Hey at least it’s interesting to watch an empire crumble, right? Right?

Generally the hospital has checks and balances to prevent fraudulent billing (well not in this case, apparently).

My bigger issue with the RVU system is how it promotes sub sub specialization into procedure based specialties which are the antithesis of preventative medicine. The system valuee family medicine doctors the least despite the massive shortage in their services (especially in rural communities).

So, the surgeon that fixes the broken hip gets paid more than the doctor that gets the bone density scan done and starts meds that support bone health. The cardiologist that opens up the blocked vessel gets more than the PCP who takes the time to counsel on athersclerotic cardiovascular disease and controls risk factors medically and with lifestyle.

I’m not saying the surgeon / proceduralist shouldn’t get paid more. I’m just saying that when your system incentivizes ‘wait for the problem to happen and then fix it’ you’re going to have some bad health outcomes.

Yea exactly! The user sets an interval and then the app sends a push notification saying ‘its been x hours since last feeding’ or diaper change etc. Ideally can choose ringtone, vibrate or of its just a regular notification and it would be available for specifically recurring activities (feeding, diaper change, sleeping and pumping).

Also an option to record in imperial units (ounces) would be great too!

It appears that the home screen doesn’t refresh upon adding an entry also. Have to toggle to a different view and come back for the timer and summary to refresh. Ideally it would update immediately.

Great app! Especially like the timer from last feeding, diaper etc. Would it be possible to institute an alarm / notification after a certain time [set by the user] as a sort of reminder tool?

I find that in many cases, if you actually click the link to find the sourced information, it’s not there. I’ve experienced this with nearly every LLM front-end platform.

I’m going to leave it at this: Doctors and lawyers know more about this than you or I do and it borders on conspiracy peddling to think that not saving a life is being done through simple negligence here.

That particular case needs to be fleshed out in court and may well be an anomaly but there’s a reason she is not the only one and the source of that is in the legislature.

EMTALA does not apply once the patient has been admitted to the hospital. It applies to ER care only.

There is no medicolegal standard for “life-threatening” That determination is, to a degree, subjective.

In many cases, a patient will come to the ER in a non life threatening clinical state and get sicker following admission. EMTALA no longer applies to these patients.

If, in retrospect, a doctor performs an abortion and its decided that the mother’s life was not at risk, they face a felony charge.

Per the Texas Supreme Court, exceptions apply only when death or serious physical impairment is imminent (which is probably too late to save the patient and have a good functional outcome, unfortunately)

The problem here is legislation. There is no medical error. Practitioners are making a risk-benefit assessment and choosing not to martyr themselves.

I feel that you’re not familiar with medical practice and are oversimplifying a very complex issue.

In this case, the legal issue is a felony and potentially life in prison.

EMTALA supercedes state law because it is federal law. This is standard legal doctrine.

Texas disagrees. Please see above source.

Nobody has been prosecuted for performing an abortion since the Dobbs decision. Hundreds of abortions have happened in Missouri since Dobbs, and nobody has been prosecuted there.

No one’s going to risk their livelihood on precedent. While legal precedent is important, it doesn’t provide meaningful reassurance when the stakes are this high.

Do you have any specific examples of such cases?

Let’s leave aside that a surgeon cannot operate without the infrastructure a hospital makes available to them in most cases. OR space, equipment, scrub nurses etc. If hospital management decides the risk is too high, the surgeon/obstetrician’s hand are tied.

Let’s say that’s not an issue. Would you risk your career and livelihood in this scenario? It’s easy to talk a big game but the vast majority of people would not. I can’t blame them. I blame the legislators and those that elected them.

The HHS secretary can say whatever they want. It doesn’t mean they know how things will play out in court. Hospitals employ leagues of lawyers to assess legal risk/exposure and with criminal penalties on the table in all of the 14 states where abortion is banned, it appears that they’ve determined its better to pay the fine than have many of their doctors and nurses go to jail.

Which federal law are you referring to? EMTALA does not supersede state law, nor does it prevent the state from pursuing criminal charges for abortion.

It’s unrealistic to expect a significant number of doctors to throw away their livelihoods and go to prison to prove a legal threat. Doctors are being advised by risk management divisions of the hospital to not even consider abortions in these cases (in certain states) because it means saying goodbye to your practice, your savings, and your family.

Texas successfully challenged EMTALA's application to abortion cases through a lawsuit in 2022. The 5th Circuit Court ruled that EMTALA does not mandate abortion care or override state law. Texas became the only state exempt from federal emergency care requirements for pregnant patients. Under Texas law, abortion is only permitted for "risk of death" rather than EMTALA's broader "serious jeopardy" to health standard

Tuesday’s ruling, authored by Judge Kurt D. Engelhardt, said the court “decline[d] to expand the scope of EMTALA.”

“We agree with the district court that EMTALA does not provide an unqualified right for the pregnant mother to abort her child,” Englehardt wrote. “EMTALA does not mandate medical treatments, let alone abortion care, nor does it preempt Texas law.”

https://www.texastribune.org/2024/01/02/texas-abortion-fifth-circuit/

It wasn’t just getting sued. Your healthcare provider would face a class B felony and likely revocation of their license prior to amendment 3 passing.

Missouri faces the nation's fourth-largest shortage of healthcare professionals, with 111 of 114 counties designated as health professional shortage areas. The state projects a deficit of 3,102 doctors by 2030, including 687 primary care providers. Hospital staffing remains strained, with a 17.4% vacancy rate for registered nurses, representing 6,982 unfilled positions. The crisis is compounded by Missouri exporting one-third of medical students to out-of-state residency programs.

It’s not good business for a portion of your workforce to end up in prison when you’re already in a shortage area.

That’s a misinterpretation of EMTALA and the words of the HHS secretary.

They didn’t say that they would protect providers who perform abortions. They said they would seek civil punishment for those that do not. That’s very different from providing protection.

See my comment above for more details.

This is not a medical error. EMTALA is not a protective law for healthcare facilities or professionals. The state can still prosecute based on their own laws, and in Texas, for example, performing an abortion can come with a lifetime sentence.

From the medical provider and hospitals standpoint, you are now stuck between a rock and a hard place. Perform an abortion and face criminal charges from the state or refrain and face civil charges from the fed.

If you had the choice to face a criminal charge (prison sentence) or a civil charge (fine), which would you pick?

Texas law imposes severe criminal penalties for performing abortions. Medical professionals who perform abortions face first-degree felony charges punishable by five years to life in prison if the procedure results in fetal death. Attempting or inducing an abortion is a second-degree felony, carrying two to 20 years imprisonment. Additionally, providers face minimum civil penalties of $100,000 per violation and mandatory revocation of their medical license.

80% white. 40% with a high school education or less.

In 2022, over 100 anti-vaccination protesters rallied at the state Capitol against health director Donald Kauerauf’s confirmation, despite his opposition to mask and vaccine mandates. Protesters displayed signs reading “God-given natural immunity” and “We’re not guinea pigs.”

In 2024, House Bill 1424 was introduced to prohibit COVID-19 vaccination requirements for transportation access. Missouri Senators Josh Hawley and Eric Schmitt co-sponsored federal legislation to ban mask mandates through 2024.

The state as a whole gives a certain vibe…

There’s a reason they’re so threatened by words like equity and inclusion. When the culture of your ancestors was based on exclusionary hierarchies it can be very hard to embrace all people as equal, even if that is a fabled part of the American ethos (on paper, not in practice).

https://streamable.com/36e2vk

Can I access it via Eternity app? Is it basically another instance?

There are definitely some doctors that are susceptible to this (especially surgeons) but it’s worth pointing out that there are relatively few doctors in the billionaire class and doctors in general have not brought upon societal decay in the way that techbros have.

Most doctors spend their career simply treating patients under some type of corporate or insurance owned overlord.