Re: When The Advice You Can Get At The Mineshaft Isn't Bad Enough

1

Obviously, she should have picked a Sagittarius with Gemini rising. LIKE ME.


Posted by: apostropher | Link to this comment | 09- 6-13 8:00 AM
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Could you really be trusted not to sneak off and become a head and neck surgeon, though?


Posted by: LizardBreath | Link to this comment | 09- 6-13 8:08 AM
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Is that Gemini rising, or are you just glad to see me?


Posted by: politicalfootball | Link to this comment | 09- 6-13 8:09 AM
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This query would have been different in the US, where there would be a presumption that the surgeon had at least the potential to be pretty rich.


Posted by: Robert Halford | Link to this comment | 09- 6-13 8:47 AM
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And rather severe unlikelihood of a 40-hour workweek.


Posted by: Minivet | Link to this comment | 09- 6-13 8:48 AM
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6

Yeah, seriously. Wow.


Posted by: x.trapnel | Link to this comment | 09- 6-13 8:55 AM
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7

Who cares if he's moving around the country, it's like the size of a medium sized state.


Posted by: SP | Link to this comment | 09- 6-13 9:01 AM
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7: Wow, you're more right than you know. I was slightly skeptical - thought it might be bigger - but by land area, England is 50,000 square miles, just between Iowa (26th state in land area) and New York (27th). England, not the UK, since NHS is different programs by country, although I don't know the extent to which doctors can or do move between them.


Posted by: Minivet | Link to this comment | 09- 6-13 9:19 AM
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9

I mean, maybe you know.


Posted by: Minivet | Link to this comment | 09- 6-13 9:19 AM
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10

Definitely worth a click through for some of his other "responses," BTW. I think Shakespeare vs. the Puppies guy is my personal fave.


Posted by: Lord Castock | Link to this comment | 09- 6-13 9:19 AM
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I googled Virginia as my first guess and was within a few thousand square miles so I thought close enough.


Posted by: SP | Link to this comment | 09- 6-13 9:22 AM
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Since her main criteria seem to be high availability and frequent sex, it seems as if she should be able to find someone new in short order.

What could possibly be at the root of the antagonism between the letter writer and the boyfriend's mom?


Posted by: Megan | Link to this comment | 09- 6-13 9:25 AM
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England, not the UK, since NHS is different programs by country,

Not very relatedly: How many countries are in this country?


Posted by: Criminally Bulgur | Link to this comment | 09- 6-13 9:40 AM
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3: Nice.

OT: If any of you reprobates is a fan of Patton Oswalt or just wants to make fun of him for losing the "Comedy President" title to that mopey balding guy, he's standing outside the 72d St. subway station with a camera crew right now.


Posted by: Flippanter | Link to this comment | 09- 6-13 9:46 AM
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although I don't know the extent to which doctors can or do move between them.

Shorter: A lot.

Longer: Scottish doctors are much sought after because the training used to be, and may still be for all I know, better. Conversely English med students really like going to Scottish universities for that reason. Also, there's a chronic shortage of doctors in Norn Iron, so they import them as much as possible.


Posted by: chris y | Link to this comment | 09- 6-13 9:51 AM
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This query would have been different in the US, where there would be a presumption that the surgeon had at least the potential to be pretty rich.

Oh, surgeons do OK in the UK too. If you're lucky, you could be pulling in £90-£100k.
http://www.nhscareers.nhs.uk/explore-by-career/doctors/pay-for-doctors/

(This is where Halford explains that US surgeons get paid $2.5 million a year.)


Posted by: ajay | Link to this comment | 09- 6-13 9:52 AM
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17

And I forgot to mention they can get up to another £75k on top of that as a reward for clinical... excellence.


Posted by: ajay | Link to this comment | 09- 6-13 9:53 AM
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16 -- I'm not really up on surgeon salaries in the US, but my rough understanding is that for a decent number of them max annual salary tops out at somewhere between 3 and 5x that amount.


Posted by: Robert Halford | Link to this comment | 09- 6-13 10:08 AM
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(This is where Halford explains that US surgeons get paid $2.5 million a year.)

That's only literally true of the top couple percent of the distribution (Beverly Hills cosmetic surgeons, frex), but the national average is above $300K for general surgery, and above $500K for surgical specialties.


Posted by: knecht ruprecht | Link to this comment | 09- 6-13 10:11 AM
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It's so much more rational for the government to loan money out at interest for them to be trained, which they they repay them via exorbitant charges to individuals and public programs.


Posted by: Minivet | Link to this comment | 09- 6-13 10:16 AM
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21

Beverly Hills cosmetic surgeons, frex

They're doing God's work!


Posted by: Flippanter | Link to this comment | 09- 6-13 10:17 AM
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They're doing God's work!

Strikebreaking bastards!


Posted by: God | Link to this comment | 09- 6-13 10:19 AM
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Further to 19, the more eye-popping statistic is that a practicing physician in the U.S. has better than a one-in-five chance of being in the top one percent of the income distribution. That's a higher probability than literally every other occupational group except CEOs of brokerage and investment companies.


Posted by: knecht ruprecht | Link to this comment | 09- 6-13 10:31 AM
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24

Here's what I got from a quick google on how much head and neck surgeons make.


Posted by: Robert Halford | Link to this comment | 09- 6-13 10:56 AM
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I get tired about hearing how nobody will become a doctor if they can only make $150,000 - $200,000.


Posted by: will | Link to this comment | 09- 6-13 12:47 PM
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Yeah, their excuse is always loans, but the salaries stay high even after loans are paid off.


Posted by: Minivet | Link to this comment | 09- 6-13 12:51 PM
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I get tired about how there is a shortage of some types of doctors because by going into primary care they relegate themselves to miserable lives in the 96th percentile of income rather than the 99th.


Posted by: Cryptic ned | Link to this comment | 09- 6-13 12:53 PM
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You can go into private practice pretty easily in the UK. Many specialists split time between private and the NHS. I talked to a charming young doctor who told me his boss had taken to flying planes to lighten his wallet. Apparently he was pulling about a million per year.


Posted by: W. Breeze | Link to this comment | 09- 6-13 12:58 PM
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29

My doctor was just telling me that:
1- almost nobody will accept this transitional federal pre-existing insurance program (that runs only until the end of the year), and he's doing me a huge favor by taking me as a patient at all;
2- my plan might demand justification for the prescription he was writing me (a pretty standard daily asthma-control drug), and if they did, he wasn't willing to jump through any hoops;
3- he predicts that the single-doctor family practice will be extinct in SF within 5 years.

Everything about healthcare/insurance makes me exhausted and anxious, when it doesn't enrage me.


Posted by: x.trapnel | Link to this comment | 09- 6-13 1:37 PM
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29: Did he have any thoughts on whether the Lizard People will increase their human organ harvest after the ACA goes fully into effect?


Posted by: Natilo Paennim | Link to this comment | 09- 6-13 1:46 PM
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29: The best part of our current health insurance regime is the habit of pushing down upon the patient the responsibilities for record-keeping, diagnosis-negotiating, paperwork-processing, etc., etc. That's awesome.


Posted by: Flippanter | Link to this comment | 09- 6-13 1:48 PM
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he predicts that the single-doctor family practice will be extinct in SF within 5 years

Doctors have a strong tendency toward chicken-littleism on many subjects. And that outcome isn't impossible, but if it happens it will be the glorious Market Forces at work, not the ACA - consolidation into practice associations has been going on for some time now.

Also, frankly, I prefer multifunctional groups over single-doctor practices, because I think they have the potential to make medicine work much more smoothly and effectively. Not that they're doing so now, but as an example, last year at Kaiser, my PCP brought a dermatologist into the examination room so they could look at me together, which is something simple and great that you rarely see anywhere.


Posted by: Minivet | Link to this comment | 09- 6-13 2:03 PM
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33

Once at Chicago my doctor brought a med student into the examination room so they could misdiagnose me together. That wasn't so great.


Posted by: essear | Link to this comment | 09- 6-13 2:10 PM
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34

Once my doctor brought three hobos into the examination room and gave a pint of MD 20/20 to the one who came closest to his diagnosis of me.


Posted by: Moby Hick | Link to this comment | 09- 6-13 2:13 PM
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35

He'd written the diagnosis on a slip of paper hidden under a jar of tongue depressors. The guy who knocked the jar over got the wine.


Posted by: LizardBreath | Link to this comment | 09- 6-13 2:20 PM
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36

Is that are those Gemini rising, or are you just glad to see me and have two dicks?

Also I laughed very hard at the response.


Posted by: Mister Smearcase | Link to this comment | 09- 6-13 2:37 PM
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37

What could possibly be at the root of the antagonism between the letter writer and the boyfriend's mom?

Maybe mom is a water sign with her moon rising in Leo/Aquarius cusp.

I'm freaking out about a job search thing and am thinking I'm gonna go be a gin sign somewhere for a while.


Posted by: Mister Smearcase | Link to this comment | 09- 6-13 2:43 PM
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38

Speaking of interacting with professionally who unnecessarily inject their political views...
An external recruiting agency somehow got our AA to set up a meeting with me to push her services. I was already disinclined to listen to her, then she hands me a card and the name of the agency is Jo/hn Ga/lt staffing (motto: wh/ere the good peo/ple are.) Perhaps you should not be offering your services in the Boston MSA.


Posted by: SP | Link to this comment | 09- 6-13 4:19 PM
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I was already disinclined to listen to her, then she hands me a card and the name of the agency is Jo/hn Ga/lt staffing (motto: wh/ere the good peo/ple are.)

An affiliate.


Posted by: Minivet | Link to this comment | 09- 6-13 4:31 PM
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40

Motto "Hire us and we'll convince you to run away to a remote village to farm chickens, leaving the flaming wreck of your company behind!"
Their website is hilarious.


Posted by: ydnew | Link to this comment | 09- 6-13 4:37 PM
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Doctors and hospitals seem to be completely unaware that very few people can pay for their care. It is the collective pooling of money that makes it possible.


Posted by: will | Link to this comment | 09- 6-13 4:45 PM
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32: last year at Kaiser, my PCP brought a dermatologist into the examination room so they could look at me together, which is something simple and great that you rarely see anywhere.

Wow, that would have been really useful 6 months ago when I was desperately wandering around going, "Huh, the allergist totally didn't help and thinks I should just wait and see whether the hives I've had for 2 months now go away by themselves, because he's certain that it's not an allergy to penicillin, so he doesn't want to give me another prescription for Prednisone; maybe I should find myself a dermatologist" ...

who 2 weeks later for an new appointment at a different place took one look at me and said, "Drug eruption. Penicillin, you say? Yep. You just need to take a stronger dose of Prednisone for a longer period of time -- you were on the weakest, shortest dose before. Have this prescription. Allergists frequently misdiagnose dermatologic drug eruptions, because they tend to focus on respiratory allergies. We see it all the time."

Oh. (Not that I'm disgusted or anything.)


Posted by: parsimon | Link to this comment | 09- 6-13 5:54 PM
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43

I'm currently hopped up on prednisone to treat a rash also. It's great.


Posted by: Moby Hick | Link to this comment | 09- 6-13 6:46 PM
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44

I just went to the first GP near by with an open appointment.


Posted by: Moby Hick | Link to this comment | 09- 6-13 6:48 PM
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45

Prednisone is great. I realize in retrospect that I was kind of hopped up on it -- else how was I managing to function on like 3 hours of sleep night after night (due to itching, man, itching).

You guys, I totally blew my health insurance broker's mind today by telling him that he was an instrument of Blue Cross's con job against Obamacare exchanges. I mean, I didn't say *that*, but that was the idea.


Posted by: parsimon | Link to this comment | 09- 6-13 7:12 PM
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46

|| It's not exactly consequential, but holy crap is anyone watching Red Sox Yankees? |>


Posted by: CharleyCarp | Link to this comment | 09- 6-13 7:31 PM
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If by watch you mean I had it on the radio when the Yankees were up by 5, I went into home depot, and I came out and they were losing by 2.


Posted by: SP | Link to this comment | 09- 6-13 7:55 PM
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48

And now 4 down going into the bottom of the 9th.


Posted by: CharleyCarp | Link to this comment | 09- 6-13 8:03 PM
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49

Now that that's over, anyone know where I can watch the US-Costa Rica game online?


Posted by: SP | Link to this comment | 09- 6-13 8:10 PM
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I walked into the room and the announcer said the Red Sox had won. Does that count? Am I too late?


Posted by: bianca steele | Link to this comment | 09- 6-13 8:40 PM
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51

he predicts that the single-doctor family practice will be extinct in SF within 5 years

Why would this be a bad thing? Partnerships can offer better service in most areas. Also they tend to impose limits on this sort of thing.


Posted by: chris y | Link to this comment | 09- 7-13 1:52 AM
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52

The limit varies from practice to practice, but most will impose a ceiling of 10 old dears murdered per partner per year.


Posted by: ajay | Link to this comment | 09- 7-13 2:35 AM
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53

Somewhat topically, I'm sitting in an emergency room. I'm not the patient and it appears to be nothing too severe, but involved the typical middle of the night uncertainty/debate on what to do with off-hours escalating pain and other symptoms (we literally got in the car then out of the car and back into the house before finally deciding, "Nope, needs attention now.").


Posted by: JP Stormcrow | Link to this comment | 09- 7-13 4:14 AM
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54

Any news? Hope things are ok.


Posted by: asilon | Link to this comment | 09- 7-13 4:24 AM
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55

Best wishes and take care.


Posted by: Moby Hick | Link to this comment | 09- 7-13 4:26 AM
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56

Also, best wishes. There's nothing like an emergency room in the middle of the night.


Posted by: chris y | Link to this comment | 09- 7-13 4:30 AM
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57

I was heartened to see that Miss Manners gave an equally curt response as Bad Advisor to the woman asking about how to decline the invitation to her sister's wedding to her female partner.


Posted by: asilon | Link to this comment | 09- 7-13 4:31 AM
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Right now appears to be gall stones. Getting sonogram to confirm. I did not realize the extent to which the gall bladder is yet another semi-useless organ waiting around to go bad on you. Sort of like a husband who shares your medical condition with the internet.


Posted by: JP Stormcrow | Link to this comment | 09- 7-13 5:17 AM
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Gall stones are horrible. Mrs y suffered from one for years, and it put her in literally, non-nosflowly, screaming pain two or three times a month. Get it out soonest.


Posted by: chris y | Link to this comment | 09- 7-13 5:23 AM
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I think that psychiatry (depending on sub-specialty and the population treated) is a field that doesn't want to lose solo practitioners. If they don't handle insurance claims, they can get away with not having any administrative professionals.

Many combine part-time work in a clinic with a team approach with a private practice, particularly those who who want to work in public psychiatry with very sick people and have time to work with a higher-functioning population.


Posted by: Bostoniangirl | Link to this comment | 09- 7-13 5:35 AM
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58: ouch, but hooray for medical imaging.


Posted by: torrey pine | Link to this comment | 09- 7-13 6:04 AM
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61: Yep. Sono came back with nothing much, but symptoms and location are specific enough that HIDA scan is next step. Home with narcotics for now.


Posted by: JP Stormcrow | Link to this comment | 09- 7-13 7:31 AM
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63

Home with narcotics for now.

So, same as before?


Posted by: Moby Hick | Link to this comment | 09- 7-13 7:38 AM
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64

Hope she feels better soon.


Posted by: Moby Hick | Link to this comment | 09- 7-13 7:38 AM
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65

There's nothing like an emergency room in the middle of the night.

All things considered that part was not so bad, a pretty nice hospital and uncrowded in the very early morning but just after the day shift had arrived so relatively quick. Different form a number of years back when one of my kids broke their collarbone and it was the first day they had moved to U/P/M/C computer systems following their joining that system. Everything operating at a crawl, and repeating basic information to frustrated people every step of the way.


Posted by: JP Stormcrow | Link to this comment | 09- 7-13 7:51 AM
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ouch, good luck with the gall stones to mrs. stormcrow. :-(

I switched to Kaiser when I got hired out of a desperate bid to save money, having been paying individual health insurance through the nose and getting essentially no health care anyway. I'm totally in love with it now. Seriously, I kind of want to go work for their propaganda dept. The goofy commercials actually make me smile when they come on the radio. I've gotten way more and better health care in the last year than the previous ten, and feel like I'm actually dealing with and making progress on some of my health problems. Have had the doctor do the "let's call up an expert right now" thing a couple of times, to good effect. Had a shockingly good ER visit for mysterious vomiting where the nurses were somewhat adorably clucky and well, nursing, and the Dr. was absurdly communicative about what he was doing and why, and very diligent about making sure he wasn't missing anything. Found an eye doctor who was actually willing to discuss the statistical evidence with me that justified his switching me to a more sophisticated exam. The electronic records are a dream. I've google stalked a few of the doctors and a lot of them seem to have been health care justice activist types in medical schools. Some of them even blogged, and it seems like at least a couple of them were rich enough to not take out loans, and nice enough to recognize the privilege of that and use the resulting freedom to work for a better system. The only problem is I lost the first really awesome one b/c she decided to go back to graduate school in public health. It's kind of amazing to realize how much I actually just had come to *hate* doctors prior without even realizing it.

36: Heh. I laughed very hard at your comment.


Posted by: Ile | Link to this comment | 09- 7-13 9:40 AM
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67

Ah, poor Mrs Stormcrow. Hope this attack passes quickly and they come up with answers and a good plan.


Posted by: asilon | Link to this comment | 09- 7-13 12:06 PM
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68

The plan is almost certainly going to end up being to take the fucker out, but I guess they want a little better evidence first. (Not normally something I'd comment on the blog about, but catching up on yesterdays threads'* this morning the semi-appropriateness of being in the ER struck me.)

*I worked doing actual work all day until about 9;00 PM which was actually kind of refreshing, and so I only had time to drop the one cock joke** into the body-painting thread.

**Which concerns Aussie rules and is totally safe for work; people should click the link.


Posted by: JP Stormcrow | Link to this comment | 09- 7-13 12:17 PM
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Seriously, I kind of want to go work for their propaganda dept.

I had Kaiser about a decade ago when they still operated in North Carolina and it was easily the best health care delivery/insurance system I've ever navigated. Nothing else has been even remotely comparable. Blue Cross Blue Shield rivals Time Warner Cable as my worst customer service experience. Consistently.


Posted by: apostropher | Link to this comment | 09- 7-13 12:46 PM
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I grew up with Kaiser, which meant I didn't know exactly how fucked the US healthcare system was until I was kicked off my parents' insurance. It makes me foaming at the mouth angry when I realize that Kaiser is similar to what we'd have with a national healthcare systems, and most Americans can only wish they get healthcare that good.


Posted by: Ile | Link to this comment | 09- 7-13 9:29 PM
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Um, 70 is me. Somehow I meant to address it to Ile but wrote the name in the wrong place due to jetlag. Apologies Ile, not trying to steal your identity.


Posted by: Britta | Link to this comment | 09- 7-13 9:30 PM
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Heh, my parents ended up in GA because it was the one state that met both their retirement conditions that would not be budged on. My mom's was she refused to move to a state that didn't have one of her kids living in it. My dad's was he refused to move to a state that didn't have Kaiser.


Posted by: gswift | Link to this comment | 09- 7-13 11:07 PM
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68.1: My advice is to definitely get it removed when it's in a "healthy" state rather than in the midst of a horrible infection if you can in any way control that. I didn't have the option and it was a very unpleasant recovery for a lot of reasons. Not having a gall bladder changes how you can process fat, but most people who have the surgery find it's minor and that they recover quickly. My mileage varied because I had to spend a few days in the hospital on IV antibiotics to try to balance getting the fucker out before it ruptured with trying to decrease the infection level enough that it was unlikely to be a dangerous extraction. And the opiates were horrible for me. Somehow I still got quite a bit of knitting done.


Posted by: Thorn | Link to this comment | 09- 8-13 5:03 AM
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74

What Thorn said. Don't hang around. Do it soonest.


Posted by: chris y | Link to this comment | 09- 8-13 6:12 AM
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75

|| I don't usually approve of chains, especially in the downtown area. We just got a zpizza: any opinions out there on them? |>


Posted by: CharleyCarp | Link to this comment | 09- 8-13 7:06 AM
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75: the one near my house in California was pretty meh.


Posted by: Sifu Tweety | Link to this comment | 09- 8-13 7:35 AM
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Back in the 90s I really liked the cheese pizza from the zpizza in the mall across from UCI. I have since switched allegiance to the cheese pizza from the other pizzeria in that mall.


Posted by: nosflow | Link to this comment | 09- 8-13 7:43 AM
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78

Killed the blog?


Posted by: CharleyCarp | Link to this comment | 09- 8-13 12:01 PM
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Assad, or maybe one of his underlings acting without authorization


Posted by: Moby Hick | Link to this comment | 09- 8-13 12:09 PM
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I initially thought 68.1 was about Assad.


Posted by: Walt Someguy | Link to this comment | 09- 8-13 12:36 PM
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66: I've never had Kaiser, but I really miss the health care I had in grad school, of all places. The health center was excellent, all of the various specialist shared their electronic records, and I could get almost everything done on campus or at the hospital next door. This may be the only thing that was better as a grad student than as faculty.


Posted by: J, Robot | Link to this comment | 09- 8-13 4:32 PM
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Is zpizza the opposite of New Haven apizza?


Posted by: Mister Smearcase | Link to this comment | 09- 8-13 5:42 PM
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83

Apiaaz is maybe the opposite if it exists.


Posted by: Moby Hick | Link to this comment | 09- 8-13 5:47 PM
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84

Judging by the number of times I've seen their material linked, one thing that Kaiser appears to be doing a decent job of is communicating basic facts with regard to the ACA. I certainly appreciate their commercial reasons for doing so, but given the storm of BS on the subject competent truthful self-interest is refreshing.


Posted by: JP Stormcrow | Link to this comment | 09- 8-13 6:53 PM
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85

I underestimated the extent to which doctors are rich people and therefore Republicans.


Posted by: Cryptic ned | Link to this comment | 09- 8-13 6:55 PM
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85: Almost every one of my relationships with friends who are medical doctors have included politically-induced strains over the last 20 years. Several have ended (usually in conjunction with other factors).


Posted by: JP Stormcrow | Link to this comment | 09- 9-13 9:55 AM
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70/71 it's all good.


Posted by: Ile | Link to this comment | 09- 9-13 6:13 PM
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