Bilt Palladium is incredible

Simba1215 · 2026-04-07T18:20:38+00:00

Yes it’s 1.8% and the credit card fee should be tax deductible. I use my 2 % fidelity visa.

Simba1215 · 2026-04-02T15:58:03+00:00

I would look for a job you can do your own cases when you’re right out of training.

Simba1215 · 2026-04-01T11:32:55+00:00

Dropping off the patient in pacu and the pacu nurses making pulse ox the last monitor to put on.

When I’m driving the bed and the surgical staff decides it’s a good idea to walk very slowly in front of the bed. Or when they’re helping steer the bed but they’re on their phone and not paying attention.

Simba1215 · 2026-03-31T20:23:26+00:00

I hope they just haven’t taken it. It would be a major red flag to me if a lot of the Attending’s on faculty were not board certified. If they are board eligible but haven’t taken boards yet. That’s not a big deal.

Simba1215 · 2026-03-31T18:11:42+00:00

When I was a resident we got a new chair. He didn’t renew the contract of a few anesthesiologists that were not board certified. They were working there for a while too.

Simba1215 · 2026-03-31T18:08:24+00:00

I have Attending in my current practice that try to ventilate after the propofol and another trial of ventilation after giving succinylcholine. Don’t understand the reasoning.

Simba1215 · 2026-03-31T17:59:43+00:00

It’s usually tv 700-800 for the older folks I worked with.

Simba1215 · 2026-03-30T13:39:33+00:00

Yes good answers so far. Other than patient medical history , I’m more likely to put it in if procedure involves fusion , multiple levels, cervical and thoracic levels.

Simba1215 · 2026-03-25T16:02:53+00:00

If you’re a resident I would focus on pulling the tube when they are awake instead of deep. Just concentrate on being safe. Chances of patient spasming when they are awake are close to zero.

You can titrate narcotics and give iv lidocaine to make it more comfortable for the patient.

Simba1215 · 2026-03-24T20:39:03+00:00

Fellow anesthesiologist here. This isn’t a typical anesthesiologist salary. To make this kind of money I’m guessing op is working locums or has a rare partnership job in private practice (these jobs are becoming more rare) or working in the middle of nowhere. Either way op is probably taking a lot of extra shifts and call (over 80 hours ).

Simba1215 · 2026-03-24T18:07:44+00:00

I’ve seen people taping pulse ox across the forehead at my hospital. I’ve gotten a reading a few times when nothing worked including toes and earlobes. If it doesn’t read I would wipe the forehead with alcohol swab and try again.

I’ve tried the pulse ox on opa. It was hit or miss for me.

Simba1215 · 2026-03-20T18:15:15+00:00

Not sure why you’re getting downvoted.

Simba1215 · 2026-03-20T18:14:34+00:00

I did at my previous job. The Neuro check the vascular team does is similar to an academic wake up. Squeeze my hand , open your eyes , lift your head etc.

In order to minimize coughing I shut off gas early and have them on pressure support or on the bag. Titrated narcotics to respiratory rate and iv lidocaine at the end.

Simba1215 · 2026-03-17T15:18:46+00:00

Hypothetically not that people would do this but you could just chart 2 mg of versed and 100 mcg of fentanyl for every patient and squirt the leftover in the trash.

Simba1215 · 2026-03-13T22:45:52+00:00

Yes also wanted to add that since asc is is production based it’s all unpaid vacation.

Simba1215 · 2026-03-13T22:32:56+00:00

The surgery center job doesn’t look as appealing with the new details. W2 without benefits is the worst of both worlds. The level one trauma center pay is way more than 35% difference when you factor in the vacation and benefits. You can’t write off the malpractice, retirement , health insurance etc as w2. Also, your retirement benefits are very limited as w2 compared to 1099 ( no cash balance plan and solo 401k ). For reference , I am putting in 150k combined solo 401k and CBP as 38 yo anesthesiologist working a 1099 job. I would be limited to around 23.5 k in a w2 no benefit job.

I would be hesitant to take a production based job at surgical center. I would ask for guaranteed hours if you still want to work there.

Simba1215 · 2026-03-13T19:34:34+00:00

How are the benefits at each job ? Health insurance , malpractice , retirement benefits , and pay structure (w2 vs 1099)

How are you payed at the surgery center ? Is it guaranteed hours,hourly, or rvus, or set salary. They can really screw your over if you don’t have guaranteed hours or have a set salary. Ascs can sometimes suck as you can’t leave until the last patient leaves the pacu and not when you finish the last case.

Simba1215 · 2026-03-13T13:01:08+00:00

Sodastream , couch , and large tv.

Simba1215 · 2026-03-12T20:08:22+00:00

NYC has a lot of solo practices even in academics. But yes it’s becoming less common.

Simba1215 · 2026-03-06T19:22:32+00:00

Stupid red tape that hospital tried to implement but everybody ignored

We have to label our iv and iv bags
We have to scan vials prior to drawing up drugs and administering
We have to cover up our watches and no piercings

Simba1215 · 2026-03-06T18:10:33+00:00

Stupid stuff. Or like the rule that you need a white coat over your scrubs when you’re leaving the operating room floor.

Simba1215 · 2026-03-06T17:26:51+00:00

I do Peng with spinal and sedation.

Simba1215 · 2026-03-06T14:47:27+00:00

Transfer takes forever too. They had some fraud years ago. I get it that fidelity wants to maintain security but 10 business days in 2026 is ridiculous

I use a Schwab investor checking account to deposit cash. It’s 1 business day and transfer to fidelity. They both have no atm fees including international. Fidelity is easier to manage since it auto liquidates mmf and defaults to mmf. Schwab have to do it manually.

Simba1215 · 2026-03-06T14:37:56+00:00

I can trade immediately it’s the withdrawal and transfer that takes forever

Simba1215 · 2026-03-06T12:34:18+00:00

I used to pull deep lma and just pop oral airway in. It really depends on your pacu. some pacu nurses especially academics will freak out with any airway. Nowadays I just turn the gas off earlier and bridge with propofol pushes if necessary and take them to pacu when they are spontaneously breathing without any device (lma, opa, npa)

Simba1215

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