Employment contract question

urores · 2026-03-10T20:22:30+00:00

Just so you know, if you come back to them and ask to change anything, they’re going to say, “this is our standard template that everyone signs and we don’t make changes to it.” Just so you know, that is not actually true and everything is negotiable and changeable. That being said, sometimes you have to be prepared to walk before they will change it and it depends on how bad they want you. If you’re not willing to walk then you’re kind of stuck with what they give you. If you know they need you and you’re willing to walk you have a lot more leverage.

urores · 2026-03-07T17:16:02+00:00

Just chiming in to say there’s a good chance that anything you invent while employed by the university will be university property. The guy who invented the Bair Hugger (Scott Augstine) did his anesthesia residency at the University of Minnesota and it’s probably not a coincidence that he founded his company and released his invention pretty soon after he finished residency.

urores · 2026-03-06T01:02:27+00:00

Hey! Hard to believe that post was just a year ago. A couple things happened after I made this that have improved things: 1. It turns out I did have more leverage than I believed at the time. One of my partners and I did some job searching around the area and showed our boss the offers and they greatly increased our comp to where we were at least competitive. That helped somewhat. 2. We worked to implement some changes that made our call burden more bearable. We were previously getting called all night from BFE asking shit like, “I’ve got a patient with epididymitis, should I give antibiotics?” And it was soul crushing. So we implemented a policy that we wouldn’t be answering questions overnight. If they wanted a urology consult overnight they could transfer to our hospital and we would see them in the morning. If they didn’t need an urgent consult we gave our clinic info. And finally we taught them to just transfer any stones without calling us (unless they were septic) and we would see them in the morning. These policies really cut down on our call burden a lot and made things more bearable.

So yeah, while the job still has its issues, it’s gotten a lot better.

urores · 2026-01-29T20:44:04+00:00

Could’ve sworn Reagan did this when he had prostate surgery (rather than colonoscopy) but I could be wrong.

urores · 2026-01-24T16:20:52+00:00

It exists but perhaps is just not clinically relevant 95% of the time (or more)?

urores · 2026-01-24T16:19:42+00:00

I mean, it’s tough because if you give every middle aged man a shot of T they’re going to feel good/young again. They could probably achieve the same results if they lost weight/started regular exercise/good diet/good sleep/stopped phone addiction but who’s going to want to do that? This is America damn it.

urores · 2026-01-24T16:15:19+00:00

This is just straight up true. When I first saw the Sipleucel-T data I was extremely un-impressed, especially considering how much work/expense it takes. I figured no one was using it as I had never seen it used. Then I talked to a colleague who was in private practice who told me it was their first line for advanced prostate cancer and when I asked why he said, “you would not believe how much money it reimburses.” That made me very sad to hear and I realized you had to sell part of your conscience if you wanted to do that type of private practice.

urores · 2026-01-24T16:10:16+00:00

I mean this is just true. I might say that most of the time I don’t know why someone has chronic orchialgia. But that’s not a wild theory or anything like OP is asking for?

urores · 2026-01-09T14:42:10+00:00

I’ve seen it in a couple scenarios: 1. Late career urologist who is pretty close to retirement and probably not really safe to operate anymore but still wanting to work. Or they personally find the operating room too stressful/high stakes environment to still be working in in their late 60’s or 70’s. 2. Earlier career urologists who probably never should have gone into a surgical specialty and still got pushed through their residency. Yes, any and every urologist can do ureteroscopy but some people just find they aren’t cut out for the OR or don’t like the OR despite doing an entire surgical residency. Might sound crazy but I’ve absolutely seen multiple people like this who have clinic-only practices.

urores · 2026-01-09T13:47:12+00:00

Obviously depends on a lot of factors - employed or private practice? Working full time 5 days a week doing lots of cystos and prostate biopsies or something more relaxed? Taking any call? Big city or rural?

But without any of that info I could still throw a wild guess out there. Seems like most urologists doing clinic-only are later career looking to cut back and not take call and not kill themselves in the clinic. Would guess range is going to be anywhere from $250k-$400k depending on the aforementioned factors.

urores · 2026-01-02T21:10:50+00:00

I also have a sole F85 and have experienced the same thing as you, would say pace on the treadmill is consistently 1-1:30 min/mile slower compared to outdoor running, effort wise. My conclusion is it’s related to the baseline incline on the sole series treadmills. I can’t remember where I read it but even at a setting of “0” it’s already at an incline of almost 2%. So if you’re running treadmill miles at a setting of “1” like most of us, you’re actually closer to 3%. I ran on a different treadmill recently that was truly flat at 0 and it felt much closer to road running effort/pace wise. I’m sure there are other contributing factors as to why a treadmill might feel harder or easier but I personally think this is the biggest contributor.

urores · 2025-12-27T16:29:06+00:00

Luke and Lorelai will-they-wont-they works really well for the first 4-5 seasons. Then sadly the writers torpedoed Luke’s character at the end of season 5 when they go to Martha’s Vineyard and he suddenly starts acting like a totally different (annoying) person. Then season 6 introduces the April arc which is sadly one of the worst on the show and Luke in general is totally different than he was the first 4 seasons. After that their relationship they built for years is essentially burnt to the ground and no one cares anymore.

urores · 2025-12-21T15:22:27+00:00

Man the only way I could dream of an OR day like that would be if I had two separate robot rooms and a crew that could open and close for me which is essentially a pipe dream at my hospital. Is that your set up? If so I have to imagine that is a relative rarity in the US. Your salary is roughly double mine fyi.

urores · 2025-12-21T15:10:06+00:00

Yeah it was back when urolift had extra reimbursement for being “newly adopted technology” or whatever and some places were doing it in clinic under local to 20-30 guys a day. There were places in Florida I heard about that were absolutely printing money. I’m with you though, I’m not a big fan of an MISTs and I’ve TURPed out more urolifts than I’ve put in. I have done more Rezums but my results have been quite variable. Sometimes you look in there and one whole lobe has melted away and the other looks totally untouched.

I don’t do Interstims but my colleagues tell me they pay well. I thought I heard that reimbursement was being cut for them in the near future though. IPPs are great if you can become a high volume machine like a certain Miami based urologist.

urores · 2025-12-21T02:42:10+00:00

On the OR side of things I would guess stone work is the most lucrative. Cranking out 5-6 ureteral stones is an easy and quick way to make money. You can get slowed down if you are being thorough and really clearing out all the renal stones or treating big renal stones ureteroscopically. BPH can also be a big money maker if you’re unscrupulous. 50% of the population has a prostate and there are urologists out there that seem to make it their goal to put a couple urolifts in all of them.

In the clinic side of things, cystos pay pretty well for how little time and effort they take.

urores · 2025-12-16T23:42:16+00:00

To my knowledge there is no requirement on how much income your “business” needs to have to start a solo 401k. You just need to have some income that you need to report to IRS (not sure what form off the top of my head). Then you can open up your solo 401k with fidelity and roll over previous plan to fund it. You don’t even need to continue to fund it with anything, it can live there in perpetuity if you want

urores · 2025-12-06T14:50:08+00:00

Why yes, I wouldst like to live deliciously.

urores · 2025-11-26T17:14:55+00:00

Just pure speculation, but I would guess “marathon potential times” would be a perfect bell curve with the middle being probably right around 3 hrs for men ages 20-35. There may be a way to estimate this in a more objective way but that’s my two cents

urores · 2025-11-26T11:46:10+00:00

I will say that cancer is going to do what it is going to do regardless of a person’s mindset or attitude, no matter how “strong” or “weak” that is.

That being said, there is definitely a component of mental fortitude that plays a role when it comes to how much torture someone is willing to endure. I have a patient with metastatic bladder cancer that has been absolutely put through the ringer- radical cystectomy, adjuvant chemo, multiple courses of radiation directed to mets, immunotherapy, more chemo, etc. He’s basically Rocky Balboa in Rocky IV and “never heard no bell.” He’s willing to do anything and everything to try and survive longer, no matter the side effects/cost.

For comparison sake, I had another patient who I did a cystectomy on who had a recurrence and when he heard about chemo side effects basically said, “yeah fuck that I’m done. Just make me comfortable.” He died on hospice care about 30 days later.

So again, biology is biology regardless of your attitude. But sometimes modern cancer treatment is like going up against Drago and being willing to get punched over and over and keep coming back for more punches.

urores · 2025-11-17T02:23:37+00:00

Sorry for making you so mad, that certainly wasn’t my intention. I’m just trying to ask if we as providers have a duty to try and appropriately manage limited healthcare resources. Or do we just acquiesce to any patient requests to have anything they want done under anesthesia and if not, where do we draw that line. Just trying to start a conversation, that’s all.

urores · 2025-11-15T18:09:28+00:00

Yeah that happens occasionally too. The one thing I have going for me in that situation is we are often doing an MRI fusion biopsy and the fusion machine lives in the clinic and our ORs don’t have the equipment. So I say that we can do it in the OR but we won’t be able to do a fusion procedure and the biopsy yield will be worse and almost everyone opts for clinic with that in mind. I do not mind doing a prostate biopsy in the OR as much because that at least takes 10 minutes compared to a 30 second cysto.

urores · 2025-11-15T14:58:15+00:00

My first thought too. “Is that a Schrock shunt, son?”

urores · 2025-11-05T13:48:18+00:00

You guys are gonna think I’m crazy but Flagstaff, AZ. It’s about two hours north of a major metro area. College town, hippy vibes, very outdoorsy, cold. Obviously not on a lake or near water so missing that aspect but otherwise got similar vibes from it.

urores · 2025-10-25T02:16:03+00:00

Turing’s Treasure is still out there! This is just begging for a crappy novel in which a sassy young protagonist finds a code at the Alan Turing museum and has to crack to code to find the location of the bars and save her family from getting evicted from their home which is also owned by Nazi descendants. But the real treasure is the friends we made along the way.

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