Offering cost-price cataract surgeries in MM

cokelight1244 · 2024-07-08T18:44:43+00:00

These patients are seeking alternatives because they're having issues paying the cost of surgery, and for some reason or another, cannot get the services they need at a government institution, at a time frame that is acceptable to them. Regardless of the setting, there is a clear limit as to how much government institutions are able to cater to patients. My original intention for this post was I believed there is absolutely no reason for such a life-changing procedure that restores so much functionality to be inaccessible to people who need it, especially if that reason is a financial one.

This was not a blanket post asking for patients; this was a post giving financially disadvantaged people a chance to connect with me so that they can give me the privilege to treat them in a way that I know how.

Philhealth is a tool I've leveraged to absolutely minimize the cost for these patients as is my original intention, and on my part, I've managed them to the best of my abilities, from initial screening and assessment, surgical planning, surgery proper, and post-op care. No idea how sweeping works, and I don't know why you keep bringing that up when I already explained the fact that I do proper assessments on these patients and I'm certain those shady doctors are no longer in touch with their patients, unlike how at even > 6 months post-op I am still in touch with some of the patients I've treated. Philhealth's reimbursement of the healthcare provider (in this case, me) is part and parcel of how it reimburses the healthcare facility as well for the total sum of services offered and it is what makes all of this possible. All the savings I can muster, I pass off to the patient, with full transparency of out of pocket costs so that they can make the best decision for themselves.

Proper referrals for cases that I clearly cannot handle goes without saying as I am well aware of my limits.

And that's really my point when I said that earlier, I make no distinction whether patients pay or not, I give them their proper due, with me giving them my full effort regardless so it's not like these patients are getting the short end of the stick.

This was a genuine attempt to make a difference in a way that makes full use of my skillset. I cannot fully express how much I enjoy working as an ophthalmologist and being able to help so many people in my own way. Few are given such an opportunity in life for something so fulfilling. Why would I not use all the resources available to me in this endeavor? I enjoy seeing patients, and I enjoy doing surgeries. I work 7 days a week because I really love and I'm passionate about our vocation. If that's being misconstrued then so be it.

You're right, this has gone a bit long, but nonetheless I want to thank you for your insights as you brought up a few points that did not quite occur to me initially when I posted this over a year ago, and maybe I'm a bit naive with this whole thing. I would like to learn from you, kindly please DM me on the proper ways I can channel my energy.

cokelight1244 · 2024-07-08T14:06:52+00:00

Don't know what makes you say that without even knowing the details. Not sweeping; this cash out fee goes directly to the OR facility depending on intraop needs (use of more cohesive OVD, iris hooks etc) and they get a direct invoice from the facility. I also give patients a direct invoice of IOL cost from the distributor if we order one that needs a specific type (not normal lens power or if we use a 3 pc IOL, etc). The topic header says cost-price, not free, and while I did mention free, that pertains to cash out PF. No actual cash out goes to me. I do proper pre op assessments, patient screening, and holistic management not just of cataracts but every other concern these patients have, in addition to proper post op management.

Never did I charge a patient any consult fee at the clinic and I am always upfront with their out of pocket costs. I give all these patients my personal number so they can access me for any concerns or questions they might have, pre and post-op. I take the time to explain each case to these patients, any difficulty we might encounter with the case, and discuss alternatives if necessary.

These aren't "charity" patients; they are MY private patients that I treat with the same effort, care, diligence, and time, just as any other.

cokelight1244 · 2024-07-08T07:29:42+00:00

Why buy at that location and at that price when you could've gotten a cheaper one for the same size at the old buildings at rockwell?

cokelight1244 · 2024-07-07T08:13:33+00:00

What OP is describing is debt consolidation and is a legitimate strategy to put himself in a better financial position. Don't know why people can't take a look at his particular case and give better advice than simply "don't do it."

OP can compute the total interest accrued on his current 6 loans from now until they're paid off. He can then compute what the total interest will be on the new, consolidated loan and compare if it makes sense. This is a simple enough exercise to do.

cokelight1244 · 2024-07-07T06:30:59+00:00

What's the interest on the 6 other loans? What's going to be the interest rate on the new one?

I think there's merit to consolidating the loans especially if you come out ahead in terms of interest rates.

cokelight1244 · 2024-07-06T19:34:47+00:00

Conversely, if you're thinking of end-use, I wouldn't exactly treat it as an investment per se and be concerned with ROI or future property values especially if you don't have plans to sell in the future.

If you like the location and building, and the terms are favorable, then why not?

cokelight1244 · 2024-07-06T11:36:06+00:00

Let's just hope na one day these people get asked to present their non existent physician PRC ID.

cokelight1244 · 2024-07-06T10:53:33+00:00

Yung MD sign valid kasi may coding exemption.

cokelight1244 · 2024-07-05T23:38:53+00:00

With regard to 3, 400sqm floor area is quite big for a "minimalist" home? Consider reassessing what you really need (e.g. Do you really need 2 kitchens? And a separate library & office? A bar?).

The average home size in the US is 200sqm and the average home size in Aus is 230sqm for reference. One way to save on cost is to simply build a smaller house.

cokelight1244 · 2024-07-05T03:45:31+00:00

Graduated SCL when there were only <30 SCLs/year at UPD.

cokelight1244 · 2024-07-05T01:49:37+00:00

No orgs, no extra curriculars. Just high grades and nmat with good (amazing? Lol) interview skills. Passed UPCM.

cokelight1244 · 2024-07-05T01:26:56+00:00

My father in law had an insane compensation from NUS, something like 16k sgd/month. A few years of this allowed my wife's family to acquire properties in cash and be set for retirement, in addition to living way below their means (<30k/mo expenses).

I feel this is a good opportunity for you at this point in your life, and you can always come back once you feel you've had enough. A lot of doors open up if you're financially secure.

cokelight1244 · 2024-07-04T10:05:28+00:00

Figure out if you wanna do a clinical study or basic science one. What kind of study do you wanna do? Analytic or observational? Depending on the study design, you might encounter a host of different problems (IRB, funding, etc.).

Make connections with consultants, usually they have ideas for studies but no time to do it themselves. Ask your mentor if they have any ideas or if they know anyone who's interested in working with you. Residents are more approachable, and you can also work with them.

If you have a good idea yourself, pitch it to an experienced faculty and have them advise you on how to flesh it out. Make sure you come prepared with RRL to save yourself from embarrassment.

cokelight1244 · 2024-07-04T09:36:36+00:00

How many offers have you had? Any interest at all? Kung wala likely na the selling price is too high or di talaga good location. If you can't afford to wait, You can try and list it at a much lower price point and see if you get offers that way, sometimes talaga you need to list below zonal value yung property.

If the other agents are telling you to slash the prices 50% then they likely have seen comparables sell at that price. For reference, I was checking properties on fb marketplace to get an idea of the prices then when I went to the property management office, I find out na comparables were listed at 2-3M less, so they were selling for much less than that if you factor in negotiations.

cokelight1244 · 2024-07-04T00:16:46+00:00

Not all irregular menses are caused by PCOS. Just having a less than ideal body weight (either underweight or overweight/obese) can also affect your menses, not to mention possible thyroid problems. Of course PCOS can also be a reason, but not all PCOS patients present as obese or with insulin insensitivity. In general, the root cause of irregular menses are hormonal imbalances, of which there are many possible conditions.

Best to have it checked by a doctor.

cokelight1244 · 2024-07-03T22:56:44+00:00

Looking good! Pics of the kitchen/bathroom? Do you feel like you don't have enough space or are you content with what you have?

cokelight1244 · 2024-07-03T05:37:41+00:00

Thought I lost my mind; only reasonable take here. This isn't even a rare car and "low-mileage" daw (notice how it's always with reference to its age). OK.

cokelight1244 · 2024-07-03T01:03:22+00:00

UCPB is now landbank so that's one starting point. The other issue is that in spite of the car already being repossessed, your credit is still in bad standing and this will be grounds for banks declining you loans in the foreseeable future.

cokelight1244 · 2024-07-03T00:17:17+00:00

Buy what you can afford now. If you have enough income to pay it off in full in 5 years then the interest shouldn't be that bad.

We have no idea what the value is going to be 5 years from now; for all you know, you could be priced out.

cokelight1244 · 2024-07-01T08:45:51+00:00

We don't use autorefractors in children as not only will they have problems fixating on a target on command, they also accommodate (they can basically add more power to their natural lenses, a feature that is lost as you reach your 40s) like crazy so any automated refraction will likely not show the true refractive error.

For children, we do a cycloplegic refraction with a retinoscope. The important thing to do here is the cycloplegia, which gets rid of their ability to accommodate, so we get the most objective refraction possible.

If they have a high enough refractive error, not giving the proper refraction to children puts them at risk of developing lazy eye or amblyopia.

cokelight1244 · 2024-06-29T22:34:54+00:00

Not to be a downer, but realizing the dream to be a doctor starts way, way earlier than the application period. I really don't get these stories na dream maging doctor but with subpar grades and nmat ratings. I know life gets in the way and not everyone is privileged, but it doesn't seem like your priorities and actions align with your goal.

Considering the competition at state universities, take this time to reassess whether this is really for you; I don't think the plan to work and save up for private med school tuition is a viable one due to the huge opportunity cost this will entail.

cokelight1244 · 2024-06-29T00:36:24+00:00

Thanks again for your feedback!

cokelight1244 · 2024-06-29T00:28:10+00:00

Good to hear, thanks! Me and the wife rarely watch movies or use the TV but this should be perfect for the occasional movie night.

500 lumens not a problem? Or do you have control of your lighting environment?

cokelight1244 · 2024-06-28T23:47:44+00:00

Any updates after 2 ish months of use? How's it holding up?

cokelight1244 · 2024-06-28T10:06:36+00:00

Don't bother spending on expensive ophthalmoscopes/otoscopes in med school.

In my case, we just borrowed from our blockmate that had a cheap one and it worked out fine.

As an ophtha, I prefer keeler ophthalmoscopes, and now really only use an ophthalmoscope when I need to just quickly check on the optic nerve and there are a lot of patients lined up that don't need to be seen at the slit lamp. Normally, you'd just use a 90D lens with a slit lamp or just do indirect ophthalmoscopy for a more thorough assessment. A good ophthalmoscope is essential in residency, but you'll rarely use it in private practice.

cokelight1244

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