On 8/25/2021 at 4:32 AM, LookingAround said:

All medications you are on are part of a national database so any physician or nurse practitioner with a computer can access it and see what meds you’ve been prescribed. 

Hi LookingAround

1 hour ago, LookingAround said:

Keep trying Josh. 
All of my docs are affiliated with major medical centers/hospitals, as an example. I’m sure somewhere there’s an isolated sole practitioner (maybe you’re one of the few) without an affiliation. But I don’t believe that’s the norm.

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:

1 hour ago, LookingAround said:

You think it’s no more than 5% market share? 😂

EPIC has a third of the market, sir. 

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. 

16 hours ago, LookingAround said:

Are you in NY? As has been mentioned NY has a database accessible to all health care providers. 

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 

15 hours ago, LookingAround said:

All medications you are on are part of a national database so any physician or nurse practitioner with a computer can access it and see what meds you’ve been prescribed. 

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...

GABRIEL_TOP & I texted back & forth & I (quickly) discovered he is unreasonably expensive. 

He charges (or tried to) $800 for an outcall/2 hours plus an uber.

I (quickly) balked.

He (quickly) responded $700 for in an call.

Nope, outcall only. 

He then (quickly) responded with $700 for an outcall with an Uber. 

I still (quickly) passed.

And I (quickly) found myself an even hotter guy (imo) for $500, outcall, 2 hrs.  I tipped him well. We had an awesome time, and I (quickly) decided that I will repeat with him.

Happy hunting, guys.

Hugs

Josh 

PS. "Quickly" was the Word of the Day on Sesame Street today. Did I learn to use it correctly? 😉

Dear HoleTrainer,

Ok, ok, you

CONVINCED me.

You're completely insane.

On 6/29/2021 at 3:17 AM, mike carey said:

would it be too cynical of me to suggest that some  doctors know that the time each appointment takes is unpredictable and liable to last longer than the blocked time, so they not too concerned about missed appointments because they help get them back on schedule?

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.

Well, I have zero sympathy for Meghan

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

Ah, you're an escort. Now I understand. Sorry, I didnt know know that before till I read your profile. I shudda been more thorough.

Ok, first: your testing is absolutely NOT making you safe. The reality is it's making your interactions more dangerous.

IF you have Covid, but have NO symptoms, your results are 60% likely to return NEGATIVE. Yes, it's a false negative but unfortunately, the technology we have is not as good as we need in finding truly infected people who have no symptoms. The Covid testing technology we have is best at testing someone with symptoms.

Therefore, the use of testing to give you the feeling of security is likely actually giving you a false security. That's how it's making your interactions more dangerous.

Also when traveling a lot of places now either require you to quarantine or have a neg test result

Yah, that makes sense. If one has to show a recent neg test to board a plane or train, then you gotta do what you gotta do.

So be aware that not only could your clients be inadvertently giving YOU Covid, you very possibly could be giving it to THEM.

How do you feel about that?

PS. I'm not judging you. I promise. I freaking love escorts!

Have also been getting tested for covid every other week to be safe.

May I ask, and I'm not challenging you or trying to be disrespectful, but what is the clinical goal of being tested for Covid every other week? I ask with these thots in mind:

1) People who have no symptoms of Covid, yet are infected have a 60% or greater chance in producing a false negative test.

2) What would you do differently, if anything, if it returns poz?

Just curious.

Hope you are well.

Josh

PS I love how proactive you are with keeping yourself safe from HIV

The testing protocol for brothel workers in the state of Nevada is WEEKLY testing for STIs, not every 3 months. I strongly (and respectfully!) urge all escorts to consider matching such intervals. The 3 month testing interval is the medical recommendation for non-sex workers. But that interval can (and should) be shortened if clinically warranted. Review this with your physician & decide together what is best for you.

Most STIs are asymptomatic. One CAN get chlamydia, gonorrhea, even syphilis from kissing. The incidence of STIs in the Gay community (or those who are sexually active with men) has never been highest. Therefore, the 3 month interval is woefully inadequate for some people, whether escort or client. An STI panel by definition includes a pharyngeal and anal swab for chlamydia & gonorrhea. Blood work must include syphilis (and HIV, of course if one is HIV negative). If your clinic does not provide this full battery of tests, ask for it, or go elsewhere. One could very easily add mycoplasma & trichomoniasis to this standard battery of tests. These are less frequent STIs & are often missed.

Much love to all escorts & the services they provide.

Be safe.

Josh

PS. I'm a physician on the East coast and I treat STIs All.The.Time. For some, 3 months is far too long of an interval in my professional opinion.

Unicorn: you are still going on supposition, and not DATA. That is an is unscientific approach. We currently have no robust evidence to give a percentage of the chance a fully vaccinated person has in transmitting the virus.

So, YES or NO, do you think it is at all possible that contracting Covid-19 from a vaccinated person is anything but an extremely rare phenomenon?

So for me, I cant (and wont) answer that question because it's too soon. I have not (yet) seen the data (because there isnt any yet) to be able to answer that such an event is an

extremely rare phenomenon

But I suspect Covid-19 transmission from a fully vaccinated person is.... uncommon. So you and are at least ...close... to same page?

Rather, you are proposing a HYPOTHESIS, which is testable. For example:

I propose that a Covid-19 vaccinated individual transmitting the virus, resulting in active infection in others is a rare event.

To answer that question we need rigorously constructed research resulting in evidence that can be peer-reviewed in a reputable scientific journal. Its premature to use the phrase "extremely rare phenomenon". But I certainly hope you are right!!!

I call upon more funding to the CDC and other research organizations so this important clinical question is answered.

Love to you, Unicorn and everyone else on this site.

Be safe.

My blood oxygen level dropped 2 points since the pandemic from being indoors more and masked outdoors.

Um, what?

Could you clarify?

While this report of 23 deaths in Norway is very important and requires further investigation that is robust & transparent, please be very careful to NOT MAKE ASSUMPTIONS or come to ANY CONCLUSIONS as that would be premature at this time. Good Science does not allow for this.

Specifically, people get heart attacks every day, sometimes in the morning. Do we blame breakfast for their heart attacks?

Continuing, the above report of deaths is from the British Medical Journal (BMJ) which reported in the article that, "More than 20 000 doses of the vaccine have been administered over the past few weeks in Norway and around 400 deaths normally occur among care home residents every week. ". (italics emphasis mine)

Also from the article from BMJ, "Norwegian authorities have prioritised the immunisation of residents in nursing homes, most of whom are very elderly with underlying medical conditions and some of whom are terminally ill."

Maybe these were patients who were dying & the vaccine had no relationship to their deaths? It is not clear (yet).

Therefore, today we can say nothing about the relationship, if any, between the Covid-19 vaccine & these deaths.

Give science time to fully investigate & report their findings.

As of January 15 2020, over 37.9 MILLION vaccines have been safely administered.

It is STILL this physicians (VERY) strong recommendation for everyone to get their Covid-19 vaccine when available to you.

Be safe my friends.

The BMJ article: https://www.bmj.com/content/372/bmj.n149

She was just here. It took an hour.

I'm a physician and know (oh so very) well of these "wellness visits".

Please be honest: do you think it provided you any health benefit (excluding the financial incentive) that your primary care physician doesnt already provide? If so, where?

Now that you have experienced this wellness visit, how could it be improved?

What can your doctor do, if anything, to help you improve your long-term heath that s/he is not already doing?

Anyone with first hand experience with the (patient compensated) wellness visit is very welcome to chime in.

And Happy Holidays & good health to all.

If there's evidence it's helpful, that's one thing. However, I think it's awful to put people out of a job and places out of business just because politicians feel they should show they're "doing something" instead of following the science.

The terrible impact on the economy & individual livelihoods is heartbreaking, especially to our beloved restaurant staff. But to say there is no data on how outdoor dining is a location where Covid-19 transmission occurs is inaccurate.

Below is a link to a CDC report that investigated how people got infected.

"Close contact with a person with known COVID-19 was more commonly reported among case-patients (42%) than among control-participants (14%). Case-patients were more likely to have reported dining at a restaurant (any area designated by the restaurant, including indoor, patio, and outdoor seating) in the 2 weeks preceding illness onset..." (emphasis mine).

https://www.cdc.gov/mmwr/volumes/69/wr/mm6936a5.htm

Excellent video link to some researchers & how they demonstrate dispersement of cough particles in the air.

https://www.cnn.com/videos/health/2020/05/04/cough-coronavirus-masks-kaye-pkg-vpx.cnn/video/playlists/coronavirus

I see a lot of "outdoor" dining restaurants with the tents & multiple tarp side walls around said "outdoor" dining. Even if it only has a tarp roof with no side walls, the roof will decrease the natural disbursement of the Covid pathogen. In addition, people take off their masks in these faux-outdoor dining establishments where they eat, talk & laugh loudly. People dont just go to restaurants with people they are quarantining with. They go with friends and family where they sit right across from. All of this completely erodes the safety of being outdoors and thus Covid-19 transmission can occur. And the above CDC paper described outdoor dining transmission.

I genuinely dont think one can blame the politicians for the bans on outdoor dining. These recommendations are coming from the medical community. The politicians are just following public health department recommendations.

Covid sucks.

When made available to you, get the Covid vaccine.

I'm a physician. I'm getting it the moment its available to me.

Be safe my friends.

Unicorn,

You are having people over to your house that you are NOT quarantined with as your household. Do you think you are contributing to this pandemic by all of you potentially exposing each other to Covid-19? Do you worry about your risk of contracting Covid-19 and its consequences to your health? If any of your (awesome) escorts or you get Covid-19 you all could be asymptomatic, but unknowingly infect others who may have serious health consequences, even death. Does that concern you? Just curious.

Hi westernsyd

Your supplement "Immune Health" from the company Modere has listed several ingredients: echinacea, thyme, and Hawthorne berry.

Let's review these 3 components.

1) Echinacea

has been debunked as a successful remedy to the common cold. See the following scientific research:

Barrett BP et al. Treatment of the common cold with unrefined echinacea: A randomized, double-blind, placebo-controlled trial. Ann Intern Med 2002 Dec 17; 137:939-46.

From Medscape, a robust physician textbook, that is excellent in producing up to date medical information found:

"It seems very unlikely that echinacea effectively treats the common cold."

https://www.medscape.com/viewarticle/449051

How can echinacea be helpful against viruses? It's already proven not to work against the cold viruses, which there are hundreds/thousands. Where is the scientific evidence it helps against influenza?

2) Thyme - I looked & looked and my apologies but couldn't find one shred of scientific evidence that researched thyme using the scientific method. Please provide some. Or provide just one.

3) Hawthorne Berry.

The FDA is cracking down on herbal companies who promote & sell this compound.

https://www.fda.gov/inspections-compliance-enforcement-and-criminal-investigations/warning-letters/natures-mojo-inc-11122015

And another one:

https://www.fda.gov/inspections-compliance-enforcement-and-criminal-investigations/warning-letters/herbal-healer-academy-inc-570957-09122019

And continuing

You reported that the supplement is FDA "approved".

"I know exactly what is in the supplement, it is approved by the FDA made by a reputable company in North America and manufactured with the highest integrity." written by westernsyd

You report utter bullshit.

From the FDAs own website:

FDA is not authorized to review dietary supplement products for safety and effectiveness before they are marketed.

https://www.fda.gov/food/buy-store-serve-safe-food/what-you-need-know-about-dietary-supplements.

TO OTHERS STILL ON THE FENCE ABOUT WHETHER OR NOT THEY SHOULD GET THE FLU VACCINE:

Westernsyd is making what scientists call a Cause and Effect Error.

Many, many thousands of years ago, as we lived in Mother Africa, we heard roosters crowing at EVERY dawn. We therefore thought at that time that the roosters crowing at dawn BROUGHT UP the sun. We now dont think such nonsense as obviously we see now that these bronze age people were making a Cause and Effect Error. Just because one event follows another, doesn't mean the first event caused the second.

Just cuz westernsyd takes this (nonsense) supplement and then feels good doesn't mean the supplement was directly responsible for making him safe from influenza. The events were random. The supplement did not do anything. SO, dont be like him and FOOLISHLY make this error. Use the evidence we HAVE: flu vaccination can save your life. It can save the lives of those you love.

Get vaccinated AS! SOON! AS! POSSIBLE!

This is NO year to get both influenza AND Covid-19.

Love to all.