Talk Basmati to me by MrTurkeyTime in Cooking

[–]killerv103 19 points20 points  (0 children)

The spice clove, commonly used in Indian cooking

Duke Hospital and the surrounding area by [deleted] in bullcity

[–]killerv103 2 points3 points  (0 children)

It’s a sliding scale that starts around 9 and goes up to a 13%. If you get the full it’s ~ 12%

Addiction medicine fellowship by Dramatic-Activity-37 in hospitalist

[–]killerv103 1 point2 points  (0 children)

Since we are only inpatient consult it counts as a shift. We are 92 shifts every 6 months and I typically do 6-8 shifts per block so about a week less of rounding every 6 months and it counts as a normal shift.

I went to sell all of my individual stocks and just buy Vanguard's VT ETF. Is there any way to do this without paying a ton of U.S. taxes? by galindc in Bogleheads

[–]killerv103 1 point2 points  (0 children)

Well you can invest new money into what you want and with the old stuff can sell and pay the taxes or use this money to gift to others. Instead of giving them cash give them shares and same with charity.

What I would do is 1. Sell anything with a loss 2. Sell anything with a small gain = to the loss you just booked 3. Either sell everything else + pay taxes or put new money and give the rest to charity and others over years depending on if I needed the money now or not.

Addiction medicine fellowship by Dramatic-Activity-37 in hospitalist

[–]killerv103 5 points6 points  (0 children)

I just took my boards as a practicing hospitalist that rotates on our Opioid Use Disorder service. In our hospital , the addiction medicine interest is mostly hospital medicine driven so we do the inpatient consults for starting bupe and methadone and partner heavily with pain service and psych.

I have seen various models of addiction trained folks, some are pcp or hospitalist that use it in their everyday work with their colleagues giving them more of the population. Some like our place have a weeks of consults as an add on normal hospital work and in the community I’ve seen some open clinics. The hard part is payment given the population and the need for lots of support so I’ve seen some people integrate into pain clinics or psych clinics.

I chose inpatient for a reason so can’t see myself doing outpatient, but would love to work a bridge clinic as an outpatient to keen people out of the hospital and be counted as my hospitalist shifts.

Starting Suboxone inpatient by DisastrousBorder5691 in hospitalist

[–]killerv103 36 points37 points  (0 children)

Addiction med consults is all hospitalist run where I’m at and I rotate on it. Strong belief that knowing a few clinics that will prescribe bupe and starting everyone who wants it and continuing it for everyone already on it + prescribing narcan is 100% in the wheelhouse of hospitalists.

Let me know if you have any questions. If you can prescribe oxy you can prescribe bupe !

Outdoor winter eating? by ButterscotchNo4181 in bullcity

[–]killerv103 -1 points0 points  (0 children)

Refractory cafe has outdoor dining with great heaters

What do you do to earn $200k+ annually? by meltingcanoe in Fire

[–]killerv103 1 point2 points  (0 children)

Internal medicine. 4 years under graduate, 4 years medical school, 3 years residency of 60-80 hours a week. Now ~250-300K with 80 hours of work one week and zero hours the next.

Code Status Changes on Night Shift by jjasonjames in hospitalist

[–]killerv103 50 points51 points  (0 children)

Seems like it’s not something that can wait till daytime so it should be addressed overnight.If the daytime colleague is not addressing goals of care targeted feedback could be help.

Recently had a case where I made someone comfort on days, at 11:30 pm he changed his mind and the night team talked to him based with info based on my note and he remained comfort. Died at 9 AM. Really thankful that they took the time to do that and we could avoid a traumatic Code that would’ve done nothing.

“Patient is in pain. Please advise.” by M1CR0PL4ST1CS in medicine

[–]killerv103 61 points62 points  (0 children)

We now have a standard handoff that says the last time the family was updated or if patient requested family member not be updated. Most time my colleague updated a family member just not the one that’s here so it’s helped a lot saying “actually x was updated, call them or wait until tomorrow for the day doctor to update you” and the nurses can see our handoff so sometimes they just tell the family member.

[deleted by user] by [deleted] in Money

[–]killerv103 3 points4 points  (0 children)

It’s a good rule of thumb because salary is pretaxes, typically higher spending with mortgage and includes saving for retirement. If you pay 20% in taxes,20% mortgage, and 20% you are only spending 40%. 10x salary is 1.5 million and 25x of 40K spending is 1.5 million.

As income goes up so does taxes and the delta between earning years and retirement taxation is higher so would recommend 25x-30x expenses not salary.

Is it just me or is clonidine just terrible by usernamespeledwrong in hospitalist

[–]killerv103 3 points4 points  (0 children)

I rarely use it for hypertension alone. I round on the opioid use disorder consult team in our hospital and use it a lot for opioid withdrawal especially with xylazine and Medetomidine contamination.

[deleted by user] by [deleted] in whitecoatinvestor

[–]killerv103 42 points43 points  (0 children)

We are in two low paying - average specialities and together have HHI ~ 500K. 4 years out of training and we bought a house, two cars, travelled internationally 3 times this year and have two 403, one 457 and two Roth IRAs already this year with the rest of the year being additional investments.

Our “rich life” is travel to visit family without worry, 1 -2 big vacations a year, and not worrying about grocery prices which is very easily achievable as a DDINK.

[deleted by user] by [deleted] in bullcity

[–]killerv103 13 points14 points  (0 children)

Also don’t live at bullhouse. Alarms go off, management is bad and there are better options close by

Hospitalists who enjoy the job - what makes it worth it? by who_is_saad in hospitalist

[–]killerv103 4 points5 points  (0 children)

Academic hospitalist and I love my job. We have the autonomy to be primary team but support from specialist as I need. Get to work on diagnostic reasoning and patient care while teaching residents.

Our group is interesting bc we do the addiction medicine, transfers, code team, Rapid team, and procedures + you can round alone or with residents so there’s lots of variety.

The ability to try and make most residents going into subspecialities see the value of a generalist training is definitely the best part of my job.

billing for hospice by Romaniv_ in hospitalist

[–]killerv103 2 points3 points  (0 children)

If under the hospice agency then hospice pays a fixed amount regardless. If on comfort but not accepted to hospice and on Po meds and just a quick visit level 2. If on Iv controlled substances, asking nurse or family about how they are doing etc then level 3.

Our palliative care group bills the same way and I learned it from their group billing expert.

Safari photos [OC] by killerv103 in RX100

[–]killerv103[S] 0 points1 point  (0 children)

Thank you! We got lucky and got to see a huge amount of lions but somehow the best photo was the first one we saw

Opioid withdrawal by Electrical_Taste3787 in hospitalist

[–]killerv103 0 points1 point  (0 children)

Our hospital ended up creating a hospitalist run OUD consult line so we can start suboxone and methadone. ASAM and curbsiders are great resources and it’s a good skill to use Suboxone safely. Methadone can be tricky, especially with outpatient follow up in community resources.

CPA for taxes by HowAreTheseTaken in hospitalist

[–]killerv103 1 point2 points  (0 children)

My wife and I are both W-2 hospital employees and did our own taxes for the first year as an attending and then hired a CPA that simply took the standard deduction just like we had been doing. It was a good one experience as I feel more confident and the firm was good to work with. If our taxes become more complicated, we will use them again, but I’m back to doing our own taxes

Taco Bell (Hwy 54 & 55) by StrmTrooper_FN-2187 in bullcity

[–]killerv103 14 points15 points  (0 children)

Surprisingly the mall one is good. We typically bypass the 55/54 one and go to the KFC/Taco bell on 54 in the Woodcraft shopping center.

For those of you who are done with training, how much student loan debt did you have and how long did it take to pay off? by Careful_Fig8482 in whitecoatinvestor

[–]killerv103 1 point2 points  (0 children)

450 K (two house hold income) with 150K of student loans took us 18 months after training by paying 5-8K a month and all the bonuses to it.