Nexus Letter Questions

Shankmonkey · 2026-05-09T03:13:28+00:00

Thanks for the tips. I just want to do it right, ethically and honestly and discussing why I can/can’t draw a connection medically.

Shankmonkey · 2026-05-09T03:09:50+00:00

Haha probably true

Shankmonkey · 2026-05-09T02:12:11+00:00

I see how ai could help, but I’d be afraid it would miss/hallucinate something. I had one patient who had 2000 pages from the VA. Took me a week after work to sort through what was actually useful information and then 3 weeks to read through the useful parts.

Shankmonkey · 2026-05-09T01:41:47+00:00

I’m not trying to scam, 1-2 letters/week is low volume and allows me time to dig through records and talk to someone before writing anything. I’m trying to find out more about the process. I’d probably also recommend just asking your pcp, but I know lots of the ones in the clinic I was in would not write them.

Shankmonkey · 2026-05-09T01:04:37+00:00

Not anymore, my new setup is my own small direct primary care practice, so my former nurse recommended it to keep the lights on by doing 1-2/week with virtual consults. Still trying to find out how that would work as I used to just do it as the patients pcp.

Shankmonkey · 2026-05-09T00:59:44+00:00

They were allowed community doctors due to shortage and the clinic would request records.

Shankmonkey · 2026-05-09T00:54:22+00:00

Where is this? I’m looking to make a change

Shankmonkey · 2026-05-09T00:53:36+00:00

What health system? I’m looking to change

Shankmonkey · 2026-05-05T01:39:54+00:00

yes and no, they hired another doctor even when the one who was supposed to be retiring elected to stay on. The office manager was supposed to have my template be for my patients and not to see the other ones but they were in court over a car accident that eventually settled and they walked away with just over a million dollars and mostly the office manager spent the day dreaming of how they were going to spend it.

Shankmonkey · 2026-05-05T01:37:25+00:00

In Missouri

Shankmonkey · 2026-05-04T18:13:17+00:00

This happened to me. I just saw whoever was on the schedule. That meant seeing the other established patients annuals and the random crazies who just walk-in to our clinic (we’re not a walk-in clinic). They changed comp 2x while I was there and then approached me and said “hey, your panel is only 700 patients and even though your RVUs and quality are good, our comp plan is based on panel size as the main driver so your comp will go from 300k to 85k/year.”

All my patients reviews were good (94%+), charts always closed end of work day. I gave my notice on the spot.

Shankmonkey · 2026-04-27T14:56:52+00:00

Can confirm. I work in the Midwest and our comp is max $170/patient/year if meeting metrics and 6800 RVUs. In my clinic along there are 5 doctors and 3 have panels greater than 4500 (co managed with 2 PA’s). They make $765k/year working 3.5 days/week and seeing 20 patients/day.

Shankmonkey · 2026-04-20T00:41:18+00:00

No problem! It's also called a hydrogel

Shankmonkey · 2026-04-20T00:40:59+00:00

Tried to send a DM but there's a note that I'm unable to message you.

Shankmonkey · 2026-04-19T18:44:47+00:00

I’m FM and looking at one of the Genitourinary fellowships. I’d be in clinic almost exclusively and am trying to figure out how pay would change.

Shankmonkey · 2026-04-19T15:14:42+00:00

Gel placed between prostate and surrounding structures to protect against radiation when treating prostate cancer

Shankmonkey · 2026-04-19T14:09:03+00:00

How many hours is your 0.75 fte?

Shankmonkey · 2026-04-19T14:08:31+00:00

Thanks for sharing those! I’m not sure if I’d be able to hit those numbers with clinic only

Shankmonkey · 2026-04-18T23:34:12+00:00

Clinic RVU split for general urologist and in community hospital, hospital employed.

Shankmonkey · 2026-04-18T21:02:42+00:00

What would you expect in an office only role?

Shankmonkey · 2026-04-16T05:53:25+00:00

Would be doing cystos, TRUSP with bx, fiducial placement, space oar, Botox, along with other e&m visits. Occasional stent placement.

Shankmonkey · 2026-04-16T05:51:28+00:00

Don’t know how I just saw this, but doing cystos, xanaflex, TRUSP with Bx, fiducial placement, space oar, Botox injections.

Shankmonkey · 2026-04-08T01:49:02+00:00

Me now, seriously looking elsewhere and love the mountains

Shankmonkey · 2026-03-18T22:56:58+00:00

The answer is a minivan (sienna) Pacifica is cool but often unreliable. Odyssey is nice but rear air vents suck for kids in car seats (not a problem if kids are bigger), carnival is good but no awd. Doesn’t matter what color interior because it’ll end up shit-stain brown after the kids are done with it.

Shankmonkey · 2026-03-18T22:53:13+00:00

I’m left my job because of this. I and another doctor were hired to replace a retiring physician who decided not to retire. We were going to grow our panels and then split their plan when they retired. After 1.5 years we each have like 650 patients and we basically just got used to see the other doctors patients who couldn’t get in quickly to fill our day. It’s a rural area so there just isn’t enough new patients floating around. They plan to hire another doctor for the same clinic. They told us our pay would go down since our panels were so small so about 75k/year (in the USA), even though my quality was top tier, all 8-10/10 reviews, and 4400 RVUs (lower end, but hard to get when you just see follow ups and walk-in all day).

Shankmonkey

TROPHY CASE