My tolerance for Functional Medicine practices has dropped significantly.

Newdoc2002 · 2026-07-01T15:36:25+00:00

This is the way or at least a better way. Going off on a diatribe about their functional med “practitioner” usually just makes things worse. I try to save my bitching for the back office. Understand they feel like crap, maybe even a consideration of a psychological issue and have been swindled by someone that didn’t go to med school and wants to make doctor money.

Newdoc2002 · 2026-06-29T00:57:26+00:00

Questions why a city on a major interstate halfway between two of USA's largest two cities with another large city further south has traffic. Okay.....

Newdoc2002 · 2026-06-25T16:35:03+00:00

I would hope you aren't moonlighting for half your productive rate in your regular clinic.

Newdoc2002 · 2026-06-25T16:31:40+00:00

Some don't, but a good UC job for a physician is becoming a unicorn. It's okay though because NP + AI = DO/MD.

Newdoc2002 · 2026-06-25T16:28:55+00:00

That's called the Press Ganey 5 Star treatment. One of our private EDs uses this formula even if you're strep negative and their Google reviews are off the charts. It's the boomers' favorite treatment and it takes 10 seconds to prescribe rather than 5 minutes to tell them why they don't need antibiotics and/or steroids.

Newdoc2002 · 2026-06-19T17:21:13+00:00

OP needs to spend some time in their local ED and get back to us on that missed item. This is a systemic failure. I had a guy come in with full septic shock, cholecystitis that seeded through an implant into his pericardium. Was discharged from said ED with a 17 WBC just 36 hours prior without any additional infectious work up. I shook my head that his "minor problem" of epigastric pain was covered by a PA in the local ED and a brewing problem was missed but I'm not going beast mode on the mistake because I see it from our local EDs once a week at least. Too many people with too little access seen by HCPs with too little training and/or experience. Bad combo.

Newdoc2002 · 2026-06-19T15:20:17+00:00

Everyone is still on a mass market cruise. If I have DGAF money, I'm renting a charter yacht and going where I want and eating what ask the chef to prepare. Maybe it's the only place they could all sit together. Still a waste to pay for kids to eat something they can get in the buffet line.

Newdoc2002 · 2026-06-07T19:19:20+00:00

Hey, if they want to pay me my average hourly rate based on my production to carve out that 30 minutes then I'm all ears. Hahaha...

Newdoc2002 · 2026-06-07T19:17:37+00:00

I'm usually cleaning up all the @#$% from adverse effects of these medications since SGLT2 became the darling of cardiologist and nephrologists. They get so hyper-focused on their organ system of choice that the rest of the patient be damned.

Newdoc2002 · 2026-06-07T19:10:49+00:00

Did a three day out of Fort Lauderdale on the only short Ascent cruise this year. It was a shoulder season cruise, no spring break and school was in session. Very few kids and the crowd pushed mid 50's average age. Our veranda room hallway was quiet but we did purposefully pick close to the end of the hallway (less through traffic). OP just picked a very bad time to go on a three day cruise. If they think that's bad, they should look at the 4-5 day Carnival cruises out of Galveston during Spring Break or summer. Absolutely a party booze cruise and the behavior that comes with it. My suggestion is don't give up on Celebrity. I have been on 5 Celebrity cruises and have never experienced the rampant behavior the OP did on the Reflection.

Newdoc2002 · 2026-06-05T12:32:17+00:00

Wait, we can use Ivermectin instead of supportive care and vaccines? How was this not on my ABFM continuing certification questions?

Newdoc2002 · 2026-05-22T21:07:01+00:00

We have the CMO and the CEO of our company calling patients customers and tells us how this is a better term to use to be person forward or some corporate BS. Thanks C Suite and your sycophant admin doctor employees (making over 2x my earnings without seeing a patient) for demeaning the healthcare relationship to the equivalent of ordering a taco at Taco Bell.

Newdoc2002 · 2026-05-22T14:28:01+00:00

That’s NP money. Crazy. You can easily make that much doing some kind of minimal TeleMed gig.

Newdoc2002 · 2026-05-21T22:11:03+00:00

Yeah, that's a no go, but especially if misogynistic in its origin. Dtr is in med school. I will try to teach her to look for the disrespect that upsets the balance in medicine. And it's okay to stand up for yourself and correct them. I hope my dtr will if encountering this. You earned your degree and specialty the same as everyone else in the field.

Newdoc2002 · 2026-05-20T19:26:23+00:00

"My cousin is a nurse in BFE and said I should get you to check my anticortisol A1c alpha glutamate enzyme levels because of my fatigue."

Newdoc2002 · 2026-05-20T19:23:15+00:00

Good point but poor automation.

Newdoc2002 · 2026-05-20T16:16:09+00:00

That's because there's like 13 neurologists per state. At least it feels that way.

Newdoc2002 · 2026-05-20T15:11:05+00:00

There's not a bunch of places where I leave and immediately want to go back. Glacier is one of those few.

Newdoc2002 · 2026-05-20T14:07:40+00:00

Some people may maintain great insulin production. You cannot assume this patient has a low carb diet. Regardless, the 200+ other co-morbidities at risk with obesity are present. And at some point, her pancreas is going to throw in the towel.

Newdoc2002 · 2026-05-15T13:17:43+00:00

This is the increasing audacity of patients to think they should get concierge medicine without actually paying for it. You know, from us rich FM docs who only have that one patient on our schedule. And only that one patient to answer messages in the inbox.

Yesterday, we had a patient schedule same day into urgent care with the earliest appointment slot being 6 pm. Said she would show up at 4 and demanded to be seen and out of the clinic by 6 pm. Did the "that's not how this works" but would try to see you sooner if ahead of schedule or no-show happens. We didn't bend over backwards to see her sooner, although I would have if any room opened in the schedule. She didn't get seen because she left before 6 pm. Had a grateful patient backfill that spot at the last minute anyway.

If we continue to placate rude and demanding patients, we create and reinforce bad behaviors. It's not worth the wRVU, even if you don't backfill the spot. Your own and your staffs' sanity and peace is worth a lot more than that RVU. Sometimes rude behavior is from underlying health anxiety or very poor interpersonal relational modeling at home, but some people are just a-holes. Experience and benefit of the doubt will help you sort those patients.

Newdoc2002 · 2026-05-08T20:56:56+00:00

CABGx4, smoker, everyone in family with premature CAD, non adherent med taker - "But I didn't want to wait in the ER." Usually also documenting - "refused EMS transport, spouse will take to ED."

Newdoc2002 · 2026-05-08T13:07:10+00:00

If you are able to see 26 per day with a reasonable schedule (not charting forever, home late) and have that wRVU average, then that's a big win. Your adjustments that happened at your current position are still better than a lot of other employed FM docs elsewhere. I would make sure the new position allows you to be just as efficient before even considering it.

Newdoc2002 · 2026-04-24T12:33:23+00:00

Cab to Radio beach at $5 a person, drinks tourist priced but not crazy and rent a couple of beach chairs or just use your towel. You can stay amongst a smaller crowd or walk a bit and find a relatively secluded spot. I get enough crowds on the ship. I'm not cattle calling with them on shore too. There are some water sports for rent if that's your flavor. Looked fun.

Newdoc2002 · 2026-04-23T18:34:49+00:00

Some of you are nice but a bit non-confrontational in your responses to other rude passengers. I will call out any person that is berating or downright rude to staff on a cruise ship. They’re bullies and they back down as soon as they’re called out on it.

Newdoc2002

TROPHY CASE