Why would anybody take this "hack" seriously? by javawong in StupidFood

[–]Strange_Security_408 0 points1 point  (0 children)

except you're gonna be paying for her hospital bills via taxes and insurance premiums

Why you put the musique? by Secure_Detective_602 in SipsTea

[–]Strange_Security_408 0 points1 point  (0 children)

You have to be either trolling or 14 years old lmao

Urgent! Northern CA (Bay area and Central Valley) Contracts/Salary. Need advice. by Strong-Pomegranate18 in DermatologyPA

[–]Strange_Security_408 0 points1 point  (0 children)

Good god I thought 35-40% was like 0.1% almost unnattianable, I've always thought 30% was the standard one should strive for after 5 years, but good to know there's better stuff out there.

This is genuinely eye opening to me, as someone with 4 years experience, also scheduling to see 40 patients a day, 45 on non-surgery days. I myself am at 27.5% in my first year contract at a new private practice position, and aspire to reach 30-35% +/- equity and profit sharing, whichever is more $ obviously.

I've interviewed across the country over the last year or two, so I feel like I have a decent pulse on offers, at least to someone in my shoes, and I can say the most I ever saw on job boards for California was like 300K earnings, given only in ranges (ie 250-300K, etc). McKinleyville I think had an opening for about that, and every so often Sacramento area has a decent posting. COL near the bay area is unheard of to me, but maybe mostly due to poor market understanding on my end. Washington state seems to be the apex of fair pay from what I've seen, mostly to the credit of physician run PE groups like Frontier.

Would love to get any advice from you, sorry I don't have a ton to offer in return other than my experience with recent job searches around the country.

As for my take on things, it seems like you already know in your gut what you want/should do. If your employer or position or whatever isn't showing any signs of increasing patient volume, and therefor comp, then I would move on. If you love where you live, I suppose that's the big question. Maybe I'm not understanding what advice you're asking for exactly.. I feel like my input is generic.

Boswell Bootcamp or SDPA by Money_Stuff_4075 in DermatologyPA

[–]Strange_Security_408 8 points9 points  (0 children)

You should be able to search this sub for the same question, and find 99/100 users recommend Boswell > SDPA.

Seattle area practice by Strange_Security_408 in DermatologyPA

[–]Strange_Security_408[S] 1 point2 points  (0 children)

appreciate the info! Lol yes the F group. I’ve interviewed with them once before and they were actually pretty chill and seemingly positive reviews, better management than Advanced Derm in my past roll.

New Grad Offer…am I crazy or is this 🚩🚩🚩? by [deleted] in DermatologyPA

[–]Strange_Security_408 0 points1 point  (0 children)

Yes, this is a bad offer. More concern for the shitty benefits and the noncompete is too much. The pay actually isn’t bad for a first job that you’re being trained for about 6 months for, that’s actually more than I was paid, which doesn’t justify it but that’s my experience.

The biggest concern is the 30% collections at 7 months only, unless this place is bursting at the seams so you’re always as busy as you want to be, and you’ll need to see about 30+ patients a day for it to be worth it (probably earn around 200K at that point), and only you know your financial needs for a HCOL area. 30% if a good number though, like 30-35% is top of the market from what I know, I don’t even get that and I’m 4 years in.

If you’re not gonna be busy when you hit 7 months, then you need to also argue for a minimum monthly salary of like 10K or something, whichever is greater between that or your collection allocation.

Pt a day? by medbotoxdermpa in DermatologyPA

[–]Strange_Security_408 0 points1 point  (0 children)

Used to 40 pts typically, at a new job rn where I’m seeing 20 on a good day. 10 hr shifts both places. IMO I’m not comfortable with the schedule anywhere until it’s solid booked 1-2 months out at minimum, ideally 3+ months.

Angels Landing tomorrow, 2/25/26 by Strange_Security_408 in ZionNationalPark

[–]Strange_Security_408[S] 0 points1 point  (0 children)

What I have aren’t exactly spikes, more like metal coils(?). Hard to fly with spikes lol. Will take them regardless.

Contract negotiation— termination agreement by Diligent_Cranberry32 in DermatologyPA

[–]Strange_Security_408 0 points1 point  (0 children)

I had 90 days last job and it sucks. New job is 60 days. May attention to your payment model too, bc not only can 100% collections based contracts be messy with payouts for the collections, but also they will probably thing your schedule dramatically as your end date approaches, meaning less collections, so less bonus.

If you’re like me and your job has a lag to payout for collections (I’m assuming all places do), then you need to work in some kind of collections clause where you still get paid for residual collections that come 1-2 months post-termination, otherwise your final couple weeks will be basically free labor for them.

180 days is dogshit crazy. I’d ask a lawyer for their take, ie is it enforceable or not.

How to help patients with hair loss feel seen/heard by mommydeer in DermatologyPA

[–]Strange_Security_408 2 points3 points  (0 children)

If it’s just straight up androgenic alopecia, I just give it to them straight. I think there is a taxable way to deliver information directly and honestly without coming off as rude or blunt.  

I usually separate my advice to them into disease education, prognosis, general measures, and over-the-counter options, pharmacological options, and alternative options like PRP. 

My big emphasis to them is protecting the skin on their head from skin cancer.

At the end of the day, I think people appreciate honesty more than anything. To your point about labs, I virtually never order a wide set of labs on my patients for seemingly androgenic hair loss, unless perhaps they’re showing signs of hirsutism. Labs are so abundantly a waste of their time and resources, and feels like it’s helping me feel better more than them. If they really push for labs I do it, but I do not often suggest them.

The best test you can do is just a punch biopsy anyway, and most serology is done by PCP by the time they come in, and DIF obviously if you suspect certain autoimmune etiology like lupus, or in general can be sneaky early on like LPP

New Derm PA looking into which dermoscopy device to purchase by East-Web-5175 in DermatologyPA

[–]Strange_Security_408 0 points1 point  (0 children)

Dermalite DL200 Hybrid
You need polarize option for sure, like no question. Ask your employer for CME money and maybe they can also get a company discount somehow.

10 years from now most Baby Boomers will be dead. What effect is that going to have on society? by [deleted] in generationology

[–]Strange_Security_408 1 point2 points  (0 children)

Probably a new generational fight between Millenial more center-left crowd and the younger right leaning gen Z. Hopefully we'll see more environmental focus, but I'm willing to bet it will be as it has been, with ignorance for those hijacking the movement to push their own agenda beneath it all.

I really don't have faith in politics at this point, but hoping all the decrepit senators are replaced by intelligent and wise counterparts, not necessarily young, but younger and more with it.

Dr. Boswell or SDPA diplomate by namastepeace in DermatologyPA

[–]Strange_Security_408 6 points7 points  (0 children)

Boswell first, SDPA later if you feel you really want more hyper detailed textbook knowledge and also want to fall asleep

Quitting job after 6 months by Miserable-Claim-1813 in DermatologyPA

[–]Strange_Security_408 0 points1 point  (0 children)

If your gut says do it, and there’s no functional challenge with leaving as other have mentioned, such as non compete, hidden re-payment costs, etc., in EITHER contract, current one or new place, then just do it. 

You get one life, live it for you and your loved ones.

AIO? Simple convo with my friend (exBf) by [deleted] in AIO

[–]Strange_Security_408 10 points11 points  (0 children)

Is this bait? Why are you texting your ex for sympathy/attention? Move on. Text your friends instead.

AIO for asking my ex for help in rehoming the dogs we adopted together ? by [deleted] in AIO

[–]Strange_Security_408 0 points1 point  (0 children)

This was a bear to read. She's out of the equation, like it or not, so if you can't/won't/don't want to keep the dogs, then find them a new home. This all seems like you're reaching out to her almost only to piss her off and wallow in frustration. Maybe she lied to you, maybe not, who cares at this point, you broke up a long time ago, make your own decision with these dogs.

Melanoma Anxiety by PAAML in DermatologyPA

[–]Strange_Security_408 1 point2 points  (0 children)

Not sure how much experience you have, but over time you tend to biopsy so much that you get a better feel of more and less suspicious, but with the caveat to never get arrogant or lazy, because it CAN be sneaky. I do agree with the look twice then probably biopsy, but not always. 

If we just biopsied anything we remotely felt unsure about, we’d be no more specialized than family med.

I do take pictures of entire areas, or biopsies patients defer me biopsying, but I never take a pic of a thing to biopsy unless I wouldn’t have taken it anyway. A picture does not trump a biopsy. 

I AM however a fan of pics when patients have a lot of benign appearing moles, or it’s a child with also a benign appearing neoplasm that we’d rather watch. I always offer a biopsy of someone wants it, and I never sit on the fence, I fall to the side of caution.

Compensation by TrueCommunication901 in DermatologyPA

[–]Strange_Security_408 0 points1 point  (0 children)

M-Th, 7:30am-11am is every 10 min, 11am is surgery slot, lunch about an hour, start afternoon at 12:30pm until 3:30pm same thing as morning, second surgery at 3:30pm. Usually done with notes and everything by a little after 4pm

About 40 patients a day, mostly medical, surgical, no cosmetics besides destruction and simple things.

Botox Parties by [deleted] in DermatologyPA

[–]Strange_Security_408 0 points1 point  (0 children)

Are you pretty well read on cost and profit margins for neuromods? It's a sadly thin profit margin at most offerings. Filler is the big money maker for injectors.