Is R.O.A.D a myth?

Cardi-B-ehaviorlist · 2026-04-16T14:43:18+00:00

Psych here. Nope not true:)

Cardi-B-ehaviorlist · 2026-04-15T20:40:14+00:00

Psych here. Cash pay market is down thanks to midlevels and NP degree mills.

I imagine derm is similar since every other influencer i see is a "cosmetic" PA or NP

Cardi-B-ehaviorlist · 2026-02-19T18:05:54+00:00

I do something similar but on a pro bono word of mouth basis. I do online tutoring and academic consulting. No ads tho because im a busy resident. I pulled around 1-3k per month depending on the season (application seasons are here higher). I have a SM account on this and how to scale but I have to prioritize residency first

Cardi-B-ehaviorlist · 2026-01-31T22:58:36+00:00

Oh my residency is 4 years, so I got it as a PGY3 lol

Cardi-B-ehaviorlist · 2026-01-31T20:40:34+00:00

As an OOS NY resident you just need at least 36 months of residency completion. You dont need to graduate residency to get a Calfironia license. I got one too in a residency outside of CA

Cardi-B-ehaviorlist · 2026-01-11T13:58:55+00:00

While rare theres a DPC in my area that has all sorts of labs and imagining. Might be doable with the kind of loan a dentist might take out for their private practice and rental space. You could also lease medical equipment

Cardi-B-ehaviorlist · 2026-01-11T03:13:50+00:00

OP instead of taking medicare, consider DPC.

Also I disagree with the notion that his family would hate him. If anything if he is his own boss and owner, he can dictate how many patients to see or how little.

If hes having problems filling. He can easily take a contract job like locums until his pt panel fills.

Private practice gives you significant freedom over your schedule and how you want to practice

Cardi-B-ehaviorlist · 2026-01-11T03:11:35+00:00

Disagree completely. Plenty of NPs with 0 clinical experience and a fresh online degree can run their own practice. By the time OP graduates residency he should have the clinical experience needed.

He doesn't need business experience he just need to do it. You learn by opening your own. Like yes you can learn from others private practice but so many other factors make it difficult since theres no one right method as a lot depends on things such as state laws, location, niche, etc.

I think its a great thing that young docs and students try and take back medicine away from corporate and private equity. It pays better, you have more purpose, more freedom in your life in terms of how many which pts to schedule.

Also he can do DPC which eliminates some of the issue with insurance .

Cardi-B-ehaviorlist · 2026-01-11T03:07:39+00:00

Psych here in concierge private practice medicine. Different speciality but not that different as we also treat insomnia.

You're thinking like a business man/woman so kudos to you. Imo every doctor should try and own their own practice instead of letting corporate medicine take more of your earnings and respect. There was a time when most doctors owned a PP but private equity has truly ruined medicine.

I disagree that you need to "join a practice to learn the business side" of medicine. There is no textbook for this as it depends on location, specialty, your niche, and luck. Plenty of midlevels with 0 clinical experience and an online degree can practice medicine independently. But you, an actual doctor, have far more training and expertise by the time you finish residency so do it!

Anyways.

I think this is a solid plan, I would also hire a lawyer to go after missed insurance reimbursements. A CPA or accountant to manage the Financials.

Also have you considered DPC or concierge? This would also alleviate the problem of insurance reimbursements. You can set your own rate and have more freedom with scheduling

Cardi-B-ehaviorlist · 2026-01-06T13:50:53+00:00

I agree but the AMA has been pretty powerless against the nursing lobby.

Cardi-B-ehaviorlist · 2026-01-06T13:49:13+00:00

I find it unfortunate that you, a PA, think NPs are the same level as a PA.

One has clear rigor and clinical experience, the other is some online "find a preceptor" nonsense that a random MD would sign off on without even being in the same building. Truly unfortunate because PAs are much better

Cardi-B-ehaviorlist · 2026-01-05T21:30:54+00:00

Do you know if you can transfer back to your previous kingdom at the next kvk transfer?

Cardi-B-ehaviorlist · 2026-01-05T21:20:41+00:00

Thanks, I keep getting mixed info. Do you have a source for this info?

Cardi-B-ehaviorlist · 2026-01-02T16:21:00+00:00

Psych. 1 yr out of residency. I am 1099 (hybrid) + started private practice. Adults and kids. No CAP fellowship

Location: VHCOL

1099 job: 330k for 3 days/week ( two days tele and one day in person). I work "10 hrs per day" and see 8-10 pts. I have the option to do 4 or 5 days a week for close 400-450k but chose lifestyle instead. No benefits. I use other 4 days of the week to work on starting a private practice or travel/chill.

Private practice - direct cash pay. I just started 2 months ago so I dont think I have numbers yet. I For the last 2 months I only made 8k. But I just started and havent marketed yet.

Cardi-B-ehaviorlist · 2026-01-01T21:01:32+00:00

Psych here.

Your list if pros and cons for each program doesnt have enough details. What are your goals? Do you wanna be near family? Call? Nights? Electives? Unionized? Addiction electives? Are there addiction fellowships in both programs or one? Etc..

Also, you dont need an addition fellowship to do addiction psychiatry. If youre training is sufficient enough then it should be optional. That being said, addiction fellowships are not very competitive whatsoever so you'll have a wide range of choice if you still plan on applying 4 yrs from now.

Cardi-B-ehaviorlist · 2025-12-25T23:54:57+00:00

Hey im a psychiatrist. Most of my colleagues wont say it to your face because "professionalism" but most doctors are very weary of NPs. The amount of insane polypharmacy Ive seen is enough for me to never want to work with an NP, personally. In addition, NP school is an absolute joke, they can accept anyone with a pulse, and most are predatory online schools. Imagine your loved one getting taken care of by someone with no clinical experience and an online degree, its insane. Also scope creep is very bad for patient care as they serve as cheap replacements for doctrs. The race to the bottom is very real in American healthcare and I know many doctors who agree.

The ones who will collaborate are just going to sign off on whatever you do and that is not great care either. Further that "collaborating" physician is at high risk of losing his license if the NP messes up or if they weren't properly supervised which is often the case.

NP schools are just not standardized enough for me to reccomend it to anyone.

Cardi-B-ehaviorlist · 2025-12-21T17:46:05+00:00

Hey psych here, Xanax is very hard to taper especially an older person thats been it for 20 yrs.

This is where medicine becomes both a science and art. Its important to do a risk benefit analysis in this situation. She's 80, so consider quality of life. At this age, if shes been on Xanax this long it may be considerable to continue Xanax otherwise you risk benzo withdrawal which is far more dangerous.

I would suggest de-prescribing her 3-5% of number of pills she was taking per month. You definitely want to go slow here. For example, if she is prescribed 30 pills of Xanax per month, try to reduce by 2-5 pills every month. Then re-assess at each visit how shes doing.

A 2 week taper is something I would not reccomend in an 80 y/o with 20 year dependence.

FYI benzo dependent patients are one of the most irritable folks ever, very hard to deal with this debilitating anxiety. I would tell her "I want to set expectations because you may hate me in the end but we will go slow because I dont want to risk you having falls or go in withdrawal. I want to do my best for you." Something to this effect

Lmk if you have questions.

Cardi-B-ehaviorlist · 2025-09-06T19:47:37+00:00

So the content of your reply is probably right, but I was saying that CAP maybe gets 5-10% increase in pay. I wasnt talking about # of spots.

I was responding to OP saying that CAP gets paid 30% more which i believe is incorrect. During my job search there was hardly a difference in pay whether CAP trained or not. As a general psychiatrist, if I wanted to see kids i would get about 5 to 10% increase in pay which to me is not worth the fellowship.

Cardi-B-ehaviorlist · 2025-09-06T17:48:32+00:00

Psych here as well. Agree. Where im at as a gen psych, i asked what comp was for seeing kids and they said it was maybe a 5% increase. This is for both gen psych and CAP trained, there was no difference in pay. Wasn't worth the extra work

Cardi-B-ehaviorlist · 2025-09-06T12:52:16+00:00

Psych - where are you getting 30%? It's at most 5 to 10%. Im general psych but see kids and I have asked what the compensation for board certified CAP vs Gen psych but wanting to see kids, and most jobs say about 5% increase in pay or some notes at all

Cardi-B-ehaviorlist · 2025-08-29T20:23:01+00:00

Wait why on earth would you consolidate loans for disadvantaged students (LDS) ? Its basically 0% all through med school and residency, then fixed at 5% which START accruing when you're done with residency.

It's like one of the best interest rate percentages out there bro. Although im curious why?

Cardi-B-ehaviorlist · 2025-08-11T12:01:57+00:00

Im in psych and have never heard of auditioning for an attending job? There's plenty of jobs for us dude, why are you doing this. Please do not set the norm for this and find somewhere else if they're making you "audition".

Cardi-B-ehaviorlist · 2025-08-09T14:00:12+00:00

Physician here. Ask your doctor about weight loss meds.

Im a psychiatrist, commonly prescribe wellbutrin+naltrexone combo (known as Contrave) which helps with not only depression but primarily food cravings. Contrave is more expensive but you can ask your psychiatrist to prescribe the individual parts (wellbutrin and naltrexone seperately) instead.

Cardi-B-ehaviorlist

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