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bloh

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Everything posted by bloh

  1. I wasn't totally certain that sharing this much information was a good idea but then the more I thought about it, the more I realized that I would have appreciated seeing something like this 3-4 years ago. This is a snapshot of my finances with monthly statements going from ~180,000 of debt to zero net worth. It starts from first day of residency until January 2018. My hope was that I'd be able to shave some of it off during residency but it just wasn't realistically possible because I didn't want to compromise QOL. For reference, I'm a GP. I work in a major city but did spend about 10 weekends including 2 full weeks rurally. I didn't keep track but I worked ~5.5-6 days/week with 4 weeks vacation. Columns Chequing - $ in my chequing account Visa = $ owed on VISA LOC = $ owed on LOC Total Debt = self explanatory Monthly change - Change in debt that month Investing - $ used to invest in the stockmarket. For the calculation, this was a wash. However, if I actually used the current value of investments, my debt was "paid off" much sooner than shown. Student loan - $ owed in student loans Taxes YTD - Projected $ owed for taxes. I approximated 0.45 of gross income.
  2. How do you determine the "difficulty"? I've intubated people, put in central lines, treated STEMIs, reduced fractues and have listened to people cry how Brenda at work is giving them a hard time week after week. I find the last issue the most difficult one any day of the week. I still infrequently have to do the former but would do that over the last 10 times out of 10. And it's not reflected in the pay, whatsoever
  3. Ok for the sake of an example, let's say you are a cat and your farts meow.
  4. bloh

    Family Medicine Income

    Sure, they're not universally pushing it. In alberta, 8% of GIM bills more than 1M while 39% of cardiologists bill more than that. The ones that are doing it are the interventional ones but a good chunk of those are also people running cookie-cutter risk-stratification clinics that order the same work-up for absolutely everyone.
  5. bloh

    Family Medicine Income

    Good for you! Your GIM colleagues are pushing 1M though, running the same treadmill/echo +/- MIBI scans on everyone that comes through the door with less hours than you My first full year was $390k pre-tax. Second year will be $360k. But I work hard, with clinic, walk in, LTC, hospitalist + emerg weekend locums and close to 5.5-6 days a week in Alberta.
  6. Are we really going through this again? Can't someone bring up the 90s where there was a huge drain to the states? There definitely has to be some sort of equalization between sections but cutting everyone is just going to fuck shit up.
  7. bloh

    fam med vs gen dent salary

    I work in a FFS model. 40-45 hours a week with an added weekend out of the city about once a month. 60% family practice, 30% walk in, 10 % LTC. Out of town work is all emerg.
  8. bloh

    fam med vs gen dent salary

    While the median would be a better measure, an average of all the MDs in Ontario is a lot more accurate then your anecdotal "evidence" of a bunch of people you asked in person. For the record, I net 30k/month in AB.
  9. bloh

    Consultation Fee as a GP

    It really depends on the province. In alberta it's about 65$ + x. They're not a bad thing if you set up a niche for yourself. I do all the joint injections in my clinic which others refer for; and it ends up being more because you also bill for the procedure.
  10. The first post in this thread is not my personal experience over the last 2 years of practice. My main place of work is a large city in Alberta but I've done everything except obstetrics. In order of best paid to least: -Emergency/Urgent care on a weekend, evening or statutory holiday -Efficient LTC, ~10 patients/hr (although the added billing crap you have to do afterhours ruins the experience) -Busy walk in clinic -ARP hospitalist, ARP LTC, ARP anything (it's a set hourly rate). Anecdotally, hospitalists often "bill" for more hours then they normally work. -Efficient clinic booking 4 patients an hour -Emergency/Urgent care on a weekday -Extenders, surgical assists Obstetrics is a bit tricky because they often have different shifts. Some do 24 hours shifts, others 12 hours, some are nights which screw your following day, some are on weekend, etc.. so I don't know how it washes out in the end. On a per shift basis, it certainly is good but you have to look at the complete picture. With cosmetics there's a huge variation in income. For it to really be profitable, you almost have to do it 100% and have a constant referral base. Even then, the difference between best paid and least paid on above scale is barely 100%, so do what you like and mix it up.
  11. I think it saddens me to see statements that "physical exams are useless". Something to keep in mind is that the vast majority of MDs in Canada practice in a clinic setting. I can't get imaging results or tests in a timely manner. It takes a day at best. When I see a patient it doesn't do me any good to send that patient to get xrays and bloodwork while they're struggling with SOB over the next few days. Physical exams, while not perfect, do give you confidence and direct you to a treatment plan while you wait.
  12. I don't think any residents have any ulterior motives. If they're sending you home, it's either because there's really nothing left to do (or there's scutwork that only they can really do) or because they want you to go because they're in a bad mood/not in the mood to teach/just want to be alone. Just go home. "Overkeeness" would be highly dependent on each resident/staff. For me, asking a million questions, just for the sake of asking questions "and looking interested" drove me nuts.
  13. You need to do some reflecting. Every single specialty in medicine gives you an excellent income. Focus on other aspects of the field or you'll be a miserable wreck and no richer than any of your peers.
  14. This is a common thing in FP. The best way to avoid this is to start with open-ended questions to get their story. Use focused "ROS" questions at the end. This is where FIFEing is actually really helpful in practice. "what were you looking to get out of this visit?" "what do you think all of this could mean?" At the end of the day, you do have to give them the benefit of the doubt. I'll even throw out stuff like "hmm a measured and documented fever for 2 weeks in your baby is usually worrisome that requires a visit to the hospital for investigations.... did they really have a temperature for the entire 2 weeks or did it break during that time". Sometimes they correct themselves, other times they don't. Most patients are wussies; even with forceful and purposeful questions they'll still skirt around the issue and not ask for what they really want.
  15. That is false. You can claim and deduct travel expenses not from your primary work site. This will be different for different residents. FM residents can generally claim any location that's not their primary clinic. Hospital-based residents can generally claim everything. It's a term of your employment but you are not reimbursed for it. Thus it's your own personal expense and is deductible. Work will have to give you a form stipulating that they don't cover your expenses and that it's mandatory for you to visit other sites.
  16. bloh

    Family Medicine Salary

    100k+ in government is very easy. Just look at the various sunshine lists. And what you don't take into account is the generous pension and benefits. Most can easily retire rich at 55, barely having worked their life. Government pays very well. FFS models are common across the country, because the government can't afford to pay MDs a salary.
  17. bloh

    Clinic overhead/Joining a practice

    You would need a bare minimum of 2 support staff in a 2-MD clinic. You need someone to answer the phone, check-in people and book/cancel appointments. And you need someone to room people. I know that on evenings where I work with a 2nd MD, the nurse + receptionist really scrambles to keep up with us. Ideally you need 3, because there's a lot of other stuff that happens and you'd need other people to handle referrals and all the other bullshit. This is why 1-3 MD clinics are not common and not profitable unless there's no other way
  18. I claimed the mileage for driving to each of my work sites.
  19. I agree with everything above. People try to minimize the 'age factor' but the truth is, the age matters. It's harder to study, it's more difficult to work long hours and your cohort is at a different stage of your life. All of this makes a tremendous impact on your well being and isolation. I wasn't much older, but even <5 years makes a difference. I get the hint that motivation here is largely driven by dissatisfaction in current career. Fine, switch careers. Consider nursing. Consider MBA or another designation that will allow you to switch an area but make you happier. But going down this route is going to be exceptionally risky and difficult. There is even suggestions that medical school spots will be cut back given the CARMS situation which will make an already difficult situation worse. I wouldn't do it.
  20. Of course it's sketchy. There's no evidence to any of his garbage. It's a extremely low calorie diet supplemented by unnecessary potions to give you the wonderful placebo effect. No one keeps the weight off.
  21. Can you guys stop feeding the troll? He lived at home his entire training and was likely surrounded by other similarly privileged kids. Stick to the facts, which says the average debt is 160k https://www.doctorsofbc.ca/news/facts-cost-becoming-doctor
  22. You're welcome to come and report back in 2022, medical student. I never once mentioned "time-consuming". There's more to preclerkship than that. The uncertainty about the future, stress, and having your life out of control all adds up over the years. It may not seem like it in the moment, when you're there observing other people taking blood pressure but I guarantee that the journey adds significant burden over time.
  23. Denial in medicine is very prevalent but ok. Believe what you believe.
  24. Preclerkship may not be disruptive at 22, but it is at 30+. Unless you're a still a single child with no responsibilities.
  25. This would be fine. Some of us do CBT already. You would be able to bill the government for those services. In Alberta you'd be able to bill about 200$ for a 53min face to face session. I see no conflict of interest here at all, but you'd have to be clear with your patients that a booked CBT/pscyh session is for psych and psych only. No checking labs, sore wrists, etc. Or it would drive you crazy. EDIT: As an aside, and keep in mind it's my opinion only, this would be a terrible idea. You already have a job that you enjoy and going through years and years of training is a waste of your precious life. There's more to life than work and to think that you'd have to train and study for 6 more years or more and put your friends and family on hold just makes me nauseated.
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