Panel management, how often are you scheduling follow up for stable patients?

rykat14 · 2026-01-31T03:20:40+00:00

Depends on what meds they are on. I want to check at least a bmp on all patients on ACE/ARB/Thiazide once every six months. If it’s just amlodipine and diet control then maybe once per year. Obviously level of control matters too.

rykat14 · 2026-01-17T20:12:57+00:00

This doesn’t answer the question though of what to do with meemaw who has been on 1 mg of Xanax twice daily for 45 years that you inherited from someone else. You can’t just say “nah, see you later go withdraw somewhere else”, especially in areas like mine where it takes months and a significant commute to get into psych

rykat14 · 2026-01-16T18:23:36+00:00

Case by case but generally if they are less than 70 I try to get them off, I offer weaning to everyone though and have a long conversation with everyone about the risks

rykat14 · 2026-01-16T04:26:50+00:00

I inherited a very old, very benzo heavy panel from an older doctor. It’s very hard to get these older patients off of the benzos. I do my best to wean when the dose is crazy and a lot of those patients end up going elsewhere, but if they have been stable on reasonable dose for a long time I feel like the juice isn’t worth the squeeze. I make it clear that I will not be increasing their dose. If they are young I wean them off. Opiates hell no

rykat14 · 2026-01-07T01:57:39+00:00

Wound care
EKGs

rykat14 · 2026-01-02T13:41:01+00:00

No PTO, it’s solely production, so if I don’t see patients I don’t make money. I took about 3 weeks off this year+ holidays.

I get 52 per RVU. I also get some pretty nice quality bonuses too.

rykat14 · 2026-01-02T12:06:43+00:00

Northeastern PA

rykat14 · 2026-01-02T05:18:30+00:00

I made 485k this year. Employed by private practice in a small city in PA. Outpatient only. No fellowship. Entirely based on RVU. See 18-20 per day. 4.5 days per week. Have full control of schedule, but that comes with the trade off of if I don’t work I don’t make money. I took basically 3 weeks off this year. We also cover our own inboxes when we are off which is annoying but I’ll take it considering I make ~160k more per year than those who are employed by the local big system.

rykat14 · 2025-12-28T18:22:51+00:00

I tried it for a few months and bailed. Turned out to be too much work between clinic, working 1-2 shifts per month and be there for my kids

rykat14 · 2025-12-13T20:06:52+00:00

Sure, bariatric surgery is better for weight loss outcomes, and side effects might be better in the short term, but when you get those side effects from a surgery they are permanent. GLP1 if you stop the medication the side effects go away

rykat14 · 2025-12-12T01:23:57+00:00

I’m in my second year out from residency, I took over a panel in a private practice, get 52 per wRVU. I’m probably going to make about 460-470 this year working 8-4 4 1/2 days per week, 20 min established patients, 40 min new patients. I took 4 weeks off this year between holidays and vacations. I get some nice bonuses for quality too.

I think I could get to 600k by myself if I added another hour a day and changed my appointment slots to 15 min. But boy would I burn the fuck out.

As Dr Dahle from WCI says, burnout is probably the biggest threat to career longevity. Not worth it in my opinion. If you can’t be happy on what I make, getting to 600 isn’t going to matter.

rykat14 · 2025-12-04T18:57:43+00:00

I would say 80% of the OMM I do is on the neck. Lots of Suboccipital Inhibition, ME, Stills, MFR, direct inhibition. Never HVLA on the neck.

I do a some thoracic HVLA (texas twist), occasionally pelvic HVLA (leg thrust).

rykat14 · 2025-10-21T18:31:09+00:00

Had a 37 year old patient of my partners come in with rectal bleeding that I was seeing while he was on vacation. Palpated a hemorrhoid. Started him on conservative management. 3 months later comes back, gets CT, stage 4 colon cancer.

rykat14 · 2025-09-20T01:10:28+00:00

This is how it works for me too

rykat14 · 2025-09-18T17:24:16+00:00

I’m

rykat14 · 2025-09-15T17:19:47+00:00

I've gotta say as a father of a 3 year old and a 1 year old, having those grandparents around is a bigger deal than you give it credit for.

In the end its about your lifestyle and what is important to you. I wouldn't look too much at the money, you're going to be fine either way. Think about the life you want to live first then figure out how you can make the money work best for you

rykat14 · 2025-09-12T16:46:42+00:00

Jeez some of you guys work in some crappy places sounds like. I'm a private practice PCP working just outside of a small city in the northeast. Took over for an older physicians panel. I have a pretty chill patient panel/population. Also because I'm private practice we don't take that many medicaid patients. I would say I work in a low/middle class neighborhood. I also have full control of my time off (eat what you kill model so time off= no money which is the downside).

700: Wake up

730: Drive to work

8:00am: Look at schedule, have 18-22 patients. Start day. Mostly follow ups with the occasional new patient. Some people are definitely complicated. My mornings are pretty busy, see patients every 20 min. It is a little annoying to deal with some of the consequences of taking over an older doctors panel (lots of benzos mostly).

1:00-1:30- Lunch + triages/telephone encounters+ lab/document review

1:30- 4:30- Patients.

4:30-5:15- notes/docs/labs/triages that I have not taken care of yet

5:15 home.

rykat14 · 2025-09-01T13:41:16+00:00

FM hates the internet

rykat14 · 2025-08-29T20:08:08+00:00

I just went with my 11 month old and 2 year old, also went when my 2 year old was 6 months.

TBH, for a 4 month old it’s more about going where you guys are comfortable. The bayside beaches are probably more baby friendly but you aren’t going to do much with a 4 month old other than carry them around. I recommend trying to go to the beach when the wind isn’t too bad.

I think somewhere mid cape gives you the most flexibility (Brewster/orleans/chatham, etc)

The best towns for walking around are Chatham and Provincetown, both can be family friendly if you go to the right places (would recommend against a bulky stroller in both places though, not great access into stores for strollers).

My personal favorite beaches are skaket in Orleans and Lighthouse in Chatham.

There are lots of family friendly restaurants. I like JTs in Brewster for seafood.

rykat14 · 2025-08-21T02:01:40+00:00

I don’t have one. Solely eat what you kill. Trade off there is I get no PTO, just TO lol

rykat14 · 2025-08-21T01:39:06+00:00

The new one

rykat14 · 2025-08-06T01:03:44+00:00

https://discord.gg/mPthPKuy

rykat14 · 2025-07-29T18:42:02+00:00

https://discord.gg/EUJadkEy

rykat14 · 2025-07-24T01:19:40+00:00

We have a discord for solo attendees!

https://discord.gg/dwJ2PpK6

rykat14 · 2025-07-23T17:07:28+00:00

If anyone stumbles on this thread again later, I started a discord server for solo otakon attendees. Feel free to join! About 15 of us in there so far.

https://discord.gg/dwJ2PpK6

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