> Gusband’s BP is garbage. Any ideas?
Maybe, but I'd have to know a bit more about his medical situation. Let me know if you'd like me to review his chart.
Email: 7rrpprjc5y@snkmail.com

> My girl left me for Chad Thunderfuck.
Bruh.

Medicare criteria for Hospice is basically 6 months life expectancy, or less:
https://www.medicare.gov/coverage/hospice-care

No requirement regarding whether or not you have a cardiologist. However, if this is going through a payer other than Medicare, then the criteria might be different. There might also be some in-house referral criteria being used by his primary care provider.
Some kinds of end-stage cardiac patients can fall into the situation where they amaze everyone by hanging on for years and years of 6-month hospice renewals, and this had lead to some crack-down on hospice being used to provide care for patients who are maybe not truly terminal.

Yup, I'm on Oahu.

It worked out well, Hawaii turned out to be one of the best possible places I could have ended up working at. The state and its people have really been quite responsible and diligent in keeping the pandemic under control -- mostly.

I'm doing fine, signed up for this temp agency job with a hospital in Hawaii, for a contract that was supposed to be 6-months long. That was in March of 2020, right before the world exploded. I'm still here, although hopefully not for that much longer.

Halloween, when the dead visit the living.

Braaaaiiiiiiinnnnnsss....

There are not that many primary care doctors that can manage to deliver personalized care in a modern "retail medicine" environment.

For those that insist on trying, many burn out -- as one of my co-workers just did about two months ago. She was a very dedicated family medicine doc who I respected a great deal. She knew all her patients in detail, even the most complex ones. Actually, I should say ESPECIALLY the most complex ones. I've inherited about half her patients, and her finely detailed patient narratives are a marvel to behold. Back when I first started, I didn't see how it was possible for her to keep up with everything, and in the end it seems she couldn't -- by the time she departed, it was common for her to be 1-2 hours behind schedule by the end of the day, every day.

Now, the highly efficient docs in the group? The ones who never catch grief from impatient parents in the waiting room, or from the administration wanting the late paperwork completed yesterday? Most of them produce the most disorganized pieces of crap, relying on the EMR to produce a perfectly bill-able but completely gibberish mess of auto-generated text, created from check-boxes and drop-downs. I've too often seen patient records where anything not auto-generated was simply strings of the same note cut-and-pasted with barely anything updated. Patient walks in, they do a quick exam based entirely on pattern-recognition, then slap the patient into a template.

Your best bet for an medical experience with a personal touch? Well, there are "Concierge Medicine" doctors, who will give that sort of treatment, at a high price. To find someone who takes ordinary insurance though, you'll have to do a lot of searching to find someone not too ambitious, not too well advertised, practicing in some niche that's sheltered enough to allow that un-optimized style to survive.

And oh yes, I turned in my 90-day resignation notice already as well. I'm quitting too.

Shit. I was giving a patient a referral to a urologist and didn't quite manage to suppress a giggle when I said "Dr. Whang".

What happens if the final is Clara vs. Clara?
This outcome is reserved for the "secret hidden evil twin sister" scenario.