What personality should a female surgeon possess?

[touchpause13]

"Telling them to stop" is not an intervention. Stop characterizing it as such.

What does your intervention look like then?

Because my intervention would be motivation interviewing combined with clean needles.

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[DermViser]

I assumed it was HIV and hepatitis. Feel free to correct me if I'm mistaken

Yes. It prevents them from getting things like HIV ON TOP of their using drugs. By itself, it doesn't stop them from using that drug.

 

[touchpause13]

Yes. It prevents them from getting things like HIV ON TOP of their using drugs. By itself, it doesn't stop them from using that drug.

No shet sherlock

 

[DermViser]

What does your intervention look like then?

Because my intervention would be motivation interviewing combined with clean needles.

You're right "motivation interviewing" will surely help. Do you ride a unicorn that farts rainbows to work?

 

[touchpause13]

You're right "motivation interviewing" will surely help. Do you ride a unicorn that farts rainbows to work?

Another dodge

 

[DermViser]

No shet sherlock

My point which you obviously missed is that it comes nowhere close to solving or making the problem better.

 

[PL198]

Assuming it was: yes I'm cool with it.

I just think that we should meet patients where they are at. Telling a drug addicted patient to stop is not helpful. That is doing nothing for that patient. Getting them clean needles is helped them to prevent disease as well as sowing some trust in the healthcare system. Maybe if I can show that person that I'm not going to judge or brow beat them, when they are ready they will come to me for help and get into a treatment program. If they don't, oh well but at least they don't have HIV on top of their addiction.

but now you're an accomplice in their criminal activity. if my patient is a bank robber, I could tell them to stop, or I could buy them a faster car so they can get away quicker. which one should I do? I mean only one of those is actually going to help them. there are some things you just have to do as a physician, regardless of if you think it will be effective or not. when someone is out cold, I still have to try to wake them up before I plunge into CPR even though it's extremely unlikely that this will be effective in terms of waking them up and fixing what is going on.

 

[Bearded_Monkey]

Maybe for you. It's not a dodge at all when these drugs cause very real functional impairment and death. You don't need to look any further than Phillip Seymour Hoffman to see how much damage illicit drugs can cause. If anyone is bringing in a non sequitur it's you.

I tend to agree with Southplains. If it was decriminalized, we could work on helping addicts as opposed to judging them from our ivory towers. Don't send them to jail, send them to rehab.

It definitely isn't a non sequitur, or at least with the point RJGOP is trying to make. I'd be willing to bet that cigarettes and obesity have killed more people in the last 5 years than heroin has in 50. 5 big mac's a day and a pack of reds aren't illegal, but following your logic of how detrimental they are, they should be illegal. It costs tax payers exponentially more to deal with obesity related health issues than it does with drug addicts. Decriminalize most drugs and we won't have to spend tax payer money on jails either. Smoking and drinking kill more people every year than every single illicit drug combined. But we are in America, you can't take away my 52oz super big gulp.

You name one actor who OD's on heroin, and I can name 500 more regular Joe Americans who have died from obesity related complications.

 

[DermViser]

Another dodge

Not a dodge at all. It does show that you don't know (or don't care) to effectively solve the problem. I can't believe someone as smart as you would think exchanging the needle used to shoot up heroin is the solution, oh along with "motivational interviewing".

 

[PL198]

same thing for antibiotics and viral illness. I might be fairly confident that the patient has a viral illness and thus won't want to give them antibiotics, however due to placebo effect, it's quite likely that receiving antibiotics would actually help them. You have a greater duty towards health than you do to appeasing them. clean needles just appeases the patient and allows them to keep doing the same bad activity.

 

[DermViser]

I tend to agree with Southplains. If it was decriminalized, we could work on helping addicts as opposed to judging them from our ivory towers. Don't send them to jail, send them to rehab.

It definitely isn't a non sequitur, or at least with the point RJGOP is trying to make. I'd be willing to bet that cigarettes and obesity have killed more people in the last 5 years than heroin has in 50. 5 big mac's a day and a pack of reds aren't illegal, but following your logic of how detrimental they are, they should be illegal. It costs tax payers exponentially more to deal with obesity related health issues than it does with drug addicts. Decriminalize most drugs and we won't have to spend tax payer money on jails either. Smoking and drinking kill more people every year than every single illicit drug combined. But we are in America, you can't take away my 52oz super big gulp.

You name one actor who OD's on heroin, and I can name 500 more regular Joe Americans who have died from obesity related complications.

Southplains did not mention smoking. He mentioned eating fast food, drinking a liter of soda, and drinking a beer a day. But yes, eating and drinking that shooting up heroin have the exact same level of functional impairment and organ/physiologic consequences. Uh, huh. But telling people that heroin use is wrong is "judgeing them from our ivory towers". Give me a break.

 

[PL198]

if you're gonna talk about liters of beverage, you have to say liter of cola, come on did you people really never see supertroopers

 

[touchpause13]

You still have failed to provide a better alternative derm.

I'm just being realistic here. I'm not saying needle exchange is the salvation of all that patient's problems. I'm saying that's something I can do to help that patient. I can help prevent them from getting HIV. I can't force them to not be addicted to drugs. They have to want to do that. So I think it's better to meet the patient where they are at.

Again. What is your solution?

 

[touchpause13]

if you're gonna talk about liters of beverage, you have to say liter of cola, come on did you people really never see supertroopers

Lol i can quote that entire movie

 

[PL198]

If we extend that, then you should just give poor people money. you can't directly motivate them, so why not just give them money? It's what you can do to help them

 

[touchpause13]

If we extend that, then you should just give poor people money. you can't directly motivate them, so why not just give them money? It's what you can do to help them

So are you completely against welfare then?

 

[DermViser]

You still have failed to provide a better alternative derm.

I'm just being realistic here. I'm not saying needle exchange is the salvation of all that patient's problems. I'm saying that's something I can do to help that patient. I can help prevent them from getting HIV. I can't force them to not be addicted to drugs. They have to want to do that. So I think it's better to meet the patient where they are at.

Again. What is your solution?

Except you're not helping the patient, you just THINK you do, and it helps you feel all warm inside which helps you sleep better at night. Don't get it confused with actually helping the patient. I swear sometimes I wonder whether you go to medical school at UCSF.

 

[DermViser]

So are you completely against welfare then?

I'm pretty sure that's not what he said.

 

[PL198]

So are you completely against welfare then?

I'm not completely against it, but I feel for most it just encourages the very thing that it tries to prevent.

 

[touchpause13]

Except you're not helping the patient, you just THINK you do, and it helps you feel all warm inside which helps you sleep better at night. Don't get it confused with actually helping the patient. I swear sometimes I wonder whether you go to medical school at UCSF.

So what does actually helping the patient look like? Seriously, just answer the question

 

[PL198]

also isn't it kinda paternalistic to think you know what would help them and what wouldnt?

 

[touchpause13]

also isn't it kinda paternalistic to think you know what would help them and what wouldnt?

I somehow doubt an addict would tell me that doesn't help

 

[DermViser]

So what does actually helping the patient look like? Seriously, just answer the question

Have you heard of a subspecialty of Psychiatry called Addiction medicine?

 

[touchpause13]

Have you heard of a subspecialty of Psychiatry called Addiction medicine?

Obviously.

 

[DermViser]

I somehow doubt an addict would tell me that doesn't help

You're right. They'd thank you for giving them a clean needle right before they shoot it up. Pat yourself on the back.

 

[DermViser]

Obviously.

So then you've heard of it, but just don't care about it.

 

[touchpause13]

So then you've heard of it, but just don't care about it.

I don't see how my views are incompatible with the general theories of addiction psych

 

[DermViser]

I don't see how my views are incompatible with the general theories of addiction psych

You're right exchanging dirty, used needles for clean ones is exactly in line with addiction psychiatry.

 

[touchpause13]

You right exchanging dirty, used needles for clean ones is exactly in line with addiction psychiatry.

Yeah pretty sure it is.
Idk if anyone here is in addiction psych specifically to ask tho.

 

[Mad Jack]

Are you ******* serious dude? You don't see the difference? It really pisses me off that you're going to be a doctor.

In all fairness, most people have a very warped perception of the average drug user. Not everyone who uses drugs is some methed out criminal with no teeth waiting in a bank alley to shank you over tree fiddy.

 

[Winged Scapula]

Needle Exchange Programs are supported by many medical professional societies including American Psychiatric Association, the AMA, American Academy of Psychiatrists in Alcoholism and Addiction, American Society of Addiction Medicine.

 

[Mad Jack]

You're right. "Please don't shoot up drugs, but if you do could u use a clean needle first on taxpayer dime?" - wonderful intervention.

I don't think you understand the public health reasons for clean needle programs. If you don't provide needle exchanges, people share needles. When people share needles, they tend to acquire diseases like HIV and hepatitis C. When they acquire diseases like HIV and hepatitis C, they bring those to the people that they sleep with. When they break up, those people sleep with other people, and you've got yourself a new HIV flareup. Think what you want about the people shooting up, but this is a very serious public health issue with consequences that stretch far beyond the drug use itself.

 

[Mad Jack]

Who do you think actually pays for these programs and funds them?

You do realize that it is a net money saver for taxpayers. A box of needles a month is a whole lot less expensive than HIV medications, which are, by and large, paid for by taxpayers.

 

[Southplains]

but now you're an accomplice in their criminal activity. if my patient is a bank robber, I could tell them to stop, or I could buy them a faster car so they can get away quicker. which one should I do? I mean only one of those is actually going to help them. there are some things you just have to do as a physician, regardless of if you think it will be effective or not. when someone is out cold, I still have to try to wake them up before I plunge into CPR even though it's extremely unlikely that this will be effective in terms of waking them up and fixing what is going on.

Giving a bank robber a getaway car is not helping their (or others) health at all. These programs aren't about helping people get high, they're about minimizing infectious disease, and not just for the user.

 

[DermViser]

Needle Exchange Programs are supported by many medical professional societies including American Psychiatric Association, the AMA, American Academy of Psychiatrists in Alcoholism and Addiction, American Society of Addiction Medicine.

The AMA also has said obesity is a "disease", the American Academy of Pediatrics has come out to talk about same-sex marriage (even though it had no business coming out on a political issue), and many people have advocated that getting a sex change should be covered by medical insurance. A specialty society putting out a press release doesn't always consider putting medical science over political correctness when doing so.

 

[Southplains]

Needle Exchange Programs are supported by many medical professional societies including American Psychiatric Association, the AMA, American Academy of Psychiatrists in Alcoholism and Addiction, American Society of Addiction Medicine.

Cue smug look of satisfaction

 

[DermViser]

You do realize that it is a net money saver for taxpayers. A box of needles a month is a whole lot less expensive than HIV medications, which are, by and large, paid for by taxpayers.

So bc something further down the line (may) be stopped, we should just go ahead and cough up money for it now even though it doesn't treat the immediate problem. Kind of like Obama when he told all of us that we would save $2,500 on premiums once Obamacare was implemented.

 

[DermViser]

Cue smug look of satisfaction

Only if you're so uninformed and actually think specialty societies or groups like the AMA actually take what their actual members believe into account. After Obamacare, at least with the AMA, it's pretty obvious that's not the case.

 

[DermViser]

Giving a bank robber a getaway car is not helping their (or others) health at all. These programs aren't about helping people get high, they're about minimizing infectious disease, and not just for the user.

You're right. It's helping them get high without getting the infectious disease they would normally get and die from.

 

[Mad Jack]

The AMA also has said obesity is a "disease", the American Academy of Pediatrics has come out to talk about same-sex marriage (even though it had no business coming out on a political issue), and many people have advocated that getting a sex change should be covered by medical insurance. A specialty society putting out a press release doesn't always consider putting medical science over political correctness when doing so.

A year's supply of needles costs about $20 if you're buying them in bulk. That's about the cost of two days of HIV treatment. It makes sense from a medical, fiscal, public health, and moral perspective. Arguing needle exchange programs should be abolished is basically like arguing you should be letting people and their loved ones die needlessly and that we should be expanding our spending on HIV and hepatitis C medications dramatically.

 

[Mad Jack]

So bc something further down the line (may) be stopped, we should just go ahead and cough up money for it now even though it doesn't treat the immediate problem. Kind of like Obama when he told all of us that we would save $2,500 on premiums once Obamacare was implemented.

This is why you're in dermatology and not preventative medicine or primary care.

 

[Southplains]

You're right. It's helping them get high without getting the infectious disease they would normally get and die from.

See you're getting it.

 

[DermViser]

A year's supply of needles costs about $20 if you're buying them in bulk. That's about the cost of two days of HIV treatment. It makes sense from a medical, fiscal, public health, and moral perspective. Arguing needle exchange programs should be abolished is basically like arguing you should be letting people and their loved ones die needlessly and that we should be expanding our spending on HIV and hepatitis C medications dramatically.

You are free to pay for that with your own money, not by the taxpayer. I would much rather see that money go towards another part of the budget - i.e. secondary education.

 

[DermViser]

This is why you're in dermatology and not preventative medicine or primary care.

You're right bc there are so many preventative medicine docs out there. And I'm sure every primary care physician believes as you do.
I don't see what one's specialty has to do with this. If I was a pediatrician it would be different?

 

[DermViser]

See you're getting it.

I already knew that before. I was being sarcastic bc it's not actually addressing the underlying problem but a future event.

 

[Southplains]

I already knew that before. I was being sarcastic bc it's not actually addressing the underlying problem but a future event.

Yes that is the clearly stated goal. I don't know what point you're making?

 

[DermViser]

Yes that is the clearly stated goal. I don't know what point you're making?

Obviously.

 

[Mad Jack]

You are free to pay for that with your own money, not by the taxpayer. I would much rather see that money go towards another part of the budget - i.e. secondary education.

http://www.cdc.gov/hiv/prevention/ongoing/costeffectiveness/

Look at how much a lifetime of treating a single HIV patient costs. Each case you prevent could pay for literally all of the needles for all of the addicts you've got for an entire year. Needle exchange programs have been proven to cut HIV infection rates in communities by roughly a third. Your mentality on the issue is very, very shortsighted.

 

[DermViser]

http://www.cdc.gov/hiv/prevention/ongoing/costeffectiveness/

Look at how much a lifetime of treating a single HIV patient costs. Each case you prevent could pay for literally all of the needles for all of the addicts you've got for an entire year. Needle exchange programs have been proven to cut HIV infection rates in communities by roughly a third. Your mentality on the issue is very, very shortsighted.

Again, I am referring to stopping the actual drug addiction not the future STD that a drug addict will contract, due to his habit of sharing needles. I don't want to aid and abet someone's addiction, when that money could be used toward the funding of schools. Sorry, not sorry.

 

[oldbearprofessor]

the American Academy of Pediatrics has come out to talk about same-sex marriage (even though it had no business coming out on a political issue)

Member funded professional organizations should not "talk about" health or health care-related issues that affect their members even if they are "political"? Why not? Does that mean the anesthesiologists' organizations should not "talk about" CRNA practice laws, a clearly political issue?