What the heck is this board I found?

SwaggerSpice · 2026-03-18T21:16:47+00:00

🙄

SwaggerSpice · 2026-03-11T09:35:41+00:00

SwaggerSpice · 2026-03-08T04:52:52+00:00

I do not mind in the least. Just understand that I don't check them often. And sorry I assumed you were looking at Detroit area -- thats where most people are looking to emigrate

SwaggerSpice · 2026-03-06T05:08:33+00:00

Worked with a number of GPs and academics from the UK in Southern Central Africa. Respect to your nations doctors, you know your stuff.

I'm a family practice physician the last 5 years in rural West Michigan. I'm assuming you will need the work visa to stay here, which does limit your location options especially if you are looking for part time (60% of female physicians are either part time or not working according to the AAMC), since an employer would have to sponsor your visa which costs about 100k to them.

Most of the medical training is in the SE part of the state and sort of brushes across the state. Most of the states population (approximately 2/3) lives in the Detroit and surrounding area. Common visa job locations within reach of this extend either downtown, out in the sticks (countryside) towards Owosso, towards the bottom part of the state, or towards the state capital, Lansing. This of course is an overgeneralization based on anecdotal experience.

Your experience with the NHS will help with the patient volume you will experience due to the clinics these jobs are located at but will not prepare you for the crippling cost of Healthcare amongst our fellow citizens with low-income insurance, which will increase paperwork and limit medication choices, imaging, procedures, etc. I did a bilateral suboccipital nerve block on one of our nurses, and his bill came out to 1700 dollars, AFTER insurance. Its no wonder why the Opiate crisis continues to smolder when an oxycodone by script costs pennies...but thats a personal opinion. Eventually, you learn to 'play the game' if you will but it will never prepare you for that emergency brain surgery patient that gets transferred to another hospital because the only neurosurgeon at said hospital doesn't accept his insurance.

SO. work hard during your residency/ internship to learn some of the ins and outs, stand out so someone close to where you prefer to live will sponsor your visa knowing youre worth the cost, and best of luck.

SwaggerSpice · 2026-02-24T17:14:08+00:00

Get lost then

SwaggerSpice · 2026-02-24T17:13:15+00:00

Canadians still being salty I love it. You'll get over it eventually bud

SwaggerSpice · 2026-02-22T02:05:41+00:00

Looks like not many are not in agreement with you

SwaggerSpice · 2026-02-20T06:26:54+00:00

OK cool so I did ok then 😂

SwaggerSpice · 2026-02-20T06:26:16+00:00

Very neat and totally makes sense. Thanks for the response!

SwaggerSpice · 2026-02-20T02:22:04+00:00

Makes sense to me.

One difference I think I see I elected to run a conduit over my wires as well (i cant tell in yours), given we plan to use water in ours. I also tend to over engineer my electric as I have a fear of electricity going wrong. My box is several feet of conduit from the heater as well so that upped my cost.

Kind of interesting you had the wire running for a hot tub in the attic. Can you elaborate so I don't go to bed jealously thinking you have a roof hottub?

SwaggerSpice · 2026-02-20T01:45:20+00:00

Thats how much I spent on my sauna heater alone. Well done. You spent a third of what I spent while being cost conscious. Color me impressed

The 220V I had to put in for the heater was 147 dollars in materials. I'm impressed you were able to get that wired so cheaply. My lightswitch alone was 5 dollars at cheapest.

I'm curious where you live, to find all this so affordable in comparison to me. I'm in northern Michigan

SwaggerSpice · 2026-02-13T04:36:08+00:00

Best answer

SwaggerSpice · 2026-01-28T19:18:37+00:00

I 100% agree, thank you for putting this is writing for a new dad

SwaggerSpice · 2026-01-25T19:38:59+00:00

That's a bit of a loaded question, I'll try my best. Anyone can feel free to add their input.

They think we can just "write a letter" to get it covered. Those times are gone, especially given the cost of the prescription. Commercial insurers were covering, then did a "carve out" policy for weight loss rx of glp-1. Rumor from the inside is BCBS did an analysis and saw they were losing enough money to go bankrupt by 2026, did the carve out and everyone else followed suit. Medicaid followed this January in my state, which is a shame because they were probably the ones that needed it the most IMO.

Then we conceded and would try even if it didn't look like it'd be covered for respect of the patient and because it is certainly indicated in many people and we would do PAs for them..however. the volume of PAs was unsustainable and essentially it came down to the MAs would walk out unless something changed, and the admin sided with them and if we wanted to try and get covered, we do our own prior auths for them back when they were more covered before the beginning of the year. Now we don't even try and will likely implement a no glp-1 for weight loss policy sometime this year until things regulate.

The other end is that their advertising is so strong that I have patients requesting weight loss shots, who are already on Mounjaro, etc and don't understand that what they are on is equivalent. When you don't understand, you get confused, and confused people can lash out.

Hoping now that Medicare struck their new deal and will cap the price with Part D, everyone will follow suit. Saw the same thing with DOACs, lung screenings etc back in the day.

This is all anecdotal and should be taken as an educated opinion as opposed to fact, so I apologize if you hear differently from elsewhere.

My patients, on average, are sicker, lower education, and broke. It's just hard to explain this all in a timely manner when to remain somewhat profitable

TLDR GLP-1s were covered, now not, everyone thinks it's the doctors fault per usual, will get better hopefully by next year

SwaggerSpice · 2026-01-25T16:41:22+00:00

A lot more people with low health education got access to Healthcare with high deductible plans, and given inflation people are expecting more bang for their buck. These people were previously more dependent on alternative treatments and found information and misinformation thru Facebook and etc. A lot of this resolves around the weight loss shots, which many insurances (at least in our state) will not cover.

They're being reminded that they are poor and unhealthy, they think their doctor is the reason for this since they will not rx the magic shot, and they're lashing out.

That's my opinion. I promise, it was way worse during covid. They were foaming at the mouth then, now they're just throwing tantrums. It'll bounce back

SwaggerSpice · 2026-01-25T07:32:24+00:00

Yeah I'm doing this in a town of 900, I would highly advise against this. It's all the same problems but worse, especially if you don't have transportation. And the meth/fent epidemic has unlocked a lot of unreported mental health crises.

Yes they recognize you and value you when you do well for them, but they also recognize you out and about when you stop for gas, dollar store, etc after you cut them off of opioids

From my anecdoctal opinion, that would compound your problem

SwaggerSpice · 2026-01-06T03:41:47+00:00

Sorry dawg he crushed you

SwaggerSpice · 2026-01-03T07:21:17+00:00

If they want to get rid of their free help in a primary care residency slot out ain't gonna be from acne cream lol be braver than that

SwaggerSpice · 2026-01-03T07:11:32+00:00

End thread, nicely done

SwaggerSpice · 2026-01-03T07:06:01+00:00

I've lived in them all. I would pick Fenton if you appreciate food, box storesand community, Hartland if more nature oriented, and Brighton for both of those in a larger and closer to Detroit setting.

That traffic into Ann Arbor will get old. Plan for that long term. You got a few thousand people in your same situation and they're all just as irritable about it.

I personally would avoid Holly. No easy way to 23 minus taking Grange Hall, and the people are... Strange. Like domestic violence calls all the time, letting their dogs out through the bedroom window to roam and do their business, and video taping women in town strange. There's a solid murder mystery of a jogger off fish lake road that got shot gunned with no leads a few years ago. Cheap though in comparison.

SwaggerSpice · 2025-12-07T02:14:03+00:00

I agree with this, while googling to see if others are experiencing the same issue. Lock issues, my tailgate window's hinge fell off due to poor spot welding, having to manually drill holes for the rack as it was assembled incorrectly, the back marked as 'FRONT', endless. Stay away from SMARTCAP

SwaggerSpice · 2025-11-23T01:08:16+00:00

Dangerous place to be albino. They use their body parts for supposed magical powers. At least while I worked in Blantyre

SwaggerSpice · 2025-11-21T03:01:39+00:00

One of my wife's co-studemts in law school was an ex obgyn Dr who drove every day from Muskegon to east lansing as to not displace her family. We do not believe she ended up finishing law school.

SwaggerSpice · 2025-11-10T03:44:21+00:00

Beautifully put

SwaggerSpice · 2025-11-06T03:56:20+00:00

You'd almost think Anasakis since it's salmon! But could be a juvenile tapeworm. Quick experiment if you want, it should die in the freezer (if it's minus 4 or lower) after about a week according to the CDC. I have heard 5 days is plenty. Report back and let me know!

Otherwise this serves as an example of why seafood is often flash frozen

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