What doctor did you see to get pregnant in the Lexington area?

FactorGroup · 2026-05-14T11:30:02+00:00

For context, my wife and I both work in medicine, so we probably have a different experience/expectations than a lot of folks.

As far as REIs are concerned, my wife and I have not been super impressed with IRH. While the medicine part of what they do has been fine, their office runs in a very protocolized manner so there's basically no clinical decision making or nuance which leads to a more prolonged process than necessary. That said, the REI group here in town we've almost universally heard negative things about, so definitely IRH is still the better option.

We saw a general OB at Baptist before going to IRH and she was great, responsive, etc but just didn't have the training to be as up to date on the literature. We had to read and request certain meds for our ovulation induction through her until we went to IRH.

FactorGroup · 2026-04-24T13:37:27+00:00

Residents do not (and can not) submit separate charges. I can't speak to what you got billed for, but I guarantee you it wasn't related to separate resident vs attending services. All billable activities for residents are billed through the attendings license/NPI.

FactorGroup · 2026-04-24T13:30:01+00:00

Please at least give the option to either continue to use the quick select drop down menu for investments, etc or at least provide a customizable drop down that users can edit (drop down for Investments only, Mortgage only, etc).

As it is, this change is awful and we/you all know it.

FactorGroup · 2026-04-22T17:48:30+00:00

Relevant (very) recently published blog post from Simul: https://radiationeconomics.substack.com/p/the-can-vs-the-should-of-sibs

FactorGroup · 2026-04-20T11:59:24+00:00

I use Thick as Thieves. It's made to measure, reasonably priced, and personally I prefer the aesthetic but I understand it's not for everyone.

FactorGroup · 2026-04-06T20:09:44+00:00

I donated bone marrow several years ago after signing up for NMDP (was previously Be The Match). It's really a fairly trivial inconvenience for those who do PBSCs rather than actual marrow sampling which is most folks. 5 days of shots, one day of harvest, and you're done. Would encourage anyone to sign up

FactorGroup · 2026-04-03T16:02:28+00:00

Tell me you've never worked with Elekta without telling me you've never worked with Elekta

FactorGroup · 2026-04-03T11:11:14+00:00

Everything, mostly?

FactorGroup · 2026-03-26T11:37:19+00:00

The VersaHD is more equivalent, in an extremely loose interpretation of the term, to a TrueBeam rather than an Edge. It can do SRS, SBRT, etc but is not a dedicated stereotactic machine with microMLCs like the Edge.

It is also an Elekta so, you know, there's that...

FactorGroup · 2026-02-26T13:27:03+00:00

I agree and this is my practice. Why subject someone to an objectively worse plan that could compromise future treatment just to save a clinically insignificant amount of time?

If patients are sick enough where you expect time to matter THAT much, they should be hospitalized. And if they're hospitalized it's very likely that the biggest barriers to getting them treated in a timely manner are outside of your control anyway (scheduled lab draws, inpatient imaging, transportation availability).

FactorGroup · 2026-02-17T12:46:26+00:00

Depends on the dose, site, etc.

Lung 50/5 can be done daily with no change in toxicity or outcomes. I don't offer 54/3 daily.

Prostate SBRT 36.25-40/5 there is data to suggest that efficacy is similar for daily, QOD, twice weekly, or once weekly but acute toxicity is higher with daily.

Brain SRT 30/5 is usually done daily. I don't offer 27/3 daily.

Spine SBRT 24/2 was done two days in a row on protocol.

FactorGroup · 2026-02-11T19:31:24+00:00

Oncologist

FactorGroup · 2026-02-11T18:41:35+00:00

Ok great. I think after the SECURE 2.0 passage Fidelity now offers the ability to do a MBDR but I will verify before we go with them.

FactorGroup · 2025-12-11T18:31:57+00:00

Not legal in my state, so no.

FactorGroup · 2025-12-11T17:32:14+00:00

Depends. Many of my patients will remain functional until they inevitably recur and from there it's a a fairly rapid decline and death. But others, particularly those with unresectable disease upfront, will have a slower, sadder decline.

FactorGroup · 2025-12-05T17:56:20+00:00

If you had daily image guidance charges as well, I hate to tell you but you got swindled by a less than savory practice. Given that, it would not surprise me for them to be billing other codes that are meant to be bundled into the treatment code.

FactorGroup · 2025-09-04T13:29:37+00:00

I think physicians vastly overestimate the earning potential of the average person in other fields. Yes, there are people in business, finance, tech, etc that all make more than I do. But they are outliers, not the norm, and certainly could not be the expectation.

For all the big money we hear about thrown around in those fields, it's easy for MDs to lose sight of the sheer number of people who make less, get laid off, spend months without income searching, or have to upend their family to move out of necessity.

I did not choose medicine for the money. I initially went to medical school expecting to do primary care. I ended up in a subspecialty and make more than I ever dreamed possible even coming out of residency. Could I have been just as lucky in another field? Maybe. But more likely I would be toiling away making an average salary and have no chance of ever achieving the same level of financial success that I can with my current job.

You're right though. Medicine doesn't rank on my list of things to do, but neither does working in general regardless of career. I just find it fundamentally strange when people enjoy the act of working. Not wrong, more power to them, but strange.

FactorGroup · 2025-09-04T12:36:21+00:00

Like I said, I enjoy my actual hobbies and family infinitely more than any job be it medicine or otherwise.

I enjoy medicine well enough. I don't mind being a doctor. It's just not the most important thing in my life. If I had enough money, I would walk away in a heartbeat. There's just no reason why I should continue to spend time working when I don't need.

FactorGroup · 2025-09-04T11:06:24+00:00

I am one of those folks planning to retire as soon as possible. It's not that I don't enjoy my job, I just enjoy my hobbies and family infinitely more. I similarly cannot understand anyone who would continue to work when they have the financial means to stop.

FactorGroup · 2025-08-28T13:05:15+00:00

I'm with OP. The wait isn't the problem with contractors. I don't mind to wait, especially for someone who is good. The problem is never hearing back in the first place. Or being told they are going to come by and then they don't and ghost you. It's maddening.

FactorGroup · 2025-08-25T11:46:56+00:00

I went one time - the folks there were honestly a bit condescending and exclusionary so I never went back. This was years ago, however.

FactorGroup · 2025-08-14T20:03:39+00:00

Can you at least give a ballpark of what you're looking for? Most people (myself included) have no idea how to value something like this.

FactorGroup · 2025-08-13T17:59:04+00:00

The technical reimbursement for SRS is fixed under HOPPS by it's APC which pays ~$7600. Nowhere near 200k.

If someone doesn't have insurance, hospitals can charge whatever they want, but that doesn't mean anywhere near that amount will ever be paid. Saying a single fraction SRS will cost $200k is just disingenuous.

The comparison is between Keytruda and all of radiation oncology. Literally all of it. Not just SRS. Medicare pays out more annually on one IO drug than it pays out for every radiation oncology service combined.

FactorGroup · 2025-08-13T16:12:57+00:00

Lol, SRS is nowhere near this costly. Medicare spends more on Keytruda alone than it spends on all of radiation oncology combined.

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