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  • Avatar Dusn 
    Participant
    Status: Physician
    Posts: 199
    Joined: 01/02/2018

    One of the things that doesn’t seem to get factored into to “how much life insurance do I need?” calculations is what might happen to your savings during a prolonged illness (and with improving healthcare some of these terminal illnesses can take years before they finally do you in).  Suppose I get a terminal cancer… I’m personally not going to want to work and will want to spend as much of that time as possible with family.  So in fact, I would hope my wife wouldn’t have to work during my last few months or years to live as well and maybe she’ll need time to grieve and figure things out should I pass away.    And healthcare expenses might go up dramatically.  So I may have a good amount of savings now  but I don’t want to have to worry about that savings while dealing with a terminal illness.

    in reply to: How much term life insurance should I buy? #104918 Reply
    Liked by LizOB
    Avatar Dusn 
    Participant
    Status: Physician
    Posts: 199
    Joined: 01/02/2018

    Thank you both for the info.  And thanks for the links Vagabond.

    in reply to: Long Term Care Insurance #104833 Reply
    Avatar Dusn 
    Participant
    Status: Physician
    Posts: 199
    Joined: 01/02/2018

    If you’ve see one VA, you’ve seen one VA. The Durham VA had amazingly efficient turnover with the circulating nurse waiting outside in the hallway with the next patient and the resident barely had time to finish the discharge orders. But the eye clinic there wasn’t as well run. Asheville VA on the other hand had a very well run eye clinic and hospital in general with great ancillary staff (it seems much better than the private hospital monopoly in that area). NYC – pretty poor but I found the the ancillary and nursing staff in most NYC hospitals so poor that I saw no difference at the VA.

    My advice to anyone planning on working at the VA (or really anywhere) is to try to get some inside knowledge about where you’re planning on working.

    in reply to: Veterans Administration employment #104777 Reply
    Liked by StarTrekDoc, Anne
    Avatar Dusn 
    Participant
    Status: Physician
    Posts: 199
    Joined: 01/02/2018

    You seem to think medicine is more secure of a career than it really is.  During my residency, 2 residents were fired for…  well… essentially making the attendings nervous about their clinical judgement or surgical ability.   They were in their late 20’s or 30’s by that point with several hundred thousand dollars of debt with interest and no job and no chance of becoming a doctor.  One of them actually contacted me years later asking if she could be my technician.  It felt devastating to see that.  And these were hard workers who cared and did not think of medicine as “just a job.”   Most people I know have seen a co-resident fired or an attending who is unable to work due to a health/disability issue or a serious malpractice issues + a punitive hospital administrator.

    I’m trying to reach financial independence so that I don’t have to practice medicine much longer and I still think that your attitude is disturbing.   The reason I want to reach FI is because the stress of medicine, the responsibility of having patient’s lives (or in my case their eye sight) on my hands and the risk of possibly blinding someone every time I do a procedure is more than I really want to deal with for the rest of my life.  I think about medicine and my patients all day at work and I worry about them when I get home.

    With the attitude you express I can’t imagine you making it through residency.  Do yourself and your future patients a favor and get out of medicine now.  There’s nothing wrong with making money but there is a much easier and shorter path to it in business and finance.

    Avatar Dusn 
    Participant
    Status: Physician
    Posts: 199
    Joined: 01/02/2018

    I would avoid using HSA money for as long as possible

     

    in reply to: HSA dilemma #104420 Reply
    Avatar Dusn 
    Participant
    Status: Physician
    Posts: 199
    Joined: 01/02/2018

    Haha.  Yes. Finding a little parasitic worm wiggling around the retina and trying to shoot it with a laser as it tries to hide is the coolest treatment in medicine IMO.  And DUSN is a pretty cool name for the condition.

    That’s great to hear that the ophthalmology job market has opened up!  It wasn’t that way a few years ago….  I like my current job but maybe I should keep my eyes open for one closer to family…. And maybe I should stop telling my residents who want jobs on the east and west coasts that they need to specialize in retina or glaucoma for the job market.

    in reply to: Veterans Administration employment #103923 Reply
    Avatar Dusn 
    Participant
    Status: Physician
    Posts: 199
    Joined: 01/02/2018

    Wow,  I’ve never lived in an area where there wasn’t a oversupply of cataract surgeons and I’m not even near a big city.  Our VA does about 7-8 cataracts per day but an attending is generally supervising and training a resident.  But there aren’t that many visually significant cataracts with worse than 20/40 vision anyway.

    The real demand is for glaucoma and medical retina.  The demand for intravitreal injections at most eye clinics I’ve seen is overwhelming.  And with lucentis and eylea costing about half as much for the VA and opposed to private practice (the VA negotiates the cost of their meds) keeping retinal injections in-house is the most cost effective measure they can have.

    I’d agree with the above statement that every VA is very different.

    in reply to: Veterans Administration employment #103847 Reply
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