ventana

Depends. Ibu equivocal to oxycodone in one stUdy on dental pain

If only they would do a CAQ for out patient internal medicine. I just don’t understand why not. I have email nccpa numerous times over the years. Few answers are typically we are trained as generalists. Well duh so are IM docs but they have boards. CAQ and DMSc and independent practice.

what is your point??

look at what happened to the childhood viral infections with the start of social distancing.... almost dropped to zero.... social distancing and masks works.... (I hope)

look at what happened to the childhood viral infections with the start of social distancing.... almost dropped to zero.... social distancing and masks works.... (I hope)

Way to go!!!!! Love Alaska!!!!

fyi. I have heard that Nebraska is doing a program as well as a grad of their MS I am waiting on their program to compare the two...

this thread has run it's course

Boats you are simply beyond logic you seem only interested in stirring the pot for the mere reason to create conflict many different posters are calling you out on your mis information and statements and all you do is pivot to a different topic To state that the opioid crisis is part of infant mortality and then defend it shows a startling lack of understand of the timeline of both problems, a total lack of looking at data and history and in general a very mean streak to try to through more blame at a population of people (those suffering with OUD) for something they clearly do not control. I just do not understand how you can continue to have such beliefs and statements that are so far from the proven mainstream......

Funny just reread your post. I find it odd that you describe yourself as newish. my goodness you have a whopping 2 months of work experience. I wonder if not accepting your true abilities. I don’t pretend to know anything about you, but wound about the following : Thinking everything comes easy. Getting by in school. And now the stark realization of not everyone winning all the time is settling in. I just ? Level of self honesty You are brand new. Period. btw this is not bad, you have a great education and the world ahead of you but as I have always said everything up to and including passing boards for the first time is merely the price of admission, now the fun begins.

this is a great idea, but impossible to implement. How much care is not getting done in a population is next to impossible to tell, but we can come up with generalities and follow these - the point is that the monies are already there, and BTW the working class PA is paying MORE then their share either through their employer paying tens of thousands of dollars for insurance, or the employee portion OMG I just about lost my coffee How dare you throw such vitriol and hate towards a medical Dx of addiction - as well it is absolutely unbelievable to think that people think the USA doing well in the 20th century and this was only a problem in the last 15 years. This is a long standing problem, please go look at WHO rankings... News flash, we have been trailing the first world for most of recent history please if you do not know the answer to something do not just pick a likely culprit and blame that.... ie addiction, that is dangerous and ill willed. I have seen numerous articles over the past 15 years that infant mortality rate in the USA is most likely tied to lack of following standards of care, including pre-natal and at the same time the actual care delivered by medical professionals like us - ie not following the guidelines... And I am not even in OB or GYN - just have read them as general interest This is from the CDC. https://www.cdc.gov/mmwr/preview/mmwrhtml/mm4838a2bx2.htm Challenges for the 21st Century Despite the dramatic decline in infant and maternal mortality during the 20th century, challenges remain. Perhaps the greatest is the persistent difference in maternal and infant health among various racial/ethnic groups, particularly between black and white women and infants. Although overall rates have plummeted, black infants are more than twice as likely to die as white infants; this ratio has increased in recent decades. The higher risk for infant mortality among blacks compared with whites is attributed to higher LBW incidence and preterm births and to a higher risk for death among normal birthweight infants (greater than or equal to 5 lbs, 8 oz [greater than or equal to 2500 g]) (18). American Indian/ Alaska Native infants have higher death rates than white infants because of higher SIDS rates. Hispanics of Puerto Rican origin have higher death rates than white infants because of higher LBW rates (19). The gap in maternal mortality between black and white women has increased since the early 1900s. During the first decades of the 20th century, black women were twice as likely to die of pregnancy-related complications as white women. Today, black women are more than three times as likely to die as white women. During the last few decades, the key reason for the decline in neonatal mortality has been the improved rates of survival among LBW babies, not the reduction in the incidence of LBW. The long-term effects of LBW include neurologic disorders, learning disabilities, and delayed development (20). During the 1990s, the increased use of assisted reproductive technology has led to an increase in multiple gestations and a concomitant increase in the preterm delivery and LBW rates (21). Therefore, in the coming decades, public health programs will need to address the two leading causes of infant mortality: deaths related to LBW and preterm births and congenital anomalies. Additional substantial decline in neonatal mortality will require effective strategies to reduce LBW and preterm births. This will be especially important in reducing racial/ethnic disparities in the health of infants. Approximately half of all pregnancies in the United States are unintended, including approximately three quarters among women aged less than 20 years. Unintended pregnancy is associated with increased morbidity and mortality for the mother and infant. Lifestyle factors (e.g., smoking, drinking alcohol, unsafe sex practices, and poor nutrition) and inadequate intake of foods containing folic acid pose serious health hazards to the mother and fetus and are more common among women with unintended pregnancies. In addition, one fifth of all pregnant women and approximately half of women with unintended pregnancies do not start prenatal care during the first trimester. Effective strategies to reduce unintended pregnancy, to eliminate exposure to unhealthy lifestyle factors, and to ensure that all women begin prenatal care early are important challenges for the next century. Compared with the 1970s, the 1980s and 1990s have seen a lack of decline in maternal mortality and a slower rate of decline in infant mortality. Some experts consider that the United States may be approaching an irreducible minimum in these areas. However, three factors indicate that this is unlikely. First, scientists have believed that infant and maternal mortality was as low as possible at other times during the century, when the rates were much higher than they are now. Second, the United States has higher maternal and infant mortality rates than other developed countries; it ranks 25th in infant mortality (22) and 21st in maternal mortality (23). Third, most of the U.S. population has infant and maternal mortality rates substantially lower than some racial/ethnic subgroups, and no definable biologic reason has been found to indicate that a minimum has been reached. To develop effective strategies for the 21st century, studies of the underlying factors that contribute to morbidity and mortality should be conducted. These studies should include efforts to understand not only the biologic factors but also the social, economic, psychological, and environmental factors that contribute to maternal and infant deaths. Researchers are examining "fetal programming"--the effect of uterine environment (e.g., maternal stress, nutrition, and infection) on fetal development and its effect on health from childhood to adulthood. Because reproductive tract infections (e.g., bacterial vaginosis) are associated with preterm birth, development of effective screening and treatment strategies may reduce preterm births. Case reviews or audits are being used increasingly to investigate fetal, infant, and maternal deaths; they focus on identifying preventable deaths such as those resulting from health-care system failures and gaps in quality of care and in access to care. Another strategy is to study cases of severe morbidity in which the woman or infant did not die. More clinically focused than reviews or audits, such "near miss" studies may explain why one woman or infant with a serious problem died while another survived. A thorough review of the quality of health care and access to care for all women and infants is needed to avoid preventable mortality and morbidity and to develop public health programs that can eliminate racial/ethnic disparities in health. Preconception health services for all women of childbearing age, including healthy women who intend to become pregnant, and quality care during pregnancy, delivery, and the postpartum period are critical elements needed to improve maternal and infant outcomes (see box, page 856). Reported by: Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, CDC. This graphic is particularly powerful at how bad the USA is at this

welcome to being a professional medical provider it is now time to treat you job like a profession, have pride, learn, work exceptionally hard first year out of school you still should be hitting the books every night, absorbing like a sponge your time to hit cruise control is about 3-5 years away If you are not able to do this you best leave before your confidence is totally shot Sorry to be blunt but you are getting out of the job exactly what you are putting into it, very little by the sounds..... This is not just limited to you, even in these hard times we just let an15 yr provider go after 3 weeks, it was obvious they were not a fit for the clinic and like you were not willing to invest time energy and effort in learning medicine (at 15 yrs out of schooling this is a different issue). Point is that you need to work incredibly hard and prove to yourself (yes yourself) that you can do this....

70% of health care is ALREADY paid for by Govt health insurance creates huge expense and restricts care we already spend more then enough to pay for health care for all, just re-allocate it so that pharma and insurance companies do not make profit literally every other first world country has already figured this out... we don't have to reinvent the wheel Your question is a good one as there would be job losses in these fields - but with a slow introduction and formal retraining programs change is possible, avoiding change is not a reason to not change... whoa.... lets go back to the definition of socialism as people are oh so quick to call it socialism (which it is not) DEFINITION". a political and economic theory of social organization which advocates that the means of production, distribution, and exchange should be owned or regulated by the community as a whole. nowhere no how does this apply to a single payer system. The hospital, dr's office, NH's, rehabs are all still privately owned, the paycheck still comes from the same employer, and not the gov't. Throwing out the "Socialism" label is just a fear tactic the right has come to provide a sound bite (simple and concise but wrong) about universal payer. My stats has had universal coverage since 2006. We also continue to have, and they continue to thrive, some of the biggest and more prestigious hospitals in the country. Brigham and Womens, Tufts, Mass General, Lahey, Beth Israel........ your comments about letting grandma die i the ICU or not paying for insulin are meant to inflame. that is not what anyone is saying and in fact I would suggest many many more people die needless deaths now, at home, with out care, due to no insurance and no care. I did not get into medicine to care only for those that can afford it, and I don't think most people did. I find it amazing that MASS did this 14 years ago and no one is running around saying the sky is falling, the hospitals are broke, the practices are bankrupt and we are in trouble. In fact out health care economy in the state is healthy and robust and we are covering something like 97% of our population.

please tell me more specifically population catchment unsure my area has the population to support it, but I see the way some americans are so foolish with money and I think 'maybe'

unsure what is real and what is memorex.... pre-existing conditions do not count right now, and in MASS they have been excluded for years unsure also how this applies to taking a job as you suggest and rather it would ever stop me from asking for a raise..... lets keep it to the facts and not fear please