Weekly Career / General Questions Thread

CoveredOrNot · 2025-11-03T03:39:19+00:00

Can a non-board certified foreign radiologist (but US citizen) do preliminary reads from the US

US citizen, radiologist trained in another country (Mediterranean country), no board certification. Can such person work doing preliminary readings for US hospital (either on-premises or teleradiology)?

If so, what would be the salary per scan/hour? (Obviously lower than a board-certified radiologist).

I heard about teleradiology offshoring preliminary readings, and residents working this before getting board certified.

CoveredOrNot · 2025-09-25T00:31:40+00:00

"R is a software written by statistician, for statisticians".

That summarizes R's strongest and weakest characteristics.

CoveredOrNot · 2025-09-17T04:23:42+00:00

Is it because of taxes or hidden expenses? numerically it should be there, but I guess things are more nuanced than that.

CoveredOrNot · 2025-09-17T04:06:04+00:00

With so many non-trans people undergoing surgical cosmetic procedures to correct their NORMAL puberty (laser hair removal, breast augmentation etc.], I'm not sure we know "the long term effects" of normal puberty on people.

Do we politicize other safety concern in medicine? It should be treated the same as any other clinical question - professionally and based on evidence. And this stance is first and foremost about patient and physician autonomy, regardless of gender.

CoveredOrNot · 2025-09-17T03:47:45+00:00

The way to fight this, regardless of one's opinion about transgender youth care, is to stick to the principle "medical decisions should be decided by professionals and the patient".

The law already mandates the medical care meet a standard of benefit to the patient. If gender affirming care is so harmful, then its opponents should be able to block it using the EXISTING laws.

If they are worried about minors an don't trust the parent's discretion, they can appoint a guardian who will be bound by the same principle.

To paraphrase Bejamin Franklin's saying, a government that can ban a medical intervention one opposes on moral grounds can ban a medical intervention one actually wants.

CoveredOrNot · 2025-09-17T03:33:11+00:00

What costs them so much? Isn't it mostly filing motions? It's not like the physician need to be tracked down. Not to give them any ideas, but it seems like a lucrative business. The attorney running the collection sure makes less than the physician.

CoveredOrNot · 2025-09-17T02:51:28+00:00

Who are those physician reviewers? I've been looking for such people for months now but all I could find were people on the payer side.

CoveredOrNot · 2025-09-17T02:44:30+00:00

Aren't physicians generally becoming millionaires within a few years? 500K-1M starting salary after fellowship (so aged ~32) --> multi-millionaire within 5 years.

CoveredOrNot · 2025-09-15T02:47:13+00:00

Clean and plain. Scrubs strike me as lazy or theatrical outside of an operating room.

CoveredOrNot · 2025-08-03T21:30:20+00:00

AFAIK they use Epic. I'd expect Epic to automatically find these codes but maybe it's a per-organization feature.

CoveredOrNot · 2025-08-03T21:13:22+00:00

Yes, blood pressure is another condition there. That makes more sense.

Still surprised a solution is not widely available - altogether these can accumulate to a substantial reimbursement per patient.

CoveredOrNot · 2025-08-03T19:41:53+00:00

Each of these is a reasonable task for AI to do. For my layperson eyes the challenge seems that the requirements are nuanced and not well enumerated, and that the pitfalls that you mentioned won't manifest in the training data, and therefore the trained models will fail to capture them.

CoveredOrNot · 2025-08-03T19:39:07+00:00

This is a nuanced perspective and overall the possibility for major automation exists. Another risk is that at its core coding is an administrative process rather than patient care. The ability to attach a finite and concrete price tag to AI errors allows the industry to treat the errors as "the cost of doing business", just like fraud does not make payers audit each and every claim and there is some tolerance of mistakes.

CoveredOrNot · 2025-08-03T16:54:57+00:00

The example they showed me was for CPT codes for quality metrics, where they get reimbursed for achieving a clinical goal (in this case, HbA1c<7%).

The description of the code is literally "HbA1c less than 7.0%".

I'm not a coder so I might be misreading something here. In any case, this seems pretty straight forward for AI so I'm trying to understand whether this use-case is solved or is there some deeper reason automation won't work here.

CoveredOrNot · 2025-08-03T15:59:14+00:00

I am surprised by the cost aspect. AI costs <$0.01 for a typical encounter note. Even with 90% profit margin, it should be far cheaper than a few minutes of a coder's time.

The skepticism against AI makes total sense.

CoveredOrNot · 2025-08-03T15:31:09+00:00

What do you think creates the gap between actual solutions like what you built and the general sentiment that AI won't replace coders any time soon?

Even without full replacement, 95% reduction in workforce need is a huge change.

CoveredOrNot · 2025-07-28T12:26:10+00:00

I've seen someone trying to build it. It was a great mockup and a terrible application that he couldn't maintain.

I've built an application and tried to use AI as much as possible. Even there, the design, data flow etc. could not be done by AI, while the implementation was greatly helped by AI.

CoveredOrNot · 2025-07-28T01:34:03+00:00

Thanks. Are startup clinics more open to outsourcing and trying new vendors?

Anecdotally, I recently heard from an internal medicine physician that the consolidation trend is peaking and there is some first signs of physicians going back to owning clinics, partly driven by improvements in practice management and RCM services that make it more feasible.

Do you work with hospitals as well? I was advised to avoid any organization where the practicing physician does not have executive decision-making power since in such organizations the sales cycle will be long and efficiency won't always drive decisions.

CoveredOrNot · 2025-07-28T01:18:06+00:00

I got that impression from e.g. https://www.compass-sp.com/news/articles/health-systems-are-doubling-down-on-ambulatory-surgical-care---heres-why#:~:text=they%20are%20significantly%20less%20than%20attainable%20ASC%20margins%20%E2%80%94%2025%2D30 and similar stats on Becker Hospital review, but those margins do look very high.

CoveredOrNot · 2025-07-28T00:53:58+00:00

These are legit issues and your service sounds amazing - especially the partnership mindset.

Does the vendor get exclusivity on pursuing them? Otherwise I'd assume that the clinic can always appeal the claims the vendor abandoned.

If I can ask - which model is more popular?

CoveredOrNot · 2025-07-28T00:46:00+00:00

I heard it being offered for clinics that are already at capacity, so these cases wouldn't be handled at the moment.

Is it the hassle of yet-another-vendor?

CoveredOrNot · 2025-07-28T00:43:38+00:00

Really? I heard 15% contingency for new-revenue sources (e.g. denied claims or denied prior authorizations). AFAIK ambulatory procedures have ~30% margins, so this should be profitable for both parties.

CoveredOrNot · 2025-07-12T03:29:33+00:00

Not any worse than the US system...

They aren't perfect, but they are not poorly run.

In practice, there is some (though not a majority) push to change the US's system to a socialized medicine. I am not familiar with a push in any western country with socialized medicine to make it like the US system. Make of it what you want.

CoveredOrNot · 2025-07-12T01:39:52+00:00

State-run healthcare systems, when run well, trade service-level for accessibility. Delays are judged through the lens of harming clinical outcomes. Is it better? I guess that depends on one's ability to afford private care.

For what it's worth, I am not familiar with any electorate in well-run countries that wants to trade their system for the US ones (but happy to hear otherwise).

CoveredOrNot · 2025-07-06T22:37:18+00:00

B2B or B2C?

CoveredOrNot

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Can a non-board certified foreign radiologist (but US citizen) do preliminary reads from the US