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  • Avatar HandFellow 
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    Status: Physician
    Posts: 193
    Joined: 01/18/2016

    If he owns a house and rents it out, he will be taxed on the rental income, whether it comes from a stranger or from his child paying for the rent through the 529.   It is a qualified education expense, regardless of who owns the rental property

    in reply to: Purchase home, use 529 to pay for it? #239501 Reply
    Avatar HandFellow 
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    Status: Physician
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    Joined: 01/18/2016

    If you are nervous about the compounding interest, pay off all the loans.  The 9k loan is the least of your problems.  If you want PSLF, why would you pay off any of the loans?  that doesn’t make sense

    in reply to: loan payoff with pslf #239421 Reply
    Avatar HandFellow 
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    will you never be able to contribute to a 401k?  or is there a 1 year period of employment before you will be able to contribute?

    in reply to: No Retirement Account at New Job #237441 Reply
    Liked by Vagabond MD
    Avatar HandFellow 
    Participant
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    Splash Refinancing Bonus

    When I read this, all I think is that this RVU structuring is convoluted and a mess.  I have no idea what it means and I’m happy I don’t have to worry about it.

    All I can say is that your visits for established patients, if they are complicated will be 99214 more than 3 if you have sick and complicated patients, just based documentation.  In my practice, even though they talk about the bell curve, my established patients tend to be on the 4 side since they don’t come back unless they have problems.  And don’t forget your new patients, for FM, I would imagine it isn’t unheard of to do 99204s mixed in with 203s.

    Avatar HandFellow 
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    definitely something I have thought about.  Year to date, we have saved 40% of our pretax income and then found out when filing our extended taxes that we actually overpaid by quite a bit last year.  So we are saving a lot and have a lot of cash coming our way.  We travel a fair amount, which is always nice and we don’t really skimp when we travel.  But as I was telling my father, there isn’t anything that I want that I don’t have.

    I don’t think I am going to start spending just because I am saving too much, but if something comes up I don’t really think twice about buying it.  Except the pool that my wife wants.  I’m not quite there yet.

    in reply to: Enjoying your money while you're young #235704 Reply
    Liked by Antares, AZPT, ZZZ
    Avatar HandFellow 
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    Joined: 01/18/2016

    I would feel uncomfortable helping a friend if I had to ask a forum for an answer.  It is one thing to do it for yourself and assume that risk.  It is different level to say you are going to help a friend and then ask other people if it is okay.  If things don’t work out, you are on the hook and it’s going to make your relationship quite awkward.  I would say you should steer your friend to education himself on the matter and tell him what you are doing for yourself.

    Avatar HandFellow 
    Participant
    Status: Physician
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    P.S. edit: A photo I recently took of a note by a recently graduated MD. This shit is weak, and this weakness exists on all levels in the business of “providing” “health” “care”.

     

    Click to expand…

    I like that they under-billed too.  an established 3 for 3 chronic problems for which you don’t know the answers to?  an NP could easily do that.

    Avatar HandFellow 
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    Status: Physician
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    Joined: 01/18/2016

    I almost backed out of my refi last month.  I was so tired of all the documents requested over a 2 month period.  We opened up the books and returns and statements.  They were asking me to get a letter from my accountant explaining the difference between a distribution and profit from my practice, among other things.  We refused to do any more and after some waiting, the loan was approved.  When you look at the money we are going to save, it was worth it.

    in reply to: Ridiculous questions from mortgage lender #234922 Reply
    Avatar HandFellow 
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    Status: Physician
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    I have the weber, but with 4 burners.  I wish I had the gas line one not the propane one.  Wife loves it and that’s all that matters.  Stop worrying about it and pull the trigger

     

    in reply to: To grill or not to grill? #234921 Reply
    Avatar HandFellow 
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    medical school scholarship sponsor

    Billions is a great series on the financial world.  Will you learn anything that you can actually apply?  No, but they do use a lot of financial terms.

    in reply to: Any good financial movie suggestions? #232256 Reply
    Avatar HandFellow 
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    First Mr. Jones’ truck and now TVs.  People will spend their money on what they value, whether that be vacations, cars, houses.  Everyone has their vice.  Any doctor can afford that tv if he or she really wants it.

    Regarding tv vs projector, to get a good projector in the perfect room and get some speakers and the actual screen to hang on the wall, you don’t come that far from a $4500 85 inch TV.  Last I checked, which was christmas, 85 was the top size for reasonable priced TVs, after that things got out of hand.

    Also, if you really want to see where the money goes, its on the sound system to make the projector or TV sound good.  Guy up the street dropped 20k on the sound and the anesthesia guy across the way dropped 40k.  Kids don’t know the difference with a good sound bar.

    in reply to: 5K for a TV? #230737 Reply
    Avatar HandFellow 
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    The comment was back door roths, not roth conversions.  The back door method is a way of funding a retirement account, not converting one account to another.  It is funding an entirely different account classification.  You fund an IRA and then convert it to a Roth within a few days.  6000 dollars for earner and spouse per year (12000/yr).  As it is post tax money, it is similar to using a taxable brokerage account but never having to pay taxes on it again.

    in reply to: Guidance #230509 Reply
    Liked by Infinity, SLC OB
    Avatar HandFellow 
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    Joined: 01/18/2016

    In residency, the nurses used to wear buttons on their scrubs that said, “8s don’t count” or something like that.  I think part of that was to remind people that they were aiming for excellent, 10/10 care, but the other part was to remind patients that when they got their surveys to give them 10s.

    I agree with the above.  Don’t waste tons of time with patients giving them information they don’t ask for.  I always ask my patients if they have any other questions.  If they ask them, I answer them. But I certainly don’t tell them everything they need to know on the topic.  If you have some things you think they should know, give them a handout or a website.  Once all their questions are answered, tell them about the survey and as others have mentioned, tell them to give you 20 out of 5.

    in reply to: Patient feedback ratings impact on pay? #230138 Reply
    Liked by Tim
    Avatar HandFellow 
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    I wouldn’t condemn this version of health care coverage any quicker than typical health insurance.  There are lawsuits where insurance companies have denied treatment to cancer patients.  I have had two patients with health insurance who were injured doing stupid things and their claims denied.  Both required surgery but insurance companies refused their treatments due to patient action.

    Avatar HandFellow 
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    Click to expand…

    This happens at all hospitals, man…

    Sticker prices are a joke for the insurance games.

    Click to expand…

    Here is what happens, patients have health insurance with a deductible.  So they utilize their insurance and consume health care, either in an ER or a clinic or wherever. So when the bill comes, it is an accepted expense that goes towards the deductible.  After all, the insurance is there to cover large expenses that they otherwise wouldn’t want to pay.  Everyone is working toward their deductible.  You have to hit the deductible, especially in these plans where everyone is paying 100% of the bill.  The deductible is the goal!   After that, it’s free money.

    The alternative is cash pay.  Of course everyone could go to cash pay, but they don’t get reimbursed for it like a ministry program AND it doesn’t go toward the blessed deductible.  So if my kid needs tonsils out and I have a deductible, I go through insurance in the hopes that if something else happens that year, my insurance might actually pay for part of the expenses.  If I go cash pay, I might save some money, but on the back end I might lose money.  The ministry programs have protections on the back side since they are getting their money back AND getting the cash discounts.

     

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