markroseman

5 ms·

1.
by markroseman 4y ago
Speaking as a daily TaskPaper user, this looks great! I totally get why you're doing the things you're doing with this, implementation-wise, and what you're able to achieve because of it. Having said that, you know very well
2.
by markroseman 5y ago
Has anything improved recently for RM2 around secure sync to a LAN? Would like to experiment with one for my psychiatrist wife to replace her paper chart notes, but anything hitting an external cloud service is out of the question for patie
3.
by markroseman 5y ago
Off topic, but one of my CS professors was part of the original Simula group. Had long sinced moved onto more formalized approaches, i.e., denotational semantics. On more than one occasion was heard to say "the only good object is a de
4.
by markroseman 6y ago
I agree. There's not a chance that it will be enough to change practice at this early stage, but it will be interesting.
5.
by markroseman 6y ago
On the other hand, there are so many opportunities for experimental design limiting the applicability of results in mental health experiments, that sample size and distribution doesn't even begin to touch on it. Bottom line: getting a
6.
by markroseman 6y ago
Simplistic in the extreme, especially given nobody has ever really enumerated all the (many, many) forms of depression in a meaningful way.
7.
by markroseman 6y ago
Totally agree on your last point. There's little connection between DSM and treatment guidelines (which do exist, separately). And treatment is so fragmented between multiple care providers (with most people accessing a small subset) t
8.
by markroseman 6y ago
Have met lots of people who are depressed and don't have a troubled past or present. Your descriptions of etiologies, how medications function and help, etc. are simplistic and ignorant at best. My opinion of your opinion is not high,
9.
by markroseman 6y ago
I'd agree in so far as it makes pulling scams (or innocently giving useless advice) far too easy: "I had depression, and I tried X, and it worked. You've got depression, so you should try X." Extremely unlikely to be he
10.
by markroseman 6y ago
Reading some of the comments is a good reminder that solid and meaningful mental health research is very tough and expensive, just based on the sheer variability, which can't be meaningfully captured by 99.9% of studies. Each needs to
11.
by markroseman 6y ago
Economically, the numbers are on your side (e.g. leading illness for workplace disability)
12.
by markroseman 6y ago
Applying the (current for any given time) criteria for depression requires a certain amount of training and skill, and the point form list of symptoms that you see as the first section in each diagnosis in the DSM-5 is not standalone. To me
13.
by markroseman 6y ago
You're probably confusing science as a top-down enterprise rather than a field that works bottom-up (where "bottom" would be grad students). Evidence emerges and builds from below.
14.
by markroseman 6y ago
Oh please, come on. There's an entire "field of study" that seems designed to prove that through the age-old mechanism of twisting logic into absurd pretzel knots that don't hold up to scrutiny from any but the most casu
15.
by markroseman 7y ago
Immense kudos for the Douglas Coupland reference.
16.
by markroseman 7y ago
Depends how it's organized, but it could be much better. In Canada, physicians don't need to get approval before they do everything, admin overhead for a physician to bill is a matter of a few minutes a week. Not two full-time sta
17.
by markroseman 7y ago
Is that when you omit infinity from the calculations in the US...?
18.
by markroseman 7y ago
People seem to think that if you move to single payer that the single payer would behave like any of the existing payers, i.e. you call to fight for approval for everything you do, argue about fees for each item, denying things is routine,
19.
by markroseman 7y ago
Because all the doctors in countries that have single payer are so horribly done by...?
20.
by markroseman 7y ago
That also doesn't factor in the indirect benefits to the economy, like all the people who can't start a new business (etc.), being stuck in jobs they don't want because if they left they'd lose their benefits.
21.
by markroseman 7y ago
Yes, in a properly functioning universal healthcare system, wait times for specialists can be longer for things that are less urgent. First priority is those with the most medical need, not whoever steps up to pay to play.
22.
by markroseman 7y ago
Lower administrative costs? In the US, doctors need at least one or two full-time admin staff to negotiate with a variety of insurance providers, argue for approval of every line item, etc. Here in Canada, I spend about 5-10 minutes per wee
23.
by markroseman 7y ago
Healthcare is under stress everywhere, but those of you in the USA who don't understand how fundamentally broken your system is need to give your heads a shake. It's precisely because of how it's treated like a business first
24.
by markroseman 7y ago
Wow, where to start... 1. The whole 'chemical imbalance' thing is a gross over-simplification that might help as an introductory mental model but breaks down quickly. 2. The right thing to be measuring is symptoms, not the mythica
25.
by markroseman 8y ago
Some other reinvented wheel that makes one thing 10x easier but takes five years to build up an infrastructure from scratch for everything else that real programs need (an infrastructure that was already present in whatever the new thing re
26.
by markroseman 8y ago
Varies by jurisdiction, but there are a lot of places, including many areas in the USA, where this is very much an issue, affecting licensing and credentialing. Would it survive a court challenge? Probably not, but I don't know a lot o
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by markroseman 8y ago
Your "one size fits all" approach to depression is greatly at odds with the great diversity of presentations that exist. There are absolutely roles for biological solutions like antidepressants to play for many people.
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by markroseman 8y ago
Best to think of them as a possible way of accelerating a course of psychotherapy.
29.
by markroseman 8y ago
Depression and anxiety can result in a rather wide range of cognitive symptoms. For many people, that's what eventually convinces them to seriously pursue treatment. Yes, there are risks that side effects of SSRI's can affect cogn
30.
by markroseman 8y ago
Compliance with medication regimes and followup care can affect outcomes in cardiology, as in other areas. Understanding a patient's psychiatric illness, psychosocial functioning, and other factors can help predict treatment compliance

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