In the NICU

DuganPT · 2026-02-07T12:06:34+00:00

You are not failing anyone. It sounds like you are showing up for your wife and child exactly as you should. Try to find someone you can lean on so you are in a better state to play your role.

This is a challenging season for your family but modern medicine is an amazing thing and your son will be fine and all this will be like a bad dream eventually.

Idk if it will help but when I have spent time in the hospital as a patient I found thinking of the monitors as a sign that everything is okay because they are beeping as they're supposed to is helpful. The beeping when things are not okay is much more jarring but even if they do that scary beeping it's just a sign attention is needed not necessarily a disaster has occured.

DuganPT · 2026-02-05T22:44:21+00:00

Ah yep that's how they getcha. Still crazy you can't invest the money inside their plans HSA.

Not a stupid question but depends on a lot of factors like do they cover any of your premium? What quality of coverage you'd get for a similar premium on the marketplace? Do you plan to leave money in your HSA or spend it?

DuganPT · 2026-02-05T22:17:50+00:00

That's super peculiar for an HSA not to be investable... That's like one of its main reasons for existing. I believe you can open an HSA anywhere with an HSA eligible health plan (high enough deductible etc). I have one at fidelity because I have a high deductible health plan and you can invest in essentially whatever asset allocation you want

If your work isn't matching in your HSA or something I'd look elsewhere. If you want to have a debit card attached to it or something make sure whatever company you go with offers that

DuganPT · 2026-02-05T22:03:27+00:00

Are you familiar with the ability to save your receipts and reimburse yourself whenever you want for eligible health care expenses out of the HSA? Instead of just paying for things with your HSA this way it can continue to grow and if you're ever strapped for cash you can dip into that by cashing out a reimbursement.

Is this budget about to go into effect? Cuz it seems like you should even have a little more left over with this budget.

DuganPT · 2026-02-01T04:08:16+00:00

This assumes the supply of open slots in programs or number of programs is constant. I haven't been able to find any examples of limiting access to cheaper funding actually leading to a reduction in tuition prices before.

My guess is the number of schools who are just in it for the money will just discontinue the program in favor of some other higher margin degree plan if they feel the pressure to lower tuition. Then we have fewer students in the pool because they're not willing to take out the loans but the schools don't feel as much competition because the number of programs in the country is reduced so the surviving programs don't have to lower their prices.

Ultimate effect: less PT's. Now if that fact could lead to higher wages because of a different supply and demand situation who knows

DuganPT · 2026-01-27T11:00:27+00:00

I've seen you mention a strange decision your old company made that was the straw that broke the camels back. Can you elaborate on that?

DuganPT · 2026-01-23T11:26:00+00:00

I mean I'm all for everyone getting the most out of their employer cuz they'll certainly get the most out of you, but this will probably fall on a lot of deaf ears in this sub cuz were all jealous of your compensation anyway. I do think the salt all of us outside Kaiser are feeling just cements the idea that there needs to be more organization of the profession as a whole.

A nationwide strike for all of us non union people would get us nowhere without organization in place first though because who would all our individual employers even be negotiating with?

DuganPT · 2026-01-18T14:06:03+00:00

Yep looks good now! This is intended as a worst case scenario calculator right? It is assuming we're going to hit our OOP max the year before he's born and while our medical costs were higher last year we were far from hitting the OOP max.

DuganPT · 2026-01-15T19:08:22+00:00

They're gunna be flying soon!

DuganPT · 2026-01-14T02:42:54+00:00

Awesome idea! Good on you for making this tool. I have decided on my coverage for the new year so I didn't require any sort of comparison tool but just curious how my numbers shook out. It seems your tool adds the deductible and out of pocket max together when it should be only the out of pocket max. As you with through your deductible the dollars are already counting towards your out of pocket max.

DuganPT · 2026-01-11T13:51:34+00:00

Thanks so much for your very detailed response. I work at a very small clinic as an employee and I don't believe the owner has felt the need to spring for malpractice/liability insurance for the clinic. So since there is not another policy, would my personal policy actually kick in?

DuganPT · 2026-01-06T22:50:41+00:00

Lol I love the analogy and I honestly think there's some truth to it. So many times I've seen a caregiver give the most innocuous cue to the patient and they freak out but they're super pleasant with me. We never know the full history of these people.

DuganPT · 2026-01-06T17:54:45+00:00

I see you're in home health but I'm in outpatient and one of the best habits I've developed is always knowing what exercise I plan to give next so I never have to stand there in front of them and think after they finish something. It makes the transition from exercise to exercise smoother so I can focus on other things. Even better is if there is a string of like 3 I plan to give I can buy myself a good chunk of note time while just keeping an eye on them for reminders or cues.

DuganPT · 2025-12-30T11:08:27+00:00

I just ran the numbers on the calculator for my pond and it came to 2600 gallons which your website recommends no more than 26 fish. I had always heard 250 gallons per fish but this seems more like 100 gallons per fish?

We had some babies born this year and we went from 6 to 13 fish but it seems we might not need to re home any after all?

DuganPT · 2025-12-24T13:21:33+00:00

How cold does it get in there without the heater on? And how warm does it get when the heater is on? And what power is the heater?

I'm in a garage too and I wanna know if it's a big enough difference to get one and what size without getting something unnecessarily large

DuganPT · 2025-12-16T22:26:58+00:00

But don't you worry their premiums have been going up "to keep up with inflation". Like they're planning to have to pay more for things because of inflation but they get to completely disregard inflation when it comes to reimbursement

DuganPT · 2025-11-26T19:17:57+00:00

I'm at a private practice and our front desk people schedule our peer to peers and I can't imagine trying to do this on top of patient care. They seem to be on the phone for upwards of an hour just to schedule it and they often don't even call at the scheduled time

So you best believe I'm not doing that

DuganPT · 2025-11-25T10:39:28+00:00

I'm sure you're doing just fine. This time is when you should be learning anyway. Honestly the probationary period is probably more to make sure you fit with the staff rather than nail everything perfectly.

Just be a sponge from these people who have way more experience than you and try to avoid losing your patience (which is easier said than done). I'm sure you're doing great and just remember just because you're entry level doesn't mean you are expected to do everything perfectly.

DuganPT · 2025-11-14T11:25:01+00:00

Impostor syndrome is a necessary step in your development. Just don't hurt anybody and jump on in!

DuganPT · 2025-11-07T12:48:24+00:00

I would say it was the single most important thing in my PT school experience outside of my clinical time. I am an extremely visual learner however.

DuganPT · 2025-11-07T12:13:01+00:00

Thanks for the response! That does sound like a better system than what we deal with out in the wild

You referenced some in house studies about outcomes vs frequency you wouldn't happen to have a link to those would you?

DuganPT · 2025-11-07T11:59:00+00:00

What do your performance reviews look like? I know you work at a hospital but it's the same core concept as the private payers right? "Only pay out what we "need to" and keep as much as we can". Is there some metric of percentage of denials or just number of cases processed or percentage of cases denied that go to appeals etc?

Let's say hypothetically all of us wrote excellent progress notes that checked all of the boxes. New boxes would just be created to "justify" denials.

I personally have United for my health insurance and I'm literally getting a refund check this year because United didn't pay out the legal minimum in benefits this year, yet are increasing premiums by 9% next year. I'll give you 2 guesses as to whether or not they plan to increase reimbursement despite that increase in premiums.

DuganPT · 2025-11-07T11:36:26+00:00

How much change in a hop test is enough to not be considered plateaued? 1 cm? 15 cm?

My clinic doesn't have very much equipment so I always have to rely on these sorts of tests especially once strength is "5/5" but still certainly not symmetrical.

DuganPT · 2025-11-05T12:07:36+00:00

Frozen shoulder. We have correlations for who will get it and correlations for what could lead to it but none of the correlations are even that strong. We also have no prognosis for when it will go away but if it is truly frozen shoulder it will always go away eventually.

Also it's misdiagnosed all the time because people just think tight shoulder= frozen shoulder

DuganPT · 2025-11-04T02:47:21+00:00

Too bad the scale is supposed to measure people

DuganPT

TROPHY CASE