And they come with no warning,
nature loves her little surprises.
Continual crisis!

Tuesday, September 5, 2017

Linkee-poo, Monday, Tuesday (wait, that ain't right)

Again, go with "what would a racist and misogynistic president do" and Trump will go that way. Every. Single. Time.

Irma is already a Category 5 Hurricane. That's all the scale goes up to, and she's still strengthening (but will weaken by the time she makes it to Florida, but if she goes into the Gulf, she may revive her strength).

Replacing radiologists with AI. "In health care, you could say radiologists have typically had a pretty sweet deal. They make, on average, around $400,000 a year — nearly double what a family doctor makes — and often have less grueling hours. But if you talk with radiologists in training at the University of California, San Francisco, it quickly becomes clear that the once-certain golden path is no longer so secure." Okay, let's clear up some misperceptions in this article. First, radiologist spend 13-15 years in post-secondary education and residencies (longer than any other medical speciality - Edit Janiece reminds me some specialties are as long or longer /), so they don't start earning that until they're 31+ (and heavily in debt - 13 years of school will do that to you). So, yeah, they make a lot of money (I'm not saying they aren't rich, but let's put that number in perspective). Also, you may think that your doctor is going too fast for only spending 15 minutes with you. Radiologists will spend 2-5 minutes reviewing and dictating an exam (those thousand of images take a little longer, but if a viewing takes more than 15 minutes even with those thousand images, something is wrong and the radiologist may receive a report for moving too slowly). During that time the radiologist will look at the images in different "windows" (contrast and brightness settings), so even if it's a 2 view chest x-ray, they'll review each image in at least 3 different windows. For that 2-5 minutes, radiologist reports change the course of people's lives. Radiologists are often sued (for missing something that should have been an incidental finding, or for misdiagnosis). Now, AI will be able to do a lot of the work (there's a position I looked at call a "Radiologist Assistant", think Physician's Assistant but for radiology - yeah, that position will go away), but nobody is the same on the inside. X-rays aren't all the same, there are subtle differences that can obscure pathology even if you're only 1-2 degrees off (even less with skull x-rays). AI can take away much of the routine work, and even may help with incidental findings (#1 most missed diagnosis, pancreatic cancer, because it's hard to see, and if that's not the initial suspected diagnosis it's easy to miss). Machine learning is great, it can spot lots of patterns and discern patterns we can't even see, but it's not so great at variety of patterns or knowing when to ask more questions.

"Automatic speech seems to originate in structures in the right hemisphere of the brain, whereas Wernicke’s and Broca’s areas are on the left." So cursing isn't a part of the "normal" language centers. Hmm, make me wonder if a lot of animal vocalization is actual cursing? Not mentioned in this article on What the F: What Swearing Reveals About Our Language, Our Brains, and Ourselves by Benjamin Bergen is that cursing can actually lessen our perceived levels of stress and pain. This is why I've encouraged some patients to swear (some people swear and then apologize profusely, my most common response is, "Darling, some of my friends are Senior Chiefs in the Navy, that wasn't swearing, try again but do it better"). (Grokked from Dan)

Continuing the cult of conservative victimization, "A company that publishes books by Laura Ingraham, Mark Levin, Ann Coulter and other conservative authors says it wants nothing to do anymore with The New York Times and its best-seller list." And the villagers rejoiced… Yeah, I don't think the NYT bestseller list is an opt-in/opt-out kinda list. "'I ask you to consider this: We are often told it’s foolish to bite the hand that feeds you,' Marji Ross, president and publisher of Regnery, said in a letter to its authors. 'I say it’s just as foolish to feed the hand that bites you.'" I'm sure that sounded much better in your head, Marji Ross. (Grokked from John Scalzi)

Remember when I said that Congress already has a lot to do, and if the President ends DACA with a 6 month window for Congress to act that means DACA is dead because Congress won't be able to get to it? Well, here's a short run down of everything Congress needs to do before the end of the month. Expect a CR bill to keep the government running until December (maybe even February), expect some delaying action on the other bills (like 3 month or a 1 year extension "as is"). But even doing that will take up all their time. And as we all know, the GOP can't walk and chew gum at the same time. Oh, and lest we forget, they also need to investigate Russian meddling in the 2016 elections and probably rehash the Clinton Emails and Benghazi time sinks.


Janiece said...

Interesting - I did not realize radiologists' schooling was comparable in length to a neurosurgeon's.

Steve Buchheit said...

Hey Janiece, some neurosurgeons go longer, but the majority of that is their residency. For radiologist (IIRC), they have to complete 1 year of a general residency after general medical school before they can start their radiology certificate program and residency. Radiologist also have "internships" before their radiology residency. Mostly it's because radiologists have to have knowledge comparable to several specialities to correctly diagnose patients. Although lately I've run into radiologists who "specialize". While mammography has been a distinct specialty since the 90s, I just had an issue where one of our radiologists was an "abdominal only" radiologist (serious side-eye there). Most of the ones I work directly with look at everything from x-rays, to CTs, to MRIs, to Mamms, to sonography and look at all parts of anatomy (note here, not all CTs/MRIs are the same, some have very different protocols and techniques depending on the disease being screened - such as we have 3 different ways to scan your liver). And then there's the additional complication of those who do interventional procedures (contrast injection, CT guided surgery/drainage, bone biopsies, etc).