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lkth487

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lkth487 last won the day on June 29 2018

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About lkth487

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  1. All of that, plus an uncontrolled diabetic is not a threat to the other patients in the waiting area.
  2. It is not illegal to refuse a patient if they don't accept vaccinations. As for dismissing them, usually ethically you have to do your best to make sure they find someone else. I don't believe it to be unethical to outright refuse a family who won't immunize their children, though it may be a gray line because it's not a child's fault that their parents are like this, and you might be driving them towards someone who will peddle other unscientific nonsense. But does the pediatrician have an ethical responsibility also to protect the other patients in his or her practice - those who might be too young, or have legitimate reasons that they cannot get immunized (kids with cancer, immunodeficiencies, etc)?
  3. That's why good studies are placebo controlled.
  4. I think it's true to some extent. It depends on what you mean by 'leaving medicine'. There are a lot of opportunities for physicians in pharma (in drug development or QI or testing), in other industries (EMR, etc), or in healthcare administration. There's also suprisin amount of opportunities in consulting and finance - people want someone with a medical degree (along with a MBA or some other experience) as part of their team for specific cases as it relates to investing/managing/consulting/ in health care or pharmaceuticals or biotech, etc. I get emails all the time about opportunities like that. I got an email the other day about a company offering to pay for an MBA if I was interested in joining some consulting (in a field I had never heard of) firm. On the other hand, if you wanted to do civil engineering, then it is probably a complete waste of time.
  5. I did a pediatrics residency - and one of my colleagues from residency is in a practice that makes all vaccine refusers sign a form at every visit, stating they know the risks and harms of their choice. I am not sure how that effective that is. Two of my colleagues who graduated with me specifically sought out and joined a practice that refuses all anti-vax patients. I am not quite sure how I feel about that, but I understand where they are coming from. If parents won't listen to their physicians on this issue, how can there be trust about anything else? On the other hand, it's not the child's fault and I wouldn't want them to turn to people who peddle in complete nonsense for their primary care because those are the only people who take those patients. I don't have the right answers or have any bright ideas, unfortunately. Other than keep doing your best to inform people at every visit...
  6. I will try to approach the subject at each visit with parents. Sometimes it works - most of the time, I've found that it doesn't. I've taken care of kids who've died because they were unimmunized. I tell them those stories sometimes. I am not sure if it helps.
  7. Anecdotes aside, the actual surveys of satisfaction across specialties doesn't really bear that out. Dermatology is at or near the top, but so are fairly easy to get into specialties (which wouldn't be described as tier-1 by anyone). For example geriatrics is always very high. On the other hand, Neurosurgery (a "tier 1" specialty) tends to be very miserable. Top: 1) PEM, 2) Geriatrics, 3) Derm, 4) Peds, 5) IM/peds, 6) Peds specialty, 7) Nicu, 8 ) Allergy/Immunology, 9) Child and adolescent psych. For 7 out of those 9 specialties, you can likely be the lowest ranked med student in your class and still get into that specialty. So certainly not tier-1. Many of those specialties had MANY unfilled spots last year (programs are really hurting for applicants - because many of them pay less than other specialties, but not surprisingly - satisfaction and salary weren't particularly closely related). Bottom (worst first): 1) neurosurgery, 2) pulm/cc, 3) OB/Gyn 4) Nehrology, 5) Vascular surgery https://bmchealthservres.biomedcentral.com/articles/10.1186/1472-6963-9-166
  8. Playing the odds, she probably still had a better shot taking that chance than staying. People don't undertake these journeys for fun. If I were living in an environment like that, I'd probably take that chance too. Seeing a PA vs seeing a doctor didn't make the difference I'm sure - it was just the nature of the facilities and the situation. I'm sure people did the best they could.
  9. I am supportive of a lot of what people want in this thread, but experience is different than training. I can't work in a practice and assist a surgeon who does appy's for 15 years and then sit for the general surgery boards even though I have a MD after my name. Formal training with specific training and didactic requirements are important. This is why I think PA residencies are vital, especially if some body comes together and creates formal training requirements for them.
  10. There are ~30,000 allopathic residency spots per year, with less than 20,000 graduates. The overall number of US grads who end up in a residency is likely ~99%. Though some of those may have to scramble. The people who are feeling the squeeze are the graduates of foreign medical schools.
  11. This is a horrible idea for physicians. It will create an incentive to increase med school spots without a corresponding increase in residency spots. It's not hard to get into a residency right now, but it might eventually.
  12. I never shadowed anyone prior to medical school (I was not a PA either). I did some admissions committee stuff for a med school, and that was primarily an issue to make sure you know what it is like and that your only experience was not from Grey's Anatomy (or House). If you're a PA, you will be more than fine.
  13. There are other (nicer) reasons to pick med school :)! Plus, these days, the whole status thing is very much overrated.
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