Oh, does that mean we get to count sales tax, gasoline tax, alcohol tax, etc. as income tax now? Perhaps you might even say that's correct and a travesty -- but it's not a double standard.
Not sure if this is sarcasm, but x-rays most definitely "bounce" or reflect off surfaces. You're correct in your thinking -- either the poster was incorrect or was referring to the fact that you need x-rays to pass through the patient to tell you anything.
There are different types of IUDs. While the progesterone form shouldn't really change sex drive, you could look into the copper ones. They release no hormones; it works by irritation of the lining of the uterus.
I'm sorry you had side effects from a medication or felt that your physician was not being honest with you. However what you are saying about cholesterol and statins is utter BS. Sure cholesterol is necessary for us to live -- every cell has cholesterol in its cell membrane to regulate membrane fluidity. We use it in construction of bile salts for fat absorption and to make endogenous steroids. But its role in cardiovascular disease is well documented since the 1950s. Here, let me cite you the Framingham Heart Study website. Literally thousands of papers demonstrate that high cholesterol, specifically LDL, leads to atherosclerotic plaque formation, then eventual arterial occlusion, infarct, and possibly death.
Regarding statins -- sure there are side-effects, the most notable being liver dysfunction and myalgia. But let me cite you another famous study, the Scandinavian Simvastatin Survival Study (4S). The pertinents: 30% relative risk reduction in all-cause mortality and 42% relative risk reduction in coronary mortality (patients with angina or prior MI).
So please cite me some evidence for what you are saying, or stop spreading ridiculous misinformation.
Without making any arguments about immigration in the current time, let me point out the Emergency Quota Act of 1921. Ok it was 89 years ago rather than "100+", but that's pretty close in my mind. It had also been proposed several times before. Immigration quotas are nothing new.
As for your question, infection implies pathological invasion of the host. Otherwise you are merely colonized with the organism. For example, many people have MRSA present inside their nose, but that doesn't mean they are infected. And yes, you do have a symbiotic relationship with your bacteria, especially the skin and gut. Just have a look at wikipedia for lots of fun facts.
Basically. If you somehow lost them all in the same proportion, this might not happen. The general problem is that you take, for example, an antibiotic like clindamycin that selectively kills anaerobes of the gut but not Clostridium Difficile. Now all of a sudden you have created a selective pressure that favors the growth of C.diff, and you develop an infection with pseudomembranous colitis.
I agree with your overall point, however I would not consider significant weight gain to be "useless rubbish." It can be a sign of many diseases if put into context.
I don't disagree except for the webcam part. If there's a lesion that needs to be looked at, they need to just come on in. A professional camera often can't do a rash justice, much less some crappy webcam.
I see your point, but if the diagnosis is wrong because the evaluator had incomplete data, I fail to see how this is better. If someone diagnoses GERD (acid reflux) rather than a peptic ulcer with the potential to bleed because the person would never come in for an endoscopy, I see that as worse.
*Disclaimer: I'm not sure if endoscopy is warranted for suspected PUD off the top of my head - treat as a hypothetical that could apply to many situations*
While I sympathize, there are reasons some of this takes place. What if on a macro level, anyone could just order a B12 test? You would likely have lots of unnecessary tests driving up costs for everyone. So insurance shouldn't necessarily be faulted for that. Now the $25 per visit does suck, so you would think they could come up with some kind of "package deal" for everything. Sorry:/
One shortcut for your situation: why not just ask for the shot and ask the doctor to forgo the lab test. Getting a shot of B12 isn't going to hurt if you're not B12 deficient. If the symptoms persist, you're going to go to the the follow-up appointment anyway, and it can be addressed with the lab test then. That may or may not be possible, but it's a thought.
It does seem like a virtual appointment (or just a phone call) might fit your situation if she is asymptomatic after the shot.
Since the doctor examination is theater anyway, why not just run down the symptom checklist and guess at a prescription just like they do in doctor's offices anyway!
If this is what your doctor does, you need to find a new one.
Most of the time I have gone to the doctor when I was sick they did not bother with blood work - they just prescribed some medicine to treat my symptoms.
Perhaps your symptoms didn't warrant a blood test. There are hundreds of tests than can be ordered, they all cost money, and none of them are perfect. If someone has a cold, should blood tests be ordered? Of course not. The likelihood is that the person will get over their symptoms in a few days on their own. Ordering blood tests in this situation, on a macro level, will result in lots of false positives that lead to further work-up of non-existent problems. This leads to patient anxiety, possible iatrogenic diseases, and (even more) skyrocketing health costs.
In the few cases where they did order blood work, I was well on my own by the time the blood work came back.
Sometimes tests are negative. That doesn't mean they shouldn't have been ordered. Many other people had your symptoms, got your tests, and had a far different result.
I'm sorry but you don't seem to know much about a proper physical exam. While USB sensors would work, I think they are pretty impractical except for your pulse ox example. If someone requires an EKG they should be coming in anyway. As for devices for auscultation (thoracic "listening") or a light for visual inspection: wishful thinking. There is a lot of technique involved in auscultation that is difficult for a professional to do, let a lone a patient without experience (or the ability reach around to their back). And I certainly would not want to rely on a crappy webcam for visualizing the body.
I find this comment pretty amusing. One of my med school professors likes to go on and on about how aspirin would never get FDA approval in modern times to be an OTC medication. It has tons of effects besides analgesia that were only recognized in modern times. Your second reference is to "cold medicine" which often includes acetaminophen, most recently known for overdose issues that might get it removed from combo drugs, or pseudoephedrine, which is basically semi-controlled because of the ability to make illicits.
Anyway, when "controlled substances" are mentioned, I think they are referring to scheduled drugs like narcotics rather than something like a beta-blocker.
I'm up to about $100000 so far in my third year of medical school. As you can probably guess, I sure as hell won't be going into primary care. Sure there are ways to get it forgiven, but these are almost more trouble than they're worth. I voted for the Dems this time around, but it would sure be nice if they would help some of us out in these health care reform bills. I realize many would say we don't deserve the help given the salaries we'll (likely) be making, but you have to level the playing field somehow if you want the best and brightest to go into primary care.
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Employer?
Oh, does that mean we get to count sales tax, gasoline tax, alcohol tax, etc. as income tax now? Perhaps you might even say that's correct and a travesty -- but it's not a double standard.
You haven't seen enough people then, because it may not be so quick. Talk to someone with class IV heart failure from ischemic cardiomyopathy.
Mesenteric ischemia from atherosclerotic disease would be another. Smoking is a risk factor for your intestinal arteries just like your coronaries.
Not sure if this is sarcasm, but x-rays most definitely "bounce" or reflect off surfaces. You're correct in your thinking -- either the poster was incorrect or was referring to the fact that you need x-rays to pass through the patient to tell you anything.
There are different types of IUDs. While the progesterone form shouldn't really change sex drive, you could look into the copper ones. They release no hormones; it works by irritation of the lining of the uterus.
I preferred a nice game of Global Thermonuclear War.
I'm sorry you had side effects from a medication or felt that your physician was not being honest with you. However what you are saying about cholesterol and statins is utter BS. Sure cholesterol is necessary for us to live -- every cell has cholesterol in its cell membrane to regulate membrane fluidity. We use it in construction of bile salts for fat absorption and to make endogenous steroids. But its role in cardiovascular disease is well documented since the 1950s. Here, let me cite you the Framingham Heart Study website. Literally thousands of papers demonstrate that high cholesterol, specifically LDL, leads to atherosclerotic plaque formation, then eventual arterial occlusion, infarct, and possibly death.
Regarding statins -- sure there are side-effects, the most notable being liver dysfunction and myalgia. But let me cite you another famous study, the Scandinavian Simvastatin Survival Study (4S). The pertinents: 30% relative risk reduction in all-cause mortality and 42% relative risk reduction in coronary mortality (patients with angina or prior MI).
So please cite me some evidence for what you are saying, or stop spreading ridiculous misinformation.
This is complicated by the fact that if you ask those over the age of 50 what 2 + 2 * 2 equals, they'll answer, "Get off my lawn."
Without making any arguments about immigration in the current time, let me point out the Emergency Quota Act of 1921. Ok it was 89 years ago rather than "100+", but that's pretty close in my mind. It had also been proposed several times before. Immigration quotas are nothing new.
Gestures and multi-touch I'd guess.
Perhaps you don't realize this, but not all antibiotics can be given as an intramuscular injection.
No problem :)
As for your question, infection implies pathological invasion of the host. Otherwise you are merely colonized with the organism. For example, many people have MRSA present inside their nose, but that doesn't mean they are infected. And yes, you do have a symbiotic relationship with your bacteria, especially the skin and gut. Just have a look at wikipedia for lots of fun facts.
Basically. If you somehow lost them all in the same proportion, this might not happen. The general problem is that you take, for example, an antibiotic like clindamycin that selectively kills anaerobes of the gut but not Clostridium Difficile. Now all of a sudden you have created a selective pressure that favors the growth of C.diff, and you develop an infection with pseudomembranous colitis.
And get off my lawn!
Anyway, I look forward to your RCT comparing not being a sissy to placebo.
I agree with your overall point, however I would not consider significant weight gain to be "useless rubbish." It can be a sign of many diseases if put into context.
Interestingly enough, many people are on low-dose rat poison - it's called warfarin/coumadin!
I don't disagree except for the webcam part. If there's a lesion that needs to be looked at, they need to just come on in. A professional camera often can't do a rash justice, much less some crappy webcam.
I see your point, but if the diagnosis is wrong because the evaluator had incomplete data, I fail to see how this is better. If someone diagnoses GERD (acid reflux) rather than a peptic ulcer with the potential to bleed because the person would never come in for an endoscopy, I see that as worse.
*Disclaimer: I'm not sure if endoscopy is warranted for suspected PUD off the top of my head - treat as a hypothetical that could apply to many situations*
While I sympathize, there are reasons some of this takes place. What if on a macro level, anyone could just order a B12 test? You would likely have lots of unnecessary tests driving up costs for everyone. So insurance shouldn't necessarily be faulted for that. Now the $25 per visit does suck, so you would think they could come up with some kind of "package deal" for everything. Sorry :/
One shortcut for your situation: why not just ask for the shot and ask the doctor to forgo the lab test. Getting a shot of B12 isn't going to hurt if you're not B12 deficient. If the symptoms persist, you're going to go to the the follow-up appointment anyway, and it can be addressed with the lab test then. That may or may not be possible, but it's a thought.
It does seem like a virtual appointment (or just a phone call) might fit your situation if she is asymptomatic after the shot.
Since the doctor examination is theater anyway, why not just run down the symptom checklist and guess at a prescription just like they do in doctor's offices anyway!
If this is what your doctor does, you need to find a new one.
Most of the time I have gone to the doctor when I was sick they did not bother with blood work - they just prescribed some medicine to treat my symptoms.
Perhaps your symptoms didn't warrant a blood test. There are hundreds of tests than can be ordered, they all cost money, and none of them are perfect. If someone has a cold, should blood tests be ordered? Of course not. The likelihood is that the person will get over their symptoms in a few days on their own. Ordering blood tests in this situation, on a macro level, will result in lots of false positives that lead to further work-up of non-existent problems. This leads to patient anxiety, possible iatrogenic diseases, and (even more) skyrocketing health costs.
In the few cases where they did order blood work, I was well on my own by the time the blood work came back.
Sometimes tests are negative. That doesn't mean they shouldn't have been ordered. Many other people had your symptoms, got your tests, and had a far different result.
I'm sorry but you don't seem to know much about a proper physical exam. While USB sensors would work, I think they are pretty impractical except for your pulse ox example. If someone requires an EKG they should be coming in anyway. As for devices for auscultation (thoracic "listening") or a light for visual inspection: wishful thinking. There is a lot of technique involved in auscultation that is difficult for a professional to do, let a lone a patient without experience (or the ability reach around to their back). And I certainly would not want to rely on a crappy webcam for visualizing the body.
I find this comment pretty amusing. One of my med school professors likes to go on and on about how aspirin would never get FDA approval in modern times to be an OTC medication. It has tons of effects besides analgesia that were only recognized in modern times. Your second reference is to "cold medicine" which often includes acetaminophen, most recently known for overdose issues that might get it removed from combo drugs, or pseudoephedrine, which is basically semi-controlled because of the ability to make illicits.
Anyway, when "controlled substances" are mentioned, I think they are referring to scheduled drugs like narcotics rather than something like a beta-blocker.
I'm up to about $100000 so far in my third year of medical school. As you can probably guess, I sure as hell won't be going into primary care. Sure there are ways to get it forgiven, but these are almost more trouble than they're worth. I voted for the Dems this time around, but it would sure be nice if they would help some of us out in these health care reform bills. I realize many would say we don't deserve the help given the salaries we'll (likely) be making, but you have to level the playing field somehow if you want the best and brightest to go into primary care.
Funny? This is Insightful!