Oh yeah, a lot of common causes need to be evaluated plus we need to assess if the person should be on blood thinners due to the risk for a clot in the heart that can travel to the brain. I’ve admitted quite a few patients for new onset Afib due to their underlying causes as we didn’t think they were good to go home. Admittedly most people would be fine and we can be too cautious due to legal liability and physician anxiety over bad outcomes but considering the possible consequences, it’s not a terrible thing to do that.

Afib, which commonly causes palpitations, should be seen in the ER if you can’t get in to your PCP that day. Could be caused by a lot of things and a work up is warranted including lab work, echo, etc if new.

If you in the US, you’re primary care doc’s office wil havel an after hours number to call if you’re not sure. Unfortunately you’ll likely be told to go to the ER if it’s heart related because we have to err on the side of caution since we can’t evaluate you very well over the phone. Urgent cares are hit or miss since they’re staffed mostly by mid levels who may or may not be well trained but they can handle sore throats/colds, simple cuts/infections/foreign objects, STD testing, etc. depending on their facilities. I’ve been to one without basic labs which is crazy. I’d suggest calling you doc’s office first to see if they have acute visit slots that day. A lot will.

I’m not sure, only ever used it with my PC. As for the touchpad, haven’t noticed not having it but I mostly play COD and older aRPGs.

I just got a 8BitDo pro 2 because every PlayStation controller for the last 4yrs has broken in less than 6 months and it’s great. Feels good, connects over Bluetooth, and has Hall effect joysticks that aren’t prone to drift, which was the Sony controller main issue. All for $50. I think I’m done with Sony controllers.

Yeah, a good physical therapist will push you past your limits. From personal and professional experience, mental limitations will hold you back when you’re rehabbing. With my less uptight patients I’ll tell them physical therapists don’t give a shit about your pain and discomfort, they’re there to get you better. I love those fuckers, they do wonders.

I’m sad to see you go.

Is it actually hilarious? Did you fall out of your chair, laughing so hard you shit yourself? Or are you just performing for the internet, being the cool guy? Looking at your profile you’re trying hard to be “the smart guy”. Or you may just be a sad troll, lashing out in an attempt to foist some of your misery on those around you but also avoid the consequences of your actions. Hard to suss out with certainty but happy to keep fucking with you if you want to keep going.

You may be right a out that but I’ll keep trying. I’ve seen some truly egregious care provided by midlevels who were hired for primary care because hospital admins only care that midlevels can bill 80% of a physician but they only have to be paid a third of a physician salary. Unfortunately people aren’t able to differentiate between all the people in scrubs that they see so I recommend supporung Physician for Patient Protection , a great organization that lobbies against unsuper mid-level practice.

And as for chiropractors? I have little against them except for neck adjustments and adjusting childre. Necks are fragile and so are the arteries in it and kids are the just straight up flexible, they don’t need placebos to feel better.

I disagree with the use of doctor for anyone who hasn’t completed medical school and their field’s respective post-graduate training. I’ve seen the term watered down to the point that anyone tangentially related to a physician-led field uses the term. Chiropractors, nurse practitioner, administrators, etc. etc. It leads to confusion in patient populations. I’ve had patients in the ER tell me that their nurse practitioner was equivalent to me in temrs of training which is absolutely not the case. I finished 3,000 hours of clinical rotations by the end of med school and another 10,000 hours of training by the end of residency. Patients are lucky if an NP has 500 hours of clinicals before they’re hired to provide “primary care”. The training an optometrist has is specialized but not to the level of an opthalmologist so using the same term muddies the water and makes it difficult for people to discern the difference.

I worked with European PhDs at the NIH and the impression I got was that they don’t use it regularly or even prefer it. Small sample size but at the upper echelons of their respective fields.

An opthalmologist is an eye doctor. They go to medical school and do a residency for extra training. Optometrists have doctorates in optometry meaning they do four more years of school after their bachelor’s. They can call themselves doctor because in the US that’s the convention for doctorate’s (in Europe ony medical doctors use the term). There’s avast difference in intensity, depth, bredth, etc. of training between the two. It’s easy to miss the difference if you’re not familiar with the system.

UK narrow boats and canals. YouTube figured out I like nerdy people being passionate and interesting about the nerdy things they nerd about. Do you think I’m gonna go on a canal boat tour when I go to England? You’re god damn right I am.

Well shit, I grew one town over from there. Pretty sure that’s right by our cliff diving spot on the Croton Falls Reservoir. I never went in it most kids in highschool knew some “facts” about that mine.

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Fortunately CMS is rethinking the role of primary care and realizing we can save money if we’re able to provide high quality preventive care like we’re supposed to. PCP service payments (RVUs) are up 18% since 2020 which has been a long time coming. Unfortunately physician pay is down vs inflation over the last few decades but thank Christ administration salaries are way, way up over the same timeframe.

Just bought a couple of their 4oz coffees, thanks for the suggestion. The Gera Honey dark roast I have high hopes for since I hate light roasts but I don’t really understand what the fuck they’re taking about on their product pages. All I understood was dark roast so I’ll giveit a shot.

And on the total opposite side from the neo-African coffee roaster you suggested, Harrio has the hipsteriest hipster pictured on the Switch product page. Instantly made me hate the product with absolutely no basis for that opinion. Interesting dichotomy of suggestions, 9/10 would look at again.

Schwab app works for me on Graphene and that’s my main bank/stocks app. I’ve found I don’t really need all my credit card apps or my other bank app. I check once a day if that and just keep a bookmark. It hasn’t been bad at all.

Oof this is definitely wrong. A blood thinner is one of the most important things whether a patient is taking or not. It’s the nurses job to let the doctor know whether the patient is compliant not only for medical reasons but for documentation. That’s outside the argument about profit in healthcare in US, that’s basic medicine. What if that patient falls and hits their head? Do we need to know if they’re on s blood thinner? What if they’re hemoglobin starts dropping? What if they need a procedure? What tif their platelets start dropping? Etc, etc, etc.

Don’t be a dick and not do your job, that makes your coworkers miserable and puts people in danger especially in medicine. I agree with burlit being and issue and chronic understaffing but be an adult and quit or move positions if you don’t like it.

What about the 19yo I saw today, with a BMI of 62, who’s so far stuck in the cycle of self loathing, inactivity, depression, and pleasure seeking behavior that he can’t see a way out let alone start creating himself a new reality? What if I have a drug that I’m pretty confident can help him lose 200lbs? Is it ethical for me to not prescribe it because “he should be able to do it on his own?” How many people do you know who have done that? Out of the hundreds or horribly obese patients I’ve seems, I have tow that have done it with diet and exercise. We have not evolved for a world where 20,000 calories costs $20 and is available 24/7.

I agree we need to be cautious with these drugs since long-term adverse effects aren’t known but the long-term effects of obesity are well documented. I have backed off on pitching these drugs since I learned the companies making them have infiltrated the obesity research community in the US (because of course they did). They’re still an amazing tool in the fight against an obesity epidemic which has many, many different contributing factors li ok e trauma, depression, mental health issues, upbringing, genetics, etc, etc. it’s not as easy as “just don’t eat so much.”