asciilifeform: awt, phf, signpost , jonsykkel , et al : predraft of 0xfa updated to give chained-multipart cmds own coades, as discussed recently.
asciilifeform: nuffin else changed since last announced rev.
asciilifeform: ( chained-multi nao carries 288-byte chunk -- zapped 'mark' and 'z' fields , as not req'd nao; broadcasttextm nao coad 0x06, directtextm -- 0x07. )
phf[asciilifeform]: u.s. is all kinds of fucked, i've discovered a new vector of fucked. medical services out in deplorables land is utter trash
phf[asciilifeform]: primary care doctors don't exist anymore, they are all ancient, and cultivate a roster of equally ancient patients. everyone new gets deferred to "nurse practioners"
signpost[asciilifeform]: and "what pills do you want?"
asciilifeform: 'colt '45 health insurance and retirement co.'
signpost[asciilifeform]: even here in texfrancisco we were on a 2wk wait list to pop out the new bean.
asciilifeform: dunthink this is confined to 'deplorable land' tho
asciilifeform: afaik whole usa precisely like this
phf[asciilifeform]: correct, nps are there to basically prescribe you pills, because that's the only thing they know how to do. but there's all kinds of kabuki around the pill prescription.
phf[asciilifeform]: like they dress like real humans^W^Wdoctors, and also pretend to be doctors, but they are otherwise totally useless. they waste your time with a ritual "i'm going to doctor you real good now"
phf[asciilifeform]: i'm subscribed to two nps, the good old boy hick np, who charges less and is otherwise down to earth (no masks required!11) and shiny waiting room np who pretends to be serious business and otherwise loves the science. charges more of course, for that "city" experience
phf[asciilifeform]: so i needed two pills issued, a simple pill and a slightly more complicated pill. i've been prescribed those pills by real doctors, after waiting something like 2 months for appointment. i love visiting those doctors, because we end up spending extra time chatting about interesting
phf[asciilifeform]: , non doctor related things, in the "holy shit, you're a human!" format
phf[asciilifeform]: but i don't want to wait 2 weeks ("sorry, shortes we can get you in", i guess beats 2 months) for pills, so lets go ask hick np
phf[asciilifeform]: go check CVS "sorry you only have one prescription" "but there should be to" "sorry one only". so the hick mp manages to fail at one thing she's any good at
phf[asciilifeform]: but she checked my heart and blood pressure! and ask me if i smoke daily or once a month!
signpost[asciilifeform]: did she do the knee hammer thing? folks love it when they get the knee hammer.
asciilifeform: this afaik sop nao for # of yrs. to the point where many usa folx skip straight to 'order pill from india' (if had the fortune of somehow discovering 'which pill' needed) and pray to satan that it won't vanish at customs
phf[asciilifeform]: aye, and that gets my to the point, the "us is fucked" part. telemedicine!
signpost[asciilifeform] knows someone who needed an antifungal and just ordered primate veterinary after similar idiot thwarting.
signpost[asciilifeform]: close enough!!!11
asciilifeform: signpost: in recent yrs 'veterinary' vendors tightened screws (e.g. at one time could get antibiotic 'for aquarium fish' for coupla $. nao -- rarity and over9000 fakes)
phf[asciilifeform]: instead of going to your local hick np, you can talk to an np in buttfuck, TX, who's got a klicking sound in the name, and he'll do the absolute minimum kabuki required by law, on account of having a clicking sound in his name, he doesn't pretend to legitimacy, is there to write you a script.
asciilifeform: mega-popular iirc. there are at least a dozen of these (occasionally usg shutters'em when they start prescribing morphine etc but short of this, generally leaves'em alone)
signpost[asciilifeform]: if I could figure out where to be gone to, I'd be gone
asciilifeform: 'does the klein bottle have an outside'(tm)
phf[asciilifeform]: asciilifeform, i've discovered this wonderful world on account of not being able to easily travel to russia this winter. so my yearly "fix every possible medical issues for $1k" ritual is thwarted, and i've discovered that everything's fucked
asciilifeform suspected
asciilifeform: and erryone knows 'usa -- medically fucked' but even the most mundane household repair co. fucked. asciilifeform spent month+ chasing down 'why furnace stops', instead of hiring repair ( 100% of repairmen offered a 5-figure 'we can install new one' ), finally traced problem to defective solder joint on mobo that vibrated l
asciilifeform: ... that vibrated loose over some # of yrs
asciilifeform: reflowed that 1 ball -- fixed.
phf[asciilifeform]: out in the deplorables land you can still get appointment with a real doctor, and because they are not all puffed up on bethesda residency and morning npr programming, they tend to talk straight and have very sensible opinions. and they all think shit's fucked. "you need any script
signpost[asciilifeform] has contractors worth a shit, filtered for rednecks when selecting.
phf[asciilifeform]: s while you're here? as you might know narcotics are out, but depression? issues sleeping? maybe stack up on some antibiotics? anyway, see you in a year!"
signpost[asciilifeform]: but it took a few attempts.
phf[asciilifeform]: the case where your urologist is also your general practitioner
asciilifeform: klicking indian autoprescriber prolly cheaper
asciilifeform: (tho not so great for idle chat)
phf[asciilifeform]: ayo hol up, why is it when africa man gets to be an np in america eryone assume he indian
phf[asciilifeform]: clicking languages are african
asciilifeform not spent much time with doctors (aside from dr.mengele-style 'you dun need novocaine' dentist) but expects that when he ends up needing actual doctor, the kind that cuts etc. -- will prolly simply feed worms
phf[asciilifeform]: asciilifeform, that's why you pay them to chat once a year. you want the whole roster of potential medical issues covered, so when you call them you say "can you please leave a message with dr such and such"
phf[asciilifeform]: this way a kind of a card game, "ah, fuck, i don't have a suit to cover that one, guess i ded now"
phf[asciilifeform]: i do wonder which one's the horse and which one's the cart. could be the case that pervasive internet is eating up the legacy institutions is the cause rather than the other way around
phf[asciilifeform]: like for example i don't have much insight into why nps have replaced doctors, which started a decade ago? was it the case of kids these days, or too many people too few doctors, some kind of regulatory shit, or was some aspect of proto telemedicine already thinning the margins
asciilifeform: 'few doctors' afaik is phakt -- in usa is a cartel, and explicitly exempted from antitrust etc
asciilifeform: ( they graduate with ~1/2mil in debt, and pay it off by charging over9000, which is normally paid by 'insurance' (fraudulently labeled, in fact is scheme for (miserly) distribution of freshly-printed usd to doctors/pharma cos )
asciilifeform: the Officially-ordained doctors normally do very little doctoring, instead overseeing a stable of nurses (formerly; nao these ~also~ graduate in debt, and not do much nursing, instead oversee technicians, who... fuck knows what with next 'turn of screw')
signpost[asciilifeform]: speaking of insurance, I literally just got a letter calling a hospital birth an unnecessary procedure.
signpost[asciilifeform]: I assume they send these out because some percentage of duds wont bother to follow up.