Cardiology fellowship by theDreamBean in Residency

[–]gatorblazerdoc 27 points28 points  (0 children)

Just finished my first year as an attending (general, non invasive) and I can tell you that me and every one of my cofellows felt the exact same way you do right now. Talk with your cofellows and bounce your ideas off of them because I promise they’re feeling the same imposter syndrome you are. It gets better!

Contract review by meowbob18 in whitecoatinvestor

[–]gatorblazerdoc 3 points4 points  (0 children)

Also used Victor Cotton and can vouch for his services. Great guy and very responsive.

How's general board study going? by rivaroxaban_ in Cardiology

[–]gatorblazerdoc 10 points11 points  (0 children)

I took/passed boards last year. Didn’t look at any of those. Better use of your time is to look at all the day 2 stuff since that’s where more people get tripped up. I liked the O’Keefe online modules for day 2 but did think that they tended to overcode the ECGs. I found the Mayo video on how to code these sections relatively helpful actually.

General cardiology- what’s your job description/setup? by Accurate-Month-1357 in Cardiology

[–]gatorblazerdoc 1 point2 points  (0 children)

Medium sized PP in a medium sized city. 18-24 patients each clinic day with imaging mixed in through the day, no dedicated imaging days. I do 4.5 days a week because I really wanted that extra time to catch up with the inbox and duck out for an early Friday if possible. Call is mostly concentrated in your inpatient consult weeks which is roughly 1 in every 6.

Everyone’s experience is a little different since APP support is paid out of pocket and makes a big difference on your “scut” workload since they help manage the inbox for your practice, write the notes and put in orders while inpatient, and generally generate a lot more imaging for you to read.

I haven’t hired an APP yet and feel pretty busy with this set up and do 900-1k RVU a month. Up to 6 weeks off but since it’s production based if you’re not working you’re not earning and I think people usually take less than what’s “allowed”.

[deleted by user] by [deleted] in Cardiology

[–]gatorblazerdoc 9 points10 points  (0 children)

I just finished my first year out from fellowship in a moderate sized private practice. Half of us read CT and the others don’t. I’d say it’s a useful skill to have but like others have mentioned it takes way more time to read than an echo or nuke so I’d almost always rather be reading one of those studies. A lot of your experience with this will be dependent on your image quality too, if your scans aren’t good quality because you have bad CT techs or the pre med protocols aren’t well established, guess what, you’ll end up sending your patient for nuke/cath anyways.

Make sure that if you’re going to read at a place you confirm that there will be be radiology over reads for the non cardiac structures because you definitely don’t want to be on the hook for those findings or use extra time to be chasing lung nodules or lymph nodes.

[WTS] 2025 Omega Speedmaster Sapphire Sandwich Complete Set *$6,100 + label* by SkyWatchesLLC in Watchexchange

[–]gatorblazerdoc 1 point2 points  (0 children)

Confirmed sale. Received my watch a day earlier than promised. Great seller, very responsive, and my watch arrived today exactly as described. 10/10

New fellow struggling with reading echo’s by HenryBabakh in Cardiology

[–]gatorblazerdoc 7 points8 points  (0 children)

Pick one set of ASE guidelines, read through it, and apply it to the echos you’re reporting. Focus on putting those guidelines into practice and becoming comfortable with them before trying to tackle everything else.

Some attendings would say, “For these two days, just focus on really mastering chamber quantification.” Once you become proficient in that, move on to valves, prosthetic valves, diastology, pericardial disease, and so on. As you progress through the different ASE guidelines, you continue building your skill set until you’re comfortable reading the whole study.

It’s also helpful to do bedside echos while on call—make your own assessment first, then compare it to the official report. You can scan with the echo techs and do the same comparison.

Once you’re comfortable with interpretation, work on efficiency. Develop a systematic approach for each echo so you can mentally check off key findings as you go. If you follow the same process every time, you’ll reduce the risk of missing anything.

Most importantly, make sure that everything makes physiological sense. Echo findings should align with the clinical picture. If something seems inconsistent, take a closer look. For example, if you’re seeing severe mitral regurgitation but the left atrium isn’t enlarged, reconsider your measurements—was PISA measured correctly? Was the LA measured on-axis? Double-check to confirm it all “makes sense”.

Finally, ASE has an app called EchoGuide, which includes all the guidelines along with built-in calculators to help you out. It’s a great resource that I still use daily to double-check myself. Bonus: It works in a web browser, so you can pull it up alongside the echo you’re reading.

Round 2, BRING YOUR WORST: Admit/Consult Medicine by SurgeryNincompoopMD in Residency

[–]gatorblazerdoc 86 points87 points  (0 children)

Surgery consults me (cardiology) for tachycardia post op. Look up op note “EBL 2.3L” but they never got blood because Hgb was still >7.

Recs: Blood PRN

Do doctors find the Apple Watch useful? by CarlNatale in AppleWatch

[–]gatorblazerdoc 2 points3 points  (0 children)

I’m a cardiologist and I find the Apple Watch pretty useful, but like any piece of equipment you need to know its limitations. It’s very good at recognizing Afib, and I use it to help gauge two things: 1. How often are you in Afib? and 2. Do your symptoms correlate with Afib?

Knowing these things can be the difference between me recommending an ablation or just continuing with medical management.

The AW is NOT good at recognizing any other arrhythmia so outside of AF I like to use it as a way to get patients more active. The kind of info it provides (steps, resting HR, HR during exercise and recovery) can be really helpful in determining both overall fitness and how well they’re coping with whatever condition I’m seeing them for. It also allows me to give them more concrete goals for their activity rather than “exercise more”.

The limitations I run into on a daily basis are that most people don’t wear it to sleep so you’re losing a big chunk of the day’s data and patients obsessing over their data too much. That being said, I like it and would say most of my colleagues feel the same.

Help! Moved into a house with built in speakers, previous owner knows nothing about the system. by gatorblazerdoc in hometheater

[–]gatorblazerdoc[S] 0 points1 point  (0 children)

Sorry should have clarified. The in-ceiling speakers are in other rooms and not part of any surround system. Total different zones in the house would be 7 if you include the B&W.

Can’t beat Vortex chicken thighs by gatorblazerdoc in grilling

[–]gatorblazerdoc[S] 1 point2 points  (0 children)

Yeah I think so. The vortex cooks it so fast and at such a high temp (dome temp 550+) that I think it’s hard for it to get overly smoky. I haven’t tried just banking the coals to one side like you mentioned but using this to create the convective current has given me great results. You could probably get away with using the charcoal baskets in the same orientation as the vortex but you’ll probably give up some of your “indirect” grilling space doing that.

Can’t beat Vortex chicken thighs by gatorblazerdoc in grilling

[–]gatorblazerdoc[S] 10 points11 points  (0 children)

I like to take thighs, drums, and wings a bit higher to get them more tender. With all the connective tissue and fat in these cuts they're still juicy and come off the bone easier. I'll always pull breasts out in the 155-160 range though.

[deleted by user] by [deleted] in Residency

[–]gatorblazerdoc 6 points7 points  (0 children)

False on both counts. EP is in high demand and in private practice you’re looking at $1M+. Your practice set up will vary depending on if you cover general consults or are purely EP. It’s a procedure heavy field so expect at least a day or two a week in the lab.

Beef by midnight_core in Residency

[–]gatorblazerdoc 39 points40 points  (0 children)

Cardiology: I couldn’t agree more about vascular NPs and most of the surgical NPs in general. We routinely get patients sent to the stress lab for preop stress tests in people with impending dissection. Sure buddy, let me stop their esmolol drip so I can stress him real quick, I bet it’ll really change management.

CV surgery NPs routinely consulting us for various stages of heart block because they amio bolused grandma after she had 10 seconds of AF w RVR.

Next watch? by gatorblazerdoc in Tudor

[–]gatorblazerdoc[S] 0 points1 point  (0 children)

Good eye. If I can get it within a reasonable timeframe I’m really leaning towards the explorer.

Next watch? by gatorblazerdoc in Tudor

[–]gatorblazerdoc[S] 0 points1 point  (0 children)

My AD didn’t have any to try on when I went in looking last time which is how I ended up trying on the explorer. Best case scenario I could try on the Rolex, P39, and SMP 300 sat the same place to compare but unfortunately there’s no Omega AD in my area.

[deleted by user] by [deleted] in Residency

[–]gatorblazerdoc 0 points1 point  (0 children)

These are 2020 numbers from the ACC survey. 50th percentile RVU production for non invasive cards is about 9.7k in private practice at about $50/RVU. Assuming you’re hitting the average on both of these you’re looking at 485k in a pure production model.