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Joined 2 years ago
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Cake day: May 31st, 2023

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  • The whole men’s barrier to seeking care think has gone on way longer than the grindset attitude of late. Any doctor or nurse will tell you “My wife/child made me come” are scary words to hear from a man in the ER. I think a big aspect is related to the grindset attitude though, but is deeper and more indolent. It’s that men are often primary/majority breadwinners in a household lots of the time, and on top of the social stigma of seeking care (independence, weakness), you make more money if you set your health on the backburner. The benefits of primary care are not often easy to conceptualize (you never think about a stroke you didn’t have) and this diminishes the importance of regular primary care vs acute care for illness and injury. It’s important to note that this is a generational trend in both sexes, healthy, young folks are less likely to have a regular primary care physician as compared to older people or children.



  • It’s a procedure in search of indications. Unethical and surprisingly still common and covered by insurance. No doctor would perform aesthetic surgery on a child for any other reason save ear piercings, i don’t think it’s as common as it used to be, but an infant couldn’t consent to that either.

    For some reason, I’ve encountered lots of moms (occasionally would get a “hell no” from dad though) whose biggest concern after their son was born is when the circ was going to be performed. I wish the medical organizations would put some more focus on the ethics and aspect of consent/assent. There’s a lot of talk about research in public health about how it may or may not affect STI rates, and then the argument gets stuck on risks/benefits rather than ethics.

    It ultimately is a procedure rooted in cultural and religious practice, and the American medical establishment is pretty slow, especially in that aspect.



  • Lol. I can tell you if you asked doctors what the biggest problem in their clinic, it’s the EMR. I can say this myself, I’ve been in healthcare for a while in various roles, and i’m not to far off from graduating as a physician.

    To find out what happened overnight to a patient, I have to sift through pages of computer generated junk to find just a few things. It’s even worse in clinic, if I want to read what happened last time a patient was here, I have to sift through a note that is 50% auto generated lists of stuff to find what I really need to know: what the last doctor said the plan was for today.

    They mention inbasket messages, and that’s a huge issue. Now with the rise of patient portals, patients would message now for something that previously was a visit. Only recently has there been ways to recoup this cost (not that this is appealing to most patients, who see it as nickel and diming, though I empathize, I never can get to talk to a nurse/MA at my own family doc’s clinic either).

    Doctors are swamped, most of the day is charting, ultimately to appease insurance companies so that we get paid. If you’re slotted for a 15 minute visit, and I’m not out after 10 minutes, I’m going to be late to every appointment until lunch or close, then I’ll spend time at home finishing up notes and paperwork (prior auths, refilling meds, replying to messages from nurses and other clinic staff). Ultimately, for what good our regulation of healthcare has brought in the US, it remains that it is regulatory capture nonetheless. Healthcare orgs are quickly conglomerating, so the hospital, clinic, pharmacy, and insurance company are all owned by the same company. At the loss of good patient care, doctors are being removed from the equation, care is being fragmented and compartmentalized in a lot of aspects and less of our time in the day is available for patients.

    What they call burnout, really is moral injury. People who go into healthcare do it because at some level, they want to help people. It really sucks when you realize 90% of your day is screwing with a computer system that seems to be diametrically opposed to letting you do your job.



  • Ultimately this a definition issue, and is philosophical more than scientific. I have no doubt he’s a great neuroscientist, but it’s really not a great take. I think that the whole idea of neurochemistry cascading into the decisions we make doesn’t mean we don’t have the ability to choose within our neurochemical makeup. I think it definitely pushing a good point in that the root causes of our behavior, especially anti-social behavior, is possibly addressable in how we support and raise our kids.



  • While I can’t say much about the specifics of Japanese health and nutrition, I’d argue it confirms the general tenet of dietetics that restrictive dieting is largely not good for you (and isn’t easily maintained either).

    Eating too little (or unbalanced) taxes your metabolism to free up glucose from your organ stores and store what it has, plus running the risk of nutrition deficiencies too. Plus eating too much also has it’s obvious risks.

    I think in regards to keto, the risks of high fat diets are independent from the effects of ketosis. You still run the risk of CAD, obesity, high cholesterol and the issues those bring. (It raises LDLs but lowers triglycerides according to a paper from the ACC, they and the AAND are not convinced one way or another it seems on if keto should be recommended)