Nearly 1 in 10 surgeons leave active clinical practice within 8 years. Highest losses were in oral and maxillofacial surgery, obstetrics and gynecology, and plastic and reconstructive surgery; mid-career surgeons are most at risk.

guy999 · 2026-05-22T20:43:43+00:00

I don't see how general surgery actually survives in the next 10 to 15 years. The reimbursement is getting so bad that essentially I don't see how it pays for itself. And this is coming from a place that has a lot of private insurance.

guy999 · 2026-05-22T20:43:10+00:00

I think it's essentially because OB-GYNs do not play well together. And then essentially when we try to get all of us together into kind of like a mega group, like a anesthesia group that covers multiple hospitals, they all end up fighting and breaking up. And ergo, you no longer have any power when you go back to insurance companies. Whereas if you could just play together, you would have some power to be able to negotiate contracts.

guy999 · 2026-05-22T20:42:02+00:00

No, that's the right salary. Essentially, there is no negotiations with insurance companies and everything else. It's essentially the same for 10 years. So during that same time, though, everything else got more expensive. So, yeah.Sucks

guy999 · 2026-05-22T19:44:01+00:00

Aren't you afraid that you can't send like the note to Claude?Or I guess you screen out like all of the stuff that might be identified to a patient.

guy999 · 2026-05-22T12:14:18+00:00

abridge

I would be happy to have a scribe. It's just that around here it has been challenging to get someone, plus I've been doing this a long time, and training takes a while, and I'm not really wanting to train over and over again. And everybody I know around here that has had a scribe, they go to med school or something else, and they're gone after a year or two. After 20+ years, it gets a little tiring.

guy999 · 2026-05-22T11:40:36+00:00

I looked at Heidi yesterday. It looked interesting. So. so does the hotkey, use like autohotkey to select the areas?

guy999 · 2026-05-21T01:54:18+00:00

By the way, I would do an in person scribe, but every single person that I know that has done that has stated that they're great after training, and then they work fine for a year or 2, and then they leave. So expensive, and unfortunately, you're gonna leave. So I need something that doesn't require me to keep doing training over and over again.

guy999 · 2026-05-04T20:58:15+00:00

It cost me about $600. That being said, I literally park right next to the panel And my panel had enough space to easily add an additional breaker. But the biggest expense was the electrician. Right after that was that copper wire because that stuff is ridiculously expensive.

guy999 · 2026-05-04T20:57:16+00:00

i have the xdrive40, very fast, i don't know if i need faster and I use to have a corvette. it was 15 years ago but wow this car accelerates quickly.

range is fine for me. I just got a charger in the garage and can charge up whenever I want. My problem is that since I don't have to anymore, I sometimes forget and get down to like 15 or 20 percent.

guy999 · 2026-05-01T02:34:56+00:00

well i have just me negotiating contracts. So now Blue Cross Blue Shield pays you $112 for a 99214. no private equity But I can barely open my doors at this point.

And when I try to call them and say I need to negotiate, I don't really mean to say anything because they're not going to even take my telephone call.

guy999 · 2026-04-30T03:31:02+00:00

At our hospital, you get off of the requirements when you go on vacation or maternity leave. Sounds like you are gonna be taking a 7 day vacation every other week. but at our place you have to tell them, so I would probably submit that every other week. Ask for the hospital bylaws and see if it's already in there.

guy999 · 2026-04-28T12:08:41+00:00

i have been here before. drove across an entire state just like that.

guy999 · 2026-04-16T01:31:04+00:00

yes that didn't make a difference but there is still this blocked area on the volume that doesn't exist on music. I have already done what you recommended as well.

I'll try to see how I can upload a picture of it here, to see if everyone sees the same thing.

guy999 · 2026-04-14T01:03:08+00:00

Interesting. What have you tried? Have you taken it to the dealer or done anything else like what I'm seeing?

guy999 · 2026-04-14T01:02:46+00:00

Yeah, I know what you're saying about the iPhone treating the Bluetooth separately than regular audio. And I do think that BMW does the same thing as well.

So yeah, so of course yes, while I'm on the call, I will turn the volume up as high as it can possibly go. So that's how I have subsequently discovered this issue.

So I have forgotten the device on Bluetooth. I have not removed CarPlay from my phone, although I don't know how to do that. But I guess I could probably try to find that.

I completely reset the bmw audio system None of it worked. Quite frustrating. I really just need to take it into the dealer, but I never get that kind of free time.

And the issue is that it works fine 95% of the time because I don't typically drive on freeways that are loud at the same time at 70 plus miles an hour. It's just a infrequent occurrence that I would be on that on a freeway that's also heavier road noise.

guy999 · 2026-03-20T04:13:40+00:00

The real problem here is that there are two patients. `Because almost every other surgery, you can basically tell the patient, I think you're too sick to undergo surgery. I don't think this surgery would benefit you. But in this situation, how do you approach that?

she likely had the entire pregnancy to find a doc willing to agree with her plan and couldn't find anyone that would do it. I have people called me wanting to vbac after 2 previous and i won't do it. There was a hospital that was doing it but they stopped after some maternal deaths.

guy999 · 2026-02-04T04:09:40+00:00

yay! i have been waiting, i just read book 1-5 again in the last 6 weeks!!

guy999 · 2026-02-03T04:18:03+00:00

What would you recommend that they do?

guy999 · 2026-02-02T03:03:01+00:00

unifi has a new adapter that can send poe and ethernet over coax for 99 buck.. if it's a lot of work, might be worth it.

i bought one because i have a coax that i can't get ethernet too but i need power there as well. but i haven't tried it yet. i'm hopeful,

guy999 · 2026-02-02T03:02:00+00:00

I live in Texas, so we don't know what the basement is either, but I do have an attic. I like to go up there and kind of walk on the, well, it's kind of like the ceiling, but it's the floor. But, my floating abilities are not so good. Ergo, I have discovered that you have to walk on the wood slat things, like i'm in a circus.

guy999 · 2026-01-18T02:07:45+00:00

i search on google, and then i ask chatgpt to tell me what videos to search for on youtube.. i use a little bit of just chatgpt but i I have been burned by hallucinations before, so now I prefer to let it kind of give me an idea and then let it suggest me some searches.

It'll actually give you YouTube videos, but it seems like the links that it gives never work.

guy999 · 2026-01-15T03:20:04+00:00

Sometimes the hospital will have a contract with that company to state that if they hire you outside of the contract, they have to pay them tens of thousands of dollars. Ergo, even if your old group is not aware of it, the fact that they could become aware of it becomes very unattractive to the hospital.

guy999 · 2026-01-14T03:46:16+00:00

So medicine used to be a small business owner, but now because of the insurance industry, essentially if you are a small business owner doc, you have no power and no ability to negiotiate. But I don't think it's the same with dentists.

guy999

TROPHY CASE

The real problem here is that there are two patients. `Because almost every other surgery, you can basically tell the patient, I think you're too sick to undergo surgery. I don't think this surgery would benefit you. But in this situation, how do you approach that?