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Everything posted by bloh

  1. 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.
  2. 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.
  3. 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.
  4. 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
  5. I claimed the mileage for driving to each of my work sites.
  6. 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.
  7. 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.
  8. 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
  9. 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.
  10. Denial in medicine is very prevalent but ok. Believe what you believe.
  11. Preclerkship may not be disruptive at 22, but it is at 30+. Unless you're a still a single child with no responsibilities.
  12. 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.
  13. bloh

    Income taxes

  14. bloh

    Unfilled carms spots

    When I was going through CARMS many years ago, a few programs would outright not give you an interview if you didn't do at least a 2 week FM elective. I can't think of anything more indicative of a back-up applicant than that, and it's very reasonable. I feel very bad for all the applicants going through CARMS right now as it seems to be giant zoo.
  15. In Alberta, a GIM consult/admission is 200$. 250$ if after 1700 350$ if after 2200 It all depends on how many patients you see. It's much easier to make money in community hospitals are patients are simpler but the pay is still the same.
  16. Yeah this stuff is fairly straightforward if you've been involved in filing your taxes. I'm guessing you haven't...:) Better catch up!
  17. You can look at my thread below to see that it isn't that scary. I started with about $180,000 and paid it off in less than 2 years with no parental support. I worked hard but also didn't sacrifice QOL; only thing would be is that I still drive a shitty car. We did 2 large overseas trips, yearly caribbean excursions about half a dozen trips through North America. \
  18. We all had to do it. Which is why net income per day is the most relevant statistics and it shows absurd variability between groups. The ability to 'scale' is at best a minor issue but most likely a fallacy. If that was true why is the wait time to see an ENT surgeon for tinnitus in my city now more than 6 months? Those are non-surgical issues that they see merely to comfort patients, because they somehow don't believe the truth when they hear it from a non-specialist.
  19. I do 72 hour call shifts at least once a month. And I don't have resident scutmonkeys to help me. Thank's for assuming things. Also, no one I know does 12 hour work days as a GP and it's for an exhausting reason that you can't appreciate. I would work 2-3 days a week to make an equivalent 5 day income anytime. That's the part you don't get. That someone's time is worth exponentially more
  20. 1. They are the same tax credits. You get more during residency and you can start using them to reduce your income tax. You'll probably have enough to credits to pay $0 tax in PGY1 2. Yes, they're income 3. It shouldn't be much different than what you lived off as a medical student
  21. Most of what you said is incorrect and I wish people with no real work experience would stand on the sidelines and just listen in. I do comprehensive family medicine in a large city. On a weekly basis I have my family practice, a few walk in shifts and a half day in nursing home. On weekends I do hospitalist and emergency room work. I keep detailed track of what I earn and where it comes from. In the order of earning capacity, it goes like this: 1. Emergency room work - strictly because it's weekend work in a remote location. You get stipends for being on call, you get afterhour premiums and all your procedures are boosted. If you do a daytime shift in the city, you will be making less than clinic work. Not only do you miss out on all the premiums but there are also inefficiencies in the triage system, having to clean the room, prepare the chart, etc. 2. Busy walk in shift 3. Family practice = nursing home 4. Slow walk in shift The figure I posted that shows net DAILY payments between specialists is the most relevant statistic you can look at it. Looking at medians, averages, etc all of that is difficult to interpret because of variable practices. But knowing that a surgeon makes $1400/day vs a GP at $800/day is all you need to know. It also tells you what you may be able to make depending on how much you work. This is how everyone else in society compares jobs. They will all value a job that pays $14/hour than one that pays $8/hour. They realize that their friend may be making $2000/month but also appreciate they can make just as much by working 50% less shifts, since their hourly pay is 14$ and not 8$
  22. 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.
  23. It's not true because it's based purely on billing statistics for Alberta physicians. They're all non-part time physicians, billing at least 100k+ and working a set minimum number of days. Are you suggesting the data I provided is faulty in some way? "How efficient are they?" Do you understand averages? Or are you stipulating that the data is representing non-efficient GPs or overly-efficient surgeons? "Bonus private billings?" This stuff (insurance letters, other notes, etc) makes up less than 5% of a GPs income and trust me when I say that it's more tedious work and it doesn't make more than FFS billings would take. It's also shit That's regularly done outside business hours
  24. That isn't true. Also the image you provided isn't the most appropriate; the one below is. It's from the same document you drew yours form and it standardizes to training time and overhead. In order for a GP to "catch up to a surgeon's 5 day/week pay", he or she would have to work 8.4 days/week.
  25. I'm still working the same hours since I still technically have to pay the debt off and save for a downpayment. Will probably dial down to 4-5 days/week sometime next year.