Title: Physician Online Services for Bitcoin: btcdocs Post by: btcdocs on May 31, 2013, 10:43:09 PM Greetings fellow denizens of the net! Tired of over-regulated anti-innovation partisan sick-care? Tired of not knowing if your condition actually requires you to go into see the doctor, paying whatever-unreasonable-deductible and probably having to take time off work? We would like to help offer an alternative. The bitcoin infrastructure along with net pseudo-anonymity are fertile grounds for innovation, patient-satisfaction, profit, and alleviation of suffering.
We have been working up to this for a long while, and figured the time was right to debut our very-preliminary services on the btc forums. We are slowly rolling out internet chat sessions with physicians of various specialties. Initial prices are low given possible technical issues. For the first few sessions we will refund all coins if you are not satisfied with the services delivered. If you want to use escrow with a trusted OTC or forum member we can accommodate that. We appreciate any feedback, thoughts or suggestions! If you have any specifically desired services (e.g. psychotherapy/CBT) please let us know and we will try and accommodate you. Services available now: Dermatology consult w/dermatology resident MD - 15 min, BTC0.15, 2 sessions available most saturdays - please contact for times and availability
We will send connection details via email, and encourage use of PGP. If you are a physician interested in working with us, please drop us a line! Thanks for reading and have a great voluntary day! Contact us: btcdocs@yahoo.com our public PGP key: -----BEGIN PGP PUBLIC KEY BLOCK----- Version: GnuPG v1.4.10 (GNU/Linux) mQINBFGMEL4BEADROqAG43MBHMbfdvSK3Ewvv9cJefs8YiVxdfVnTVKorz1ovaYm 1Mge7ofTK24hKWbOhY/7Z66nRG8u9ZLjj+0D8Nzn3/FsxuEW8rzkdB+XNtxkE0+X 7nfsDNWoaGpSxxQg4UR4G4JJ7oWk0ceE+OSZ8hZr5hycOnMnCY7mAdYmYG2Vtzeu fbQXae+xD86zmRXamr44i6glwuYbrogBt1zb4PAihLlXvjoi+cKT5vtizMefVw+o 5dnJ67PgAQGohhG/tkYgMkqoohJsYX9Q22X/UrKX8IfJnOwCzLT8wjmiwF+4X0OR MJCI8Xttui7f1BQ93712gZLzAt1TXdxValwNhrlB9R31gxP8WcDyfIcqJ7Uo8cvq xI3Np4Pdr7EwHTVJIeQn8Oe7v2l9dSUFgkauY9f53h/wEdRlfT5jLengoW7xYM6g dpBPj+u2b6XblAtuv/hNCjGoeL+7cR3rBePlj71RPvDis1ALS9zKW8z8rPk19FtK emYclg0Q7kzjXt6TjcVMs9lN9u1RGw6gG/fHtYNZCVRt3KBkNawWBaGeLg/+h3G6 gmTr9Y4xZNpEQu5UleZeG4Hx21tKJnL+WpT/8m1CMsq7EmoMbgvmwOKW5f087Xup ncCYCt0k69OLVNXPs49IG5rX6L9u2c5p2kH033c77lK0JLP3hU3k6Fuh9wARAQAB tBxidGMgZG9jcyA8YnRjZG9jc0B5YWhvby5jb20+iQI9BBMBCgAnBQJRjBC+AhsD BQkB4TOABQsJCAcDBRUKCQgLBRYCAwEAAh4BAheAAAoJEGeXxT+tFIjRLzsP/01u dchAyzviO58gRo+RPhpw2/v2h5NfHudUNTiflo4EoMSlDpAZmzo69cJnsRT+uumq 5KYV+3Aqmf5OpDlKeSTQ1rXJd/fprCZqnFESVnhCIXncXM9SAFxqtP8avHN9i7cD aQxI+7GrohWc0xvnAASJf4DmF+zfYeZx4V3o0lbOvbbE6VVhBUTaOnwdp5Se09kC qIgwkjE8kikKu2UO5trCD2dVvUl6sLfLNWeiNfNtmWx7SheAeaS+CXM4oaWUw1js IW7k0RwVHijBqbnmo4wO7B21QLcHe0k4eGtKVIZRPGJYdYmMXzI44j0E5bbKhzp1 oBK1eFZVfKIs+PHfv5RDvN2qwWvxYIitw3uRAC5Hf1Pe6caGuz260ME/HHlAtGvf fRsuwgemnDU65BF6RlrGwMYj8KgtAF7IHuMXFpQvuM8LX4rG+C/l4Vn4AQOsMsG9 WUixjT2uXwbuMym/TkXi41TS5/kFl5mYzt9XtBsYO/PG/VZqNYd7iHLsXSntDGMN mGKESgY7ffZ5IG8cX4ZAnYFvrlsluPURPydr4jMKga9/qDYaMAiGaDUQSXMLLBd2 9L9eF2WVKinha5va9JTkGlkfX3MPxarKlob1CKTbRJtGD8VOuLfSALjZZ6HK96/l fSX+uC3c161zkKmexoY5Y/zjMJTeWWEOfGsRsi6tuQINBFGMEL4BEAC6LeS+gYXZ QalQaKyz0BpdCFtFnXaswlIWqHR9CC+7HpF/sg2W8uMKr/Uh0jw9hE61sY2pvKPX IsiBCifiA7r0NGuIucTqsc658pC/vk2ZBeq5z/4LNZsKBqK959UHLynsyINdhnMj lW7kNOUWkdAmm77+kC1DAWFCwBF4DAWusD4FM6r1cdY4mJ7cJXws5/Snt7NdmOCL ztLaR8Y5ABgESHcq6MqxQvYphvbqQo0QxrHyHYheNGbLPDOQsHTMCwBpezlXXXFu jmBQNb8PbPbUhbLDod0N7r1oA/2EmkRctO/gLAHv4vDTAtK8klfOTduIfOdOSXzu Mg+WFSGdiBSCaA3wtnzbcKpCD5n6JSmH8f6owc92+pqDJnDGc/deWmQ/++xhRMjq UHW/EGbbcUuNEC/EcZjlWkKD7s3KaGLWrMSBKvdEke8UfKKOMvRUlkUxNbHXbfrX qJ5vjm7YzomnWkmnlUZigeJMmmfdxAItxs/5CwNIDqska2myAOsrT3hWzLx7v1LA 55SgXTMbgRXThNRDbwGYD7zvOtSbT3+KR8qHJkKVfKIFu8uplw4HDBHvdyGa69cc Rr0nZV+pnkUb28DbBRD//cRioyv4dfinPK/BDIefgRa0MWhu6YhwZ5YBKIozw0W4 m5JLzLoul8K89tlhlZpjkJxxzsSvx9NAKQARAQABiQIlBBgBCgAPBQJRjBC+AhsM BQkB4TOAAAoJEGeXxT+tFIjRbTkP/2dvNfsAK+vN+gPUjJobaKQw4Uxk1M6Egqoa j23y34KnGCkLcLBIb+UO3CZPFK6TFV92vDhD00oVFJjE8xYlYoIryFDYqDfVi+4H BE6BHqeJrN3neo/a2wLVoEEjwPRBYSIYm0og6gGZGOhoj00lfvTV6NySZfHRs2jR k/MMx/NzS5xV+v9jyYYfP6ab2LD6wMaHeVHJNmqX2NQrSgB8J3LqwMzvHngmpc77 5hgmO7APoOqmQYBCKg2HpF2fRPy5dcUXUbjy7FtQrV7rFGi2Jp8qqn43BJi5Yads 1j/mS1h175Sg88QJxnj090ltI/HfwqdsU3eZgQYO0pvRragiI7VL/O2eTDCiy5n3 y6foLivZ3nLp/pOlcbtoUfvIugL1DypTSZG0JhvCRtr7KwL3HTIztrb3x/OkwzbB A+TOD1pT8FQzJ1OSclRhNyh9D6M6pm/H0VXz18/oLS7DbH/5JlXzb1eQ9/aU1fOE /W2Eko2q6dC+Ml03G4yJEGWdgOnaKwNDCTFdhEaX5jXp0Vz5idEPZHRzdPtHFgNo 0ig0zwcUx880dBr3wG8OjSRfZiWJnufvQDjIFFreM/vzAC+ABynT40KD5AnCa2Y/ rMnNf7953kni2X/PpRWLl19mpbG+ueRMz8yiruByMNcEJ9h/8usZtoTFK3Pq3tNQ csbmbcSL =YNdB -----END PGP PUBLIC KEY BLOCK----- Title: Re: Physician Online Services for Bitcoin: btcdocs Post by: TheButterZone on June 15, 2013, 06:06:13 AM Anywhere near San Diego County, CA? I'd like to just jump to the shave excisions for my nevi and pay in BTC at a discount (will sign a cosmetic waiver, don't care about scarring if done by interns or PAs at a licensed practice/teaching facility; just use a local, sterile equipment and electrocautery and I'll do the aftercare perfectly as usual. Also if you want to do a before/after photo series for PR, that would be fine too.) I do have a PDF of the 14 really worrying ones with a ruler here (https://dl.dropboxusercontent.com/u/16538039/JRmoles.pdf), FWIW.
Obviously confidentiality is waived since I'm posting this in public. Title: Re: Physician Online Services for Bitcoin: btcdocs Post by: btcdocs on June 17, 2013, 05:07:00 PM Hi TheButterZone!
Thanks very much for submitting the first question to us! Following is sk1nd0c's (a derm specialist) response. Unfortunately sk1nd0c's clinic is not yet able to accept btc re you going to their clinic (we will definitely post if we find any btc-accepting derm clinics). Would you mind if I cross-posted this on the forum at btcdocs.net (http://btcdocs.net) ? Any feedback would be appreciated if you have the time (eg if you do go into get some of these moles removed, was having any of the following information helpful?). Thank you again for the question. -btcdocs Derm specialist response: It appears that you have what is called common intradermal nevi, which are benign raised "moles". Due the the image quality/resolution on some of the later photos, it was difficult for me to be certain 100% that they are benign (and honestly the only way to be completely sure is to perform a biopsy). There are other tumors that mimic intradermal nevi - blue nevi, spitz nevi, dermatofibromas, juvenile xanthogranuloma, and even malignant tumors like nodular basal cell carcinoma and melanoma. So with the image resolution lacking, it's difficult for me to appreciate the subtleties that would help me clinically distinguish these lesions and provide the reassurance you desire. Even if your photos had better resolution, moles are an example of a dermatological condition that is still best evaluated in person by a dermatologist (sometimes with the assistance of additional magnification). I wish I could be of more help in this regard, but I do not want to mislead you. In determining benign versus malignant lesions, particularly with moles, I teach patients about the ABCD's of melanoma: A stands for asymmetry (we like to see nice round moles - as yours appear to be), B is for border (nice even, not jagged edges), C is color variability (same pigment throughout, without multiple shades of black, blue, pink, etc), D is for diameter greater than a pencil erasor (i'm not particularly fond of this one because some people just grow larger moles). The E was added - for evolving, and I think that is the most important component - a mole that begins to be symptomatic, is developing new colors within it or growing strange borders. It's estimated that 50% of melanomas arise in pre-existing lesions and the remainder arise as new lesions. In regards to removal, I would hesitate to see any physician that offers to remove all of your moles at your first visit. I usually offer to remove one or two at the first visit, and the purpose of this is to see how patients scar at follow-up and to make sure the patient is satisfied with the cosmetic appearance of the scar before removing more lesions. I cannot predict how each individual patient will scar. Although I understand the desire to just get them off even if that means trading for a scar, scars can also be "ugly", symptomatic and worse than the original lesion. It sounds as though you have some experience with shave removal, which is where the skin is numbed and the mole shaved off flush with the surrounding skin, leaving a round scar. This does leave some possibility of recurrence if nevus is left at the base. Depending on site, size of the lesion, and proximity to skin lines, I may also offer a "punch" excision or regular elliptical (football-shaped) excision which require sutures and leave linear scars. Again I wish I could be of more assistance to you, I hope the information I have provided has been helpful for you. Rashes like psoriasis, eczema, etc are fairly straightforward, but within dermatology moles are comparatively difficult to diagnose via photography alone (and sometimes, even clinically). To give you a sense, there was a recent article in a dermatology journal discussing the controversy of iphone apps which allowed users to submit photos of their moles to "determine" whether benign or malignant, and the frequency of wrong diagnosis was quite substantial. -sk1nd0c 16SqgezceSdf9weWxpC2UHG7jv1oh52Fut Title: Re: Physician Online Services for Bitcoin: btcdocs Post by: TheButterZone on June 17, 2013, 05:40:20 PM Hi TheButterZone! Thanks very much for submitting the first question to us! Following is sk1nd0c's (a derm specialist) response. Unfortunately sk1nd0c's clinic is not yet able to accept btc re you going to their clinic (we will definitely post if we find any btc-accepting derm clinics). Would you mind if I cross-posted this on the forum at btcdocs.net (http://btcdocs.net) ? Any feedback would be appreciated if you have the time (eg if you do go into get some of these moles removed, was having any of the following information helpful?). Thank you again for the question. -btcdocs Go ahead and cross-post. I didn't want the consult as I knew all of that already, except that there was a punch biopsy (http://www.aafp.org/afp/2011/1101/p995.html) (doctor only offered shave or cut). My first two were elliptical excisions, and biopsied benign, which combined with my youth and the appearance of the last one, factored into shaving the last one. It has been years since that one was shaved and I can't tell it was ever there, other than looking at old pictures. I have not been able to learn the results of the shave biopsy as the doctor moved far away and demands an office visit to tell the results (won't even allow a Skype video chat despite having a scan of my driver's license & photo). So effectively, I'll only find out if I go back for another excision, and then the biopsy for the next one will rinse and repeat. Without going into extreme detail on each remaining one, they are not all perfectly circular, smooth, consistently-colored domes, but some will probably have higher priority than others. Thanks. |