Recent content by end stage fibro

For 40k(~26k after taxes?), I don't think it worth the chance of wearing a scarlet letter for the rest of your career. I agree with dozitgetchahi - this is such a roundabout way of "disciplining" you. Furthermore, if we take you at face value, you didn't do anything to get into this mess. How...

Dude just leave

Interesting to read this. I have had the same feeling, especially over the last few years. the inmates are running the asylum. Some of the newer nurses (and NPs) spend so much time debating the treatment plan. Frequently, what they are suggesting is batsh*t crazy - willy nilly adjustment of pulm...

I agree with everyone telling you this should raise alarm bells in your head. Regarding the Stark law concerns, you can probably get around it legally. This is not for the faint of heart, but under value based purchasing and ”continuity of care,” you can kinda direct patients to your SNF (not...

I agree with the thrust of your post, but I have to say that staying in the hospital is worth pennies in street cred and I think is mostly theatrical. Some hospitalists go home and nothing gets followed up until the next morning- that is malpractice, especially when you can get results "paged"...

If i had a phd in pchem I would probably go by “dr fibro, phd ( and also MD).” Hell, sometimes time I want BS in biomed engineering/informatics* on there first. *Was a soul crushing day for me when i found out hospital informatics is essentially sloppy IT. My undergrad work was way more...

I have been doing this for roughly 2ish years full time now. I wrote a post about it in the IM forum. It is maddening dealing with payors all the time. As you and your program mature, you become a victim of your success. All the easy cases are already streamlined (XSOLIS is well utilized, there...

i surmised you were a good doctor from your posts on here; I can tell for sure you are good person because you did not include Dr. Pulaski on your list

Outside academic navel gazing, chief resident is not worth anything to anyone, ever. Do you get any advantages? Better schedule? At least it’s not an extra year.

this is so true it bears repeating. doomsday scenario: i feel like each year, the job of a hospitalist gets slowly whittled down and will eventually become a triage NP job. you need to ahve a job where you make a ton of money for the hospital or control your own patients also agree on the...

NYS was one of the 4 states that I know where medicaid blows. didn't realize there was an increase in payments. :banana:

People bring it up all the time. Essentialy, only the American Hospital Association and ilk want more payments for the hospital, this is an example why. I am actually not sure what CMS says exactly (searching their archives is annoying, though I am kinda curious now so I will edit this if i...

Just to add a little to this... Everyone here uses CPT codes: 99223, 99291, 99205, etc. Many CPT codes have a facility and non facility value (facility meaning a hospital, SNF, ASC, LTACH, etc. NOT the office). If something is done in a facility, the practice expense RVU is much lower and gets...

For hospital medical directorships, I see those figures commonly. I am not sure what is reasonable for a SNF. I trust the guy asking me to do it and he says it’s an easy job. The SNF is part of a large corporation that already has lots of pathways and algorithms in place so I wouldn’t be...

Excellent post above. I’m several years out from residency and have lowered my ABG ordering substantially. A good pleth and SpO2 seems plenty accurate to me and gives some sense about perfusion. I only get ABGs now if i am worried about CO2 or pH. One facility I work at, the lab draws the...