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bshep

1,062 karma · joined June 22, 2009

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bshep··on The fight between doctors and insurance companies over 'downcoding'
but the landscaper has a photo of the clean yard after they finished. They send it to you but you ( as the insurance company) say they need to call a specific time and speak to your 12y/o who is the yard representative of the house.

The 12 y/o say ‘no you stink’ and hangs up. Then you send the landscaper a letter saying ‘sorry your peer to peer was denied’

( I know this is exaggerating a bit and made to sound funny but it mostly works like that in healthcare )

bshep··on It's just a virus, the E.R. told him – days later, he was dead
sometimes, but extra hours dont get paid extra, so very little incentive to do so. there are many different models for compensation but you can think of it as a 'fixed salary with optional bonuses'.

EDIT to add:

Most places have a base + bonus structure. You get your base salary, and you see patients, for each patient seen you generate 'RVUs' which is how your group/practice generates income ( by billing insurance companies ). Once you generate enough RVUs to cover your base salary, you start accumulating 'bonus' and that gets paid out down the line using whatever formula your employer uses. There is some variation to this but for the most part groups follow a similar scheme.

EDIT #2: This is US centric, i dont know how other countries do it.

bshep··on It's just a virus, the E.R. told him – days later, he was dead
The pharmacies issue is a constant problem: patient lives out of town so prescription is sent to his home pharmacy at his request, on the day of discharge he realized his pharmacy is closed and wants them sent to a local pharmacy, of course this always happens at 5pm when you are driving in traffic, the patient is angry because they want to leave but there is not much you can do. This happens very frequently, doesnt matter if you ask ahead of time for the patient to confirm the pharmacy, something inevitably happens.

The other issue is peer to peers and prior authorizations, these take up a significant amount of time and are essentially ways the insurance companies put barriers to care and reduce their costs.

I think some of your ideas could work but good luck getting anything past the politicians, some of these things would be expensive and others would be unpopular to those that donate to the politicians.

bshep··on It's just a virus, the E.R. told him – days later, he was dead
The docs dont get paid per hour, they are salaried, so 2 docs is double the cost of 1 doc.

This is why they are overworked, why pay 2 docs if 1 can do the work, the burnout of the doc is irrelevant as there are more docs to hire after they burn-out.

bshep··on Futurehome smart hub owners must pay new $117 subscription or lose access
This is why if you have a choice you should buy devices that have ‘local only’ option.

Unfortunately the masses dont care or dont have the technical knowledge to taoe advantage of it

bshep··on MTA Open Data Challenge
Where I grew up the data for murders is curated in such a way that anybody that dies 24 after being attacked is not considered a ‘murder’. Tehy do this to reduce the statistical murder rate.
bshep··on Hackers may have leaked the Social Security Numbers of every American
Slightly related, my uni id was a prefix for the campus + year of admission + serial number

the serial number was sequential based on last name, you could essentially guess anyones student id if you had a couple of data points of last name : serial number

As far as I know no one used it for nefarious purposes, but it was a cool party trick to guess someone’s number.

bshep··on The darker side of being a doctor (2017)
You are correct in your points.

In the end I don't know where the solution lies, sometimes I feel the best solution is to re-design everything from the ground up. Other times I feel like regulation would help, but it would have to come from someone who practices actual medicine, bureaucrat.

bshep··on The darker side of being a doctor (2017)
What would happen if doctors simply refused to do more then 60 hours a week? -> you can get sued for patient abandonment if you refuse to followup on a patient you are responsible for

Is there really enough supply of new doctors coming in that the hospital can just fire them all and replace them with doctors willing to burn themselves out? -> in part yes there are ( in some fields) but what would happen is that patients would be shifted to other facilities that have staff to see the patients, also when you have 400-500k of school debt its hard to refuse work

Or would it mean the hospital would have no choice but to hire additional doctors so that each one would only have to work a sustainable number of hours? -> this happens as well, they hire locum tenens docs to fill in gaps ( higher short term expense in exchange for not giving staff docs what they need)

bshep··on Riven
no really, you click on them and they show up... i'm not sure why it isnt working, they load up from archive.org so maybe its a block in your country?
bshep··on Riven
infinite mac and load the myst cd from their UI

http://infinitemac.org

bshep··on Amazon ditches 'just walk out' checkouts at its grocery stores
I agree, and if you bring bags with you, you can bag as you scan. Works great for quick shopping trips, not so much when I'm making a big purchase.
bshep··on BMW drops controversial heated seats subscription
I find the subscription model leaves a bad taste in my mouth. I’d rather pay up front or pay to add it later. I also firmly believe in voting with you wallet and it doesnt matter what their marketing says, they are backtracking because it did not generate the income they hoped.
bshep··on BMW drops controversial heated seats subscription
Probably a good idea, I pretty much eliminated them from the list of possibilities when shopping for a car this year because of this. I’m just one data point but I’m pretty sure im not the only lost sale.
bshep··on “How is your thesis going?” Students’ perspectives on mental health and stress
I guess the best explanation is that I liked engineering but it didnt 'fulfill' me. It's something tough to explain.

In any case make sure you know what you are getting yourself into ( speak to medical colleagues ) as medicine has changed a lot in the last 5-10 years. I suspect in 10 more years medicine will be completely corporate run, as things are going now, small practices are being absorbed and being merged into larger and larger groups.

Also I agree with the sibling comments by Arch and snakes.

bshep··on “How is your thesis going?” Students’ perspectives on mental health and stress
So i did a masters in engineering(3yrs), worked for 2 years then went into med school (4yrs) and finished residency (3yrs) in the same time a friend of mine did a PHD in engineering…

I was shocked when i found out he had just finished the PHD when i was graduating residency.

bshep··on MythTV 33 Released – open-source all-in-one DVR
I had a similar experience!

We had 3 TVs hooked up, each with its own instance and a central recording instance with 3 capture cards. It worked great, you could record or playback from any of the TVs.

Main issue we had was getting the remotes to work correctly. I remember editing configs constantly to get correct behavior from the remotes.

bshep··on Taking over a Dead IoT Company
They are standard P4 panels, you can buy them for about $20-30 depending on seller/volume. They are 64x32 pixels.

You can also buy P5, P10 and other sizes. They number tells you how many millimeters between each physical pixel.

I use P10s for my Christmas display, they look good from about 15feet away or more.

bshep··on Taking over a Dead IoT Company
I just got home and was able to look at some of the RE efforts, here is one that looked interesting:

https://hkubota.wordpress.com/2022/01/31/winter-project-colo...

bshep··on Taking over a Dead IoT Company
So the configuration is a one time thing to set the card parameters, you shouldn’t need to touch it once its setup for your panels and layout. As far as I know it can only be done using their widows app.

The display is done by sending the card network frames ( someone did a reverse engineering of the protocol, i dont know the details ). You can send the display anything you want.

bshep··on Taking over a Dead IoT Company
You can use a colorlight card to control the panels, they can be had for $15 and connect to the nerwork using gigabit ethernet ( must be gigabit ). You then send then data using the windows software or you can use a Pi/computer running FPP software to send whatever you want.

This would reduce cost to:

2x panels

1x colorlight card

1x power supply

Misc cables / case

Edit: The card can handle an 8x8 matrix of panels ( IIRC ) and the cards can be chained together to make larger displays. I dont recall the max size. The biggest I’ve made is 5x5 for a xmas display.

bshep··on Why I use Jellyfin for my home media library
FWIW you can now disable the other streaming services, they annoy me as well and just today found a way to do it ( Settings -> Online Media Sources -> set all to 'Disabled' ).
bshep··on Poll HN: Do you use SSH certificates (not mere public-key authentication)?
I would love a HOWTO link.

Also, can the DNS server be public facing? Any issues with the authorized keys being public (AFAICT there isnt but i am not a security expert)?

bshep··on What would a “good” WebMD look like?
I’d say its more likely that they are vague because of regulations and liability.

IE you cant/shouldn’t give blanket medical advice and if you do you may be liable if someone has a bad outcome from the advice.

bshep··on Plex: Important notice of a potential data breach
I got it claimed again after several tries. I suspect they are getting hammered by a lot of people doing the same thing (changing passwords)
bshep··on Surgery estimated cost $1,300. Then the Bill Came: $229,000
In my experience these forms are only signed by patients, so why are they valid in those cases?
bshep··on Surgery estimated cost $1,300. Then the Bill Came: $229,000
I wonder what would happen if a patient swapped the form with an identical looking form with different verbiage, making the hospital responsible for any overage past what insurance would pay.

I very much doubt anyone would catch it until the bill was contested later. What would a court say? Would it be as legally binding as the standard document?

Edit: Or imagine a disgruntled employee in the copy room changing the form?

bshep··on Report: 90% of nurses considering leaving the profession in the next year
There are no other source of income other than insurance plans, so if they decrease rates we have no choice but to decrease pay.

Im not sure where you are getting the ‘you ignored it’ comment, when the new rates were announced we adjusted pay according to the decrease in rates.

bshep··on Report: 90% of nurses considering leaving the profession in the next year
In relation to #5 we had to drop pay by ~6-7% due to medicare cuts in 2021. Me and my MDs salaries are paid directly from medicare ( and other insurance companies who peg their compensation to the medicare rates ) so we have no choice but to drop salaries or close up shop.

With the inflation numbers this year I have no idea what we are going to do, since we are already 6-7% in the hole from the 2021 cuts and now inflation is 8-9% ( assuming the economic numbers are correct... )

bshep··on Ask HN: People who use different emails everywhere, who sold you to spammers?
Last message on that thread from jul/2021 says it will not be shutting down for now. I really like the service and I hope it doesn't shut down..

Also these are my overall stats:

  Your message stats: 21,008 forwarded, 272,134 eaten. You have 1007 spamgourmet address(es).
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