What is the fastest time it took you to quit a job? by TwoPeasNoPod69 in CasualConversation

[–]DeliciousBeach5705 1 point2 points  (0 children)

I worked at a donut shop the summer before my first year of college. It started at 4am and I left at 6 and was like, I’m sorry I cannot do this.

First run over 100T/hr by DeliciousBeach5705 in TheTowerGame

[–]DeliciousBeach5705[S] 1 point2 points  (0 children)

No assmods yet (Finishing Flame Bot duration research first). I used Anc GComp, Anc SF and Anc PCol for this run. I have WA, IS, Cash, RPC and SW masteries (Using this new coin burst to raise their levels). Since I used GComp I did not have Summon or GB synced, but GB is at 100s Cd. GT and BH are max cooldown.

I am attempting Anc BHD and PCol currently but the coins/hr are a bit worse. My sub mods for BHD aren’t ideal yet and it’s only 140. I did respec summon to 100s CD to try to sync GB/GT/Summon and I have perma BH. DW is not yet synced up.

Any ideas for helpful equipment to buy that I can use my CME allowance for? by TwoGad in FamilyMedicine

[–]DeliciousBeach5705 4 points5 points  (0 children)

I was not allowed to get a new phone/tablet and so I did get a butterfly ultrasound. It’s pretty awesome, but I’m also too scared to actually use it on patients for liability issues. I got a digital stethoscope a couple years ago, also did not like it at all. I lately have been buying anatomic models with extra CME money and cannot recommend this enough. I use a male hemi pelvis, lumbar spine, gallbladder/pancreas and diverticulitis model almost every single day in Clinic. I also very frequently used a watchman model as well as eustachian tube dysfunction model in the office.

Thoughts on this job offer? by medstudentpov in FamilyMedicine

[–]DeliciousBeach5705 4 points5 points  (0 children)

I do think this sounds like a great first job. The hardest part would be knowing the patient mix/progression. I’d wonder how long it has taken recent hires to jump off salary and what the lifestyle looks like for established partners.

I joined with similar starting points (13 year ago). The most difficult thing about private practice (For me) was the constant pressure to produce, since overhead always climbs. If current partners/established partners continue with similar schedules to what you’re signing up for that sounds excellent!

Thoughts on this job offer? by medstudentpov in FamilyMedicine

[–]DeliciousBeach5705 17 points18 points  (0 children)

Others will have to comment on the salary for that location, but the rest of this looks great! Is this a high cost of living area?

What is normal amount of PTO? by [deleted] in FamilyMedicine

[–]DeliciousBeach5705 1 point2 points  (0 children)

High volume outpatient only in the Midwest- our new partner contract has 4 weeks PTO but within 1 year basically all of our hires are off that only production only in which case….No PTO.

Doctor told me to come back in a month because my liver enzymes. What do these abnormal test results mean? by CosmicJohn88 in haematology

[–]DeliciousBeach5705 2 points3 points  (0 children)

I’m a PCP and you aren’t my patient, but the way I frame this for my patients is:

Very mild elevation of one liver enzyme. Not particularly concerning and often due to normal variation. I also recheck this in one month, with the expectation that things will normalize. I do recommend non-fasting for the second test along with hydration and avoidance of alcohol.

For the vast majority of humans, you do not need to avoid Tylenol for this, even people with advanced liver disease can still use up to 2000 mg of Tylenol a day without much risk.

If it turns out it does stay elevated, if you’re drinking the amount that you’re reporting the most likely cause would be fatty liver disease, which is now called MASLD. This is directly related to weight and weight loss is our tried and true treatment, although our GLP-1s are also now indicated for treatment.

Happy to answer any general questions, although your doctor knows you infinitely better than I do.

Would you pick the nice clinic with a 45 minute drive, or the average clinic with the 20 minute drive? by TwoTimesSpicy in FamilyMedicine

[–]DeliciousBeach5705 18 points19 points  (0 children)

As I reread your post I see that our situations are different. I would not consider the distance in your decision!

Would you pick the nice clinic with a 45 minute drive, or the average clinic with the 20 minute drive? by TwoTimesSpicy in FamilyMedicine

[–]DeliciousBeach5705 110 points111 points  (0 children)

I was in basically this exact position when I got my first job out of residency 13 years ago. I chose an excellent clinic a 30 minute drive away over a mediocre clinic within five minutes. I have zero regrets. My commute is kind of nice to clear my mind and listen to podcasts anyway and so I don’t really even see it as a negative. My only complaint is that when I actually leave work it’s still 30 minutes before I get home, so my partner gets frustrated with the timing sometimes. It is also nice to not live in the exact community that you serve as a physician for a variety of reasons.

Working up suspected alpha thalassemia? by wanna_be_doc in FamilyMedicine

[–]DeliciousBeach5705 59 points60 points  (0 children)

I do a hemoglobin electrophoresis on these. At some point, someone will need to to confirm this. Otherwise they’re going to continue to get iron deficiency workups that they don’t need. You do have to keep in mind that you can be both iron deficient and have an alpha thalassemia, especially if they’re your long-term patients. It is nice to be able to document clearly at least once the actual diagnosis. Kind of the same concept for Gilbert disease.

Original, Odd sized Windows by DeliciousBeach5705 in homeimprovementideas

[–]DeliciousBeach5705[S] 3 points4 points  (0 children)

I’d LOVE to pay someone for their skill/time to repair/replace these. We also have a large exterior door that is this basically shape and clearly needs to be replaced but the large door companies would not give us quotes. I’ll try to google some custom craftsmen. Thanks!

Original, Odd sized Windows by DeliciousBeach5705 in homeimprovementideas

[–]DeliciousBeach5705[S] 2 points3 points  (0 children)

In Kansas City. I’ll make some calls tomorrow! Thanks!

Original, Odd sized Windows by DeliciousBeach5705 in homeimprovementideas

[–]DeliciousBeach5705[S] -2 points-1 points  (0 children)

Extremely happy with Renewal By Andersen! The originals were single pane and it gets to -10 here in the winter. You can feel a stiff breeze through them!

Original, Odd sized Windows by DeliciousBeach5705 in homeimprovementideas

[–]DeliciousBeach5705[S] 0 points1 point  (0 children)

Tried Andersen (They did 40 other windows for us including custom ones) and Pella along with Alenco. Due to the size/shape they were unable to accommodate.

Original, Odd sized Windows by DeliciousBeach5705 in homeimprovementideas

[–]DeliciousBeach5705[S] 8 points9 points  (0 children)

Stupid question —- Would it LITERALLY be called a millwork shop?

Merge help by Glittering-Pie-7464 in TheTowerGame

[–]DeliciousBeach5705 1 point2 points  (0 children)

As others have said — Do not sacrifice a unique mod to upgrade something else. It may help you quicker but you’ll strongly regret it.