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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.

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.

izomiac1 karma

As a physician who's practiced rurally in two of the most conservative states in the country I have difficulty believing any of your points.

  • doctors making the correct diagnosis less than chance -- by that logic mortality rates would be higher than before we had modern medicine

  • rampant cheating in medical school -- there's some, but such people fail on their step exams (heavily moderated & designed to be near impossible to cheat during), or on their clinical rotations when you have to apply the knowledge

  • taught by white old people -- academic teaching positions pay crap salaries so they're mostly taught by first generation immigrants

  • black people don't feel pain -- this is 2018, I'm not going to dignify this drivel with a response

  • diabetes type one being a rare disease -- it's commonly seen in practice, nobody would think otherwise

  • not understanding statistics -- partially true, but the bias is the other way, we overtest for rare diseases

  • doctors don't want favorable outcomes in patients -- I don't even know where to begin with this one. Yeah, I went through more than a decade of schooling just so I could ignore it and watch people suffer & die.

  • litigation is just for rich people -- lawyers mostly work on contingency for medical malpractice.

One amusing thing about your post is how you seem to take special objection toward racism against black people, yet accuse roughly 800,000 doctors from diverse backgrounds of all being horrible people & incompetent sadists. It's not racist, but it's a damn similiar type of tribal thinking.