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  • Avatar HandFellow 
    Participant
    Status: Physician
    Posts: 210
    Joined: 01/18/2016
    Earnest refinancing bonus

    putting aside the question about the advisor, why can’t you do both?  there should be plenty left over for a couple of DINKs.  The second question would be why would you need 1.2-1.4 million house with no kids.  Perhaps I am just showing how naive I am living in a small town in flyover America.

    in reply to: Save for home down payment vs 401k contribution #253751 Reply
    Avatar HandFellow 
    Participant
    Status: Physician
    Posts: 210
    Joined: 01/18/2016

    I leave too many credit cards in my wallet. Thanks for the reminder. Sorry about the incident. My problem would be trying to remember which of the cards was actually in the wallet. Was the delta platinum in there that day? The new Alaska card? And why do I carry a debit card with me?

    in reply to: PSA – What's in Your Wallet? #253413 Reply
    Avatar HandFellow 
    Participant
    Status: Physician
    Posts: 210
    Joined: 01/18/2016

    Excellent input. I would hate the constant barrage of messages in the emr. Before the emr how was all that infor handled? Stack of papers and a signature?

    Agree that over documenting is a thing. On the complicated patients I put a 3 line blurb at the end to summarize. Other than that, mention only the pertinent stuff. But it sounds like the real time suck is the indirect patient care behind the scenes stuff that is a serious drain on resources. How much of that is really necessary ? Can that be done by nurses and extenders? My experienced MA keeps so much stuff from involving me that it probably saves me an hour a day.

    in reply to: Time on EHR/Computer #253300 Reply
    Liked by Tim
    Avatar HandFellow 
    Participant
    Status: Physician
    Posts: 210
    Joined: 01/18/2016

    Sure, but how much time do you spend on these charts?  The 15 minute goes 5 minutes over, how long does it take to document it?

    I’m not saying I don’t believe there is a lot of work going on outside of direct patient care.  I’m only asking how much do y’all do?  I’m fortunate that I don’t have much.

    in reply to: Time on EHR/Computer #253061 Reply
    Avatar HandFellow 
    Participant
    Status: Physician
    Posts: 210
    Joined: 01/18/2016

    There is a local fine men’s apparel place that I go to every few years to get a suit.  Great fit, fashionable, and….expensive.  For some reason I feel better wearing an expensive suit.  They are definitely an anomaly in my closet and I wear a suit maybe 3-4 times a month, so they aren’t for the office or heavy use. I get a new one every 5 years or so.

    in reply to: suits #252729 Reply
    Avatar HandFellow 
    Participant
    Status: Physician
    Posts: 210
    Joined: 01/18/2016

    Come on now. You know the answer to this. There is little you can do to screw this up. With no loans and high salary and low spending. If you can’t buy this house, what are you saving all your money for?

    With regards to timing housing markets, my business partner sat on the sidelines for 3 years because housing was at its “peak.” He finally bought this year, and guess what? The market is still high and he probably cost himself 50k waiting for prices to come down. If you are planning on being there for a long time, it shouldn’t really matter anyway.

    in reply to: New attending home purchase. Time housing market? #250278 Reply
    Avatar HandFellow 
    Participant
    Status: Physician
    Posts: 210
    Joined: 01/18/2016

    Range: Why generalists triumph in a specialized world by David Epstein.

    Interesting read. We’ll see if it applies to medicine

    in reply to: What book(s) are you reading right now? #249561 Reply
    Liked by lilsnappa, Anne
    Avatar HandFellow 
    Participant
    Status: Physician
    Posts: 210
    Joined: 01/18/2016

    You can convert as much as you want to a Roth in any year penalty free. You just have to pay tax on it. If you 401k that magically got converted to an IRA is a small amount, that’s probably the way to go. If you have the ability to open up an individual 401k by starting a side business, that’s the other way. Just make sure the company you go with allows rollovers

    in reply to: Excess Funds Stuck in IRA #249065 Reply
    Avatar HandFellow 
    Participant
    Status: Physician
    Posts: 210
    Joined: 01/18/2016

    This is why I don’t hire a PA/NP.  people want to see the person in charge with the expertise.

    in reply to: Going to dentist and not seeing a dentist? #246527 Reply
    Liked by hatton1
    Avatar HandFellow 
    Participant
    Status: Physician
    Posts: 210
    Joined: 01/18/2016

    I just received an interesting letter from BCBS about the “medical loss ratio rule” as set forth by the Affordable Care Act.  The act requires insurance companies to pay out at least 80% of all premiums to medical care for their customers.  Well, it appears in my state, BCBS did not meet that standard and only paid out 76.6% of its premiums towards health care.  It is required to rebate 3.4% of those premiums back to its customers.  So good news to me.

    What that might mean for a few of these plans that require the patient to pay a steep premiums for absolutely no benefit until deductible is met might be scaled back a little bit.  Either that or lower premiums, which is what happened to me.

    in reply to: diabolical high deductible plans #246525 Reply
    Avatar HandFellow 
    Participant
    Status: Physician
    Posts: 210
    Joined: 01/18/2016

    I can’t help too much without knowing more details. With what I know, my question would be what is the device and is there growth potential.

    In my first few years of practice there were some opportunities that came my way. I had interest in them for sure, but I had too many things going on.  There were student loans, retirement plans, house down payment, taxable account, insurance plans, practice buy-in, etc.  Realistically, there wasn’t much left over to do those sorts of ventures.  Don’t be afraid to pass on any of these things.  there will always be another one.

    in reply to: Fair Market Valuation Advice #246493 Reply
    Avatar HandFellow 
    Participant
    Status: Physician
    Posts: 210
    Joined: 01/18/2016

    You will likely have an easier time getting a loan, if in fact you have to secure one yourself, if you don’t have 45k in credit card debt outstanding.  Don’t worry about the future buy-in mechanics if you have that much in student loans and credit card. The most important thing for your future will be how fast you pay off your debt; it will be a sign that you don’t grow into your income too quickly, especially considering how poorly you did in the past (45k cc debt).

    Avatar HandFellow 
    Participant
    Status: Physician
    Posts: 210
    Joined: 01/18/2016

    Overhead of 15-20%?  Sign me up!

    in reply to: Help evaluating 2 job offers #244382 Reply
    Liked by Zaphod, ENT Doc
    Avatar HandFellow 
    Participant
    Status: Physician
    Posts: 210
    Joined: 01/18/2016

    My vegetable garden is 4 rows of corn,  a giant pumpkin, row of tomato and green peppers.  All are producing well, but the peppers are a bit weak.

    early season planted peas, beets, carrots, and onions.  They all produced wonderfully and are done.

    the weeds this year has been insane.  It’s like Jumanji out there.

    I dont bottle or can.  if i dont eat it them when i pull them, im not going to eat it

    in reply to: Gardens #243772 Reply
    Avatar HandFellow 
    Participant
    Status: Physician
    Posts: 210
    Joined: 01/18/2016

    It’s ridiculous to think that your attorney is going to go in guns blazing and offend everyone she talks to.  You’ll have conversations about how aggressive you want the negotiations to be and what you’ll be willing to sacrifice to get a concession.  Negotiations are part of the game in any contract and they are to be expected.

    I am the absolute worst negotiator I know.  I give in way too fast the second I sense that the other party is uncomfortable or if I am uncomfortable, so i would much rather have someone else be in that position for me.  I think that is the role of using the attorney.

    As I said earlier, I would hire out the contract review portion first and then make the decision later about negotiations.

    in reply to: Physician Contract Negotation #243031 Reply
    Liked by Tim
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