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  • Avatar SValleyMD 
    Participant
    Status: Physician
    Posts: 449
    Joined: 05/12/2016

    I disagree.

    Imo the concept of nursing “experience” is vastly overrated.

    I’m not sure how the current state of nursing really prepares them to diagnose and treat. Sure it’s some exposure to a handful of things but I really don’t thing the carryover is that significant. Most are also in completely different settings (outpatient, specialty) as well.

    We’ve had better luck with fresh ones that are trained up . That’s probably anecdotal

    I think it just comes down to the individual and they type of direct supervision they get in their early NP years.

    Avatar SValleyMD 
    Participant
    Status: Physician
    Posts: 449
    Joined: 05/12/2016

    If EM I think you could pull it off no problem

    My biggest concern would be commuting as others alluded to as the places you will likely want to live can be a fair distance away from where u work, but most EM are only working 10-14 shifts a month with some random and weekend start times, so it’s not like you’re grinding away at the 7-8 am commute 5 days a week

    Try and keep the house as reasonable as possible for the area and I’m sure you’ll be fine.

    in reply to: Northern California #238139 Reply
    Liked by MDaware, SLC OB
    Avatar SValleyMD 
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    Status: Physician
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    Joined: 05/12/2016

    I like the idea.

    The fly down for one case seems a little silly but group 4-10 cases together, pay cash and I can see how that’s appealing

    in reply to: NYT: Total knee arthroplasty in Mexico #237966 Reply
    Liked by hatton1
    Avatar SValleyMD 
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    Status: Physician
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    Joined: 05/12/2016

    Sorry, a little confused..

    Are you a general cardiologist (that also does some primary care)?

    If you’re a cardiologist, share what u take home at the end of the year and I can give u a ballpark of what u likely would pull in employed..

    in reply to: Thoughts on Selling Private Practice #237792 Reply
    Avatar SValleyMD 
    Participant
    Status: Physician
    Posts: 449
    Joined: 05/12/2016

    I wouldn’t think twice if that’s what you want to do

    3 years is less than many IM sub specialties

    Just look at it like you’re doing a fellowship.

    in reply to: Specialty Switch #236401 Reply
    Avatar SValleyMD 
    Participant
    Status: Physician
    Posts: 449
    Joined: 05/12/2016

    Tell them it’s 30k less than what they stated..

    in reply to: Letter of Intent Base Salary #236167 Reply
    Avatar SValleyMD 
    Participant
    Status: Physician
    Posts: 449
    Joined: 05/12/2016

    You obviously need to know your $ per rvu then it’s all about what your expected production is going to be, what the boss man wants it to be and what you want it to be..

    You need to be on the same page as all three

    1. Regardless of whether u want to crank rvus you still want to be efficient.. how many rooms do I have, how quickly can MA room, how much support with nursing for paperwork, how are new patients divided up, how many new pts are out there, etc

    2.. sometimes boss man actually doesn’t want u to be busy (I know sounds stupid but it’s true).. They hate outliers. They don’t want others saying you’re too busy or busier than them. They often don’t want u hitting high income numbers.
    They don’t like the 90% rvu guys hitting 90% production

    3. How busy do u want to be.. can u hit your income targets based on your conversion factor and expected work. Can u psychologically take time off when you’re eat what u kill and “losing” $ wity each day off. Do u have the potential practice growth to hit the numbers u want..

    in reply to: What do you need to know for a wRVU based job? #236063 Reply
    Liked by MaxPower, Tim
    Avatar SValleyMD 
    Participant
    Status: Physician
    Posts: 449
    Joined: 05/12/2016

    i cant imagine trying to find a job in nuclear medicine in today’s day and age..

    Avatar SValleyMD 
    Participant
    Status: Physician
    Posts: 449
    Joined: 05/12/2016

    Another vote for anesthesia based on your description

    Avatar SValleyMD 
    Participant
    Status: Physician
    Posts: 449
    Joined: 05/12/2016
    Splash Refinancing Bonus

    I had to laugh at panscans “dangerous doctor list”

    Let’s see how that goes. I love residents.

    It did remind me when I was a naive new doc and I actually wrote down all the crazy stuff I saw from my partners as I though they were all idiots and felt I needed to record it..

    I then realize there will soon be a new crop of docs who think I’m a complete idiot.. and that mistakes can happen to anyone.

    As long as u aren’t the one running the dept “bad docs” can be a good thing. It keeps admin focused on them. As long as I’m seen as “better/safer” then hopefully they get fired before me.

    in reply to: Anyone moonlight as an Expert Witness? #235403 Reply
    Liked by Lordosis, Zaphod
    Avatar SValleyMD 
    Participant
    Status: Physician
    Posts: 449
    Joined: 05/12/2016

    “One doc practice with the office manager being the spouse.”.. that sentence would make me more nervous than about anything out there. I’m full partner from day 1 or I’m not touching that with a 20 foot pole.

    Avatar SValleyMD 
    Participant
    Status: Physician
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    Joined: 05/12/2016

    I would ask for 50k…

    Funny thing in my specialty is that my/our worth decreases each year (my anecdotal experience). The most “valuable” guys are the new fellows. Each hospital would LOVE to snag them. Not sure if experience just means baggage or entitlement to admin which rules the world but the longer you’re out or the older you are the more on an uphill battle u have from what I’ve seen

    in reply to: Negotiating sign on bonus, not using recruiter #234142 Reply
    Liked by Zaphod, Peds
    Avatar SValleyMD 
    Participant
    Status: Physician
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    Joined: 05/12/2016

    I would wait a year but then would have no problem pulling trigger on a 1-1.2m house.

    in reply to: How much house? #233724 Reply
    Avatar SValleyMD 
    Participant
    Status: Physician
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    Joined: 05/12/2016

    I go first name.. then just end it with my first name only.

    I Always thank them or say good catch. Tell them to call or text if anything comes up and I put my cell in there. . Love my mid levels. They keep me a float.

    in reply to: How to address NPs and PAs in letters #233660 Reply
    Avatar SValleyMD 
    Participant
    Status: Physician
    Posts: 449
    Joined: 05/12/2016

    None.

    Grew up in a country club lifestyle. Played college sports (which as many know is a full time thing) so combination of that resulted in me being a bum when it came to working.

    in reply to: How many paid jobs did you have before being an MD? #233554 Reply
    Liked by hatton1, CM, bean1970
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