@paulsaladinomd I suspect he meant that it is heritable, which is true. It runs in families, moreso than T1DM, but this is confounded as one also inherits lifestyle habits, epigenetics, etc. Doesn’t mean T2DM is destiny irrespective of habits and choices.
@CoffeeBlackMD I was planning on doing pulm/CC as a resident and I did lots of ICU and lots of pulm consults. My fave was IP consults, where I routinely got consulted from NPs in the onc service, verbatim for “hypoxia, evaluate for thora or any other procedure”
I took my kids to COSI, the science museum, and you look at the exhibits and it’s all these doctors from just one or two generations ago, who were major philanthropists and pillars of the community.
Our profession has been destroyed.
Basal expectations of a physician entering practice 50 years ago:
-build an independent practice employing other people
-investment and ownership
-stay at home or socialite wife
-nanny/housekeeper
-custom home in best neighborhoods
-top private schools for 2+ children
-country club membership at exclusive club
-second home(s) at beach, lake, ranch, or mountains
-boat and/or plane
-high social standing
Today:
-employee in a large hospital system or PE
-own nothing
-working wife, likely another medical professional
-day care or au pair
-tract home in the suburbs
-public schools
-Lifetime Fitness and public links
-air bnb rental
-Disney cruises and economy class
-nobody knows your name
@DutchRojas Isn’t this the trial in which the history was straight out of step 1 vignettes? I’d like to see what AI does with real world patients. I think highly intelligent people significantly overestimate the level at which the general population interacts with doctors.
@JamesTate121 Illegal immigrants are net tax takers, not net payers. As a population their effective tax rate is negative, unlike these companies which make enormous net tax contributions.
@dieworkwear Agree it’s silly to hide the studs under a vest. I definitely like the low cut waistcoat better than a cummerbund which always looked weird to me. Thanks.
@dieworkwear Never knew this was the distinction between these styles of waistcoat. Still, I have always preferred the higher cut, I think it draws the eye upward and looks more flattering, the lower cut draws the eye to your gut and can accentuate a belly if you have one. What do you think?
This is a graph of budget deficits, not of revenues. The revenue does go up after tax cuts. Laffer didn’t lie. The issue is spending.
Here is the actual graph of revenues.
You’ve seen this movie before: Maybe Reagan guessed, Bush hoped, and Trump tried—but tax cuts never paid for themselves. Given the mountain of evidence, claiming once again that "tax cuts will pay for themselves" is no longer ideologically motivated optimism.
It's a lie.
Some more thoughts on AI. Specifically, this explores what has happened to doctors that will eventually allow health execs to replace us with AI. We increasingly are following a script that we didn’t write, making it easy to substitute in the script itself and cut us out.
@DanLairdMD Even pain management specialists refuse to prescribe opiates and are sending their patients to the ER. The patients tell me that their pain specialist told them “the ER has better pain meds.” I’ve heard that exact quote from patients so many times that it has to be real.