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izomiac53 karma

Census data is kept classified for 72 years, so the most recent census we can review is 1940. That one was used to arrest anyone who reported their race as Japanese and put them into concentration camps. The census bureau publically denied that fact until the records were declassified.

As such, how can one justify encouraging people to fill out more than the legal minimum? The census has a noble purpose, but such a serious betrayal of confidentiality isn't something that should be easily forgiven or overlooked...

izomiac40 karma

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izomiac8 karma

The issue is that people who are Baker Acted don’t have a lot of choice in the facility they end up in.

I work in a smaller ER in TN and I'll generally try to honor patient preferences for psychiatric hospitals. You've got a certificate of need so you have to go somewhere, but if you don't like the first available option then you can wait an extra day or two for something else to open up.

Obviously this isn't absolute. If the hospital you don't like is the only one with a bed for the foreseeable future then too bad. You also can't refuse everything and hope it expires. First of all, I wasn't born yesterday, and second, it doesn't. We renew it every 24 - 48 hours until you're transfered or get better. The state of TN doesn't want people killing themselves in hospital parking lots after 72 hours just because the psych hospitals are busy.

But that's just me. Busier ERs might send you to the first option simply because they can't spare the room.

izomiac7 karma

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izomiac5 karma

Finishing up at age 30 - 31 is if someone goes straight through and does a 3 year residency. Mid-to-late thirties is more realistic for specialists and the majority who don't go straight through. As for salary, the average for primary care (50% of all doctors) is $180k. If they have an above average amount of school debt (e.g. $300k+ for an IMG who went to a good private college), and add on a mortgage (at a higher interest rate than the student loans), and a high cost-of-living area plus kids, then it would not at all be unreasonable to still be paying on it after 10 - 15 years in practice.

OTOH, if you make positive assumptions -- low school debt, high paying specialty, no kids / low COL, then paying off one's loans shouldn't take five years. It's a very individual thing. That said, a lot of doctors are terrible at finances which makes it all a moot point. I have one friend who is planning on the 25 year loan forgiveness option since he won't have them paid off before he retires.