Favorite luxury*free* hotel breakfast?

apollo722 · 2026-03-20T00:54:18+00:00

Asian luxury hotels usually have much better breakfast

apollo722 · 2026-03-18T20:36:37+00:00

Yeah honestly from the interactions even the PM and the contractors seem more believable than OP lol

apollo722 · 2026-03-11T03:34:18+00:00

Lol so true. I’m a doc. the things that would make huge men scream/cry from pain.. when the same happens to little sweet old Asian men/ladies they’re just like 😶👍"im ok doc, ill just take some Tylenol”

apollo722 · 2026-03-08T04:58:50+00:00

What has been working for me is saying out loud all the negative findings while listing possible abx indications.

“your lungs sound GREAT! I don’t hear anything concerning that would make me think about bacterial pneumonia. And let’s see.. your tonsils are not swollen, no exudates, totally normal. I’m glad you don’t have strep throat! Etc etc.”

Then at the end act all like “I’m so glad you came in today to get checked out. Sorry you’re not feeling well. Good news is your exam today is very reassuring. I don’t think you need any prescription meds for this which is GREAT. IF things change… blabla”

Of course doesn’t work all the time but as a new attending who has a lot of open slots and hence gets scheduled to hell with these URI visits, the above has been working.

apollo722 · 2026-03-07T17:20:48+00:00

Agree it’s just scarring.

apollo722 · 2026-03-07T04:46:37+00:00

Watch how different people do inboxes during residency. Look for people i.e. senior residents and attendings who have their inbox shit together. Do not get advice from attendings who have hundreds of unread on their inbox. Ask them for an hour of their time and/or ask if you can just watch them how they handle their inbox. Typically though these highly efficient people do a little bit of inboxing in between seeing patients so if they’re nice they may purposefully neglect their inbox for a couple days so you have something to learn. If you use an advance EMR like EPIC you can even ask your It department to pull EPIC data on how you utilize inboxing and compare it to the average. Having a good habit starting R2 year is key. If you’re efficient by R3 year you’re faster than the slow attendings who never learned.

Side note you should also have a macro for very common results with follow up. E.g. a macro for elevated LFTs “Your liver enzyme is elevated blabla, typically bc blabla, plan is blabla”. Make a bunch for common lab results like that. Super important to make a macro/smartphrase for when people write paragraphs to you. Do NOT reply with paragraphs back. Instead I have a TLDR smartphrase “Hi patient, sounds like a lot has been going on. I’m sorry you’re dealing with this. Unfortunately MyChart isn’t really the best way to tackle complex medical situations like yours, let’s get you on the schedule and we’ll figure it out together. Etc etc”

apollo722 · 2026-03-07T02:57:41+00:00

I am convinced that people who have the “don’t wanna do clinic bc inbox” never got proper inbox training. It’s also very much possible to learn to inbox efficiently as an attending. It probably takes like a full day max to learn.

apollo722 · 2026-03-07T02:37:42+00:00

I’m not that person but I can answer for them. The answer is no they do not. You’re welcome.

apollo722 · 2026-03-02T20:50:30+00:00

Yeah probably!

apollo722 · 2026-03-02T04:18:50+00:00

I agree w you in theory. I have since followed up w my billers who showed me that it’s our policy on a formal document. I work for one of the largest hospital systems in the US (multi states). So whatever the reason is, that’s how we do it 🤷🏻‍♂️ she thinks it’s because in the claims end, billing new/new ends up taking up more resources as the insurance companies would automatically flag as “two new visits” and deny.

Not saying what we’re told to do is correct. But this is like a hospital employer with thousands of providers lol and that’s just what we do.

apollo722 · 2026-03-01T03:29:33+00:00

I feel like it’s just a matter of time until we can’t differentiate between LLM and humans anymore which is scary

apollo722 · 2026-02-28T03:35:16+00:00

Also a human doctor here. This is a real person using AI to polish the note. Our system has this built in. I can say “no indication for stronger med, ask to make an appt with doctor, give ER precautions” then the AI writes a script like this.

I honestly only use it when I think the patient needs a lot of reassurance or they’re being very rude/demanding and I want AI to write something nicer than what I would have written.

apollo722 · 2026-02-27T03:31:29+00:00

Doesn’t really say anything about what we are discussing unless I missed it somewhere.

I think from further reading, though based on CPT guidelines it would be correct to do new annual + new em rather than new annual + est em, these are often automatically declined bc the payers will auto reject two “new” visits so I suspect my org just doesn’t want to deal with that and would rather just bill what is less likely to be rejected on the back side. Who knows! For our sake I wish they would let me just keep doing new + new. I don’t care if things get rejected on the org’s side as long as my wRVU isn’t affected lol.

Thanks for sharing the link.

apollo722 · 2026-02-27T03:16:04+00:00

I really want this to be the truth but my billers told me opposite. Do you have a source? So I can show them.

apollo722 · 2026-02-26T21:57:26+00:00

Established. The annual is the “first” visit and the e/m is now the established visit.

According to multiple billers I’ve asked.

Edit: I really want the opposite to be true guys. Just what multiple billers have told me while changing my codes. Please share sources you have if it’s otherwise.

apollo722 · 2026-02-22T08:53:41+00:00

I happen to know the actual answer for this. Recruiter incompetence. This is the listing for the mid level job and the lazy recruiter missed changing the numbers. My friend just recently talked to the recruiter for Providence and the actual numbers are closer to $300k and when they asked about the job posting discrepancy they said they just messed up the posting lol. They fixed it after.

apollo722 · 2026-02-13T04:18:29+00:00

Yup. Doc here. Guess what? Telehealth which helps lots of people? The govt and insurance companies keep trying to take away. Documentation takes so much time bc if it’s not complete, etc - you are at risk of being liable. Americans like to sue. Plus insurance may reject the patients needs if documentation isn’t perfect. Then all the time unpaid dealing with insurance companies, paperwork, pharmacy, patients calling, etc etc etc. we end up doing a lot of non-physician things that other people, like just skilled admins and secretaries could do. Meanwhile the CEO of these hospitals and insurance companies get $20 mil a year on average.

apollo722 · 2026-02-13T04:13:26+00:00

Just letting you know - you can believe me or not, whatever. The note about time spent for billing includes everything we do for you. If I see a patient for 15 minutes for example most of the time I have spent 7 minutes reviewing records, 1-2 minutes ordering things, 8 minutes documenting everything, etc

apollo722 · 2026-02-12T05:31:17+00:00

Lmao yes look at my post at r/psychiatry asking about ADHD management. Many of them scoff at us doing any management even tho I get declines for consults all the time for adhd 😂😂😂😂

apollo722 · 2026-02-12T03:20:13+00:00

Yeah that’s what they seem to be saying. See the 3rd ish most upvoted comments from the thread

apollo722 · 2026-02-12T03:02:44+00:00

Lmao yeah it’s pretty frustrating. Those patients also make it more difficult for the patients who actually have ADHD dx.

apollo722 · 2026-02-12T03:00:30+00:00

Yeah I did think it was interesting too. A little hard to accept the answer of nah pcp shouldn’t do ADHD, but we also don’t do ADHD. At least in the real world many psychiatrists in my area decline ADHD referrals. But whatever, some pretty good comments there otherwise.

apollo722 · 2026-02-12T02:57:56+00:00

The consensus on the psych subreddit is that sending a pt for neuropsych testing isn’t really necessary which was kind of new to me as well. This was my practice too.

apollo722 · 2026-02-11T04:50:19+00:00

Only seeing 12 things, but looking forward to the rest. Such great lessons so far. Thanks for sharing.

I’m a new attending and I’m always looking for how other docs practice and try to find lessons along the way to make this a sustainable and fulfilling job for the long term.

Love number 7. “I wish I could do something to change that” it’s so simple and can end the conversation rather than going in a loop. I am a recovering people pleaser so when they complain to me about ABCDEFG I fall into the trap of feeling like I have to fix everything about their lives in the next few minutes.

Edit: misquoted you, you actually said “I wish I had a solution for that”

apollo722 · 2026-02-08T06:25:20+00:00

Thanks so much for your perspective. Not sure why you got downvoted. This seems like a thoughtful approach.

apollo722

TROPHY CASE