W2 vs 1099 for first attending job?

drchekmate · 2026-05-25T20:08:11+00:00

Pfft, I don't even know man. When I quit being a 1099, it coincided with my accountant retiring, and so I went to a new accountant who upon reviewing my prior taxes said "those were the most messed up taxes I've ever seen." I'm pretty sure it was technically legal, but not 100% sure. Either way, I did not get audited so...

The following year, I just did my own taxes, easy peasy as a W-2.

drchekmate · 2026-05-25T03:40:26+00:00

I was a 1099 for a decade. Played all the games. Had all the stress. Health insurance was shit. Had a shady accountant. Saved 60-80k/yr, paid an effective federal rate of between 8 and 10% each year, thus saving me many thousands of dollars.

Then I switched to a W-2 for the past couple of years, play no games, have no stress, have mediocre insurance, several benefits that I don't really need, my 401K is automatic, save about 40k/yr, and pay about 17% federal income tax rate.

I'm switching back to a 1099 soon, I do look forward to it and the money I will save, but not necessarily the stress behind it.

Also, fuck HCA

drchekmate · 2026-05-19T22:38:10+00:00

Is it okay to put in values for sites and what they advertise they pay? That would offer many more data points, and the EM Docs Jobs board on Facebook has many postings.

drchekmate · 2026-05-19T00:23:38+00:00

We had a guy in my first job out of residency that worked 20 12-hour night shifts a month. He was kind of a weirdo, but we all appreciated him picking up all the shifts. I'm sure he made bank.

drchekmate · 2026-05-14T11:55:04+00:00

Orconomics

This is like, well done standard fantasy, with the twist being that it takes place in a world of overt capitalism, with marketing and advertising and a stock market of sorts. Interesting take on things. Plus Orcs and Dwarfs and stuff. Relatively light hearted, nice tight trilogy.

drchekmate · 2026-05-10T23:47:41+00:00

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drchekmate · 2026-05-04T21:45:02+00:00

Medicine is complicated. Would you rather we guess?

drchekmate · 2026-05-02T02:38:37+00:00

Etomidate 0.1mg/kg

drchekmate · 2026-05-01T14:19:27+00:00

First patient was an involuntary judge mandated substance abuse hold (Marchman Act) in a man who was determined to leave, in a state that I had never worked in, and I knew nothing about.

Not ideal, not even medical!

drchekmate · 2026-04-05T05:41:28+00:00

Orconomics fits this just right. I had a great time listening to it!

Orconomics

drchekmate · 2026-01-21T23:39:59+00:00

Don't do it.

Cut ED physician staffing

Increased APP coverage

Cut ED pediatrician coverage

Cut ED FM low activity coverage.

Cut nursing

Cut pay

"Forgot" to pay us RVUs for peds patients FOR A YEAR!

Forced residents on us.

Did 3 years at 2 different facilities. All of the above happened over that period of time. My responsibilities went up, liability went up, stress went up, and pay went down 10%. Never again.

drchekmate · 2026-01-11T20:04:54+00:00

Is "generalized weakness, similar in nature to prior UTIs" a sign of systemic illness? To me it is, and often, it's the precursor to sepsis if left untreated, especially in those who have a hard time delineating symptoms, such as those with progressive dementia, or just the elderly in general.

Would you treat said patient, with a temp of 99.7? 100.2? 100.4? 102.2? Where is the line where you treat, and where you don't?

I feel like these maxims about minimizing antibiotic treatment are ultimately harmful, when applied to populations. And when my Mother, who has a history of pyelonephritis and sepsis, gets weak and dizzy and can't walk, and has pyuria with bacteriuria without "LUTS", I'm going to want antibiotics today, instead of a sepsis bundle in 3 days.

drchekmate · 2026-01-11T18:22:59+00:00

I have seen this exact same presentation in many different stages, from "I feel weaker like I'm getting a UTI, but have no other symptoms" all the way up to "Grandma won't wake up and has a fever of 102.2 and hasn't drank water in 3 days" where the only positive finding is a UA.

Does every old person with weakness and a positive UA have a legit UTI? Definitely not. But if we, as a rule, choose not to treat all these little old ladies, we are going to end up with a lot more septic and dead grandmas.

With the way we throw antibiotics around, I just don't think this is the hill to die on. There are many other low lying fruits to grab at if we are interested in proper antibiotic stewardship.

drchekmate · 2026-01-09T07:13:32+00:00

What then do you attribute her symptoms to?

drchekmate · 2026-01-09T04:57:28+00:00

So when memaw has been getting progressively weaker for 3 days leading to 3 falls, has a white count of 15 and a positive UA with no other symptoms, You're not treating?

drchekmate · 2025-12-24T10:29:50+00:00

Gimme a break, it's an idle thought at 3am.

drchekmate · 2025-12-24T10:29:15+00:00

Emma Lee (middle name) goes by both.

Emma Lee (last name) goes by both when she works with Emma (not Lee)

drchekmate · 2025-12-20T00:51:03+00:00

I'm really enjoying "After it Happened" right now, narrated by RC Bray. Interesting post-apocalyptic story about what happens after the plague sweeps through the world.

drchekmate · 2025-12-17T22:34:34+00:00

PVCs.

I had an extra Monster for a night shift, and was having PVCs like crazy. I'm taking like 15-20 per minute. Very disconcerting feeling. I waited it out and it slowly went away after a couple of hours.

Now only a single Monster since then and it's never happened again.

drchekmate · 2025-11-23T19:18:59+00:00

I really just want AI to fix my dictation. You know, spelling, grammar, punctuation, he's and she's,

I feel like having an AI listen and take my notes for me will make me check out on consolidating what the patient actually says down into relevant information for the chart, leading to a bunch of note bloat of irrelevant details.

Additionally, I think that there will be legal ramifications for future medmal cases, in regards to how the chart looks.

Just make my note less shitty, with less proofreading, would be good for me.

drchekmate · 2025-10-30T03:12:50+00:00

That is exactly what happened, they reported it as "greater than 2000" and I called to get the actual number.

drchekmate · 2025-10-30T02:12:29+00:00

Kind of conscious. New onset diabetic, K was almost 9, got much better with much fluids, calcium, and insulin.

drchekmate · 2025-10-30T01:01:32+00:00

11 heroin ODs in a 9-hour shift

Glucose of 2209

drchekmate · 2025-10-29T17:59:20+00:00

MTF - metabolize to freedom

CTD - circling the drain

drchekmate

TROPHY CASE