psycho hard working men for the whole thing to work.
God I wish I could get people IRL to think about this at all.
Throwaway05
3mo ago
The only remarkable thing about this post is the political valency; what is this place if not nut-picking to wage the culture war?
I know it's hard, I've seen you fight the local politically unpopular fight here for years and value your participation - but this poster does not match your quality and is giving off some serious troll energy.
Throwaway05
3mo ago
I think the way teachers have been in the last few decades is often on most of our minds, no worries.
Throwaway05
3mo ago
but because they managed to persuade them that all of their murders were really vigilantism, meting out "justice" to those deserving.
I find that even in medicine I usually have to give a lecture about how it's our job to heal no matter the person when someone odious shows up. Students these days (and I think it has worsened) can't even treat someone obviously racist without losing their minds. A pedophile? Absolutely no.
This is with tolerance and acceptance baked into applications and course work at all levels.
Someone gives them the ick and they are no longer good doctors.
I can't imagine how much less professional fields without selection for this are (like the police).
Throwaway05
3mo ago
Maybe healthcare just is a cursed industry.
It absolutely is. So much regulatory burden. Razor thin profit margins that fall and rise with political winds. Failed disrupters (Google, Apple, Microsoft have all entered and left). Outright lies (Theranos).
The deck was stacked against you :/
Throwaway05
3mo ago
Comedy value on point though.
Throwaway05
3mo ago
If you mean injecting drugs....sure.
Lots of Meth users are pure meth though.
Throwaway05
3mo ago
I think this may be one of those things where you are looking into it from outside the medical community and going "huh that's interesting."
But what you are stumbling into is an appeal to the work of an alternative medicine practitioner whose work seems to be heavily cited by the "cluster-b but in denial of it" community to flatter their understanding of their own pathology despite clear instruction to the contrary by legitimate medical resources.
At the same time the reference seems to completely misunderstand the wide body of clinical and genetic research as well as basic understandings in terms as well effectively universal clinical consensus.
Attempting to fit some bullshit 2+2=5 stuff into an explanation of priestliness is a fools errand since what its looking to use is total crap.
Nothing about it makes any sense and ive rattled off several significant examples (that's not how mental illness categorization works, thats not how EDS works, thats not how allergies work....).
Additional people who work in the priestly cast do not have the personality attributes you associate with most of these line items.
Again none of this make any sense.
Throwaway05
3mo ago
Alright I've repeatedly tried to be a bit soft here but to be blunt this is absolutely horseshit that seems to not match genetic studies, general research, or the gross consensus of individuals working in the field.
Some additional examples:
Gifted people have good life outcomes and contra to expectations are more attractive than average.
The "major psychiatric diagnosis" is just not true by any stretch of the imagination. It does not capture definitions of serious mental illness, inpatient populations, or most the most likely diagnosis (anxiety disorders are more common).
EDS has several known genetic markers and the one that all of the psych patients has is mysteriously the one that doesn't have genetic markers. Also women are more flexible than men and many women who are normal will claim they have EDS.
Additionally googling this person appears to show all the usual signs of questionableness and medical inaccuracy.
You are falling for pure ascientific bullshit quackery.
Throwaway05
3mo ago
No there is a specific pattern of issues in emotional response and personality construction with associated genetic markers known as borderline personality disorder. Many people with this condition incorrectly label themselves with a bunch of other stuff that may or may not be real but generally doesn't apply to them.
True allergies have an at least partially known mechanism.
Depression doesn't quite march clearly with the others listed and likely represents multiple syndromes.
Some of the big names in medical research have tried to genetically localize schizophrenia and firmly failed to do so, even if it is strongly suspected to be genetic and cause.
Emotional instability is poorly correlated with abrahamic tradition priests.
And so on and so forth. This model really doesn't make sense and ignores quite a bit of known medical knowledge.
Throwaway05
3mo ago
People with Autism and people with "Autism" are very different. There is a large community of people in the US who have a number of the conditions on this list by their own understanding but are really just someone with BPD.
"Yes I have depression, anxiety, PTSD, EDS, mast cell blah blah and 5 allergies as well as a non-typical gender presentation." That person is a borderline who refuses diagnosis or is not diagnosed.
This is so wildly off base.
Additionally most of these people are women. Women aren't really priests in the abrahamic tradition and the emotional instability associated with these people is not a good fit for priestliness.
Most of the listed disorders are incompatible with leadership and gravitas.
Throwaway05
3mo ago
I've never heard of this idea before but it grossly fails the sniff test - a lot of this stuff is pretty much known in medicine to almost always be untreated/diagnosed/refused diagnosis Cluster-B.
Some of the rest of it is known to have other different causes for instance (allergies).
Seems very likely to be bullshit, especially since the patients we see who fit into these buckets are um very un priestly.
Throwaway05
3mo ago
Now the secret is that I haven't actually reread it in nearly 20 years. But it was "sticky" (and formative given my age when I read it).
It's okay to love something and not be obsessed with it. It's also okay to keep bouncing off of it even if you love it - stop when you feel you've got enough.
That's maybe one of the lessons of the book haha.
My experience of the discourse of the book is course then out of date.
Throwaway05
3mo ago
What about Anki decks for your boards?
Yeah F codes are a little silly at times cough cough struck by orca but automated tools help make them less of a pain in the ass.
The DSM is great though for kludging a million random phenomena into something that can be actually communicated between humans.
Throwaway05
3mo ago
Honestly I've used the downvotes from my sometimes half-cocked healthcare economics rants as part of exposure therapy for fear of online censure.
Our people pleasing and neuroticism needs treatment!
My recollection of medical school was that almost all of the stellar students and smartest students were the same people. You did have a pot of smart bad students but usually they had something like ADHD and couldn't keep up with the study demand. Although I find that the smart people who didn't do well were better at retaining information years later than the not as smart but better students (this retention being in reference to things like other people's specialties).
However, "bad student" for medical school in the U.S. is a god outside of it - things like pre-exam crams and all nighters are flat out impossible. It isn't uncommon at the start of first year to be basically learning multiple undergrad classes worth of material in a week, every week. Almost all exams are incredibly high stakes and some are full days in length or more etc.
The material usually doesn't require much beyond an above average IQ to learn but the amount of it is vicious - the classic statement is "like drinking from a firehose" and then you do that for years.
No amount of pure horsepower can do it - you also need the effort.
That said an interesting part of how this has gone in the US is that the rote memorization component of medical education has become more or less solved, and since they need to do some candidate discrimination..... they've worked very hard to dial in on the "thinking" parts instead of pure memorization.
A question might be - patient with x disease has y side effect, which of the following medications most likely caused the side effect? And then all 6 meds cause that side effect - they want you to know that one of the medications is overwhelmingly likely to be prescribed because of a practice guideline, causes the side effect at a much higher rate, or something else like that.
15-20 years ago the standardized tests were hard because the way medical knowledge has exploded in recent years. Now they are actually fucking hard and require much more in depth understanding.
This may be a bit US specific though, as the population of students here is generally neurotic passionate about care people or money seekers looking for the best gig (which also requires high performance).
EDIT: An added layer of problem is that the exams have no constrained syllabus, the best you have is weights. The contents is usually "everything." Nephrology in Ortho boards? Sure. A modality that hasn't been used outside of Eastern Europe for 30 years? Sure. A drug that just cleared clinical trials five minutes ago? Yeah.
The secret is that all of the questions are fair or at least important (ex: new drug is actually the first in a new class of medications that they've been trying to get off the ground for decades), but as a student you don't know that until years later, so if you want to do well (and people do) you have to know absolutely EVERYTHING.
Throwaway05
3mo ago
It's my favorite book but it can be Work.
I am shocked at how it only seems to become more prescient as I age.*
*and disturbed.
Throwaway05
3mo ago
Ya'll don't have review books over there?
Dang.
Also medical classification systems are great. Fight me bro.
Throwaway05
3mo ago
Uhhhhhh let's see. Lose weight, stay hydrated, have muscles. I believe staying warm and avoiding activity before hand also help.
Ultimately some people just be like that though.
If that's you I'd avoid blood donations - you know it's going to present a challenge and you know you'll have an increased risk of complications.
Unless you have a rare blood type I'd try and do some good by nagging someone else to go in your stead b/c it isn't super viable for you.
Throwaway05
3mo ago
Who can actually draw blood with some skill is pretty variable, usually a hospital will have a formal or informal plan for how to do this ("call the ultrasound guided IV team" or "get Agnes") and hospital blood draw quality has worsened in recent years because of various healthcare problems. Most hospital staff also don't like working with police and will probably not put in an effort to be independent about fixing the issue in a case like this.
Of note one of the biggest factors impacting ease of blood draw is hydration - someone who used meth and passed out in a car is probably dehydrated and going to a hard stick.
Throwaway05
3mo ago
No worries, I'm just here to be ornery on medicine topics periodically. >_>
Throwaway05
3mo ago
Or even massage artists as compared to chiros as compared to orthopedic surgeons.
Hold up now. The primary role of an orthopedic surgeon is to provide medical and surgical management for orthopedic issues. A chiropractor is a physical therapist with less training, delusions of grandeur, and a notable fatality rate (dissections).
Everything that a chiropractor can do that is actual medicine is better served by a PT or PM&R doctor, and a lot of what they do is placebo bullshit at best, actively dangerous frighteningly often.
I've heard anecdotally from the national media that the DC NG has made a huge difference.
Less reporting of it being helpful in other areas, the proposed explanation for that is that DC was somewhat open to the idea and coordinated areas for them to be present.
Even some dems have supported it, although usually quietly.
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