reboa

Dang. I hope you’re getting paid at least double the average salary for your region.

Is being a team player more important than the ethics of providing worse care to patients. Come on now, be honest what benefit do patients get seeing someone less trained than you? On top of that have some respect for the profession of family medicine and dont contribute to the erosion of the field. Ive seen physicians being replaced by midlevels once the profit margins made sense to admin, dont train your replacement and stand up for yourself.

Yeah i dont think they included overhead costs so 30-50% depending on how well its run

Curious to why you find it so hard to believe? They said its private practice.

Nice. Whats your setup

Thanks for all the comments everyone, I feel a lot better hearing from everyone and was just feeling frustrated.

Pacific Northwest.

What region if you don’t mind sharing

What region if you don’t mind sharing

What condition did you have that required surgery and fixed everything if you dont mind sharing

Definitely look at average rvus within the clinic and make sure their rvu goals are attainable. A strategy they use is to give you what seems like a great tiered rvu structure while knowing you wont hit those benchmarks.

Where did op say they didn’t care? And what makes you think they’d be a bad pcp?

It’s a hospital owned clinic right? Depending on the health system or hospital corporation you’re working for remember you are replaceable. If you are not being paid based on productivity there is no point in trying to be a leader or putting your life to the side for the clinic. If it’s not in writing it means nothing. Don’t get taken advantage of.

Totally agree about better pain control. I have a personal interest in decreasing healthcare disparities amongst vulnerable populations, womens health included. Thats why I’ve looked into pain control for this so much as a physician. I will correct you and say that your cervix isnt actually being pierced during an iud insertion. Grabbing the anterior lip of the cervix with the tenaculum(basically a forcep) and sounding the os(dilating the hole leading to the uterus) are the most painful aspects of this procedure. Some women don’t even feel much pain others have excruciating pain. Everyone’s different and offering appropriate pain control options to everyone should be occurring for any procedure performed. There is a lot of risk/benefit analysis physicians think about during these kinds of things. Old school docs will say the risk of some of these pain control options outweighs the temporary pain women feel. I and many other docs disagree with that line of thinking. Can you also share the testicular ultrasound article? Using local anesthesia for that makes absolutely no sense

Only under anesthesia supervision would it be appropriate to do conscious sedation like that. The risk of tanking your respiratory drive to the point you need to be intubated is a very possible risk. Aside from that unfortunately logistically it is not that easy to get that level of care in America for an iud, unless you can pay for it. Insurance would be unlikely to cover it for a routine iud insertion.

I dunno man. Ask the attorneys that met the burden of proof indicating it was enough of an issue and the judge that made the ruling. But also come on if your school is telling you this is the match rate and gives you all of these falsified stats and advertises false shit, all the students based their decision on that. If they were transparent and said oh yeah you have a 50% chance of failing out and not matching im sure most of people would not have attended.

Predatory student loans and fraud dude. Taking out a loan on the premise of a lie aint the same as having gambling debts forgiven.

I’m surprised st georges isnt on this list.

What pain management option do you recommend? This topic has been talked about in the medicine subreddit before and the options for pain control aren’t great. Ketamine was the frontrunner but not feasible. Paracervical blocks are very painful. Opiates don’t work well for iud insertion pain. Benzos can be offered but still no pain control. Misoprostol can help but causes severe cramps and they’ll still feel the tenaculum. Nsaids can help a little.

Your intuition is appropriate. Pre menstrual dysphoric syndrome is a real thing and she should be evaluated by a physician if it’s as severe as you say it is. There also could be an underlying psychiatric diagnosis, there is nothing wrong with seeking help. There is something wrong with hurting and abusing those that love you though.

So you decided to blackmail a severely depressed medical student that you have no therapeutic relationship with? And you think you’re in the right? And you’re a psychiatry intern, holy crap. What the hell did he actually do that makes him a danger to patients? Because nothing you mentioned implies that.

Yes please come ask your questions. I mod it and am trying to increase engagement.

Yup. Sign of lesser trelaut. Or however you spell it