Lucille: How’s my son? Doctor: He’s going to be all right. Lindsay Funke: Finally some good news from this guy. Doctor: That’s a great attitude. I got to tell you, if I was getting this news, I don’t know that I’d take it this well. Lucille: But you said he was all right. Doctor: Yes, he’s lost his left hand. So he’s going to be “all right.” Lucille: [Jumping on the doctor] You son of a bitch! I hate this doctor!

My favorite running gag, love the literal doctor

As the article points out prion diseases are still extremely rare. There’s also no proof yet that the deer prion can make a jump and cause disease in humans. I rationally know this, and yet having seen prion disease before in person, I irrationally (rationally?) avoid venison now just in case.

Subsequent encounter means you’re seeing the doctor again for the same problem. So if you got sucked into a jet engine and lived somehow you’d probably be seeing the doctor a bunch of times, and the second doctor visit and all later visits would be encoded as “subsequent encounter”

I love weird icd 10 codes, my favorite is V91.07, burn due to water-skis on fire. Like has that ever actually happened? If so please post link, I must know.

I’ve never heard of urgent care requiring referral from a pcp, that wouldn’t make any sense as the whole point of urgent care is being seen more urgently than your primary physician can accommodate. And seeing people who don’t have a primary physician and keeping them out of the ed if not necessary. I would ask your insurance for that policy in writing, that can’t be right. And if it is it should be reported to that state insurance commission because that’s totally asinine. I mean never underestimate the dumbness of insurance companies but I think something might be being lost in translation here.

This is mildly infuriating, I can give you a little more context though if you’re interested. I don’t know exactly about contracts between insurance companies and CVS so I can’t speak to that definitely. Probably something related to how much insurance is willing to pay minute clinic for such a short visit, and what things are feasible to address in such a short visit (hence CVS only allowing certain complaints).

I think this is something to do with the concept of “uncomplicated” vs “complicated” uti. Complicated utis are when there’s an increased danger of serious complications from a uti or increased likelihood of failing a typical antibiotic therapy. Utis in men are much much rarer than women, and are considered to be an automatic “complicated” uti by many. The greater length of the urethra in men helps prevent bacteria from being able to travel up to the bladder, whereas in women the short distance allows for this to happen much more frequently. So when a male has a UTI there is a much greater chance there will be complicating factors like prostate issues, structural problems, kidney stones, kidney infection, catheter use, atypical bacteria, etc. If you look more into their info on utis, they also state if they suspect any of those things, even in women, they won’t treat it and will just refer you to someone else, probably the Ed or a real urgent care clinic. Since the odds of that are much greater in men, they probably aren’t allowed to have longer appointments in minute clinic based on what insurance will pay for what they’re providing, they just decided to not see that at all in minute clinic. Looks like they do see men for sexually transmitted infections though, which are actually the most common cause of utis in young men, so if that’s a concern looks like they would be able to see people for that.

But I totally agree with you, fuck insurance companies in general.

My donations lately have been focused a lot on the LGBT community. Things like lambda legal, local LGBT advocacy groups, and community health efforts. While discrimination from society as a whole and the health system in particular have been leading to worse health outcomes for, well since forever basically, this recent backsliding, especially rampant hate towards Trans individuals and laws preventing them from getting health care has been especially worrying for me.

I agree with this. The area of medicine I’m most involved in has had a crazy rate of new medications approved and innovations with a giant pipeline of possibilities on the way. The article focuses on crispr a lot, which is cool and always get the headlines, but I think in the nearer term oligonucleotide therapies or even viral vector gene therapies are already here. Oligonucleotide therapies use rna to affect gene expression, usually decreasing it. Theoretically it can be used in any toxic gain of function mutation, which covers a lot of genetic diseases. It’s not really a question of do we have the ability to treat genetic diseases anymore, it’s more getting all the time, money, expertise, and prerequisite natural history work done on the sheer number of them so these tolls can be tested in all these diseases and brought to patients.

The importance of high quality natural history studies and biomarker development cannot be overstated too. When you design a clinical trial you need to know how many patients need to be in it and how long it needs to run, or else you might accidentally throw out a treatment that works by designing the trial incorrectly. Natural history studies are where you get that information. Biomarkers can help provide more sensitive measures of change so you can more quickly figure out if a treatment has potential or not (ideally followed up by proving efficacy with clinical measures too).

The availablity of the these tools for making new treatments but limited resources for testing them is also leading to ethical issues and inequality. For instance there have been a number of “N of 1” trials where treatments were made specifically for a particular patient. I hope that benefit would then flow to other patients eventually too, but it does raise a lot of questions.

Yet another disastrous effect of restricting abortion access. The many harms from restricting reproductive care need to keep being hammered on in the media. Thanks for posting this.

Rip my heart out, geeze. Alright, I’ll go with metroid 6 just since the development of metroid prime 4 has been so rocky. I do appreciate that when Nintendo sees a game isn’t working they’ll scrap it and go back to square one and try and make it good though, rather then just releasing something subpar. While usually at least. On the other hand who knows when metroid 6 will come out? Anywhere from 2-15 years is the range apparently.

But we can’t go NSFW! It’s not the Jedi way!