Stopping Elective Cases

[BLADEMDA]

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Honestly, things are not that bad in most ORs. Yes, they are twice as slow as an ASC but typically the patients are sicker and ASA3/4 types with much worse medical care than the ASC patient.

I have worked in all types of settings and despite the issues I prefer the hospital to the ASC as the Anesthesiologist. As the patient I would evaluate my type of procedure and go from there.

As we move towards a single payer system one needs to think in terms of the VA or the big academic centers for how we will deal with staffing, turnovers, etc.
The ASCs will continue to expand and take volume leaving the vast majority of Anesthesiologists who work there at below average compensation for above average work. That's the cost for those who must work mommy track hours at a privately owned ASC. I don't think it is worth the trade-off the vast majority of times.
I also want to add surgeons are clueless to how much it costs to staff a room and how little Medicare, Medicaid, Tricare, etc pays us vs their reimbursement. If the department or company staffs 2 rooms for one surgeon that can end up being a huge money loser. Sure, spine pays well but many other types of cases do not. Almost all of us have staffed 2 rooms for the fast surgeons either routinely or on occasion but that still doesn't change the math.

 

[Blockit]

Heard from a colleague of mine in South Florida that their CEO announced that their facility would be suspending all elective procedures that required a postoperative hospital admission.

 

[2.0%]

It's starting up here in Washington state too.

 

[BLADEMDA]

Heard from a colleague of mine in South Florida that their CEO announced that their facility would be suspending all elective procedures that required a postoperative hospital admission.

Yes, that is the routine in my area at almost all the hospitals. They don't have any available beds/rooms. I suspect that this winter we will all be quite busy with the postponed cases from the summer/fall. I expect either vaccinations to finally reach 80% or the delta variant to infect the majority of the unvaccinated people over the next 45 days.

https://nymag.com/intelligencer/2021/08/the-u-k-s-delta-surge-is-collapsing-will-ours.html

 

[GassYous]

Well here we are folks. Our beds are completely full due to covid.

 

[coffeebythelake]

Well here we are folks. Our beds are completely full due to covid.

Due to covid AND unvaccinated idiots

 

[D P356]

Pacu becomes overflow icu in some hospitals. When that happens there is no room to recover even outpatient elective cases.

Bypass phase 1. Straight to phase 2, of course.

 

[dpmd]

Bypass phase 1. Straight to phase 2, of course.

No phase 2 in one of the hospitals I work at

 

[D P356]

No phase 2 in one of the hospitals I work at

It’s called their “ride,” or uber if they don’t have one.

 

[Robotic Wis-Hipple]

The taking a piss thing is crazy to me. While I might hold my own on occasion while doing stuff because I would rather get through what I am doing and then go (especially during a case) i would never deny someone else the opportunity (not that they need my permission). Eating I could see being potentially an issue since the surgeon might see you eating and say something if they are jerks, but slipping away to pee unnoticed shouldn't be hard (when the circulator is giving the premedication and rolling back seems like a perfect time but I have even had anesthesia leave the room briefly during a case because they really needed to go and the bathrooms were close enough that it didn't seem unsafe even if there wasn't an extra person to break them).
Funny thing about the eating thing. For me it is often the opposite. I want to eat so I ask about taking a break between cases and everyone else says no let's keep going so I have to try to get food really quick in between and sometimes end up having to leave half my meal because they are ready quicker than I ate. I have seen colleagues continue to eat or do whatever after getting called to the room and I think that is pretty rude to the patient who get longer than necessary anesthesia not to mention rude to the team.

Another small part of this is the difference in the terminology and timing of a surgeon vs an anesthesiologists work flow.

If anesthesia is involved the circulator typically isn’t giving premedication (a few reasons most of which are billing/legal, or controlled drug related issues).

Also, and I’m not saying you fall in this category as you seem pretty well in tune but more surgeons than should think that the minute they scrub out and the minute they can cut on the next case should be 30min. They’ll leave their PA on skin with dressings to place, in lateral position with a 250lb pt, and an emergence to occur but in their mind calling that end room time (let alone anesthesia end time). Expecting to walk out of an OR with 15-20min of stuff still to happen, anesthesia to transport to pacu , room turnover, anesthesia consent and the start of a new case in 20-30min is more prevalent than it should be. Surgical end quite simply does not equal anesthesia end. So while you go eat your sandwich anesthesia is still waking up or transporting and then setting up a room and seeing the next pt etc. (You absolutely should eat your sandwich or dictate or whatever you like in this time, it’s to be expected).

Our workflows are just different. We get to complain about living on cliff bars and holding a piss for 4hrs in a case that should take 2hrs and you get to think we’re all lazy asshats who go check our stonks for 20 min instead of seeing the next pt and then put an extra IV in to annoy you during your bloodless surgery. 😜

 

[chessknt]

Well here we are folks. Our beds are completely full due to covid.

Yep. We had 2 emergent head traumas stuck in er because or refused to take them until icu was open and there was no icu space until I was able to expedite withdrawal on 2 doomed covids. Some billing rule apparently prevents them from going postop back to er so guess it’s sucks to need emergency surgery today.

 

[GassYous]

Yep. We had 2 emergent head traumas stuck in er because or refused to take them until icu was open and there was no icu space until I was able to expedite withdrawal on 2 doomed covids. Some billing rule apparently prevents them from going postop back to er so guess it’s sucks to need emergency surgery today.

Can't believe people who actually want and need help are having delays or even denial of care due to the stupidity of others.

 

[Robotic Wis-Hipple]

Yep. We had 2 emergent head traumas stuck in er because or refused to take them until icu was open and there was no icu space until I was able to expedite withdrawal on 2 doomed covids. Some billing rule apparently prevents them from going postop back to er so guess it’s sucks to need emergency surgery today.

Yikes. That’s not good.

 

[dpmd]

Another small part of this is the difference in the terminology and timing of a surgeon vs an anesthesiologists work flow.

If anesthesia is involved the circulator typically isn’t giving premedication (a few reasons most of which are billing/legal, or controlled drug related issues).

Also, and I’m not saying you fall in this category as you seem pretty well in tune but more surgeons than should think that the minute they scrub out and the minute they can cut on the next case should be 30min. They’ll leave their PA on skin with dressings to place, in lateral position with a 250lb pt, and an emergence to occur but in their mind calling that end room time (let alone anesthesia end time). Expecting to walk out of an OR with 15-20min of stuff still to happen, anesthesia to transport to pacu , room turnover, anesthesia consent and the start of a new case in 20-30min is more prevalent than it should be. Surgical end quite simply does not equal anesthesia end. So while you go eat your sandwich anesthesia is still waking up or transporting and then setting up a room and seeing the next pt etc. (You absolutely should eat your sandwich or dictate or whatever you like in this time, it’s to be expected).

Our workflows are just different. We get to complain about living on cliff bars and holding a piss for 4hrs in a case that should take 2hrs and you get to think we’re all lazy asshats who go check our stonks for 20 min instead of seeing the next pt and then put an extra IV in to annoy you during your bloodless surgery. 😜

Here for some reason every anesthesiologist and crna hands the circulator the versed or orders it in the chart (have seen both happen) and then leaves while the nurse finishes their stuff, gives the med, and then rolls the patient back and calls anesthesia when the patient is in the room. That was the main time I was thinking a pee break would go unnoticed. But if you have to give the med and roll back with the patient that eliminates that option which sucks.

I am aware of my colleagues who think their room exit time is anesthesia end time. I usually do my own closures so anesthesia end time is often close to when I leave but I no longer dictate in pacu so that visual cue of the dropping the patient off is lost. I usually ask when they came out if I am peeved about how long stuff is taking and I haven't seen them in the lounge to ask them (most of the time the delays have nothing to do with us do we hang out in the lounge and suffer together). That way if stuff went down that took longer than normal I can calm back down.

 

[dpmd]

Yep. We had 2 emergent head traumas stuck in er because or refused to take them until icu was open and there was no icu space until I was able to expedite withdrawal on 2 doomed covids. Some billing rule apparently prevents them from going postop back to er so guess it’s sucks to need emergency surgery today.

They couldn't just go to pacu postop until an icu bed opened up or they called in a critical care nurse to come to pacu? The pacu nurses hate it and they aren't as good as having a critical care nurse (unless they have that background) but if the patient is going to worsen without surgery anyway better to get surgery and subpar critical care than herniate and become a donor.

 

[Aether2000]

Most hospitals in the Tampa Bay area have suspended elective surgeries even for outpatient surgeries. Our hospitals are way too full. One hospital I work in has 45% of the entire patient population admitted for COVID. Pregnant patients have a 20% vaccination rate and are being intubated after delivery due to COVID and we have had many fetal demises in advanced pregnancy due to COVID. We have no more ventilators in several hospitals, COVID wards are open fully and there is still not enough room for all the COVID patients. Our ER had 45 patients waiting for beds, a line of ambulances full of COVID patients outside the ER, and PACU full of post surgical patients with no where to send them. We live in the land of the vaccine resistant rednecks who are proud of their lack of masking or social distancing and refuse vaccines no matter what.

 

[chessknt]

They couldn't just go to pacu postop until an icu bed opened up or they called in a critical care nurse to come to pacu? The pacu nurses hate it and they aren't as good as having a critical care nurse (unless they have that background) but if the patient is going to worsen without surgery anyway better to get surgery and subpar critical care than herniate and become a donor.

I thought the same thing but I have no sway over the or. Neurosurgery was ringing all the alarm bells and documenting delays due to capacity issues. No idea why they wouldn’t allow a crash to pacu after.

 

[pjl]

Another small part of this is the difference in the terminology and timing of a surgeon vs an anesthesiologists work flow.

If anesthesia is involved the circulator typically isn’t giving premedication (a few reasons most of which are billing/legal, or controlled drug related issues).

Also, and I’m not saying you fall in this category as you seem pretty well in tune but more surgeons than should think that the minute they scrub out and the minute they can cut on the next case should be 30min. They’ll leave their PA on skin with dressings to place, in lateral position with a 250lb pt, and an emergence to occur but in their mind calling that end room time (let alone anesthesia end time). Expecting to walk out of an OR with 15-20min of stuff still to happen, anesthesia to transport to pacu , room turnover, anesthesia consent and the start of a new case in 20-30min is more prevalent than it should be. Surgical end quite simply does not equal anesthesia end. So while you go eat your sandwich anesthesia is still waking up or transporting and then setting up a room and seeing the next pt etc. (You absolutely should eat your sandwich or dictate or whatever you like in this time, it’s to be expected).

Our workflows are just different. We get to complain about living on cliff bars and holding a piss for 4hrs in a case that should take 2hrs and you get to think we’re all lazy asshats who go check our stonks for 20 min instead of seeing the next pt and then put an extra IV in to annoy you during your bloodless surgery. 😜

I love when Im running the ORs and a surgeon comes to me to ask why the turnover has taken an hour, and I get to reply that when the PA is done closing their previous case we can start that timer.

 

[Robotic Wis-Hipple]

Here for some reason every anesthesiologist and crna hands the circulator the versed or orders it in the chart (have seen both happen) and then leaves while the nurse finishes their stuff, gives the med, and then rolls the patient back and calls anesthesia when the patient is in the room. That was the main time I was thinking a pee break would go unnoticed. But if you have to give the med and roll back with the patient that eliminates that option which sucks.

I am aware of my colleagues who think their room exit time is anesthesia end time. I usually do my own closures so anesthesia end time is often close to when I leave but I no longer dictate in pacu so that visual cue of the dropping the patient off is lost. I usually ask when they came out if I am peeved about how long stuff is taking and I haven't seen them in the lounge to ask them (most of the time the delays have nothing to do with us do we hang out in the lounge and suffer together). That way if stuff went down that took longer than normal I can calm back down.

I’ve got to say, though I haven’t worked at a ton of places, I’ve worked at enough to be able to tell you that this circulator gives versed then takes pt to the OR while the anesthesia “provider” attends to bodily requirements is quite atypical. Sounds to me like something is off there.

If I’m doing the same surgeons back to backs I’ll have tried to pre-draw up drugs, setup intubation equipment, looked up the next patient, and started the preop etc during the preceding case. So then I take pt to PACU/ICU, go take my pee break grab my quick bite, then go consent/examine next pt (I do it in this order so nobody rolls back with my pt while I’m not ready). Typically I’m done with this then go back to the OR and the OR staff is still setting up/counting. So I don’t really understand what’s happening where the anesthesia can’t get their personal needs met without handing off scheduled drugs and technically starting the “anesthesia time” before going to do so. I suspect it’s hourly type “providers” that don’t truly care when your OR finishes because their shift ends at 3pm and they sure as hell are taking their breaks.

But we digress. Sounds like you are a reasonable one. So 👍🏻.

 

[deleted697127]

I’ve got to say, though I haven’t worked at a ton of places, I’ve worked at enough to be able to tell you that this circulator gives versed then takes pt to the OR while the anesthesia “provider” attends to bodily requirements is quite atypical. Sounds to me like something is off there.

If I’m doing the same surgeons back to backs I’ll have tried to pre-draw up drugs, setup intubation equipment, looked up the next patient, and started the preop etc during the preceding case. So then I take pt to PACU/ICU, go take my pee break grab my quick bite, then go consent/examine next pt (I do it in this order so nobody rolls back with my pt while I’m not ready). Typically I’m done with this then go back to the OR and the OR staff is still setting up/counting. So I don’t really understand what’s happening where the anesthesia can’t get their personal needs met without handing off scheduled drugs and technically starting the “anesthesia time” before going to do so. I suspect it’s hourly type “providers” that don’t truly care when your OR finishes because their shift ends at 3pm and they sure as hell are taking their breaks.

But we digress. Sounds like you are a reasonable one. So 👍🏻.

This all sounds really inefficient. Versed is unnecessary in the vast majority of cases unless you’re doing a block or awake art line. Don’t really understand why it’s necessary to draw up drugs before the patient gets in the room. Does it really save you that much time? Takes like 30s to draw up prop roc fent while waiting for cuff to cycle.

 

[dpmd]

I’ve got to say, though I haven’t worked at a ton of places, I’ve worked at enough to be able to tell you that this circulator gives versed then takes pt to the OR while the anesthesia “provider” attends to bodily requirements is quite atypical. Sounds to me like something is off there.

If I’m doing the same surgeons back to backs I’ll have tried to pre-draw up drugs, setup intubation equipment, looked up the next patient, and started the preop etc during the preceding case. So then I take pt to PACU/ICU, go take my pee break grab my quick bite, then go consent/examine next pt (I do it in this order so nobody rolls back with my pt while I’m not ready). Typically I’m done with this then go back to the OR and the OR staff is still setting up/counting. So I don’t really understand what’s happening where the anesthesia can’t get their personal needs met without handing off scheduled drugs and technically starting the “anesthesia time” before going to do so. I suspect it’s hourly type “providers” that don’t truly care when your OR finishes because their shift ends at 3pm and they sure as hell are taking their breaks.

But we digress. Sounds like you are a reasonable one. So 👍🏻.

I didn't mean they do this to go pee or whatever, they just all do this, maybe so they don't have to wait for the circulator to be ready and don't accidentally give it before consents are signed? Not sure their pay structure but most of them are partners in the group I thought.

 

[nimbus]

This all sounds really inefficient. Versed is unnecessary in the vast majority of cases unless you’re doing a block or awake art line. Don’t really understand why it’s necessary to draw up drugs before the patient gets in the room. Does it really save you that much time? Takes like 30s to draw up prop roc fent while waiting for cuff to cycle.

I draw up drugs during the previous case because I have nothing else to do. But I agree versed is unnecessary in 95% of patients.

 

[nimbus]

Most hospitals in the Tampa Bay area have suspended elective surgeries even for outpatient surgeries. Our hospitals are way too full. One hospital I work in has 45% of the entire patient population admitted for COVID. Pregnant patients have a 20% vaccination rate and are being intubated after delivery due to COVID and we have had many fetal demises in advanced pregnancy due to COVID. We have no more ventilators in several hospitals, COVID wards are open fully and there is still not enough room for all the COVID patients. Our ER had 45 patients waiting for beds, a line of ambulances full of COVID patients outside the ER, and PACU full of post surgical patients with no where to send them. We live in the land of the vaccine resistant rednecks who are proud of their lack of masking or social distancing and refuse vaccines no matter what.

Why do you think it got so bad there?

 

[coffeebythelake]

Most hospitals in the Tampa Bay area have suspended elective surgeries even for outpatient surgeries. Our hospitals are way too full. One hospital I work in has 45% of the entire patient population admitted for COVID. Pregnant patients have a 20% vaccination rate and are being intubated after delivery due to COVID and we have had many fetal demises in advanced pregnancy due to COVID. We have no more ventilators in several hospitals, COVID wards are open fully and there is still not enough room for all the COVID patients. Our ER had 45 patients waiting for beds, a line of ambulances full of COVID patients outside the ER, and PACU full of post surgical patients with no where to send them. We live in the land of the vaccine resistant rednecks who are proud of their lack of masking or social distancing and refuse vaccines no matter what.

Why are these people even coming to the hospital?

 

[GassYous]

Why are these people even coming to the hospital?

They are short of breath. "You have covid sir". "No I don't, I don't believe in that liberal bull****!"

 

[chocomorsel]

Can't believe people who actually want and need help are having delays or even denial of care due to the stupidity of others.

We should simply turn all Covids away unless they have been vaccinated.
These selfish jerks are affecting the care of others and literally killing others because of their selfishness and stupidity.
This country is going to hell in a hand basket.

 

[chocomorsel]

Can't believe people who actually want and need help are having delays or even denial of care due to the stupidity of others.

We should simply turn all Covids away unless they have been vaccinated.
These selfish jerks are affecting the care of others and literally killing others because of their selfishness and stupidity.
This country is going to hell in a handbasket

Why do you think it got so bad there?

Look at their governor? Isn’t he threatening to cut funding to schools w mask mandates or something? No mask mandates, mostly a red state, a bunch of backwood hillbillies who refuse to believe the false narrative that is Covid. I have had someone go to Disney tell us that most people are unmasked.
Quite frankly I wouldn’t have gone in the first place.

 

[VA Hopeful Dr]

We should simply turn all Covids away unless they have been vaccinated.
These selfish jerks are affecting the care of others and literally killing others because of their selfishness and stupidity.
This country is going to hell in a handbasket

Look at their governor? Isn’t he threatening to cut funding to schools w mask mandates or something? No mask mandates, mostly a red state, a bunch of backwood hillbillies who refuse to believe the false narrative that is Covid. I have had someone go to Disney tell us that most people are unmasked.
Quite frankly I wouldn’t have gone in the first place.

Was that recently? We've been to Disney twice since COVID hit, both times mask compliance was easily 95+%. I felt safer there than the grocery stores where I live.

If its been since Disney relaxed its mask rules, I doubt many people were masked. But, very recently they went back to requiring masks indoors at all times for everyone. Given how strict they were previously, I'd be surprised if indoor mask compliance wasn't pretty darned high.

 

[ryanjmy]

Why do you think it got so bad there?

Just a guess but maybe the area got mostly Pfizer vaccines. Pfizer is only 40% effective against delta. It seems like my area fits that description. It’s certainly effective at reducing M&M but probably only slight effective at reducing spread. Certainly won’t get to herd immunity at that efficacy.

 

[chocomorsel]

Was that recently? We've been to Disney twice since COVID hit, both times mask compliance was easily 95+%. I felt safer there than the grocery stores where I live.

If its been since Disney relaxed its mask rules, I doubt many people were masked. But, very recently they went back to requiring masks indoors at all times for everyone. Given how strict they were previously, I'd be surprised if indoor mask compliance wasn't pretty darned high.

Two weeks ago.

 

[VA Hopeful Dr]

Two weeks ago.

Might be close, they started mandating again July 30th but only indoors. So if since then the indoor mask compliance has been terrible, that could be concerning.

 

[Iso4ane]

We should simply turn all Covids away unless they have been vaccinated.
These selfish jerks are affecting the care of others and literally killing others because of their selfishness and stupidity.
This country is going to hell in a hand basket.

They would turn it into a ‘Woe is me, I’m strong as a bull (I think they mean they weigh as much as one), and they turned me away from the hospital. They’re trying to ration care and ruin this country.’

 

[vector2]

We should simply turn all Covids away unless they have been vaccinated.
These selfish jerks are affecting the care of others and literally killing others because of their selfishness and stupidity.
This country is going to hell in a handbasket

Look at their governor? Isn’t he threatening to cut funding to schools w mask mandates or something? No mask mandates, mostly a red state, a bunch of backwood hillbillies who refuse to believe the false narrative that is Covid. I have had someone go to Disney tell us that most people are unmasked.
Quite frankly I wouldn’t have gone in the first place.

What DeSantis is doing with the threats to defund schools and put a hold on the salaries of superintendents is some of the most obscene bull**** that's happened since the start of the pandemic.

 

[VA Hopeful Dr]

What DeSantis is doing with the threats to defund schools and put a hold on the salaries of superintendents is some of the most obscene bull**** that's happened since the start of the pandemic.

We have that here except it was passed by the Legislature, not executive order. Lawsuits are pending, so fingers crossed there.

 

[Aether2000]

Why do you think it got so bad there?

The land of the unvaccinated rednecks that do not believe in the medical system, the CDC, the FDA, and listen to our brain dead governor.

 

[Aether2000]

Just a guess but maybe the area got mostly Pfizer vaccines. Pfizer is only 40% effective against delta. It seems like my area fits that description. It’s certainly effective at reducing M&M but probably only slight effective at reducing spread. Certainly won’t get to herd immunity at that efficacy.

Almost all of those hospitalized refused vaccines.

 

[Robotic Wis-Hipple]

This all sounds really inefficient. Versed is unnecessary in the vast majority of cases unless you’re doing a block or awake art line. Don’t really understand why it’s necessary to draw up drugs before the patient gets in the room. Does it really save you that much time? Takes like 30s to draw up prop roc fent while waiting for cuff to cycle.

Drawing drugs and setting up things you’re going to use next case in your current case is inefficient? I’m just as much a smart ass as the next guy but this just sounds like critiquing to critique.

I rarely give versed and some of us do more than choles. 🙄

 

[GassYous]

Drawing drugs and setting up things you’re going to use next case in your current case is inefficient? I’m just as much a smart ass as the next guy but this just sounds like critiquing to critique.

I rarely give versed and some of us do more than choles. 🙄

Yeah what's the point? I can draw up meds and set up a tube in the time it takes the patient to move from the gurney to the table. Why do a task that takes a minute early? I don't see the advantage.

 

[Robotic Wis-Hipple]

Maybe I’m slow
Maybe I’d rather do it while sitting in the previous case
Maybe I’m drawing push dose pressor dilutions or block concoctions
Maybe because I’d like to induce the second the NIBP spits out a number
Maybe I’m sensitive to appearing unprepared to my non-versed snowed patient

Or maybe it’s just my workflow and how I save a minute here or there which is all the original post was meant to show rather than become a swinging d!ck contest. Some of you think we all can’t just stroll in after nursing has transported and loaded/monitored up the pt and draw up prop and sux and push. 🤷🏼‍♂️

 

[Leon'sMom]

IMO, Here are the top 3 reasons why people are hesitant to get Covid vaccines:

1) They don't trust anything that the media tells them. Anything. Nothing. Nada. Zilch. Zero. After 5 years of blatant lies about anything and everything, people do not trust the media. If the media is advocating (correctly or incorrectly) for something, people put their guard up.

2) Who has the lowest vaccination rate (regardless of urban/suburban/rural location and regardless of education level)? People of color. Why is that? Perhaps it's for 2 main reasons: a) Historically, people of color were improperly used for experimental medical treatments in the US. In recent history, they've seen reports of poor African nations and vulnerable Caribbean islanders being harmed or exploited by medical/humanitarian interventions. People tend to remember those things and they distrust. b) 24/7 we are bombarded with the message that there is systemic racism at play in the US legal and medical systems. Disparity of outcomes between whites and non-whites with Covid has been emphasized. They don't hear people talking about biological/genetic differences that may be causing worse outcomes. No, they hear people talking about societal/economic/discriminatory reasons for the worse outcomes. Hence, reread reason 2a. They distrust.

3) The medical profession does not sit high upon the pedestal that it once did. For all the years of medical education, training, advancements in technology or procedures that have been mastered, it is evident now more than ever that medicine has become very much a top-down, one-size fits all, homogenized, franchised profession. Insurance companies dictate to the physician. Hospital systems dictate to the physicians. Professional Boards and Organizations set the standards for each specialty. Those experts in the field do the heavy lifting of collecting, analyzing, and disseminating studies of evidence based practice, recommendations, and guidelines-for which you would be considered a heretic for not adhering.

People have seen medical professionals from around the world stand up with questions, alternative ideas, differing analysis of Covid related things, and they've been censored by media. The public is not blind. They know that medicine is science. Science is the exploration of ideas, the collection of data, analysis and conclusion. Anyone that has participated in a 4th grade science fair knows that. So when highly educated physicians, researchers, mathematicians are getting censored and banned for going against the main narrative, something seems amiss. They distrust.

Physicians are less autonomous now than at any time in history, taking orders and shaping their care by what they are told. Ask yourself this: During this pandemic were you personally creating and shaping the treatment protocols for your patients? Were primary care physicians? Were ICU physicians? Or was there a top-down approach by which decisions were deferred to a select few? Who were those select few? Who has been directing the general public on what they are supposed to be doing? Was it their longtime, personal, trusted family physician? Or was it Fauci, the CDC, the FDA, the NIH, The WHO? So-called experts at the top levels of government (and some like WHO possibly under the influence of the CCP). Why would the average Joe trust any of those people or institutions?

So, if people are hesitant to get this vaccine, maybe it's not that they are "stupid idiots," "rednecks," or "selfish." Open your mind to some of the other reasons people have for being hesitant. I know it's difficult and frustrating on the front lines, but the way some of you talk about people/patients is an embarrassing and horrible representation of the medical profession, and, quite frankly, of humanity.

 

[vector2]

IMO, Here are the top 3 reasons why people are hesitant to get Covid vaccines:

1) They don't trust anything that the media tells them. Anything. Nothing. Nada. Zilch. Zero. After 5 years of blatant lies about anything and everything, people do not trust the media. If the media is advocating (correctly or incorrectly) for something, people put their guard up.

2) Who has the lowest vaccination rate (regardless of urban/suburban/rural location and regardless of education level)? People of color. Why is that? Perhaps it's for 2 main reasons: a) Historically, people of color were improperly used for experimental medical treatments in the US. In recent history, they've seen reports of poor African nations and vulnerable Caribbean islanders being harmed or exploited by medical/humanitarian interventions. People tend to remember those things and they distrust. b) 24/7 we are bombarded with the message that there is systemic racism at play in the US legal and medical systems. Disparity of outcomes between whites and non-whites with Covid has been emphasized. They don't hear people talking about biological/genetic differences that may be causing worse outcomes. No, they hear people talking about societal/economic/discriminatory reasons for the worse outcomes. Hence, reread reason 2a. They distrust.

3) The medical profession does not sit high upon the pedestal that it once did. For all the years of medical education, training, advancements in technology or procedures that have been mastered, it is evident now more than ever that medicine has become very much a top-down, one-size fits all, homogenized, franchised profession. Insurance companies dictate to the physician. Hospital systems dictate to the physicians. Professional Boards and Organizations set the standards for each specialty. Those experts in the field do the heavy lifting of collecting, analyzing, and disseminating studies of evidence based practice, recommendations, and guidelines-for which you would be considered a heretic for not adhering.

People have seen medical professionals from around the world stand up with questions, alternative ideas, differing analysis of Covid related things, and they've been censored by media. The public is not blind. They know that medicine is science. Science is the exploration of ideas, the collection of data, analysis and conclusion. Anyone that has participated in a 4th grade science fair knows that. So when highly educated physicians, researchers, mathematicians are getting censored and banned for going against the main narrative, something seems amiss. They distrust.

Physicians are less autonomous now than at any time in history, taking orders and shaping their care by what they are told. Ask yourself this: During this pandemic were you personally creating and shaping the treatment protocols for your patients? Were primary care physicians? Were ICU physicians? Or was there a top-down approach by which decisions were differed to a select few? Who were those select few? Who has been directing the general public on what they are supposed to be doing? Was it their longtime, personal, trusted family physician? Or was it Fauci, the CDC, the FDA, the NIH, The WHO? So-called experts at the top levels of government (and some like WHO possibly under the influence of the CCP). Why would the average Joe trust any of those people or institutions?

So, if people are hesitant to get this vaccine, maybe it's not that they are "stupid idiots," "rednecks," or "selfish." Open your mind to some of the other reasons people have for being hesitant. I know it's difficult and frustrating on the front lines, but the way some of you talk about people/patients is an embarrassing and horrible representation of the medical profession, and, quite frankly, of humanity.

Are you vaccinated?

 

[Leon'sMom]

Are you vaccinated?

Yes, I am.

 

[nimbus]

IMO, Here are the top 3 reasons why people are hesitant to get Covid vaccines:

1) They don't trust anything that the media tells them. Anything. Nothing. Nada. Zilch. Zero. After 5 years of blatant lies about anything and everything, people do not trust the media. If the media is advocating (correctly or incorrectly) for something, people put their guard up.

2) Who has the lowest vaccination rate (regardless of urban/suburban/rural location and regardless of education level)? People of color. Why is that? Perhaps it's for 2 main reasons: a) Historically, people of color were improperly used for experimental medical treatments in the US. In recent history, they've seen reports of poor African nations and vulnerable Caribbean islanders being harmed or exploited by medical/humanitarian interventions. People tend to remember those things and they distrust. b) 24/7 we are bombarded with the message that there is systemic racism at play in the US legal and medical systems. Disparity of outcomes between whites and non-whites with Covid has been emphasized. They don't hear people talking about biological/genetic differences that may be causing worse outcomes. No, they hear people talking about societal/economic/discriminatory reasons for the worse outcomes. Hence, reread reason 2a. They distrust.

3) The medical profession does not sit high upon the pedestal that it once did. For all the years of medical education, training, advancements in technology or procedures that have been mastered, it is evident now more than ever that medicine has become very much a top-down, one-size fits all, homogenized, franchised profession. Insurance companies dictate to the physician. Hospital systems dictate to the physicians. Professional Boards and Organizations set the standards for each specialty. Those experts in the field do the heavy lifting of collecting, analyzing, and disseminating studies of evidence based practice, recommendations, and guidelines-for which you would be considered a heretic for not adhering.

People have seen medical professionals from around the world stand up with questions, alternative ideas, differing analysis of Covid related things, and they've been censored by media. The public is not blind. They know that medicine is science. Science is the exploration of ideas, the collection of data, analysis and conclusion. Anyone that has participated in a 4th grade science fair knows that. So when highly educated physicians, researchers, mathematicians are getting censored and banned for going against the main narrative, something seems amiss. They distrust.

Physicians are less autonomous now than at any time in history, taking orders and shaping their care by what they are told. Ask yourself this: During this pandemic were you personally creating and shaping the treatment protocols for your patients? Were primary care physicians? Were ICU physicians? Or was there a top-down approach by which decisions were deferred to a select few? Who were those select few? Who has been directing the general public on what they are supposed to be doing? Was it their longtime, personal, trusted family physician? Or was it Fauci, the CDC, the FDA, the NIH, The WHO? So-called experts at the top levels of government (and some like WHO possibly under the influence of the CCP). Why would the average Joe trust any of those people or institutions?

So, if people are hesitant to get this vaccine, maybe it's not that they are "stupid idiots," "rednecks," or "selfish." Open your mind to some of the other reasons people have for being hesitant. I know it's difficult and frustrating on the front lines, but the way some of you talk about people/patients is an embarrassing and horrible representation of the medical profession, and, quite frankly, of humanity.

Yes, I am.

You list a lot of reasons why people don’t get vaccinated. Why did YOU get vaccinated?

 

[Leon'sMom]

You list a lot of reasons why people don’t get vaccinated. Why did YOU get vaccinated?

I chose to get vaccinated because of my professional exposure/risk level and based on my age and individual health profile.

 

[nimbus]

I chose to get vaccinated because of my professional exposure/risk level and based on my age and individual health profile.

Seems like other reasonable people would come to the same conclusion.

 

[vector2]

I chose to get vaccinated because of my professional exposure/risk level and based on my age and individual health profile.

Must be just an inconvenient coincidence that Fauci, the CDC, the FDA, the NIH, the WHO, and the "So-called experts at the top levels of government" all recommended the course of action that you ended up taking.

 

[abolt18]

IMO, Here are the top 3 reasons why people are hesitant to get Covid vaccines:

1) They don't trust anything that the media tells them. Anything. Nothing. Nada. Zilch. Zero. After 5 years of blatant lies about anything and everything, people do not trust the media. If the media is advocating (correctly or incorrectly) for something, people put their guard up.

2) Who has the lowest vaccination rate (regardless of urban/suburban/rural location and regardless of education level)? People of color. Why is that? Perhaps it's for 2 main reasons: a) Historically, people of color were improperly used for experimental medical treatments in the US. In recent history, they've seen reports of poor African nations and vulnerable Caribbean islanders being harmed or exploited by medical/humanitarian interventions. People tend to remember those things and they distrust. b) 24/7 we are bombarded with the message that there is systemic racism at play in the US legal and medical systems. Disparity of outcomes between whites and non-whites with Covid has been emphasized. They don't hear people talking about biological/genetic differences that may be causing worse outcomes. No, they hear people talking about societal/economic/discriminatory reasons for the worse outcomes. Hence, reread reason 2a. They distrust.

3) The medical profession does not sit high upon the pedestal that it once did. For all the years of medical education, training, advancements in technology or procedures that have been mastered, it is evident now more than ever that medicine has become very much a top-down, one-size fits all, homogenized, franchised profession. Insurance companies dictate to the physician. Hospital systems dictate to the physicians. Professional Boards and Organizations set the standards for each specialty. Those experts in the field do the heavy lifting of collecting, analyzing, and disseminating studies of evidence based practice, recommendations, and guidelines-for which you would be considered a heretic for not adhering.

People have seen medical professionals from around the world stand up with questions, alternative ideas, differing analysis of Covid related things, and they've been censored by media. The public is not blind. They know that medicine is science. Science is the exploration of ideas, the collection of data, analysis and conclusion. Anyone that has participated in a 4th grade science fair knows that. So when highly educated physicians, researchers, mathematicians are getting censored and banned for going against the main narrative, something seems amiss. They distrust.

Physicians are less autonomous now than at any time in history, taking orders and shaping their care by what they are told. Ask yourself this: During this pandemic were you personally creating and shaping the treatment protocols for your patients? Were primary care physicians? Were ICU physicians? Or was there a top-down approach by which decisions were deferred to a select few? Who were those select few? Who has been directing the general public on what they are supposed to be doing? Was it their longtime, personal, trusted family physician? Or was it Fauci, the CDC, the FDA, the NIH, The WHO? So-called experts at the top levels of government (and some like WHO possibly under the influence of the CCP). Why would the average Joe trust any of those people or institutions?

So, if people are hesitant to get this vaccine, maybe it's not that they are "stupid idiots," "rednecks," or "selfish." Open your mind to some of the other reasons people have for being hesitant. I know it's difficult and frustrating on the front lines, but the way some of you talk about people/patients is an embarrassing and horrible representation of the medical profession, and, quite frankly, of humanity.

Minus the last paragraph, I think you make some good points. However (in)correct they are, I have to imagine this is a driving force for a lot of people. Doesn't make them right, but people aren't all refraining just because they're idiots (though that may be true for many). In our tumultuous world I'm sure that many don't know who/what to believe. Then they get on Facebook where all the people they interact with and follow think the same way as them, so there are some dissenters and their bad ideas get reinforced over and over again.

 

[Drangue]

I love when Im running the ORs and a surgeon comes to me to ask why the turnover has taken an hour, and I get to reply that when the PA is done closing their previous case we can start that timer.

Are they not allowed to be in another room scrubbed if the case before that hasn't finished? Is that a legal thing or a hospital policy thing?

I can see how that could be a problem as he's starting another case and the PA causes a surgical mishap and he has to stop surgery in the current room and get to the previous one.

Cuz we do this ALL THE TIME. The moment he unscrubs the next patient is induced or the spinal is done.

 

[Aether2000]

IMO, Here are the top 3 reasons why people are hesitant to get Covid vaccines:

1) They don't trust anything that the media tells them. Anything. Nothing. Nada. Zilch. Zero. After 5 years of blatant lies about anything and everything, people do not trust the media. If the media is advocating (correctly or incorrectly) for something, people put their guard up.

2) Who has the lowest vaccination rate (regardless of urban/suburban/rural location and regardless of education level)? People of color. Why is that? Perhaps it's for 2 main reasons: a) Historically, people of color were improperly used for experimental medical treatments in the US. In recent history, they've seen reports of poor African nations and vulnerable Caribbean islanders being harmed or exploited by medical/humanitarian interventions. People tend to remember those things and they distrust. b) 24/7 we are bombarded with the message that there is systemic racism at play in the US legal and medical systems. Disparity of outcomes between whites and non-whites with Covid has been emphasized. They don't hear people talking about biological/genetic differences that may be causing worse outcomes. No, they hear people talking about societal/economic/discriminatory reasons for the worse outcomes. Hence, reread reason 2a. They distrust.

3) The medical profession does not sit high upon the pedestal that it once did. For all the years of medical education, training, advancements in technology or procedures that have been mastered, it is evident now more than ever that medicine has become very much a top-down, one-size fits all, homogenized, franchised profession. Insurance companies dictate to the physician. Hospital systems dictate to the physicians. Professional Boards and Organizations set the standards for each specialty. Those experts in the field do the heavy lifting of collecting, analyzing, and disseminating studies of evidence based practice, recommendations, and guidelines-for which you would be considered a heretic for not adhering.

People have seen medical professionals from around the world stand up with questions, alternative ideas, differing analysis of Covid related things, and they've been censored by media. The public is not blind. They know that medicine is science. Science is the exploration of ideas, the collection of data, analysis and conclusion. Anyone that has participated in a 4th grade science fair knows that. So when highly educated physicians, researchers, mathematicians are getting censored and banned for going against the main narrative, something seems amiss. They distrust.

Physicians are less autonomous now than at any time in history, taking orders and shaping their care by what they are told. Ask yourself this: During this pandemic were you personally creating and shaping the treatment protocols for your patients? Were primary care physicians? Were ICU physicians? Or was there a top-down approach by which decisions were deferred to a select few? Who were those select few? Who has been directing the general public on what they are supposed to be doing? Was it their longtime, personal, trusted family physician? Or was it Fauci, the CDC, the FDA, the NIH, The WHO? So-called experts at the top levels of government (and some like WHO possibly under the influence of the CCP). Why would the average Joe trust any of those people or institutions?

So, if people are hesitant to get this vaccine, maybe it's not that they are "stupid idiots," "rednecks," or "selfish." Open your mind to some of the other reasons people have for being hesitant. I know it's difficult and frustrating on the front lines, but the way some of you talk about people/patients is an embarrassing and horrible representation of the medical profession, and, quite frankly, of humanity.

I vehemently disagree with virtually all of your harangue. The main reason people are not getting vaccinated is because they DO BELIEVE SOCIAL MEDIA and all its bizarre whacko statements that detract from the science behind the vaccines. The black social Tuskegee collective unconsciousness of antivax unravels when several studies have actually asked the blacks about why they refuse vaccination, and only 10% cite past experimentation- their paranoia is fed through nonsensical idiotic notions about the vaccine that come from social media. The idea that people are not getting vaccinated because they do not believe the medical profession is not the problem since both right and left wing politicians, the majority of the population, virtually all levels of government, all health agencies, celebrities, and now with even Fox media on board, there simply are very few influencers in society that oppose vaccination. The antivax conspiracists, the ultra right wing conspiracists that now distrust even Fox, the rural uneducated with very strong opinions based in fantasy and misinformation juxtaposed against an ocean of data (read: rednecks), and those that are fundamentally uneducated in basic science and research are increasingly becoming victims of their own biases as they become hospitalized in increasing numbers, and continue to spew viral loads into both other unvaccinated individuals and those who are vaxxed. The same group that refuses vaccinations also refuses to exercise even an iota of common sense including masking, social distancing, avoiding crowds of unmasked individuals, and believe bizarrely that their personal liberty is worth far more than the people they are murdering through their twisted psyche. They see any attempt to control this pandemic as an affront to their freedoms, everyone else be damned. They are not selfish for not wanting to be vaccinated- they are selfish for not employing the corollary to lack of vaccination- protecting others through well described health measures. A pandemic with the "me first and only" attitude of Americans is ultimately causing massive disease spread. Why don't you open your eyes to the realities of what is happening on the ground. Physicians and nurses speaking at school board meetings are being attacked and threatened because of rednecks. The polyannish "you do you and I'll do me" coupled with paranoia of the CDC and the many researchers that have spent more than a year and billions of dollars researching COVID so that people who don't trust them can survive this pandemic, is not helpful- it is harmful.

 

[vector2]

Minus the last paragraph, I think you make some good points. However (in)correct they are, I have to imagine this is a driving force for a lot of people. Doesn't make them right, but people aren't all refraining just because they're idiots (though that may be true for many). In our tumultuous world I'm sure that many don't know who/what to believe. Then they get on Facebook where all the people they interact with and follow think the same way as them, so there are some dissenters and their bad ideas get reinforced over and over again.

Idiot is a strong word, but ultimately the hesitancy in many people can be traced back to the notion that they simply don't know what "knowledge" is or how to determine whether something is a fact or not. And ultimately that stems from how piss poor our educational system is for the vast majority of people who matriculate past high school. When the average person has a science class, they think it's about regurgitating tidbits about eukaryotes or cumulonimbus clouds, but they never learn the philosophy of science or the basics of epistemology or why the scientific method works. The byproduct of this is that you end up with a human being who doesn't understand why some things are more true than others, and thus it's easy for them to come to the conclusion that expert (peer-reviewed) scientific consensus on a topic carries the same weight as the opinion of some jerkoff on facebook.