cfu28

I don’t have the source on hand, but during my clinical informatics rotation it was mentioned that many early EMR implementations actually increased drug errors

I didn’t think PCOS could be triggered by birth control - doesn’t seem to be a lot of evidence to support this either. Looking at the mechanism of action of COCs, I can’t think of a mechanism of why COCs would cause PCOS. Oral contraceptives are usually first line in treating PCOS which makes this anecdote even more weird. Can you provide any more information?

Super early stage still, but I’m building a progressive web app that lets you see all of your medical records across your doctors in one app. The goal was to build an app that focused on privacy and offline-first functionality - storing your medical records on your device, not in the cloud. It’s missing a few core features (like backup and sync to a self hosted server, encryption at rest, etc) but it already (should) work for 3000+ healthcare providers in the USA.

https://www.meremedical.co

Your numbers are way off, but even assuming they weren't, 1 hour of PA training is not the same as 1 hour of MD/DO training.

Well: https://www.statnews.com/2023/05/18/doctors-trained-outside-...

I think that’s the point, the patient didn’t seem pregnant but the doctor had some clinical suspicion given the presentation and the location of the pain. He wasn’t withholding information from ChatGPT, he was just providing the same initial information he had when he saw the patient.

If

Prevents arachidonic acid from being converted to thromboxane needed for platelet aggregation. Here's a diagram I find helpful of the arachidonic pathway and which drugs inhibit which parts of the pathway: https://files.mari.casa/aapathway.jpg

Aspirin inhibits COX-1 and COX-2 irreversibly, which decreases synthesis of thromboxane which is key to platelet aggregation and vasoconstriction

I mean, this isn’t new information for doctors. It’s a pretty well known fact that estrogen agonists can increase risks for breast cancer - that’s why decisions made about birth control are patient centric and consider the patients risk factors.

For reference, risks of breast and cervical cancers are increased in women who use oral contraceptives, whereas the risks of endometrial, ovarian, and colorectal cancers are actually reduced.

Also IANAD

Cold Turkey also works on Mac FYI

Great minds think alike! I'll shoot you an email

Ha, funny timing. I’m building a PWA as a side-project that lets me sync all of my medical records from different patient portals in one place. It’s pretty far from being production ready but maybe you’ll find it useful?

https://www.meremedical.co

Sorry about your experiences, that must have been incredibly frustrating. I guess I'm surprised that it took that many doctors to figure it out because it is taught pretty early in medical education. I remember practicing Adsons Test as a first year med student (not diagnostic in any way, but just to emphasize that TOS is taught early).

Sort of like how I would be surprised if I interviewed a developer who didn't know what an array was.

AMA membership by physicians have dropped from 75% in the 1950's to about 15% a few years ago. Doctors are actually not that great at advocacy which is the main reason why counter-AMA organizations don't exist imo.

A large chunk of their membership is just medical students and residents but thats primarily because they offer good savings to them like study materials.

The AMA does not represent physicians.

There are a lot of examples of these "expert systems" in medicine that seem to do well in research, but fail in other ways. We're seeing some of these failures again these days with ML models in medicine, especially bridging the gap between the proof-of-concept and production systems.

https://www.jstor.org/stable/3666074

https://aimi.stanford.edu/events/bridging-ais-proof-concept-...

That's weird, TOS is something taught to first year med students. It isn't that esoteric of a diagnosis.

What percent of doctors do you think contribute to the lobbying organization or agree with its direction?

No need for OO hierarchy, just use a protocol

Obsidian is an example of an app built with capacitor

Is the point you're making here that removing the "premed" undergraduate degree (which doesn't exist) will somehow lead to reduced healthcare costs?

Conceptually, I'd agree with you. I don't think medicare alone needs to fund residency spots (its just currently tied to the amount of spots last I checked). I'm more concerned about the total number of residency spots.

Doing this would make the problem worse by increasing the amount of unemployable newly graduated doctors that can't practice because they can't match into a residency program. Medical schools have exploded in number the past few decades compared to the actual amount of residency spots that have been opened.

The limiting factor isn't medical school admissions, it's residency spots. We'd need to increase medicare funding if we want more residency spots.

Operating theater overflow :)

I’ve heard this a lot, but my experience is actually very different using Anki to study medicine. While I agree creating cards definitely helps with memory, it’s extremely time consuming. If I need to memorize several chapters of material, I might give up if I had to create flash cards for all that content manually.

For medical students, there’s a fixed number of study resources that create a shared knowledge context for everyone using them. Anki decks are created from these resources and shared. In this case, shared decks are actually useful, high quality, and closely cover the material.

It’s much more efficient to use these premade decks - in the time it would take me to create one card I could have reviewed 5. If you have high quality decks, you can really optimize time spent on active recall by doing flashcards.

I guess it depends on the community. AnKing's deck is the gold standard in medical education community despite being public.

At least coming from the medical school perspective - there is a huge culture of using shared Anki decks built off of popular board review books and courses so you can read a chapter/finish a section in some course and immediately jump to Anki to do the corresponding flashcards.

It's gotten so popular that now theres a shared 30,000k card deck called AnKing that a lot of students use. The deck itself is free, but the curators of the deck recently launched a new paid service to automatically update the deck as new cards from the community are added: https://www.reddit.com/r/medicalschoolanki/comments/rb62m6/a...

Right, but a positive screen is usually followed up with a more specific test (karyotype, cvs, amniocentesis) which can give a definitive diagnosis.

Also the screen has a sensitivity of 95% with a positive test indicating > 1/300 chance in Down’s syndrome, so the screening is not nearly THAT bad

A screen for Down's syndrome is routinely done at the end of the first trimester/start of the second trimester.

It's not the number of medical schools that is the issue, it's the amount of residency spots available after graduating med school (in the us).

Let’s say starting tomorrow we decided to pay all doctors in the US $0 dollars a year. How much would the US actually save an annual healthcare expenditures? Approximately 8%

Doctors salaries are not a major driver of healthcare expenditures - they’re just an easy target because doctors tend to be the most public facing part of healthcare. How many health care administrators do you meet when you go to the hospital?