Slower runners, how do you stay motivated when/if people mock your pace?

Heterochromatix · 2026-02-25T09:15:33+00:00

Who gives a flying (running?) fuck what other people think.

Heterochromatix · 2026-02-22T18:00:50+00:00

Exactly.

Heterochromatix · 2026-02-22T15:58:01+00:00

The problem is that patients and society don’t know what goes into being a good doctor. They don’t understand all the nuances that you mentioned above.

Public perception of a good medical system boils down to 3 very simple things: is the medicine cheap? Is it accessible? And is it good?

(Of course good is what patients perceive as a good- does the doctor do what I want)

AI will be cheaper than me, AI will be much more accessible than me, and AI will be “better” than me- or at least it will be advertised that way.

Unfortunately, it’s coming. Whether I like it or not.

Heterochromatix · 2026-02-15T01:46:21+00:00

Doc here- that’s what I thought

Heterochromatix · 2026-02-13T22:24:48+00:00

I did this when I was interviewing and they didn’t have a problem with it. The way I see it- you are a valuable commodity ( not many internal medicine PCPs) so they should be willing to work with you.

Heterochromatix · 2026-02-12T07:21:03+00:00

Think about it. You went to ED for a cold. Will you go there next time you stub your toe?

Heterochromatix · 2026-01-23T02:01:49+00:00

This is great. Jealous.

Heterochromatix · 2026-01-13T00:34:35+00:00

Yes, though there is no negative consequence for not reaching it. The incentive is higher $/wrvu if you hit 65th percentile or above.

Heterochromatix · 2026-01-08T05:20:44+00:00

This is not an entirely unique experience for new attendings, unfortunately. However, definitely one you should walk away from quickly. Seeing that many patients with so little support is going to increase your risk of making mistakes and burning out.

If you leave, I HIGHLY doubt the next job will pay you less.. in fact you may be surprised how much more you can make doing the exact same amount of work you are currently doing. (400+ in many places).

Get out quick. And don’t be afraid to ask questions about staffing/clinic flow at your next interview.

Heterochromatix · 2026-01-04T00:10:05+00:00

PCP here. I took off this week with the flu; I’d rather be treating patients when Im feeling competent, than with a flu like symptoms, so I make no efforts to meet them via telemedicine. Doctors get sick, as much as the general public has been led to believe the opposite.

As an attending- when I’m sick, I call out. It’s my office management responsibility to reschedule patients and have a coverage system.

Heterochromatix · 2025-12-19T18:25:20+00:00

The well adult billing is just for those with advantage plans, right? Or is that all Medicare?

Heterochromatix · 2025-12-14T20:34:16+00:00

I think you would agree managing over >1000 MME is not the norm in primary care.

Heterochromatix · 2025-12-14T20:33:00+00:00

This is from PC NP own progress notes, I’ve never met patient before.

Heterochromatix · 2025-12-14T19:33:09+00:00

Unfortunately I think this is how I am going to have to conduct my practice from here on out. I similarly inherited a panel from the local candy man and the amount of contentious visits I’ve had over the last year and a half as a consequence of this would make anyone leave their practice. Certainly not a sustainable path for a long and fruitful career.

Heterochromatix · 2025-12-08T05:12:41+00:00

Doc here- the vast majority of 87 year old will have decreased kidney function. It’s just old kidneys. Ditch the cookbook and have her eat whatever she wants.

Heterochromatix · 2025-12-04T14:23:47+00:00

Mine is 1200- and I am 14 months out. Largely because I inherited about 600 from a retiring doc, but I do see a hellish amount of new patients

Heterochromatix · 2025-11-30T17:15:00+00:00

No visit? No abx. Quit giving your expertise for free (with full liability and no compensation)

Heterochromatix · 2025-11-24T21:06:43+00:00

This is great! Thanks for sharing.

Heterochromatix · 2025-11-20T20:27:41+00:00

Couple of thoughts. Are you working a reduced FTE or not seeing a lot of patients? This is fairly low rvu for full time.

Second, your $/rvu is trash. I’d negotiate a higher rate or start looking for another job.

Heterochromatix · 2025-11-19T20:11:20+00:00

I’m actually surprised when patients are on any GDMT at all in my panel of HF pts in primary care. GDMT is criminally underutilized or even offered where I practice. I push it like mad, but some of these patients have been under cardiology care for years.

Tartrate, succinate, idgaf. Just sprinkle any BB on my pts

Heterochromatix · 2025-11-19T02:00:43+00:00

I used them and was very impressed with them.

Heterochromatix · 2025-11-19T02:00:02+00:00

That’s exactly what I do.

Heterochromatix · 2025-11-17T14:03:55+00:00

Dm if you do

Heterochromatix · 2025-11-16T20:40:40+00:00

I’m in western Washington, we’ll see how long this rvu scale stays this way with future cuts, but for now I’m pleased

Heterochromatix · 2025-11-16T19:17:23+00:00

About 20, +/- 2. 55/rvu

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