So when it comes to picking who gets care and who does not ....

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Almost makes one wonder why people go to medical school at all when the random interwebs people have it all figured out.

Wish you guys well and hope the armchair from which you practice medicine and policy never breaks.
 

Dennis in MA

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Murdrerers, rapists, illegals, drug dealers and wife beaters need to go to the back of the line. Let them suffer the most. Those are the dregs that suck up taxpayer dollars.
Convicted or just charged of said-crimes? What about those who paid their debt to society and are now free men? How do you process all that due process????
 
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Almost makes one wonder why people go to medical school at all when the random interwebs people have it all figured out.
A totally serious question: Where in the medical school canon is an aspiring physician taught that "Medical workers and those who maintain societal order" go to the head of the line when there's a triage situation?
 
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Picton

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A totally serious question: Where in the medical school canon is an aspiring physician taught that "Medical workers and those who maintain societal order" go to the head of the line when there's a triage situation?
You're asking whether triage is taught in medical school? I'm not clear on where your confusion lies.

Of course it is. Triage is a vital feature of crisis medicine. Someone makes the choice, always, and they're always medical workers.
 
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A totally serious question: Where in the medical school canon is an aspiring physician taught that "Medical workers and those who maintain societal order" go to the head of the line when there's a triage situation?
I didn't think I'd really ever have to spell this out for anyone but, if the doctors all die during the middle of a pandemic that's killing people, who is going to treat the rest of the people? This seems more like basic logic than something that should have to be taught to a person.
 

jpk

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Almost makes one wonder why people go to medical school at all when the random interwebs people have it all figured out.
This is part of the problem

Its taken some trial and error to find an Md that didnt think they were going to dictate various things to customers.

Your typical Md-Customer situation is that after having a sum total of 10 mins per year with the person......ie they have no fooking clue about the person or the persons history, requirements, etc.....they dictate a course of action/treatment/etc.

Friend of mine was forced to change Md's after long term Md retired

She came down with Bronchitis couple months back, went to new Md who confirmed and wanted to prescribe antibiotic in penicillin family......she's allergic to it....says so in her file/records.....she told the Md she was allergic and the dumb twat Md insisted that she try this med and refused to prescribe tried/true zpak which was in her records as being used successfully

Sure enough a couple days later after having an allergic reaction she has to spend more money to go back and battle with the young dumb twat md with no listening or reading skills and guess what she walked out with a script for......zpak and another script for something to help alleviate the allergic reaction.....at her own cost of course
 
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This is part of the problem

Its taken some trial and error to find an Md that didnt think they were going to dictate various things to customers.

Your typical Md-Customer situation is that after having a sum total of 10 mins per year with the person......ie they have no fooking clue about the person or the persons history, requirements, etc.....they dictate a course of action/treatment/etc.

Friend of mine was forced to change Md's after long term Md retired

She came down with Bronchitis couple months back, went to new Md who confirmed and wanted to prescribe antibiotic in penicillin family......she's allergic to it....says so in her file/records.....she told the Md she was allergic and the dumb twat Md insisted that she try this med and refused to prescribe tried/true zpak which was in her records as being used successfully

Sure enough a couple days later after having an allergic reaction she has to spend more money to go back and battle with the young dumb twat md with no listening or reading skills and guess what she walked out with a script for......zpak and another script for something to help alleviate the allergic reaction.....at her own cost of course
Ignoring the fact that you don't treat bronchitis with antibiotics, and the fact that upper respiratory infections are usually viral and again not treated with antibiotics, and the fact that doctors always listen to patients about allergies, and the fact that athizromycin isn't the preferred antibiotic for a bacterial upper respiratory, and the fact that its a patients responsibility to be their own best advocate, and the fact that if your "friend" knew she was allergic to it she should have exercised some intelligence and not taken it, and about a half dozen other things... sure.

And here I was thinking that people go to doctors to dictate a course of treatment to people. I really appreciate you letting me know I had that backwards.

I see we've reached the point in our discussion where the facts don't matter and the biases and conspiracies run free. Cheers guys.
 

greencobra

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What about those who paid their debt to society and are now free men?
there still has to be a hierarchy for treatment. if 2 people, same age etc. presenting identical symptoms are in triage, one has a dwi conviction from several years ago and the other a clean record...you tell me who should get treatment.
 

jpk

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Ignoring the fact that you don't treat bronchitis with antibiotics, and the fact that upper respiratory infections are usually viral and again not treated with antibiotics, and the fact that doctors always listen to patients about allergies, and the fact that athizromycin isn't the preferred antibiotic for a bacterial upper respiratory, and the fact that its a patients responsibility to be their own best advocate, and the fact that if your "friend" knew she was allergic to it she should have exercised some intelligence and not taken it, and about a half dozen other things... sure.

And here I was thinking that people go to doctors to dictate a course of treatment to people. I really appreciate you letting me know I had that backwards.

I see we've reached the point in our discussion where the facts don't matter and the biases and conspiracies run free. Cheers guys.
Actually a zpak is commonly prescribed for bronchitis.....which can be bacterial or viral.......but you would have known that already right?

You seem to have missed the part where the patients allergy was written in chart AND the patient also told the young twat Md......who disreguarded the patients warning anyway

In other news for those of you in Mass

The rationing has begun....despite President Trump making it clear yesterday and for the last several weeks they have vents, drugs and lots of other resources in national stockpile ready to ship to states that ask for them

 
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Actually a zpak is commonly prescribed for bronchitis.....which can be bacterial or viral.......but you would have known that already right?
Except for the small tiny itty bitty fact that bronchitis is just a fancy word for inflammation of the airway caused by any means. But yea, you go right on thinking that antibiotics will cure that for your "friend." Thanks for giving me a good chuckle. Like I said, might want to take a break form hitting the "..." key so much and reinforce that armchair. [rofl]
 

dlarge

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The DNV majorly impacted the ER I worked at a few years back. Every time they visited we'd be stuck with more rules/regulations that severely impacted patient care. Got to the point where I was spending 8 hour shifts watching stable mental health patients sleep.
 
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jpk

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Except for the small tiny itty bitty fact that bronchitis is just a fancy word for inflammation caused by any means. But yea, you go right on thinking that antibiotics will cure that for your "friend." Thanks for giving me a good chuckle. [rofl]
And whats the cause of the inflammatory response.........its not spontaneous combustion......

I hate to break it to you but lots of other people who have had bronchitis also are treated SUCCESSFULLY with Zpak as well

I've been there as well as a pile of others who've posted similar experiences here
 
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And whats the cause of the inflammatory response.........its not spontaneous combustion......

I hate to break it to you but lots of other people who have had bronchitis also are treated SUCCESSFULLY with Zpak as well

I've been there as well as a pile of others who've posted similar experiences here
Lol

Edited to add:
Because I do think it's super important to educate people on the CORRECT uses of antibiotics, and so you don't just take some random internet person's word on it:

-----
"Because most cases of bronchitis are caused by viral infections, antibiotics aren't effective."
-----

Bronchitis just means inflammation of the bronchial tubes. This can be caused by anything - inhalation of an inflammatory agent (like some dust), coughing too much, exercise, viral infection, bacterial infection, blunt force trauma, etc.

The only thing that can treat bronchitis is something like an albuterol inhaler, which directly treats the inflammation. Doctors often erroneously prescribe antibiotics because it's cheaper and quicker to do that than it is to send out a culture to see if it is in fact bacterial, which in the majority of cases, it isn't. Bacterial infections rarely, if ever, improve without antibiotics, and the symptoms of such an infection would be far greater than just a bronchitis inducing cough.

You're welcome to search online for yourself but, my specialty is infectious diseases. This whole "well there are stories of it" type thing is how things like the anti-vax movement got started. Strong opinions and snarky remarks aside, please everyone just stay safe and practice good objective judgement, regardless of your political beliefs and opinions.
 
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Rob Boudrie

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Money talks and bullshit walks. Hypothetically, if there were only two ventilators left and one of us peons had to compete with Taylor Swift and Beyonce for them, who do you think would get them? I don't think that I need Las Vegas oddsmakers to figure that one out. Larry Hagman, "Papa" John Phillips and David Crosby, among other celebrities who skirted the organ-donor list, would seem to prove my point.
Celebs have at least three advantages:
  1. They can more easily list in multiple centers (as in "keep a flight crew on standby and the jet fueled") in different organ procurement regions. This is probably why Steve Jobs went to TN for a transplant when a liver became available.
  2. They are not intimidated at the prospect of their insurance not paying for the pre-transplant workup and semi-regular follow-up at multiple centers.
  3. Since livers go to the sickest (whereas kidneys are more of a queue), and important person will probably have an easier time convincing the transplant team to exaggerate how close to death they are.
As to money talks - people do get denied transplants in the US if they fail the wallet biopsy.

A "few centur[ies] of doctors and medical experience"
Adding up years of experience of multiple people is just plain bogus. More useful is "An average of X years of experience with a standard deviation of Y for our practicioners" or "80% of out medical staff has over a decade of experience".
 
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Adding up years of experience of multiple people is just plain bogus. More useful is "An average of X years of experience with a standard deviation of Y for our practicioners" or "80% of out medical staff has over a decade of experience".
What I know about medicine isn't limited to just my experience or that of my instructors. What we know about physiology, medications, incident management, etc, is a collection of all knowledge prior. Just like what we know about firearms isn't limited to just our own experience - we build on what was previously proven.
 

Rob Boudrie

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What I know about medicine isn't limited to just my experience or that of my instructors. What we know about physiology, medications, incident management, etc, is a collection of all knowledge prior. Just like what we know about firearms isn't limited to just our own experience - we build on what was previously proven.
True, but I was referring to those who try to present "total years of experience" as if it is meaningful in establishing credibility. Would you rather be surged by an MD from a practice of 5 surgeons with a total of 50 years surgical experience, or one from a practice of 100 surgeons with a total of 100 years experience?
 
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jpk

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Lol

Edited to add:
Because I do think it's super important to educate people on the CORRECT uses of antibiotics, and so you don't just take some random internet person's word on it:

-----
"Because most cases of bronchitis are caused by viral infections, antibiotics aren't effective."
-----

Bronchitis just means inflammation of the bronchial tubes. This can be caused by anything - inhalation of an inflammatory agent (like some dust), coughing too much, exercise, viral infection, bacterial infection, blunt force trauma, etc.

The only thing that can treat bronchitis is something like an albuterol inhaler, which directly treats the inflammation. Doctors often erroneously prescribe antibiotics because it's cheaper and quicker to do that than it is to send out a culture to see if it is in fact bacterial, which in the majority of cases, it isn't. Bacterial infections rarely, if ever, improve without antibiotics, and the symptoms of such an infection would be far greater than just a bronchitis inducing cough.

You're welcome to search online for yourself but, my specialty is infectious diseases. This whole "well there are stories of it" type thing is how things like the anti-vax movement got started. Strong opinions and snarky remarks aside, please everyone just stay safe and practice good objective judgement, regardless of your political beliefs and opinions.
Sorry but your assertion that antibiotics dont treat bacterial infections flies in the face of the millions of people who get bronchitis every year and are prescribed zpak to treat it and almost universally get great outcomes.
 
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Sorry but your assertion that antibiotics dont treat bacterial infections flies in the face of the millions of people who get bronchitis every year and are prescribed zpak to treat it and almost universally get great outcomes.
Again, bronchitis is rarely caused by bacterial infections, but people are prescribed antibiotics anyways, the infection goes away on its own (unrelated to the use of antibiotics), and people say "well it must have been the antibiotics." This is exactly what happens with the universally decried anti vaccination movement, where children are given a vaccine, develop autism, and these people go "well it was the vaccine that caused it."
 
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jpk

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Again, they're usually not caused by bacterial infections, but people are prescribed antibiotics anyways, the infection goes away on its own (unrelated to the use of antibiotics), and people say "well it must have been the antibiotics." This is exactly what happens with the universally decried anti vaccination movement, where children are given a vaccine, develop autism, and these people go "well it was the vaccine that caused it."
Given the fact that NO ONE gets tested to determine whether or not its bacterial or viral yet almost everyone is prescribed azythromycin/zpak as a course of treatment and the overwhelming majority of people respond positively in 2-3 days after beginning course of antibiotics suggests otherwise

In my group of friends/other....every single one of them who have been diagnosed with bronchtis have also been prescribed a zpak and universally they've all responded positively. as per above

If diagnostics were to change and everyone were to be tested to confirm viral/bacterial nature of bronchitis then and only then would anyone be able to make the assertion you did
 

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You're asking whether triage is taught in medical school? I'm not clear on where your confusion lies.

Of course it is. Triage is a vital feature of crisis medicine. Someone makes the choice, always, and they're always medical workers.
Don't be obtuse - His question is clear.

Does the instruction include factors not directly related to the medical status of the patient under care?
 
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Given the fact that NO ONE gets tested to determine whether or not its bacterial or viral yet almost everyone is prescribed azythromycin/zpak as a course of treatment and the overwhelming majority of people respond positively in 2-3 days after beginning course of antibiotics suggests otherwise

In my group of friends/other....every single one of them who have been diagnosed with bronchtis have also been prescribed a zpak and universally they've all responded positively. as per above

If diagnostics were to change and everyone were to be tested to confirm viral/bacterial nature of bronchitis then and only then would anyone be able to make the assertion you did
I literally had to screenshot your post to pass around to my colleges.

They also start to get better “2-3 days after” because people typically visit a doctor as the symptoms reach their peak, which is “2-3 days” before they start to subside. Who do you think knows more about this right now? The Mayo Clinic in the link I posted, or you and your friend group?

For anyone else who wonders what it’s like trying to practice medicine at times, please let this above post serve as a small insight. You can provide logic, reason, evidence, and still “but I have a friend” almost always wins out.
 

Picton

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Don't be obtuse - His question is clear.

Does the instruction include factors not directly related to the medical status of the patient under care?
Any doctor who violates the standard of care is placing their license in jeopardy. Ultimately, it's always their call. The clinical judgement is theirs, no matter what the instruction says.
 
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I didn't think I'd really ever have to spell this out for anyone but, if the doctors all die during the middle of a pandemic that's killing people, who is going to treat the rest of the people? This seems more like basic logic than something that should have to be taught to a person.
You're avoiding the question after making a snide comment about people not attending medical school.

So, one more time. Where in the medical school canon is an aspiring physician taught that "Medical workers and those who maintain societal order" go to the head of the line when there's a triage situation?
 
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You're asking whether triage is taught in medical school? I'm not clear on where your confusion lies.
Nope. You're answer the question you wish I'd asked.

Try answering the actual question: Where in the medical school canon is an aspiring physician taught that "Medical workers and those who maintain societal order" go to the head of the line when there's a triage situation?
 
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You're avoiding the question after making a snide comment about people not attending medical school.

So, one more time. Where in the medical school canon is an aspiring physician taught that "Medical workers and those who maintain societal order" go to the head of the line when there's a triage situation?
Again, it’s taught at the same time a person learns basic logic. This has nothing to do with school of any kind. If all the doctors are dead, then triage doesn’t really matter because there are no doctors left to triage for. Your asking a question that makes no sense. If you really don’t understand that then we need to have a separate discussion.
 
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Right behind you.
Thats the written rule plan. What about the unwritten rule plan for the rich, politically connected,ect.
what about the unwritten rule plan when someone's parents are refused care bc they're old or have highly treatable cancer, but an illegal criminal alien or felon jailbird gets moved up in the line right behind some state senator. I've lost faith that there will every be a go-time in this country, but something like that sure might light a fire under my ass.
 

pastera

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Given the fact that NO ONE gets tested to determine whether or not its bacterial or viral yet almost everyone is prescribed azythromycin/zpak as a course of treatment and the overwhelming majority of people respond positively in 2-3 days after beginning course of antibiotics suggests otherwise

In my group of friends/other....every single one of them who have been diagnosed with bronchtis have also been prescribed a zpak and universally they've all responded positively. as per above

If diagnostics were to change and everyone were to be tested to confirm viral/bacterial nature of bronchitis then and only then would anyone be able to make the assertion you did
Correlation/Causation confusion
The cost and risk of the zpack are low, so while the chance that there is a bacterial factor to the bronchitis is very low it is still indicated to treat because, if it is bacterial, the wait time for test results could be very detrimental.

I get antibiotics and inhalers essentially every time I have any respiratory issue based on history - I don't have any delusions about the status of the antibiotic being anything other than a prophylactic measure to keep me from developing something worse.
 

jpk

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I literally had to screenshot your post to pass around to my colleges.

They also start to get better “2-3 days after” because people typically visit a doctor as the symptoms reach their peak, which is “2-3 days” before they start to subside. Who do you think knows more about this right now? The Mayo Clinic in the link I posted, or you and your friend group?

For anyone else who wonders what it’s like trying to practice medicine at times, please let this above post serve as a small insight. You can provide logic, reason, evidence, and still “but I have a friend” almost always wins out.
Explain away whatever you want however you want.....

The reality of what happens is that the overwhelming majority of people who are diagnosed with bronchitis walk out with a script for azithromycin....

It happens all day, every day and has for years and years and years
 
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Explain away whatever you want however you want.....

The reality of what happens is that the overwhelming majority of people who are diagnosed with bronchitis walk out with a script for azithromycin....

It happens all day, every day and has for years and years and years
My god man.
 

pastera

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Again, it’s taught at the same time a person learns basic logic. This has nothing to do with school of any kind. If all the doctors are dead, then triage doesn’t really matter because there are no doctors left to triage for. Your asking a question that makes no sense. If you really don’t understand that then we need to have a separate discussion.
You are still missing half of the question - that is what you are getting hammered on

I agree with medical personnel getting preferential care - not because of the logical fallacy of "if there are no doctors" BS but because of the very real and current issue of why would the providers put themselves at extreme risk for no benefit.
 
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