GenesisCare filing for bankruptcy

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Lots of my friends from upper-middle class families went to medical school.

None of my friends from truly wealthy families went to medical or law school. Finance degrees. Every one of them.
Fleishman Is In Trouble touches on this

People in the upper upper class don’t do this type of work. You think a Soros or a Trump is gonna have half a fist up the bunghole when they can just leverage and exploit?

No Parikh that descends from my line will engage in this type of “manual labor”! Unless they want to. Then they can.
 
So true. The true heroes of our economy are the capital allocators and their accountants and lawyers that protect their assets from the tax man.
Been this way since the 80s.

The heros are the so called “risk takers” but only certain risk takers and not the ones that do actual work in the real economy.
 
I've had quite a few old money friends from undergrad and grad school.... and, given the choice, I would choose my life over theirs, without even thinking twice.

It is very hard to be happy and fulfilled when you have everything you want without having to work for it. After all, what's the point in doing... anything?
 
So true. The true heroes of our economy are the capital allocators and their accountants and lawyers that protect their assets from the tax man.
Doing god's work

 
I've had quite a few old money friends from undergrad and grad school.... and, given the choice, I would choose my life over theirs, without even thinking twice.

It is very hard to be happy and fulfilled when you have everything you want without having to work for it. After all, what's the point in doing... anything?

Maybe you're a better person than I am but I would 100% take the old money life. I'm certain I can find ways to be happy and fulfilled as a multi-millionaire who doesn't have to work.
 
Fleishman Is In Trouble touches on this

People in the upper upper class don’t do this type of work. You think a Soros or a Trump is gonna have half a fist up the bunghole when they can just leverage and exploit?

No Parikh that descends from my line will engage in this type of “manual labor”! Unless they want to. Then they can.
The real rich kids start businesses and say they earn what they have…except that they never admit their trust fund is a giant safety net if the business fails.
 
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Banks are critical to a functioning economy. We just need to bring back the Glass-Steagall act to Make Banking Boring Again.
 
Banks are critical to a functioning economy. We just need to bring back the Glass-Steagall act to Make Banking Boring Again.

Cats out of the bag with that one. GS act never coming back. Big finance would basically crash the economy on purpose if it came back.
 
Ah memories


IMG_2663.jpeg
 
Only indirectly related to bankruptcy but anyone know why a PPS exempt center would apply FAST FORWARD data to mastectomy patients only to cause breast reconstruction complications? For the record, there were barely any mastectomy patients on the trial and even fewer implant reconstructions.
 
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Only indirectly related to bankruptcy but anyone know why a PPS exempt center would apply FAST FORWARD data to mastectomy patients only to cause breast reconstruction complications? For the record, there were barely any mastectomy patients on the trial and even fewer implant reconstructions.
Because if they hadn’t used five fractions patient would go elsewhere?
 
I've never worked academic, but I feel like most community hospital jobs are like this, with more pay and less responsibilities to do stuff. I feel like this used to be one of the worst options - this is how I ordered it in my head when I graduated.

1. Freestanding private
2. PSA community hospital
3. Employed academic satellite that pays like community
4. Employed community hospital
5. Academic satellite that pays academic
6. Academic job

Now, 3 doesn't exist. 1 is tenuous and works well in some places, terrible in others. 2 only works with high volume - I would be a poor if I did that here. I think employed at a hospital with a base plus model ends up being what most of us stumble into.

I know there are many truly horrendous stories, but there is something still happening. I don't get it. We will never return back to the golden era, but hospitals are ponying up. All 3 grads at one of our local programs are starting at >2x my first year starting salary. The grad from another nearby program had an offer of 600 not terribly far from Detroit (not a great job, but $$).

Anybody else's finger on the pulse? I am hearing mid career basing at 6 in decent cities.
 
LOL. #2 the key is, repeat after me kids, "1099 or GTFO" and whether its a community hospital, extended locums, academic satellite, it really matters not.

You LIKE giving up 15% tax efficiency? WTF. For a ****ty healthcare plan or some bs "vest in 3 years" retirement plan that matches 3% and puts your money in limited choice high cost funds controlled by your employer?

5-6 W2 in a major city where you are overworked, stressed, micromanaged by dickheads and can get replaced in a heartbeat?

Desus And Mero Pass GIF by Bernie Sanders
 
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I've never worked academic, but I feel like most community hospital jobs are like this, with more pay and less responsibilities to do stuff. I feel like this used to be one of the worst options - this is how I ordered it in my head when I graduated.

1. Freestanding private
2. PSA community hospital
3. Employed academic satellite that pays like community
4. Employed community hospital
5. Academic satellite that pays academic
6. Academic job

Now, 3 doesn't exist. 1 is tenuous and works well in some places, terrible in others. 2 only works with high volume - I would be a poor if I did that here. I think employed at a hospital with a base plus model ends up being what most of us stumble into.

I know there are many truly horrendous stories, but there is something still happening. I don't get it. We will never return back to the golden era, but hospitals are ponying up. All 3 grads at one of our local programs are starting at >2x my first year starting salary. The grad from another nearby program had an offer of 600 not terribly far from Detroit (not a great job, but $$).

Anybody else's finger on the pulse? I am hearing mid career basing at 6 in decent cities.

#3 definitely exists in several networks. It seems more likely when people leave private/community practice to go to the academic satellite. Although, I know one center and pair of leaders that seem to think people should take pay cuts to go work for them 🤣 Delusional.
 
LOL. #2 the key is, repeat after me kids, "1099 or GTFO" and whether its a community hospital, extended locums, academic satellite, it really matters not.

You LIKE giving up 15% tax efficiency? WTF. For a ****ty healthcare plan or some bs "vest in 3 years" retirement plan that matches 3% and puts your money in limited choice high cost funds controlled by your employer?

5-6 W2 in a major city where you are overworked, stressed, micromanaged by dickheads and can get replaced in a heartbeat?

Desus And Mero Pass GIF by Bernie Sanders
Please tell me how i can treat 8 patients a day on a 1099 at a rural hospital and make more money than i do now - including tax benefits you speak of. Honestly. I'm looking at collections. My family would starve.
 
Grasshopper: You misunderstand. I never said anything about collections. I haven't done my own collections since 2009.

You get paid on a flat rate PSA. After all, no you .. no department. If its a solo shop, it creates leverage. If its that AND a rural location, its incredible leverage.


You know what my favorite flavor is?

Serious Lawyer GIF by Amazon Freevee



YESSIR ITS LEVERAGE. Its even better than chocolate.
 
Grasshopper: You misunderstand. I never said anything about collections. I haven't done my own collections since 2009.

You get paid on a flat rate PSA. After all, no you .. no department. If its a solo shop, it creates leverage. If its that AND a rural location, its incredible leverage.


You know what my favorite flavor is?

Serious Lawyer GIF by Amazon Freevee



YESSIR ITS LEVERAGE. Its even better than chocolate.
I'm misunderstanding. The PSAs I am aware of go by collections. Maybe I don't understand the terminology?
 
Grasshopper: You misunderstand. I never said anything about collections. I haven't done my own collections since 2009.

You get paid on a flat rate PSA. After all, no you .. no department. If its a solo shop, it creates leverage. If its that AND a rural location, its incredible leverage.


You know what my favorite flavor is?

Serious Lawyer GIF by Amazon Freevee



YESSIR ITS LEVERAGE. Its even better than chocolate.

You should talk to people in a PSA in a competitive market. They vaguely remember the concept of leverage but haven't talked about it since they became employed.
 
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Independent Professional Services Agreement. They agree to pay you Y per month, Y x 12 per year. Maybe throw in also a 4 or 5 week vacation coverage (ie your locums coverage when you are really away on vacation).

RVU? Lol.

You provide your own medmal, set up your own health ins, and do your own retirement plan. Nobody can mess with them, and you can form a group (of 2 people!) and boom, you have access to the "good" insurance (e.g. BCBS).

There is just so much more.. but suffice it to say:

Once you go into 1099 land, you will never want to leave..