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Terracotta
8hr ago
However the bad outcomes are mostly increased lifetime mortality and risk of side effects 20 years down the line when the patient is seeing someone else. This becomes effectively impossible to study so we don't... Psychiatry is a better example - psychiatric interviews and pharmacology are the most complicated in medicine. Mental health care NPs are terrible at both of these things, give people unnecessary medications and incorrect diagnoses and are legible experienced as lower quality by patients and staff with some regularity.
I should emphasize that I have a lot of respect for psychiatrists, who seem to hurl themselves into the breach of various social ills in a way I certainly wouldn't want to do. But if we're searching for a test field where rigorous evidence makes it very legible which are the "necessary medications" and "correct diagnoses," so that MDs' highly effective healing practice contrasts clearly with NPs' useless flailing, then I'm not sure psychiatry is the obvious pick. We're talking about the same psychiatry that regularly diagnoses from subjective surveys and patient self-reports, correct? Where almost none of the biological mechanisms are thoroughly understood, either for the ailments being treated or the medications that treat them? Where exercise, healthy diet and getting plenty of sun/fresh air seem to work as well as the best drugs a lot of the time? Where official medical conditions pop in and out of the DSM with every passing political wind?
Would you say that psychiatry does a good job of monitoring its physicians' contribution to patients' lifetime mortality and/or risk of third-order side effects 20 years out, either across different levels of physician talent/conscientiousness, or versus not receiving psychiatric care at all?
Also, since this is why people normally bring it up - if you magically paid all doctors NPs salaries and didn't really change anything else......healthcare costs wouldn't go down at all in any substantive way.
I don't quite get the reasoning here. Is the idea that receiving NP salaries would cause physicians to practice as badly as you believe NPs practice, because all the competent MDs would decamp for higher-paid professions (notwithstanding the additional benefits of prestige, flexibility, autonomy and meaning in medicine)? Doctors in Canada, the UK and Germany earn about 1/3 to 1/2 what they earn in the US; is the contention that they must practice incompetently and waste a ton of money doing so?
Was it Handwaving Freakoutery? (https://hwfo.substack.com/s/egregores/archive?sort=new)
hydroacetylene
8hr ago
I think people receiving blood transfusions have bigger problems than microplastics, so I wouldn't worry too much about it.
hydroacetylene
8hr ago
We have left-wing musings that the failure to reach low-propensity voters comes from a “lack” of a left-wing media ecosystem, which makes me scratch my head somewhat, given the disproportionate skew of media to the left. There doesn’t appear to be any introspection or soul-searching here. The issue might not be a lack of left-wing media, but a lack of trust in that media; becoming more online creates a healthy level of skepticism about what we consume, especially as AI becomes more prevalent.
Legacy media is left wing. New media isn't conventionally left or right, but the most popular versions tend to lean republican.
Now make no mistake, Rogan and Trump are allies of convenience. But they are allies nonetheless and arguing with him about dragons just makes democrats look shrill and out of touch(Rogan's audience, like most normies, answers esoteric paranoid schizophrenia with 'interesting, so, uh, did you see the game last night? How about that weather we're having, huh?).
doglatine
8hr ago
I've been getting VERY interesting in egregores and eldritch analogies lately, and I'll probably do an effortpost on them at some point, but in the meantime I'm trying to track down a brilliant rationalist-adjacent blog that did long-form essays about a bit of different egregores, some of which had Lovecraftian or Biblical names. My Google Fu is failing me - anyone have any idea what I'm talking about?
lagrangian
8hr ago
My dad's theory of gifts has long been that the best gifts are something you'd want, but would never buy for yourself because you wouldn't spend the money.
I take a similar approach: buy a nicer version of something than they would buy, or even have already bought. E.g. they may have a couple $10 knives - buy a $100 knife.
Quantumfreakonomics
8hr ago
I saw very few yard signs at all this cycle. I thought everyone simultaneously realized they were cringe.
JarJarJedi
8hr ago
"Governing" here is a very murky term. Sure, they are the biggest and the meanest of the gangs, but so what? Among any set of gangs, there would be one that is the biggest and the meanest. They didn't have any process that resembles free election even remotely - they had a gang war with FATAH in which they emerged victorious, and slaughtered or exiled anybody who was affiliated with the competing gang. Being the strongest gang counts for something, sure, but that something shouldn't earn them any legitimacy in the eyes of people who should know better.
ABigGuy4U
8hr ago
-Ron Brown the Secretary of Commerce who was killed in a plane crash in Croatia. The medical examiner found a execution-style bullet hole in his head that was explained away as a flying rivet.
-Mark Middleton, who hung himself from a tree, and then after that shot himself with a shotgun.
The real suspicious thing is just the sheer volume. How many politicians have a double digit number of associates die violently or commit suicide?
Folamh3
8hr ago
Everyone knows about Epstein, I'm interested in the people who aren't famous and whose deaths were page 4 stories.
Celestial-body-NOS
🟦 All human beings are equal, **even when they aren't.**
8hr ago
· Edited 8hr ago
Children who have grown up in a WEIRD¹ society that teaches them barking-mad ideas like "When you're hiring someone with Other People's Money, you should pick the best person for the job, rather than the applicant who gave you a wad of cash." or "It matters whether someone did something wrong, not just whether they are related to you."
¹cf. The WEIRDest People in the World (Joseph Henrich), which postulates that "Western, Educated, Industrialised, Rich, Democratic" societies have world-views which are very un-common elsewhere.
sarker
It isn't happening, and if it is, it's a bad thing
8hr ago
The Democrat rank and file seem to have have largely convinced themselves that the Democratic party message is Just Being A Decent Human Being. It's hard to pivot from that to the message being a problem.
I'm a former management consultant and I'm not aware of anyone being mad about SWE salaries. The job paths are broadly comparable with broad salary scales, competition, risk, limited career length, compensation broadly tracking to productivity (usually more unequivocally so for SWEs), etc.
I feel like people complain about doctors roughly in the same way people complain about longshoremen or garbage men. A guild (or the literal mafia) capturing part of the economy, limiting access and extracting extreme rent, with doctors union arguably being even worse since they not only cost a lot of money but drain top talent from the more productive parts of economy (even within their own sector of the economy!).
Celestial-body-NOS
🟦 All human beings are equal, **even when they aren't.**
8hr ago
· Edited 6hr ago
The strongest argument for it, actually. If the only proposition made by Sklavenmoral were that 'the weak ought to be protected from the strong', and the only proposition made by Herrenmoral were that 'the strong ought to be able to do to the weak whatever they feel like', the former would be called 'morality' and the latter by the sort of words discussed in the 'Taboo vocabulary' category on Language Log.
The strongest argument in the other direction, on the other hand, is their respective attitudes towards those who Accomplish things, such as ending the almost-nine-year gap during which America Could Not Into Space.
(cf. Matt Yglesias Considered As The Nietzschean Superman, Astral Codex Ten, July 2024).
Lewis2
9hr ago
Hamas is (still?) the governing power in Gaza, having been voted into power by the population in as fair and free an election as it is probably possible to get in Gaza. Despite all their corruption, authoritarianism, and just plain bad decision making, that still gives them an edge over the other competing gangs. Plus, being bigger and stronger than the rest counts for something on its own.
anti_dan
9hr ago
If something is happening at your hospital like once a year, that seems inevitable.
orthoxerox
If you can read this, you're using a custom theme
9hr ago
Various marital aids, I presume.
Fruck
Lacks all conviction
9hr ago
It would be easier and better for your psyche if, instead of getting upset at the idea of PAs having less status than doctors, you just dropped the stigma you currently associate with the working class.
The anonymity of the internet equalises the doctor, the cashier and the executive - online all their opinions are considered equally merited. And this has mostly wonderful effects imo, but one negative is that the wealthy express their opinions on working class jobs the way they think about them - calling them worthless jobs or saying the only people fit to push a broom or work at a supermarket are 70 iq or they're jobs for drug addicts - and they're right to an extent, they aren't as skilled as professional work, and don't require as much discipline or intelligence, and can indeed be performed by drug addicts (just like medicine and corpo blah blah blah).
But this has given the zeitgeist the impression that these jobs are worthless and as a result nobody wants to do them any more. They don't take pride in doing them and resent them. And so you get passive aggression at the deli and half missing fast food delivered cold, and people getting ticked off when their respectable friends are labelled working class. But there is plenty of pride in doing any job well and more importantly there is no shame in it. A janitor who takes pride in doing his job well is infinitely more respectable than a doctor who reads webmd at people in between smoke breaks.
Who cares if Rafa or I think your sister in law isn't in the same league as a doctor? You know her, is she the kind of person to fuck over someone's life through ignorance or is she going to do her best at all times? It's that spirit that is admirable, not her position in the pecking order.
orthoxerox
If you can read this, you're using a custom theme
9hr ago
I got myself an air fryer. Now that the share of low-fat oven-baked fries in my diet is going to rise, I need some kind of sauce to enjoy them with. What are your go-to homemade low-calorie dipping sauces?
zeke5123a
9hr ago
It’s interesting the Dems have been focusing on “we have to figure out a way to get our message out” and not on “maybe the problem is the message.”
EdgeCityRed
9hr ago
If Muslims were making laws aimed at me, I'd care more about what they do.
Most people don't care about others' personal beliefs, as long as they don't affect people who don't believe the same things.
The_Nybbler
Does not have a yacht
9hr ago
Ah, thanks. My district actually IS worse than that, close to 4:1... but still, there's a lot less than 20% Trump support visible.
Gaashk
9hr ago
I don't know, and am starting to understand how my older working class relatives ended up giving each other lame things like jeans, socks, and toothpaste. Anything desirable enough to be excited about must be discussed at length (we're currently considering a three day trip to a nearby city). We're low enough SES that this includes things like an $80 espresso machine. We're both picky about personal items, and it's very obvious when someone isn't using the thing you got them. I will be missed if I leave or get home early/late by even 10 minutes.
At least 5 year olds are fun to buy gifts for. They are the best gift recipients. We got ours pajamas, after previously not having any, and she was so happy about it, and wondered out loud if Santa had placed the pajamas on the store rack for us to see, since it's so great having princess pajamas.
So, what are you reading?
Still on Future Shock, 12 Commandments, Crystallizing Public Opinion and Galactic Patrol.
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