For me personally: court = empty (though I hope to never be in this situation!), doctor = full (unless getting lab tests or a procedure; the anesthesiologists mean business when they tell you not to eat!)
Fasting from midnight has been standard practice in the belief that this secures an empty stomach and thereby reduces the risk of pulmonary aspiration in elective surgery. There has never been any scientific evidence behind this dogma. A meta-analyses including a Cochrane review of 22 RCTs showed that fasting from midnight neither reduce gastric content nor raises the pH of gastric fluid compared with patients allowed free intake of clear fluids until 2h before anaesthesia for surgery. Equally, intake of clear fluids 2h before surgery does not increase the prevalence of complications. National and European Anaesthesia Societies now recommend intake of clear fluids until 2h before the induction of anaesthesia as well as a 6h fast for solid food.
Really interesting study. I’d file this under- makes a lot of sense, but hypothesis generating, and maybe some thing to be aware if you’re a physician or patient.
It certainly passes the common sense whiff test; I'm certainly more irritable when I'm hungry (though not as much as my toddlers) and can get short when I'm running late. I really hope it doesn't impact my practice but I wouldn't be surprised if it did
Late MD's cheat patients. Our time is important also! Some years back I recall reading of a patient
who was himself a professional, who took an MD to small claims court to sue him for that hour or so he lost because the MD was that late to the appointment. The patient won.
If you are consistently late to your patient appointments, then it is incumbent upon you to cut back on appointments in order to serve your patients better! Money isn't everything. If you can't be successful doing this, then you find another practice or field of work.
I generally agree with you that the health care system should show respect for our patients' time as well as the doctor's time. Unfortunately, the system shows little respect for both. Many practices have to pack their schedules with patients to stay afloat financially--some non-procedure-oriented specialty clinics can even operate at a financial loss within larger systems. Patients no show without warning, often for circumstances beyond their control, but sometimes not. And doctors seeing patients earlier in the day often have to help them with unexpected issues that arise. There are few good answers beyond creating incentives for doctors to see fewer patients, and that's very difficult when demand for primary care doctors and specialists is so high with a limited ability to create more doctors (we're working on it, but it takes time). Nurse practitioners and physicians assistants can help fill some, but not all, gaps.
The obvious answer is going to be AI's replacing human workers, including doctors. Humanoid robots are currently being deployed in various businesses. Here's a recent interesting article:
Figure's humanoid robots are about to enter the workforce at BMW
as a patient or criminal in court would it be better to listen to the outcome on a full or empty stomach.
For me personally: court = empty (though I hope to never be in this situation!), doctor = full (unless getting lab tests or a procedure; the anesthesiologists mean business when they tell you not to eat!)
"or a procedure; the anesthesiologists mean business when they tell you not to eat!"
Not true but good luck trying to discuss this with doctors.
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SEPT. 6 2017 4:19 PM
You Don’t Need to Do a Prolonged Fast Before Surgery
The recommendation is outdated, but many hospitals still mistakenly encourage it. Why?
By Marina Kamenev
http://www.slate.com/articles/health_and_science/medical_examiner/2017/09/you_shouldn_t_fast_before_surgery.html
AND
Enhanced Recovery After Surgery
Sept 7, 2017
Fasting from midnight has been standard practice in the belief that this secures an empty stomach and thereby reduces the risk of pulmonary aspiration in elective surgery. There has never been any scientific evidence behind this dogma. A meta-analyses including a Cochrane review of 22 RCTs showed that fasting from midnight neither reduce gastric content nor raises the pH of gastric fluid compared with patients allowed free intake of clear fluids until 2h before anaesthesia for surgery. Equally, intake of clear fluids 2h before surgery does not increase the prevalence of complications. National and European Anaesthesia Societies now recommend intake of clear fluids until 2h before the induction of anaesthesia as well as a 6h fast for solid food.
http://www.clinicalnutritionjournal.com/article/S0261-5614(12)00180-X/fulltext#sec3.4.
Really interesting study. I’d file this under- makes a lot of sense, but hypothesis generating, and maybe some thing to be aware if you’re a physician or patient.
It certainly passes the common sense whiff test; I'm certainly more irritable when I'm hungry (though not as much as my toddlers) and can get short when I'm running late. I really hope it doesn't impact my practice but I wouldn't be surprised if it did
"judges tended to issue rulings most favorable to prisoners at the beginning of their work day and right after food breaks."
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So as with teachers, defendants might want to bring the judge an apple when they appear for sentencing? [lol]
Late MD's cheat patients. Our time is important also! Some years back I recall reading of a patient
who was himself a professional, who took an MD to small claims court to sue him for that hour or so he lost because the MD was that late to the appointment. The patient won.
If you are consistently late to your patient appointments, then it is incumbent upon you to cut back on appointments in order to serve your patients better! Money isn't everything. If you can't be successful doing this, then you find another practice or field of work.
I generally agree with you that the health care system should show respect for our patients' time as well as the doctor's time. Unfortunately, the system shows little respect for both. Many practices have to pack their schedules with patients to stay afloat financially--some non-procedure-oriented specialty clinics can even operate at a financial loss within larger systems. Patients no show without warning, often for circumstances beyond their control, but sometimes not. And doctors seeing patients earlier in the day often have to help them with unexpected issues that arise. There are few good answers beyond creating incentives for doctors to see fewer patients, and that's very difficult when demand for primary care doctors and specialists is so high with a limited ability to create more doctors (we're working on it, but it takes time). Nurse practitioners and physicians assistants can help fill some, but not all, gaps.
The obvious answer is going to be AI's replacing human workers, including doctors. Humanoid robots are currently being deployed in various businesses. Here's a recent interesting article:
Figure's humanoid robots are about to enter the workforce at BMW
January 18, 2024
https://newatlas.com/robotics/figure-bmw-humanoid/
Human doctors will only see the most difficult/unique patient problems.