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456 karma · joined June 13, 2009

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mv··on DOJ seizes $15B in Bitcoin from 'pig butchering' scam based in Cambodia
https://xkcd.com/538/
mv··on Heart attacks aren't as fatal as they used to be
this is why american medical care is so expensive. Family’s and Law make doctors “do everything” even when the doctors know there is 0.01% chance such a person even makes it out of the icu and that’s not saying anything about brain function.
mv··on Jewels linked to Buddha remains go to auction, sparking ethical debate
whoever owns them.
mv··on Antiviral chewing gum to reduce influenza and herpes simplex virus transmission
yes. many different strains and even if your body clears infection with one doesn’t protect against other strains
mv··on I don't like traveling anymore
that post gives similar feelings as the song Caledonia by Dougie MacLean
mv··on Police get medical records without a warrant
The information blocking rule requires that all test, notes, and labs are shared by default as soon as they result with few exceptions.
mv··on Covid-19 3rd leading cause of death among Canadians in 2022
I'd be shocked if this was anywhere near reality. Covid hasn't been an issue any of the hospitals that I work at to the point that many doctors and nurses don't even bother with N95 masks when seeing covid patients.

It's more likely this is people dying with covid and not from covid. If someone covid positive has a stroke or heart attack which column is that being written in?

I have had to write my share of death certificates, and most docs will write the easiest thing that gets the corner off their back. These statistics may be broadly true

medicine is unlike technology in that it has a much much higher level of human error in data points (intentional or not).

mv··on A fourth of U.S. health visits now delivered by non-physicians
leeches are still in use…
mv··on The planning of U.S. physician shortages (2020)
Where are you getting this 4000 hrs number from?

I’m a MD and this isn’t even remotely correct and the number seems to be pulled out of thin air. Comparing a 2 year PA program with a 4 year MD program plus mandatory 2-7 year additional training is extremely disingenuous.

mv··on Subscriptions are out, refills are in
It would make logical sense for it to function like that, but go ahead and test your theory. You will quickly find most places happily continue service for a while while sending bills and threatening collections. This is especially true of those services that are difficult to cancel.
mv··on Why Doctors Hate Their Computers (2018)
At my hospital the nursing UI of Epic is absolutely horrid. It's cluttered and confusing with multiple places to document everything.

Epic is completely customizable, but the people who make the decisions in nursing management aren't always the same people using the software. That and funding to make the changes.

If you want to see really bad software take a look at Meditech it defaults 800x600 (!), and doesn't resize well at all.

mv··on Amazon Ring went from a smart doorbell company to a surveillance network
The indiegogo funded camect is pitched as a private 'cloud optional' recorder. The beta unit I have is cloud connected but the final release has the option to be fully local. It has a lot of neat features like identifying people/ups trucks/cars/etc.

It only has a webbased client, but I kind of like it and the beta version has been way better than any of the cheap dvr trash that big box stores sell.

https://www.indiegogo.com/projects/camect-world-s-smartest-m...

mv··on Despite concerns, FDA approves new opioid 10x more powerful than Fentanyl
The Auto-injector's themselves are a solved problem and the device itself did not fail. However,

-For over 10 years, It well documented in literature that even in normal BMI women the needle is not long enough to reach muscle. https://www.ncbi.nlm.nih.gov/pubmed?term=15945556

- Prior to around 2003 IM and subcutaneous routes were both listed as valid treatments for anaphylaxis. (See https://www.aafp.org/afp/2003/1001/p1325.html)

-Depending on her weight 300mcg may be an appropriate dose for US guidelines (listed at 0.01mg/kg).

The listed issues may be from a company taking a 'one-size-fits-most' approach. They also do not update their product with respect to new guidelines and recommendations (new doses, new needle lengths, etc) Possibly to avoid further FDA approval processes? With such large profits and so little competition there is no incentive to innovate/update.

mv··on Despite concerns, FDA approves new opioid 10x more powerful than Fentanyl
It is absolutely criminal that a <$20 drug can be sold for $4500... Auto-injectors have been a solved problem for decades, and there is nothing special about naloxone vs any other drug. Treating auto-injecting tech as different for each drug only helps drive up prices and keep out competition by making FDA approval very expensive.

I hope you are successful getting a generic auto-injector approved, but I don't think your biggest hurdle will be design or engineering.

https://www.nejm.org/doi/full/10.1056/NEJMp1609578

mv··on Reference Listed Drug (RLD) Access Inquiries
I am a board certified anesthesiologist in the USA. What is your justification or source for calling this false?

Fentanyl is given to nearly every patient prior to intubation and frequently redosed throughout most operations.

mv··on Reference Listed Drug (RLD) Access Inquiries
It is deadly as a street drug, but it is safe and effective in the hospital setting.

It is used on nearly every patient that has an operation with anesthesia and would be very difficult to find a replacement that is as versatile.

mv··on No Doctor Should Work 30 Hours Straight with No Sleep
they are completely different. Where I work in cali nurses are full time working 3 or 4 twelve hour shifts a week. Overtime optional and highly compensated.

medical residents will routinely do back to back 24 hour shifts with no sleep and even the ICU attendings will do a week of every other day 24 hour shifts.

The 16 hour rule only applies to interns. Once you reach second year the rule is 80 hours a week averaged over four weeks. This means that 100 hour weeks still do happen.

mv··on Smoking “causes hundreds of DNA changes”
Opioid withdrawal while uncomfortable generally does not lead to death.

However withdrawal from benzodiazepines and alcohol are both very dangerous and can lead to death.

http://americanaddictioncenters.org/withdrawal-timelines-tre...

mv··on Inside an L.A. OxyContin ring that pushed more than 1M pills
CURES works but at the cost of completely negating any type of privacy protection on medical records. Pretty much anyone (prescriber, dispenser, law enforcement) can pull up CURES reports knowing a persons last name and birthdate.

What is the point of HIPAA and medical privacy if anyone can log in and see what scheduled drugs you're taking? From the drugs you take I can pretty much derive your medical history. I consider this a much larger problem than the 'war on drugs'.

mv··on Yes, You Can Catch Insanity
Or maybe you aren't a doctor and shouldn't be judging if your father needed abx based on a few google searches.

Get a second opinion from a professional if you think your dads doc is over prescribing.

While colds are not dangerous for the young -- they can be very dangerous for the elderly and easily progress to a pneumonia that can kill. Pneumonia used to be called 'old mans best friend' because it caused such a swift and painless death. So what is 'just a cold' for you isnt for others and that isn't even taking into account that the elderly often have baseline lung disease.

mv··on Yes, You Can Catch Insanity
There may have been things lavished on doctors in the past, but as of a few years ago docs effectively can't get anything free unless it is under $10 an instance and less than $100/year.

See: http://www.rxvantage.com/sunshine-act

mv··on Antibiotic Breakthrough Ends 25-Year Discovery Drought
Vancomycin is used routinely (at least in the three hospitals I work in) and it is far from a last ditch drug. That has shifted to Linezolid and Daptomcyin. In the three hospitals I work at, medicine doctors must consult Infectious Disease doctors for approval to place patients on those therapies.
mv··on It's Time for a Four-Day Workweek
My current schedule is 12 days on 13 hour shifts followed by two days off. Resident physicians get screwed and only recently were 'limited' to 80 hour work weeks. I would love even a five day work week.

I have noticed my moral has dropped immensely on this schedule. It is definitely hard to balance work with social life, exercise, and sleep.

mv··on I'm a doctor - help me disrupt healthcare
This question clearly reveals your lack of understanding of the US medical education system.

I hate responding to trolls, but your comments through the thread have been a bit abrasive to me. Accusing someone of 'cheating the system', saying someone has to work 70 hrs a week, only having one shot, saying they should quit, telling them they must work 13hours a day to learn.

I'm assuming you're in (or rather I hope you are) medical school and not just someone applying. Here is the rub. Some people don't have to try to do well. There are people who never studied for the MCAT and scored 36+. They didn't have to really try to do well.

A radiology at the place he mentioned is very competitive, so it is safe to assume this guy was at the top of his class. The intelligence/knowledge difference between the top of the class and the bottom is enormous. Not everyone is the same. Don't fault him for what he wants to do in his free time.

mv··on Show HN: Here is our first app after 6 months working on it. What do you think?
also getting an error trying to register. 'the file /tmp/<hash>' does not exist
mv··on Show HN: Here is our first app after 6 months working on it. What do you think?
Yosee Support link on the itunes page points at the broken link support.yosee.com

Cool intro although it took a while to load for me.

mv··on People who use Bang with Friends
I don't have graph search yet :(
mv··on Try Objective-C
the site is very slow loading next page after clicking submit... Also, no option to skip the stupidly easy levels.
mv··on NYU and Other Medical Schools Offer Shorter Course in Training, for Less Tuition
In the insanity that is the Match students must interview at 10+ places around the country in order to get a residency. Many spend upwards of $10,000 in addition to medical school for travel expenses.

Fourth year is relatively flexible because students must travel for interviews, and there is an insane amount of vacation and 'slack' rotations available to help this.

The whole damned fourth year is a ripoff, and become more so each year the 'match' become more competitive.

mv··on Those "stupid ideas" may not be so stupid
All the benefits you listed are available with the gold card which you receive after purchasing (25?) drinks with a normal registered card.
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