domain:theintrinsicperspective.com?page=1?page=4
I_Smell_Mendacious
9m ago
you can't just go out and increase residency positions
This is the problem, but not for the reason you suggest, at least in the US. The issue is funding - training residents costs hospitals money, which is covered by CMS. Technically, I guess hospitals could fund residencies above and beyond their CMS allocations, but then they are spending money to train a future doctor that may or may not work for them. The financial incentives aren't there for hospitals to fund residencies themselves, so we end up with the number of residencies CMS is willing to fund. That number was mostly static for over 20 years, until Covid made stark how lacking in medical personnel the US is. So they've slowly been increasing the allocations over the last few years, but of course, at a much lower rate than general population growth.
You'd have to do this exercise for every type of surgery that a competent surgeon should know. Gallbladder is one of the most common (hence, one of the first to come off the top of my head), but you still need your local surgeon to be able to do the less known things as well. If I'm betting my life on a baseball player hitting a home run off a knuckleball pitcher, I want him to have at least gone up against a lot of knuckleballs in his life instead of a guy who's mostly only hit against fastball and curveballs and is going to be out there winging it for the first time.
jeroboam
15m ago
Yeah, people tend to flatter themselves that there is a huge gulf in abilities between their own tier and the tier immediately below them (but, strangely, never the tier immediately above them).
It's why so much internet energy is spent talking about "midwits".
A simpler and more accurate model : intelligence matters a lot at every level with no high or low cutoff.
Celestial-body-NOS
🟦 All human beings are equal, **even when they aren't.**
19m ago
I'm going to push back on the assumption that nurse practitioners, or even registered nurses, tend provide worse care than doctors for most patients. I want something more than an impression of anecdotes--preferably actual studies--because in my circle complaining about getting misdiagnosed made by doctors is a well-honed pastime.
I haven't been able to find it again, but I remember reading a story somewhere (possibly by Dave Barry, but I could be wrong) that went something along the lines of:
My tongue was swollen, and I went to my doctor. He did an examination, then diagnosed me with two Latin words, that when I looked them up later, turned out to mean 'swollen tongue', and told me to come back if it hadn't gone away in two weeks. I then asked a nurse, who told me to gargle with salt water; I did and the swelling was gone quickly. I'm hoping my dog's tongue becomes swollen; if the vet tells him to gargle with salt water, I'm taking all my medical problems to him.
(If anyone knows the source of this, please let us know.)
urquan
23m ago
all the aspiring PMCs move as close to the blue enclave as they can manage
This is as much about economic opportunity as it is about cultural sorting.
In our country, we have red counties and blue cities. So someone with the talent, interest, and capability to do the sorts of high-skill jobs you need to do to get ahead in this day and age often end up having to move to a blue enclave, whether they like it or not.
There are certainly some strivers who pursue trades, or other skilled professions with more geographical flexibility. But in general, the money follows population, and the population is clustered around blue areas.
The brain drain is real. But describing it in terms of a desire to become Democratic simply doesn’t explain the cause by itself. People are just trying to provide the best livelihood they can to themselves and their families, and to do that they have to follow the money = population = density = Democratic correlation.
Celestial-body-NOS
🟦 All human beings are equal, **even when they aren't.**
30m ago
Laws which in practice aren't really enforced when a man is perceived to have gotten himself in over his head -- that's the point.
Yes, society still has a ways to go before it lives up to the ideal of being perfectly just.
Where $THING <> "force other people to pretend that you've changed your gender" I guess
I would describe it more as 'exist while presenting as the gender opposite that associated with your genitals at birth'.
resort to violence is not a part of the masculine story
There are times when it is perfectly justified to resort to violence; if Albert starts hitting Benjamin, I certainly do not think that Benjamin is obligated to stand there and let Albert continue.
to the extent that anything's actually changed
I don't know whether or how much it has changed, but if it hasn't, it needs to.
Who's this 'one'?
Anyone who is trying to move society in a direction in which Andrew being twice the size of Bill does not mean that the norms of society reflect Andrew's opinions more than Bill's, nor that Bill is obligated, under threat of bodily harm, to show any respect to Andrew that Andrew is not similarly obligated to reciprocate.
What does Tim Walz ... have to do with anything?
I was alluding to the speech in which Mr Walz said:
... we respect our neighbours and the personal choices they make, even if we wouldn't make the same choices for ourselves, because we know there's a Golden Rule: "Mind Your Own Damn Business.".
Even if one disagrees with the transgender ideology, a person, born with the genitals associated with one gender, choosing to exist in public while, via clothing choices/bodily alterations/whatever, presenting as the opposite gender is none of the business of the people standing next to them.
RandomRanger
Just build nuclear plants!
37m ago
I've said before that the 95th percentile human being has a lot more in common intellectually with a 10th percentile human being
Really? How many 10th percentile people do you meet?
The 10th percentile are the ones breaking into bald men's heads looking for gold or deflowering virgins to cure their AIDS. Or they star in the genre of youtube videos exposing how stupid and ignorant American university students are: https://youtube.com/watch?v=AkIUqH498PQ
The more cerebral of this cohort might subscribe to conspiracy theories about how the earth is flat, how everything is actually naval law and most countries are secretly enrolled as corporations in Delaware... They still cannot string a sentence together though, nor can they spell.
sarker
It isn't happening, and if it is, it's a bad thing
39m ago
Quick Google search suggests that there's something like half a million gallbladder removals per year in the USA. I'll leave it as a simple exercise for the reader to estimate how many residents per year could be trained to do gallbladder surgeries at such a rare.
JarJarJedi
40m ago
Nearly 100 trucks carrying food for Palestinians were looted in Gaza. Hamas security forces retaliated by killing over 20 gang members involved in the looting. Israel cited distribution challenges as the main obstacle in aiding Gaza.
Here I'd like to call out the fact that I don't see a reason why Hamas is any more entitled to have the food than the "gang members". Hamas is a gang like any other, maybe the largest and the most violent one, and maybe having the most success in controlling the food sent from abroad and thus maintaining its edge over other gangs - but I don't see why they would be allowed any more legitimacy than any other gang. The main obstacle is, indeed, that the food ends up in hands of violent gangs - either Hamas or other one - and the only way to get fed is to either associate with one of the gangs or to pay them for the food, and if you don't want to do either, you get no food. This is a huge problem but we shouldn't pretend Hamas is any different, and they have legitimate claim while "looters" do not.
thasero
41m ago
Acid neutralization is the best way to build a power grid on Vulcanus - a single plant generates a huge amount of steam, enough to run dozens of turbines and power the entire planet. Acid vents always produce a minimum amount, like oil patches on Nauvis, and the calcite patch at your landing zone will probably last you for the entire game, so there's no reason to be shy with the resources.
Although dropping free resources from space is indeed a useful strategy, especially once you hit advanced asteroid processing. The simplest is to harvest calcite from orbit and save the trouble of shipping it from Vulcanus.
JarJarJedi
46m ago
If it were about the dude in a dress and his particular emotions, it'd be so nice little summer problem. I mean sure, there are mean people around that would bully everybody who's different, and they'd want to bully the dude in a dress so hard because it's so easy. But that's like 1970s problem. We are in 2024 now, and our problems are much different. Our problems are the dude in a dress now is the school teacher, and the parents aren't even allowed to know what and how he is teaching the kids, and the dude in a dress has full unrestricted access to spaces where the girls and the women were supposed to be in the company of women and if you mention there's something wrong with that, you are the one who is suppressed. The dude in a dress is now the government functionary, and we're supposed to put up with his antics on the job and hire more dudes in dresses because otherwise we're nazis, and if he directs the vast machine of governmental oppression towards people he doesn't like - it's ok, the dudes in a dress deserve our deference, so we must say nothing.
We are supposed to literally think the dude in a dress is no different from any woman in any way from the moment he dons the dress. Nobody of course thinks that, but you are supposed to pretend you do, or bad things will happen to you. We are supposed to loudly proclaim things we know are false, because the empathy to the dude in a dress is more important than telling the truth. And this is not just a voluntary choice you can make out of sympathy for the dude - if you disagree, bad things are definitely going to happen to you. We are supposed to think a dude in a dress competing in sports with women is beating them easily (sometimes "beating" very literally) because of his great sportsmanship and not because he's a frickin dude. We're supposed to watch the dude in a dress convince mentally vulnerable kids to cut their private parts off and change their lives forever and think it's normal and a kid can't decide to drink a bud light until they are frickin 21, but they are capable of informed consent to overhaul their whole body biology forever in kindergarten. We're supposed to institute speech police and abandon freedom of speech (and freedom of scientific inquiry) because this particular dude may feel bad if somebody says something he doesn't like. While of course a dude in a normal attire does not get such reverence (not that I advocate he should, but at least that would be some kind of insane tyrannical equality). We're supposed to reform our whole language and culture and brand anyone who says something as vile as "pregnant woman" as a violent criminal, while actual violent criminals get away with wrist slaps at best, because see, it's the dude in a dress, shouldn't you have some empathy here?
You notice how it's not about the dude in a dress and his problems anymore?
I am not saying the old problem aren't a problem. I recognize it is. But it is not the problems that we as a society are dealing with right now. I'm very willing to have a little empathy for a poor dude with mental health issues (I'm even go as far as inventing some way to say "mental health issues" without it sounding demeaning, after all, there's nothing shameful in having a migraine, why it should be shameful to have broken gender identification?), but that is not helping with the real issues now. Sure, I am going to give the dude as much empathy as I can find in myself, but given how many of those dudes are involved in making the actual current problems worse, the reserves are limited.
orthoxerox
If you can read this, you're using a custom theme
56m ago
I think it's much less cringe than hiring 37-year-old prostitutes. And at 400-500 dollars per session she was a real bargain, to boot.
BurdensomeCount
Apparently "BIPOC" is a racial slur now.
1hr ago
US physicians (I will not call them doctors unless they are an MD, the word doctor comes form the latin docere, meaning to teach; unlike how the uncultured may think about it, true doctors are those with a Ph.D, not those with a BChir, there's a reason why in places like Germany these people are not allowed to call themselves "Doktor" but instead go by "Arzt") are so far up their own ass with how highly they value themselves that it boggles the mind.
I have met many many doctors and the vast majority of them are sub 98th percentile mediocrities pretending they are the intellectual equals of the 99.5th+ percentile thinkers. I've said before that the 95th percentile human being has a lot more in common intellectually with a 10th percentile human being than he does with a 99th percentile human being and something similar applies for the average doctor who isn't much better than a 95th percentile human but has the ego of a 99.9th percentile one (not saying there are no amazing doctors, I've met some of those too but they are the exception, not the average and they tend to be MDs).
I'd be very interested in comparing the average outcome of a NP with the latest AI models trained on giving medical diagnoses vs a lone doctor. My prior is that the NP+AI performs at least as well as a doctor in most non-surgical specialties. If so then the optimal thing for humanity is to cry havoc, give NP+AI combinations the same powers and responsibilities as "full" doctors and let slip the dogs of war on the protection racket US doctors are running. Of course this is a pipe dream (never mind the extreme litigiousness of the US meaning NP+AI malpractice insurance costs will be through the roof but that's a discussion for another day) but yeah, either we all grasp the nettle and do something like this or the economic rent seeking of the AMA will continue to extract blood from the rest of society.
Mihow
Lipstick on a guitar
1hr ago
From the ‘ vibes ‘ I gathered about a day after the Gaetz nomination, most Trump supporters thought he was being set up to be a lightning rod of controversy and tossed aside.
birb_cromble
1hr ago
I can't drive down twenty miles of highway without seeing a nurses wanted sign, usually with a prominent signing bonus advertised as well. Maybe it's a regional thing?
birb_cromble
1hr ago
I wish that infographic could include population change on the z-axis, in addition to the voting change.
I live in an extremely blue enclave of an extremely red region, and one thing I've seen is that all the aspiring PMCs move as close to the blue enclave as they can manage, or they flee to the DC/Baltimore/Philly/NYC megalopolis, never to be seen again.
aqouta
1hr ago
This would be a problem if every hospital was already a teaching hospital, but that is not the case.
BurdensomeCount
Apparently "BIPOC" is a racial slur now.
1hr ago
If what you are saying was truly the real problem then the easy solution would be to allow foreign doctors trained in European countries/Australia/NZ etc. to come and work in the US without needing to redo their residency. Medical standards in these countries are no lower than the US in aggregate and may well be higher. Sure you can ask for equivalency exams (like how the UK does for foreign doctors) but there's no valid argument that the 90th percentile British doctor is worse than the 10th percentile American doctor, so why block the former from working in the US?
That we don't see this is Bayesian evidence that this is not the true objection for why the US medical cartel wants so few licenced doctors.
Amadan
I will be here longer than you
1hr ago
Make your point without the snide personal digs.
5434a
1hr ago
Since my first exposure to it via /tumblrinaction more than a decade ago it's been TRA's persistence in presenting contradictory, circular and otherwise faulty reasoning as their basis for justification that frustrates me more than any idea of a man in a dress winning a sports match against women and then using the same changing room after the contest, or similar object level conflicts.
I'd be just as vexed if people made serious arguments that magic is real and that if you ruminate on it long enough your wish to learn magic can come true by forcing everyone to call your school Hogwarts, changing your name to Harry Potter and cutting a lightning scar into your head. Legislating for Hogwarts accreditation and arguing whether Griffindors are allowed in Hufflepuff dormitories is redundant.
What's crazy is that rather than getting laughed off the internet the tumblrites successfully coerced the real world into entertaining their fantasy by little more than using the threat of being shamed for intolerance on social media.
MathWizard
Good things are good
1hr ago
This. I think "don't ask don't tell" is an excellent policy that needs to be the norm in the entire culture. If I am not in or considering a romantic/sexual relationship with you, then I don't need to know about your weird fetishes, and you don't need to know about mine. Even if it's not weird, even if a straight man just really likes tits, I don't need to hear him announcing it and going on about it in public and making it his entire identity. It's tacky. Keep it to yourself, or talk about it in private with your close friends.
hydroacetylene
1hr ago
I think a bunch of this is climate, as well- in the south it’s still too warm to hang deer in November, you have to pack the body cavity with ice, or quarter it in an ice chest, which means you need a freezer to store that ice, which means you need a deer camp with electricity. + there’s less public land, you need to secure permission to hunt on someone’s private land. Militates in favor of hunt camps, and since it’s usually private land with restricted access, there’s no free rider problem to setting up feeders and tree stands.
Deer stalking is a different sport which is more common on public land- heavier forest cover makes the Rockies-style ‘drive around on public land until you see an elk’ a way to not see any game.
The gender difference I’m reasonably sure is cultural, though. AFAIK the intermountain west and northern Rockies aren’t much less socially conservative than the south, so it seems kind of random.
I'd say those people are more like 2nd percentile. Either that or I have too high an opinion of the average human being (I find that hard to believe but am open to the possibility). I think 10th percentile is more like the people manning the tills at your supermarket rather than the dangerously stupid as in your comment. Would you not agree? If not then what percentile human being would you say is doing menial supermarket work?
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