It's no secret that r/medicine has experienced an uptick of traffic and rule-breaking comments since the inauguration. This is a trend that we expect to continue for the next several years, and our current capacity as moderators is being tested. As such, we are asking anybody who's interested in lending a hand to kindly apply for consideration. We are specifically looking for individuals who have a longstanding history of positive contributions to our subreddit. As r/medicine is a very niche community and a highly curated space, lurkers or alt accounts will not be considered at this time. We do ask that all applicants hold some position in healthcare. Physicians preferred, but allied health individuals are also welcome to apply.

Unlike other subreddits, we do not require our moderators to perform a minimum number of actions per week. Our mods are empowered to make decisions independently rather than parley with the team beforehand. No prior moderation experience is necessary, but the ability to remain dispassionate in the face of offensive content and insults from angry users is a must.

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About two weeks ago the WH administration froze all NIH communications.

https://www.science.org/content/article/trump-hits-nih-devastating-freezes-meetings-travel-communications-and-hiring

It's been two weeks since then. What's been going on since then?

This is the emotional (positive ending) first-hand account of a US Army Special Operations Trauma Surgeon who survived a 22 patient Mass Casualty event when his chinook helicopter was ripped in half on decent in the middle of nowhere on a recent deployment. He also talks about his mental health recovery journey after his physical injuries were addressed. (Free) PFC Podcast 215: Surviving Chaos: The Amazing Firsthand Account of Special Operations Trauma Surgeon Max Sirkin on Narrowly Surviving a Chinook Helicopter Crash – ProlongedFieldCare.org

There is also an account from the ER Doc, Schaffrinna, who helped to treat him on the SOMed website. (Also Free to view) Special Operations Medical Association: Helicopter Crash MASCAL of Surgical Team Resulting in Prolonged Critical Care CASEVAC - A Medical Review

A couple acronyms and jargon:

Monkey tail/monkey harness = strap that connects the wearers belt to the floor of the helicopter

Hesco barrier = giant temporary square basket container filled with rocks and dirt to create a barrier

SOMA = Special Operations Medical Association conference where he first relayed this story

Role 2 = US military Surgical Team

I work in a large, not-for-profit corporate hospital in which many administrative decisions regarding local care and support are made offsite. The decisions, discussed between committees meeting over video chat, effect aspects such as staffing ratios, clinical team, size and growth of clinical teams, compensation, benefits. Many times, feedback is gathered from the local sites by administrators via digital media, which in turn is shared with separate corporate committees, also via digital meetings. These committees make decisions, which are communicated to leaders, which are then communicated to the local teams. The communication has not seemed limited by egos, personal vendettas, maliciousness, etc... it simply seems those making decisions do not hear or feel the entire message about environments in which they do not set foot. This poses a problem with departments which are barely (or almost) staffed, need growth, need improvements on approaches to growth. But on paper, spreadsheets look green, accreditation is help, random awards are won, so many in the administration think physicians are happy. All of this leads to a growing feeling of not being heard, not feeling valued, and a lack of control.

Many have written and published about lack of control: KevinMD contributing piece from 2022 which also cites a Mayo clinic piece by their CEO about executive leadership and physician well-being, Medscape survey from 2024, AMA survey published in 2024, and more.

All the while, insurance companies continue their shit so doctors, for fiscal survival, have needed to latch onto large corporate systems. Administrators in corporate point to this and small amounts of progress, comparing with smaller hospital closures, fiscal instability, and other volatile aspects of medicine, to convince us corporate medicine is a stable place to earn a wage.

So, Meddit, how do we attendings strike this balance? How do we communicate issues in a way we feel heard over video chat with people who do not work in our facilities? As we are the experts, how do we get others to "listen to the experts"?

Or do we give up the idea that our voices could make a difference? This seems unimaginable for me and many others who eagerly (ignorantly) entered medicine to "make a difference". Planning for a retirement decades away does not help in the present moment. Lastly, not all of us have the flexibility to change jobs, further adding to the feeling of helplessness.

Alright, Louisiana folks! One last chance to call Sen. Bill Cassidy's office today ahead of Tuesday's committee vote on RFK Jr. Cassidy could single-handedly derail the nomination of by voting NO in committee. If Cassidy votes no he doesn’t even make it to the floor. Senate Majority Leader John Thune can still bring RFK, Jr. up for a vote in the full Senate but 60 votes would be needed for cloture on a resolution discharging the committee from consideration of his nomination.

Call his DC office Phone: (202)-224-5824

Or his Baton Rouge Phone: (225)-929-7711

Email: cassidy.senate.gov -> "contact" -> "get in touch"

Cassidy’s chief of staff’s email address is: james_quinn@cassidy.senate.gov !

If you've called already, call again, and recruit a friend to do the same!

Good reasons to be cynical, but could prevent an awful lot of harm.

Also you can call these Rep Senators and ask them not to confirm RFK Jr!

Mitch McConnell: 202-224-2541

Susan Collins: 202-224-2523

Lisa Murkowski: 202-224-6665

TLDR: Hoping to hear from providers who answered positively on background questions for credentialing or licensures (criminal history, malpractice claims, investigations or disciplinary action) and if they’ve experienced any major setbacks or barriers to practicing medicine. Reassurance or advice would be great! I know it depends on specifics so further details below.

Long story short, I am a newer provider (PA) who self reported info to my state Board regarding a initial misdemeanor speeding ticker that was later amended/reduced down to a traffic infraction. They opened an investigation, I lawyered up and responded, it was dismissed. Reassuringly, based on my state board’s re-licensure questions, I do not have to continually report this every few years. Unfortunately, looks like I do have to report this to my current practice’s credentialing office every re-credential cycle. There’s also a possibility I will want to move in the future, and based on the lingo of each state’s licensure application, I may or may not need to report this information.

I’ve accepted that this as something that will follow me for the rest of my healthcare career and something I will continue to grow from and own up, more importantly something I’ll always be honest about. I was hoping to hear from those who have been in similar boats about if they’ve experienced any bumps or concerns with working in healthcare, maintain licensure, etc. moving forward? I’ve seen a few posts on providers with prior DUIs and that has been helpful and hopeful. I lumped in malpractice claims because I saw it on the re-credentialing background questions but am unsure if it’s similar situation.

My kid (11yo) had some lingering congestion from a respiratory virus, so I gave him (what I thought was) 30mg of Sudafed.

A few hours later he came to me, still congested and somewhat concerned that his urine was a dark orange color. For a moment I thought I had destroyed his kidneys somehow, but after looking in the toilet, I quickly figured out what happened.

Somehow we had put a blister pack of phenazopyridine in with the Sudafed, and I had given him one of the remarkably-similar tablets.

I felt like a terrible parent and doctor, but, of course, he was fine. Now it is just another funny childhood story.

Medical errors can be deadly but also hilarious under the right circumstances.

Has anyone else’s ER made stroke into the next sepsis CMS mandated train wreck? Now every altered mention or dizzy or isolated vision changes or generalized weakness is a stroke alert diverting considerable resources to patients that are actually sick. numerous times a shift alerts being called from waiting room and patients go directly for CTH CTA CT perfusion and prioritized back for nothing resembling a CVA.

Has any health system pushed back? Someone educate me why we let CMS make rules?

One of my colleagues went to the CDC website today to print information on the TDAP vaccine in pregnancy for a patient, but the information, like so much else, is gone. UptoDate's patient information wasn't very detailed. Anyone have preferred patient handout on TDAP in pregnancy or the archived info? I'm working through some archives right now and found the VIS, but not pregnancy specific info. Thanks.

Women physicians make up over 30% of the physician workforce, yet account for 72% of physician assistants and 82% of nurse practitioners. Women physicians DO NOT GET SHORTCUTS — there are no part-time, online, or "flexible" programs for physicians. Women Physicians must complete and excel in at least 11+ years of rigorous training (4 college, 4 med school, 3+ residency), 80+ hour workweeks, and often make personal sacrifices, like delaying family planning.

Despite these challenges, women physicians achieve remarkable outcomes, spend more time with patients, and focus deeply on preventive care. Yet, we still face pay gaps, role conflicts, and the undervaluation of our expertise.

Let’s honor the grit, determination, and excellence of women physicians today. They do it because every patient deserves the best care.

Say thanks to a woman physician who inspires you and show your appreciation!

Link: https://www.instagram.com/p/DFlR1CrJ688/?img_index=3&igsh=MWFnYjJ2YjQ5dXZ6bw== Context : you can see from her initial post that the request of an inpatient stay was not an error. But if insurance is going after people saying they suck on social media, that’s gonna be a lot of people to sue 😳

Since a lot of medical equipment and medicines are produced by or use parts from non-US companies, curious about how a trade war affects us.

So - the hospital I work at has these nifty things - "purwicks" (they have a lot of fun slang names), which basically vacuum urine into a suction cannister. Shortly after adopting these, we've noticed an increase of pressure injuries to the peri-urethral area.

So, the hospitals have been trying to decrease damage from falls, and one of the ways to do that is to minimize the height of the bed, right? Unfortunately; they have not simultaneously lowered the height of the suction cannister. Today, I measured the difference and found they're almost a meter and a half apart at the facility that presently employs me.

As a reminder, 150cm h2o is equal to 110mmHg. So - to get any liquid from the bed to the cannister, the vacuum has to be at least 110mmHg! Overcoming other resistances raises this requirement even further! For comparison, the purwick brand we use has a recommended pressure of 40-60 mmHg.

Anyways- I wanted to ask: where do y'all keep y'all's suction cannister to avoid the sequelae of the physical requirements of the suction required to evacuate fluids (well, really liquids, cause even though air flows we never mean air when we say fluid) from the places we don't want them cause they cause other badness by being there (e.g. uti and iad and whatever other three letter abbreviation that's in vogue)

Tl-dr: save a dick, drop your suction cannister

(Ps- surgeons, should we also drop the cannister to evacuate ng juice?)

(Pps- can we switch to damn unit of pressure? And just have it be cmh2o for everything? Seriously it's not like units are that different)

Signed a 2 year contract. It's been about a year. Contract states I need to give a 90 day notice before quitting, but I am only eligible to give such notice after working for 1 year and 9 months. The contract states that I will have to pay back a prorated amount of my signing bonus and would lose my 401k match if I leave before 2 years. It doesn't say what else would happen if I quit early. I would be ok with giving notice and staying another 90 days but don't wanna be here another year. There is no non-compete in the contract. Would there be any harm in asking to leave early? Would it cause tension if they say no? If I left early, would there be any consequences?

The Wyoming GOP, in order to get around a court ruling, is pushing through a legal definition of healthcare that would, and I shit you not, render chemo, radiation, surgery, etc. NOT healthcare.

"Steinmetz says Senate File 125 offers a new definition of healthcare in Wyoming: “No act, treatment or procedure that causes harm to the heart, respiratory system, central nervous system, brain, skeletal system, jointed or muscled appendages or organ function shall be construed as healthcare.”

https://www.theguardian.com/us-news/2025/feb/02/wyoming-republicans-anti-abortion-bill

I'm considering taking up drinking at this point. 🤯

I don't practice OB/GYN but given the pace of what the Trump Administration is doing and rapidly disappearing/ changing information, I figure I'd better download some guidelines while they are still up just in case. Some places I've visited - like ACOG - has the information behind a paywall. Thanks!

(Reddit won't let me change the title post. What I meant is not language of guidelines but concrete information about medical abortions.)

Good morning r/medicine,

I'm sure most of you are aware of the recent scrubbing of CDC data. I've been working for the past few days over on r/DataHoarder to upload a full backup of the datasets from data.cdc.gov I took on January 28th, before anything was scrubbed. That upload is now complete, and accessible from the Internet Archive at https://archive.org/details/20250128-cdc-datasets. It should contain all public datasets that were available on that date, along with most of their metadata and attachments.

If you've got any questions or notice any issues with the archive, please let me know and I'd be happy to help. Additionally, if you or someone you know is familiar with the process of torrenting, you can use the information in this post to help seed this data, to provide decentralized hosting.

Thank you, and stay safe out there.

https://www.usnews.com/news/world/articles/2025-02-01/us-spells-out-life-saving-hiv-treatment-that-can-continue-during-aid-pause

"So on Saturday the State Department's Bureau of Global Health Security and Diplomacy issued a memo, seen by Reuters, clarifying that PEPFAR was covered by the Jan. 28 memo and spelling out what activities were allowed.

These include: life-saving HIV care and treatment services, including testing and counseling, prevention and treatment of infections including tuberculosis (TB), laboratory services, and procurement and supply chain for commodities/medicines. It also allows prevention of mother-to-child transmission services.

"Any other activities not specifically mentioned in this guidance may not be resumed without express approval," it said. "

By that definition all HIV treatment are life-saving because getting onto ART reduces mortality. If they're looking to prevent TB then PrEP should also be covered. Overall still very vague which effectively lets us do the same as we did under Biden

https://apnews.com/article/hyperbaric-chamber-explosion-boy-killed-michigan-80dc89d7b48bd1119640934e06a43d4a

A tragic and horrifying event. Why the boy was undergoing hyperbaric oxygen therapy was not released, but this is a functional medicine clinic which advertises the use of hyperbaric oxygen therapy for conditions from ADHD to diabetes, “normal aging and wellness”, and hyperlipidemia.

https://theoxfordcenter.com/conditions/add-adhd/

https://theoxfordcenter.com/therapies/hyperbaric-oxygen-therapy/

Just when you think this administration couldn't get any more horrible or absurd when it comes to science & healthcare, Jeremy Faust has just posted the following claim over on his substack, Inside Medicine (https://insidemedicine.substack.com/p/breaking-news-cdc-orders-mass-retraction?r=5p3cr&utm_campaign=post&utm_medium=web&triedRedirect=true):

"...The CDC has instructed its scientists to retract or pause the publication of any research manuscript being considered by any medical or scientific journal, not merely its own internal periodicals, Inside Medicine has learned. The move aims to ensure that no “forbidden terms” appear in the work. The policy includes manuscripts that are in the revision stages at journal (but not officially accepted) and those already accepted for publication but not yet live.

In the order, CDC researchers were instructed to remove references to or mentions of a list of forbidden terms: “Gender, transgender, pregnant person, pregnant people, LGBT, transsexual, non-binary, nonbinary, assigned male at birth, assigned female at birth, biologically male, biologically female,” according to an email sent to CDC employees."

How long until Trump's NIH scrubs papers or entire journals from PubMed because they contradict his "anti-woke" agenda?

CNN article regarding announcement of tariffs:

https://www.cnn.com/politics/live-news/trump-tariff-presidency-news-02-01-25/index.html ("live" article, ref heading "Trump signs new tariffs on 3 biggest US trade partners")

"White House press secretary Karoline Leavitt previewed the tariffs during a Friday briefing for reporters — saying they would amount to a 25% duty on Mexico and Canada and a 10% tariff on China “for illegal fentanyl they have sourced and allowed to distribute into our country, which has killed tens of millions of Americans.”

I have just about had it. The press secretary for the United States of America just claimed "illegal fentanyl" has killed about as many people as TWO HOLOCAUSTS. "Tens of millions" is at least 20 million. So, how many people has it actually killed? See for yourself, but it's off by about a factor of 50x.

https://nida.nih.gov/sites/default/files/images/fig2-2024.jpg

This is blatant, explicit dissemination of WILDLY false public health information like I've never seen before in my lifetime.

Since so much about public health is under attack in the US right now, I just want to shine a quick spotlight on Newborn Screenings! Today I admitted a baby whose life was probably saved by the NBS. It detected a condition for which he had no symptoms, and the NBS folks were able to collaborate with doctors to contact the family, get the baby into the hospital, and already on proper management for the condition. The baby had no clinical symptoms but labwork was very clear that this baby would have become critically ill at any moment had he not been admitted. Without the Newborn Screening and public health providers, this baby would not have been brought to a hospital until he was possibly past the point of saving. So, thanks everyone who works to make these systems function, and fuck you to anyone trying to interfere (at a local, state, or federal level). If this isn't allowed here, apologies!

https://www.usnews.com/news/health-news/articles/2025-01-30/sen-bill-cassidy-grapples-with-gop-loyalty-and-medical-views-in-hearing-with-rfk-jr

Sen. Cassidy, a gastroenterologist Republican senator representing Louisiana who also voted to convict Trump in 2021 but up for election 2026, could turn out to be the swing vote for RFK Jr.'s confirmation. The Louisiana GOP want Cassidy to vote for RFK Jr, but Cassidy also gets a lot of calls highlighting his physician background to not confirm RFK Jr, especially.

The AAFP leadership clearly voted for Trump, and that fact in isolation is not the biggest issue. The biggest issue is that they are silent on the attacks on public health this administration has launched in just one short week, opting instead to opine that executive actions are normal and every president does them and they will be overturned if inappropriate. No condemnation of the removal of cdc clinical practice guidelines for hiv and sti treatment/ prevention and call to restore this data. No call to preserve accuracy in publications in the service of ideology. Removing any mention of transgender people when they clearly exist is gender ideology. No condemnation of the disruption to federally funded health services and research. No condemnation of suppressing federal research that was previously available. The AAFP is signaling to the White House that it is perfectly acceptable to censor scientific data and medical literature, that politics and ideology trump reason and facts. I might not renew my membership.

The Cybersecurity and Infrastructure Security Agency (CISA) has issued a warning about a backdoor embedded in the firmware of the Contec CMS8000, a patient monitor used in U.S. healthcare facilities.

The Contec CMS8000 is manufactured by Contec Medical Systems, a China-based company supplying medical devices to hospitals and clinics worldwide, including the U.S. and the European Union. The device continuously monitors key patient vitals such as electrocardiograms, heart rate, blood oxygen levels, and blood pressure.

https://cyberinsider.com/contec-monitors-used-in-u-s-hospitals-carry-chinese-backdoor/

(Excuse me, NOT Scientology, the Citizens Commision on Human Rights, in case anyone is feeling litigious.)

Strolling through Hollywood on a beautiful day, I decided to check out the "Psychiatry: An Industry of Death Museum." I was greeted by some wonderfully solicitous docents who informed me that I may tour the exhibit for 5 minutes or several hours if I liked. They insisted I give my name, which I didn't, and before I stepped inside I asked to make sure I wasn't waiving anybody of anything. (There were warnings of graphic content.) Finally I entered...

First was a padded cell with a TV. The docent informed me several of the TVs had stopped working since the fires, so we'd skip this room.

Exhibited in the next room was the evolution of psychology, with special attention to its dark underbelly, from medieval torture to early Modern developments like the straight jacket and tranquilizer chair. Critical quotes from early pioneers like Wilhelm Wundt peppered the room, which I admit was my favorite in the tour.

The next room focused on psychopharmacology and the billions made by Xanax and Prozac and the like, implying a problematic relationship between Big Pharma and mental health treatment. There were cute retro ads for Adderall and Lexapro. I don't really have any notes at this point, but then things get problematic in the next room.

Boom we're full on in the Holocaust. There's a lot going on and I'm trying to tease out a solid connection, but all the jarring photographs make it hard to pay attention to the text arguments. Something about Hitler and undesirables. I rushed to the Gulag, feeling similarly that things had gone 0 to 100 real quick.

The next rooms are sort of a blur of all the troubles of humanity (school shootings, celebrity overdoses) interspersed with modern mummies for some reason. At one point I saw another person on the tour and I said hi. It was weird.

Finally there's a room on pseudoscience but I'm pretty drained by the last 10 minutes so I make for a quick exit but am intercepted. I let slip that I'm a nurse to which is replied "Oh we get more nurses than anyone in here." 🤦‍♂️ I bid my farewell.

Overall an interesting experience. Obviously it's pretty propagandistic to juxtapose the history of psychiatry with, you know, ALL THAT. I realized about halfway through that they don't want people to seek treatment for their problems, they want them to seek out the Organization. The docents were pleasantly trepidatious. The S-word was never mentioned. I probably shouldn't have hit the vape pen so hard before going in.

2/5 stars

I’m a 2nd-year MD/MPH student, and I just got an email from my epidemiology professor saying we’ll be using the Behavioral Risk Factor Surveillance System (BRFSS) datasets for an upcoming project. However, it was then followed up by a distressed email stating the data is now unavailable. This data, and other datasets, are being scrubbed from the CDC and other government websites right now.

This is a huge issue for public health research and education, and it's happening at a time when access to this kind of data is more critical than ever. Some folks, like /u/veryconsciouswater, are working to upload what they have to the Internet Archive, but this data shouldn’t be disappearing in the first place.

I wanted to flag this to the community because it could have major implications for research, education, and transparency in the public health field. If you're relying on this data, or if this is something that concerns you, please be aware of what's going on.

Do what you can to preserve as much as possible!

Edit #1 (1/31/2025): /r/publichealth and /r/DataHoarder subreddits are currently trying to archive things. If you have anything, please share!

Edit #2 (2/1/2025): Some people wanted more specifics and an ELI5.

● ELI5: The CDC used to have a bunch of data that scientists and doctors could look at to study diseases, like COVID-19, vaccines, and deaths. But recently, they removed or changed some of these datasets, making them harder to find or use.

Think of it like a big library where people go to read books about health. Public health professionals could correlate data between these 'books' to study trends, look at patterns, etc. This can guide future studies, policy decisions, and lets people know what is currently going on with population health.

For me, a student, I used to be able to download datasets in basically a large spreadsheet. I could then use statical software, like SAS or R, to look at data trends, make graphs, find p-values, odd ratios, etc. And now I can't.

These are the datasets that were publicly or semi-publicly available. I don't think anyone knows what is happening with the non-public data that the CDC and health departments collect.

● Specifics: Some examples of now missing datasets include (on mobile so hyperlinking these are hard, but they're a google away):

• Behavioral Risk Factor Surveillance System (BRFSS) CDC Data (website is down). BRFSS websites for some state websites are still up, but the data won't download. --- A nationwide survey that tracks health behaviors, chronic diseases, and preventive care use among adults.

• Youth Risk Behavior Surveillance System (YRBSS) (gives a "webpage not found error") --- A survey that monitors health behaviors in high school students, including drug use, mental health, and sexual health.

• Social Vulnerability Index (website is down) --- A tool used to identify communities most at risk from disasters, disease outbreaks, and other public health threats.

• Environmental Justice Index (website is down) --- A dataset that helps measure how environmental hazards disproportionately impact different communities, especially marginalized populations.

● Not datasets per se, but still valuable on a public health level that is going missing:

• Atlas Plus Tool (website is down) --- A platform providing data on HIV, viral hepatitis, STDs, and tuberculosis, with detailed information on various demographics, including LGBTQ+ populations

• Current STI Treatment Guidelines for medical providers --- A guideline that provided medical providers with up-to-date information on how to treat STIs.

• Numerous LGBTQ+ related webpages on federal websites are being scrubbed. Too many to link.

Final Edit (2/1/2025): Link to the data is ready Here!

I swear I am seeing this new trend of women ages 16-30 who are having multiple syncope episodes, legitimate tachycardia with standing, and all sorts of weird symptoms. I never see older women with these issues. Just younger women. Do we think there’s an anxiety component? Honestly I’m baffled by this trend and don’t know how to explain it. Anyone seeing similar stuff?

Apparently a medical transport plane crashed in Philadelphia.

https://www.cbsnews.com/amp/philadelphia/news/plane-crash-cottman-roosevelet/

What would be the consequences of bad ACGME survey results for a new program that previously has scored a little above the national average consistently? Would there be a difference in consequences in, for example, being 10% below the national mean vs 40% in a majority of categories? Would one survey trigger an investigation if bad enough? Would anything happen to the PD if the low survey results were solely due to the PD?