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About thinkertdm

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  1. If you are getting paid a "training salary", make sure you are getting training- more than your sp expecting you to read on your own. Otherwise you are just a sucker making more money for him.
  2. I found this in up-to-date, I'm not sure if it's what you are looking for: Repeat and serial testing — If the TST is documented to be positive, it should never be repeated. Once the test is positive, it will remain positive, and repeating the test has no clinical utility. If there is a history of a positive TST but this is not documented, then it may be appropriate to confirm this.
  3. It would handy to be licensed in the states you are applying, I always figured future employers would like not having to wait 3 months plus to get licensing. Also, compile all of the info into one place, such as each state license numbers, your diploma, an unofficial copy of your transcript, an official copy of your transcript, copies of your bls and acls crest, your nccpa cert. some credentialing places want those, and it's handy to send them right out rather than having to hunt for them. Some states may need them too. I keep hard copies in a binder, and pdfs on my computer.
  4. Have you looked at Albany medical college?
  5. Oils may be essential for salads, along with vinegar. I try to skip the creamy dressings.
  6. Yeah, thanks. The problems is the contribution to the already skewed perception of science and of medical scientists by the general population, many of whom demand antibiotics a daily basis to a point they actually scream profanities at me. These are people who think colds are caused by the cold, put "salves" on various rashes, and think medical providers are hucksters. So I'm not debating the general validity of the study. I'm concerned about the portrayal of science and medicine to the masses. I would like to explain the disease process to my patients, but instead spend most of the time defending my self to people who think since they paid a copay they are entitled to whatever they want.
  7. Has anyone seen this article? New research shows fat-shaming can be a health hazard Now, I agree that many people, providers included, treat obese people with disrespect, but this line in the article caught my eye: Myriad of health conditions? Like diabetes? cardiovascular risk? sleep apnea? Hypertension? Here's the next one: So...I'm going to get sued when I recommend weight loss for someone who is 400 pounds, can't fit in the MRI machine, and has 10+ pitting edema, but I don't recommend weight loss for someone with a BMI of 26 who exercises daily? Finally: I understand, many, many MD's do not treat their patients with respect. But I'm not sure this crosses the line into "malpractice". Now, I didn't read the original study, just the ABC news article.
  8. Am I the only one who thinks of Anthony Hopkins when clarithromycin comes up? "Hello, Clarith..." Maybe it's just me...
  9. So...if the pa who is seeing my wife had an "urgent care" "rotation" in place of a real im rotation, I'm going have her schedule with the MD. Their rotations and residencies seem to be better monitored and restricted so that this very problem doesn't happen. In my mind, medicine is not "fast" "walk-in" and should not be taught that way, and the system that led to it is broken. We have flooded the market with cheap poorly made products, not the fine, lovingly made, well crafted well rounded pas we once we're.
  10. If you have any questions about one medical message me, I'll be happy to let you know about them
  11. Two days ago I had a grandmother literally scream and call me a "f***ing a**hole" because I wouldn't prescribe her granddaughter antibiotics for her allergic rhinitis. (and I'm pretty sure "feeling warm" isn't a fever). Every day I see 25-30 people who want antibiotics for their "sinus infections", who race to the clinic an hour after their sore throat starts, but who don't do a damn thing about their blood pressure, weight, or smoking- but then they want to sue me when their face droops or they feel the chest pain they spent a life time culturing. They insist the flu shot gives them the flu, yet when the DO get the flu, they lack any sort of common sense of what to do. They can not afford thermometers, blood pressure cuffs, and are more terrified of strep than cardiac arrest. The answer to your question- no, I don't think it is worth it.
  12. I hate to say this, but this rotation is probably the closest to real life as you are going to get. If you are working for a corporation, if you have an "administrator" with a high school education, if you have a "dual leadership", if your clinic has fancy logos, if they subscribe to press-ganey, then your job is primarily making money for XYC system; practicing is secondary, and not what they hired you for. I went to school to help people, to guide them through their health concerns, not to look at my watch and then usher them out. The best job I ever had was at the VA- there I had the feeling I was practicing REAL medicine, with patients who needed me. Anyways, yeah, it's unsafe; yeah, its not how it's supposed to be. But I don't see it changing. In fact, I had a VP tell me the other day that "patients WANT 'burger king' style medicine" as he was talking about rolling out an electronic visit service. Do they now? They also want antibiotics for every damn thing, but get upset when c-diff and MRSA eats them.
  13. Not talking to their patients. Not during the history, and certainly not when discussing with the patient what they have and how to treat it. I have- we all have- patient coming in without a single clue of what they have or how they are treating it. I get it, some of them are not so bright, and no matter what you tell them, they will ignore it, but maybe if someone took some time to explain what they have, there won't be so many misconceptions. For example, the baloney about colored sputum. So many people drop what they are doing- sometimes literally- whenever they cough up some yellow phlegm because somewhere, along the line, they were told it was an infection. And that seemed to stick in their head. Anyways, remember, our job is not to satisfy our insurance overlords, or Press Ganey, or the CEO- it is to treat the human in front of us. And that means slowing down. Turning away from the computer. Looking them in the eye. Actively listening - not hearing, but listening to what they are saying to you. They may be saying "I have a sore throat" or " I have a sinus infection", but maybe what they are saying is "I'm scared of being sick". Tell them why they aren't. Did I write all that? Forgive me, its early. So my beef is not talking or listening to patients. Boom.
  14. This morning as I was listening to Doctors Radio, I heard that there was going to be a segment later today where a "nurse practitioner" will be discussing the role of physician assistants. I didn't hear anything after that, and the site is blocked at work. Can anyone post details and/or listen to the show? I can't imagine why a NP would be talking about the role of PA's, especially without a PA representative. Tom
  15. I was referring to this: ...the immune response when ones body is given 3-4 vaccines at once and those shots have multitudes of antigens. What is this immune response (potentially overload) doing to these children. I am glad that diseases have been eradicated, but there needs to be studies completed on these combo. vaccines... And this: ...there needs to be studies completed on these combo. vaccines... And this: ...on the MMR study which makes me think twice about their intentions (i.e. money in their pockets vs safe vaccines)... Your comment was the most cogent response to any of this. I am not sure about the background of many of the people posting here, but it's clear to me that vaccines aren't the problem, ignorance is.