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Dusn

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

    Why are you DINKs trying to tie yourselves down when you have no real reason to?

    in reply to: Choosing a House Without Kids #225111 Reply
    Liked by Peds
    Avatar Dusn 
    Participant
    Status: Physician
    Posts: 199
    Joined: 01/02/2018

    I really hope there is a candidate in this next election who I can vote for in good conscience.

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    Agreed.  Unfortunately the primary system is creating more and more polarized candidates.

    I have an appeal to make, especially to republicans:  since we already know who the republican candidate for president will be in 2020, vote in the democratic primary.  And don’t try to game the system by voting for the biggest nutcase on the other side’s primary….  as they just might win.   Vote for someone you’d be ok with (or at least the “least bad” candidate) if your side loses in the general election.

    in reply to: Bernie Buying Votes? #224778 Reply
    Liked by Tangler, mapplebum
    Avatar Dusn 
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    Status: Physician
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    Joined: 01/02/2018

    Sure. But the tax cuts for the wealthy bought votes, too.

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    Yes, I mean, It sure would be nice if Docs paid their “fair share”. We pay almost nothing and never work for our money. We certainly deserve to be punished.

    https://whitecoatinvestor.us4.list-manage.com/track/click?u=106bf0eb2d98400b0754830dc&id=a9ac30426c&e=03a94490be

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    Docs being “wealthy” is relative.   Compared to the vast majority of the population, especially in rural areas, most doc’s are certainly wealthy.   Compared to my friends from college who are in finance or tech in NYC or SF, the average doctor’s salary is pretty pathetic.    The strangest part about it is that my patients from rural areas, who do not seem to have much money, are die-hard republicans.   My friends who make >1mil in NY or SF are Democrats.   Honestly, I don’t think it’s about the money.

    in reply to: Bernie Buying Votes? #224706 Reply
    Avatar Dusn 
    Participant
    Status: Physician
    Posts: 199
    Joined: 01/02/2018

    Why does dusn’s region matter if you want global/US numbers?

    I’m having trouble understanding your backlash to the fact we can’t answer your constantly evolving question

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    Because Dusn is reporting earnings that are much lower than the ones I see in my colleagues. So I’m trying to figure out why they are so low.

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    I’m in the Southeast in a large town.  There’s only one major hospital system and they have a near monopoly.  If you’re a group that’s not employed by this hospital system they’ll make your life miserable.

    Anyway, tell us what you think are typical salaries, for which area of the country, which specialties, and type of practice, employed vs owner, how many patients per day and what ancillaries.

    in reply to: What is the income of physicians? #223747 Reply
    Avatar Dusn 
    Participant
    Status: Physician
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    Joined: 01/02/2018

    All the primary care physicians I know make < 250k for full time but they’re all employed. It probably averages around 195k. And for Peds it would be lower. The numbers I see on this forum and on surveys are way higher than the people I know.

    One of the better paying fields right out of residency appears to be anesthesia.

    Disclaimer: the above is completely anecdotal information.

    in reply to: What is the income of physicians? #223682 Reply
    Avatar Dusn 
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    Status: Physician
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    I’ve noticed the same thing as, Wideopenspaces.   When I leave the job is when the administration is suddenly very eager to give in to my requests — unfortunately by that point it’s too late.   I’m not going to threaten leaving until I’ve reached the end of my rope and I have another offer lined up.  And by that point I might as well go ahead and leave.   Unfortunately, as employed physicians, it seems that our only leverage is to leave.   It’s a bad situation for everyone, including the patients, as often a non-compete requires that their physician move out of the area and non-competes have become ubiquitous.

    I would encourage everyone to ask their state legislators to follow Massachusetts and California lead in banning non-competes for physicians and other healthcare professionals.

    in reply to: Burnout #223097 Reply
    Avatar Dusn 
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    Joined: 01/02/2018

    Image result for kill bill eyeball

    who needs strength when you can pluck out an eyeball?

    in reply to: Ophthalmologist are the physically the weakest really? #222054 Reply
    Liked by Eye3md, jfoxcpacfp
    Avatar Dusn 
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    Status: Physician
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    Joined: 01/02/2018

    I agree with your philosophy Lordosis.    Although the reality of most of the physician practices that I’ve been to as a patient is the exact opposite:   the physician is seeing me for routine yearly visits that could be handled by a midlevel and when I actually have an issue and need to be seen acutely, they have me seeing the midlevel because the physicians are all booked.  Unfortunately, when I have an acute issue is the time when I really need to be seeing the physician.   It’s completely ass-backwards.

     

    Avatar Dusn 
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    Status: Physician
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    Joined: 01/02/2018

    Just to clarify –  if you and the kids switch off of the HDHC plan, I believe your wife can’t continue to contribute to an HSA.  Someone correct me if I’m wrong.

    Also your wife will have some expenses associated with the delivery.  Wouldn’t it make sense to switch her to your Cadillac plan prior to the delivery?    There may be other questions to consider, such as if you can keep the HSA you contributed to this year if you switch out of your HDHP this year…    and hopefully someone who understands these details better than me can answer those questions..

    in reply to: New Baby – Stay in HDHC Plan? #220746 Reply
    Avatar Dusn 
    Participant
    Status: Physician
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    Joined: 01/02/2018

    It does seem to me that index funds and the market in general seem to operate, to a certain extent, like a ponzi scheme.  I have to rely on future people to buy the stock at a higher price for my money in the market to grow.   Dividends from companies make up a small percentage of my earnings from the stocks.

    And other people have already made the point that index funds do need some people to actively invest and to do it well.

    I’d be happy to hear arguments about why this is not the case.

    in reply to: Are index funds pyramid schemes? #220683 Reply
    Avatar Dusn 
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    Status: Physician
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    Joined: 01/02/2018

    We had a similar situation and came to the same conclusion: insurance companies clearly do not have doctors evaluating your health records.  The condition does not even have to be very rare.  Due to extremely well controlled colitis (single flare on diagnosis 5 years ago and since then undetectable on colonoscopy, just on lialda), my wife was denied coverage because within the past year she had a random episode of diarrhea likely due to something she ate and had mentioned it to her GI doc who put it in his records.   A letter from her GI doc explaining the situation finally got her approved at the most expensive possible rate.  So if your doctor is willing to write a letter that may help (This was through Banner Life Insurance, other insurance companies rejected her outright).  It’ll still likely be an expensive policy but worth it.

    Just to illustrate the ridiculousness of it: My wife is otherwise completely healthy in her early 30’s with an  HDL of 88 and LDL is under 40 and all grandparents and known relatives have lived until their late 80’s or 90s.  Meanwhile I got approved at a super preferred rate from multiple companies.  Literally everyone on my mother’s side of the family has needed a CABG or died of a heart attack before age 60.

     

    in reply to: Life insurance rejection #219606 Reply
    Avatar Dusn 
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    It’s easy to switch from academics (especially if it’s at a highly ranked institution) to private practice. The reverse is not as true. Your friends starting in private practice are likely to make more. But they’re also more likely to get screwed over by the practice owners, never get offered partnership, have the practice get sold to private equity, etc.

    So I wouldn’t stress about it; I’d probably try out academics for awhile and just figure out what job you’d enjoy more.

    Avatar Dusn 
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    Joined: 01/02/2018

    While I generally agree with everyone, I just wanted to play a little bit of devil’s advocate.   If your kid got into Harvard, Yale, MIT, Stanford etc and was planning on a career in business, finance, big law,  would you encourage them to go even if they had to take out loans?

    It’s pretty hard to get into one of these fields without going to a top school and the incomes in these fields (finance, in particular) dwarfs what the average doctor make. They also start making money at a much earlier age.

    in reply to: student loan crisis #217682 Reply
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    Avatar Dusn 
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    This thread makes me realize how many folks out there have sleep issues…..it’s an epidemic. …

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    Sleep issues… or psych issues? Funny how psych and neuro are the same ABMS board, huh?

    Think about who has almost zero problems with insomnia: athletes, military recruits, yoga camp attendees, monks, hikers on the ATC or PCT, lumberjacks, etc. Basically, people who do manual labor and/or mindfulness and who don’t play on a phone or computer all day tend to sleep like the dead. They sleep on the forest floor or a rickety bunk bed. They are so tired they could sleep by the freeway… with just an afghan from a garage sale. Amazing!

    Maybe the answer isn’t getting the right blankets and temp and darkness and mattress and blah blah blah. Maybe the answer is exercise, purpose, and avoiding anxiety from info overload? Hmmmm

    …Sleep does not have to get worse as you age… most people just let unmanaged stress build up, info overload get cumulatively worse, and activity level get lower and lower. I am almost 50 and can sleep like a rock on a basketball bus trip, desert camping, mtb trip with 8 people in a small cabin, house near a busy road, boy scout outing, forest camping, with or without a woman in the bed with me, cheap hotels or posh quilts, etc etc. All I ever use is an active day (more active, easier it will be to nod off), usually an evening stroll, and maybe nature sounds once in awhile.

    Apps like GoGray and others that let people know when it is time to shut off the FB or polito or other phone distractions can surely help, but it’s a bona fide lifestyle change to grow confidence to realize you don’t need 95% of the distractions (TV, social media, web, sports, news, etc etc) and to use that time for high activity level, peacefulness, and mindfulness every day. The simplest way to start doing that is to tire out physically… but most people who “don’t have time” or “don’t like to” get active or do mindfulness/outdoor hobbies are the same ones who are hesitant to ever set their phone aside. Go figure. GL

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    I agree with your philosophy completely.  But in reality the only time I get restless leg syndrome is after a really hard workout.   I still strongly agree with getting physical activity but the ache in my muscles does not help me sleep.

    The worst thing I’ve ever done for my sleep is living with a baby.  For beings who are supposedly completely “in the here and now,” these little humans can have some serious problems falling asleep.

    in reply to: Weighted blankets #217622 Reply
    Liked by Lordosis
    Avatar Dusn 
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    When I read this I wondered if it was a ploy to gain interest in the house and make potential buyers think it’s worth more than it really is and that they’d be getting a great deal. Sort of like when a car dealer triples the price and then gives you a special offer of 50% off. Apparently the house next to him is on the market for a similar price and is twice as big.

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