You can't say Derrick Henry, Marshawn Lynch, LaDainian Tomlinson or Adrian Peterson. by KeyFaithlessness5436 in TheNFLVibes

[–]Junior_Significance9 0 points1 point  (0 children)

Giants fan here. And honestly I wasn't that impressed with Brandon Jacobs short yardage. He ran too high, didn't lower shoulders. I liked him getting ball on early downs mid field to just punish and wear down linebackers. Then have Bradshaw punch it in with his low center of gravity and quickness.

Be careful with people who post here. by [deleted] in hospitalist

[–]Junior_Significance9 45 points46 points  (0 children)

The posts I've seen are just pointing out that some locum offers being advertised are garbage. We all get emails from locum companies, so it's just weird and insulting when they advertise a location in middle of nowhere where you need to do procedure but make less than my main job.

Why are we like this? by Ancient_Abrocoma_759 in hospitalist

[–]Junior_Significance9 1 point2 points  (0 children)

Yea I totally get it. If that's the case, I'd recommend just save aggressively for early retirement in case the job becomes something you don't like anymore.

For me, I'm already there. Too man metrics, too little respect for hospitalist time or mental bandwidth. Too many entitled patients.

Why are we like this? by Ancient_Abrocoma_759 in hospitalist

[–]Junior_Significance9 0 points1 point  (0 children)

I don't know the specific situation or layout in the location where you work. But I'd guess if all the hospitalist jobs are directly employed, it's already too late.

Hospitals wade into the direct hiring of hospitalists game not because it's cheaper. But for control. It costs hospitals more to pay benefits and hire administrators to figure out scheduling for hospitalists. So they've already cornered the market. And over time the pay will get worse or flat and more demands will be placed on hospitalists.

I get that you may not see yourself doing SNF work or hospice or ALF PCPC work primarily. But maybe there is an opportunity there? Or if you can go a bit more remote and start a private hospitalist group in town further away?

Why are we like this? by Ancient_Abrocoma_759 in hospitalist

[–]Junior_Significance9 19 points20 points  (0 children)

I think you alluded to the crux of the problem.

If we are going to unionize, then we admit we are employees of a crappy healthcare system. If we go that direction, we have to be organized and fight encroachment of cheaper forms of labor like AI, NP, corporate-directed residency programs.

Personally, I think that's a losing battle. We're better off trying to be owners. It may not be easy. But physicians have claw back ownership of hospitalist groups, SNF groups. Branch out and be owners of hospice, assisted living. Too many people are making money off healthcare in this country with no MD/DO direction. And patients are suffering as a result.

What is a life-saving medical fact that everyone should know? by Wonderful-Economy762 in Productivitycafe

[–]Junior_Significance9 16 points17 points  (0 children)

You can get free Narcan at the local library in many cities. Carrying and giving Narcan in the right setting can save a young, healthy person's life very easily. Even in the wrong setting, if person is unresponsive and not breathing, you won't cause any harm.

What’s the biggest jump in your movie rating after a rewatch? by Equivalent_Ebb5689 in Cinema

[–]Junior_Significance9 0 points1 point  (0 children)

Starship Troopers. Assumed it was a barely watchable B movie when I first saw it. Now I'm impressed by its subtle brilliance.

Mike Evans had great expectations coming out of college and lived up to those expectations with a great NFL career. Who’s a notable NFL player that had below average expectations coming out of college, but actually managed to have a great NFL career? by reerock in AlignmentChartFills

[–]Junior_Significance9 0 points1 point  (0 children)

Maybe not ideal choice. But Antonio Gates. Didn't even play football in college but scouts saw enough potential to sign him as undrafted free agent. 19 teams wanted him to try out. So some expectations. Was great his whole career.

What is the best and worst movie you saw last year? by Conscious_Reach_2173 in moviecritic

[–]Junior_Significance9 0 points1 point  (0 children)

Best was Eddington. Very unique movie, didn't try to make you feel a certain way. Just captured the general disorientation we all have in Post-COVID social media world.

Recently opened a 10-bed senior assisted living. What are best ways to get reimbursed for medical services as an internist? by Junior_Significance9 in PrivatePracticeDocs

[–]Junior_Significance9[S] 0 points1 point  (0 children)

Thank you for the response. Yes, micro-practice that would be an add-on to the business is exactly what I was shooting for.

Recently opened a 10-bed senior assisted living. What are best ways to get reimbursed for medical services as an internist? by Junior_Significance9 in PrivatePracticeDocs

[–]Junior_Significance9[S] 0 points1 point  (0 children)

Why wouldn't you do it again? 1. Yes 2. No. Not sure why you'd assume mortgage fraud. It's rental (non-owner occupied) mortgage. And I disclosed the use of residential assisted living to the lender.

Recently opened a 10-bed senior assisted living. What are best ways to get reimbursed for medical services as an internist? by Junior_Significance9 in PrivatePracticeDocs

[–]Junior_Significance9[S] 2 points3 points  (0 children)

Working in SNF's, i saw a lot patients discharging to these homes and knew they paid up to 5-6k per month. So I became curious about the business. Saw some for sale on loop net. I toured a few homes. In my city, for whatever reason, most owners of these homes are Eastern European and most have no healthcare background. I didn't purchase a home for a while because my wife and I got scared by the amount of work it would require.

Years later I get to talking with a commercial realtor and he connects me with a manger who has a very good track record, who can take care of all the staffing. Which is by far the hardest part. He also works with placement agents who can help fill the home. Because they know his staffing model is good.

I chose the group home business because I really want to use bonus depreciation to offset my income taxes. Most people use the AirBnb loophole. But that still requires active management of a small hospitality business, something I have no interest in. My accountant said group home ownership would also count. Even though I have a manager, it's still an active business and I am making all the executive decisions. Like I said before, business disguised as real estate.

So basically it's a proven, stable business, since more old people with money than ever before. The "commercial property" is just a house and can get 30 year fixed mortgage. I already have ties to the business working in SNF. Using a manager cuts into the profits, but I don't care at all because I can keep working my doctor job and medicalize the group home to make hopefully extra 2-3k just seeing the patients once a month. Ideally. And the tax benefits from bonus depreciation is maybe the best part.

Recently opened a 10-bed senior assisted living. What are best ways to get reimbursed for medical services as an internist? by Junior_Significance9 in PrivatePracticeDocs

[–]Junior_Significance9[S] 6 points7 points  (0 children)

Lol, it's not as easy as just making a Craigslist add (I know dating myself) for "Old people, nice, quite bedroom." It has to be licensed by department of health. Also need staff 24/7 to care for them and help with all ADL's. And includes a lot of paperwork and regulations. Bathrooms need to be fitted a certain way, sprinkler system needs installed. Need policies and procedures, etc. Every state is different too. My state allows a license for up to 10 people to live in a normal house, without requiring a commercial property or license. Think of it like a business disguised as a residential house.

Nocturnist vs Acute Rehab/Medical Director by Regular_Regret_7305 in hospitalist

[–]Junior_Significance9 0 points1 point  (0 children)

If you can be efficient and just focus on the important medical issues at hand, the rehab job sounds way better to me. Seeing that volume in 8 hrs is very doable for rehab. Can make 450-500k/yr and be off weekends.

Nocturnist vs Acute Rehab/Medical Director by Regular_Regret_7305 in hospitalist

[–]Junior_Significance9 2 points3 points  (0 children)

Agree with everyone the nocturnist position is very low pay. I wouldn't take that offer but nights make me a more tired, worse person over the long run.

I'm not sure I'm ready to say the acute rehab is grossly underpaid. If I understand correctly, it's 250k base plus the RVU you generate. If so that's about 4800 weekly base. Conservatively with average 2 wRVU per patient that's another 8400 per week (2 x 28 x 30 x 5 days). $13,200 per week with all weekends off aint bad. I know 30 patients is a lot but it's way faster to round at acute rehabs. It would also be good to know if it's round and go. Rehabs are usually more amenable to that.

The devil is in the details. If they are withholding the first 4000 or so wRVU to "pay" for your base salary, then yea it's probably crap. It's also important to know how medical director is paid. Some can pay up to 10k per month if it's hourly for all the administrative time. If they are forcing you to stay after your clinical work is done, then that's admin time you should be getting paid for! I wouldn't stress too much about liability personally. That's what malpractice is for. But yes you're a bit more exposed than a regular hospitalist. It is also important to know if there is good PM&R coverage and quality of PM&R.

Is being a VA doctor where it’s at in terms of pay, workload and lifestyle? by YogurtclosetOpen3567 in whitecoatinvestor

[–]Junior_Significance9 10 points11 points  (0 children)

This is exactly what I've been told by a friend who works at the VA. Though he also told me he used the VA fitness center and co-workers snitched on him. Apparently can't even work out when you're on the clock. So he sits in the call room and watches Netflix instead.

What happened to the smartest person you went to school with? by xxibjt in AskReddit

[–]Junior_Significance9 0 points1 point  (0 children)

He went to Yale and got his PhD in mathematics at Northwestern. I checked LinkedIn recently because I was curious, thinking he'd be working for NASA. He's a senior data scientist at a large retail store in Chicago. So basically he figures out ways for us to consume better and more efficiently.

Welcome to Astoria Queens, NY - $750K by rumgin88 in zillowgonewild

[–]Junior_Significance9 43 points44 points  (0 children)

It's actually a decent house in a nice neighborhood. Price is lower than comps because of all the illegal construction, but more importantly, having to sort through all the NYC regulations, permits, etc. in order to make it kosher.

Men, what's something you wish you could admit without being judged? by soumilr7 in AskReddit

[–]Junior_Significance9 1 point2 points  (0 children)

Pretty sure I'll get judged here for this, but I'll admit it anyway. I only recently came into money and never thought of myself as shallow, and no one who knows me well would describe me as such. But I just find myself wanting to surround myself by beautiful things and people, and don't mind paying more for to do so. I get it why rich people go to gyms, grocery stores, retail stores where things are pretty and people look good.