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From hacker to hospice in seven weeks

benjamincburns.com

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Re: From hacker to hospice in seven weeks

#161

Post by fnordfnordfnord »

maxerickson wrote: post #142
chimeracoder wrote: post #135

Earlier quoted context omitted.

Not a direct response to what you said, but since this is a common discussion on HN, I just want to get some facts straight pre-emptively: 1) The AMA has nothing to do with limiting the supply of doctors in the US 2) The AAMC (not the AMA) formerly limited the number of medical students per-year in the US, but they stopped this practice sometime around 2004 with the stated goal of increasing the number of medical sch…

Is there some reason that hospitals can't fund the programs themselves? Or do they just choose not to? More usefully, what could be done to get hospitals to fund the programs? Some hospital systems have billions of net income, they can clearly afford to fund at least a few residencies.

> Some hospital systems have billions of net income, they can clearly afford to fund at least a few residencies.

What incentive, economic or otherwise, exists that would cause them to do that?

Re: From hacker to hospice in seven weeks

#162

Post by VLM »

maxerickson wrote: post #137
VLM wrote: post #132

Earlier quoted context omitted.

I don't know about the financial model. Google indicates you can pay up to $3M for a MRI machine and $100K/yr energy and required maint costs. Google indicates a median radiologist gets $300K/yr and to make the figures ridiculous I'll dedicate one radiologist full time to the MRI. Google indicates mean lifetime of a MRI machine is a decade. Google indicates a hospital remodel to make a MRI safe room and electrical an…

A single machine is going to have multiple technicians and service more than 1 doctor. A little bit of trying to find numbers suggests that 1 MRI machine might be feeding 20 doctors (if you've arranged for 56 scans a week to be the low end number and take into account specialization, this starts to make sense). I guess they are each spending a couple hours during many of their weeks. You have labor at ~30% of cost, i…

"You have labor at ~30% of cost, it looks like it should be more than 50%"

That's because I chose the highest possible machine price and highest possible room construction price I could find on google. Its quite possible an individual installation could get away with a merely average $2M machine and basically nil building remodeling costs, in which case the labor cost percentage would naturally dramatically increase.

I don't trust the google data I found of $100K yearly for energy and service contract. That sounds low. 10% of purchase price sounds believable for high tech devices.

I googled some MRI tech salary data and one tech for a decade is going to be $1M. So merely not installing marble and solid gold fixtures in the room would easily pay for a team of three full time techs and one radiologist doing absolutely nothing but supporting one machine. Which is pretty ridiculous, but I want to estimate high to make my overall conclusion strong.

None the less my overall conclusion stands that it would be a significant challenge to spend, both labor and capex, more than about a third of MRI sales price to provide the service. Looks like quite a nice profit center.

Re: From hacker to hospice in seven weeks

#163

Post by sgt101 »

NewDispAccount wrote: post #122
madaxe_again wrote: post #50

I don't have a brain tumour, but I have had, and am still having, an experience which has made me think seriously about my mortality. I'm 31. About three years ago I started having three/four day long bouts of total delirium, roasting fever, extreme nausea, can't even keep sips of water down when it happens - by day three or four, I'm usually too weak to move, totally dehydrated. Two years on, my GP is still going "c…

First, I'd like to say thank you for writing this. I'd also like to add a little for others who may be in a similar situation. Just to set the background, I'm in my mid-40's, was a responsible adult, and had a house and family, and worked as a programmer for 15 years. I was fairly typical as a programmer -- a bit overfocused, had an excellent memory, strong reading skills, etc... I wouldn't say I was a great programm…

have you seen a consultant neurologist? or a consultant virologist?

Re: From hacker to hospice in seven weeks

#164

Post by fnordfnordfnord »

madaxe_again wrote: post #71
debacle wrote: post #55

Earlier quoted context omitted.

Why wouldn't your GP even order an ultrasound? If you're experiencing jaundice, and are otherwise healthy, gallstones are the most likely culprit and can be detected via a simple ultrasound in most cases.

Because my GP is... not cut out for his job, to put it nicely. I need to change, but it's irrelevant right now as I've circumvented him. I thought his approach was weird and off, and must have been something I'd bought about: Him: "tell me word by word what you want me to put in your notes" Me: "uh, what? I don't care. I just want you to at least have a crack at figuring out what's wrong with me." Him: "'Abdominal pa…

> ... go be a lecturer or something.

That's a bit harsh, isn't it? & Are you sure you'd want him to go and propagate his habits by teaching them to others?

Re: From hacker to hospice in seven weeks

#165

Post by jeorgun »

byuu wrote: post #159
mingmecca wrote: post #148

Earlier quoted context omitted.

I can relate to this. A few years ago I was a 30 year old guy who felt like a feeble 70 year old. I was tired, depressed, and just didn't feel well at all. I had a blood test and the doc was flabbergasted at how low my Vitamin D levels were. Technically I had rickets! But then I started taking 10-15k of D3 a day and in a couple of weeks I felt great. Now I take 5k in the summer and 10k in the winter and haven't a had…

Exactly how I felt! I'm 31 now myself. I'm really hoping my experience is like yours, because I'm still not 100% myself again. Currently 2.5 weeks in. I can't even imagine what my levels were prior to taking the 500% RDV supplement I was on before having my blood checked. But at All doctors will only prescribe D2 (ergocalciferol); so you really need to go and get D3 (cholecalciferol). Your body naturally produces D3,…

Out of curiosity, why do doctors only prescribe D2? It sounds from your description like there's essentially no reason they shouldn't be prescribing D3, and yet apparently none do.

Re: From hacker to hospice in seven weeks

#166

Post by sgt101 »

saboot wrote: post #61

I would like to take this opportunity to remind our fellow hackers to be aware of changes within your own body. Being alert to physical and/or mental changes and relaying concerns to your doctor is one the best methods for overcoming several diseases and cancers. As a personal testimony, about ten months ago user ifktaotc made a very helpful comment regarding testicular cancer and it's prevalance among young men warn…

I have chronic Orchitis (I find the symptoms quite funny having been an avid reader of Vis) anyway, you can imagine that this has led to a lot of testicular examination (har har har)

When my testical swelled up I was quite frightened. It is essential that you go to the doctor and get checked - that's obvious, but to calm yourself down you can use a bright torch to check to see if you have any part of it which is not transparent.

A soft pink glow with some blood vessels is reassuring (go to the doc anyway as lumps are not normal and need a bit of a look see). If you observe any dark patches then this is more of a concern and you need to move fast with the knowledge that there is good treatment available and you have caught it earlier than many would.

I find shining a bright light through much easier than squeezing and feeling - but it's worth doing both.

Re: From hacker to hospice in seven weeks

#167

Post by beejiu »

grecy wrote: post #131
sillysaurus3 wrote: post #9

How long until a daily brain scan and body scan is a part of everyone's routine, the same way brushing your teeth is? Problems like these are untreatable if left for too long, but if caught early, there's sometimes hope. The solution seems to be to develop as many types of passive scanners as possible. The problem is false positives. But wasting a month needlessly visiting the doctor doesn't seem that bad.

In the UK when you move house you're required to go and have a checkup with your new local doctor. It's preventative health care, not "sick care".

In reality, you'll have your blood pressure checked by a nurse, not a doctor, and a load of boxes ticked on a form. Still worthwhile, of course, but my own experience with my local doctors is that they are under a huge amount of pressure with little time to see patients for preventative medicine. It also depends very much on where you live.

Re: From hacker to hospice in seven weeks

#169

Post by simonebrunozzi »

madaxe_again wrote: post #50

I don't have a brain tumour, but I have had, and am still having, an experience which has made me think seriously about my mortality. I'm 31. About three years ago I started having three/four day long bouts of total delirium, roasting fever, extreme nausea, can't even keep sips of water down when it happens - by day three or four, I'm usually too weak to move, totally dehydrated. Two years on, my GP is still going "c…

Man, I can only say "thank you" for sharing your story. Very touchy. I hope you will recover soon.

Re: From hacker to hospice in seven weeks

#170

Post by phkahler »

cpncrunch wrote: post #100
phkahler wrote: post #60

Earlier quoted context omitted.

>> It seemed to me that his long hours at work contributed to his developing the disease. What on earth makes you say that? Is there a documented link between working long hours and getting cancer? Citation please.

http://www.cancer.gov/cancertopics/factsheet/Risk/stress "Evidence from experimental studies does suggest that psychological stress can affect a tumor’s ability to grow and spread. For example, some studies have shown that when mice bearing human tumors were kept confined or isolated from other mice—conditions that increase stress—their tumors were more likely to grow and spread (metastasize). "

From that very same link:

"Although stress can cause a number of physical health problems, the evidence that it can cause cancer is weak."

But they do make some statements that seem to support the idea as well.

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