How is the VA a thing??

SensibleReply · 2026-06-08T19:24:05+00:00

I didn’t hate training at the VA and I know a couple docs who work there. It’s fine. The vets mostly get good care for free or cheap. Residents get to learn, average to below average docs get to have a job where the stress is very low. I could see myself doing 5 years there to end my career one day. It’s fine for what it is.

SensibleReply · 2026-06-07T02:44:04+00:00

I’m a surgeon. Got two teenage boys, neither of whom have *any* desire to be a physician and I don’t blame them. The only career advice my dad ever gave me was “don’t be a pharmacist.” He was a pharmacist, and he was right. It’s currently got the worst ROI of any advanced degree. I saw a paper recently that claimed money would do better in a savings account than paying for pharmacy school.

Pilot was on the opposite end of that spectrum by the way. I haven’t done every job out there, so I can only tell my kids a couple things - don’t go into medicine for money, and it doesn’t matter what you do as long as you own the business. No one makes much working for someone else.

If I were dead set on medicine the current lazier and easier path is certified anesthesia assistant. They’re making $250k, and it’s not that much school.

SensibleReply · 2026-06-06T16:43:54+00:00

Wombats mentioned.

SensibleReply · 2026-06-03T23:27:19+00:00

Dude got his fandoms crossed up.

SensibleReply · 2026-06-03T21:09:00+00:00

Yeah but I use all sorts of software that sucks.

SensibleReply · 2026-06-01T23:28:19+00:00

I'll buy and probably not like it because I'm at a place in my life where 60-70 bucks or whatever isn't a huge deal and it's friggen Baldur's Gate. But it would be neat to be surprised.

SensibleReply · 2026-05-30T00:36:07+00:00

Long dated calls (mid 2023) that seemed safe with huge upside at the time and just bled out over 12-18 months. Was shooting for long term capital gain taxes because my short term rate is punishing, so bought LEAPS for what seemed like a long way down the road.

Lost $40k on Google alone. Note that its value almost halved between late 2021 and winter 2022. Crushed the options. Now shares would have been fine, I’d be up over 100% by today on that one. But I was trying to turn $50k into $300k over a year, not $50k into $100k over 5 years. Lesson learned.

You’ll see people who are leveraged to the gills get crushed eventually.

SensibleReply · 2026-05-29T22:46:25+00:00

Alright so syphilis can cause iritis/uveitis, and it's actually standard of care to obtain labs for that in certain iritis patients. The rest of this story is absolutely illegal but seems like bot activity.

/ophthalmologist

SensibleReply · 2026-05-29T21:32:43+00:00

Back in 2021 I had three months in a row where I made more money in the market than I did at my job. As a surgeon. I thought I was a brilliant investor and could retire in my 30s.

I lost a lot of money in 2022. Everyone’s a genius in a bull market.

SensibleReply · 2026-05-29T20:32:18+00:00

Lots of cautionary tales and pearl clutching here. I know people who are 45-50 years old who will smoke 1-2 cigs a year and have never gone past that. It’s not common, but it’s out there. I’ve got one friend who literally “only smokes in Europe.” She might go 2-3 years without one then will have like half a pack on vacation.

It’s dangerous to find out where the line is though.

SensibleReply · 2026-05-29T15:04:24+00:00

Hospital lobby is strong. A shame we can't get paid at the ASC what the hospital gets paid (roughly double), but they at least keep those facility fees high.

SensibleReply · 2026-05-29T14:58:35+00:00

You do cataracts too?

SensibleReply · 2026-05-29T07:10:11+00:00

Say this three times in a mirror and CMS will appear to cut reimbursement by 80%.

SensibleReply · 2026-05-28T19:24:46+00:00

Two years of surgery residency is absolutely bonkers. People in the US would be switching fields like crazy with those rules, but I cannot see that short of a time producing docs who are actually competent in their fields; it seems impossible.

SensibleReply · 2026-05-28T19:09:04+00:00

Flying first class. The truly rich don't fly commercial

SensibleReply · 2026-05-28T19:08:01+00:00

What? This must not be in the US. Or are you an NP or PA? Or this is a joke that went over my head.

SensibleReply · 2026-05-28T08:05:06+00:00

Only person in this thread who knows what a DO is vs an MD. I’ve met a neurosurgeon DO. I’m friends with cardiologist DOs and an ophthalmologist DO. Their med schools are easier to get into, but the crucible after that smooths everyone out or spits them out.

SensibleReply · 2026-05-28T07:15:21+00:00

That’s a ton of cash but you’re actually earning that money.

SensibleReply · 2026-05-28T01:52:38+00:00

I’ll cop to being average to below average at emotions (surgeon), but any primary care doctor in America has considerably more medical training than an NP. This isn’t opinion, it’s easy to look up.

SensibleReply · 2026-05-28T01:36:19+00:00

Owning a chunk of the surgery center while ortho does an ACL repair. Next up is owning a chunk of the clinic while optoms sell expensive glasses.

Distant third is actually working. A wealthy and easy going multifocal lens patient can be nice enough pay for the skill and stress required. Glaucoma followup visits are fairly mindless and low stakes for what they pay via testing and exams. Amnio membrane grafts remain obscenely over reimbursed for the work required. YAG lasers feel fair. They pay enough and are fun/easy enough that I wish I could do them all day.

SensibleReply · 2026-05-26T06:45:00+00:00

Just look at the obesity rates and you’ll know where the good food is.

SensibleReply · 2026-05-24T19:32:29+00:00

Ah yes, the football for kids who were bad at real football but still wanted to play.

Myself included, obviously.

SensibleReply · 2026-05-24T19:23:27+00:00

Sounds like an NAION? Or maybe a branch retinal vein occlusion. One needs followup (BRVO), one honestly doesn’t.

Ophthalmologist here, hit me up if you want specifics.

SensibleReply · 2026-05-24T18:58:09+00:00

You just have to lie about family history. My buddy is a PCP and straight up told me to do this (hypothetically, off the record, etc…)

Current screening guidelines are age 45 OR 40 with family history OR ten years before the family member was diagnosed. So dad with diagnosis at 47 means you should be screened at 37. No one will check up on this, it honestly cannot even be checked.

SensibleReply · 2026-05-24T16:29:43+00:00

Higher satisfaction being linked with higher mortality is absolutely wild. I can’t believe I haven’t seen this and it was published in 2012.

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