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posted 1 year ago by canada_is_communist 1 year ago by canada_is_communist +98 / -0
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– Benevolentdictator 4 points 1 year ago +4 / -0

Numbness is a pretty useless bedside self-reported symptom at this point because it's way overreported and pretty much impossible to objectively prove with the tools available most of the time.

Complete paralysis is a medical emergency and is easier to assess at the bedside on physical exam. The problem is that complete sudden paralysis is also exceedingly rare. What most people describe as "paralysis" is actual muscle weakness with preserved function. Which like above, is way overreported and a nothingburger to investigate usually even if you could.

Peripheral cyanosis (limbs turning blue) is more of an objective clinical sign than a self-reported one. But also is one that people tend to exaggerate.

Having cyanosis in all 4 limbs is a systemic issue varying from nothing to something.

Having localized peripheral cyanosis limited to one limb is probably more significant. But again it's only a small clue in context that's hard to investigate unless you have other compelling factors that make you want to go down the rabbit hole as an investigator (pain out of proportion, complete inability to feel peripheral pulses whatsoever, VERY sluggish capillary refill, extreme pain with passive extension of some of the muscles in specific compartments, etc).

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– deleted 4 points 1 year ago +4 / -0
▲ 3 ▼
– Ender910 3 points 1 year ago +3 / -0

And in the case of both ER and GP situations, patients are handled with a triage mentality.

In the case of an ER I suppose it can be a "little" more understandable, but with GP's it's less about time/manpower constraints and instead seems like it has more to do with keeping on friendly terms with insurance companies (costs, etc). Since they have to justify anything they do to insurance companies.

It's honestly a fucking joke. In a big book full of horrible jokes.

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▲ 5 ▼
– deleted 5 points 1 year ago +5 / -0
▲ 2 ▼
– Benevolentdictator 2 points 1 year ago +2 / -0

Your first half definitely describes a lot of the reality.

But another huge factor as I mentioned elsewhere in the thread is that the "universal healthcare" model in Toronto where the OP talks about maxes out at about a $35 dollar cap that the government will pay out to a GP for a visit.

So the GP can't set their prices for the value of their labour or to keep pace with rising CoL, inflation, overhead, etc. The only way they can make the numbers work is to increase patient volumes and continually shorten visits and quality.

In general, they can't even hire more staff to streamline things because staffing only adds salary costs while the rate-limiting step is the doctor's face-to-face time (at $35 a pop and the government will only pay out for physician one-on-one time, not those of extenders).

This is on top of ever increasing liability, more & more diversity with non one speaking English, more forms, paperwork & more BS non-medical demands, more automated requests from the pharmacy, the lab, the patient portal (all unpaid but more liability), longer wait times to see specialists, more BS astroturfed campaigns from your betters such as screening for poverty, for DV, for guns in the home, for new cancer screening, new STI screening, pushing the new jab, screening for the latest Public Health scare disease, screening for early childhood developmental problems, etc.

The heartless, entrepreneurial shitbags thrive off the high volume by being reductionist, ruthless & pushing whatever is The Current Thing and new Big Pharma New Product.

Anyone with any introspection or qualms quickly gets crushed by the Leviathan and either finds a small niche to fill to get off the conveyor belt or burns out.

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