josh282282

PUBLIC SERVICE ANOUNCEMENT To all my esteemed friends on this board: be very aware and leery of all the NON-PHYSICIAN members who are urgently giving you medical advice here on this board. Conversely, time and time again, physicians (like Unicorn and there are others but I forget their screen names) are here giving sound, cogent responses and advice. I, as a board certified family physician do so, too: PLEASE GET COVID VACCINATED. IT SAVES LIVES. Ignore these lunatics here on this board who are NOT physicians giving anti-covid vaccine rhetoric. Do you get legal advice from a friend? NO, you go to a LAWYER. Do you get accounting advice from anonymous accountant sources? NO, you go to an ACCOUNTANT. Do you call your mom to fix your plumbing problems? NO, you call a PLUMBER. Listen to the doctors! So DO NOT LISTEN to these non-physicians (like pubic-assistance, for example) about medical care and especially vaccines. They seem to know oh-so-much (and are ever so abrasive) that the whole medical community seems to NOT know and disagrees with. Pubic-assistance and his lot never went to medical school They operate OUT of their depth. Don't let them hurt you by listening to their unproven and unsupported (and peculiar) medical advice. They have political agendas where physicians only agenda is life saving. Every one wants to be a doctor. No one wants to go to medical school. IN SUM: PLEASE GET COVID VACCINATED. IT SAVES LIVES. warmest regards and much love to all, Josh PS You got the new covid vaccine with the bivalent dose of covid, the one with the Omicron variant in it, yah? PPS You got your flu vaccine, too, right? PPS And of course you are getting as soon as you can your Monkey pox vaccine? I mean we are all a bit slutty on this board.....

Hi all (Primary care physician here) Plz dont let the article mislead you. Mycoplasma is most certainly not a new STI (its Sexually Transmitted Infections now, not STDs). I've know about mycoplasma for many years. Unfortunately, and till more recently, testing for mycoplasma was harder. But I've been using a urine test for my patients for mycoplasma for a handful of years now, so testing has definitely been available for some time. It's just some doctors dont keep up with the medical literature. (Unicorn: I most certainly dont mean you as I respect you & your fund of knowledge greatly. If I recall correctly, you did hospital medicine before you retired so this is not your field so I would not expect you to know these details. It's out patient primary care doctors who serve gay men who most certainly should know). But let's be more thorough. Many sexually active gay men SAY they get tested regularly for STIs but in my professional opinion, they are sadly mistaken. A FULL battery of STIs has ALL of the below tests. And yes these tests are commercially available. 1) urine testing for gonorrhea, chlamydia, trichomoniasis (are you aware of this fun STI & getting tested for it, right?), ureaplasma (another lesser known STI but still plenty common), and todays topic, Mycoplasma. 2) blood work to test for syphilis (an RPR) and HIV. 3) A swab of your throat and anus for gonorrhea & chlamydia. So, YES, if you have not had your throat/anus swabbed then NO, you are NOT STI tested. Wait, you say your doctor/clinic doesn't do swabs? Get a new doctor because a full battery of STI tests includes swabs of your anus & throat. And testing includes mycoplasma & ureaplasma testing, too. Unfortunately there are too many doctors who say they serve the Gay community but arent up to date. Please request good care. Many of us on this forum are quite sexually active (good for us!!!) & getting a full battery of STI testing every 3 months, yes, every 3 months is important for good genital health. As a physician who treats many gay men in a large city on the east Coast, I test my gay patients oh-so-frequently and treat STIs all week long. Treatment per the CDC which I use for mycoplasma is: If M. genitalium is detected by an FDA-cleared NAAT: Doxycycline 100 mg orally 2 times/day for 7 days, followed by moxifloxacin 400 mg orally once daily for 7 days Much love to all, Josh PS. I use Labcorp, not Quest so I'm unsure what Quest offers. I think if I recall correctly I first heard of the mycoplasma/ureaplasma tests in 2018, but I could be off by a year.

I went to the West Coast for a business meeting & some R&R once. In advance, I communicated & booked a session with Beefmuscle. It was all set to go: time, place, his rates. No red flags in our communication. I'm not new to hiring so I did no faux pas of over-texting him, was not disrespectful online with him, nor attempted to haggle his rate down. He no-showed. Fuck this loser. Dont hire him.

Wait, this is a website where gay men not only promote the hiring of prostitutes, we CELEBRATE the hiring. Yet, we are coming up with the above judgmental and cruel comments towards our gay brothers not on this board as IF we are on some Higher Holy Ground than they? Um, wat? Are we really that juvenile & petty (and off base)? Surely we can do better... Although I wouldnt set foot on a cruise right now due to Covid, I have done several gay cruises in the past & found them fun & exciting. And no, I didnt do any drugs, get drunk, nor have wild sex. Most dont on gay cruises, contrary to what you might think. It's mostly normal every day gay guys just wanting a vacation. But I find it amazing that often the loudest detractors of gay cruises are gays that have never been on one. Why is that? There are no more queens on a gay cruise than on this board. And tbh, I respect the queens. It was the queens at the Stonewall Inn in NYC in 1969 who first fought back against the police tyranny, not the respectable gays in the closet. The queens initiated the Stonewall Riots & ushered in the modern gay civil rights movement. I am no queen myself, but I am fully aware I owe a lot to that group. Unfortunate they dont get the respect they deserve, especially from this board. Love to all Josh

Happy New Year my brothers. I'm not gonna address gkim1986 directly but take this to everyone on the forum cuz I strongly suspect he isn't the only one making this horrible and potentially dangerous error. It is NOT "best" to get a prostate "biospsy" done to "avoid any wrong diagnosis". No way is it time to make this medical recommendation. WAY too soon. And its the wrong person giving the medical recommendation. gkim1986 is NOT a urologist. The OP needs to see a urologist before any recommendations are made. gkim1986 is practicing Medicine without a license and doing it very poorly and dangerously. As Unicorn well said in his post, a prostate biopsy is typically NOT the standard of care for hematospermia (blood in your cum) except in uncommon situations. Why is this important? Because prostate biopsies are NOT easy, benign procedures. There are significant risks associated with this procedure, so they shouldn't be taken lightly. Because of this, prostate biopsies should not be recommended by a non-urologist. Oh, wait, you dont know the risks of prostate biopsies? Of course not. Why would you. You are not a physician. Prostate biopsies can cause (there is more to the list but this is a start): 1) Rectal bleeding. How does blood seeping out of your underware and soiling your bed sound to you? 2) Blood in the urine. Pretty. 3) Urinary tract infections (UTIs). Painful & dangerous. 4) The above UTIs can spread to the bloodstream and the guy can go into sepsis. Fuck. 5) Difficulty urinating, meaning the guy has to push and push as he stands there to get his urinary stream going. Or he now gets up many times all night long to urinate. Sounds like a party. Yah, lots of fun. Yeah, its NOT a benign procedure. It has its risk. It has its benefits. Am I saying the OP should NOT get the procedure? NO! I am NOT! Am I saying the OP SHOULD get the prostate biopsy? NO, I AM NOT! I am not his urologist and that should be discussed between the OP and his urologist, not by gkim1986! Yet, prostate biopsies are an important and integral procedure in proper urologic care. Notice the word "proper". Please note: gkim1986 is not trained to give proper medical advice. Folks, giving medical advice is dangerous stuff, even from those who are trained to do so. Advice can go amiss (oh, what I have seen in my professional career...). Just talk to my patients who had prostate biopsies and have had the difficulties listed above (which I have seen). It isn't pretty. I'm not saying prostate biopsies are bad and should not be done. I'm just saying only urologists should be making recommendations. A urologist goes through 4 years of medical school and roughly 5 more years of surgical training in residency (thats 9 years if you are counting) to be able to decide who should and who should not get a prostate biopsy. Yet, sometimes prostate biopsies are not only important but critical. Do I think that gkim1986 is trying to HARM the OP? Nope. I just suspect he doesn't realize that what he is doing is dangerous. How many times do patients go to their doctor (like a Urologist in this situation) and DEMAND a certain procedure because he read it online that its "best to get your biopsy done to avoid any wrong diagnosis" (quote from gkim1986). Yet, that procedure is NOT indicated. Not only that, but its a potentially dangerous procedure?? You think this doesn't happen frequently? It does. All the time. And bad things happen. And sometimes its cause a patient heard something from a "friend" who gave him advice and now the patient is in the physicians exam room with bizarre, inaccurate and potentially harmful information. YOU KNOW WHAT? I think a lot of people reading my post do the same exact thing as gkim1986 does inadvertently: give medical advice when the person (you) has NO training or medical experience to give such medical advice. Yes, I genuinely think this because every day I hear from my patients "I heard from my friend...." and 80% of the time is wrong, weird advice and I gotta fix the inaccurate and harmful ideas my patient has. WHAT YOU SHOULD BE DOING? PLEASE READ THIS. Ok, I know you care about your family, friends, loved ones, co-workers etc. They start talking to you about a medical problem they have. And you care about them. You may even love them. You want to help them. Of course you do. INSTEAD of giving medical advice AND POTENTIALLY HARMING YOUR LOVED ONE consider the below suggestions: Your loved one: "Oh, my god. I'm having blood in my cum. WTF?" You: "That sounds awfully scary. Have you discussed this with your PCP?" OR Your loved one: "Oh, my god. I'm having blood in my cum. WTF?" You: "That sounds awfully scary. Have you discussed this with your PCP?" Your loved one: "...um... no, I dont have a PCP." You: "You know, I have a PCP who I really like and trust. Why dont I give you his/her number and you can call him/her to make an appt to discuss this?" OR Your loved one: "Oh, my god. I'm having blood in my cum. WTF?" You: "That sounds awfully scary. Have you discussed this with your PCP?" Your loved one: "No, but I'm so scared. My uncle died of cancer a couple of years ago and it was horrible. I'm just so scared to even make the call." You: "Yes, I understand. I'm sorry you lost your uncle from cancer. This has gotta be so unnerving to you bringing back terrible memories. Why don't you and I make the call to your doctor together, and I will even go with you to your doctors appointment for moral support? You got this, man. I'm right here with you." The above scenarios, and variations of the theme, are the ONLY things you should be recommending to your loved ones. Really, you can KILL someone with the wrong medical advice. But these are your loved ones. They deserve the BEST from you. And the best means NOT giving medical advice. STOP giving medical advice. Instead, give love and encouragement. Give blow jobs, too if its consensual. Cuz BJs are awesome. Warmest regards to everyone on this board. May 2022 be a prosperous, safe and healthy year Josh

Suggestion: all NON-PHYSICIANS on this website stop giving their medical opinions/experience here. Your information can be misleading & unhelpful. And typically wrong. Do we go to our plumbers for accounting advice? Do we go to our barber for legal advice? It took my 8 (yes, eight) long, arduous years for me to to learn my craft (I'm a physician) from medical school to residency. Unless you have gone thru such a journey your (inaccurate) advice is potentially very DANGEROUS. Yes, for real. Bad advice can lead someone astray, to their peril. One of the first things one learns in medical school is "First, do no harm". Possibly one of the most challenging issues I must navigate as a physician is trying to fix the erroneous, distracting, & sometimes bizarre ideas my patients have heard "from a friend" or "read online". When I fail to help my patient successfully navigate this problem, they get hurt. I know you mean well. But it's not helpful. Thank you Unicorn for answering the questions/comments above. Your medical opinions were spot on. I have given thumbs-up on his answers so you can see his & my (two physicians) concordance. Much love to all, Josh

THINKING ABOUT IT?!? Just DO it! (In your eyes) you are one hot tamale. You're so hot you can even filter out good paying customers by asking for a selfie. That's some pretty amazing hotness you say you are. Run with it! So heck, I'll go one step further cuz You THE MAN: you gotta, GOTTA, quit your day job RIGHT NOW. Dont think bout it one moment more. Dump that low-paying loser job & run to the very easy, low-risk job of Escorting. Just ask the other (very wonderful) escorts on this website. They constantly are saying how EASY & DRAMA-FREE escorting is. Why can't that be you, too? And escorting will be fun. You will never have ugly clients (cuz they sent you a real & truthful selfie, right?). You will never fear for an STI (its amazing how protective selfies are). You will never be stood-up by a client. And your hotness will repel all the Crazies, so it's one win after another for you!! I bet you are thinking 'why didnt you think of this before'? Well, you can make it up by charging yet NOT kissing, rimming, or blowing your clients. But what escort needs to provide those activities. I mean, clients rarely ask for them anyway, right? Once again, its Smooth Sailing to the Easy Money Ocean for you. Jump on that ship A.S.A.P. And it looks like your personality is PERFECT for escorting. Clients REALLY love a good narcissistic provider. We eat them up! Dont change a thing. You do you! So STOP, STOP, STOP asking for advice cuz you come up with INCREDIBLY SMART IDEAS ALL THE TIME! Run, dont walk, to the phone, QUIT your day job now- NO 30 DAY NOTICES REQUIRED- and set up your RM ad today!!! Your BIGGEST fan, Josh

I respectfully disagree with you. Completely. You are running a business, and it should be run with the standard business model western society is familiar with. Or get questions/concerns/issues/pushback. Or people who refuse to use your services. FYI: I practice what I preach. I'm a physician in private practice & run my business (clinic) all by myself. I see patients in my clinic and I love what I do. But whether I'm running a primary care clinic or an accounting firm or law firm or whatever, the same business principles apply to me. To you too, as well. It's not uncommon for me to see patients on a Saturday. I hate putting patient requests for appointments too many weeks in advance. Patients want (need) to be seen sooner, not later. It's their health. So I offer on occasion a Saturday here & there to keep appointments a reasonable amount of time from when they request it. Which means I gotta ask my staff to come in on their weekend and work. And PAY THEM OVERTIME. It's quite costly & frankly, a negotiation with my staff & a logistical complexity. My patients know nothing about that. Nor should they, they just seek care. But my fees for being their physician needs to cover everything that entails the cost of providing the patients medical services: its gotta cover my staff salaries, overtime, rent, utilities, malpractice etc & ultimately my paycheck. So escorts asking clients to pay for an Uber just looks bad. And guess what? Sometimes I have no-shows just like escorts. Escorts seem to think they are the only ones who experience no-shows. But I get them & it frustrates me a lot. Sometimes its even on a Saturday, dang it! And sometimes it's a patient I've never seen before who no-shows ON A SATURDAY. But no-shows are part of the reality of being in business. And my fees need to take that into account, meaning I expect a certain (small) percentage of my appointments to end as no-shows (therefore no money for me). Therefore, an escort asking clients to pay his rate PLUS an Uber is ridiculous. An escorts hourly fee should encompass ALL of the expenses (including transportation costs), which should include allowing a percentage of no-shows. Demanding me to pay for an Uber makes the escort seem unprofessional. When I start sniffing "unprofessional" I refuse to book. Unprofessional is also this maybe-I'll-offer-a-better-time-if-they-take-care-of-me mentality. No matter how much my patient pays me, whether I like the patient or not, whether I'm tired, bored, busy, sick whatever, the ultimate in Professionalism is ALWAYS giving my 100%. Did you know that physicians by law are NOT allowed to accept "gifts"? Sure, we can (gladly!) accept a (small) plate of cookies or something of very marginal value, but anything of value is a HUGE no-no in the medical profession. The agreed upon fees that are paid to me are the complete reimbursement for my services. I cant give one patient one standard of care, and another one a different (higher) standard (cuz he bought me opera tickets). The reason why gifts are forbidden in my profession is if allowed, patients might think, "oh, he wont take good care of me today cuz I didnt bring him a nice gift". A patient gets my 100% cuz he's my patient, not cuz of a gift. My fee, which incorporates the cost of my overhead & my salary, is the complete reimbursement for all my services. It's called Professionalism. So yah, no Ubers for me. Sure, I've been asked a few times. And always declined. And ALWAYS found a guy who doesn't ask for an Uber.

Board certified primary care physician here. I treat sciatica all the time. Back pain is a (very) common complaint in primary care. But, NO, syncs comment above is inaccurate. Opiates, such as Vicodin, are NOT indicated for long term LBP chronic pain. It has nothing to do with fear of lawsuits or legal restrictions (btw, what legal restrictions were being referred to? As a licensed physician with a DEA license its perfectly legal for me to prescribe opiates, although I very rarely do). Opiates rarely improve functioning and create a host of other issues that can be quite detrimental to the patient. First do no harm, after all. So any Pain Treatment plan typically declines opiates as an option. My deep empathy to you, Axiom. Sciatica is horrible. LBP SUGGESTIONS FOR ALL (not in any particular order of importance, and each patient needs a tailored treatment plan- please see your primary care physician) 1) Weight loss 2l Physical therapy 3) Epidurals 4) a TENS unit 5) ibuprofen 6) lidocaine patches 7) yoga 8 neurosurgery 9) gabapentin/lyrica 10) Cymbalta 11) exercise 12) probably more but I'm too tired to think any further, it's been a long day, and I'm exhausted but riddled with insomnia Warmest regards to all Josh

Wishing for no drama, & with respect to your contribution to our wonderful boards, and I'm sure it was just an oversight, but some people from the transgender community might be offended by use of the term, "Shemales". Perhaps "transman" might be better? This is a welcoming community, after all. Might I respectfully suggest an edit on your part? Hope you are well, Josh

Dear Daniel, I'm SO sorry you had to experience this. You deserve better. Escorts provide a beautiful service. They bring excitement, intimacy & healing to a broken world. I mean that. FWIW, I'm a physician & now concentrate solely on outpatient care. And on my schedule I have no-shows all the time. Its frustrating. And it harms my other patients who we declined offering an appointment to cuz we were full but we could have helped in the end. This happens to every outpatient physician. Any doctor who says differently is being dishonest. Ok, my 2 cents worth given I'm a "provider", too (of different sorts): 1) Focus on those you did serve, especially those you really served well. You cant always hit it out of the ballpark with everyone, so when you know you did well, congratulate yourself & be happy. And you seem to already be doing this as evidenced by your statement: Keep remembering those clients. They will keep you sane. Ok, specific suggestions: 1) My staff do NOT give an appointment to patients less than an hour away (but doc, I'm only 5 min away from your office!) from the scheduling appt time. If they are 5 min away they will invariably do some errand like stop at Starbucks and THEN be late. Nope. Maybe dont do the "now" appointments? 2) Keep a log of encounter inquires that result in a booked appointment. Briefly log how they found you (which means you gotta ask them), their tone (they were lewd & sexual from the get go or... seemingly professional... or shy ...or...). Log a "gut reaction" you get from these inquiries (I think this is gonna go well to hhhmm, I think he sounded sketchy....). Note times/dates of inquiries. Note how many bank & forth volleys of texts/phone calls till the booking was made. Add more criteria as you seem appropriate. THEN start looking for a trend. For example, 80% of inquires with a booking between 1000 pm & 500 am (the scheduling process time, not the actual meet up time) lead to no-shows but only 20% for other times. With that data, you can start implementing interventions to manage/diminish these time-wasters. For ex: if the above example is true, turn OFF your phone during those times & have an auto text-message go out saying something like you are "out" till the am but you are "VERY interested" in their "inquiry" but this "text will not go thru" so "please repeat your inquiry again tomorrow". Time-wasters may lose interest & walk away. 3. For bookings made in advance, try confirming the day before. For example, if they make a booking 5 days in advance, inform them during the initial booking process that the day before the appointment you will need a definite confirmation text (email or phone call or whatever you choose) to guarantee the next day appointment. No communication= cancelled appt. Many doctors offices do something similar. Might work for you? 4. My office has a 3 strike rule: 3 no-shows & the patient is discharged from my practice. No exceptions. And patients are informed of this. For you: one no-show & never book again. Block their number, too. 5 While booking, ask their specific goals of the session. Make them articulate their needs. You might be able to see patterns of time-wasters & then decline to book. Maybe time-wasters arent as articulate & you can sense it? Dont book those. 6 If you arent already, consider all confirmed bookings to require a 2-3 min phone conversation to confirm everyone's intentions. Maybe people are less likely to flake out if they spoke with you in a real, live human being voice versus 100% of the booking process done via text? 7. If talking with a prospective client you sense hesitation/potential flakiness, dont hesitate to speak to your concern. "I sense you are a bit unsure of your goals. Let's put off scheduling a definite appointment till we are both on the same page & I know I can give you a rocking-awesome time". 8. Like attracts like. You should strive to be the consummate professional. Never flake on a client. Its bad charmma & you risk getting a reputation for flakiness & geting like-minded clients. Physicians have been honing strategies to decrease no-shows for years, and we are still fine-tuning the strategies, cuz we arent as successful as a group as we want. Dont get discouraged & keep at it. I'm rooting for you. And come back & let us know how its going! Hugs. Josh

Hi LookingAround Hi LookingAround I must state, and I write this to you out of respect, that you seem rather self-assured in a field where you are not an expert. If that comes off as disrespectful, my apologies. Tone can be challenging to convey online & I mean you no disrespect. You stated the existence of a "national database" that I, as a physician (and all other US physicians & NPs), can access and see what meds my patients are taking. You come up with nothing but heresay nor proof of said existence. By all means, prove me wrong. Could you link me to the login to this website? I'll register & start using it. For real. It would help my patients receive better care. I then bring up the possibility that the database you reference is the scheduled drug database that each physician can get access to, meaning this is what you mistakenly refer to. But these databases only contain scheduled drugs, not PrEP drugs. You are strangely silent on this. You then bring up that surely most physicians are linked up via our EMRs. You even bring up Epic, showing that a third of hospitals use it to support how linked up we physicians are. But I then clarified for you, with a quote from the VERY article YOU linked, that it was a survey of what EMRs hospitals use, not outpatient clinics such as what the OP uses. And Nurx is not a hospital, either. Can you provide that link that shows all these amazing things you say exist? You have never been an EMR user as a physician, so I'm quite curious to see what you know, that I do not. Please educate me. But with concrete support as I have done so with you. And I hope I offer my comments respectfully as there is no reason to fight. Debate yes, fight no. My point to everyone reading this thread is there is some inaccurate idea among patients that the medical community here in the US is linked up in one way or another. I sadly report to you that, no, it doesn't exist. A huge, vast majority of the time when you see your physician, unless he/she is part of a large medical group, the EMRs from other groups do NOT auto-communicate. I wish they did!!! But I offer more evidence that this flummoxing issue is resolved in that Nurx communicated directly with the OP PCP. I think the OP just forgot that he gave Nurx his PCPs name. I'm still hopeful that the OP calls his PCP tomorrow & inquires for us. I went to Nurx website and found this in their FAQ: Does Nurx share information with my primary care physician? If you want us to, we can share your information with your primary care physician. We believe it is a good idea for your primary care physician to have a full picture of your health, and encourage you to share the health information we have about you with your primary care physician. You’re in control though, so we will not send them anything without your express permission.

Nope. That's HOSPITAL based EMRs, not outpatient clinics like the primary care clinic that the OP doctor works in (or mine). Below is from the very article you posted. But I would love to see a recent survey of the breakdown of EMR use in the outpatient primary care setting. I've seen previous year surveys but I just searched & couldnt find one, although I know surveys such as those do come out. "For its "U.S. Hospital Market Share 2021" report, KLAS examined EHR purchasing activity and contracts across the country from Jan. 1 to Dec. 31, 2020. This includes EHR market share data for acute care specialty hospitals and other specialty hospitals. "

Lol. Yes, Epic Proportions. You caught me, I love that. Epic is a popular EMR, but there are hundreds of EMRs out there. So we gotta assume Nurx AND the OPs office use it. I have used it in the past, decent EMR. But I suspect Epic has no more than 5% of the market. So yes, I'm open to what you are saying, I'm still very skeptical that a physician in one part of the US can access another physicians records from a totally DIFFERENT medical group without specific patient authorization. But I'd like to hear from the OP tomorrow what he finds out if he agrees to go ask his PCP.

Hi All, I love & respect everyone on this website dearly, but I MUST interject (with direct professional experience). There is NO such website in our country that people on this thread have mentioned that US physicians can log onto and look up their patients prescriptions from all other physicians. I practice medicine on the East Coast (not NY) but I have practiced Medicine in multiple states in my career, and I have never come across such a (wonderful) internet tool. EXCEPT for scheduled drugs. THIS is what I think some of you are (mistakenly) referring to. YES, there IS a state database of ALL scheduled drugs that a physician can (must) log onto & see all the scheduled drugs that patient has received. What is a scheduled drug? Drugs that have addiction or diversion potential. Such as Xanax. Morphine. Oxycontin. Vicodin. These drugs need a special license for the physician to prescribe, called a DEA license (Drug Enforcement Agency), and it's from the federal government. That license is different than the individual state license that a physician must obtain from the state he practices in to practice medicine in his/her state. Looking up the patient on the database is done so when a patient asks a doctor for a prescription of say, Xanax, the doctor can go to the website, look up that patient & see if the patient just got 30 tabs of xanax yesterday from a doctor down the street. This scheduled drug database is to address addiction, diversion issues & doctor shopping. Many (all?) states mandate each time a physician prescribes a scheduled drug, that he/she first looks the patient up on the database. If a red flag shows up, no Xanax is prescribed. Make sense? BUT these state databases ONLY have scheduled drugs! No diabetes drugs. No blood pressure drugs. No HIV or PrEP meds. None. Those drugs are NOT scheduled drugs. It's a good idea, though. I'd KILL to have access to it. Which goes back to the OP question: how in the world did his physician find out about his PrEP??? My suspicion is that when he was originally online filling out the questionnaire for his PrEP he listed his PCP which Nurx then captured & (somehow) sent to his physician. I think the OP has forgotten he did this. But that's only a hypothesis. We need more data. SO, it's really up to YOU David1024 to clear up this Mystery that has grown to (near) Epic Proportions. Please, pretty please, CALL your doctors office TOMORROW & ask to speak to the office manager. Ask nicely, dont sound mad or threatening. Be honest. Tell them how you are just ever so perplexed on how in world did his office discover you are on Truvada (or was it Descovy?)? Make SURE you prevent/alleviate any concern that you are mad or upset. Say rather, you LOVE your doctor, heck, you even refer him patients! You are just so freaking curious you and your friends have a $50 bet on this! Beg the other person to help YOU win the $50! Get him/her on your side. THEN, once you get the answer FOR FUCKS SAKE come back here & tell us all & put to rest this Mystery! I beg you, please, with honey on it. I beseech thee! And I suspect many on this thread want you to do this, too! So I beg on their behalf, too. Hugs to the OP & everyone else, Josh

I'm a primary care physician in the US and I have literally no idea what you are talking about. Sure, I'd LOVE to have some national database I could access, and it would help so much in providing good care, but alas, there is no such monster. There might be large medical groups that doctors within that group can access the records, such as in the VA, but that's only for the physicians within that organization. Non-VA doctors cant access the VA records. But a national database of meds listing what each patient takes available on the internet to every doctor or mid-level? Nope. I dont know everything & haven't seen everything, but I'm sure I wudda heard of something like this if it were professionally available to me. The OPs question on how did one medical organization (Nurx) communicate with the other (his PCP) is a question I'd like answered, too. But I think theres gotta be more to the story. A lot more...

Dear HoleTrainer, Ok, ok, you CONVINCED me. You're completely insane.

Depends. If the doctor has a salary schedule where s/he is paid per patient, then yes, too cynical. The physician wants to see the patient. Every patient on the list. Who wants to see money walk away? If the doctor is paid a set salary with no specific productivity expectations embedded into the salary, then ...maybe. But overall, no. We really want to see all our patients on the schedule. I know I do. I mean, we do try to help folk.

I'm a physician. I have no-shows all the time on my appointment books. EVERY physician does. Any physician who says he doesn't is lying. But do I DEMAND a deposit from a new patient (or follow up patient) to make an appointment with ME? Nope. I gotta take the good with the bad just like everyone else, escorts included. So, to all the escorts reading this (and I know there are many providers who never sign up to this forum but use it for information & learning, so yah, I know you are reading this): HELL NO, you do NOT deserve a deposit. In the same way, I dont either. Dont like no-shows? Work on strategies to diminish them. To all my client friends here: the latest deposit-scam I've come across is the escort asking (insisting) for an Uber to bring them to me. Um, yah, no. Their "Outcall" fee needs to have incorporated all of their transportation costs. I've politely declined these Uber requests and GUESS WHAT, they all have eventually capitulated. Dont (ever) be rude, demanding, or inappropriate but stay professional, and decline this not-so-subtle strategy of getting an Uber (a deposit) and you will prevail. Or just walk away. Why contribute to the downfall of this hobby? Love to all Josh

Yup. I have, on vacation while out in the West Coast once. I have no reservations recommending him to anyone cuz he's awesome, professional, & hawt AF. I'm no stranger to hiring so I know what's out there to compare. Anyone feel feel free to DM for details. It's the end of the pandemic my friends. Let's live again. Laugh again. Love again. And run naked in the sunshine. Big Boy hugs to all, Josh

Hi all. Thanks to all who gave suggestions here or in a DM. Very much appreciated. I'm even more looking forward to my Summer vacation in NYC with all these awesome suggestions. If you think of any more, feel free to let me know. Josh

Hi BBD. Thank you so much for responding. ? Well, 30 pages is a lot so, yah, you definitely have a point. Here goes: Kissing is critical. If he doesn't ever kiss, I suspect I'd have to sadly decline. I love a strong, masculine top. But I also love a short, slightly feminine twink who bottoms like a champ. Hairy or smooth just no hairy backs if possible. Muscles are great, but I'm not into muscle worship. Not into leather or being tied up or PNP. Under 35. Does that help? My apologies if I'm not more specific. Gosh, maybe I should develop a "type". This would make this exercise a bit easier. Maybe I'm just a simple w.h.o.r.e I mean, every man has his charm.... J

Greetings to all. I'm going up north to visit NYC for some R&R. Any suggestions of escorts would be really helpful & appreciated. I dont really have a "type", other than nice guys who are professional & fun. If you prefer a private convo, I'm happy to discuss it via DM. Just DM me. It's also ok warn me against any escorts. Plus, any suggestions on restaurants, museums, points of interests etc would also be really cool. Love & hugs to all Josh

RIP, Daddy. You will be missed.

Wait, zero empathy? Not even a little? Really? -Zero empathy for her as she struggled with the tragic diagnosis of MDD, Major Depressive Disorder? And her diagnosis was severe given she was actively suicidal? - Zero empathy for her as she sought help from multiple places for her terrifying symptoms of depression & thoughts of self-harm, and WAS DENIED? -Zero empathy for her as she had to hear that person/persons in the Monarchy were concerned that her children's "skin tone" would be too dark? -Zero empathy for her as she requested over & over, before the pandemic, to be allowed to leave her apartment on the palace grounds & meet up w friends & was refused. She said she saw no one for months. Are you totally lacking in care for others? Please tell me I misunderstood you. Please tell me I got you totally wrong. Surely you are an empathetic person (and retired physician), yes? I need to think better of you. Please help me do that. Respectfully yours, Josh