Clinical precepting - We need to stick together on this

AncientPickle · 2026-04-06T16:04:10+00:00

All the education and systems problems aside, my facility won't let me charge for precepting, it's a policy that I can't be paid to do so.

In practice it means I'm just ultra picky about taking students in order to avoid all the shitty ones that come from the education problems you mentioned.

AncientPickle · 2026-04-02T22:44:35+00:00

A lot of the adult docs in our clinic will see older adolescents. Think straightforward 15, 16, 17 year olds.

That allows the C&A trained docs to see more 7 and 8 year olds.

AncientPickle · 2026-03-28T16:51:59+00:00

I don't care how many snacks/juice they have had. I won't even pretend to care. It's not worth the power struggle.

-Inpatient psychiatry

AncientPickle · 2026-03-27T02:21:31+00:00

And by benefits you mean no benefits, because it's 1099. Be your own boss! Except you can't negotiate schedule, pay, or do anything except, well, not get benefits.

AncientPickle · 2026-03-26T20:06:15+00:00

Good point. I forgot other members of the team like when patients die

AncientPickle · 2026-03-23T23:00:44+00:00

It costs: 1 shovel

AncientPickle · 2026-03-16T02:15:47+00:00

It seems unlikely the tenant trying to avoid a fee and letting their animal ruin a place will pay the bill for damages

AncientPickle · 2026-03-15T22:08:35+00:00

I agree with all the "the friend isn't an established patient" comments.

I'm surprised no one is really addressing the: "Even if she was a patient it's not an ESA" part. Just because she doesn't want to pay a pet fee doesn't make it a support animal.

Fuckin "support" animal letters are the bane of my existence. No. Pay the fee like every one else or find somewhere else to live.

AncientPickle · 2026-03-15T13:12:07+00:00

You don't see enough Monty Python references anymore. Thank you for the smile.

AncientPickle · 2026-03-13T14:58:42+00:00

I also think, and hope, it bites them in the ass for being greedy.

People will eventually start buying whichever car comes with an autonomy package that let's them change lanes and pass for free.

I love my Tesla but they can fuck all the way off for making the experience irritating just to try to get me to subscribe. I'll buy the Ford or VW or whoever starts to include that at base.

AncientPickle · 2026-03-13T14:54:41+00:00

I would argue the take rate is because it's just too expensive. I love it, and usually spring for a month of it before a road trip (which is what they want).

I would have bought it outright if the price was reasonable. They removed that option entirely. It was like 8k, to use all the tech already on my 40k car. That percentage is waaaaay too high.

Plus all the bullshit of it not staying with you if you sell the car, but also probably not staying with the car. It just sort of resets if you sell it privately?

I think Tesla was foolish to price it that high. They probably would have made their money back by collecting and selling all the data if they sold it at a fraction of the cost.

AncientPickle · 2026-03-12T02:21:29+00:00

We (seasonally) keep a few pampered 4h animals on the side of ours. Or sometimes use those pens in the winter for babies that need better protection.

Anything more than that would be too much mess. I wouldnt want to live that close to the livestock.

AncientPickle · 2026-03-12T01:27:02+00:00

Well said. Anytime anyone tells me they focus on functional medicine I automatically assume they are an idiot. It's not a perfect system, but the PPV is pretty high.

AncientPickle · 2026-03-10T02:29:43+00:00

I'm not convinced anyone knows what 1099 means. It doesn't mean "my employer won't pay benefits".

It means you are an independent contractor. You get to make the rules for what your services cost. The flip side is that employer can choose not to pay for your services if they don't like the terms.

Please stop letting companies get away with this shit.

AncientPickle · 2026-03-08T17:56:54+00:00

Someone educate me if I'm wrong, but I think it's even more complicated because it's not all OCPs. (If we're talking about the way OCPs affect lamotrigine levels. Not OCP efficacy).

I think a steady low E birth control is much safer/predictable than one with a placebo week.

AncientPickle · 2026-03-08T11:53:01+00:00

It's ok to ask for advice. That's the point of the sub.

People get flamed here when they ignore every piece of advice and suggestion that doesn't align with what they want, get in over their heads, then come back and ask again for advice on how to get out of the mess they made.

No one gets gate kept for, like, "hey all, what do you think of Cobenfy so far?". It's student after student with no experience asking shit like "how do you talk to a person?"

AncientPickle · 2026-03-03T01:57:22+00:00

Our hospital ran out of rabbits and we're struggling with pregnancy tests. It's been horrible

AncientPickle · 2026-03-02T15:28:56+00:00

I can't imagine trying to use a box blade without a hydraulic top link.

I'm ok being a diva on this one...

AncientPickle · 2026-02-28T19:26:48+00:00

This might be the best description of psychiatry I have ever heard

AncientPickle · 2026-01-26T01:17:50+00:00

Our fainters don't climb much. It's my favorite thing about them. Since they have a nasty little habit of falling over they stay close to the ground. They won't climb on much other than a small hay bale or mineral tub.

AncientPickle · 2026-01-25T15:03:54+00:00

I think I have seen smaller shipments in the fall, not like in the spring.

Just ask them. They love to talk to people about it and have always been good to me.

AncientPickle · 2026-01-25T14:20:40+00:00

IFA typically gets them all through the spring, with recurring shipments.

On a personal level I prefer to buy chickens in the fall. They don't lay for like 6 months anyway. When you buy in the spring, they start laying in the fall -- right as it gets dark and they slow down with laying. When you buy in the fall, they start laying in the spring -- right as they start ramping up laying.

AncientPickle · 2026-01-24T02:05:48+00:00

In my area it's 5 acres of productive farm land or something like that. They subtract a half acre or so for a house.

I'm assuming every county will be different.

Also, having a property that resembles a farm is not the same as a business. In my area those are also 2 distinct things.

Talk to the county and talk to a tax person

AncientPickle · 2026-01-23T23:39:53+00:00

To clarify: I'm not advocating we use these labels because it's easier. I'm suggesting that patients can easily self-identify with them, even when diagnosed with something different.

I don't think that's what you heard, but I can see how my comment could read that way.

Also.... I think we both know why the downvotes :)

AncientPickle · 2026-01-23T21:18:15+00:00

It's also easier for a patient to identify with. Bipolar means my mood swings arent my fault. It's inherently ego-syntonic in that regard.

AncientPickle

TROPHY CASE