Doctors are very highly trained technicians - they are not scientists, they have very average critical thinking abilities. They do no original research and their field of work is so generalised, so overly comprehensive that they have no ability to even begin to keep up with the latest research. The methodologies they are taught and inherit to determine the "latest science", "advice" and "breakthroughs" are to read the distilled daily advice from drug companies, government and, if they are really "cutting edge" to read the occasional article in their Pfizer paid for journal digests. In my experience they are more gullible to the herd mentality and whatever is touted as "tHe ScleNcE" than the average intelligent person. Doctors are extremely well trained and educated, but as practitioners, technicians and their critical and analytical skills are primarily focused in triage and solution finding from a set of predetermined advice on treatments and drugs. They are like extremely skilled drug salesmen - yet they dont know it, thats why all these medical shows where they are heroes exists, to fool Doctors into think they are heroes and adored. If i were to use an analogy, they are more akin to mechanics than they are to engineers and a world away from the study of the physics behind the forces and principles in either. In any tyranny, you can look this up, Doctors have always been the most compliant, the most willing to allow politics to influence their practice - in fact they are often fanatical zealots for whatever political extremism has become the new normal. Their hero complex only ever leads them into whatever brings them the most adoration. This is why here in England the government pretty much demanded the people stood outside every day and banged pans in support of them - when they saw that going along got them the adoration they craved.
Doctors are very highly trained technicians - they are not scientists, they have very average critical thinking abilities. They do no original research and their field of work is so generalised, so overly comprehensive that they have no ability to even begin to keep up with the latest research. The methodologies they are taught and inherit to determine the "latest science", "advice" and "breakthroughs" are to read the distilled daily advice from drug companies, government and, if they are really "cutting edge" to read the occasional article in their Pfizer paid for journal digests. In my experience they are more gullible to the herd mentality and whatever is touted as "tHe ScleNcE" than the average intelligent person. Doctors are extremely well trained and educated, but as practitioners, technicians and their critical and analytical skills are primarily focused in triage and solution finding from a set of predetermined advice on treatments and drugs. They are like extremely skilled drug salesmen - yet they dont know it, thats why all these medical shows where they are heroes exists, to fool Doctors into think they are heroes and adored. If i were to use an analogy, they are more akin to mechanics than they are to engineers and a world away from the study of the physics behind the forces and principles in either. In any tyranny, you can look this up, Doctors have always been the most compliant, the most willing to allow politics to influence their practice - in fact they are often fanatical zealots for whatever political extremism has become the new normal. Their hero complex only ever leads them into whatever brings them the most adoration. This is why here in England the government pretty much demanded the people stood outside every day and banged pans in support of them - when they saw that going along got them the adoration they craved. 扶苏 发表于 2022-12-14 00:25
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我咋觉得住久了,选好熟悉的医生了,就还挺不错的呢。这个系统让牛人能够serve很多人,还是有挺好的一面的。
这次的paxvloid ,美国有处方了随便买,基本不要钱,看了悉尼奶爸和加拿大一些华人的帖子才知道在别的国家不是那么容易开到,更别提国内打过半价的2800了,感觉关键时候还是美国人比较有安全感
确认是小姑娘吗?小姑娘正处于烂漫向往美好年代,说话怎么可能这么暴戾啊?
我也是闲的,来顶一下这个。我周围读phd的,没人扣thesis,dissertation这种字眼
🛋️ 沙发板凳
美国狗屁党把持参议员,基本扼杀了所有有进步意义的变革,三权分立彻底玩死了。
说不定只能买Obamacare,因为好多医生单干的多。
美国民主党一直想改革医疗体系 降低医疗费用 FBI 每年都暗中侦查医生腐败情况 前几年一个国内过来考了执照的医生 因为腐败 被判了20年的徒刑 USMLE 有关机构和美国政府大官司 最高法院最后还是要求联邦政府不要干涉学术自由 专家治国和学术自由 使得美国科技世界第一 但也有它的缺点 就是美国医疗系统的弊病
然后不明事理的群众特别是黄右大骂ob care
re research是昂贵的 投入并不一定有产出,所以看起来贵
极端右派总觉得有人免费看病是在吸他们的血。, 就是愚昧。
那点钱稍微效率高一点就省出来了。
医疗技术水平和公共医疗水平 两码事
美国特色,一脉单传来源自奴隶制。。。
PCP一般赚钱不是特别高所以大部分学校特别厉害的人不咋选internal medicine这个专业。比较优秀的学生选ROAD (radiology, ophthalmology, anesthesiology, dermatology)。这四个专业比较赚钱多但是工作量估计没有surgery那么高。不过我个人感觉只是dermatology 比较轻松+高薪。现在radiology没有像以前那么competitive了。现在政策是想把小儿科和family medicine的薪水提高。这样更多人愿意选这些专业。
农村肯定比城市赚钱多。Radiologist在Midwest能赚500-600。在大城市估计300-400。其它专业我不太清楚。
信我,2022了,聪明人都不会做医生的。在美国,大多数医生给我的感觉就是照本宣科。按照guideline治病。脱离了书本根本不会治病
那只能说明,你没有遇到过厉害的医生。我遇到过两个特别厉害的医生,当然都是专业排名第一的医生,可以说是几分钟内就能准确判断是什么疾病,然后手到病除。
北京上海专家比美国医生强太多了 这些地方的人根本没有必要看美国医生
哎,得个慢性病能把人急死。yigekeshi3一个科室转一遍就一年过去了。 很烂啊。最后只能找那些自己付钱的integrated doctors, 效果很好,于是现在都是用high deductible 的保险,少付点保急性大病。在这里就是有钱人跟没钱人一样看病急死人,当然有钱还要有知识知道去找啥医生看病。总之很烂。 PCP都巨烂。
很不幸的是美国最厉害的医生我们去看病 试图欺骗我们
我家娃是cpt 2 和acad9两个不足 但是医生藏起来我家娃的newborn screening 数据 给order 的是中链和长链检测 被我们拒绝了后改了检测。。
不过后来实验室作假不报。。
医生不是水平问题 而是美国医生互相包庇杀害婴儿的问题
你在医疗系统工作保险应该都是PPO不需要家庭医refer就可以直接看专科医生吧?我都是直接找专科医生看病,家庭医生对我来说就是抽个血化验,平常小感冒需要拿点我自己都知道吃啥的药的地方。由于我病程描述很好,医生一般也都同意开什么单子。我的经验是专科医生约过一次后,后边都很快能约上,就是第一次新病人需要等的久。还有就是比如骨外科这种的要找大的有好多医生的诊所,这样当天都能约上。只有一个人开诊所的难约。
没几个医生愿意周末回信息的 医生也只是一个工作 不要指望医生周末回信,你这是特例
同意找听话的pcp. 可是选择空间非常小啊,而且pcp从来都是拍的满满的约不到,被踢到同一个practice的别的医生很常见。往往这些人水平低且不听话
有些骨科医生可以直接看. 那些 sports medicine 的就不能直接看. 看 neurology做 nerve study 和 surgical consult 就必须要 refer 还是骨科医生 refer 不能回去 PCP 那里 refer. 我第二次受伤碰上原来医生做手术放假我只能看PCP 然后PCP 也放假. 当时被安排了见一个实习医生然后以 urgency 推我进去看tauma 的骨科医生这样才能开单子拍片. 那个实习医生前前后后给我发了二十几封信就是确定我还好好的. 这些信还在我 patient gateway 里面. PCP只能下单 xray MRI 这些需要骨科. 不然保险不包.
其他的像呼吸系统医生和物理治疗也需要 refer. BCBS 的保险.
你有本事就把医生的名字说出来,不然的话我就当你瞎扯。这种牛逼我能吹100个。
当初在念本科的时候,学pre-med的也不是最聪明的人,聪明的都去读理科了。辛苦倒是真的。但是东西都是死记硬背的。当然啊,没在美国读过大学的人是不懂的
无脑仰视医生的人只能说你可能是真的很蠢吧。
刚毕业的有个问题就是经验不足,你真的有什么问题不一定查得出来
你是无条件仰视自己的吧,我说过无条件仰视了吗?不同意你的观点就是蠢,你的眼界也就到这里了
我可没说不同意我的观点就是蠢,而是无条件仰视医生的就是蠢,比如你。
本大叔做住院的时候有个同事,哈佛的MD,MIT的PHD,他的PHD是computer science,他做住院的时候替我们系免费开发了一套软件,很复杂很实用的,他一个人写的,到现在10几年过去了,还在用。那套软件如果要软件公司来开发,至少几个M,还不一定有他写的好,因为他自己同时是使用者也是开发者。还有一个女同事,是NYT的专栏作家,专门写政论的,白女,她说她很佩服吴仪,她见过还跟吴仪聊过天,哈哈。
本大叔觉得平均智商最高的应该是花街搞quant的那群人,至少他们数理很厉害。码农就算了,码农这个行业是劳动密集型的,千分之一的人智商高就够了,码农这个行业也只有在大妈网吹一下,哈哈。
真的不算高的,就问你在美国有没有读过pre-med的吧,美国大学读这个的现在都不是最聪明的人了,但是都是为了赚钱的人倒是真的。
看来保险真的不同,我的PPO不需要任何refer,我直接去找想看的专科就好了。骨外科给我开他们诊所做的物理治疗师,我没去,我让骨外医生给我开单子,我要找我认识的在医院做的物理治疗师都没问题,我都自己直接去的。
有些医生有ppo保险也需要refer的,你应该还没碰到过
医学生里面本科是pre-med的可能5%都不到吧,pre-med并不是med sch的pre admission,这是一个本科的专业。
Premed在很多学校根本就不是个专业好吗?什么都不懂,就在那儿瞎叭叭,真牛逼。
没有必要跟你debate,有损我身份,哈哈
是你不懂装懂的,而且从你说话的用语来看,你应该没受过多少教育,是从中国出来的政庇吧?
问premed这种常识问题。。。服了
我可不像你本人正经的,美国大学毕业的,哪像你啊,在美国读都没读过大学,就以为自己懂premed是什么了。真tm搞笑死了好吗
怎么啦?我就是真懂,怎么啦?不服去重新投胎啊? 不就是在别的帖子里面科普钢琴吗?我练了二十几年的钢琴啊,你呢?你练过几年啊?零年吗?然后你就在这边说我吗?你怎么这么牛逼呢?
在美国读大学是个事儿吗?premed是什么很难懂吗?你在美国上过大学,你说说premed是什么,来
随你便,像你这种在美国都没念过大学的人,轮得到你看不起别人吗?照照镜子行吗?
哈佛的MD,MIT的PHD 这个program里都是牛人
对啊,在美国上过大学就是比你有文化。怎么样不服啊?不服你自己去读个文凭啊,连人家凤姐都在美国读大学了。有些人自以为没有上过大学就知道可以premed什么东西了。我就觉得很搞笑不行吗?
扯,你接受正规的钢琴训练的时间绝对不会超过5年,还成天钻到钢琴贴里教训琴娃家长。
现在又来教训人家大叔了,就凭你用“什么是premed”提问,以及开口闭口美国大学,还有你的行文和逻辑,你的受教育水平就不会太高。
我的天哪,你敢不敢发毒誓,我练钢琴没有超过5年? 你连钢琴都没有碰过,你就知道我练钢琴没超过五年了?你怕是要笑死我吧。就好比一个人从来没学过代码,然后你说别人肯定不会写代码。笑死我了,真是的。你这人在生活中也是这样子的吗?狗眼看人低吗?
真的,医院医生才赚多少钱,保险公司才是最大毒瘤,谁能动得了它服谁。想当年寄希望奥巴马能动的,可惜没成功,弄了个奥巴马care是不错,但是大家保费一起涨,保险公司那个蛋糕是丝毫不让利呀
我在美国可不止读了大学,你知道华人上的平均受教育水平多半在硕士以上吧
另外我告诉你为什么我的语句不通顺,第1个我是用语音来打字的,第2个我的中文没有英文好。
你就是个joke
你都在美国读过大学你还不知道premed是什么课程,还要问我吗?笑死我了
Sure, in the eyes of someone pathetic like you
某些人说自己在美国“可不只读了大学”,结果一用英文对线就逃走了?这谎撒的有点低级啊。
Referral 里面没有指定找谁的.
信就在我档案里. 我找谁都行. 在 network 里外都行. 去外面我需要打印信走, 在 network 里就不需要. 好像我去 Spaulding, 这个也是 partners 系统的 他们可以看到 patient gateway 的推荐信.
看医生也是. 不过我PCP 和骨科医生会给我做功课看谁比较合适因为他们其他病人会告诉她谁不好.
推荐只是说明有这个需要看某专科 不然保险那里麻烦 专科医生那里不想浪费时间给你查保险还有不想有保险纠纷.
依大叔的意见,美国医健这块短期内有改善的可能吗?
奥巴马care的确不错,但能持久吗?
自己是医生的话,有毛病直接找专科。查体什么的让PCP开单子
请问本大叔,你们平时工作中,Epic 这种EHR 系统应该不能满足所有需求吧?小的软件开发需求多吗?
同意!我只想说美国的这个医生教育是真的有问题。很多通过AA什么进的medical school,所以真的不要以为医生有多牛逼。
小软件需求很多,医疗小软件是niche market,就像orphan drug一样,软件公司不一定有动力开发。
本大叔说的那位md/phd同事,resident毕业以后就自己开了一家软件公司做副业,哈哈。不过现在好像也关闭了,应该是不赚钱。
黄右们的鼠目寸光真的让人叹为观止
所以你这个牛逼的同事后来做什么了呢?我看下来他根本没有做医生啊
Doctors are very highly trained technicians - they are not scientists, they have very average critical thinking abilities. They do no original research and their field of work is so generalised, so overly comprehensive that they have no ability to even begin to keep up with the latest research. The methodologies they are taught and inherit to determine the "latest science", "advice" and "breakthroughs" are to read the distilled daily advice from drug companies, government and, if they are really "cutting edge" to read the occasional article in their Pfizer paid for journal digests.
In my experience they are more gullible to the herd mentality and whatever is touted as "tHe ScleNcE" than the average intelligent person. Doctors are extremely well trained and educated, but as practitioners, technicians and their critical and analytical skills are primarily focused in triage and solution finding from a set of predetermined advice on treatments and drugs. They are like extremely skilled drug salesmen - yet they dont know it, thats why all these medical shows where they are heroes exists, to fool Doctors into think they are heroes and adored.
If i were to use an analogy, they are more akin to mechanics than they are to engineers and a world away from the study of the physics behind the forces and principles in either. In any tyranny, you can look this up, Doctors have always been the most compliant, the most willing to allow politics to influence their practice - in fact they are often fanatical zealots for whatever political extremism has become the new normal. Their hero complex only ever leads them into whatever brings them the most adoration. This is why here in England the government pretty much demanded the people stood outside every day and banged pans in support of them - when they saw that going along got them the adoration they craved.
OMG 这是你自己写的吗?也太牛逼了吧
你怎么会有这么好的眼光?
不是,网上的,别人转给我的。我没那么牛,哈哈。
PCP一般是family medicine. Internal medicine 的去做hospitalist 或者specialist.
我觉得能自己知道找什么专科医生已经很厉害了,我只能找pcp说这儿不舒服你给个refer,pcp给了refer检查做完了会打电话告诉我结果接下来再看什么科的医生
我找的pcp,就是长得帅人热情会聊天,我家娃几岁都记得,而且有点不舒服就给各种refer
对np和pa的要求,就是验血查流感开药打流感疫苗,当去做lab work了。我这边的urgent care网上预约当天的去了不用排队,环境不错15 copay。 我娃被误诊了两次,幸亏都是不痛不痒的小毛病。 真有啥担心的,还是得约儿医