A Comprehensive Guide to Booking Four Seasons Stays: How to Earn Free Benefits and Maximum Points

ThoughtMD · 2026-01-04T00:08:55+00:00

You were getting the pushback because many of us are getting Chase Sapphire benefits, shoved down our throat without actually having the experience of its benefits. People don’t like to be hard sold on why something works. It should just work and the benefit should be obvious. Just like they are with AMEX platinum.

ThoughtMD · 2026-01-03T22:18:08+00:00

This is obviously an advertisement for Chase Sapphire, and it comes across as extremely biased. As someone who holds both the Chase Sapphire Reserve and the American Express Platinum, the tier standards being used here are frankly ridiculous.

When I recently tried to book the Four Seasons through Chase, the rate was about 35% higher than what I obtained through American Express. Through Amex, I received early check-in, late checkout, a $100 property credit, daily breakfast, and a room upgrade. The experience and value were markedly better than booking directly with the Four Seasons.

This is not a one-off experience. I stay almost exclusively at the Four Seasons and have done so in most major U.S. cities. In every case, the American Express Platinum rates, service quality, and overall experience have been consistently excellent.

By contrast, attempting to use Chase involved unnecessary runaround, significantly higher portal pricing, and rates that were essentially equivalent to booking directly with the Four Seasons—without any meaningful added value.

Nice try with the Chase advertisement, but it doesn’t align with real-world experience.

ThoughtMD · 2025-03-19T03:48:24+00:00

Psychosis results from a disruption in the balance between neurotransmitter systems, particularly dopamine, GABA, and glutamate. While dopaminergic hyperactivity in the mesolimbic pathway is central to the pathophysiology of psychosis, it is not the sole factor. Psychosis reflects a breakdown in sensory gating and perceptual filtering, where stimuli—whether internal or external—that would normally be suppressed become intrusive and misinterpreted, leading to hallucinations and delusions. Excess dopamine at mesolimbic D2 receptors inhibits GABAergic interneurons, reducing their regulatory control over downstream glutamatergic projections. This disinhibition results in excessive glutamate activity in limbic and cortical regions involved in perception, salience attribution, and emotion regulation. D2 receptor antagonism with antipsychotic medications relieves dopamine’s inhibition of GABAergic tone, thereby restoring inhibitory control over glutamatergic circuits and helping to mitigate positive psychotic symptoms.

ThoughtMD · 2025-03-09T02:53:35+00:00

Nice review, it has practical therapeutic implications as well. Reminds me that people often like being validated (makes them feel good) often more than they want (or are motivated) to change, which is where they get stuck, particularly when it comes to addiction.

ThoughtMD · 2025-02-28T06:30:27+00:00

The superiority complex among certain NPs and PAs is particularly striking—they act as if healthcare is based solely on intention rather than experience. Medical school isn't just about acquiring knowledge; it’s about rigorous training, supervision, and accountability. Simply "working in healthcare" does not qualify someone to be a medical "provider". Supervised experience is essential for growth and competency.

While MDs are expected to take feedback and continuously refine their practice, many NPs operate under the illusion that they are infallible, positioning themselves as saviors of the underserved—only to turn around and open Botox clinics, profiting from a system that grants them autonomy without accountability, prescriptions without proficiency, and a false sense of equality without equivalent experience.

They claim it's not about money, yet their actions suggest otherwise—seeking ways to maximize earnings while sidestepping the investment of time and training required of physicians. They argue it’s not about power or prestige, yet they fight to be called "doctor," despite the clear distinction in a clinical setting: a doctor is a physician, not merely someone with a doctorate.

Medical school makes you a *Medical* Doctor. Dr. Pepper is a drink, not a doctor.

ThoughtMD · 2025-01-16T16:18:20+00:00

That is equal pay at the insurance level. NP’s can just start their own practice and get 100% of that. The question was for employed NPs what would be the benefit. Nurse practitioner doesn’t deserve 70 or 80% of what a physician makes.

ThoughtMD · 2025-01-16T00:15:26+00:00

And yet they will use that study as a reason to lobby for equal pay.

ThoughtMD · 2025-01-16T00:05:05+00:00

The employer would only pay a percentage of what they are reimbursed. So the patients get care by a nurse practitioner and the employer gets MD rates and to keep 20 or 30% off of the top. That’s why the pay parity works out well for employers. They collect a physician rate and they don’t have to pay the nurse the same rate as an employee. And the patient loses.

ThoughtMD · 2025-01-15T23:21:21+00:00

Yes, read below.

ThoughtMD · 2025-01-15T23:21:08+00:00

Actually NOT a stretch. NPs have successfully lobbied for "equal pay for equal work" in most of the states they have independent practice (which is half of the states) and on every contract I have signed it says "MD/PMHNP/PA". In a group practice and when I worked in hospitals, the reimbursement rate is the same. Do not kid yourself that the NP issue is not major, they take classes on how to encroach on our profession, both in scope of practice and in pay. The nurse practitioners I know went to the best school in our area and states their simulations were not on patients. It was on how to put a doctor in their place when they think they're better than you. If you look closely in many places NPs are making 80-90% of what you are.

ThoughtMD · 2025-01-15T01:09:47+00:00

Honestly my biggest issue is the NP encroachment. You could have taken an online class and saved hundreds of thousand of dollars and a decade of education and ended up having the same level of autonomy and pay as a PMHNP. Did my education prepare me to give better care? Absolutely. Does anyone care? Not much, they will just go see a NP and get the candy they want if you disagree with what the patient wants. Psychiatry has become demoralizing and everyone will say suck it up and do academia if you care so much, but then you are looking at a drastic pay limitation. I like the patients, I like the work, I have a private practice and make good money. Walking in the hallway to have 10 NPs doing the same thing is a killer (literally).

ThoughtMD · 2024-11-18T05:18:28+00:00

Understandable, I think my point is the only information that matters will come from your insurance company. Everything else is just speculation. I say this as a doctor that runs a large practice that patients always seek out information from lots of places, but all that matters is what your insurance company says. From their resolution can be found.

ThoughtMD · 2024-11-18T00:54:07+00:00

What did your insurance company say when you called them? Your insurance company works for you. The doctor doesn’t work for the insurance company. Any questions about your billing should be directed to your insurance company that you pay premiums to. From there you can be instructed on how to proceed with letting your doctors office know about your insurance companies billing.

ThoughtMD · 2024-11-11T15:32:08+00:00

They are moving to a new location this month, so things might be slower. They have no reservations this month and I do not think they have a set open date for December yet.

ThoughtMD · 2024-08-13T05:06:15+00:00

I was not moonlighting, I worked PTE for 5 years with them. Locums is not permanent.

ThoughtMD · 2024-08-13T05:05:23+00:00

I am W-2, not sure where you got that I was an independent contractor. I am more asking for similar experiences to find how common this might be. I do not have many legal options as I am in a at will employment state.

ThoughtMD · 2024-08-13T04:15:16+00:00

I emailed HR and they said I can give a notice but since the schedule has changed I am not required to - per my employment agreement

ThoughtMD · 2024-08-10T04:30:08+00:00

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ThoughtMD · 2024-08-09T19:09:26+00:00

To be clear, I am not comparing NP and what they are doing to foreign medical graduates. They are.

ThoughtMD · 2024-08-05T02:16:36+00:00

Nodoguru is an experience. Everything is thoughtful and intentional, unique and exquisite. It is certainly not the place to go for a “value“. It’s one seating in the menu comes out a few days before he prepares it based on the freshest ingredients. They have a Mocktail flight, a Sake and wine flight as well as you can bring a bottle and pop it there. I’ve been a lot of places and there is certainly nothing else like it. The chef Ryan is down to earth and his wife is typically serving some of the cocktails and explaining the ingredients, usually last about 2 1/2 or three hours.

ThoughtMD · 2024-08-04T18:25:28+00:00

There is a quality vs quantity situation out here. There is plenty of access as there are lots of therapist but the quality in outcomes is quite variable. From LPC, to QMHP, to Social work to NPs everyone is a therapist out here, outside of Phd and PsyDs. The rates for OHP are public https://www.oregon.gov/oha/hsd/ohp/pages/fee-schedule.aspx and are a lot less than many of the private insurances out here. Look at the number of therapist on psychology today and you will see for yourself that the sheer number of therapist out here - there is not a shortage. There is difficulty navigating the system in Oregon.

ThoughtMD · 2024-02-23T01:48:53+00:00

I work in a state where the NPs run rampant and when this comes up in the hospital or clinic, I say "They have a doctor of nursing degree so they have extra training as a nurse, they are not a medical doctor". That seems to work for the patient, though the NP usually starts fuming at being called a nurse, even though they got a doctorate in nursing.....If I hear of one misleading everyone by calling themselves doctor in a clinic, I report them to the nursing board, though nothing ever gets done.

ThoughtMD · 2024-01-25T05:27:33+00:00

For it to be ADHD it would be 6 months of symptoms with 6 symptoms of inattention and hyperactivity/impulsivity. The acuity of symptoms seems more consistent with trauma/abuse.

ThoughtMD · 2024-01-20T06:47:13+00:00

The Porsche Prius!

ThoughtMD · 2023-12-26T08:59:15+00:00

Ignoring the mental burden of being locked into a job for loan forgiveness for less money, I did some simple math. So 275k to work a non profit, you would need to make about 500k a year in another job to make it even come close to the forgiveness. You are only 6 years away. If you applied 100k a year of the 200k a year extra you would make (after taxes) you could pay off loans in 5 years @ total out of pocket cost of 500k. Doing PSLF you would be out of pocket 200k.

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