First, private practice docs see patients with very good employer provided insurance, but residents are largely seeing patients that private practices wont see - patients who are far too medically complex to fit into a 10 minute slot and who also have particularly stingy insurance.
So as opposed to a private practice doc who is seeing 30 patients per day and billing an a average of $250 to $300 per patient (certainly not $1000 - that is unrealistic in my experience), a resident is seeing more like 10 to 15 patients per day (30 minute slots) and billing less than $100 per patient.
Second, residents have to be supervised. You have not included the salary of the physicians supervising them in your calculation.
Third, and I have mentioned this many times before on HN, training is limited by chiefly by the number of training sites that can offer quality training. For example, most hospitals will not see a single case of Guillan-Barre in a single year. Would you want to be treated by a nuerologist who trained at such a hospital? This is why neurology training is generally limited to places with a high volume of neurologic cases that would be considered rare at the average hospital, and these hospitals can only accommodate so many residents. Even for general medicine, you probably do not want to be treated by a doctor who trained at a hospital where any case that passed a certain complexity was transferred out to a bigger center.
They can make a lot more than 250K in less attractive places as well. But I believe the current cohorts of med students are more 'worldly' and in it for the money than in the past. They'll take getting paid 100K less so they can stay in a nice city and take another 50K less to work part time.
This is a classic Russian perspective on the war - that Ukraine is a gang of neo-Nazis that are dead set on eliminating Russian speakers from Ukraine by force. Russians will further claim that this gang of Russophobic neo-Nazis is led by Zelenskyy, a Jewish man who speaks Russian as his mother tongue and Ukrainian as a second language.
The absurdity of this claim should be self evident.
FYI "Jewish Nazi" isn't actually an oxymoron. In WW2 there were hundreds of thousands of Nazi party members who were Jews - they mostly got gassed along with the other Jews. Plus the whole Palestine thing.
Zelenskiy isn't a Nazi, but the reason he isn't a Nazi isn't because he's Jewish.
However this is one of the weakest possible grievances you could raise because Putin also released rapists and murderers from prison to raise manpower, most famously during the spring 2023 Bakhmut offensive. There is no moral highground on that point.
Actually, this is actually a near universal issue with Russian grievances against Ukraine. Virtually any grievance that Russia can claim against Ukraine, Ukraine can claim that exact grievance back at equal or greater measure.
You're finally getting it. Russia and Ukraine are truly the same when it comes to seeking their own interests. Ukraine was happy to fund far-right psychos to go terrorize Russian citizens of Ukraine after 2014 because that's the bargain they made. Russia invaded to stop NATO/EU from ending the kleptocracy because they are horrible shit stain oligarchs.
> Early termination of a domain registration does not impact the life cycle of the domain, as the domain can still go through the various stages of a standard life cycle.
According to ICANN cutting the life cycle short doesn't have any effect on the life cycle?
ICANN corruption is at the level of FIFA corruption.
That's like saying murdering someone doesn't have any effect on their life cycle because the full cycle: birth, life, death, plays out. The timing, evidently, isn't a factor!
Life cycle. Y'know. Birth, life, death. It had that. If you die tomorrow, you still had a life cycle. Totally not impacted. All 3 things still present and accounted for.
An absolute doddle assuming you have an absolutely excellent test suite. Otherwise on any nontrivial codebase you will still have regressions that make it to production and you will waste your time squashing bugs rather than writing new features.
the thing companies seem to be finding out is that quality is much more important when you're shipping 3-5x more per sprint and incident rates are multiplying at an even higher factor. allocating even less time to code review and testing is the norm, however, and it feels like the modern Agile SDLC is breaking a bit under this new mode
there's good skills to write test suites but each codebase needs its own bespoke implementation paired with so much institutional knowledge. but companies keep laying off those knowledge holders and QA to boot
it's almost like shareholders > leadership > middle managers see 'enshittification' as aspirational and are doing their best to implement a systems-level strategy in pursuit of it
I have a rule of thumb that goes something like, if you want to get people to use something 2x as much you need to make it 4x more reliable. The reliability becomes a enticement, and you will often underestimate how much more popular it will get, so if you aim for 2x you will likely see 3x and still have a lower incident rate per week than you experienced with lower traffic.
None of your users or managers think about errors as fraction of interactions. Even despite trying to label things as 99.99% reliable. Some managers will claim they do, but they aren’t being honest with themselves. Usually when they get mad it will be about having to deal with a problem happening twice in a week or a month. So now they’re yelling at you while you want to yell at them about being dishonest.
right, that was always the most surprising thing I saw when I made the career leap into tech
for all of it's vaunted 'big data' and 'metrics-driven outcomes' and whatnot, as soon as a single medium-to-large user starts complaining about an obscure component or wanting new features it was all hands on deck, roadmaps be damned, data out the window, who cares about CVEs/tech debt/fixing MVPs, let's do it MVP (again) instead of building something maintainable and extensible and then forget all about it like a child with ADHD when the next largeish user sends your C-suite an angry DM
meanwhile the core features that most people are happy with and the entire reason they chose your solution gets ignored and one day you look in your lunchbox and the food is all gone and C-suite's golden parachuted out to some cushier job somewhere else
Yeah the number of times displeasure with our lack of progress turned out to be some customer yelling at a manager who forgot to prioritize work for that customer and I later discovered was just letting the shit roll downhill was too damned high. I'm getting shit because you're incapable of uttering the phrase, "I messed up." Fuck that and fuck you.
As someone once put it, we should learn from the noble mule, who when beaten is more likely to stubbornly sit down and refuse to move than to get on with the work at hand.
It's a MongoDBism. The MongoDB community used document to mean the nonrelational equivalent of a row in a relational database. But over time there was definitional shift, and now it means a JSON blob, even if that blob is in a relational database.
I am confused as to how this is an argument for a single source of truth. It seems like you've presented an argument for the opposite. If there were a single source of truth, there would be no point in seeking a second opinion - it would be the same as the first. If the first opinion was correct, excellent. But if the first opinion was incorrect (and no AI model is correct 100% of the time), then you're straight out of luck.
The problem is that the first source is incorrect because she doesn't deal with lisfranc injuries frequently enough and her knowledge is not good enough. I've had to go do my own research to find a guy who specializes in lisfranc. Most patients would not.
However, if you went to an AI agent which has access to medical research, you would get the most up to date research.
Why would I seek a 2nd opinion if the initial doctor knew what to do?
> There are a finite number of words and a finite way of combining them within an academic setting/field which means that we can't build a perfect classifier with just text.
Maybe for very short phrases, but otherwise I disagree. Phrasing very quickly runs into a combinatorial explosion. In the words of Noam Chomsky, "Virtually every sentence that a person utters or understands is a brand-new combination of words, appearing for the first time in the history of the universe."
In my opinion, the difficulty in LLM/human text discrimination isn't that a person might coincidentally write exactly the same text as an LLM would, but rather that 1) LLMs aren't hard locked to a single phrasing (so this is a tougher problem than matching to a single static document, e.g. plagiarism detection) and 2) text has relatively low information density, so you need quite a bit of it to gather enough data to run a statistical test with a reasonably narrow confidence interval.
> They'll almost certainly spend more time and money on the process than is ever collected if this ever happens.
The point of regulation isn't for the state to turn a profit. In fact, I'd go as far as to say that regulations that drive a monetary profit for the state are generally bad because they create a perverse incentive. For example, municipal governments adversely affect traffic flow by lowering speed limits because those lower speed limits generate more ticket revenue.
> municipal governments adversely affect traffic flow by lowering speed limits because those lower speed limits generate more ticket revenue.
I don't know about the US because the US is weird, but:
* at 30kmph the rate of fatalities in case of a car hitting a pedestrian is basically 0%, at 50kmph I think it's 5% or more
* at 30kmph collisions are much easier to avoid due to the increased reaction time and the decreased braking distance (I don't remember the exact numbers)
* at 30kmph you can hold a conversation at normal speech levels next to a moderately busy road, at 50kmph you will have to shout (and not even notice it due to the high ambient noise)
You're right that the point of regulation isn't to turn a "profit" but the laws of economics always apply. If you have a fine of $100 for a widespread practice that costs $1,000 to collect, the state isn't going to magically allocate resource to applying it.
You could create a private right of action for this, but that is its own bag of worms.
> If you have a fine of $100 for a widespread practice that costs $1,000 to collect, the state isn't going to magically allocate resource to applying it.
Seems empirically false given e.g. the immense investment we make in counter-drug enforcement.
You're ignoring how much money and power is found in the drug enforcement industrial complex. The point of drug enforcement is not to stop the drug trade.
Several things.
First, private practice docs see patients with very good employer provided insurance, but residents are largely seeing patients that private practices wont see - patients who are far too medically complex to fit into a 10 minute slot and who also have particularly stingy insurance.
So as opposed to a private practice doc who is seeing 30 patients per day and billing an a average of $250 to $300 per patient (certainly not $1000 - that is unrealistic in my experience), a resident is seeing more like 10 to 15 patients per day (30 minute slots) and billing less than $100 per patient.
Second, residents have to be supervised. You have not included the salary of the physicians supervising them in your calculation.
Third, and I have mentioned this many times before on HN, training is limited by chiefly by the number of training sites that can offer quality training. For example, most hospitals will not see a single case of Guillan-Barre in a single year. Would you want to be treated by a nuerologist who trained at such a hospital? This is why neurology training is generally limited to places with a high volume of neurologic cases that would be considered rare at the average hospital, and these hospitals can only accommodate so many residents. Even for general medicine, you probably do not want to be treated by a doctor who trained at a hospital where any case that passed a certain complexity was transferred out to a bigger center.
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