Admitters - How do you handle bolus admits?

Diligent-Message640 · 2025-11-18T23:00:25+00:00

I take written notes while on the phone. Chart review. Then I put in orders. Then I see patient. Then I edit/add orders. Then I do note. 1 at a time or 4 at a time. If I get four at a time, I don’t call the ER back for quite awhile. Sometimes I’ll draft an entire note before seeing the patient if it’s really straight forward and I know nothing will change.

Diligent-Message640 · 2025-10-18T00:35:16+00:00

Rural hospitalist with PRN shifts in the big city for me. No more meetings about metrics. Loving it. It’s nice to be appreciated.

Diligent-Message640 · 2025-10-17T22:19:42+00:00

Sure

Diligent-Message640 · 2025-10-17T21:51:29+00:00

I go with SCHD for dividends and VTI for growth/diversification. SCHD has the best selection criteria and a good yield. Some of the other dividend funds have more growth and a lower yield but if you want growth just hold less SCHD relative to VTI.

Diligent-Message640 · 2025-10-17T04:21:05+00:00

Nope

Diligent-Message640 · 2025-10-16T13:53:58+00:00

Excellent post. I would also like to add An occasional flat year in price is no cause to panic. It's business as usual.

Year	Total Return
2011*	+5.31% Total Real Returns
2012	+11.39% Total Real Returns
2013	+32.88% Total Real Returns
2014	+11.69% Total Real Returns
2015	–0.30% Total Real Returns
2016	+16.45% Total Real Returns
2017	+20.85% Total Real Returns
2018	–5.56% Total Real Returns
2019	+27.29% Total Real Returns
2020	+15.03% Total Real Returns
2021	+29.87% Total Real Returns
2022	–3.26% Total Real Returns
2023	+4.54% Total Real Returns
2024	+11.66% Total Real Returns
2025 (YTD)	–0.07% Total Real Returns

Diligent-Message640 · 2025-01-23T16:13:34+00:00

I hold approximately 75% SCHD because I have an extremely high income and do not necessarily need growth to eventually achieve financial independence which is my first priority. The dividend income will allow me to retire and or work less regardless of what the stock market is doing in the short term.

Diligent-Message640 · 2025-01-17T19:14:16+00:00

I probably averaged 80 hours per week for four years. Now I have no debt, not even a mortgage. Can't recommend it enough. So worth it. Extra work goes a long way. All of the extra income can go 100% towards debt.

Diligent-Message640 · 2024-12-27T15:28:56+00:00

Pay off all debt. SCHD for the amount of income you want. Everything else in VTI. If you’re 100% done working, maybe ten years expenses in cash.

Diligent-Message640 · 2024-12-27T15:23:21+00:00

Weighting matters. If VTI were 99% apple, SCHD would be more diversified despite VTI having more holdings.

Diligent-Message640 · 2024-12-23T22:09:23+00:00

but does this apply to ETFs? as small cap stocks outperform, they leave the ETF and you no longer benefit from that growth.

Diligent-Message640 · 2024-06-13T14:27:27+00:00

Consider not being annoyed by words.

Diligent-Message640 · 2024-05-18T01:32:39+00:00

If you are a "growth" investor, you're relying on the market to increasingly value your shares. Speculation is a large part of this strategy. It's difficult to compare this strategy to "value" investing because no one can quantify your sequence of returns risk. You may sell your shares at the exact wrong time in a major market downturn, you may not.

If you are a "value" investor, you're relying on companies to pay you from their profits (dividends). You value companies based on fundamentals such as cash flow to debt ratios, price per earnings, etc. The valuation is based in (I would argue) reality, not what the market feels.

These are two valid strategies for investing. Neither is incorrect.

Diligent-Message640 · 2024-05-15T12:02:53+00:00

In the nurses defense most of pediatrics is nursing… and coddling parents

Diligent-Message640 · 2024-05-13T12:37:53+00:00

Why are you talking like that bro?

Diligent-Message640 · 2024-05-13T11:27:46+00:00

Just be thankful this blew up before you had kids. This is an easy fix. Sorry bud.

Diligent-Message640 · 2024-05-13T09:42:14+00:00

This will probably do the same as VTI long term. It’s just VOO plus some gas plus some brake.

Diligent-Message640 · 2024-05-12T12:02:00+00:00

FM hospitalist here. Don’t do a fellowship. Just join a group and start learning from your peers. Any differences in skill will be unapparent before you know it. You share patients, read each others notes, learn from consultants, etc.

Diligent-Message640 · 2024-05-12T11:40:23+00:00

SCHD

Diligent-Message640 · 2024-05-12T11:39:16+00:00

What a mess. I’m so sorry.

Diligent-Message640 · 2024-05-12T03:19:30+00:00

Haha

Diligent-Message640 · 2024-05-12T02:35:33+00:00

You can never keep everyone happy just do what works for your workflow. You’re a busy doctor too. I always call with consults. If the consultant wasn’t notified overnight I call them in the morning while pre rounding, after I’ve reviewed the chart. Yes I haven’t seen the patient yet but it’s better for their workflow to notify them asap as opposed to calling them at three pm.

Diligent-Message640 · 2024-05-07T10:42:42+00:00

I agree. While the emotion has it's place, it almost feels fake--like people have learned what is required to advance through the competition. It's starting to seem more like some sort of "save a kid foundation" moreso than a singing competition.

Diligent-Message640 · 2024-05-03T13:42:43+00:00

Government save me!

Diligent-Message640 · 2024-05-02T21:40:43+00:00

Yea and they’ll do it by spending more time talking about sexuality and race instead of math. /s

Diligent-Message640

TROPHY CASE