May 20, 2025
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Doctorbored
Public Teaching Hospitals v.s. Non teaching or private
From Doctored: Disillusionment of an American Physician. Could really be renamed, American Non-interventional cardiologist.
The difference between public teaching hospitals and non-teaching hospitals. Why we always say it’s better to be at teaching hospital and allow doctors of all levels (med students, residents and upwards) to be involved in patient care.
Image source
The evidence shows that patients treated for several common medical disorders, including heart failure, heart attack, and stroke, fare better at major teaching hospitals and have better overall survival.
One reason may simply be redundancy: residents and fellows may be annoying when you’re reciting the details of your fainting episode for the third time in the middle of the night—“So tell me, did you pass out before or after you hit the floor?”—but so many pairs of eyes on each patient mean things don’t get overlooked.
Eighty percent of medical diagnoses can probably be made on the basis of a patient’s history, and the more people asking, the more likely doctors are to get it right.
Another factor is the sheer number of patients treated at the average teaching hospital.
Patient mortality tends to drop as doctors get more experience. Would you rather have angioplasty performed by a cardiologist who does two hundred a year—or twenty?
We often joke attention spans wane the higher up you go. If I go to the ED to take a referral or check what the documentation was on presentation - the most detailed and painstakingly organized/comprehensively done ones are from interns. Terrified that they might miss something, or worse, piss off the department they’re referring to.
There’s a choice that can be made in the Australian system for public teaching hospital or private. I often hear shock and horror by my UK/European/Canadian counter parts that this could exist in Australia and not be the ‘horror’ show that the US’s privatized system is perceived to be.
Truth is, the private system is simply not a huge aspect to healthcare or as ‘developed’ as the public. It’s useful for elective things, or cases of less acuity.
Some private hospitals are jokingly called “medical hotels”, anyone truly sick will remain public or be sent there.
The lay public doesn’t always know this, but we do explain it. Some prefer it anyway for the veneer that they’re getting service. What they’re really after is customer service, someone on the phone at their beck and call is what they think, like 24/7 call centre access.
That’s oddly what it’s come down to nowadays for a select/minority of patient and their families. Customer service or the perception of it being more important to them than actual medical practice. I’ve had patient families explain to me or the nurses that their loved one needs a coffee or a glass of water more urgently than medications we’re trying to prescribe to actually save their lives or have important discussions on prognosis etc.
So I can see why some doctors are jaded by the profession. The way it’s been devalued into customer service really.
It’s not worth my time arguing particularly with the patient loads we have - so I normally give them what they want, settle them and then have those discussions. Often the anxiety to treat the small things are a sign of helplessness, a way of coping or masking what they’re not ready to accept. I learn to hide what I really feel, then forget that I have feelings at all and move on.
While I’m trained to death and decay, the laypublic is not, we don’t have a culture of accepting this as a natural part of life, somewhere along the way, as a society we’ve adopted a notion of must fix everything, must reverse aging etc.
This is unbelievable!
IG Report: FBI Doctored Evidence To Falsely Paint Carter Page As Russian Spy
The Department of Justice’s inspector general found that a top FBI lawyer blatantly doctored evidence to falsely smear Carter Page as a Russian spy. DECEMBER 9, 2019 By
Sean Davis and Mollie Hemingway
A wide-ranging investigation by the Department of Justice (DOJ) inspector general (IG) found that the Federal Bureau of Investigation (FBI) deliberately doctored evidence it presented to the nation’s top spy court in order to gain authority to spy on a key Trump affiliate.
The 476-page report from Department of Justice Inspector General Michael Horowitz found that the FBI falsely claimed to the FISA Court not only that Carter Page was a Russian agent, but also falsely claimed that an unnamed intelligence agency had told the FBI that Page was “not a source” in their efforts to surveil and curtail Russian intelligence efforts.
Page, who had previously been an informant and witness
for the United States in a federal espionage case against a Russian intelligence official
, was targeted by the Obama FBI as a Russian spy helping Putin to steal the election from Hillary Clinton in 2016. According to the IG report, before the FBI and DOJ went to the FISA Court to apply for a warrant to spy on Page, an unnamed U.S. intelligence agency had told the FBI that Carter Page had previously assisted that agency’s efforts against Russian spies. Although exculpatory information about potential spy targets is required in spy warrant applications, Obama’s FBI and DOJ deliberately withheld that information from the spy court in order to paint Page in the worst possible light.
The FBI’s malfeasance in the matter did not stop there. Ahead of an application to renew the spy warrant in 2017, a top FBI lawyer doctored evidence from the unnamed agency which confirmed that contrary to FBI claims that he was a Russian spy, Page had in fact assisted the United States in its efforts to counter Russian operations. An e-mail from the agency that clearly stated Page was “a source” for them was doctored by Kevin Clinesmith, a top FBI national security lawyer, to give the opposite impression to the federal spy court.
“The [Office of General Counsel] Attorney altered and sent the e-mail to a [supervisory special agent], who thereafter relied on it to swear out the third FISA application,” the IG report notes. Upon learning that a top FBI lawyer doctored evidence against a former Trump campaign affiliate to justify spying on him, the IG referred the attorney to DOJ for criminal prosecution.
Text messages from that same lawyer after the 2016 election revealed that he was an anti-Trump activist. “Viva la Resistance!” he texted on November 22, 2016, while in the midst of investigating Trump. He would later be terminated from the Mueller probe for conduct which a previous IG report said “brought discredit” to the FBI. Of FBI documents he approved authorizing spying on Trump campaign, Clinesmith wrote “[M]y god damned name is all over the legal documents investigating his staff.”
“[W]ho knows if that breaks to him what he is going to do,” Clinesmith continued, apparently worried about the ramifications of his illicit behavior against the Trump campaign. It is unclear whether he doctored evidence against Trump to protect his own career and reputation or simply because of anti-Trump animus. At the time, Clinesmith worked under James Baker, the FBI General Counsel who was a close confidant of fired former director James Comey. Baker was one of a slew of former deputies who resigned or were fired as the Russia collusion hoax imploded.
In his report, the Horowitz referred Clinesmith to DOJ authorities for criminal prosecution. Spanning more than 476 pages, the report cited countless examples of corruption and deceit committed by employees throughout the FBI and Department of Justice related to the Trump-Russia probe, confirming that the investigation against Trump was unusually aggressive, politically tainted, and bore no fruit. Despite its claims about Page being a traitorous Russian spy, the former Trump foreign policy affiliate was never charged with any wrongdoing since there was no evidence that he was working for the Russians.
A subsequent investigation by Robert Mueller similarly found zero evidence of treasonous collusion with Russia by Trump or his campaign to steal the 2016 election.
I suspect that it will keep getting worse for them as the night goes on. No wonder why MSM turned away from the Republican testimony to get ahead of this.
Thank you anon, 🥰
Eye-opening
Doctored Up Chocolate Cake Mix
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