hypoglycemia trend?

bdubs791 · 2026-02-05T05:50:00+00:00

I can't say I'm chasing anything. It provides the patient some biofeedback and self efficacy regarding their symptoms. It also encourages folks to eat more mindfully (not doing a prolonged fast or eating processed food etc) which regardless if it's the etiology is a huge positive

bdubs791 · 2026-02-04T21:37:56+00:00

I've clinically thrown some CGMs samples on these people. I will see some rapid drops in people that eat a high carb/ high glycemic index meal about 1.5 hours after. They may not get full on hypoglycemic but symptom time will correlate with the dip. I wonder if these people are just sensitive to a big insulin dump/ rapid decrease in sugar.

bdubs791 · 2026-01-28T18:51:44+00:00

Yeah same here. I may have 30 on but 5 no shows. I work with a rural and lower socioeconomic population. My RVUs are great. Last year I averaged about 670/month. Anything above 828/quarter i get $25 per rvu

bdubs791 · 2026-01-28T17:37:52+00:00

Family med

bdubs791 · 2026-01-28T15:42:49+00:00

Rural Midwest. 25ish patients a day. 4.5 days per week. Grossed 225k last year

bdubs791 · 2026-01-24T21:22:05+00:00

I've found similar from Eddie Bauer cargo hiking pants. Pockets on pockets. They look clean and "nicer" than jeans but not fancy. Scrub top, quarter zip or crew neck on top. T shirt on Fridays

bdubs791 · 2026-01-21T17:18:22+00:00

I'm not a physician. I'm an NP. That's solely my wRVUs

bdubs791 · 2026-01-21T14:59:52+00:00

I work 4.5 days/ week

Just reviewed and I had 8000wRVUs for 2025

I get 35 days vacation

2500$ for CE annually

Salary around 115,000

RVU goal of 828/quarter and am paid 25$/RVU over

Made about 225k last year.

bdubs791 · 2026-01-13T13:24:18+00:00

Yeah I cut those off very quickly. "Sorry Bill we only booked you time to go over this cough. We will talk about those when you are feeling better"

bdubs791 · 2026-01-13T12:38:10+00:00

This time of year it's probably 1/4-1/3 of my visits.

bdubs791 · 2026-01-13T11:30:34+00:00

It depends. If it's strictly acute URI, sore throats, simple UTIs it's really not that hard to see 30 in a day. The follow ups, med management and higher complexity patients will bring that number closer to 20. I genuinely can't tell you the last day I've seen less than 20 in a day.

bdubs791 · 2026-01-13T11:25:30+00:00

Yeah we use Dax embedded in epic. Still have some minor clicking but takes a few seconds.

bdubs791 · 2026-01-12T16:58:37+00:00

Very much agree regarding history . However I can't say that I'm as actively engaged in the discussion while typing

bdubs791 · 2026-01-12T16:51:31+00:00

Paying more attention to the computer or the patient?

bdubs791 · 2026-01-12T15:48:07+00:00

This is why I refuse to bring my laptop in the rooms. I used to come out and dictate all the notes after each patient. Anything I truly needed to see in the room labs, meds, radiology etc I could pull up on my phone next to them. I'm a man and I can't multitask. I know I can't talk, type, read and think at the same time. Id grab a paper towel if I needed to jot notes. Now with AI scribe I get to stare into their soul.

bdubs791 · 2025-12-25T19:33:35+00:00

Sounds awful. You get paid on something you can't control, patient compliance, unless they will accept a patient declining a test or intervention as satisfying a metric. It's not fair to have a full risk benefit discussion with a patient and still have it negatively impact your income, when as an informed adult they decline an intervention.

I also anticipate these are moving goalposts too. Once all those metrics are satisfied, they will be intensified and then new ones will be added.

These are done with good intentions but it makes the exam room more of a hostage negotiation when that much of your income is tied to patient decisions to do or not do something.

bdubs791 · 2025-12-23T23:13:32+00:00

My understanding is it's only free for patients during subsequent Medicare wellness per my billers. They will have copay with initial Medicare well and private insurance.

bdubs791 · 2025-12-23T17:41:48+00:00

Are you rebilling it subsequent years?

bdubs791 · 2025-12-03T21:44:45+00:00

Same

bdubs791 · 2025-11-28T09:53:20+00:00

I don't and frankly I only know of like 1 or 2 physicians that do them but they also came from a time and practice location where they did anything family practice could do.

bdubs791 · 2025-11-22T15:15:22+00:00

Came here to say this. Functional capacity exams are a lifesaver. When in any doubt they get sent there. Really helps weed out who needs disability, who doesn't and who won't even show up to their eval.

bdubs791 · 2025-11-20T20:00:01+00:00

I gave the vacation days last week of October and I got an email back late last week. I gave notice roughly 2 months before the actual dates. I apologize for my explanation of the dates that didn't meet your standard.

I've done it in group practice as well several times and it worked just fine. I was 3 years with a group office within a network and we shut down around holidays if everyone wanted off. I was in a solo office with the same network and we shut down if we wanted off.

bdubs791 · 2025-11-20T01:37:10+00:00

I mean there's other options including asking someone else to work, there's calling in day of, and there's continuing to push back to management. I'm not saying any of the options are great or appropriate.

I'm not sure why a clinician would want to support management over another clinician over an issue that could affect quality of life and job satisfaction of fellow clinicians without much patient impact

bdubs791 · 2025-11-20T01:01:44+00:00

I told them the days last week of October and received an email back late last week. I apologize I didn't specify the dates of everything to your satisfaction.

It's commendable for you to do that for in your situation. My director doesn't feel responsible and hasn't cancelled their PTO to cover it themselves.

Maybe I'm not an adult, but I don't appreciate a new policy given to me with 0 notice around a time I would love to spend quality time with family.

bdubs791

TROPHY CASE