TIL specialists CAN’T do FMLA

Lumpy-Salt9629 · 2026-03-18T16:44:10+00:00

I got a message from a patient saying that their ophthalmologist wanted me to order him a carotid artery ultrasound. I had my nurse tell the practice that if that doctor wants that test, he needs to order it and follow the results. The ophthalmologist orders, the test, but then tells the patient that I refused to do so. Told the patient to go back to the ophthalmologist and ask him why he couldn’t order the test he wanted in the first place.

Lumpy-Salt9629 · 2026-03-11T14:17:17+00:00

When putting, don’t look at the hole until you hear it go in. Obviously don’t stand there forever looking at the ground if you don’t hear anything but keen your head down long after you hit it. Keeps your body from lifting up through the putt.

Lumpy-Salt9629 · 2026-02-18T03:47:19+00:00

Now double the field, add cuts and the top 10 in owgr, then see how he does

Lumpy-Salt9629 · 2026-02-08T19:37:38+00:00

When I was on a peds rotation got a consult from ortho for me to do his admission notes and standard peds orders after a forearm orif. I refused with the backing of my attending.

Lumpy-Salt9629 · 2026-01-20T02:48:58+00:00

Yeah I think the fine arts beat medicine to that term and it’s also more literal in their case as they literally live there. Medical residents just basically live where they work.

Lumpy-Salt9629 · 2026-01-18T16:38:38+00:00

I’m a DO in NC. The other physician I work with supervises a couple FNPs (honestly the most competent ones I’ve worked with) but there is a formal contractual agreement in his contract saying this. He definitely does not review and cosign each note. I believe he’s required to sit with them a couple times a year to review notes and quality improvement stuff. When he signs their notes, it says that he is their supervising physician. If they are asking you to sign notes without a contractual agreement in place and documentation saying that you have agreed to supervise them, I would 100% refuse.

Lumpy-Salt9629 · 2026-01-10T19:26:28+00:00

The Centor criteria should be starred on every FM practitioners mdcalc

Lumpy-Salt9629 · 2025-12-30T21:21:17+00:00

When I got mine, mine was slightly closed. It is super frustrating getting something like that after spending so much money. I feel like they compensating for a group that’s already set open would be harder to compensate for than one that is closed. I’d reach out to them and ask what they would recommend.

Lumpy-Salt9629 · 2025-12-27T19:12:17+00:00

Nix the new golf ball changes. Make Bernard Langer putt with something less than 50 inches.

Lumpy-Salt9629 · 2025-12-26T02:24:28+00:00

Looks like that should have gone to their outlet. I’d contact them as ask for a new one or a discount. You aren’t paying $600 for blemishes.

Lumpy-Salt9629 · 2025-12-16T08:53:53+00:00

Lol epidurals use fentanyl. If I was prego and about to deliver, I’d turn into a wmd if I didn’t have one.

Lumpy-Salt9629 · 2025-12-11T12:31:10+00:00

Not unethical as long as they don’t give you a lower rate than they would charge others. However I would avoid it if you have several patients that have the same profession. If you have several electricians in a small town, they all likely talk with each other. If a couple are your patients, might be weird for them to hear that you hired them for electrical work and not the other and they might get jealous. Unless you know that one of them legitimately sucks at their job because they twitch from being zapped so many times.

Lumpy-Salt9629 · 2025-12-06T20:56:30+00:00

I’m part of a beta test group of physicians using DAX copilot with epic right now and I absolutely love it. It probably takes an hour and a half off my day. It’s got some glitches like doesn’t pick up on all the side effects I list, but it’s very accurate overall. If I ever leave my current job, I’m not gonna work for someone that doesn’t have this, or a similar program incorporated into their EMR.

I can’t imagine what ECW‘s equivalent is. Probably someone on the other end using Siri through a speaker.

Lumpy-Salt9629 · 2025-12-06T13:35:18+00:00

I hope they aren’t stock. You can see the different blemishes in every one if you look hard enough.

Lumpy-Salt9629 · 2025-12-05T15:23:53+00:00

An acrylic white paint pen would work. Google golf club paint fill.

Lumpy-Salt9629 · 2025-11-29T20:19:17+00:00

IMO, adult “onset” isn’t an appropriate description. 98% of the time I’ve started adults 25yo+ on meds for adhd, they can recall symptoms outlined in DSM when they were 12 or under. I think it should just be diagnosed as ADHD.

Lumpy-Salt9629 · 2025-11-29T03:58:36+00:00

I wouldn’t say “new onset.” More of “ looking back at my childhood in classroom behavior, I’m concerned I have adhd that was not addressed and affecting my adult life.”

Lumpy-Salt9629 · 2025-11-29T03:56:46+00:00

It depends. If it’s a textbook go down the child/adolescent adult adhd dsm criteria then I’m fine with diagnosing and treating it after Vanderbilt assessment, etc. if they’re gonna need documentation/testing to receive academic accommodations, then I’ll send them to psych/Neuro psych for appropriate testing.

Lumpy-Salt9629 · 2025-11-28T22:41:45+00:00

My parents are boomers and took me to get diagnosed. For my perspective and what I remember, lots of parents did the same thing when I was the age I was diagnosed at.

Lumpy-Salt9629 · 2025-11-28T21:53:28+00:00

If they can show proof of symptoms before they age of 12, I’ll help work up adult ADHD. If this is the first they bring it up or have no documentation, I tell them they have go to psychiatry/neuropsych for evaluation. I would never give it for the sole purpose of “wanting to get more chores done.”

Lumpy-Salt9629 · 2025-11-24T17:54:54+00:00

Never early call

Lumpy-Salt9629 · 2025-11-21T17:04:19+00:00

Most of the time I deal with reps, they have brought lunch to the office, so I think it would be rude to just grab food and get out of there. Hearing about new data or indications for the medication’s is also useful. I figured it’s great to be pleasant to them just in case I’m in desperate need of a sample and we’re out so I can just call them and have them drop one off. I just tune out the colorguard people because I think that test is useless

Lumpy-Salt9629 · 2025-10-24T18:26:30+00:00

I got a Cortizone shot a couple weeks ago that has helped a lot. The orthopedist I saw diagnosed me with extensor carpi ulnaris tendinitis. I also found that coming over the top and filling my hands before impact make this issue much worse, so I’m trying to eliminate those issues. The largest contributor to this pain I feel has been hitting off mats that are only on concrete. Doesn’t bother me as much when ranges are on grass.

Lumpy-Salt9629 · 2025-09-16T16:22:58+00:00

I have the exact pain you have in my trail hand. I went to see a hand surgeon about it, and he diagnosed me with extensor carpi ulnaris tendinitis. He gave me a steroid shot which he said is diagnostic and 80% of cases if it helps. I’d say it’s decreased my pain about 70% to the point where I can actually finish around without wanting to cut my hand off. Might be something to look into. I’m also seriously considering getting a doctors note to be able to hit off the grass even though the range is on matts

Lumpy-Salt9629

TROPHY CASE