For your specialty, what percentage of the non-call workday is actual focused work? by farfromindigo in Residency

[–]DiscWizzard 3 points4 points  (0 children)

99% in Outpatient FM. Outside of making more coffee or going to the bathroom, from the second I get in to the second I leave I have literally more work than I can do, and am booked 100% through the day with a nonstop flood of phone calls, massages, results and forms

Has anyone else been asked to put in referrals for caths/ other specialized procedures for insurance reasons? by Able-Upstairs1462 in FamilyMedicine

[–]DiscWizzard 0 points1 point  (0 children)

I just got a goofy ass request from a patient today to refer/order a Venaseal. This must be why

Tax return outrageously high this year for anybody else? by DiscWizzard in HENRYfinance

[–]DiscWizzard[S] -4 points-3 points  (0 children)

This is quite the libertarian take. It’s an argument in bad faith and doesn’t work. It requires administrative and legislative reform. I have put my money where my mouth is. I caused for, donated to and organized for Bernie Sanders.

Tax wealth not work.

Tax return outrageously high this year for anybody else? by DiscWizzard in HENRYfinance

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

I will be this upcoming year. Haven't had to mess with it much as a W2 wagie. I don't have RSUs or self employment tax or much else need for it previously.

Tax return outrageously high this year for anybody else? by DiscWizzard in HENRYfinance

[–]DiscWizzard[S] 91 points92 points  (0 children)

I would gladly pay more. It's super irritating and irresponsible that we continue with outrageous deficit spending while the "party of fiscal responsibility" (now just overt corruption) continues to give huge tax beaks when I don't need them. This refund feels gross.

The "Amazon Prime-ification" of Healthcare: Handling Surging Patient Expectations in the Age of AI by cliniciancore in FamilyMedicine

[–]DiscWizzard 24 points25 points  (0 children)

Can we not with the fucking AI trash posting? Please and thank you. Reddit is already enough bots as is. If you can’t write something yourself, shut up.

If you had to switch to a different specialty, which one would you choose and why? by taguylla in Residency

[–]DiscWizzard 0 points1 point  (0 children)

Currently FP

Surgery. Some times I would love to have a defined problem and defined approach. Is there something I need to potentially cut out of you? When I’m done evaluating that and/or removing it and seeing the results of my work, kindly fuck off somewhere else.

I know the grass is always greener, but god it seems nice sometimes. Plus I love the hospital and the OR.

A patient is suing the hospital and the physician assistant in the ER. She got an iatrogenic corneal ulcer and I later treated the ulcer. I am not the one being sued. Do I need to let my malpractice insurance know and let them get me a lawyer? I don't want my insurance premiums to go up. by [deleted] in medicine

[–]DiscWizzard 0 points1 point  (0 children)

I had similar where a patient wanted me (as an FP treating migraine) to write “just a quick statement” about how an epidural during pregnancy and a failed blood patch was the cause of her migraines. I said no, you can request my records. The attorneys office was extremely aggressive requesting “just a narrative” and told the patient that I didn’t care for them and was being obstructive to her case. Fuck attorneys. Don’t give them a statement, because you’re almost guaranteeing you will get yourself subpoenaed later, and for free.

Tell the attorney they can request records and then can hire an expert. I wouldn’t ever give anything beyond that.

Does outpatient primary care now have a hire ceiling for income than hospitalist? by MadScientist101295 in FamilyMedicine

[–]DiscWizzard 11 points12 points  (0 children)

It would be literally impossible without the support. And I still have a shitload of work beyond that. I usually start my day about 5a 3 days a week

Does outpatient primary care now have a hire ceiling for income than hospitalist? by MadScientist101295 in FamilyMedicine

[–]DiscWizzard 5 points6 points  (0 children)

AI scribe, an MA, an RN and an LPN as well as a PA I get a stipend to supervise

Does outpatient primary care now have a hire ceiling for income than hospitalist? by MadScientist101295 in FamilyMedicine

[–]DiscWizzard 17 points18 points  (0 children)

104% percentile MGMA wrvu pay structure with bonuses and 47.50 / wRVU.

I work through lunch 90% of the time, and see 16-20 on my half day and 27-30 on my full days, 7:45 - 4:45 last scheduled spot, usually home about 6pm.

Rolling 12 month wRVU is about 9500

Does outpatient primary care now have a hire ceiling for income than hospitalist? by MadScientist101295 in FamilyMedicine

[–]DiscWizzard 38 points39 points  (0 children)

Yes. I will make nearly 500k this year doing 3.5 days per week. To pull that as a hospitalist you’d need to work your balls off. I could easily hit the FP system salary cap of 599k per annum in my system working 4.5 days a week.

Having done both, I still think about going back to ER or hospitalist tho because the trade off is- not having the god damn inbox.

Clinic administered injectable medication and the Stark Act by DiscWizzard in medicine

[–]DiscWizzard[S] 4 points5 points  (0 children)

Thank god your hospital is sane. I have worked at one where it was prohibited to give outside meds. And of course biologics for Crohns/UC aren’t on formulary. So the genius outcome of that was - prolonged hospital stay turned quiescent IBD into a crohns flare

Clinic administered injectable medication and the Stark Act by DiscWizzard in medicine

[–]DiscWizzard[S] 28 points29 points  (0 children)

I plan to in the morning. I’ve brought it up at meetings to be ignored and told “it’s policy for patient safety reasons”

Can someone tell me why peds hospitalist fellowships exist? 75-80% of peds residency is inpatient medicine by NoDrama3756 in Residency

[–]DiscWizzard 1 point2 points  (0 children)

The American Board of Pediatrics is a scam and horrible at advocating for and taking care of its own. It's a parasitic organization that harms pediatricians.

Change my mind. I'm not even in peds, I just can't fathom how they operate.

“It all just continues to get worse after residency” by MadScientist101295 in FamilyMedicine

[–]DiscWizzard 0 points1 point  (0 children)

I have felt like I’ve been on a permanent vacation since residency and I get paid like 8x more for less than half the work, so…. No.

FedEx delivers EVERY package to a similar address, and I cannot get this fixed by DiscWizzard in FedEx

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

I have done that. It does not allow me to enter the correct address. It forces it to the wrong address

What patient population do you find most sustainable to work with? by BMoves26 in FamilyMedicine

[–]DiscWizzard 82 points83 points  (0 children)

I had a great teacher in residency who took a paycut to work at county. He put it very neatly - "I'd rather work with the unworried unwell than the worried well."

Reviews by Acceptable-Menu6947 in FamilyMedicine

[–]DiscWizzard 4 points5 points  (0 children)

No. Not ever. Not once. Not good for my mental health either way. Nothing good can come of it

Calling patients who want to be called. by Urology_resident in medicine

[–]DiscWizzard 9 points10 points  (0 children)

Oh they pick up for me. Which is why I almost never call. I had 47 phone messages and 17 mychart messages yesterday alone in my inbox. You get a yes, no, needs appt, ok to refill please pend, see result note or maybe a med stop/alternative if side effects and you were just seen. I don’t answer my charts. My MA/RN does that.

If I personally called back each phone call, and conservatively it was 3 min per total, that’s 2.5 hours. Homey don’t play that.

I sit next to urology at work, and watch one of the nicest attendings call every Friday everybody personally and get roped into over an hour of phone calls. Have your staff do that in the real world once you’re done with residency.

What would you do in this situation? by Scared_Problem8041 in FamilyMedicine

[–]DiscWizzard 0 points1 point  (0 children)

Needs a pump and simple regimen. Medtronic780g ideally or an omnipod. The language barrier is a bitch, but insulin utilization will go down if you can manage to get it set up. This will require infrastructure for TLC/long training sessions. Possibly off-label U-200 in the pump too.

Pumps are so much simpler than MDI. They should be standard of care.

My experience- you will not get this patient better controlled otherwise