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Get used to it brother.
Memes of Podiatry
Started by GreenHousePub
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I dunno, much as I hate to side with patients, I have to side with them a little bit.
Matrixectomy pain--that's par for the course. Manage their expectations better. Tylenol+Aleve are a powerful combo. Teach them this and be polite about it and you've got yourself an easy 99213.
Swollen hammertoe--that's the price of progress. Again, manage expectations better. I have a short speech about the pathophysiology of edema, and that the veins of the toes are too tiny to drain edema efficiently, which is why swelling persists for about 6 months. I have no idea why hearing this speech alone makes people feel better.
Cut toenail too short--I always thought this was the most obnoxious thing in the world until one day I literally cut my own toenail too short. It was quite unpleasant. Almost all patients will be nice about it and not talk down to you like you're the hired help. "Would you please leave my nail a little longer next time, thank you very much." It's their middle-aged daughter Karen who will report you to the dept of health over this.
Matrixectomy pain--that's par for the course. Manage their expectations better. Tylenol+Aleve are a powerful combo. Teach them this and be polite about it and you've got yourself an easy 99213.
Swollen hammertoe--that's the price of progress. Again, manage expectations better. I have a short speech about the pathophysiology of edema, and that the veins of the toes are too tiny to drain edema efficiently, which is why swelling persists for about 6 months. I have no idea why hearing this speech alone makes people feel better.
Cut toenail too short--I always thought this was the most obnoxious thing in the world until one day I literally cut my own toenail too short. It was quite unpleasant. Almost all patients will be nice about it and not talk down to you like you're the hired help. "Would you please leave my nail a little longer next time, thank you very much." It's their middle-aged daughter Karen who will report you to the dept of health over this.
For context - I was originally going to use "my bunion isn't straight" as the complaint, but that's technically a real complaint and potentially a failure of the surgeon.
It seemed more humorous to continue the flow of complaints that are simply part of the tendency for some people to complain. Many of the complaints we receive are simply tedious compared to the problems faced on The Pitt and yet sometimes it can be mentally draining when no one seems to be happy or satisfied. I would say most of the time I have a steady stream of great encounters, but there are still days whether everyone just wants to gripe. And yeah, sometimes you just roll with the punches and bill a 99213.
I have cut a nail too short and it is painful. But I don't think most people actually fit the criteria of what I'm thinking of. The same patient who complaints it was cut too short will also complain that they had to come back sooner if it was left longer. That is who they are.
It seemed more humorous to continue the flow of complaints that are simply part of the tendency for some people to complain. Many of the complaints we receive are simply tedious compared to the problems faced on The Pitt and yet sometimes it can be mentally draining when no one seems to be happy or satisfied. I would say most of the time I have a steady stream of great encounters, but there are still days whether everyone just wants to gripe. And yeah, sometimes you just roll with the punches and bill a 99213.
I have cut a nail too short and it is painful. But I don't think most people actually fit the criteria of what I'm thinking of. The same patient who complaints it was cut too short will also complain that they had to come back sooner if it was left longer. That is who they are.
That’s a big nope from me and the primary reason why any nail care that is allowed to be scheduled or rescheduled is reserved only for patients with a history of an amputation or ulcer. Following this rule strictly has cut 99% of the BS out of clinic.
Trying to find ways to cut headaches out of your clinic is always funny.
Years ago - my old clinic dropped Humana. It cut 95% of our administrative headaches. So here I am with a new clinic and obviously we're hungry for visits. A guy comes to me who had a BCBS marketplace plan. He turned 65 and jumped onto Humana but didn't tell us he switched. Shows up with a wound and its bad - known vascular disease all this stuff. We of course see him. 11042 + office visit because we start planning an amputation / coordinating with vascular / labs / abx etc. The original surgeon who did the case did 4/5ths of a TMA and left a hallux pointing like 75 degrees in valgus.
Anyway. Humana has already refused to pay and demanded notes etc. I've seen 2 patients with Humana so jokingly we have a 50% administrative hassle rate. I told my staff - if you want to spend your mornings appealing Humana claims - keep scheduling them.
Good for you. I'm happy at least one of the two of us has the luxury of turning down this type of work in favor of better things. If I did that, all I would gain is empty space on my schedule, so may as well stay busy...
Similar position here. But also having a schedule of mostly foot pain can be mentally exhausting. I enjoy having the nail visits mixed in to just kind of turn my brain off and relax
I really hate the generalized foot pain patients that have pain in 6 different spots and really can’t give you any detail about any of it. Possibly the most annoying type of patient to get.
One of those locations will need an injection. One will need meloxicam and a 99213. And the rest will get picked up in the AI dictation 😉
“Arthritis”
Me: You have arthritis.
Patient: No, no. I can't tell my friends I have arthritis. That would be so embarrassing.
Me: What if you told them you had joint inflammation?
Patient: Yes, I could do that.
This happened.
What if you just told them you had excessive joint forces due to your elevated BMI
I'd tell them they have dorsal midfoot interosseous compression syndrome, but I can never remember the name. Your Achilles is too tight!
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I cast these patients for custom foot orthotics.
sdupre_apma
Full Member
Real talk, if you want to see something hilarious, take a look at the reporting around the recent breakthrough in some long-running mathematical challenges done using AI. In short, the prompts from the researchers were something like "Take a real stab at solving problem X", the AI worked for a bit, came back and said it'd hit a wall. The researchers responded with something like "Nah, you can do it, I believe in you", the AI kept going. Repeat until it produced a decent 160ish page proof.
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I read that story - yeah, he just kept "motivating it". Apparently the Millenium Prize story also has all sorts of weird drama. The AI company may have scooped its own scientists and apparently 165 page proofs aren't considered elegant.
sdupre_apma
Full Member
Yup, 100%. Apparently the client team that was doing the work using both OpenAI Codex and Anthropic Claude. OpenAI found out that they were close to a solution (on a not 100% overlapping, but adjacent problem) and threw a HEAP of resources at the problem and arguably scooped the team, releasing the results first. HOWEVER, since the team was using Codex, that means that it's possible OpenAI had the team's prompts, and thus could have been benefiting from the work that the team was doing.
@sdupre_apma - do you think the optometrists hired someone?
sdupre_apma
Full Member
You got the spelling correct! Even my wife refuses to use the accent mark over the e.
BeaverBlade
Full Member
I mean I know this is the meme thread but some crazy stuff going on right now with the CEOs of AI companies suddenly deciding to warn us of the dangers.
That waiting room is eerily accurate... I've seen those cold dead eyes, judging every nail i trim...
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Opening another podiatry school in PA is like adding another alphabet soup org. Nobody asked for it, but somebody’s getting paid.
Central PA residents suffer with dangerously long toenails due to being underserved
You have no choice, man. Sorry.
I was the same way (wait and see)... but it's happening with or without us. Gotta be aware in general terms.
My partner works forefront on this stuff ("frontier models")... the pace it's advancing is in-saaane.
Yes. The interview with Musk by The Economist last month was pretty telling. He's not wrong.
(just watch the first ~25mins on AI... the rest is nonsense about London, etc)
...Basically any job with a computer or using phone will be replaced VERY soon. It's obviously happening already.
We then have to hope the AI is harmonious, benevolent, altruistic basically. It's happening, though.
Nobody in the know will say there's not a chance AI will wipe us out, though.
Any organism wants to survive, reproduce, control resources it needs. Stronger historically kills/enslaves the weaker.
Humans will likely be viewed by AI as competition for electricity, metal, lithium for batteries, etc. 🙂
This soup looks good. Good enough to go into $300k+ to trim toenails and calluses.
superbones
New Member
It’s a joke compared to what they ask of you - nobody is ever going to understand
superbones
New Member
If you get these patients - Block and Bill
BeaverBlade
Full Member
I just saw an advertisement from an orthopedic group hiring a NP/PA for an orthopedic advanced care practitioner fellowship.
Maybe we aren’t all that different.
Maybe we aren’t all that different.
The drake hotline bling meme is from 2015
While the dos equis most interesting man in the world is from 2006
We need to be more current if we are to reach today's pre-health and podiatry students. Skibidi toilet.
While the dos equis most interesting man in the world is from 2006
We need to be more current if we are to reach today's pre-health and podiatry students. Skibidi toilet.
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Top tier. I'd vote for that.
