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Yeah, me too. My patients just never got insulin again after big pharma stopped those free meals.


I do agree that not having to sit through the sales pitches . . . that's a blessing. Being told by some sales guy with at best a BS and maybe an MBA about the "benefits" of drug X was usually pretty insulting. A few times I just told them to give me the damn product insert and shut up. :D
My wife used to like when the old guys would give a prep on a new drug. They knew what they were talking about and could answer questions or get the answer. When they replaced them with young attractive people she just stopped it all. They could only recite from scripts.
 
Well dang it, the sheer volume of @bkp_duke's BS is haunting me.
Oh - and my field - pediatric endocrinology - there are VERY VERY few patented medications. Almost everything we use has been out so long that the patents have long expired. 99% of the time in my specialty we were simply replacing the hormones that a patient's body was no longer making.
I do agree that not having to sit through the sales pitches . . . that's a blessing. Being told by some sales guy with at best a BS and maybe an MBA about the "benefits" of drug X was usually pretty insulting. A few times I just told them to give me the damn product insert and shut up. :D

So in your field (as if that negates all other medical fields), there are "VERY VERY few patented medications," just hormones "99% of the time." Yet somehow you heard so many new-drug sales pitches that you finally told them to shut up, and feel blessed to escape them.

There must a whole lotta hormones if only 1% of your medications caused such sales fatigue. And again, whatever the percentage in your field, the obvious fact is conventional doctors learn mostly meds supplied by Big Pharma, and Big Pharma thrives on patents.
 
just checked the app for my wendy's and it won't let me order any of these
  • chili
  • jr bacon (or any variation of jr burger)
  • dave single (and any variation of that)
the entire hamburger menu is not available, they have bacon for the chicken sandwiches (and all the chicken sandwiches) but no beef on the menu at all.

Word online is this is happening in most of the country.

Now it's on the news. haha

 
  • Informative
Reactions: madodel
Now it's on the news. haha


I posted that on Sunday I've been seeing Wendy's beef shortage stories on the news in several states since Monday, and national news Since Tuesday. I just didn't think anyone wanted me to post all the articles about it after I got so my funny ratings for that post.

Wendy's undergoing temporary supply shortages from wymt in Kentucky from last weekend is the earliest one I saw.
 
Ok, it's time to upgrade from the dumb-ass model to a smart-ass model. I've been playing around with the case data and have noticed that trends seem to be pointing to several millions of case. So I have integrated both case and deaths into a model. This is roughly a multivariate response variation on the univariate dumb-ass model. The model is regressing both case and death growth rates on log(cases) and log(deaths). This way both outcomes are pricking up information from both processes. I am also limiting this regression to the last 28 days to avoid the nonlinearities of the deeper historical series. This also means I am incorporating the suggestion of the 14-day rolling fit, but simply extending it back 2 more weeks.

The smart-ass model also yields ultimate deaths and counts. Some will object that this does not allow for a second wave. In a single projection that of course is true, but if say case growth were to start to grow into the start of second wave, the smart-ass model would start to pick up on that both for cases and deaths. In deed, examination of the coefficients shows that if cases were to grow faster deaths, that would increase the expected growth rates of both deaths and cases. So the inclusion of cases as a leading indicator of deaths is an advantage of the smart-ass model over the dumb-ass model.

So let's see the results as of today. The smart-ass model projects 2.5 million ultimate cases and 153k deaths. This is substantially more than the dumb-ass model and 14-days model are projecting, 90k and 105k ultimate deaths respectively. The difference seems to be the push from new cases which the smart-ass is able to register.

View attachment 539102

View attachment 539103


It makes little difference visually whether we plot growth rates on total cases or total deaths. Either way, smart-ass model projects that both rates converge to each other and ultimately to zero (at ultimate cases and ultimate deaths).

View attachment 539105

View attachment 539106



Smart-Ass Projections are brought to you by the makers of SolaBag. Let the sunshine in!
Yesterday the Smart-Ass Model was predicting 2.5M ultimate cases and 153k ultimate deaths. Today this has pulled back a little to 2.24M ultimate cases and 137k ultimate deaths.

Some thoughts on interpreting projections from this model. Obviously, these ultimate projections are going to bounce around quite a bit from day to data. The aim with this projections is track performance in real time. If the projections decrease, that suggests that epidemic may be turning more favorable. If the projections increase, that would suggest that the epidemic may be turning for the worse. In the Smart-Ass Model I use the last 28 days for the fit. So with each roll forward, the model picks up a pair of observations and loses a pair. Both pairs can influence the shift in fit and projections. Each day of the week gets 4 observations, so that weekly behavior can be balanced out. Still some weekly oscillations can persist. In a way, the variability in projections from day to day can give us some feel for real uncertainty, which is likely much greater than the variability of projections. Each day is a wrestling match with this virus. How we collectively battle this epidemic will determine how bad it can get. Will we have second and third waves? Only if we collectively allow it. This simplistic model has no great insight in to how effective we will be in halting this epidemic. This model cannot predict what poor choices the president or governors will make or the consequences yet to show up in daily cases and deaths. This model can't tell us if people will become more effective with social distancing or more careless. But it can tell us how we have been trending over the last 28 days. It is our choice as a people if we will take steps to improve these projections.

What the last 28 days tell us is that we are trending toward 2.24M cases and 137k deaths.
upload_2020-5-7_0-33-47.png


upload_2020-5-7_0-37-24.png


upload_2020-5-7_0-38-19.png
 
Speaking of corruption of our medical system and government by Big Pharma, here's a short documentary about a virologist who makes explosive claims about same. I'm not endorsing it (she says nothing about vitamin C), because I don't know enough to judge the likelihood of her claims. But I do know enough about medical industry incentives (which are obvious) to believe her claims are possible.

The channel that posted it recommends watching it soon before YouTube removes it.

 
So in your field (as if that negates all other medical fields), there are "VERY VERY few patented medications," just hormones "99% of the time." Yet somehow you heard so many new-drug sales pitches that you finally told them to shut up, and feel blessed to escape them.

There must a whole lotta hormones if only 1% of your medications caused such sales fatigue. And again, whatever the percentage in your field, the obvious fact is conventional doctors learn mostly meds supplied by Big Pharma, and Big Pharma thrives on patents.

Nice to see it is SO EASY to get under your skin.

Have you seen how many different brands of insulin there are? Seriously, google it. I know that's HARD for the intellectually challenged like you . . . but I think you can do it. Why do you think those companies were paying for dinner? They wanted to tell us why "their brand" was better than the other brand. Do you think I'm too stupid to not see through that? I always prescribed what was best for MY PATIENT. PERIOD. I WAS ALWAYS VIEWING ANYTHING PRESENTED BY A PHARMA COMPANY WITH A HUGE DEGREE OF SKEPTICISM.

Do you truly think that doctors are the most gullible people there are?



Your entire argument, which you make VERY CLEAR, is that us doctors are sell-outs to big pharma and we just do their bidding to up their profit margins.

He're the rub in that argument, and an example to make my point - ONCE A DIAGNOSIS IS MADE, "standard of care" dictates how I treat that condition. Anything deviating from standard of care, without EXCELLENT documentation and reasoning, is sub-par, inadequate, puts the patient at risk, and opens oneself up for a malpractice lawsuit. Standard of care is not something made up or dictated by pharma companies, the AMA, or even the medical schools at which we train. Standard of care is based up on the FULL evidence for treatment of a condition (not cherry-picked crap that the news is tossing out daily right now). Additionally, when following standard of care, I don't get to pick the BRAND of drug that my patient has to take for their condition. For diabetes, for example, I don't have any say in the insulin that they take. You know who decides that? The insurance companies do. They only have a VERY SELECT few on their "formulary". If the patient goes to pick up their insulin and insists on a different brand . . . it's not covered. Same thing with thyroid hormone, growth hormone, testosterone, etc. etc. etc.


You want to go RAIL AGAINST the machine, go find some insurance exec to troll. As doctors, we understand the science (and YES that includes homeopathic alternatives - which you seem to ONLY want to consider), and we do our very best to always do what is best for our patients. And we do that for EVERY, SINGLE, PATIENT.


It's morons like you that make me look back on leaving medicine with a smile. You remind me of the patients that would spend 5 minutes googling something before their office visit (like treating their hypothyroidism with vitamins) and even after politely explaining to them why what they found would not work, they had the gall to think that their recently discovered blog post somehow trumped all the decades of training of the physician they were seeing that day. If they felt that way, why even go to the appointment? I suspect they were hoping, somehow against hope, that someone in a position of authority would validate that opinion.


EDIT - pulling a SageBrush - you are now a proud member of the ignore bin.
 
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just checked the app for my wendy's and it won't let me order any of these
  • chili
  • jr bacon (or any variation of jr burger)
  • dave single (and any variation of that)
the entire hamburger menu is not available, they have bacon for the chicken sandwiches (and all the chicken sandwiches) but no beef on the menu at all.

Word online is this is happening in most of the country.
No loss. Spicy chicken or GTFO.
Why are chicken processing plants being spared?

EDIT: Not sure why I thought poultry plants weren't getting hit. This CDC study says there have been outbreaks at 115 meat and poultry processing plants. Anywhere from 0.6%-18% of workers infected (average 3%).
https://www.cdc.gov/mmwr/volumes/69/wr/pdfs/mm6918e3-H.pdf
 
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  • Funny
Reactions: bkp_duke
Seriously, google it. I know that's HARD for the intellectually challenged like you . . . .
This reminds me of something I read recently:
3) you are personally attacking me - that's classic of those arguing from a weak position: use of personal attacks to distract from the fact that you don't have the data to back up your claims.
I guess consistency is the hobgoblin of small minds like mine. Or something.
Nice to see it is SO EASY to get under your skin.
Yeah, I already admitted that insults and deadly corruption can do it. Add lying to the list.
Your entire argument, which you make VERY CLEAR, is that us doctors are sell-outs to big pharma and we just do their bidding to up their profit margins.
Well, your straw-man is getting warmer but still in the Arctic.

Your latest gush of rather intense rhetoric contains false claims that I already dispatched (my alleged reliance on blogs) but also some new issues that are pretty important. I'm tired now but will write about them tomorrow, for the amusement of others since you claim to have run away.