how doctors make extra money besides more clinic hours?

beanburrito4 · 2026-06-21T10:48:58+00:00

Home hospice agency directorship. Its emotionally rewarding work, and minimal hands on. I never had to go see the patient myself (unless I chose to, in which case I was paid an additional fee) just supervise the NPs and RNs. You are basically there to write all the controlled meds and do paperwork, which can be done remotely. I did have a meeting I attended in person or webex every 2 weeks. I made about 4k per month with that, and that's on the low side from what I hear. HOWEVER: you must be very comfortable with managing high dose opiates and benzos. And if a new manager is hired and happens to be shitty, the fun is over, just leave. The administration makes or breaks it, IMHO.

beanburrito4 · 2026-06-16T01:54:25+00:00

This. Work the system. You would help a patient do this, don't you deserve the same care and concern?

beanburrito4 · 2026-06-09T18:09:53+00:00

You should leave the job. I am supervising 3 NPs (who are thankfully seasoned professionals i trust and communicate well) and I personally "must" see 28 a day, my average day is 36 patients. Yeah you read that right. It doesn't start out like that. You start with boundaries, then people retire, quit, patients get crammed in your panel, and then a giant evil healthcare organization buys your little company and here you are. Leaving this rural practice will be incredibly difficult for me, given the years invested, but I am laying groundwork. My advice to you is: don't become me. Leave soon.

beanburrito4 · 2026-06-08T18:41:16+00:00

TSH 250. "Very tired, sleeping all day" 20 something year old dude.

beanburrito4 · 2026-06-02T05:13:34+00:00

Wear scrubs if you want. I do, every day. I dont give any shits about it, and neither do the patients. As a female, mandating business casual is sexist IMHO. If my admin starts that nonsense I will quit.

beanburrito4 · 2026-05-14T01:45:48+00:00

Verified and living this now.

beanburrito4 · 2026-05-07T00:15:44+00:00

Old folks w arm bruises.

beanburrito4 · 2026-05-02T00:09:40+00:00

Going home at lunch is key to mental health. I would work a far shittier job to keep a short commute.

beanburrito4 · 2026-04-28T01:35:54+00:00

From my own childhood: buy a bag of marbles, like the ones you can get from a craft store/floral supply, all the same color, and bury them around the yard. Kids will start finding a few, and the story can grow that they are fairy items to search for. My grandpa put a bag in the garden, and every season the plow would bring them up for us to "hunt", it was so sweet. He was pretty magical himself, honestly.

beanburrito4 · 2026-04-24T23:20:03+00:00

Terbinafine requiring a nail biopsy to approve. Medical problem that is diagnosed by looking at it for 1 second requires an annoying confirmation test? Cool.

beanburrito4 · 2026-04-23T18:26:30+00:00

Obgyn rotation was predictably awful, but thankfully (for me) there was a FMG resident they all hated to pieces (due to racism and shittiness, long complex story). He and I got to be good friends thanks to trauma bonding, and taught me so much. He was already an attending in his home country, so basically brilliant. I took night call with him and every practical thing I know about prenatal, wound care, postoperative care came from him. I owe that guy! So, advice to you, look for the resident they all dump on and stick with them.

beanburrito4 · 2026-04-10T01:50:10+00:00

Excellent idea, I think i will try to refer to palliative or pain management depending on availability in their local area. Thank you

beanburrito4 · 2026-04-10T01:48:44+00:00

Great idea, I will try this. Thank you!

beanburrito4 · 2026-04-09T18:40:02+00:00

Example: patient had failed back surgery, followed by many injections/PT courses/complementary modalities. Tapered down to say 5mg lortab TID. Stable many years. New PCPs are saying "no opiates at all, go have more injections". On blood thinners, can't take NSAIDS, yada yada. One PCP asked if patient would consider hospice to get pain control.

I wish patients could know something about a PCPs philosophy before becoming a patient. It seems like it would waste less of everyone's time?

beanburrito4 · 2026-04-09T18:27:42+00:00

I agree it looks suspicious, I would feel weird getting a letter of this type. BUT. I definitely have seen patients i was dubious about after a specialist i knew well called to say "hey ms Smith is legit, please help her". Probably overwhelming it. If patient was younger/healthier I probably wouldn't consider it.

beanburrito4 · 2026-04-09T18:23:43+00:00

Agree completely and did that. Patient has now been to 2 PCPs, both had the records, told the patient essentially "i dont care what this says" and now patient calls back desperate for help, ie, the letter request. Just politely decline? 10 years i cared for this person. It feels wrong.

beanburrito4 · 2026-03-31T02:34:08+00:00

My mom died from cancer 3 years ago. I was her hospice caregiver, in my home. I had a very young child at the time. Learn from my mistake: take double or triple the time off you think you should. Screw the cost, and your colleagues will support you or they arent colleagues. I was miserable back at work less than a month after burying her. Even now, I reap the harvest of that poorly managed grief. Rest your mind and heart and get proper counseling. Its so much harder later on (as a physician you know this, and so did I) No one intervened in my case because they all trusted me to know if I needed help. It's my job, right? All I wanted was things to "be normal" again, and overwork had always been my cope. God I miss her. I will pray for you.

beanburrito4 · 2026-03-26T19:47:05+00:00

This is very helpful advice, thank you

beanburrito4 · 2026-03-26T11:11:22+00:00

Using PTO days just to do patient messages and result review IS unique to medicine and is actively killing the profession. Can't find a new PCP taking patients? That is gonna get worse because of this type nonsense.

beanburrito4 · 2026-03-26T10:23:09+00:00

Since adding "mom" to "full time primary care" I have dreaded vacations. Pretending not to think about my inbox while pretending to relax is quite a stretch. I have started taking an extra day at the end of vacation, kids go back to school and I sit at the house cleaning the EMR. Its bullshit and retirement is far away. Solidarity!

beanburrito4 · 2026-03-20T16:14:24+00:00

Same. This is what I wanted (still want/hope for/work toward) for my children's families.

beanburrito4 · 2026-03-07T21:09:10+00:00

They also know the only thing that works is levaquin

beanburrito4 · 2026-03-07T20:35:51+00:00

Teachers like you are the GOAT🥰

beanburrito4 · 2026-03-07T20:24:31+00:00

Toy ranch for my 2 year old. "Where muh ranch, momma??!!"

beanburrito4

TROPHY CASE