There's no ideal solution: either you check the file in front of the patient and many find this impolite or a sign of failure to know everything, or you don't check and many find you're sometimes over assertive and likely wrong... As in many jobs, you can't please everyone.
TBH, yes it's a big deal. You correctly identified that docs are especially good at rote memorization. I always thought that this calls for a drastic revamp of accepted UI principles. You would usually design to group things logically, conform to an assumed user story and design around it. Well, docs have exactly one single UI priority: speed. They'll adapt easily to having a thousand infos on the same screen, given time to learn the location of each of those. They'll never adapt to deep menus requiring 10 clicks to reach a form.
Honestly, the real mystery is how can GP handle the workload with this completely sequential workflow. I'd just die of karoshi and sleep at work every night if I did that. GP must be ultra efficient.
You maybe. Most other people indeed take it as a sign of failure or lack of manners. Healthcare is social first, logic second (or third, or maybe fourth...)
Well, it depends on your definition of 'surgery'. One could well imagine that transplanting your conscience into a new body might well be feasible before we get to live on Mars.
The problem will more likely be that as progress is made, more complex cases will be tried, finally extending in the category of surgeries where training data is extremely scarce. In a field with dismal information retrieval infrastructure.
In Switzerland, (public) health services are not businesses. And I don't think anyone in our system makes money from encouraging people's deaths. We also have assisted suicide services. They're a public association that brings penthobarbital to your place and assists you during your suicide.
I happen to agree partially, and wasn't trying to fight you over this matter. I generally don't have much love for US docs' attitude either. Take care.
That's not a fair assessment of our conversation, and it seems to me you've been aggressive from the start. Honestly, you reek of the typical US prejudice that 'all-docs-are-arrogant-and-speak-only-to-spite-others'. You can't imagine the relief when I got out of US healthcare and that kind of daily interaction with hospital staff and patients.
> To me it reads like anesthesia in the MRI shouldn't be allowed or needs better supervision.
It must certainly be allowed, as it greatly benefits some patients. Believe me, I'd be most happy if I was forbidden to enter MRI rooms.
> I think they were saying theres literally no one there to help.
This might happen quite infrequently, and usually just for a very short time. Problem is that others have their own jobs to do, and sometimes you get unlucky at just the worst time. It's certainly not common that no one's there, and theres almost always someone near. But since you can't leave the patient, it might be that you have to yell for 20-30s before someone notices you're in trouble.
> Emblematic of the broken US healthcare system. The guideline creates an easily preventable scenario where the patient is highly likely to die for no real reason.
I'm not currently practicing in the US. I don't think that's a fair assessment. Guidelines are born in patient blood, and although adaptation is a must deviating from guidelines still remains a bad idea most of the time.
> Presumably the patient just dies in that scenario that you are supposedly qualified and prepared for?
Yeah, can happen. That doesn't mean you did something wrong. Sometimes (very rarely), shit happens even though you've planned it all according to guidelines. What he's saying is that when shit hits the fan, he's really grateful if someone's there to assist with basic moves while he's trying to control the more pressing matters. I can relate.
The RX bay over here is like 150m^2, serves 6 MRI rooms, has nooks and corners and doubles as the patient waiting bay. Having the tech busy elsewhere while putting people under or waking them up is not a rarity. I agree the security is better for hybrid rooms, as they have their own separate control rooms and techs won't leave when the machine is running. I don't think I'm being dramatic, but you sure seem to have a cozy job if you're allowed to constantly sit around in the control room while anesthesia is under way.
Look, he might use AI but I'm not. I also have 20 years in the field, and I've lost count of how many times I found myself alone with a risky patient. Yes, oftentimes people are just 10m away. Yes, that's not supposed to happen. But that's often far enough for us anesthesiologists to wish we'd be somewhere else. Perspectives and empathy matter. Try to put yourself in our shoes, sometimes. For the record, I'm the main hybrid MRI OR guy in my hospital, so I work near MRIs most days.
I agree you should be able to provide solo, but there is also substantial evidence supporting the addition of a CRNA to make anesthesia teams, that are safer (and even more expensive) than either CRNA or MD operating alone. In many countries, teams are the standard of care.
Indeed, but you won't find yourself alone during the MRI. When you're preparing or finishing the case though, the RX tech and the radiologists often suddenly feel a need for a break. Same thing happens everywhere we go: the anesthesiologist comes in, everyone's here. 2 min later, you look around and everybody magically disappeared.
Yeah, I agree that we can find ourselves alone sometimes, although that's not really supposed to happen. For sure, most people usually aren't that useful anyway.
The MRI+anesthesia problem has recently got much worse, since we're now seeing MRI hybrid ORs pop up. Compounded with the 'lean management' principles en vogue in hospitals, this is a disaster waiting to happen. Personnel is often affected to multiple ORs, including standard and hybrid sites.
The fact that this answer is so obvious to you means you have to read up on diagnostic test performance and how screening works, because it's in fact not obvious at all. I mean that in the nicest way possible. Those companies offering expensive screening are not what they seem. Whether their offering is useful or whether they're just swindling you is a question that needs lots of time, money and sweat to answer.
Apart from the likely technical infeasibility of your idea in today's society, this would require a humongous and diversified population sample to be meaningful (your 'heterogeneous bits'). This follows directly from the complexity of metabolic pathways you wish to analyze. Socially, you'll only be able to achieve that by not asking your sample for consent. Otherwise you'll have a highly biased sample, which could still be useful but for severely restricted research questions.
The timing is pretty important to most people, and is actually the whole point of taking the test in the first place so the generating process and the test are not independent. See ?! What you said is just wrong too ! ;-)