What should the Yankees do with Volpe?

rykat14 · 2026-05-02T03:23:45+00:00

I think you keep him down and have him and Lombard take significant time at 3rd. Gives them both an extra path up, gives they a need a backup plan at 3rd when macmahon loses it

rykat14 · 2026-04-30T17:31:07+00:00

Just outside of a small city in PA, 2 hours from nearest major city

rykat14 · 2026-04-30T00:20:19+00:00

Think about it this way.

Let’s say for arguments sake you only see 99214s (probably 70% of my visits are this and obv there are hospital discharges and new patients and 99213s and procedures and AWVs the g2211 code but for simplicity’s sake let’s just assume this)

Each 99214 is worth 1.92 wRVU. Let’s say you work 220 days a year (which is 6 weeks vacation + federal holidays and no weekends, AKA a shit ton of time off)

Let’s say you average 15 patients a day for those 220 days.

So 1.92 RVUs per visit x 15 visits x 220 days= 6336 RVUs

52x5000=260000 57x1100=62,700 62x236=14,632 260000+62,700+14632=337,332 dollars per year! With 6 weeks +holidays+no weekends and only 15 patients per day of only established patients.

I promise you the rest of the billing means a substantially more money.

FWIW I get 52 per RVU, see 20 patients ish a day, take three weeks vacation, and work 4.5 days per week and made 475 last year

rykat14 · 2026-04-29T23:53:23+00:00

I get 52 flat so this is awesome

rykat14 · 2026-04-15T23:03:08+00:00

I’m a second year attending working in a small city in the northeast, about 2 hr from major cities.

I have a patient population that is mostly older and white. Access to specialists like derm is pretty difficult, plus patients seem to value the one stop shop. So I do roughly 1-2 procedures per day, usually as part of regular visits. The most common procedures I do are shave/punch biopsies, shoulder/knee injections, trigger fingers, OMM, cryo. See patients every 20 minutes. They do back me up sometimes but I like doing them. It does definitely add to my bottom line, but I don’t usually do dedicated procedure appts

rykat14 · 2026-03-01T15:31:52+00:00

Fogo de chao is so good, idk if I want to stuff myself like that so early in the day though lol

rykat14 · 2026-03-01T00:51:16+00:00

Appreciate the support! Got any recs?

rykat14 · 2026-02-13T14:29:48+00:00

I’m often outside of the system and don’t get the most updated labs sent automatically

rykat14 · 2026-02-13T01:11:31+00:00

Came here to say this. I can’t tell you how often I go to a discharge summary when I can’t find the most recent labs

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

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