As above. Got the discount flyer from AAFP and my hearing is not quite as good as it used to be. Wondering what yall think
PhD epidemiologist here. I know this pre-print is more for pediatric urologists than family med docs, but educating families and patients starts with PCPs (and there isn’t a large urology sub).
Anyway, sharing this for awareness of new research on long term negative physical and mental outcomes after VCUG procedure (gold standard for vesicoureteral reflux (~1-2% children)). Bigger (and better designed) study needs to be done, but this suggests education for families and patients might be helpful as well as additional training for radiologists performing the procedure on pediatric populations. Author also presented on research here: https://youtu.be/gHoHIA9oydk?si=ay_3x2Iq4IvkaLVM).
20+ years in medicine and I still cannot stand trachs & their secretions. I’ve done wound care. I don’t mind pus and blood. But a slimy wet trach still makes me want to look away.
My wife can’t handle broken bones.
Just wanted to know if you’re numb to everything or if something still gets under your skin.
I almost never introduce myself by my physician title outside of the office. And if you are another physician I know, I expect to use first names. However, If contacting another physician I am not familiar with, I will address them by Dr. XXX. It seems to be a known decorum.
But I continue to get medical practice marketing emails, "consulting" gigs, other promotional material where the non physician employee addresses me by my first name in the header. That's an absolute no go for me. Maybe I am overly sensitive for this, but it tells me what you think of my position and that you likely won't value my time. Delete button is used quickly.
Hello!
I’m planning to start my big boy job after residency. I just wanted to ask if there are some tips for billing/coding to maximize RVUs when I start?
I know a few bits of information, such as the G2211 code but I would like to have a compendium of good tips!
Has anyone built a FM practice with a neurology focus? I know it’s not generally one of the primary care specialties so wondering if anyone has done it before and what that looks like for them
48 y/o morbidly obese female, hispanic. BMI 52. HbA1c 7 on metformin 500 BID Other h/o ventral hernia, limits mobility.
When asked about her diet, she only dates chicken broccoli pasta and skips breakfast sometimes.
Other lab workup normal.
How can somebody be so obese with such a healthy diet lol. And what can else be done for her? Can't afford GLP, no insurance
I’m finishing residency right now and getting ready for maternity leave soon so I’ve been trying to bring in a little extra money where I can just wanted to share my sources here cuz Reddit helped me find a lot of these when in need. Have made a little over $2000 in the last few months but I don’t do every single survey that comes in
Definitely not life changing income, but honestly enough to help with baby stuff, registry extras, our babymoon, preparing for COBRA insurance BS etc.
I know there are a million sketchy survey sites out there, but these are the ones I’ve actually used and gotten paid from as someone in healthcare. Steer clear from others imo
A lot of them are market research/pharma surveys aimed at healthcare workers some surveys online some phone calls some mail in forms
I’ll share both referral and nonreferral links if interested but feel free to just google and sign up organically too
ZoomRx
This is probably the one I’ve used the most lately. Mostly healthcare/pharma surveys and sometimes interviews. I usually just do them while eating lunch, between patients, or when on the couch after clinic lol
The pay is better than most normal survey apps I’ve tried and the surveys are usually actually relevant to healthcare
Referral link:
ZoomRx referral Sign Up Link
InCrowd / OpinionSite
These are nice because a lot of the surveys are short and phone friendly. Some take only a few minutes.
Not every month is amazing, but they’ve been good for random extra spending money. I’ve used money from these for registry items, eating out on our babymoon, and honestly just offsetting pregnancy expenses in general because everything adds up fast. Definitely the most active site but can get screened out easily
Working on some simple mail in forms for them for a couple hundred which is cool
InCrowd Sign Up Link (non referral)
M3 Global Research
This one tends to have some higher paying surveys/interviews for physicians and residents.
Sometimes you don’t qualify, but when you do the payouts can actually be decent. I don’t get too many from them to be honest but when they come rarely get screened out
Referral link:
M3 Global Research referral Sign Up Link
All Global Circle
Sister company to M3. Smaller amount of surveys for me personally, but still worth signing up for since it’s another source of opportunities. High paying when they do come
Referral link:
All Global Circle referral Sign Up Link
All Global Circle Sign up (nonreferral)
Enos / SightX
Another healthcare market research one. I’ve gotten some decent studies through them too. Support is very competent and surveys go quick
Referral link:
Enos referral Sign Up Link
Enos Sign up (non referral link)
Sermo
This one’s a mix of physician discussions/news plus paid surveys. I honestly signed up more for the survey side, but sometimes the discussions are entertaining too
The surveys can pay pretty well depending on specialty/topic, and it’s nice having another source because some weeks one site is dead while another suddenly has multiple studies but they do fill INCREDIBLY quickly like sometimes within minutes so make sure you’re fast. Also keeping $100 in your account without withdrawing gives you premium status which gives you more survey
opps that I definitely recommend
Referral link (I earn $40 and you earn $20):
Sermo Referral Sign Up Link
Sermo Sign up Link (nonreferral)
Also experimenting with Amazon Seller App scanning books at local thrift stores will update how that goes
Anyway, figured I’d share because residency already pays very little for the amount of work we do, and adding pregnancy + preparing for leave on top of that has me looking for every extra dollar I can find lol
If anyone else has found good side income stuff for healthcare workers that doesn’t completely suck let me know feel free to add here
New patient to me, brought in by family after moving here from out of state. Was living on her own but her family had heard she had a few falls and wanted her closer, so she is now changing over to my practice.
She has always been a small woman, now is pretty frail, BMI 17, has had a gradual weight loss the last few years. This is not new to them, they tell me it is partially attributable to a jaw surgery in 2019 or so and so she has needed pureed diet ever since. Exam was OK, a little bit slow to rise from chair and her gait is a bit slow, she is using a walker. She is pleasant and conversant, relates most of her history herself, MMSE was fine, 26/30.
Her history is pretty unremarkable except she is on once monthly injectable B-12. Her only other medication is also once monthly injectable estrogen. I asked why, they are not clear. She thinks it has been prescribed to her for around 60 years, since Hyst at around age 30.
Oddly, she and daughter were adamant this "cannot be stopped" since when she "gets low" she has "had seizures." They don't recall details of these episodes, just that she had seizures and they told her that her "estrogen was low...." Also they tell me that her primary doc back home said she "cannot get too low" so has continued to prescribe it.
Oh yeah, did I mention she is a 1/2ppd smoker?
Wut?
I have no records, so cannot find out the former doc's reasoning, but will try to call their clinic and hope for a convo. Regardless, I am kinda perplexed here... Anyone seen this before? Any reason to continue this? I am willing to admit my blind spots so if there is a reasonable explanation I'm all ears...?
I am a new attending working at an FQHC, contracted for 4 days per week totaling 80 patients. I am generally happy with my job and happy with my compensation structure (decent salary that never goes away with additional income available beyond a certain annual billing threshold). I could never strive to hit my productivity bonus and still live very comfortably, so this isn’t a money issue. Also worth noting I’m the only physician in my office with 5 capable mid-levels that aren’t my direct responsibility but that I do help out often because they’re good clinicians and nice people.
My clinic has daily walk-ins with each provider expected to cover it once a week. It is a 2hr period with no patient cap, and it is generally understood that we are not to be booked appointments during that time or the hour after without asking. The hour after is intended to finish seeing patients who’ve checked in before walk-ins end and to do documentation.
For the last 4 weeks I’ve continually been booked 2-4 patients during that time, as well as being randomly double-booked throughout the rest of my day without my consent. Tomorrow I have 4 patients during walk-ins, ultimately scheduled for 15 patients during the day without taking any walk-ins into account. I’m meant to work from 8-4 with an hour lunch/admin, so if I get 10 walk-ins I’m seeing 25 patients in 7 hours which is just not acceptable to me. I’m also double-booked an establish care for a patient in their 70s and a hospital follow-up in their 80s in the afternoon.
I have politely requested multiple times that this not be done without my permission and have kind of reached a breaking point on it because I feel like I’m just being treated like a door mat as the new guy. Is it unreasonable for me to say that after this week I’m not going to accept it at all any more? I’m either going to suggest that the person who double-books me without asking can cancel the appt and explain why, or state that I’ll just shut my laptop and go home once I hit my daily patient capacity if I exceed it because of inappropriate scheduling.
Is this unreasonable? Am I being a diva? Looking for genuine feedback because I’m pretty sure I could take my talents elsewhere quite easily
ETA: thank you for the insights! I’ve already asked my office manager to meet tomorrow morning prior to walk-ins and I will essentially say what I said above, keeping in mind that I don’t want the patients to be pawns in my fight with admin. I actually have a vacation the next 2 weeks so I plan on seeing the patients I’m scheduled for the remainder of the week and then giving them 2 weeks to sort it out. I’ll also make it clear I’m ready to walk if this can’t be sorted out reasonably, pretty sure in my neck of the woods I can have a job lined up by the end of my 2 weeks off if push came to shove.
I keep seeing people talk about $300k+ jobs with tons of vacation. Where are these actually at?
I just got my Florida license and the offers have been underwhelming. Urgent care: $120/hr as a contractor, 12-hour shifts, two full weekends a month, malpractice 250k/750k. Primary care: $230k, 22–24 patients a day, no inbox support, 2–3 weeks PTO.
Meanwhile, every listing says “competitive pay” and “generous PTO” with no numbers.
Is this just the Florida market, or am I looking in the wrong places?
Hello,
I was curious on everyone’s thoughts on the contract below. It seems very fair for a new attending. Higher than the average salary around here. Thank You!
Site near Philadelphia (35 minutes outside the city)
Base salary: 240k
Incentive bonus: 50k (works on a point system most people average 40K)
Sign on: 30k (two year commitment)
Retention bonus: 17.5k (starting after year 2)
CME: 4k
Total compensation: 301k - 314k on average
2.5k a month while in residency (35k extra in my case also two year commitment)
PTO: 26 days
CME: 4 days
Sick time: 480 hours
Non compete: 25 miles from primary location for a duration of 1 year.
Other benefits:
1:1 MA
Inbox coverage/management
Nurse triage
Scribe
PSLF
457b
Standard health care plans, disability, etc…
It’s Monday and I feel like I’ve been working for ten days straight. I’m starting to hate this job. Being a PCP is so draining. I can’t listen to another patient talking about ten different things or go on a rant when it’s a simple yes or no question.
For those of you who have been doing this for years, what’s your secret?
I’m contemplating fellowship. This is no way to live.
Thank you for listening to my rant.
I’ll go see my next Medicare wellness visit now.
Saw a 47-year-old man today working in education who said he feels like he’s “losing his mental edge.”
Not overt memory loss. Still functioning independently. Mainly describing reduced focus, slower thinking, less mental sharpness compared to a few years ago.
Basic workup was unremarkable including B12, TSH, ferritin, etc.
He asked about supplements/nootropics. I mostly emphasized sleep, physical activity, diet, stress, abdominal adiposity, etc. But honestly I left the visit thinking how difficult this category of complaint is in primary care.
These patients are usually not demented or clearly MCI, but many genuinely feel cognitively different.
And I’m never fully sure what to make of it..
Sometimes it’s sleep/stress/metabolic health. Sometimes depression/anxiety presenting this way. Sometimes people noticing normal aging for the first time. And sometimes you’re left asking yourself whether this is the very beginning of something you still can’t detect clinically.
I also struggle with how objective to get when labs and day-to-day functioning are still normal.
Curious how others approach this group clinically.
Do you quantify objectively in some way?
Use screening tools?
Treat mainly through lifestyle/metabolic risk?
Refer?
Or mostly reassure and follow longitudinally?
Ugh had a challenging house call patient wondering if I dropped the ball. Pretty sure I didn’t.
Mid 60s F hx if lung cancer post partial lobectomy currently chemo recently dx with ALS bed bound g tube placed.
House call for cough concerns for PNA.
Exam benign, afebrile, normal RR cough clear production inconsistent, pulse ox 94-96 which is baseline. Cardiac benign
Advised no concerns for PNA, to do incentive spirometer prescribed her atropine drops sublingual prn for excessive saliva.
Over the weekend choked on food went to ER dx sepsis possible PNA. Noted inflammation right lung vs infection. Although patient also had many leuks in UA as well.
Just the thought I missed the PNA. Pretty confident I didn’t just due to the likely aspiration with right lung finding. But still can’t help but wonder.
Venting over.
I hate these . Looking to see if we can streamline. Do yall do the following and if not is it not required? Tired of the mountains of paper
Just wondering if we’re doing too much… I’m asking the rectal incontinence screening be removed. It’s not part of the requirements.
father want's declaration of incapacity for his adult child. form is adult guardianship. the patient has autism but functional. i met the patient once... will probably have them defer to psychiatrist. wanted to know what hive opinion is on these kind of legal documents
I would like to connect with fellow match applicants, residents, or attending who are going to attend AAFP this year. Just drop a DM.
Anyone who has attended before, please share tips for this conference, such as travel plans, accommodation, or anything else that might be helpful, since this is my first time attending any conference.