Hospitalist

[Quinn C]

One of the recent Jeopardy candidates was introduced as a pediatric
hospitalist.

I had never heard of hospitalists. It seems to be a US-specific word for
"a physician and especially an internist who specializes in providing
and managing the care and treatment of hospitalized patients" or "a
health-care professional (such as a nurse practitioner or physician
assistant) who is not a physician but assumes a similar role" (Merriam
Webster).

So using that word could be a way of not letting on whether you're a
doctor or not, although the second sense is often used as an attribute,
as in "hospitalist nurse".

As for the first sense, I didn't know that this is a thing that one
would need a word for. I guess it only makes sense in the context of the
American/Canadian healthcare system, where doctors with their own
practice also work in hospitals (either on certain days or when their
patients are hospitalized), whereas e.g. in Germany, you'll
automatically treat mainly hospitalized patients if your main employment
is at a hospital rather than in a street practice.

--
There is, at a women's college, always some emancipating
encouragement for those with masculine tastes for such things
as mathematics, philosophy, and friendship.
-- Jane Rule, This Is Not For You, p.15

[Ken Blake]

On Sat, 21 May 2022 16:20:51 -0400, Quinn C
<lispa...@crommatograph.info> wrote:

>One of the recent Jeopardy candidates was introduced as a pediatric
>hospitalist.
>
>I had never heard of hospitalists. It seems to be a US-specific word for
>"a physician and especially an internist who specializes in providing

Maybe it's US-specific , but I've never heard of hospitalists either.

[Sam Plusnet]

The Knights Hospitaller may have thought of themselves as hospitalists.

--
Sam Plusnet

[Janet]

In article <pcfiK.646730$2OB.2...@fx09.ams1>, n...@home.com says...

A hospitalist treating broken knights probably keeps a Hospitallers
hospitalist

Janet

[occam]

On 21/05/2022 22:20, Quinn C wrote:
> One of the recent Jeopardy candidates was introduced as a pediatric
> hospitalist.
>
> I had never heard of hospitalists. It seems to be a US-specific word for
> "a physician and especially an internist who specializes in providing
> and managing the care and treatment of hospitalized patients" or "a
> health-care professional (such as a nurse practitioner or physician
> assistant) who is not a physician but assumes a similar role" (Merriam
> Webster).
>
> So using that word could be a way of not letting on whether you're a
> doctor or not, although the second sense is often used as an attribute,
> as in "hospitalist nurse".
>
> As for the first sense, I didn't know that this is a thing that one
> would need a word for. I guess it only makes sense in the context of the
> American/Canadian healthcare system, where doctors with their own
> practice also work in hospitals (either on certain days or when their
> patients are hospitalized), whereas e.g. in Germany, you'll
> automatically treat mainly hospitalized patients if your main employment
> is at a hospital rather than in a street practice.
>

It sounds like an attempt at a gender neutral term for a 'nurse' (or a
'male nurse').

If I were a physician, I would object to having this term used to
describe my function.

[Peter T. Daniels]

On Saturday, May 21, 2022 at 4:21:00 PM UTC-4, Quinn C wrote:

> As for the first sense, I didn't know that this is a thing that one
> would need a word for. I guess it only makes sense in the context of the
> American/Canadian healthcare system, where doctors with their own
> practice also work in hospitals (either on certain days or when their
> patients are hospitalized), whereas e.g. in Germany, you'll
> automatically treat mainly hospitalized patients if your main employment
> is at a hospital rather than in a street practice.

That makes it sound like you don't have a doctor of your own who knows
you and is reminded of your history and quirks by looking at your chart --
but instead you just get handed off to a new one if things get serious.

[Tony Cooper]

Many people in the US who are hospitalized will be seen by a
"specialist" that they have never before seen. They may be admitted
for one thing, but their admitting doctor may bring in some other
doctor if a condition is suspected that was not part of the original
reason for admittance.

I've never come across the specialty of "Hospitalist", but I can
understand the function. Many people are admitted to a hospital who
do not have a primary care physician. They are admitted through the
ER (Casualty, in some places) and initially seen by the physician of
the specialty involved in the primary diagnosis. Other conditions may
be observed, and a "Hospitalist" might be the one to decide what other
specialists need be brought in.

In fact, the need for Hospitalists is greater in the US because we
have so many people without health insurance and do not have a medical
record with any doctor.

I don't think my PCP (Primary Care Provider) has my "quirks" on
record, though.

--

Tony Cooper - Orlando Florida

I read and post to this group as a form of entertainment.

[Ken Blake]

Oddly enough,, my main chess set had a broken knight, but I glued it
back together years ago.

[Quinn C]

* Peter T. Daniels:

The doctor who knows me with my history and quirks is - at best - my
family doctor. The specialists I've been seeing once a year or every
other year for the last few years don't know that much. And the
optometrist can't operate on me (eye surgery being the only major
surgery I ever had so far.) Even in your system, the doctors you know
usually won't be the ones doing the surgeries, are they?

Once you need a treatment that requires hospitalization, you start
seeing a doctor at the hospital where you plan to do it, and they
familiarize themselves with your history.

I know there's limits to that, especially if it's not a one-shot thing.
My mother, having worked as a secretary and thus being used to
organizing papers, took to carrying a thick binder to visits at the big
hospital to ensure all the information was at hand.

--
Quinn C
My pronouns are they/them
(or other gender-neutral ones)

[Quinn C]

* Sam Plusnet:

Wiktionary lists that meaning, but I didn't see it anywhere else.

[Peter T. Daniels]

On Sunday, May 22, 2022 at 11:11:14 AM UTC-4, Quinn C wrote:
> * Peter T. Daniels:
> > On Saturday, May 21, 2022 at 4:21:00 PM UTC-4, Quinn C wrote:
> >
> >> As for the first sense, I didn't know that this is a thing that one
> >> would need a word for. I guess it only makes sense in the context of the
> >> American/Canadian healthcare system, where doctors with their own
> >> practice also work in hospitals (either on certain days or when their
> >> patients are hospitalized), whereas e.g. in Germany, you'll
> >> automatically treat mainly hospitalized patients if your main employment
> >> is at a hospital rather than in a street practice.
> >
> > That makes it sound like you don't have a doctor of your own who knows
> > you and is reminded of your history and quirks by looking at your chart --
> > but instead you just get handed off to a new one if things get serious.
> The doctor who knows me with my history and quirks is - at best - my
> family doctor. The specialists I've been seeing once a year or every
> other year for the last few years don't know that much. And the
> optometrist can't operate on me (eye surgery being the only major
> surgery I ever had so far.) Even in your system, the doctors you know
> usually won't be the ones doing the surgeries, are they?

Of course. They make "referrals" to specialists. But you don't go
doctor-shopping because you decide you might want an ophthalmologist
to do an operation.

> Once you need a treatment that requires hospitalization, you start
> seeing a doctor at the hospital where you plan to do it, and they
> familiarize themselves with your history.
>
> I know there's limits to that, especially if it's not a one-shot thing.
> My mother, having worked as a secretary and thus being used to
> organizing papers, took to carrying a thick binder to visits at the big
> hospital to ensure all the information was at hand.

Nowadays it's all electronic. But H.I.P.A. means they still have to do
a whole lot by fax.

[Tony Cooper]

On Sun, 22 May 2022 11:11:05 -0400, Quinn C
<lispa...@crommatograph.info> wrote:

>Once you need a treatment that requires hospitalization, you start
>seeing a doctor at the hospital where you plan to do it, and they
>familiarize themselves with your history.
>

My situation is probably different from the situation of other
Americans, but my medical insurance provider designates certain
physicians - from all specialties - as "in plan". Those are the
physicians that accept the terms of my insurance provider for their
reimbursement.

All of the "in plan" physicians have access to my full medical files.
By computer, of course, not a folder of paper.

I have an appointment with an "in plan" opthalmologist coming up. If
he schedules catract surgery (which is a real possibility), he will
have access to all of my medical history post-1972. I have been
seeing the same PCP since moving to Florida, and all procedures since
that year have been done in the hospital group that he is affiliated
with.

When I saw my PCP a few weeks ago, he looked at his laptop and made
some comment about the results of my annual visit to my cardiologist.
They don't share an office, but notes by the cardiologist are
automatically added to my PCP's records.

I can, of course, choose to go to a specialist who is not "in plan".
That could result in a greater expense to me, but I have the choice. I
assume that a physician who is not "in plan" can request and receive
my records, but it's never come up for me.

[Adam Funk]

On 2022-05-21, Quinn C wrote:

> One of the recent Jeopardy candidates was introduced as a pediatric
> hospitalist.
>
> I had never heard of hospitalists. It seems to be a US-specific word for
> "a physician and especially an internist who specializes in providing
> and managing the care and treatment of hospitalized patients" or "a
> health-care professional (such as a nurse practitioner or physician
> assistant) who is not a physician but assumes a similar role" (Merriam
> Webster).

I think this it the first I've heard or seen of the term.

> So using that word could be a way of not letting on whether you're a
> doctor or not, although the second sense is often used as an attribute,
> as in "hospitalist nurse".
>
> As for the first sense, I didn't know that this is a thing that one
> would need a word for. I guess it only makes sense in the context of the
> American/Canadian healthcare system, where doctors with their own
> practice also work in hospitals (either on certain days or when their
> patients are hospitalized), whereas e.g. in Germany, you'll
> automatically treat mainly hospitalized patients if your main employment
> is at a hospital rather than in a street practice.
>


--

From east of Needles to eternity,
Space truckin', son, ain't what it used to be

[Rich Ulrich]

On Sun, 22 May 2022 11:45:04 -0400, Tony Cooper
<tonyco...@gmail.com> wrote:

>On Sun, 22 May 2022 11:11:05 -0400, Quinn C
><lispa...@crommatograph.info> wrote:
>
>>Once you need a treatment that requires hospitalization, you start
>>seeing a doctor at the hospital where you plan to do it, and they
>>familiarize themselves with your history.
>>
>
>My situation is probably different from the situation of other
>Americans, but my medical insurance provider designates certain
>physicians - from all specialties - as "in plan". Those are the
>physicians that accept the terms of my insurance provider for their
>reimbursement.
>
>All of the "in plan" physicians have access to my full medical files.
>By computer, of course, not a folder of paper.

I get confused about my own details, but my providers who
are merely "in plan" do not have computer access to my medical
records, which are maintained by the UPMC hospital system and
not by the insurance company.

My UPMC /insurance/ system is a separate legal entity. I'm pretty
sure that the companies' official names have UP rather than the
spelled out version, "University of Pittsburgh."

A dozen or so years ago, my PCP's group split, and my PCP
departed from another hospital system and joined UPMC. They
effectively lost access to my older records. Eventually, they got
onto the UPMC computer network, but I think a few years of
records were never integrated with the UPMC files.

My opthamlogist is "in plan" -- fully paid for his work -- but his
appointments do not show up in the UPMC medical records. If
he wanted access to some of my full medical record. I assume
that I would file a request of some kind. At each visit, I tell him
my interim medical history.

>
>I have an appointment with an "in plan" opthalmologist coming up. If
>he schedules catract surgery (which is a real possibility), he will
>have access to all of my medical history post-1972. I have been
>seeing the same PCP since moving to Florida, and all procedures since
>that year have been done in the hospital group that he is affiliated
>with.
>
>When I saw my PCP a few weeks ago, he looked at his laptop and made
>some comment about the results of my annual visit to my cardiologist.
>They don't share an office, but notes by the cardiologist are
>automatically added to my PCP's records.
>
>I can, of course, choose to go to a specialist who is not "in plan".
>That could result in a greater expense to me, but I have the choice. I
>assume that a physician who is not "in plan" can request and receive
>my records, but it's never come up for me.

--

Rich Ulrich

[Quinn C]

* Peter T. Daniels:

> On Sunday, May 22, 2022 at 11:11:14 AM UTC-4, Quinn C wrote:
>> * Peter T. Daniels:
>>> On Saturday, May 21, 2022 at 4:21:00 PM UTC-4, Quinn C wrote:
>>>
>>>> As for the first sense, I didn't know that this is a thing that one
>>>> would need a word for. I guess it only makes sense in the context of the
>>>> American/Canadian healthcare system, where doctors with their own
>>>> practice also work in hospitals (either on certain days or when their
>>>> patients are hospitalized), whereas e.g. in Germany, you'll
>>>> automatically treat mainly hospitalized patients if your main employment
>>>> is at a hospital rather than in a street practice.
>>>
>>> That makes it sound like you don't have a doctor of your own who knows
>>> you and is reminded of your history and quirks by looking at your chart --
>>> but instead you just get handed off to a new one if things get serious.
>> The doctor who knows me with my history and quirks is - at best - my
>> family doctor. The specialists I've been seeing once a year or every
>> other year for the last few years don't know that much. And the
>> optometrist can't operate on me (eye surgery being the only major
>> surgery I ever had so far.) Even in your system, the doctors you know
>> usually won't be the ones doing the surgeries, are they?
>
> Of course. They make "referrals" to specialists. But you don't go
> doctor-shopping because you decide you might want an ophthalmologist
> to do an operation.

I don't understand what you are trying to say.

I hadn't seen an ophthalmologist regularly since I'd come to Canada, so
when I had a problem beyond the scope of the optometrist, I went to see
a specialist ophthalmologist, who ended up being the one doing the
operation after seeing me twice. I've seen him for reviews since then,
but even in his street practice hours, he doesn't do vision tests or
treatment of conjunctivitis, like the generalist ophthalmologists I saw
in countries where there are no or few optometrists.

>> Once you need a treatment that requires hospitalization, you start
>> seeing a doctor at the hospital where you plan to do it, and they
>> familiarize themselves with your history.
>>
>> I know there's limits to that, especially if it's not a one-shot thing.
>> My mother, having worked as a secretary and thus being used to
>> organizing papers, took to carrying a thick binder to visits at the big
>> hospital to ensure all the information was at hand.
>
> Nowadays it's all electronic. But H.I.P.A. means they still have to do
> a whole lot by fax.

But the patient doesn't control what the doctors actually pulled and
looked at, even if they had the chance, so you sometimes need to give
them a push when you're there.

I know this from a slightly different situation - since most doctors are
woefully badly informed on issues of trans medicine, academic patients
like myself go into appointments armed with research articles to
convince them to give a certain approach a try.

[David Kleinecke]

I fell and wife called 911. And I started seeing doctors - the ER decided
I had pneumonia and I spent the next two weeks in the hospital. I was
quite sick. Every day a doctor (usually a different one) came by and
said hello. But after the first ER doctor no MD ever examined me.

The MD's seem to have treated me on the basis of the ongoing test
results and never contact. This supports the idea of telemedicine.
(Full disclosure: Two family members are teledoctors).

Medicare paid but they scraped together $1000 in charges for me to
pay. Maybe more bills will arrive - in the US so-called healthcare
system you never know.

[Tony Cooper]

On Sun, 22 May 2022 17:28:30 -0400, Quinn C
<lispa...@crommatograph.info> wrote:

>I hadn't seen an ophthalmologist regularly since I'd come to Canada, so
>when I had a problem beyond the scope of the optometrist, I went to see
>a specialist ophthalmologist, who ended up being the one doing the
>operation after seeing me twice. I've seen him for reviews since then,
>but even in his street practice hours, he doesn't do vision tests or
>treatment of conjunctivitis, like the generalist ophthalmologists I saw
>in countries where there are no or few optometrists.

In my experience, opthalmologists don't do refractions. (the "vision
test"). That is done by a technician in his/her employ. That's done
prior to seeing the doctor. The doctor does a visual examination
using an opthalmascope and a slit lamp.

An opthalmogist may diagnose conjunctivitis, but the treatment is done
by the person with "pink eye". Eye drops, ointments, and artificial
tears, are self-administered.

In this area, it takes about 3 months to get an appointment with an
opthalmologist. (I just went through this) I doubt if they see many
cases of conjunctivitis unless it started the day or two before an
appointment. A drugstore pharmacist can diagnose it and provide a
product to treat it.

Perhaps "street practice" is a Canadian term, but I would use "in his
office hours" as a comparison to when he's either on call at the
hospital or doing rounds at the hospital.

[Tony Cooper]

On Sun, 22 May 2022 16:57:47 -0400, Rich Ulrich
<rich....@comcast.net> wrote:

>On Sun, 22 May 2022 11:45:04 -0400, Tony Cooper
><tonyco...@gmail.com> wrote:
>
>>On Sun, 22 May 2022 11:11:05 -0400, Quinn C
>><lispa...@crommatograph.info> wrote:
>>
>>>Once you need a treatment that requires hospitalization, you start
>>>seeing a doctor at the hospital where you plan to do it, and they
>>>familiarize themselves with your history.
>>>
>>
>>My situation is probably different from the situation of other
>>Americans, but my medical insurance provider designates certain
>>physicians - from all specialties - as "in plan". Those are the
>>physicians that accept the terms of my insurance provider for their
>>reimbursement.
>>
>>All of the "in plan" physicians have access to my full medical files.
>>By computer, of course, not a folder of paper.
>
>I get confused about my own details, but my providers who
>are merely "in plan" do not have computer access to my medical
>records, which are maintained by the UPMC hospital system and
>not by the insurance company.
>

If I implied that the records are kept by the insurance company, I did
not mean to do so. I think all of the providers in my area who are
"in plan" would have access to my records if they have priviliges with
the hospital system.

"Access" in that they *can* pull them up if I become their patient.

All of the physicians I see are in the same hospital system. It's the
largest chain of hospitals in Florida.

For example, if the ophthalmologist I'm scheduled to see recommends
cataract surgery, he will do in his facility. I assume he'll have
access to my records to make sure he's aware of any medical conditions
that I might forget to inform him of.

[Peter T. Daniels]

On Sunday, May 22, 2022 at 5:28:39 PM UTC-4, Quinn C wrote:

> I hadn't seen an ophthalmologist regularly since I'd come to Canada, so
> when I had a problem beyond the scope of the optometrist, I went to see

I don't understand -- optometrists don't deal with "problems," they fit
you for eyeglasses or contact lenses (opto- + -metrist).

[charles]

In article <e5528b92-bc77-4c5a...@googlegroups.com>,

Peter T. Daniels <gram...@verizon.net> wrote:

optometrists MEASURE you for eyeglasses, but they can also spot problems -
for which they refer you to a specialist.

--
from KT24 in Surrey, England
"I'd rather die of exhaustion than die of boredom" Thomas Carlyle

[J. J. Lodder]

Quinn C <lispa...@crommatograph.info> wrote:

> One of the recent Jeopardy candidates was introduced as a pediatric
> hospitalist.
>
> I had never heard of hospitalists. It seems to be a US-specific word for
> "a physician and especially an internist who specializes in providing
> and managing the care and treatment of hospitalized patients" or "a
> health-care professional (such as a nurse practitioner or physician
> assistant) who is not a physician but assumes a similar role" (Merriam
> Webster).

A variation perhaps on the already well-established 'intensivist'?

Jan

[lar3ryca]

On 2022-05-23 05:53, charles wrote:
> In article <e5528b92-bc77-4c5a...@googlegroups.com>,
> Peter T. Daniels <gram...@verizon.net> wrote:
>> On Sunday, May 22, 2022 at 5:28:39 PM UTC-4, Quinn C wrote:
>
>>> I hadn't seen an ophthalmologist regularly since I'd come to Canada, so
>>> when I had a problem beyond the scope of the optometrist, I went to see
>
>> I don't understand -- optometrists don't deal with "problems," they fit
>> you for eyeglasses or contact lenses (opto- + -metrist).
>
> optometrists MEASURE you for eyeglasses, but they can also spot problems -
> for which they refer you to a specialist.

I consult an optometrist who has all the same equipment as the
ophthalmologist I consult. He has diagnosed three separate problems for
which I needed the services of the ophthalmologist to treat.

The ophthalmologist seems to resent the fact that I came in already
knowing the diagnosis, and that it was an optometrist that made it.

--
What do you call a fish without an eye?
Fsh.

[Quinn C]

* charles:

> In article <e5528b92-bc77-4c5a...@googlegroups.com>,
> Peter T. Daniels <gram...@verizon.net> wrote:
>> On Sunday, May 22, 2022 at 5:28:39 PM UTC-4, Quinn C wrote:
>
>>> I hadn't seen an ophthalmologist regularly since I'd come to Canada, so
>>> when I had a problem beyond the scope of the optometrist, I went to see
>
>> I don't understand -- optometrists don't deal with "problems," they fit
>> you for eyeglasses or contact lenses (opto- + -metrist).
>
> optometrists MEASURE you for eyeglasses, but they can also spot problems -
> for which they refer you to a specialist.

Exactly. My optometrist also does the retina check and eye pressure
check I mentioned in another post.

[Quinn C]

* Tony Cooper:

> On Sun, 22 May 2022 17:28:30 -0400, Quinn C
> <lispa...@crommatograph.info> wrote:
>
>>I hadn't seen an ophthalmologist regularly since I'd come to Canada, so
>>when I had a problem beyond the scope of the optometrist, I went to see
>>a specialist ophthalmologist, who ended up being the one doing the
>>operation after seeing me twice. I've seen him for reviews since then,
>>but even in his street practice hours, he doesn't do vision tests or
>>treatment of conjunctivitis, like the generalist ophthalmologists I saw
>>in countries where there are no or few optometrists.
>
> In my experience, opthalmologists don't do refractions. (the "vision
> test"). That is done by a technician in his/her employ. That's done
> prior to seeing the doctor. The doctor does a visual examination
> using an opthalmascope and a slit lamp.

In both Germany and Japan, the options for vision tests are at an
optician or an ophthalmologist. For a case of extreme myopia like mine,
where things like possible tears in the retina and eye pressure should
be monitored regularly, often even using pupil-dilating drops, the
ophthalmologist was the obvious choice.

I don't know what "do refractions" means in this context. A technician
would do the check with a machine that automatically measures my eyes,
and also the machine that measures pressure with a puff of air, but the
thing where they switch lenses back and forth and have me read from the
vision table, it would be done by the doctor. Even the one time I did it
at an ophthalmologist in Canada (it was a doctor in training.)

> An opthalmogist may diagnose conjunctivitis, but the treatment is done
> by the person with "pink eye". Eye drops, ointments, and artificial
> tears, are self-administered.

Of course. A doctor "treating a disease" may always include the patient
applying drops or swallowing pills. I don't think there's anything wrong
with the expression, though. I think my family doctor is treating my
high cholesterol by prescribing pills and ordering blood tests, no?

> In this area, it takes about 3 months to get an appointment with an
> opthalmologist. (I just went through this) I doubt if they see many
> cases of conjunctivitis unless it started the day or two before an
> appointment.

There wasn't this issue with ophthalmologists in Germany or Japan (maybe
more so with some other specialties.) I could get squeezed in for an
emergency appointment within two or three days if I stated I had this
kind of problem, certainly with a doctor who already knows me. I could
of course also just see my family doctor in the drop-in hours for such a
mundane problem.

> A drugstore pharmacist can diagnose it and provide a
> product to treat it.

If you're ready to pay out of pocket. This specific product is probably
cheap.

> Perhaps "street practice" is a Canadian term, but I would use "in his
> office hours" as a comparison to when he's either on call at the
> hospital or doing rounds at the hospital.

What I'm referring to is where I see him at a practice in a normal
("street") building with just his name on the door, as opposed to at the
big hospital. Doctors who do major surgeries at a big hospital in
Germany usually don't have such a separate place, but would have their
"office hours" at the big hospital, so I felt the need to express that
difference.

You guys talk about a "doctor's office" even though it has all that
medical equipment inside that make the name "office" a bit weird to me,
so I tend to prefer the word "practice" (the German being "Praxis".)

The first time I saw this doctor was in a, what shall I call it,
"consultation area" in a big hospital - with no equipment, so much more
of an "office" - but after that, at his own place.

Except for the surgery itself, of course - which was at a different big
hospital, physically, but they must be part of the same organization. A
lot of different hospitals here are part of one of the two big
university systems, even while keeping their old names.

[Tony Cooper]

On Mon, 23 May 2022 09:45:44 -0400, Quinn C

<lispa...@crommatograph.info> wrote:

>* Tony Cooper:
>
>> On Sun, 22 May 2022 17:28:30 -0400, Quinn C
>> <lispa...@crommatograph.info> wrote:
>>
>>>I hadn't seen an ophthalmologist regularly since I'd come to Canada, so
>>>when I had a problem beyond the scope of the optometrist, I went to see
>>>a specialist ophthalmologist, who ended up being the one doing the
>>>operation after seeing me twice. I've seen him for reviews since then,
>>>but even in his street practice hours, he doesn't do vision tests or
>>>treatment of conjunctivitis, like the generalist ophthalmologists I saw
>>>in countries where there are no or few optometrists.
>>
>> In my experience, opthalmologists don't do refractions. (the "vision
>> test"). That is done by a technician in his/her employ. That's done
>> prior to seeing the doctor. The doctor does a visual examination
>> using an opthalmascope and a slit lamp.
>
>In both Germany and Japan, the options for vision tests are at an
>optician or an ophthalmologist. For a case of extreme myopia like mine,
>where things like possible tears in the retina and eye pressure should
>be monitored regularly, often even using pupil-dilating drops, the
>ophthalmologist was the obvious choice.
>
>I don't know what "do refractions" means in this context.

The refraction is the vision test. A device (a Phoroptor) is placed
in front of you that allows you to see the chart using a series of
corrective lenses. You are given a choice between two and tell them
if your vision is sharper with the first one or the second one. Then,
two more and so on.

It's called refraction because it detects refraction errors in the eye
due to changes in the eye's shape.

That process doesn't require the opthalmologist. It's just a sequence
of this one or that one until the best combination if found. A
technician in the opthalmogist's office, or an optician, can do it.

> A technician
>would do the check with a machine that automatically measures my eyes

The "machine" doesn't measure the eyes. You are describing a slit
lamp, and it is used to examine the eyes by projecting light at an
angle. It illuminates the interior and the retina.

>and also the machine that measures pressure with a puff of air, but the
>thing where they switch lenses back and forth and have me read from the
>vision table, it would be done by the doctor. Even the one time I did it
>at an ophthalmologist in Canada (it was a doctor in training.)

The "puff of air" is to test for glaucoma. Normally, fluid drains
from the eye through the Canal of Schlemm. If it is blocked, the
fluid builds up. The puff of air should force fluid out of the
eyeball. If it doesn't, it indicates glaucoma.

That test used to be done with a hand-held tonometer, which was a
weighted device that did the same thing. That took longer and was
uncomfortable for the patient.

>You guys talk about a "doctor's office" even though it has all that
>medical equipment inside that make the name "office" a bit weird to me,
>so I tend to prefer the word "practice" (the German being "Praxis".)

In our lingo, the doctor's office is where he or she sees patients. A
waiting room, exam rooms, and the room where the doctor has a desk are
all part of the "office". Doctors don't seem to need a desk anymore,
though. Everything is written or read on a laptop. They do need to
sit behind it when discussing something with a patient in order to
appear more important, though.

A "practice" is the doctor's specialty. We might say "Dr Brown's
practice is gastroenterology." Sometimes we use it geographically:
"Dr Brown's practice is in Brooklyn".

Hoping, of course, that Dr Brown has practiced it enough to be good at
it.

[Peter T. Daniels]

On Monday, May 23, 2022 at 8:03:02 AM UTC-4, charles wrote:
> In article <e5528b92-bc77-4c5a...@googlegroups.com>,
> Peter T. Daniels <gram...@verizon.net> wrote:
> > On Sunday, May 22, 2022 at 5:28:39 PM UTC-4, Quinn C wrote:

> > > I hadn't seen an ophthalmologist regularly since I'd come to Canada, so
> > > when I had a problem beyond the scope of the optometrist, I went to see
> > I don't understand -- optometrists don't deal with "problems," they fit
> > you for eyeglasses or contact lenses (opto- + -metrist).
>
> optometrists MEASURE you for eyeglasses, but they can also spot problems -
> for which they refer you to a specialist.

Exactly. They don't deal with the problems after they identify them.

Speaking of which, several years ago on "Selected Shorts" some elderly
British actor was reading a story by Edith Wharton that dealt with an
oculist (as was clear from the context). But time after time, he read it
as "occultist."

Was "oculist" never a term for 'optician' in BrE? (It isn't one in AmE
_any more_, but it might still have been seen on historic storefronts
that no one had bothered to remodel.)

[Peter T. Daniels]

Never heard of that one either.

[Peter T. Daniels]

The regulations must be different in Canada.

The point remains that _all_ "problems" are "beyond the scope" of
the optometrist. If they notice one, they send the client to the
specialist who _deals with_ problems.

[Tony Cooper]

On Mon, 23 May 2022 07:48:16 -0700 (PDT), "Peter T. Daniels"

<gram...@verizon.net> wrote:

>On Monday, May 23, 2022 at 9:45:51 AM UTC-4, Quinn C wrote:
>> * charles:
>> > In article <e5528b92-bc77-4c5a...@googlegroups.com>,
>> > Peter T. Daniels <gram...@verizon.net> wrote:
>> >> On Sunday, May 22, 2022 at 5:28:39 PM UTC-4, Quinn C wrote:
>
>> >>> I hadn't seen an ophthalmologist regularly since I'd come to Canada, so
>> >>> when I had a problem beyond the scope of the optometrist, I went to see
>> >> I don't understand -- optometrists don't deal with "problems," they fit
>> >> you for eyeglasses or contact lenses (opto- + -metrist).
>> > optometrists MEASURE you for eyeglasses, but they can also spot problems -
>> > for which they refer you to a specialist.
>>
>> Exactly. My optometrist also does the retina check and eye pressure
>> check I mentioned in another post.
>
>The regulations must be different in Canada.
>
>The point remains that _all_ "problems" are "beyond the scope" of
>the optometrist. If they notice one, they send the client to the
>specialist who _deals with_ problems.

Different how? Optometrists in the US use a slit lamp. A retinal
tear or detachment is seen using a slit lamp. The glaucoma test is
part of an optometrist's exam.

[Peter T. Daniels]

On Monday, May 23, 2022 at 10:40:55 AM UTC-4, Tony Cooper wrote:

> The refraction is the vision test. A device (a Phoroptor) is placed
> in front of you that allows you to see the chart using a series of
> corrective lenses. You are given a choice between two and tell them
> if your vision is sharper with the first one or the second one. Then,
> two more and so on.
>
> It's called refraction because it detects refraction errors in the eye
> due to changes in the eye's shape.
>
> That process doesn't require the opthalmologist. It's just a sequence
> of this one or that one until the best combination if found. A
> technician in the opthalmogist's office, or an optician, can do it.

Things have certainly changed. Before I go into the ophthalmologist's
room (there are two side by side, so one patient can be busy dilating
while he's seeing the other; we used to be sent back out to the waiting
room to dilate, but I suppose covid), I go with a technician into a little
cubbyhole where I look into a machine (once for each eye) at a picture
of a farmhouse at the end of a very long driveway, while the machinery
whirrs, moves in and out, and yields a set of measurements.

I then go to the ophthalmologist's room (the technician has me read
the chart on the wall, glasses on, with each eye), and the first thing
the ophthalmologist does is the "refraction" as described above.

After complaining several times that my progressive lenses were
unsatisfactory with the laptop sitting on the desk maybe 3 feet (1 m)
away (external keyboard on the drawer in between), he finally wrote
a prescription for middle-distance-regular lenses but in the computer
only -- I had to go to the optician next door to get it written on a
prescription form.

She's a rather severe Eastern European woman and I couldn't tell
how displeased she was that she had to write it out for me to take
elsewhere. The whole shebang -- lenses, premium for strong prescription,
and frame -- came to less at Walmart Optical than the frame alone would
have been at the optician's shop. And -- I brought in the prescription on
Monday morning and got the call at 7 pm Wednesday evening (even
though she said 7-10 days).

> > A technician
> >would do the check with a machine that automatically measures my eyes
>
> The "machine" doesn't measure the eyes. You are describing a slit
> lamp, and it is used to examine the eyes by projecting light at an
> angle. It illuminates the interior and the retina.

That doesn't sound like it at all.

> >and also the machine that measures pressure with a puff of air, but the
> >thing where they switch lenses back and forth and have me read from the
> >vision table, it would be done by the doctor. Even the one time I did it
> >at an ophthalmologist in Canada (it was a doctor in training.)
>
> The "puff of air" is to test for glaucoma. Normally, fluid drains
> from the eye through the Canal of Schlemm. If it is blocked, the
> fluid builds up. The puff of air should force fluid out of the
> eyeball. If it doesn't, it indicates glaucoma.

In the 15ish years I've been going to this ophthalmologist, he has
never used the "puff of air" to test for glaucoma. It was surprising
the first time he announced the glaucoma result (none) without
having done that.

> That test used to be done with a hand-held tonometer, which was a
> weighted device that did the same thing. That took longer and was
> uncomfortable for the patient.

No touching any more, either.

There are two other computerized tests -- click the button when a
dot appears -- one is visual field (where I can see the blind spot in
the result) and I don't remember what the other one is, because they
alternate (each one done once a year) and I suppose I'll have that one
in August.

[Peter T. Daniels]

It's been a lot of years since I went elsewhere -- Sears Optical in
the Newport Mall, since you're such a JC maven -- but I'm pretty
sure he did neither of those things.

[Ken Blake]

On Mon, 23 May 2022 12:53:03 +0100, charles <cha...@candehope.me.uk>
wrote:

>In article <e5528b92-bc77-4c5a...@googlegroups.com>,
> Peter T. Daniels <gram...@verizon.net> wrote:
>> On Sunday, May 22, 2022 at 5:28:39 PM UTC-4, Quinn C wrote:
>
>> > I hadn't seen an ophthalmologist regularly since I'd come to Canada, so
>> > when I had a problem beyond the scope of the optometrist, I went to see
>
>> I don't understand -- optometrists don't deal with "problems," they fit
>> you for eyeglasses or contact lenses (opto- + -metrist).
>
>optometrists MEASURE you for eyeglasses, but they can also spot problems -
>for which they refer you to a specialist.

Yes, that's exactly I got to see an ophthalmologist and had cataract
surgery.

[lar3ryca]

Right, but the optometrist can't (at least in Canada), treat those problems.

--
Unix is user friendly.
It's just very particular about who its friends are.

[J. J. Lodder]

Peter T. Daniels <gram...@verizon.net> wrote:

You are way behind the times. (as usual)
Wikipedia and Meriam Webster do know about it.
<https://en.wikipedia.org/wiki/Intensivist>

Do pay attention: one of them may save your life,
(especially so after Covid)

Jan

[Quinn C]

* Tony Cooper:

Would that be used without a human looking into it? No, I'm talking
about a machine that measures the degree of myopia or hyperopia. Not
very precise, so not very useful for adults in most cases, but quite
useful for children, and can rule out some very wrong results.

<https://en.wikipedia.org/wiki/Autorefractor>

I'm surprised in retrospect that this wasn't used during the medical
examination for the military. They just measured my glasses and gave me
an out based on that, but all the proof they had that those glasses were
correct for my eyes was just seeing me walk around.

>>and also the machine that measures pressure with a puff of air, but the
>>thing where they switch lenses back and forth and have me read from the
>>vision table, it would be done by the doctor. Even the one time I did it
>>at an ophthalmologist in Canada (it was a doctor in training.)
>
> The "puff of air" is to test for glaucoma.

As I was explained it, it measures pressure in the eye, which is a risk
factor for glaucoma. And strong myopia is a risk factor for high
intraocular pressure.

>>You guys talk about a "doctor's office" even though it has all that
>>medical equipment inside that make the name "office" a bit weird to me,
>>so I tend to prefer the word "practice" (the German being "Praxis".)
>
> In our lingo, the doctor's office is where he or she sees patients. A
> waiting room, exam rooms, and the room where the doctor has a desk are
> all part of the "office". Doctors don't seem to need a desk anymore,
> though. Everything is written or read on a laptop. They do need to
> sit behind it when discussing something with a patient in order to
> appear more important, though.

Almost all the doctors I've seen were using desktop-type computers.
Sometimes, they use the keyboard on their lap instead of on the desk
(especially my dentist, for obvious reasons.)

> A "practice" is the doctor's specialty. We might say "Dr Brown's
> practice is gastroenterology." Sometimes we use it geographically:
> "Dr Brown's practice is in Brooklyn".
>
> Hoping, of course, that Dr Brown has practiced it enough to be good at
> it.

Maybe I could say here in Canada I see the ophthalmologist who did
surgery on me at his *own* office, to distinguish it from "at the
hospital".

[Peter T. Daniels]

That hardly justifies "already well-established."

> Do pay attention: one of them may save your life,
> (especially so after Covid)

It is not the patient's choice to be placed in the ICU.
That is usually for post-surgery patients.

[Tony Cooper]

On Mon, 23 May 2022 08:12:41 -0700 (PDT), "Peter T. Daniels"
<gram...@verizon.net> wrote:

>On Monday, May 23, 2022 at 10:40:55 AM UTC-4, Tony Cooper wrote:
>
>> The refraction is the vision test. A device (a Phoroptor) is placed
>> in front of you that allows you to see the chart using a series of
>> corrective lenses. You are given a choice between two and tell them
>> if your vision is sharper with the first one or the second one. Then,
>> two more and so on.
>>
>> It's called refraction because it detects refraction errors in the eye
>> due to changes in the eye's shape.
>>
>> That process doesn't require the opthalmologist. It's just a sequence
>> of this one or that one until the best combination if found. A
>> technician in the opthalmogist's office, or an optician, can do it.
>
>Things have certainly changed.

I don't think it's a change as much as it might be an omission on my
part in neglected the possibility of state law or state medical
society rules.

I have personally sold and set up slit lamps to both opthalmologists
and opticians offices in Indiana, Illinois and Florida. As a salesman
for a company that distributed Zeiss products, and later as the owner
of a company that distributed Zeiss products, I've sold and set up a
great man slit lamps.

State law does vary, and perhaps opticians can't do refractions in
some states. In the states where I've lived, they have and do.

It's a matter of economics for the doctor. He or she can see more
patients per day if a technician can perform tests like the
refraction. The more tests the doctor orders, the more income.

In my own experience, I spend more time in the office having the
refraction than I do with the doctor. When the refraction is done by
a technician, the doctor can see two patients instead of one.

>I then go to the ophthalmologist's room (the technician has me read
>the chart on the wall, glasses on, with each eye), and the first thing
>the ophthalmologist does is the "refraction" as described above.

In my experience, the ophthalmologist's time is far too important to
do this test when a technician can be trained to do it.

>
>After complaining several times that my progressive lenses were
>unsatisfactory with the laptop sitting on the desk maybe 3 feet (1 m)
>away (external keyboard on the drawer in between), he finally wrote
>a prescription for middle-distance-regular lenses but in the computer
>only -- I had to go to the optician next door to get it written on a
>prescription form.

I also get a written prescription form and take it elsewhere to get
filled. The glasses sold by the in-house optician at an
opthalmologist's office are double or more the cost elsewhere.

Well, it depends on what equipment he's purchased. I've sold
hand-held tonometers and slit lamps equipped with Haag-Strait
tonometers that pressed against the eyeball, but Zeiss didn't add the
"air puff" devices while I was active in the business. I'm sure he
employed some device to test for glaucoma.

Some ophthalmologists stick with techniques and equipment they've used
for years, and some like to get on board with all the new
developments.

>
>> That test used to be done with a hand-held tonometer, which was a
>> weighted device that did the same thing. That took longer and was
>> uncomfortable for the patient.
>
>No touching any more, either.
>
>There are two other computerized tests -- click the button when a
>dot appears -- one is visual field (where I can see the blind spot in
>the result) and I don't remember what the other one is, because they
>alternate (each one done once a year) and I suppose I'll have that one
>in August.

There are several additional tests that can be performed, but the
refraction is the basic test. I did the "click the button" test
(which tested peripheral vision) several years ago.

[Tony Cooper]

Some states in the US allow optometrists to issue prescriptions (for
certain medications) and some don't. I have a friend who was (now
retired) an optometrist, and went up to Tallahassee every year to
lobby for optometrists in Florida to issue prescriptions for certain
medications. Currently, they can't.

[Tony Cooper]

Why should any individual be considered "behind the times" if he/she
is not aware of the terms currently used in the ICU of their local
hospital? Or the staffing?

First of all, we rarely get to choose which hospital we will be in and
will end up in Intensive Care. We don't wear a ID that says "Take me
to City General if I'm in an accident that may mean I'll end up in ICU
because City General has an Intensivist on call in the OR".

We will go to the hospital where our physican has privileges and wants
us to be admitted or we will go to the hospital where the ambulance
takes us. Or, possibly, the nearest hospital with an ER (Casualty)
when we are badly ailing.

obAUE: In the US, the term "privileges" in regard to a doctor
indicates that the doctor has the ability to admit patients to a
particular hospital and treat patients in that hospital.

In a large city, where there are several hospitals, any one doctor may
have privileges at one or some hospitals, but not all hospitals.

There are doctors in this two-hospital town that have privileges at
one hospital but not the other. (There are more than two hospital
buildings, but only two ownership groups)

[J. J. Lodder]

Peter T. Daniels <gram...@verizon.net> wrote:

> On Monday, May 23, 2022 at 1:01:40 PM UTC-4, J. J. Lodder wrote:
> > Peter T. Daniels <gram...@verizon.net> wrote:
> > > On Monday, May 23, 2022 at 8:55:00 AM UTC-4, J. J. Lodder wrote:
> > > > Quinn C <lispa...@crommatograph.info> wrote:
>
> > > > > One of the recent Jeopardy candidates was introduced as a pediatric
> > > > > hospitalist.
> > > > > I had never heard of hospitalists. It seems to be a US-specific
> > > > > word for "a physician and especially an internist who specializes
> > > > > in providing and managing the care and treatment of hospitalized
> > > > > patients" or "a health-care professional (such as a nurse
> > > > > practitioner or physician assistant) who is not a physician but
> > > > > assumes a similar role" (Merriam Webster).
> > > > A variation perhaps on the already well-established 'intensivist'?
> > > Never heard of that one either.
> >
> > You are way behind the times. (as usual)
> > Wikipedia and Meriam Webster do know about it.
> > <https://en.wikipedia.org/wiki/Intensivist>
>
> That hardly justifies "already well-established."

If Meriam Webster has it it can't be new.

> > Do pay attention: one of them may save your life,
> > (especially so after Covid)
>
> It is not the patient's choice to be placed in the ICU.
> That is usually for post-surgery patients.

More generally, anyone in a critical condition
that needs permanent monitoring.
May be planned, after surgery, but the cause for arriving there
may also be have been some disease getting out of hand,
or some accident, or...

Jan

[J. J. Lodder]

Tony Cooper <tonyco...@gmail.com> wrote:

> On Mon, 23 May 2022 19:01:36 +0200, nos...@de-ster.demon.nl (J. J.
> Lodder) wrote:
>
> >Peter T. Daniels <gram...@verizon.net> wrote:
> >
> >> On Monday, May 23, 2022 at 8:55:00 AM UTC-4, J. J. Lodder wrote:
> >> > Quinn C <lispa...@crommatograph.info> wrote:
> >>
> >> > > One of the recent Jeopardy candidates was introduced as a pediatric
> >> > > hospitalist.
> >> > > I had never heard of hospitalists. It seems to be a US-specific
> >> > > word for "a physician and especially an internist who specializes
> >> > > in providing and managing the care and treatment of hospitalized
> >> > > patients" or "a health-care professional (such as a nurse
> >> > > practitioner or physician assistant) who is not a physician but
> >> > > assumes a similar role" (Merriam Webster).
> >> >
> >> > A variation perhaps on the already well-established 'intensivist'?
> >>
> >> Never heard of that one either.
> >
> >You are way behind the times. (as usual)
> >Wikipedia and Meriam Webster do know about it.
> ><https://en.wikipedia.org/wiki/Intensivist>
> >
> >Do pay attention: one of them may save your life,
> >(especially so after Covid)
>
> Why should any individual be considered "behind the times" if he/she
> is not aware of the terms currently used in the ICU of their local
> hospital? Or the staffing?

The use of 'intensivist' became fashionable during the covid pandemic.
(complaining on TV about lack of beds, and so on)

But perhaps not in your part of the world,

Jan

[Kerr-Mudd, John]

This is incomprehensible to this Brit; you get taken to the nearest (or best specialist, if that's what's needed) hospital. No-one has to check your insurance, or prefered healthcare provider.

--
Bah, and indeed Humbug.

[Tony Cooper]

On Mon, 23 May 2022 22:03:09 +0200, nos...@de-ster.demon.nl (J. J.

So what is your objection? That we aren't aware of some "fashionable"
term that is used in hospitals?

Add it to list of "fashionable" terms on TikTok, Instagram, and the
text chain of the students at my local middle school.

Please tell me how knowledge of this term "may save (my) life".

If, on the way to ICU, I'm assured that the hospital I'm in has an
intensivist on call, I don't think I'd be in any shape to receive that
message. Or, if I ask the person wheeling me into ICU if there will
be a intensivist on duty, and am told that there will not be, is that
going to cause me get up and run - with my bare ass exposed in that
hospital gown - to get directions to a hospital with one on duty?

Look, Jan, if there's a new and fashionable term for a specialist that
could serve a function important to me, it's nice to know it. Present
the word and the meaning and we'll all learn.

But skip the bullshit "behind the times" and "not in your part of the
world" that is so embedded in your arrogance that somehow the rest of
the world isn't quite up to par with your part of the world.

[Tony Cooper]

What is incomprehensible?

There's nothing above that touches on being taken to a hospital in an
ambulance and the person's insurance or provider being of concern.

What you describe is what is done here when taken to the hospital in
an ambulance. The hospital is required by law to treat any emergency
patient regardless of insurance or what the person's primary provider
is.

There are some exceptions when the hospital does not have the
facilities or staff for certain conditions. Obstetrics, for example.
They must treat the patient for immediate and life-threatening
conditions, but may schedule a transfer to a different hospital with
those facilities.

My comments above pertain to voluntary admissions.

My son, the Firefighter/Paramedic, may take several patients who have
no insurance and no primary care physician to the nearest hospital
when he's on shift, and those patients will be treated.

[Peter T. Daniels]

On Monday, May 23, 2022 at 4:03:12 PM UTC-4, J. J. Lodder wrote:
> Peter T. Daniels <gram...@verizon.net> wrote:
> > On Monday, May 23, 2022 at 1:01:40 PM UTC-4, J. J. Lodder wrote:
> > > Peter T. Daniels <gram...@verizon.net> wrote:
> > > > On Monday, May 23, 2022 at 8:55:00 AM UTC-4, J. J. Lodder wrote:
> > > > > Quinn C <lispa...@crommatograph.info> wrote:

> > > > > > One of the recent Jeopardy candidates was introduced as a pediatric
> > > > > > hospitalist.
> > > > > > I had never heard of hospitalists. It seems to be a US-specific
> > > > > > word for "a physician and especially an internist who specializes
> > > > > > in providing and managing the care and treatment of hospitalized
> > > > > > patients" or "a health-care professional (such as a nurse
> > > > > > practitioner or physician assistant) who is not a physician but
> > > > > > assumes a similar role" (Merriam Webster).
> > > > > A variation perhaps on the already well-established 'intensivist'?
> > > > Never heard of that one either.
> > > You are way behind the times. (as usual)
> > > Wikipedia and Meriam Webster do know about it.
> > > <https://en.wikipedia.org/wiki/Intensivist>
> > That hardly justifies "already well-established."
>
> If Meriam Webster has it it can't be new.

If you'd looked, you'd have seen it has 1965 for the earliest known
attestation. But what does newness or oldness have to do with
being "well established"?

[Peter T. Daniels]

Now he's claiming that "fashionable" = "well established."

[J. J. Lodder]

Tony Cooper <tonyco...@gmail.com> wrote:

> On Mon, 23 May 2022 22:03:09 +0200, nos...@de-ster.demon.nl (J. J.
> Lodder) wrote:
>
> >Tony Cooper <tonyco...@gmail.com> wrote:
> >
> >> On Mon, 23 May 2022 19:01:36 +0200, nos...@de-ster.demon.nl (J. J.
> >> Lodder) wrote:
> >>
> >> >Peter T. Daniels <gram...@verizon.net> wrote:
> >> >
> >> >> On Monday, May 23, 2022 at 8:55:00 AM UTC-4, J. J. Lodder wrote:

[-]

M-W says first known use 1965.

It can't be that fashionable,

Jan

[Quinn C]

* Peter T. Daniels:

Optometrists can remove foreign bodies from the eye, insert punctual
plugs into the tear duct to help with dry eyes, and prescribe a number
of medications. That's about the extent of "dealing with problems".
Details vary by province.

[Quinn C]

* Tony Cooper:

> It's called refraction because it detects refraction errors in the eye
> due to changes in the eye's shape.
>
> That process doesn't require the opthalmologist. It's just a sequence
> of this one or that one until the best combination if found. A
> technician in the opthalmogist's office, or an optician, can do it.

Has never happened to me. It was always "the doctor" (assuming one could
call an OD that.)

> A "practice" is the doctor's specialty. We might say "Dr Brown's
> practice is gastroenterology." Sometimes we use it geographically:
> "Dr Brown's practice is in Brooklyn".

There is

| practice
| ...
| 4. (countable) A place where a professional service is provided, such
| as a general practice.
|
| Synonym: general practice
| She ran a thriving medical practice.

<https://en.wiktionary.org/wiki/practice>

[Quinn C]

* Kerr-Mudd, John:

The thing with the privilege is for planned procedures that aren't super
urgent. The doctor to treat you is already selected, and the hospital
follows from that.

It's not that different in Germany: when you plan a procedure, you
choose a hospital, talk to a doctor there, and if you're happy with
them, make the appointment there, if not, you try to find a better one
elsewhere.

If you're in an ambulance, at least here in Canada, the deciding factor
will be whether a hospital feels capable of admitting you. Most of them
are already beyond capacity a lot of the time.

--
Jesus is like Elvis - I love the guy, but the fan club scares me.
-- John Fugelsang

[Tony Cooper]

In the US, you see a doctor and if a procedure is required, the doctor
generally chooses the time and place. In a large city, where the
doctor has privileges at more than one hospital, you may be offered a
choice. The doctor's office then schedules your appointment at the
hospital.

[Tony Cooper]

On Mon, 23 May 2022 17:06:50 -0400, Quinn C
<lispa...@crommatograph.info> wrote:

>* Tony Cooper:
>
>> It's called refraction because it detects refraction errors in the eye
>> due to changes in the eye's shape.
>>
>> That process doesn't require the opthalmologist. It's just a sequence
>> of this one or that one until the best combination if found. A
>> technician in the opthalmogist's office, or an optician, can do it.
>
>Has never happened to me. It was always "the doctor" (assuming one could
>call an OD that.)

An O.D. is an optometrist: Doctor of Optometry.

What I've been saying is that the M.D. doctor (ophthalmologist), in my
experience, doesn't do it
>
I miswrote "optician" above, by the way. I meant optometrist. The
optician is lower down the skill pole.

When I was younger I went to the optometrist when I wanted to see if
my current prescription was right. Now I go only to an
ophthalmologist on the premise that I want to be seen by the person
who can both diagnose and treat the condition if I have one.

[Quinn C]

* Tony Cooper:

> On Mon, 23 May 2022 17:06:50 -0400, Quinn C
> <lispa...@crommatograph.info> wrote:
>
>>* Tony Cooper:
>>
>>> It's called refraction because it detects refraction errors in the eye
>>> due to changes in the eye's shape.
>>>
>>> That process doesn't require the opthalmologist. It's just a sequence
>>> of this one or that one until the best combination if found. A
>>> technician in the opthalmogist's office, or an optician, can do it.
>>
>>Has never happened to me. It was always "the doctor" (assuming one could
>>call an OD that.)
>
> An O.D. is an optometrist: Doctor of Optometry.

Who did you wrote this for, I wonder.

> What I've been saying is that the M.D. doctor (ophthalmologist), in my
> experience, doesn't do it

What I've been saying is that most of my life, I was only seeing
ophthalmologists, not optometrists (because they're an American
invention), and they did my vision tests. Never an assistant.

[Tony Cooper]

On Mon, 23 May 2022 18:24:00 -0400, Quinn C

<lispa...@crommatograph.info> wrote:

>* Tony Cooper:
>
>> On Mon, 23 May 2022 17:06:50 -0400, Quinn C
>> <lispa...@crommatograph.info> wrote:
>>
>>>* Tony Cooper:
>>>
>>>> It's called refraction because it detects refraction errors in the eye
>>>> due to changes in the eye's shape.
>>>>
>>>> That process doesn't require the opthalmologist. It's just a sequence
>>>> of this one or that one until the best combination if found. A
>>>> technician in the opthalmogist's office, or an optician, can do it.
>>>
>>>Has never happened to me. It was always "the doctor" (assuming one could
>>>call an OD that.)
>>
>> An O.D. is an optometrist: Doctor of Optometry.
>
>Who did you wrote this for, I wonder.

The person who wondered if a optometrist could be called "doctor".

>
>> What I've been saying is that the M.D. doctor (ophthalmologist), in my
>> experience, doesn't do it
>
>What I've been saying is that most of my life, I was only seeing
>ophthalmologists, not optometrists (because they're an American
>invention), and they did my vision tests. Never an assistant.

I suppose that is because you have been in systems based on some sort
of national health scheme, and I have been in a system where the
doctor's income is directly related to the number of patients he can
see and the number of tests he can have done that he will derive
income from.

As I said in another post, the more the M.D. can have others do, the
more income he receives.

Just plugging in figures, if the M.D. has to do everything himself, he
can charge $X a day in fees that the insurance company pays him. If
he can have a technician do what takes the M.D. half his time to do,
then he can earn $X times 2 a day less the cost of the technician by
seeing double the number of patients.

[Peter Moylan]

On 24/05/22 00:40, Tony Cooper wrote:

> On Mon, 23 May 2022 09:45:44 -0400, Quinn C
> <lispa...@crommatograph.info> wrote:

>> A technician would do the check with a machine that automatically
>> measures my eyes
>
> The "machine" doesn't measure the eyes. You are describing a slit
> lamp, and it is used to examine the eyes by projecting light at an
> angle. It illuminates the interior and the retina.

It does more than that. When I visit an optometrist, he/she takes a
photograph of the interior of my eye. (And I imagine that all
optometrists are doing that these days.) On one visit, that led to a
recommendation that I needed surgery on my left eye.

The actual surgery was done by a different specialist - someone with the
ability to operate inside the eyeball - not the optometrist.

--
Peter Moylan Newcastle, NSW http://www.pmoylan.org

[Tony Cooper]

Yeah...I never sold that system to an optometrist, but many
opthalmologists added it. It requires a beam splitter, camera
adapter, and still or video camera. Not inexpensive.

A teaching tube can be added so a second person can have the same view
as the primary user.

Both additions are common where the slit lamp is used in a teaching
enviornment. Also used in private practice when the doctor is
planning on giving a paper at some meeting.

[Peter Moylan]

On 24/05/22 04:25, Peter T. Daniels wrote:

> It is not the patient's choice to be placed in the ICU.
> That is usually for post-surgery patients.

These days it seems to be mostly for covid patients.

[Peter Moylan]

The rule here seems to be that the ambulance will take you to the
hospital with the shortest ambulance queues.

[Peter Moylan]

On 24/05/22 11:25, Tony Cooper wrote:
> On Tue, 24 May 2022 10:51:20 +1000, Peter Moylan
> <pe...@pmoylan.org.invalid> wrote:
>
>> On 24/05/22 00:40, Tony Cooper wrote:
>>> On Mon, 23 May 2022 09:45:44 -0400, Quinn C
>>> <lispa...@crommatograph.info> wrote:
>>
>>>> A technician would do the check with a machine that
>>>> automatically measures my eyes
>>>
>>> The "machine" doesn't measure the eyes. You are describing a
>>> slit lamp, and it is used to examine the eyes by projecting light
>>> at an angle. It illuminates the interior and the retina.
>>
>> It does more than that. When I visit an optometrist, he/she takes
>> a photograph of the interior of my eye. (And I imagine that all
>> optometrists are doing that these days.) On one visit, that led to
>> a recommendation that I needed surgery on my left eye.
>>
>> The actual surgery was done by a different specialist - someone
>> with the ability to operate inside the eyeball - not the
>> optometrist.
>
> Yeah...I never sold that system to an optometrist, but many
> opthalmologists added it. It requires a beam splitter, camera
> adapter, and still or video camera. Not inexpensive.

And an interface to the optometrist's computer. That way it can be shown
to the patient, and also transmitted to the surgeon.

More importantly, on the computer the optometrist can rotate the view,
zoom in, etc.

[lar3ryca]

The main reason I keep going to the same optometrist is that he explains
everything on those pictures to me while telling me what they signify.

--
Synonym: a word you can use instead of a word you can't spell.

[J. J. Lodder]

Peter Moylan <pe...@pmoylan.org.invalid> wrote:

> On 24/05/22 04:25, Peter T. Daniels wrote:
>
> > It is not the patient's choice to be placed in the ICU.
> > That is usually for post-surgery patients.
>
> These days it seems to be mostly for covid patients.

Yes, and mostly unvaccinated ones,

Jan

[Peter T. Daniels]

By country.

Searching < insert punctual plugs into the tear duct > (not something
I'd heard of) first corrected the spelling and then turned up this page.

https://www.aao.org/eye-health/diseases/punctal-plugs

It refers to "your eye doctor," anesthesia, and forceps, none of which
seems appropriate to an optometrist.

I'd be surprised about "prescribing medications," as well.

[Peter T. Daniels]

On Monday, May 23, 2022 at 9:29:13 PM UTC-4, Peter Moylan wrote:
> On 24/05/22 04:25, Peter T. Daniels wrote:

> > It is not the patient's choice to be placed in the ICU.
> > That is usually for post-surgery patients.
>
> These days it seems to be mostly for covid patients.

That would seem to be a mass-produced Darwin Award. More
of those are given out than even Grammys these days.

[Snidely]

Peter Moylan explained on 5/23/2022 :

I think you've been to an optometrist more recently than Tony has sold
a slit lamp, since he has reported for some time being retired.

/dps


--
You could try being nicer and politer
> instead, and see how that works out.
-- Katy Jennison

[Quinn C]

You forgot an "and". Or an "and of course".

> Searching < insert punctual plugs into the tear duct > (not something
> I'd heard of) first corrected the spelling and then turned up this page.
>
> https://www.aao.org/eye-health/diseases/punctal-plugs

Thanks. Even if I noticed, it'll be hard to stop the fingers from typing
the much more familiar word at first.

> It refers to "your eye doctor," anesthesia, and forceps, none of which
> seems appropriate to an optometrist.
>
> I'd be surprised about "prescribing medications," as well.

[Quinn C]

* Tony Cooper:

> On Mon, 23 May 2022 18:24:00 -0400, Quinn C
> <lispa...@crommatograph.info> wrote:
>
>>* Tony Cooper:
>>
>>> On Mon, 23 May 2022 17:06:50 -0400, Quinn C
>>> <lispa...@crommatograph.info> wrote:
>>>
>>>>* Tony Cooper:
>>>>
>>>>> It's called refraction because it detects refraction errors in the eye
>>>>> due to changes in the eye's shape.
>>>>>
>>>>> That process doesn't require the opthalmologist. It's just a sequence
>>>>> of this one or that one until the best combination if found. A
>>>>> technician in the opthalmogist's office, or an optician, can do it.
>>>>
>>>>Has never happened to me. It was always "the doctor" (assuming one could
>>>>call an OD that.)
>>>
>>> An O.D. is an optometrist: Doctor of Optometry.
>>
>>Who did you wrote this for, I wonder.
>
> The person who wondered if a optometrist could be called "doctor".

More specifically "the doctor". And it didn't answer that question. I'm
a PhD ("Doctor of Philosophy"), and it's not conventional to call me
"the doctor".

>>> What I've been saying is that the M.D. doctor (ophthalmologist), in my
>>> experience, doesn't do it
>>
>>What I've been saying is that most of my life, I was only seeing
>>ophthalmologists, not optometrists (because they're an American
>>invention), and they did my vision tests. Never an assistant.
>
> I suppose that is because you have been in systems based on some sort
> of national health scheme, and I have been in a system where the
> doctor's income is directly related to the number of patients he can
> see and the number of tests he can have done that he will derive
> income from.

No. In Quebec, the refraction is not included in the provincial health
insurance, and in Germany, the government sets most of the prices, but
doctors who aren't employees of a big hospital are self-employed, get
paid per service delivered and have to look at their profits.

I remember from childhood how my mother claimed the internist we all
used as a family doctor would do a lot of ECGs, because those can be
done by an assistant and thus have a good margin. I think the experience
of her consultation being interrupted by an urgent call from the
stockbroker contributed to her eventually changing doctors (I had this
experience with a dentist.)

--
Dottie: Maybe you can give him a pep talk.
Tunde: He is a white man with money. God already gave him a pep talk.
-- Bob hearts Abishola, S01E10

[Madhu]

* Tony Cooper <hiel8h99igmkhf8jd...@4ax.com> :
Wrote on Sun, 22 May 2022 18:53:51 -0400:
> Perhaps "street practice" is a Canadian term, but I would use "in his
> office hours" as a comparison to when he's either on call at the
> hospital or doing rounds at the hospital.

In India I think it is called "Outpatient consulting." Many doctors we
know do a round of 3-4 hospitals a day. Their primary job would be at a
govt. hospital (usually attached to a school, with a faculty position)
on a shift of a few hours. After they may consult in upto 3-4 different
hospital and clinc locations each for a few hours every day. This is
designated commonly i think as outpatient consulting. During this time
they may often disappear for a short stretches from their offices, when
they on on "rounds", visiting their in-patient patients who happen to be
admitted in that hospital (through their recommendation), but the
designating term remains the same.

[Tony Cooper]

On Tue, 24 May 2022 07:05:36 -0700, Snidely <snide...@gmail.com>
wrote:

Probably true, but it doesn't change my comments.

The ability to use a beam splitter and add a camera was in place when
started in the field. The cameras used when I started were the Zeiss
Ikon Contax film bodies and Urban Engineering film video cameras.

The principle is the same, though. The ability to project the image
to a monitor or screen came along after I retired, but I'm active in
the photography field and have done the same thing with a DSLR linked
to my laptop. It's not a new concept to me.

The only thing a bit strange to me is the idea of a optometrist being
that involved. An opthalmologist, yes. I think the lines of who does
what are different outside the US.

Sending the image to the surgeon is particularly strange to me. My
many years of experience in dealing with opthalmologists in this
country doesn't allow me to think that any of them would consider
something submitted by someone without M.D. after their name to be of
any importance or use.

In chatting with other people in my end of the business, we used to
joke about which surgical specialty group was the most egotistical and
which were the least egotistical.

Opthalmologists won "most egotistical" every time. Urologists won
"least egotistical" every time.

U.S. Senator Rand Paul, who was an opthalmologist before entering
politics, is a prime example of this egotism.

[Ted Heise]

On Tue, 24 May 2022 11:03:56 -0400,
Tony Cooper <tonyco...@gmail.com> wrote:

> Sending the image to the surgeon is particularly strange to me.
> My many years of experience in dealing with opthalmologists in
> this country doesn't allow me to think that any of them would
> consider something submitted by someone without M.D. after
> their name to be of any importance or use.
>
> In chatting with other people in my end of the business, we
> used to joke about which surgical specialty group was the most
> egotistical and which were the least egotistical.
>
> Opthalmologists won "most egotistical" every time. Urologists
> won "least egotistical" every time.

Having worked in medical device development for nearly three
decades and a good portion of that having involved work with
surgeons, I would agree with the generalization. A favorite joke
is...


Five doctors (a GP, a psychiatrist, a pediatrician, a pathologist,
and a surgeon) went duck hunting and were sitting in a blind.

A bird flew up and the GP raised his gun, but he didn't shoot
because he wasn't sure if it was a duck.

The psychiatrist knew it was a duck and raised his gun, but he
didn't shoot because he wasn't sure if the duck knew it was a
duck.

The pediatrician raised his gun, but he didn't shoot because he
didn't know if it was a girl duck or a boy duck.

The surgeon raised his gun and fired, and the bird fell to the
ground. He turned to the pathologist and said, "Go see if that's
a duck!"


--
Ted Heise <the...@panix.com> West Lafayette, IN, USA

[Tony Cooper]

On Tue, 24 May 2022 15:14:18 -0000 (UTC), Ted Heise <the...@panix.com>
wrote:

I like that joke.

You worked with or for Cook, right?

[Mack A. Damia]

On Tue, 24 May 2022 15:14:18 -0000 (UTC), Ted Heise <the...@panix.com>
wrote:

There is an old, old story about a traveling evangelist who also
advertised himself as a faith healer. In one of his crusade
services he jumped on the platform and said, “I have faith that two
people will be healed tonight. Where are you?” he asked. “Who would
like to be healed?”

A man ran down the aisle, named Harry. The healer asked what his
ailment was, Harry said he had a lisp. He explained sadly, “I can’t
talk wite.” He was instructed to go behind a curtain.

Another man hobbled down on crutches. His name was Frank. He said,
“I haven’t walked in 20 years without crutches.”

He was told to go behind the curtain with Harry. Then the healer
said “Frank, you’ve been healed. Slide those crutches out under
curtain one at a time.” Slowly the crutches appeared under the
curtain, and the crowd went crazy. The healer held up the crutches
and broke them over his knee. Everyone cheered!

Then dramatically he declared that Harry was healed of his speech
impediment too. The evangelist said: “Harry, the next sentence you
speak will be the first you’ve ever said normally.” Then he said,
“Usher, take him a microphone.” After he was certain Harry had the
microphone the evangelist asked, “What would you like to say,
Harry?”

There was a moment of silence. Then, from behind the curtain came
these words, “Fwank fell on hith ath!”

[Peter Duncanson [BrE]]

On Sun, 22 May 2022 11:44:36 +0200, occam <nob...@nowhere.nix> wrote:

>On 21/05/2022 22:20, Quinn C wrote:
>> One of the recent Jeopardy candidates was introduced as a pediatric
>> hospitalist.
>>
>> I had never heard of hospitalists. It seems to be a US-specific word for
>> "a physician and especially an internist who specializes in providing
>> and managing the care and treatment of hospitalized patients" or "a
>> health-care professional (such as a nurse practitioner or physician
>> assistant) who is not a physician but assumes a similar role" (Merriam
>> Webster).
>>

>> So using that word could be a way of not letting on whether you're a
>> doctor or not, although the second sense is often used as an attribute,
>> as in "hospitalist nurse".
>>
>> As for the first sense, I didn't know that this is a thing that one
>> would need a word for. I guess it only makes sense in the context of the
>> American/Canadian healthcare system, where doctors with their own
>> practice also work in hospitals (either on certain days or when their
>> patients are hospitalized), whereas e.g. in Germany, you'll
>> automatically treat mainly hospitalized patients if your main employment
>> is at a hospital rather than in a street practice.
>>
>
>It sounds like an attempt at a gender neutral term for a 'nurse' (or a
>'male nurse').
>
>If I were a physician, I would object to having this term used to
>describe my function.

The OED has this definition:

2. Medicine (chiefly U.S.). A physician specializing in the care of
hospital in-patients.

--
Peter Duncanson, UK
(in alt.usage.english)

[Ken Blake]

On Tue, 24 May 2022 10:45:07 -0400, Quinn C

<lispa...@crommatograph.info> wrote:

>* Tony Cooper:
>
>> On Mon, 23 May 2022 18:24:00 -0400, Quinn C
>> <lispa...@crommatograph.info> wrote:
>>
>>>* Tony Cooper:
>>>
>>>> On Mon, 23 May 2022 17:06:50 -0400, Quinn C
>>>> <lispa...@crommatograph.info> wrote:
>>>>
>>>>>* Tony Cooper:
>>>>>
>>>>>> It's called refraction because it detects refraction errors in the eye
>>>>>> due to changes in the eye's shape.
>>>>>>
>>>>>> That process doesn't require the opthalmologist. It's just a sequence
>>>>>> of this one or that one until the best combination if found. A
>>>>>> technician in the opthalmogist's office, or an optician, can do it.
>>>>>
>>>>>Has never happened to me. It was always "the doctor" (assuming one could
>>>>>call an OD that.)
>>>>
>>>> An O.D. is an optometrist: Doctor of Optometry.
>>>
>>>Who did you wrote this for, I wonder.
>>
>> The person who wondered if a optometrist could be called "doctor".
>
>More specifically "the doctor". And it didn't answer that question. I'm
>a PhD ("Doctor of Philosophy"), and it's not conventional to call me
>"the doctor".

I know several DMAs (Doctors of Musical Arts). They are all classical
guitarists. With one exception, they don't use the term "Doctor" for
themselves, and nobody addresses them as "Doctor."

[Ted Heise]

On Tue, 24 May 2022 11:25:11 -0400,

Tony Cooper <tonyco...@gmail.com> wrote:
> On Tue, 24 May 2022 15:14:18 -0000 (UTC), Ted Heise <the...@panix.com>
> wrote:
> >On Tue, 24 May 2022 11:03:56 -0400,
> > Tony Cooper <tonyco...@gmail.com> wrote:

> >> In chatting with other people in my end of the business, we
> >> used to joke about which surgical specialty group was the
> >> most egotistical and which were the least egotistical.
> >

> >Having worked in medical device development for nearly three
> >decades and a good portion of that having involved work with
> >surgeons, I would agree with the generalization. A favorite
> >joke is...
> >
> >
> >Five doctors (a GP, a psychiatrist, a pediatrician, a
> >pathologist, and a surgeon) went duck hunting and were sitting
> >in a blind.

> >The surgeon raised his gun and fired, and the bird fell to the
> >ground. He turned to the pathologist and said, "Go see if
> >that's a duck!"
>
> I like that joke.

Most in the business do. I usually avoid telling it when surgeons
are around. There are a few (usually who also have really good
technical wire and catheter skills) that have a temperament that
might appreciate it, but I've never taken the chance.

> You worked with or for Cook, right?

That's right. Started at a small R&D group of theirs, spent an
additional 14 years at corporate in Bloomington, and am now back
at the small group. Going half time next year, and then maybe a
bit of hourly work beyond 2023.

[Snidely]

On Tuesday, Tony Cooper yelped out that:

But the concept was new when you were selling the optics, and not yet
to PM's "this always happens" stage.

/dps

--
"What do you think of my cart, Miss Morland? A neat one, is not it?
Well hung: curricle-hung in fact. Come sit by me and we'll test the
springs."
(Speculative fiction by H.Lacedaemonian.)

[Peter T. Daniels]

On Tuesday, May 24, 2022 at 5:12:33 PM UTC-4, snide...@gmail.com wrote:

--
> "What do you think of my cart, Miss Morland? A neat one, is not it?
> Well hung: curricle-hung in fact. Come sit by me and we'll test the
> springs."
> (Speculative fiction by H.Lacedaemonian.)

How many years has that been appearing here? Yet never before
did I notice "is not it?"

IIRC Helen included several alternanyms in each message.

[Peter Moylan]

On 25/05/22 01:03, Tony Cooper wrote:

> In chatting with other people in my end of the business, we used to
> joke about which surgical specialty group was the most egotistical
> and which were the least egotistical.
>
> Opthalmologists won "most egotistical" every time. Urologists won
> "least egotistical" every time.
>
> U.S. Senator Rand Paul, who was an opthalmologist before entering
> politics, is a prime example of this egotism.

When I had to have eye surgery a few years ago, I found the surgeon to
be so arrogant that I decided not to have the operation. A little later
someone convinced me to seek a second opinion. The second person was a
lot more reasonable, and explained to me in detail what was wrong with
my eye, so I went ahead with it.

I might have asked the second specialist to do the surgery, but he died
a few weeks later. I hope there was no causal connection.

[Tony Cooper]

On Tue, 24 May 2022 09:20:04 -0700, Ken Blake <K...@invalid.news.com>
wrote:

I have always followed the practice of using, or not using, "Doctor"
according to how they introduce themselves.

[Peter Moylan]

And the ones who escape the covid are now out bonking monkeys.

[CDB]

On 5/24/2022 5:18 PM, Peter T. Daniels wrote:
> snide...@gmail.com wrote:

> --
>> "What do you think of my cart, Miss Morland? A neat one, is not
>> it? Well hung: curricle-hung in fact. Come sit by me and we'll test
>> the springs." (Speculative fiction by H.Lacedaemonian.)

> How many years has that been appearing here? Yet never before did I
> notice "is not it?"

You get that word-order in Austen sometimes. I suspect it may have been
an early attempt to write the contraction.