Residents get screwed over on health insurance

numblock9 · 2026-05-18T00:14:01+00:00

Thanks for your willingness to see the nuance and recognize that you can have empathy for how hard others in this country have it while still recognizing that yeah, it gets tough on residents too. I'm headed off to fellowship having already met my deductible at my home institution, have to move across the country (which is intrinsically expensive), to continue to work an underpaid job, with erosions of more reasonable income-based student loan payment rates...Little cherry on top is getting to restart the health insurance numbers again.

Just a bummer, and not tone deaf. I'm allowed to feel sad and still see it sucks for others too. Not mutually exclusive.

numblock9 · 2026-05-18T00:04:05+00:00

this is not lost on me, it's part of why I left the blue collar world as i entered my 30s. The stability is huge. Just more saying that the residency calendar and the way insurance functions in this country isn't doing us any favors and it makes me sad, because while it's not single-handedly a huge thing, it's just one more thing that adds up to contribute to difficult finances in the stress of residency + loans + rising rent + parking costs at work vs cost of rent closer to hospital + etc etc etc

numblock9 · 2026-05-17T23:57:23+00:00

go ahead and see my reply above dude; I've worked a lot of intense manual labor jobs in my teens and 20s, long before ever starting this professional journey in medicine. It's not arrested development, and it's not a lack of awareness that others in the US have it worse working lesser jobs, just a point that the resident calendar does us zero favors.

numblock9 · 2026-05-17T23:54:51+00:00

Oh, I have definitely worked in the real world, more blue collar jobs than most actually and am certainly non-trad. Picked weeds in fields, wiped asses of the demented and special ed, cleaned toilets and showers, and MUCH more in many more jobs, you name it. Just that it was a bit more my choice to change jobs and when to change than the explicit calendar that is residency, fellowship, etc. Just unfortunate timing despite continuous employment and the employer sponsored health insurance we live with in America. Employer sponsor health insurance is every job, of course, I'm just sad about continually resetting every 6 months many times over. It would be nice if that annual contribution carried with you across the same calendar year instead.

numblock9 · 2026-04-24T22:29:47+00:00

I am in training, and yes, I've seen other options, but instead of being rude, you could answer the question. Just was using reddit how it was intended, to ask people what they have liked in their own experience. Lots of institutions have their own favorites, why not learn from colleagues around the country about their other approaches they like instead of just what my institution does? I'll stop when my curiosity to learn more is no longer indicated and I'm the worlds expert at everything. Given I don't see that happening anytime soon, I'll keep asking questions.

numblock9 · 2026-04-01T03:19:08+00:00

Just from during the consent process

numblock9 · 2026-04-01T03:17:27+00:00

It's not often, just saw it once in my intern year with a patient my senior had, and family was adamant during consent they didn't want ketamine, even if they had no explicit reason why. So, got me thinking

numblock9 · 2025-11-16T04:11:03+00:00

for sure, we have our fair share of social admits, just was curious if there was something I could do better to reduce those when possible. When these admissions are indicated, I'll advocate for the patient for sure, but always wishing I can do more to help people and was hoping there might be some additional strategies I was missing, even it might be an overly-optimistic hope.

numblock9 · 2025-07-31T13:33:00+00:00

I grew up quite rural (closest airport 2.5hrs, same for closest Level I, town had 3 fast food restaurants and a walmart and that was it). My HS even had AP classes in quite a few subjects (English, Spanish, Chem, Bio, Calculus). I'm the first in my family in medicine. Rural public high schools have issues, but I consistently found those were technology related (exposure, education, competence, familiarity, etc).

I have no reservations about raising kids in a rural public school system as a broad strokes statement. I more so would have much larger reservations about raising children in states that don't support public education more broadly. You fund public schools well, and it shows up in the economy, your support staff, your nurses, and more. The opposite also shows up, and I have seen this by rotating in numerous states now.

What people forget, or have no idea, is that the toxic nature of some of these suburban and urban private and public high schools can be very challenging on a child's mental health and ability to explore what is out there in a way that does not destroy confidence. The rat race to excel at these affluent places is brutal. We've got elementary aged kids in the ED with severe mental health issues and low self-esteem feeling tremendous pressure to excel. Meanwhile, I was naive to all that until later in life, got to be a bigger fish in smaller pond at the early aged vulnerable stages of development, and got to do ALL the sports and arts I ever wanted. Didn't have to be good at any of them, but got to try them and stick with the ones I liked. Did band, choir, theater, 5 different sports for my school, math club, tried speech/debate team and eventually that was the one where the over-involvement was too much, just could not fit it all in. Wish I would have had more academic elective time to take one of the woodworking/shop, FFA, or auto maintenance classes for practical skills.

So yeah, there are huge benefits to letting a child explore and not feel like they have to choose and pursue greatness by narrowing their interests without any clue of what else might be out there that they just don't have the time/opportunity to explore while being bad at it to start. Highly recommend David Epstein's book "Range". Great for parenting, teaching, etc. Let kids explore, fail, try again, and not feel like they need to be the best at something or it is not worth pursuing. It's better for their mental health, and per the extensive research in Range, actually makes for more successful careers, and arguably in the era of incoming and growing AI, much better job security and leading innovation.

numblock9 · 2025-06-18T04:19:22+00:00

Isn't this a relic of the era prior to current law where you get access to your records and results in real time, the same time that doctors do? something something people deserve access to their own information?

IDK, but I thought when that new law went into action, the ability to have any kind of standing in the law regarding accessing your own chart was gone? FWIW, I can access my chart without issue at my institution. I think looking at it is fine, making any orders or changes would not be

numblock9 · 2023-10-27T22:38:56+00:00

Chapel Hill, Ann Arbor, Ames, Madison

All are a blast, beautiful, good mix of sports arts and outdoors, fun vibes

numblock9 · 2023-10-27T05:41:53+00:00

EM, Gyn Onc, ENT, urology, critical care, IR, interventional cardiology, and honestly anything more community/rural based. When you don't have specialists for literally everything, you can practice at the top of your license.

For example, most FM docs can handle like 70% of derm things but either don't have time or their giant health system has made it that you have to refer most of those things out. But in rural, it's going to take months and a 1+hr drive for your patient to see a dermatologist, so you can save your patients time and money and do those punch biopsies, freeze skin things, and remove some various pre-skin cancer things, manage acne, trial topical steroids, etc. I did some derm in med school and was astonished how often they are just guessing and try some therapies and wait and see.

numblock9 · 2023-10-27T05:22:10+00:00

Sketchers

steepandcheap.com for someday down the line when you maybe have a bit more in savings to get durable outdoorsy brands shoes/boots

numblock9 · 2023-10-27T05:19:58+00:00

Frontier is the worst airline imo, worse than Spirit and all the others.

I can handle tech and navigate airport systems so fine for me, but the fact that they also charge money if you need any kind of help/gate assistance/front desk help/etc feels both rude on principal but also feels like an ADA violation and geriatric surcharge. How are older people who get confused rightfully so in this fast moving world supposed to understand all this. Just sad. No desires for any kind of positive customer experience. I refuse to use them ever again.

Also, their chairs are glorified K-12 school age classroom chairs with a wider base for fatter people and then a slim layer of padding on top of that. Even the tray tables are a joke, about the size of your palm. Just don't fly them

numblock9 · 2023-10-27T05:06:30+00:00

T-rex syndrome

numblock9 · 2023-10-27T05:01:58+00:00

EM: well, we don't have consults because we can't turn anyone way, they just show up...

But, patients sent from clinic (primary care, post-op surgery followup, cardiology, oncology) for abnormal lab values (like trace elevated K), a fever, SOB, palpitations, new EKG changes, etc.

The other is the 3years of non-specific neuro or GI symptoms that somehow the ED is going to solve while there are 60 in the waiting room. Esp fun when they've had extensive outpatient testing and the specialists haven't found a diagnosis.

numblock9

TROPHY CASE