u/benjediman

I’m more than a decade out from graduating med school. I’m interested in clinical education. But I trained in institution with no clerks/interns so I wasn’t able to follow changes if there are.

Is scutwork still there and non-stop? Blood extractions, q(n) vitals monitoring? Paperwork?

PS not looking for comments comparing what was before vs now lol just looking for objective data

Specialist, started working in a diagnostics center that rents to MDs. They have no secretarial services, so I found it a bit (read: a lot) awkward to charge the patient money directly 🤣 Ended up showing patients my gcash QR.

Is this really how it is? How do you do it in these situations?

How do doctors' salaries progress around the world as you go up in training?

I'll start with 🇵🇭

Our education and career progression are modeled after US.

After 4 years of med school:

1 year of post-graduate internship (not residency yet): variable (some places give like $20 to $50 "allowance")

After boards, people can practice as GP; highly variable, many probably earns less than $2000 per month, but some report earning more than that if they fill up their month with jobs.

Residency & Fellowship: $500 to $1200 per month, depending on the hospital, private vs govt, etc
(Most places still do q3 calls, and postcall people stay until noon or the whole day depending on program)

Post-residency or fellowship: very highly variable, and practically no one reports their salaries so no good data, but anecdotally medicine-based specialists starts at $2000 early in career then can progress to above $5000 in mid- or late-stage careers. Surgical specialties can earn up to $10,000 monthly. Some of the most well-known surgical subspecialists can earn above $20,000. BUT, all rare, and distribution skews right heavily and highly dependent on availability of work (difficult to get to these numbers in big city centers except for a select few).

Curious how it is in other countries

PS: I've seen a lot of highly opinionated posts talking about US salaries... let's not get into that lol

Made question very general intentionally to get a variety of response in different scenarios.

Inspired by the ICU doc who made his patient pee 12L in a day in the “peak of your specialty” post.

Where I trained everyone gets jittery for AKI if you went past 2L a day.

Yeah I know about venous hypertension, but my conservative training stops me from confidently going over that much.

I work in a facility that basically does executive health-checks for paying customers (age range 20s to 50s). Part of the job is to literally watch people do their treadmill tests and give them feedback right there and then.

Obviously abnormal stress tests a dime a dozen. But literature isn't clear with asymptomatic, low pre-test people.

If you have a similar population, what's your spiel/next step process? Do you tell them "don't put any meaning to this test and just live your life", or "we absolutely have to do more tests"?

EDIT:
Just to be clear, I’m not the one ordering these tests. The patients pay for it like a buffet package. And that is why I’m stuck in the position of having to interpret for which there is no evidence for.

EDIT2:
For complete clarity:
Here in my country, some medical services are offered cheaply AND commercially. You, as a patient, can get a full panel of tests (as part of an executive “annual” check) for approximately $500. You don’t need prior authorizations from insurances. You pay upfront cash or you get it as benefit from working for a company. That includes labs, including superfluous things like cancer markers (AGAIN, I get that it’s low value care). This apparently clicked with a certain market (mostly upper middle class), so a LOT of people do get these. Are these tests ridiculous and low value? Yes, no argument there.

I, as a cardiologist fresh from fellowship, hungry for work to finally earn a decent wage, was hired by such a company who offers such services, where one of my jobs is to watch over these paying customers when they do their stress test, and to interpret the results. I did NOT order these tests. That said, I am still tasked to interpret these in the context of mostly asymptomatic patients.

So please to everyone asking why I order these tests in the first place, again, I do not. But nevertheless, there is still the matter of interpreting them.

And to give a broader context, NO DOCTOR ordered them. They did not need approval from a primary care doctor to get these tests. Some don’t even have doctors. These tests are simply commercially available, and people pay to get them. So no, I also cannot tell them to go talk to their doctor about what to do next.

Hi! Want to gift the lady doctor of the house hehe.

As I am not experienced with these things, I want to ask for help!

She stuffs everything in there: steth, white coat, 13 inch laptop with case, and she would even put her tumbler in if she could (it gets heavy!)

Siguro I'm looking for something a little classy, big enough for stuff, but not too big so she can bring it anywhere and during rounds.

Any ideas?

Thanks!

Recently graduated fellowship. Now practicing.

Wondering if social media presence is a must?

Does it influence your practice volume? Or is it just too much work for little return?

Would like to hear your thoughts!

Graduated fellowship, looking for jobs

A lot of places asking for HMO accreditations, which in turn are asking for Philhealth accreditation

However, plan to go into subspecialty training early next year; then my PRC renewal is due mid next year

In this case, is it OK to not renew as provider when I renew my PRC, then will just renew once I finish subspecialty training?

Thank you!

For context, my institution recently switched from paper charts to an EMR (Sunrise Clinic Manager).

Because our country basically is still used to paper charts, most of our research just depends on census reports that were manually, painstakingly typed by residents/fellows. That's also why it's rare for use to produce any research that are more than a few year's worth of samples.

Our IT (?) department said they can now extract data if we submit the request for it but because our EMR is new and probably used poorly (people forget to add problem lists, ICD coding probably isn't up to par, etc), I don't believe the data would be as robust.

That said, I would like to ask researchers around the world: how is data collected and gathered in your institutions? Does it require a good EMR? Or do you still keep records of patients as text documents? Do you need a sophisticated research/IT department for these papers with 10+ thousand sample sizes?

Hi!

Partner and I are both MDs. Partner lost 2 booklets. Diligently looked everywhere, but so far cannot be found. 20ish used for the first booklet (but no record, unfortunately), while the other booklet is completely unused.

Plan to report to RDO, but we've been receiving some mixed information regarding penalties. Some say its as high as 5000 per receipt (like, a single sheet costs 5000). Some say its per booklet. Some say its based on the ITR. Someone we know was quoted 20K for a single missing page one time, then 10K when she went back.

Does anyone has experience, or has related resources/guidelines we can check so we know we're not being gouged on price for penalty?

Thank you!

There is a branch of HP that’s about to open literally right on my doorstep where I live lol. No idea how to apply as a specialist. Any tips will be utmost appreciated!

I have a Keychron K1 which worked perfectly right out of the box. I bought some replacement keycaps and replaced all the switches with mint opticals.

After everything is set, the down and right arrows won't work normally. They do register but it takes significant force.

I'm quite new to all of this so I'm not sure what the next best step is. I suspect that the PCB board might be a little bent near the corner where the involved keys are (but that's just a hunch).

What should I do guys?