Throwaway05
17hr ago
godspeed my guy
Throwaway05
18hr ago
Don't they give you dx and med questions???
Throwaway05
1d ago
What you provided was evidence of nearly every stake holder involved saying "this is a bad idea" including PTs themselves.
That is not evidence that the AMA is indirectly or directly responsible for this, it may be evidence that the AMA had a stance, but that doesn't make the AMA the villain here, or the decider.
It also does not establish that cutting physicians out is a good idea, indeed PTs don't seem to think it is a good idea as per your source.
And again, the restrictions seem to be reasonable and common sense, again as per your source.
Things like "if you try for awhile and it doesn't work you need to escalate the level of care providing therapy that appears to be ineffective."
That's common sense!
And why are you focusing on blaming the AMA when seemingly everyone opposed the change??
Throwaway05
1d ago
Your citation is from 1991 - even with an atypical forum such as this one....most of our posters didn't exist at that time.
This is one of the central problems of complaints like yours, the lobbying activity of the AMA that people get frustrated about was something that occurred in their parents time, or their parent's parents.
That system is dead. Private practice is dead in most specialties. Physicians don't bill, the people who own the work of the physicians bill and make decisions.
You are misattributing blame.
Speaking of which, from your own citation -
"Opposing forces varied from state to state and included hospital and medical associations, physicians, chiropractors, and physical therapists."
If the AMA is the villain can you explain why doctors, physical therapists, and even fucking chiropractors were on the same side of the lobbying?
Throwaway05
1d ago
Weird, could have sworn I double checked and didn't see anything about the timelessness in your original post. shrug
That doesn't address the substance of my complaint, however.
Throwaway05
2d ago
So I stand by what I said - in many states it is illegal to see a PT indefinitely without seeing a doctor.
That's extremely different from what you said before - seeing a PT for initial evaluation and treatment is not the same as seeing a PT indefinitely without further evaluation (such as things like imaging).
One of the purposes of that sort of restriction is to prevent scams where a PT just bills insurance without doing anything.
One of the reasons I can be reliably summoned this way is because the complaint is essentially baseless slander that does not acknowledge the possibility of other sensible explanations or the reality that the situation has changed in healthcare has changed. I am therefore (reasonably I think?) frustrated.
Conspiratorial posts about the AMA have low predictive value and create uncertainty for legitimately information seeking third parties like OP.
Throwaway05
2d ago
As per your link the restrictions include things like:
"A therapist who has more than one year of experience supervises any therapists licensed for less than one year."
And:
"The therapist thinks the care is within his or her scope. If a therapist thinks the care is outside of his or her scope, he or she must refer the patient to an appropriate healthcare provider."
How are these unreasonable?
Insurance is more likely to prove a barrier.
Throwaway05
2d ago
My usual recommendation for this kind of thing is to look for stuff you can pirate that US grads are using. Most US speciality boards have at least on killer app or test prep book. Easy to nab on Libgen or whatever.
Obviously might end up with different areas of focus but overall should get the job done?
Throwaway05
2d ago
Yes this is always my plan - straight to PT. Obviously I have more information which makes things a bit easier for me.
In the U.S. you do need to ensure your insurance will allow this, but a local PT can usually help walk you through that.
Throwaway05
2d ago
it really shouldn't taste like fried rice
You mean like....good?
Throwaway05
2d ago
I think I'm just expecting it to taste like fried rice and it doesn't. Might be an expectation thing.
Throwaway05
3d ago
.... I think I'm just a heathen, I've been to the few places in the US with legit stuff and still meh
Throwaway05
4d ago
And if I recall correctly the author is an actual straight up SneerClub poster.
Throwaway05
4d ago
beyond a fondness for biryani.
Can you change my view that Biryani is just crappy fried rice?
Throwaway05
9d ago
The more healthy hospitals I've worked in have often had residents (and sometimes attendings) cross lecture - psychiatry explains capacity, surgery comes to IM to explain wound case basics etc.
If you feel like tilting at windmills its a nice thing to try.
Throwaway05
9d ago
The meme in the U.S. is that the majority of Psych (and to a lesser extent Neuro) consults are inappropriate. Both tend to get Delirium/TME consults for which the recommendation is "fix the underlying medical problem" (with a side helping of "no this 85 year old grandma does not have late onset schizophrenia). Psych also gets capacity consults - any physician can determine capacity and should be able to do so unless something weird is going on. You call Psych if mental illness is complicating things only.
Throwaway05
9d ago
by making someone in California have like 10x less say than the same person in Mississippi in Congress and the presidency.
The Electoral College prevents a small number of influential and high population urban centers with views that may be broadly considered alien from running a country most of the size of a continent. It is likely responsible for quite a bit of US stability.
Look at the Hunger Games, where a large capital dictates unpopular policy to the other regions.
It's likely we would have significant ongoing issues with places like Texas trying to leave if California was in charge.
The EC allows the federal government to have teeth without a shit ton of civil wars.
The American founding fathers were some of the most brilliant and successful political theorists in the history of mankind. Don't throw out the political technologies they invented because it has been recently expedient.
Throwaway05
9d ago
Oh there's no rush. Get well soon.
Oh no, I was guessing that ED was the rotation.
Why is your CL service busy? Do your surgeons not understand how capacity works?*
*This insult of European surgeons not guaranteed to match the medico-legal requirements of British healthcare.
Throwaway05
9d ago
Pshh skip the meet cute hoss, I want to know what the rotation is.
Busy......Emergency?
Throwaway05
9d ago
I think this is a really stellar comment!
Throwaway05
9d ago
To your point about culture, I do think part of it might be that society sees Internet activity as not really being "real" social interaction, even though hanging out on a forum is probably filling the same psychological need that hanging out at a pub would've done.
Absolutely, any para-social or other unconventional socialization is still socialization. Assessments aren't really updated to reflect this (well, for the most part).
If you are the kind of person who is posting here you may appreciate and benefit from interrogating your own personality in an organized way - maybe figure out why you are this way, maybe to see if it's what you truly want. If that's the case...chase the thread.
Not doing so is perfectly cromulent however, especially because learning about yourself can be an info hazard that can't be put back in the bottle.
Throwaway05
9d ago
Hopefully he's just on a new rotation :/
Throwaway05
10d ago
I think this is a good time to take stock of your stances on things and go "do I really think this is a good/bad idea or am I just responding reflexively because of Trump."
By all accounts the lack of a proper presidential ballroom has been considered a minor national embarrassment for years... but people in D.C. just don't want Trump to be in charge of fixing the problem. That level of petty vindictiveness isn't a surprise, but it shouldn't really be supported, and if you speak to the relevant officials I'd bet money that most of them only oppose it to salve their constituents and not out of genuine belief. Supporting the worst impulses of the populace isn't always wise.
On top of that we have the current issue. Imagine if you were nearly killed in a plane crash or in the hospital, and the Swiss Cheese model successfully prevented the bad outcome. Do think the response to a "near miss" is to leave everything as is? No, we make improvements to close the hole, to avoid the risk of multiple holes lining up next time.
Blessedly the system didn't totally fail. That's not a reason to make no adjustments.
Throwaway05
10d ago
A few things moving in parallel here:
-
The explanation as to what a personality disorder or personality is is a long lecture at absolute minimum. It's a complicated concept with very specific (and for some dimensions debated) meanings. Takeaway: It may be reasonable to go "meh" in response to labels.
-
Schizoid personality disorder is one of the most poorly understood diagnostic entities in medicine. Patients essentially never present for psychiatric care because they don't see the need (and unlike say anti-social PD, they don't otherwise live their lives in a way that gets them attention). To my understanding the only reason why we know anything at all about this diagnosis is for historical reasons (it was thought to be a pre-morbid state for schizophrenia and was therefore very heavily explored, once we figured out that wasn't the case we stopped expending excess resources on trying to spot it and it went away*). Non-psychiatric medical providers see these patients far more than psychiatrists (since they do still require medical care). Takeaway: I'm not sure really this label means anything or requires anything.
-
The internal and external expression of the self is heavily impacted by culture and environment. Takeaway: I'm not sure a diagnosis that primarily served to describe behaviors in a wildly different social milieu totally applies to modern heavily atomized culture.
-
Asking this question is suggestive of the diagnosis not being relevant - satisfaction with the state of affairs is hallmark of the diagnosis.
-
Regardless of any of the above and anything related to the diagnosis - it is totally reasonable to have questions about your self, your preferences. Some people are fine with being solitary. Some people are being solitary as a defense mechanism. Some people are fine with being solitary as a defense mechanism. It is hard to explore these things by yourself, and in a situation where you don't have a lot of external entities to help you, a therapist or other professional way to organize and explore yourself is totally reasonable.
*not 100% sure on this.
When using LG make sure you are using the latest TLD - it's still up as of this posting.
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