u/MadameTrashPanda

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Very curious to know what people think about this topic because I have zero expertise in law or privacy. My recent experiences have me wondering about the use of AI in medicine (for transcripts, billing, etc.), which I'll add below. Maybe some lawyers who regularly work with HIPAA and medical privacy can chime in with their thoughts. I do understand that HIPAA covers, but is not exclusive to, providers keeping health data accurate, providing that data to me upon request, and NOT sharing it with others unless I authorize it. So maybe this isn't a HIPAA thing. Maybe it's a tech privacy thing. Maybe it's medical law. I'm confused, so I'm turning to you all out of curiosity. Maybe my big question here is: What would allow a provider or practice to share my medical data while also being HIPAA-compliant?

I've been a One Medical patient since the early 2010s. Then Amazon acquired it, which made me nervous because of Amazon's scale. I understand that many other doctors' offices are adopting AI. My thoughts are that One Medical is now owned by Amazon, and Amazon can provide in-house services to the practice to save on costs like servers, data storage, and the use of Amazon's AI models. To comply with HIPAA, those servers are separate and have the highest security to ensure privacy. Ideally. I am not an expert.

My thinking is if all my medical data is with One Medical and Amazon acquired it, then the logical assumption would be that Amazon has access to my medical data. Yes, Amazon One Medical (as it's now rebranded) still can't share my data with other entities without my explicit consent, but what about using that data for the company's own internal use? Would HIPAA cover the sharing of medical data within Amazon? In obvious cases (hopefully), there's a separation between the commerce/entertainment business and One Medical. But where would that separation be if One Medical uses Amazon's AI tools? Servers?

What about Amazon's LLM using the medical data (not just mine) to learn and improve itself? I work in advertising and data. I am familiar with the advertising side of removing PII and anonymizing data to run analyses and understand that regulations for health and finance data are much stricter, especially on sharing outside of a company.

In the past, I also allowed health information exchange between my PCP at One Medical and the specialists I see outside of One Medical. Some of that information is mental health, so that my PCP can safely prescribe medication or test and treat for the non-mental things. And now I hesitate to do this because of my concerns about privacy.

I realize that, with all this, many of you may say to just leave One Medical. Yes, I'm seriously considering it. I'm STILL going to curious about how this all works if I leave One Medical. I have 10+ years of my medical history with this practice, but I'm also thinking about whether leaving and taking that history somewhere else would be futile. Who's to say another practice is using AI/LLM like Google, or smaller companies like Anthropic or OpenAI? If those smaller AI companies create an enterprise product that's compliant, they're still probably going to expand their business and the same questions come up.

And on opting out, I already opt out of having my visits transcribed by AI. But what about things I can't opt out of because I'm not given a choice in it?

I'm not asking for advice on this, but curious to know if my concerns are unfounded and if there are already legal guardrails in place or active discussions to eventually regulate this? Is regulating it this even possible?

My thoughts: I've been seeing therapists for almost 20 years and longest one for more than 15, so I rarely needed to look for a new one. When I first saw Google reviews for therapists and psychiatrists on maps I felt some type of way. I personally would never post one because I'm too paranoid of my Google profile being tied to me going to therapy and it showing up on a background check. Or if somebody cyber-stalked me.

Now people are using Google reviews more over yelp and more reviews for therapists along with it. I admit, I've used a mix of Google reviews, zocdoc, yelp to shop for medical specialists because I've had bad experiences with overbilling insurance or lack of empathy. I use the positive reviews more than the negative.

But what do therapists actually think/feel about this? Not like you can take down Google reviews because don't you need new clients to find you? In the past, people were searchable through insurance directories but I feel like more therapists are self pay/out of network so Google is the best way to find them.

I was looking for a couple's counselor today and saw their reviews on Google maps AND that they respond to those reviews so I was inspired to ask this question.

Why would PDST be preferable to PST?

For anybody whose therapist recommended DBT for sh reduction, do the distress tolerance skills work for you? I did find some parts of DBT useful but didn't think that some skills were effective for me.

I've done 2 rounds of DBT back in my 20s and the "squeeze an ice cube in your hand" method didn't reduce my urge at all. In fact, I felt even more frustrated. I guess that's covered by the Emotion Regulation module.

I feel like I should try DBT again but maybe I'm too jaded in my 30s?

Is it collision work from accidents that are ultimately paid by insurance? Is it regulars who come to you for fixes and mods?

Is it one offs like people who come for inspection?

Whether you attend or not, how do you deal with a patient's passing (if sudden/natural and not self inflicted) especially if you've known each other for years? And you like them as a person?

I am interested in different therapists' pov on this. I am assuming that self inflicted death may be a separate category and even more complicated reasons of not going.

Context:

Earlier this year, one of my non therapy doctors passed away after a long battle with an illness. We weren't close but I do care about my health providers. The doctor had a social following from documenting their health journey and their funeral was even live streamed. I was heartbroken when I found out about her passing since she was young with a family. I found out the day after her funeral was live streamed and considered watching it. Ultimately I decided not to but it got me thinking...

I've been seeing my therapist for more than 12 years. Our relationship has been purely professional and my therapist has helped me in so many ways. If my therapist passed away, I'd strongly consider going if I got an invite. And maybe I won't and that's fine. So now I'm curious about therapists in general if the tables were turned.

I understand there are professional boundaries and ethics. On the other hand, we're all human and death is such a major event.

But also told my bm issues are unavoidable due to being premenstrual for 1 week, having my period, and then post menstrual symptoms for a week.

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Sigh

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3-4 years ago (the bunny pellet era) my bms were every 2 days. Bristol type 1 and 2 for 3 weeks and 1 week of Bristol type 2 followed by a Bristol type 5 and 6 in the same bathroom visit. That one week of mixed was blamed on my monthly menstrual cycle.

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My doctor advised I lose weight through exercise and a healthier diet and hydrate. I agreed. Added more fresh salad and fiber, stopped soda consumption, tried to drink 96 oz of water a day, and avoided potential triggers like dairy, gluten, greasy foods. I haven't lost weight because I haven't been able to consistently exercise hard. I black out after minimal exertion and I feel so pathetic. I keep trying though.

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For the past 2 years, my bms are twice a week and for 3 weeks, it's a type 4 followed by type 6 in the same sitting. For 1 week I have type 6 and 7 days.

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Does anybody else relate to this?

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I am both a driver and sometimes I'm also a passenger. Map chat was so useful as a passenger for real time context behind an accident or traffic issue. Specifically I found it helpful like when other people write whether a crash is a minor fender bender or more serious (damage to vehicle but no injuries) and whether the fire dept or ambulance just arrived and traffic is clearing up. Map chat was a reliable real time update that was a great supplement to the quick reports using icons.

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As a bus rider in nyc Map chat was great for my morning commute and updates on the Midtown tunnel HOV lane. If a car or express bus broke down in the tunnel people gave each other a head's up through map chat.

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I hope waze reconsiders Map chat with these benefits in mind. I may be in the minority here but wanted to get it out there.

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I swear, I've used sling before covid.. and even 4 years ago I remember putting my zipcode in the settings so that I can watch my local news even if I was a couple of states away. I knew the tradeoff was that I wouldn't be able to watch the local abc/cbs/fox channel of whatever city I was in.

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This was clutch for local sports or even when I wanted to look at city traffic.

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I'm trying to watch the Knicks game on ABC while I'm on a flight and halfway through, ABC 7 disappears from my guide.

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Now sling is telling me I have to buy their $60 dollar antenna for a feature I used a few years ago. On top of the $50 dollars I pay a month.

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Anyway, can somebody recommend another streaming provider that can give me local channels?

I used to use Indeed before 2022 because jobs were posted there before I saw the same postings on LinkedIn. Now that Indeed is terrible and the keyword search function returns jobs that are nowhere near relevant to me, I'm giving up on the site. Anybody have recommendations for alternatives?

First off, I have a safety plan with my therapist if I am in any life-threatening danger. I am not in danger.

Maybe this is a vent.

I've been having a hard time the past couple of years and it feels like it's been worse the past few months. In the past two months I cut myself twice.

I feel ashamed because I don't even remember the last time I did this. I think it's been at least a decade. Maybe 2 decades. The shallower scars were almost faded. I feel so angry with myself.

Found this subreddit because I wanted to find other people...I think?

Edit* I cut myself as a weird alternative to the permanent solution. I don't want to and don't plan to choose the permanent solution. However, the urge is strong and I am telling myself that this is a way to trick that urge.

And I had a potentially controversial thought. Wouldn't it be cool if somebody created a colorized version of these episodes? I still love classic black and white but I also love watching colorized versions of old videos and photos. I don't want the color version to replace the originals, I just want to compare.

The later seasons are in color so if anybody ever does this, I hope those seasons are used as a reference and whatever colorization happens won't be overdone. I know most video colorizations are done with AI.

Interested in what other people think? Anybody else think of this?

Internally debating whether the price was worth it. $600 USD 6 years ago. It did purify the air in my bedroom. At least that's what I think.

Super frustrating that this clicking noise, which other people have encountered, is now happening.

I feel like if I drop $600 on an appliance, it should work reliably for 10 years OR it should be repairable.

Now I'm trying to decide whether to take it apart and try to fix the issue myself or see if dyson is willing to even repair it without charging me as much as a new fan.

I guess I need to ask this to either get affirmation/not feel alone/ or be gently told I've been doing it wrong. I'm on the cleaning sub and it was pointed out that dirty water from cleaning/grey water should only go down the toilet. Not even the tub!

I'm not disagreeing. It makes sense. I just feel like, "have I been so ignorant?"

What are people's thoughts?

1. realm depot purchasing min/max

Am I the only fool whose finger slipped and accidentally bought 20 of a furnishing from realm depot bc it auto sets to max buy?? I've done this more than once now and wasted so much realm currency.

2. ability to collect my realm currency from the hoyoverse app

3. allow me to get furnishings from past events (example: liyue and inazuma flower pots)

Edit: for 1) I mean mostly for the trees/rocks/ bushes

Couldn't ask a person on the line bc I was on the bus but there were a bunch of fancy dressed-ish people in a long line around 36th and 6th. Anybody know what the event was? Was it a sample sale?