Emergency Rooms refuse to treat pregnant women; one miscarried in lobby restroom

I don't understand this logic. I truly don't. Whether you like me or not, I'm an expert. I'm board certified in emegency medicine. I'm a medical director of a national insurance company. I am an expert of managed care (medicaid/medicare policy).

Again you might not like me, but there can't possibly be a person here that understands how healthcare works better than I do.

You just don't like my answers. I didn't make a system that incentivizes profit. I just work in it. Pays the bills.

I'll not engage in debate, but I will ask you to Google the dunning-kruger effect. Confidence is very high when knowledge is very low. That's the reason half my patients would tell me I'm wrong or explain some made up medicine to me works better than antibiotics.

Hell. I've only been doing this for less than a year in my current role and some of the bureaucracy is still overwhelming (and i think InterQual was made to punish). So how you know more than me is mysterious.

Do you support gender affirming care for trans children?

You just don't like my answers.

No. It's that your answers showed you were incapable of providing proper medical care to patients who came into your ER or office.

The board should strip your license if they ever heard about how you treated your patients the way you told us you did.

You shouldn't be managing anyone's care but your own. Maybe not even then.

Depends on how you define "support."

Personally, this feels like something that needs more research. The confounding psychiatric conditions I see on these patients make it difficult at times to assess. This is such a controversial area I won't say anything further beyond my wish more is known about etiology of gender dysphoria.

But if you mean "support" in terms of professional work, my opinion is irrelevant. I have very rigid guidelines to enforce. If I get a letter from their psych doc saying it's okay, I see good documentation of the gender dysphoria, continuous hormone therapy usage (depends on age), and a few other things I approve surgery.

The hardest requirement to meet is "exclusion of incongruency." This is hard to meet since it becomes a cart-before-the-horse phenomenon. Ie, I had a case where one doc documented a 14 year old wanted reassignment because she was angry at her parents. I don't know if that's true but I can't by policy approve if someone documents that.

These are pretty rare anyway but can involve over 100 pages of chart to review. Even one thing out of line like what I mentioned can derail the whole thing.

Same for any procedure, really. It's not a secret that insurance companies don't want to pay for things. Personally I think that's a part of the overall Healthcare problem but what do I know...

And I feel like I've derailed this topic enough so I'll step out.

Well thats a lot of words where no would suffice.

Dunning-kruger

A lot of words to just tell CSCA "no."

I wonder if he also needs to know more about the etiology of being gay

I don't understand this logic. I truly don't. Whether you like me or not, I'm an expert. I'm board certified in emegency medicine. I'm a medical director of a national insurance company. I am an expert of managed care (medicaid/medicare policy).

Again you might not like me, but there can't possibly be a person here that understands how healthcare works better than I do.

I've noticed something really interesting about the people who use that word term a lot.

I just learned that trans people in India were idolized for thousands of years until it became a British colony.

I didn't say "no."

But if you mean "support" in terms of professional work, my opinion is irrelevant.

If I get a letter from

Thats appeal to authority in action

Whether you like me or not, I'm an expert.

Depends on how you define "support."

User is not currently an active member.

Depends on how you define "active".

So well never see Nightingale back here on this board eh? Such a shame, truly. Not sure how well ever survive.

unless they get away with a warning somehow

I mean Roe v Wade being appealed massively blindsided me I didn't think anything like that would ever happen. I still strongly doubt something like gay marriage would be repealed and if it ever was I'd be just as surprised.

Yeah, no chance of that happening

Wait he's a fake doctor? Lmao! I gave him the benefit of doubt.

Had him tagged as fake too. Didn't say anything earlier because I wanted him to have the chance to prove himself.

The fact that he brough it up every time he posted was also pretty sus.

Wait he's a fake doctor?

there can't possibly be a person here that understands how healthcare works better than I do.

Confidence is very high when knowledge is very low.

Putting MD in his username clinched it. He was a gimmick poster, nothing more.