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

Picton

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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?
Post 52.
 

Rob Boudrie

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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.
Actually, that item is in the written plan.

"Societal order" is offensive to many because it is a catch-all for important people who don't actually do anything to maintain order.
 
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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 used to get bronchitis like 3 times a year when I was a cigarette smoker starting back in highschool. Every time if it got bad enough I'd go to the doctor, be given a z pack and be like 50% better the very next day.

Then when they started trying to crack down on the overprescription of antibiotics, suddenly bronchitis, I was told, is almost always viral. I'd ask the doc, "ok so how come every year for the last 5 years doctors gave me antibiotics and it cleared up immediately, but suddenly this year bronchitis is always viral and you don't want to give me the medicine we both know will cure me?".
luckily my PCP was old school so if ER or urgent care pulled this shit I could call his office and he'd call me in a z pack.

I learned that the healthcare system is completely full of bullshitters who act according to the way the political winds are blowing and whatever their professional association (AMA) tells them to do.
 
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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 were making a big case about medical history and known ethics. Suddenly, you are reverting to a case of "everybody knows" and restricting it to doctors.

Again, that not what I asked. If you would like to narrow it: Do they teach in medical school that those who "maintain societal order" should be prioritized in triage situations?
 
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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.
And to respond to that situation, the governor is filing legislation to grant legal immunity to doctors from making judgments based on the guidance, which would certainly imply that the guidance is outside the bounds of normal standard of care.
 

jpk

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I used to get bronchitis like 3 times a year when I was a cigarette smoker starting back in highschool. Every time if it got bad enough I'd go to the doctor, be given a z pack and be like 50% better the very next day.

Then when they started trying to crack down on the overprescription of antibiotics, suddenly bronchitis, I was told, is almost always viral. I'd ask the doc, "ok so how come every year for the last 5 years doctors gave me antibiotics and it cleared up immediately, but suddenly this year bronchitis is always viral and you don't want to give me the medicine we both know will cure me?".
luckily my PCP was old school so if ER or urgent care pulled this shit I could call his office and he'd call me in a z pack.

I learned that the healthcare system is completely full of bullshitters who act according to the way the political winds are blowing and whatever their professional association (AMA) tells them to do.
This.....Quoted for Truth......and its why I've always said that finding a really good PCP is the best thing you can do.......rolling the dice on the intern of the week that you've never met, doesnt know you let alone knows nothing about your history (if you have any) is little more than a gamble
 

Mountain

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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.
Maybe not the best examples? Both are younger than me. Maybe Jane Fonda as an example? [devil]
 

Mountain

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I used to get bronchitis like 3 times a year when I was a cigarette smoker starting back in highschool. Every time if it got bad enough I'd go to the doctor, be given a z pack and be like 50% better the very next day.

Then when they started trying to crack down on the overprescription of antibiotics, suddenly bronchitis, I was told, is almost always viral. I'd ask the doc, "ok so how come every year for the last 5 years doctors gave me antibiotics and it cleared up immediately, but suddenly this year bronchitis is always viral and you don't want to give me the medicine we both know will cure me?".
luckily my PCP was old school so if ER or urgent care pulled this shit I could call his office and he'd call me in a z pack.

I learned that the healthcare system is completely full of bullshitters who act according to the way the political winds are blowing and whatever their professional association (AMA) tells them to do.
Amen to that!

For years my PCP in Tennessee (also a family friend) didn't mess around with treating stuff. Not that I was often sick, but if I was there was no 'let's wait and see' BS. My first PCP in Mass was decent but leaned strongly to the 'let's not overprescribe antibiotics' even though I almost never visited except for physicals or preventatives for 3rd world travel. He was pretty good about scripts for travel to BFE. Our new family PCP is a young guy but very old school and doesn't screw around if there's a chance of nipping something in the bud. He's freaking awesome in general.
 
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Amen to that!

For years my PCP in Tennessee (also a family friend) didn't mess around with treating stuff. Not that I was often sick, but if I was there was no 'let's wait and see' BS. My first PCP in Mass was decent but leaned strongly to the 'let's not overprescribe antibiotics' even though I almost never visited except for physicals or preventatives for 3rd world travel. He was pretty good about scripts for travel to BFE. Our new family PCP is a young guy but very old school and doesn't screw around if there's a chance of nipping something in the bud. He's freaking awesome in general.
yeah I mean there's obviously a lot of truth to the dangers of overprescribing antibiotics, especially when idiot patient take half the course and then stop...I saw a study not long back where they had time lapse videos of bacteria in petri dishes and they applied "just not enough" antibiotics and what happened was the bacterial growth retreated but then resumed. Then they'd add another dose of "not quite enough" antibiotics and did this over and over. Eventually the bacteria completely stopped responding at all to the drugs. Basically allowing you to witness evolution in nearly real time. It was pretty fascinating.

My old PCP retired last year. It sucks. A few years ago I was diagnosed with early diabetes and he told me to lose weight. That's it. He adamantly did not want to put me on drugs bc he said blood sugar of 126 might meet diabetes diagnostic criteria now the threshold used to be higher, and it's still easily reversible with lifestyle changes. I lost a bunch of weight on keto and run like 89-92 blood sugar now even if I eat a carb bomb dinner the night before. When I went for a follow up he was thrilled and then told me his son was in med school and they're all being taught now that as soon as a patient meets the 126 blood sugar diagnostic criteria they immediately put the patient on 3 drugs: cholesterol, blood pressure, and metformin. That is regardless of whether or not there is even high BP or cholesterol in the labs. Basically no matter what, the AMA wants any new, even slightly diabetic, to be put on 3 unnecessary pills that they'll never ever come off of.

It's really hard to find an old school doctor who doesn't subscribe to that bullshit.
 

Picton

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All right. Well, I don't know what to tell you. This is likely to be Societal Issue #3,451,007 that NES loves to bring up, loudly whine about, and then in the end have no real solution for. I doubt the answers you seek actually exist, to be honest.

Good luck and stay healthy.
 

Rob Boudrie

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What I'm trying to convey is that (as someone in the medical field) these aren't rules that "tie the doctors hands." These are the rules that doctors have come up with for how to best save lives. After countless incidents, we've come up with a system to best limit the loss of life. These scoring and triage criteria are what we have been using for years, before Obama or any of us were even born, to best decide how to handle health care.
What about the concept of involuntarily removing someone from a life support system because someone else would have a better chance with it? Have you been doing that for years, or has the policy been "once you are on a machine you will not be removed until it is medically advisable for you, the individual patient?".

There will always be triage situations like two MIs are adjacent bays in the ER but only one cath lab and team is available ... who gets to go first? If you have a 70 year old being wheeled to the cath lab would it be protocol for the ER to call with "we have a 35 year old, have you opened the femoral yet? If not, send him back to the ER to wait behind the younger patient"

This is getting more attention because it is large scale.
 

Rob Boudrie

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If you have a four legged friend, time to stock up on Ivermectin because someone, somewhere, found it kills the virus in a petri dish.
 

babygorilla

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My god man.
What you are missing is; 1) SOMETIMES bronchitus is bacterial, even if uncommon; 2) That there is no test given to determine root cause of bronchitus initially (prolonged acute, yes it is tested, but at initial visit, no); 3) That antibiotics do have added benefit for a damaged immune system and have a tendency of being overprescribed; 4) Many doctors just see what sticks to the wall if the root cause is unknown; 5) Antibiotics are realtively inexpensive for a fix, even if they may be the wrong fix.
Even the article you posted from the Mayo clinic confirms what I stated.
 

Dennis in MA

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I used to get bronchitis like 3 times a year when I was a cigarette smoker starting back in highschool. Every time if it got bad enough I'd go to the doctor, be given a z pack and be like 50% better the very next day.

Then when they started trying to crack down on the overprescription of antibiotics, suddenly bronchitis, I was told, is almost always viral. I'd ask the doc, "ok so how come every year for the last 5 years doctors gave me antibiotics and it cleared up immediately, but suddenly this year bronchitis is always viral and you don't want to give me the medicine we both know will cure me?".
luckily my PCP was old school so if ER or urgent care pulled this shit I could call his office and he'd call me in a z pack.

I learned that the healthcare system is completely full of bullshitters who act according to the way the political winds are blowing and whatever their professional association (AMA) tells them to do.
Some of it is just fluid. They really don't understand fully - 100 years later - effective use of antibiotics. The fear is getting higher #'s of AB-immune bugs so they are trying to limit stuff. Hell, the sacrosanct #-of-days theory is even falling by the wayside. I mean, 14 days of AB for an ear infection like when I was a kid???? "You gotta take all 14 days or you might die!" LOL

Look at the last 40 years of CPR training. I learned under the old 5'and'1 program. We've seen it go one way, then the other. (The reality is that non-professional CPR is almost always useless - but we don't want to let that data get out.)

The REAL lie we don't want to hear is that the medical community isn't as sure of things as we'd like it to be. EEEK!!! LOL


Oh, and a lot of infections will just go away on their own.


Oh oh - and you can buy Fish Mox and Fish Flex by mail order. Just saying. ;)
 

drgrant

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Frankly, no. It's not the government's place (at least not here) to get to decide who rations care. We've always worked under a "if you're here and if treatment is available, you get it" model and this is no time to change that. Once you get the government, or for that matter medical "ethicists", making that determination, you've reduced people to commodities. Once you do that, you open up to "Well, there is a ventilator available, but your mom doesn't get it because it's the last one and we want to keep it open in case someone higher on the list comes in", or (as implied by Rob B below) "We're taking your mom off because someone higher on the list came in." That has no place in the US.
Lol you can embrace that fiction all you want but when things get tight they will make controversial decisions. Has nothing to do with gov bs, though. Hopefully in most places it won't reach that point....
 

drgrant

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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.
That gets into f***ery real fast if you want someone to have that power.
 

drgrant

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seems to be where we're heading, no?
If you're making a medical judgment based on a criminal record of 2 people who are supposed to be legally equivalent in the eyes of the law that's f***ed. Let's stop f***ing around and just blow people's brains out if you're not going to restore their rights.... Or just keep them incarcerated.
 

greencobra

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If you're making a medical judgment based on a criminal record of 2 people who are supposed to be legally equivalent in the eyes of the law that's f***ed. Let's stop f***ing around and just blow people's brains out if you're not going to restore their rights.... Or just keep them incarcerated.
what we're basically talking about is "moral triage." below is an earlier post in this thread i made...when people starting getting indignant over the posted selection system.
i don't believe there's anything in the often quoted constitution about separating muggers, rapists and thieves and "others" from the "good folks." i could be wrong so our constitutional experts please set me straight.
but we all know how things are gong to go if a class 3 sex offender is taken in and triaged for life saving treatment over a sweet grandmother. there's a bunch of posts in the thread of people already rattling cages over the proposed selection process.
 
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Some of it is just fluid. They really don't understand fully - 100 years later - effective use of antibiotics. The fear is getting higher #'s of AB-immune bugs so they are trying to limit stuff. Hell, the sacrosanct #-of-days theory is even falling by the wayside. I mean, 14 days of AB for an ear infection like when I was a kid???? "You gotta take all 14 days or you might die!" LOL

;)
The study I referenced might convince you that taking the full course as prescribed actually IS pretty important. The gist is that if you don't completely kill the entire bacterial population responsible for the infection, the surviving bugs can evolve to become resistant. The next person you pass that strep to might have a really hard time with it.

Whether or not 14 days is a magic number or not, who knows, but people who take only the first few days worth of a script, feel better, and stop are playing with fire. It's not that YOU might die if you don't take the full course, but the next person you spread it to might have a much harder time of getting cured.

I'll see if I can dig up the study....it was pretty fascinating.
 
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The study I referenced might convince you that taking the full course as prescribed actually IS pretty important. The gist is that if you don't completely kill the entire bacterial population responsible for the infection, the surviving bugs can evolve to become resistant. The next person you pass that strep to might have a really hard time with it.

Whether or not 14 days is a magic number or not, who knows, but people who take only the first few days worth of a script, feel better, and stop are playing with fire. It's not that YOU might die if you don't take the full course, but the next person you spread it to might have a much harder time of getting cured.

I'll see if I can dig up the study....it was pretty fascinating.
How DARE you talk science and reason. Blaspheme!
 

Guyute

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Probably also people getting in before the general election.

I feel a little sorry for people who only got into firearms post Trump. They probably did not understand the need to stack deep during the good times.
what we're basically talking about is "moral triage." below is an earlier post in this thread i made...when people starting getting indignant over the posted selection system.

but we all know how things are gong to go if a class 3 sex offender is taken in and triaged for life saving treatment over a sweet grandmother. there's a bunch of posts in the thread of people already rattling cages over the proposed selection process.
Unless they’re doing background checks on every patient how will they know
 

G Port

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I agree with the prior poster who said hot chicks should be given priority. Having said that, I believe we should also be harvesting the organs, and draining the blood, from criminals and illegal aliens. That would both help out normal people with medical needs and provide a nice disincentive to commit crimes and border jump.
 

Rocco Mozz

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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.
But then we're also asserting that people cannot atone for their crimes and past wrongs and will always be seen as criminals in society, even after time served and alleged rehabilitation. So if they've served their time and they're now a contributing member of society why should they have a lower standard of healthcare than others?
 

greencobra

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But then we're also asserting that people cannot atone for their crimes and past wrongs and will always be seen as criminals in society, even after time served and alleged rehabilitation. So if they've served their time and they're now a contributing member of society why should they have a lower standard of healthcare than others?
my comment was tongue in cheek based on some of the posts. i've quoted 2 of them below. people already are talking a hierarchy for vital health care. you either got to do the all men are equal, first come....selections or start to divide the population on who's worthy and divide that again on who is more worthy and who decides the worthy baseline. one of those slippery slopes you always hear about. sounds like the state of massachusetts has already done that.
So, if it comes down to a choice between your 72 year old mom and a 27 year old illegal immigrant jailed for murder, mom loses.
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.
 
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