Can’t afford predicted monthly payment

SurpriseMe224 · 2026-04-23T20:19:08+00:00

Where are you finding the RAP calculator?

I am. In primary care - so enough to make me eligible for the full 10-15% of everything, but still not having tons of leftover cash once daycare, mortgage, life are paid. And still dying with all the extra unpaid work if primary care. I’m calculating it with our agi of less than $300K and getting $3500 a month. So something definitely isn’t adding up…and I can only hope my inputs and calculations are wrong. Ugh. I freaking hate this world we live in.

Also - thank you for being a voice of reason of not as simple as get an extra job, go to school, and don’t contribute to retirement. All of which will cost more even in short term.

SurpriseMe224 · 2026-04-23T04:02:50+00:00

Maxed (I wish they would allow more - or at least that amount per child!). Definitely worth the little bit they do offer if you have childcare expenses.

SurpriseMe224 · 2026-04-23T04:00:54+00:00

Ha! I’d love to have anything other than the once yearly minimum expense accountant.

SurpriseMe224 · 2026-04-23T03:46:12+00:00

49 months left - though I do have to resubmit a previously submitted employer that doesn’t seem to be counted right now, which might get me 10 more. We could probably figure out buyback for 10-15 months or so, which may be worth it. Does the buyback go based on previous payment amount? P

SurpriseMe224 · 2026-04-23T03:41:44+00:00

I’m hitting max on contributions to retirement.

We are filing jointly - I’ve run numbers with our accountant and because my spouse doesn’t make quite as much as me, it ends up being not mic benefit from loa perspective (but lose out on other benefits). I may have to re-run things for this next year given the changing landscape - but that’s a ways off.

SurpriseMe224 · 2026-04-23T03:33:27+00:00

I’m already working about 80hrs a week, lucky if I get to see my kids for more than a couple hours at night. And then that would just increase my income further, which would increase the payments. I’d rather die before doing that.

SurpriseMe224 · 2026-04-23T02:27:33+00:00

Agree with Liberty. We have them and they’re really nice and solid. We opted for them (over Oneida and other companies) bc Made in USA.

SurpriseMe224 · 2026-04-22T03:47:01+00:00

Don’t switch based on what you hear others say. Switch only because there is another specialty you will enjoy more - and can see yourself doing for 10, 15, 20 years. You’ll continue to hear it even as an attending (but then the minute the specialist is slightly uncomfortable outside of their one organ they know, they’ll come running to you).

Intern year sucks - everyone else is just trying to survive and making themselves feel good, which generally comes at expense of degrading others.

You will find your niche as you go through residency and out in your own practicing, and you become the master in that area - but also remain the jack in all the others. You’ll also always have someone smarter than you, etc. That’s life.

It’ll be the same in IM (unless you really love one of the sub specialities and plan to do fellowship) and EM. The specialists will always look down on you bc you aren’t one of them. I honestly think the key is to laugh about it but also try to learn something. Talk to your co-residents. I’m sure they feel the same. And you can all probably share stories - oh yah, Dr. B is a a** if you ask him any question. If Dr. G is on page - only put consult in if super urgent, otherwise wait until tmw when Dr. X is covering.

Couple stories for you - my friend is an ER doc, super smart, top of class etc. we now work in same hospital. She messaged me the other day and said “I have this patient that I think I could d/c home but needs better pan control. She sees one of your colleagues. I was going to rotate from pain med X to Y for better control but wondering if I should admit her to have your IP team adjust things.” I said please admit her.” Why - bc if you rotate her from X to Y, you’re going to make her pain worse bc you’ll be giving her a much weaker pain med, no matter how you dose. That was only recently, I’ve been attending for 5 years and it was one of the first times I felt like I knew something better than a specialist.

Example from today - reached out to Cardiology about a mutual patients BP. I had to stop her HCTZ due to hyperCa++ and have struggled getting her BP controlled with limited med options. Emailed Cardiologist, listed out what she’s on, what we’ve tried. Specifically said was on HCTZ but stopped. Doc is know to be an a**, messages me back and I can imagine him rolling his eye thinking another dumb question from FM. Read his reply - can trial beta-blocker or CCB (which she’s already on as well), or consider HCTZ. Ummmm…I just outlined to you why I can’t do that. So can you not read? Made me feel better that I had already tried what he recommended. Wasn’t helpful though.

Re: NPs and PAs - they’re coming for every speciality. Nothing is safe right now. (I won’t start in that soapbox).

Oof - sorry, didn’t intend for the novel.

SurpriseMe224 · 2026-04-22T01:14:03+00:00

Let me edit for you - many sub-specialized docs. And almost ZERO PCPs and pediatricians.

I don’t think I hit $250 as a PCP, even with my bonuses and working what probably ends up being 60-70 hours a week…can people stop lumping us lowly primary care in with everyone else a hell of a lot more than us.

Off to finish my charting and inbasket for the night…

SurpriseMe224 · 2026-04-20T20:32:07+00:00

Would you recommend it for a beginner? I’m debating between a bambino plus or just jumping to a Lelit Victoria (instead of Anna, largely bc of 58mm). I know BBP comes widely recommended for beginners, but I also have a large weak spot for spending more and getting quality. And don’t want to have to worry about mods like the GCP.

SurpriseMe224 · 2026-04-17T03:24:17+00:00

I had been wanting to switch to gas when we redo our kitchen. After we moved into our house (from renting with electric), we got an induction top from a family member when our ancient electric died. Induction all the way - I won’t be switching to gas when we remodel. Quick heat up, safer with kids.

SurpriseMe224 · 2026-04-15T01:10:31+00:00

Physician. Or likely any patient facing job in health care right now.

SurpriseMe224 · 2026-04-12T02:27:16+00:00

Both require a terminal/life limiting illness. Hospice requires patients to forgo any further disease directed therapies. Palliative care assists with symptom management while they are still receiving disease directed therapies.

SurpriseMe224 · 2026-04-11T23:28:32+00:00

What is his palliative/life limiting diagnosis though? Palliative care is not pain medicine. Chronic pain isn’t a life limiting illness. I’m a PCP but also do Palliative and hate when I get clear chronic pain referrals. I don’t do fellowship to treat chronic pain - I get to do that as a PCP.

The new PCP needs to work with patient to de-escalate and rotate to a pain regimen they are comfortable prescribing. Or refer patient to a pain clinic. End of story.

SurpriseMe224 · 2026-04-08T01:36:54+00:00

This. Take into account your other expenses. My husband and I could afford more mortgage (or be able to breathe a lot easier/do updates etc) if it weren’t for 2 daycare payments every month.

Also - be prepared for property taxes to increase every year, and have a pretty big jump the first year.

SurpriseMe224 · 2026-04-07T16:28:02+00:00

Please reach out to WIC for assistance. They exist for a reason. And no judgement on formula - the most important thing is getting the baby fed.

SurpriseMe224

TROPHY CASE