I like treat and street patients

[Angry Birds]

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I’ve started to dislike admissions due to needing to beg people for admission and all the talking down that happens. Meanwhile treat and street patients are usually more rewarding especially if you fix them.

I especially dislike taking care of very old patients. And sometimes I also miss things on complex medical patients due to not having time to look through the chart and thinking it through, which results in more talking down by admission team or consultants.

I realize I’m an urgent care doc working in an ER. A sad thing I suppose but it is what it is.

 

[RustedFox]

The rot consumes.

 

[thegenius]

I’ve started to dislike admissions due to needing to beg people for admission and all the talking down that happens. Meanwhile treat and street patients are usually more rewarding especially if you fix them.

I especially dislike taking care of very old patients. And sometimes I also miss things on complex medical patients due to not having time to look through the chart and thinking it through, which results in more talking down by admission team or consultants.

I realize I’m an urgent care doc working in an ER. A sad thing I suppose but it is what it is.

I just want my patients to have any one of the 150 true medical emergencies that exist. I like taking care of real chit. The next best group are routine urgent care crap like ankle sprains, etc. I get most disgusted with people who have absolutely no business coming to the ER, including every single tube that falls out, no one can fix me so you have to, med clearances, and about 84 other categories.

 

[CoolDoc1729]

Most of the time we are urgent care doctors working in an urgent care. I share your fatigue with the complicated trainwrecks even though my hospitalist staff basically doesn’t ever push back with me anymore. It’s exciting for a while, but then it’s just a drag when you’re kind of doing the math in your head of what time you can leave and then some unresponsive nursing home friend rolls in 🤣

 

[WhatJobDoIPick]

I just want easy dispos on reasonable patients.

Be fast; be perfect; satisfy the customer.

You can't do all three.

It's a dying field.

 

[Angry Birds]

Just took care of a critical care patient and had a blast. So, I’m going to amend my statement. I like treat and street and also those patients who are so sick no hospitalist can deny the admission.

I also think I’m just feeling extra cranky nowadays due to a bad hospitalist on this week.

 

[oldtown]

I’ve started to dislike admissions due to needing to beg people for admission and all the talking down that happens. Meanwhile treat and street patients are usually more rewarding especially if you fix them.

I especially dislike taking care of very old patients. And sometimes I also miss things on complex medical patients due to not having time to look through the chart and thinking it through, which results in more talking down by admission team or consultants.

I realize I’m an urgent care doc working in an ER. A sad thing I suppose but it is what it is

Agreed. Give me a whole shift of ankle sprains, URI’s, uncomplicated UTI’s, etc. The less thinking I have to do and the more straightforward, the better. Oh yeah, no procedures either.

Med students, pay attention to this thread if it goes the way I think it will go. Everything that seems so cool about EM early on (procedures, really sick patients, undifferentiated patients, difficult problems to solve) just becomes a big burden and time/soul suck by the time you reach my stage (PGY 18).

 

[CajunMedic]

Getting that way myself. I'm particularly fond of anything I can 86 out of triage. Best recent door to dispo time has been 6 minutes. (URI that is spreading through the schools like wildfire. Was the 6th one I had seen that shift)

I don't have urology, GI, nephrology, OB, intensivists. The general surgeon is overworked. Ortho is amazing. My biggest time suck are the transfers. Pretty much anything else I'm stuck trying to send out and if i'm lucky, I've got unit coordinator to make the calls for me. Even luckier if I can get transport out.

Oh, And I can't tell you the last time I got paid on time...

 

[HemorrhagicShock]

Agreed. Give me a whole shift of ankle sprains, URI’s, uncomplicated UTI’s, etc. The less thinking I have to do and the more straightforward, the better. Oh yeah, no procedures either.

Med students, pay attention to this thread if it goes the way I think it will go. Everything that seems so cool about EM early on (procedures, really sick patients, undifferentiated patients, difficult problems to solve) just becomes a big burden and time/soul suck by the time you reach my stage (PGY 18).

I'd say you're lucky it took you 18 years to reach it

I couldn't even last a single digit number of years

EM is such a stupid waste of a career for an MD/DO. At least in yesteryear you could FIRE pretty quickly. Current graduates are screwed unless they bail into CCM or pain.

 

[CoolDoc1729]

Wanted to add:

Procedures people think we do : intubations, lines, lumbar puncture, deliver babies, fracture/dislocation reductions. We do some, certainly enough to maintain proficiency.

Procedures we actually end up doing frequently: abscess I&D, lac repair, thrombosed hemorrhoid, dental block, replacing tubes that fall out (SP cath, PEG, foley, trach, laryngectomy, etc ), some reductions

Medical care in some ways has gotten better. Many people who would have gotten intubated can be managed with BiPAP. There are meningitis vaccines. CTs are better and better. Peripheral pressors. Etc. yet the access to care is getting worse, so we end up doing minor things for people who should go to urgent care if they had insurance or the urgent care didn’t close before they get off work.

Another thing to keep in mind for the med students considering EM.

 

[Janders]

I’ve had similar thoughts, and my simplified version is I like acute things.

Acute critical care? My fav!
Acute urgent care? I don’t mind!
Acute exacerbation of a chronic problem? Sure thing!

Chronic issue chronically bothering you chronically not diagnosed by a dozen chronic specialists but I need to solve it tonight at 0100 in a community ED with minimal specialists? Eh. No fun. I’m not good at this. Patient unhappy.

I particularly enjoy patients with acute mild things who apologize for coming, but truly didn’t have a reasonable alternative (PCP appointment in 6weeks, UC not open), and have strep throat or a small abscess or a chipped distal fibula. I’m good at this, it’s quick, I totally don’t mind, and I can give good service. I’ll take 12 of those and 6 truly sick people and call it a day thanks.

 

[AlmostAnMD]

I'd say you're lucky it took you 18 years to reach it

I couldn't even last a single digit number of years

EM is such a stupid waste of a career for an MD/DO. At least in yesteryear you could FIRE pretty quickly. Current graduates are screwed unless they bail into CCM or pain.

Not a fair comparison if it makes you feel better

In my region, pre-covid em and post-covid em are night and day. Pre-covid I was planning on buying in and working decades. Post covid I started looking for exit plans.

 

[EMhawkeye]

the soul sucking:
Headache for one day
Took nothing before they came
Sitting in a hall chair texting

 

[HemorrhagicShock]

Not a fair comparison if it makes you feel better

In my region, pre-covid em and post-covid em are night and day. Pre-covid I was planning on buying in and working decades. Post covid I started looking for exit plans.

Agreed fully

Half of my EM years were before COVID ("the golden era") and there's nothing anybody can say that would convince me that they're the same job.

Two totally different careers if you ask me.

What saved me was investing aggressively, early, and broadly. VTI/VOO and chill. Bought real estate at the right time, used it as a tax offset, and now I'm at the point where I can say "F you" to EM.

The problem is.... what to do now?

I like being a physician, though nothing else appeals to me that doesn't require excessive amounts of work to achieve.

 

[AlmostAnMD]

Agreed fully

Half of my EM years were before COVID ("the golden era") and there's nothing anybody can say that would convince me that they're the same job.

Two totally different careers if you ask me.

What saved me was investing aggressively, early, and broadly. VTI/VOO and chill. Bought real estate at the right time, used it as a tax offset, and now I'm at the point where I can say "F you" to EM.

The problem is.... what to do now?

I like being a physician, though nothing else appeals to me that doesn't require excessive amounts of work to achieve.

Not quite FU money yet but investments are coming along nicely.

I did what a few other EM docs have done, went into advising. It's more chill, no nights/weekends, no medmal. It was a 25% paycut to do it FT but the intensity of work is 99% less and feels more sustainable.

 

[HemorrhagicShock]

Not quite FU money yet but investments are coming along nicely.

I did what a few other EM docs have done, went into advising. It's more chill, no nights/weekends, no medmal. It was a 25% paycut to do it FT but the intensity of work is 99% less and feels more sustainable.

Advising as in becoming a financial advisor? You went and got your CFP?

 

[AlmostAnMD]

Advising as in becoming a financial advisor? You went and got your CFP?

Rofl no

The Physician Advisor: A Nonclinical Career Within A Hospital System

What this nonclinical career entails and how to get started

www.physiciansidegigs.com

I saw two options

Suffer in the ed forever, even just part time

Or do something different that doesn't make me angry

I chose option 2, option 1 would put me in an early grave. I haven't been doing it long enough to do a full write up but I get the sense I can do this for 30 years and not die early. Or just keep doing it even if my investments pay off since it's not stressful.

 

[WhatJobDoIPick]

Rofl no

The Physician Advisor: A Nonclinical Career Within A Hospital System

What this nonclinical career entails and how to get started

www.physiciansidegigs.com

I saw two options

Suffer in the ed forever, even just part time

Or do something different that doesn't make me angry

I chose option 2, option 1 would put me in an early grave. I haven't been doing it long enough to do a full write up but I get the sense I can do this for 30 years and not die early. Or just keep doing it even if my investments pay off since it's not stressful.

Always thought the "advisor" moniker was interesting. Are you providing advice, or merely telling pit docs what they can and can't admit?

 

[AlmostAnMD]

Always thought the "advisor" moniker was interesting. Are you providing advice, or merely telling pit docs what they can and can't admit?

I mostly talk to hospitalists and consultants and insurance directors. And coordinate with UM nurses. I don't think I've spoken to an ed doc once, not out of attitude or contrition but it's just not really what I do.

We aren't in the business of telling people what can be admitted. That would, as an ed doc, drive me insane. Admit whatever you want. My role is to figure out how to maximize revenue from the admission, flip as many from obs to full IP as possible and figut insurance when they argue it should be reversed.

Other docs on this site have done it. I'm so new I'm not a really good resource as I'm still feeling it out but 100% reduction in medmal and 99% reduction in stress with zero nights and weekends merits a 25% paycut, especially as my investments are growing nicely. I'm actually so new to this i just got my ACPA-C certification, an advising cert merit badge, this week. Like I said I'll write it up at some point to tempt y'all away from the abuse but I'm too new to speak authoritatively.

 

[EctopicFetus]

I am very friendly with a few local Phsyician advisors. The ones i know were OB, nephro and internal medicine before they did it. They seem to like it.. seems boring to me. I’ll say i found the unicorn. Very high pay at a sustainable pace (for me) and a group of people i like being around. I work clinically around 100 hours a month and do quite well. I have dabbled in investing, real estate etc. Have a few other ideas im working on but who knows.

 

[TooMuchResearch]

Just took care of a critical care patient and had a blast. So, I’m going to amend my statement. I like treat and street and also those patients who are so sick no hospitalist can deny the admission.

I also think I’m just feeling extra cranky nowadays due to a bad hospitalist on this week.

I can only think of one hospitalist who routinely tries to say no to admissions, and it's always some flavor of "at major academic institution where I trained we never admitted this." We aren't the major academic institution.

 

[TooMuchResearch]

Agreed. Give me a whole shift of ankle sprains, URI’s, uncomplicated UTI’s, etc. The less thinking I have to do and the more straightforward, the better. Oh yeah, no procedures either.

Med students, pay attention to this thread if it goes the way I think it will go. Everything that seems so cool about EM early on (procedures, really sick patients, undifferentiated patients, difficult problems to solve) just becomes a big burden and time/soul suck by the time you reach my stage (PGY 18).

The best shift is a rural shift where I see four patients. They're getting further and further apart though. Maybe I need to expand more rural.

 

[RustedFox]

The best shift is a rural shift where I see four patients. They're getting further and further apart though. Maybe I need to expand more rural.

I'm all for making more places more rural.
Maybe we need less people.

 

[Tiger26]

I mostly talk to hospitalists and consultants and insurance directors. And coordinate with UM nurses. I don't think I've spoken to an ed doc once, not out of attitude or contrition but it's just not really what I do.

We aren't in the business of telling people what can be admitted. That would, as an ed doc, drive me insane. Admit whatever you want. My role is to figure out how to maximize revenue from the admission, flip as many from obs to full IP as possible and figut insurance when they argue it should be reversed.

Other docs on this site have done it. I'm so new I'm not a really good resource as I'm still feeling it out but 100% reduction in medmal and 99% reduction in stress with zero nights and weekends merits a 25% paycut, especially as my investments are growing nicely. I'm actually so new to this i just got my ACPA-C certification, an advising cert merit badge, this week. Like I said I'll write it up at some point to tempt y'all away from the abuse but I'm too new to speak authoritatively.

Same here--I do about 20% of my FTE as a physician advisor.

 

[Angry Birds]

What the hell is a physician advisor

 

[Janders]

What the hell is a physician advisor

I’ve heard it referring basically to utilization management docs that work on the hospital side to help increase leveling and fight back against insurance company denials.

The fact we need a bunch of docs to do this and came pay them close to MD salary is so ridiculous.

 

[RustedFox]

I’ve heard it referring basically to utilization management docs that work on the hospital side to help increase leveling and fight back against insurance company denials.

The fact we need a bunch of docs to do this and came pay them close to MD salary is so ridiculous.

QFT.

 

[JAFERD_MD]

I’ve heard it referring basically to utilization management docs that work on the hospital side to help increase leveling and fight back against insurance company denials.

The fact we need a bunch of docs to do this and came pay them close to MD salary is so ridiculous.

At the risk of drawing ire from everyone, my side gig is doing UM on the payor (insurance) side. I am paid hourly, not incentivized to deny or approve, and my payor is publicly-funded (ie, your tax dollars). I agree that reform is needed but there are some crazy requests for payment from hospitals in my very short time doing this.

It is sad, though, that hospitals and insurance companies just employ doctors to fight each other over a pot of money.

 

[WhatJobDoIPick]

At the risk of drawing ire from everyone, my side gig is doing UM on the payor (insurance) side. I am paid hourly, not incentivized to deny or approve, and my payor is publicly-funded (ie, your tax dollars). I agree that reform is needed but there are some crazy requests for payment from hospitals in my very short time doing this.

It is sad, though, that hospitals and insurance companies just employ doctors to fight each other over a pot of money.

Riiiiiight.

Not incentivised to deny but, "Hey doc, can ya just take another look at this case, wink wink."

I assume you work for either Medicare or Medicaid. How's it feel to post-hoc deny payment to an ER physician while they are providing EMTALA mandated care?

1.8% CMS cut coming ladies and gents. All the while hospital facility fee reimbursement increasing. Wonder why? They want you employed; they want you enslaved; they want forced consolidation and to stamp out private groups. Their goal is one unified health system wherein none of us have any negotiating power.

 

[JAFERD_MD]

Riiiiiight.

Not incentivised to deny but, "Hey doc, can ya just take another look at this case, wink wink."

I assume you work for either Medicare or Medicaid. How's it feel to post-hoc deny payment to an ER physician while they are providing EMTALA mandated care?

1.8% CMS cut coming ladies and gents. All the while hospital facility fee reimbursement increasing. Wonder why? They want you employed; they want you enslaved; they want forced consolidation and to stamp out private groups. Their goal is one unified health system wherein none of us have any negotiating power.

I've never denied payment to an ER doctor. They never land in my inbox. I assume it just gets paid, because only doctors can deny. Sometimes I do overturn appeals from hospitals that a colleague initially denied.

I have denied the hospital who wants to be paid for 2 DRG admissions when the patient AMA'ed after 2hrs and then came back 6 hrs later. Lemme know if you want your tax dollars paying for two hospital bills.

I used to think what you wrote until I actually tried it out. I'm still not sure if I'll do it full time in the long run, but it has improved my documentation at my clinical job much better since I know what criteria they want for a full admission.

 

[WhatJobDoIPick]

I've never denied payment to an ER doctor. They never land in my inbox. I assume it just gets paid, because only doctors can deny. Sometimes I do overturn appeals from hospitals that a colleague initially denied.

I have denied the hospital who wants to be paid for 2 DRG admissions when the patient AMA'ed after 2hrs and then came back 6 hrs later. Lemme know if you want your tax dollars paying for two hospital bills.

I used to think what you wrote until I actually tried it out. I'm still not sure if I'll do it full time in the long run, but it has improved my documentation at my clinical job much better since I know what criteria they want for a full admission.

An ER doc had to reevaluate, a Hospitalist had to re-do the H&P, nurses had to re-insert an IV.

Yeah, we should be paid.

Patient being a dingus shouldn't factor into that.

So, pay us, or allow us to balance Bill and send them to collections.

 

[JAFERD_MD]

An ER doc had to reevaluate, a Hospitalist had to re-do the H&P, nurses had to re-insert an IV.

Yeah, we should be paid.

Patient being a dingus shouldn't factor into that.

So, pay us, or allow us to balance Bill and send them to collections.

Not when there's not even an H&P from the first visit. The hospital is not getting paid for 2 DRG hospitalizations. As an ER doc I'm annoyed AF about bouncebacks but the note takes me <2 minutes, there are no new labs and the hospitalist will copy and paste the H&P (or do it for the first time).

What's the cutoff then? Why not just conveniently tell a patient to go outside to have a smoke q8hrs so you can collect 3 hospital bills in a day?

 

[VA Hopeful Dr]

I've never denied payment to an ER doctor. They never land in my inbox. I assume it just gets paid, because only doctors can deny. Sometimes I do overturn appeals from hospitals that a colleague initially denied.

I have denied the hospital who wants to be paid for 2 DRG admissions when the patient AMA'ed after 2hrs and then came back 6 hrs later. Lemme know if you want your tax dollars paying for two hospital bills.

I used to think what you wrote until I actually tried it out. I'm still not sure if I'll do it full time in the long run, but it has improved my documentation at my clinical job much better since I know what criteria they want for a full admission.

It would be nice if we all had access to those criteria...

 

[JAFERD_MD]

It would be nice if we all had access to those criteria...

Most common is Interqual or MCG. You can ask your UM people. I figured out my hospital used Interqual and then though some light searching found it on our Intranet.

I do think it's BS that Change Healthcare and Hearst created these proprietary subscription services that an average doc can't access on their own. Can't play the game if you don't know the rules.

 

[HemorrhagicShock]

At the risk of drawing ire from everyone, my side gig is doing UM on the payor (insurance) side. I am paid hourly, not incentivized to deny or approve, and my payor is publicly-funded (ie, your tax dollars). I agree that reform is needed but there are some crazy requests for payment from hospitals in my very short time doing this.

It is sad, though, that hospitals and insurance companies just employ doctors to fight each other over a pot of money.

How did you get into part-time UM?

How's the pay?

I hear it's fully impacted now, and finding positions is near impossible.

What's your advice for somebody looking to do this part time?

 

[WhatJobDoIPick]

Not when there's not even an H&P from the first visit. The hospital is not getting paid for 2 DRG hospitalizations. As an ER doc I'm annoyed AF about bouncebacks but the note takes me <2 minutes, there are no new labs and the hospitalist will copy and paste the H&P (or do it for the first time).

What's the cutoff then? Why not just conveniently tell a patient to go outside to have a smoke q8hrs so you can collect 3 hospital bills in a day?

Because it's not us driving it, duh.

Patient can be a dingus in their own dime. Pay up, or let us balance Bill.

I like to be paid for my time, thanks.

 

[JAFERD_MD]

Because it's not us driving it, duh.

Patient can be a dingus in their own dime. Pay up, or let us balance Bill.

I like to be paid for my time, thanks.

Talk to CMS about it.

How did you get into part-time UM?

How's the pay?

I hear it's fully impacted now, and finding positions is near impossible.

What's your advice for somebody looking to do this part time?

DM'ed you

 

[WhatJobDoIPick]

We like to lambaste folks here for working for CMGs, sometimes warranted, sometimes not.

We should treat those who choose to work for big daddy CMS or insurance who deny physicians their due compensation the same.

You're part of the problem.

 

[WhatJobDoIPick]

I hope working from home in your jammies is worth the blood on your hands of a sepsis fall out cause the ER doc gave 27 cc / kg of NS instead of 30.

 

[JAFERD_MD]

You don't need to air your grievances at me on matters I already told you I am not involved with to get this thread closed just because you don't understand the nuances of my job.

DM me to talk about the moral superiority of being a pit doc and make me feel bad. That being said, several people have already DM'ed me on how to join "the dark side."

Not responding anymore.

 

[EMhawkeye]

My question is why somebody would come on here and brag about working against the interests of other physicians and patients

 

[RustedFox]

My question is why somebody would come on here and brag about working against the interests of other physicians and patients

I don't think they're bragging as much as they are admitting defeat by the slings and arrows of what a career in EM has sadly become.

Getting paid fairly is in the interests of both physicians and patients.

 

[deleted239798]

It’s funny seeing some of the same people who feigned moral superiority and roasted that guy who wanted to open a ketamine clinic defend working for an insurance company.

 

[RustedFox]

It’s funny seeing some of the same people who feigned moral superiority and roasted that guy who wanted to open a ketamine clinic defend working for an insurance company.

If you're referring to me, I'm not defending the UM folks.

I see the UM folks like "the force"; it can be wielded for good or for evil... but it's not drug-dealing-on-demand.

 

[deleted239798]

If you're referring to me, I'm not defending the UM folks.

I see the UM folks like "the force"; it can be wielded for good or for evil... but it's not drug-dealing-on-demand.

I mean ketamine does have evidence based applications for treatment resistant depression so the same argument applies - it can be used for good or evil too. For the record I don’t care either way if someone does UM or any other gig, it’s just a little amusing that the logic is so flexible here. We’ve all got our personal biases but best to be self aware and own them or we get twisted in knots 🤷‍♂️

 

[RustedFox]

I mean ketamine does have evidence based applications for treatment resistant depression so the same argument applies - it can be used for good or evil too. For the record I don’t care either way if someone does UM or any other gig, it’s just a little amusing that the logic is so flexible here. We’ve all got our personal biases but best to be self aware and own them or we get twisted in knots 🤷‍♂️

Read my very first reply to that thread and you'll see my point.

There's a big difference between "treatment resistant depression, having failed multimodal therapy under the care of psychiatry" and "but being a parent is so hard, I need Ketamine or I'll give you a bad Yelp review."

Big. Difference.

 

[deleted239798]

Read my very first reply to that thread and you'll see my point.

There's a big difference between "treatment resistant depression, having failed multimodal therapy under the care of psychiatry" and "but being a parent is so hard, I need Ketamine or I'll give you a bad Yelp review."

Big. Difference.

I see someone mentioning a side gig and a response laden with assumptions. Nowhere did that poster say that they intended to practice unethically - however you assumed they would. Maybe, maybe not.

As for UM, the entire purpose is to increase the profit of health insurance companies. I don’t blame individual doctors for working for them but it does not add to the societal good.

But I can tell this isn’t going to be a fruitful discussion either way since you have positioned yourself as the moral arbiter regarding people’s side gigs, so I’m going to tap out.

 

[AlmostAnMD]

As for UM, the entire purpose is to increase the profit of health insurance companies.

i mean....no.....that is one way. I do UM from the hospital side. I don't influence admission decisions or withhold tests, I lobby hard for patient stays to be appropriately reimbursed and to get testing clinicians asked for by appealing to insurance companies denying the requested procedure.

Like someone else said, you can do UM for the dark side or the light. But your phrasing makes it sound one sided.

Honestly, both sides shouldn't be necessary. If a hospitalist wants to keep a chf patient for 3 days for exacerbation it shouldn't take a chess match between hospital and insurance docs and a dozen UM nurses on both sides to agree to this. I fully agree, in general, we waste entirely too much money and time on this.

But its not going to go away by just wishful thinking, so I do it.

Also it's infinitely less ****ty than EM, at least locally. My mental health is 200% improved getting out of a malignant SDG. Never going back.

 

[deleted239798]

i mean....no.....that is one way. I do UM from the hospital side. I don't influence admission decisions or withhold tests, I lobby hard for patient stays to be appropriately reimbursed and to get testing clinicians asked for by appealing to insurance companies denying the requested procedure.

Like someone else said, you can do UM for the dark side or the light. But your phrasing makes it sound one sided.

Honestly, both sides shouldn't be necessary. If a hospitalist wants to keep a chf patient for 3 days for exacerbation it shouldn't take a chess match between hospital and insurance docs and a dozen UM nurses on both sides to agree to this. I fully agree, in general, we waste entirely too much money and time on this.

But its not going to go away by just wishful thinking, so I do it.

Also it's infinitely less ****ty than EM, at least locally. My mental health is 200% improved getting out of a malignant SDG. Never going back.

To clarify I was referring to UM on the insurer side.

 

[RustedFox]

I see someone mentioning a side gig and a response laden with assumptions. Nowhere did that poster say that they intended to practice unethically - however you assumed they would. Maybe, maybe not.

You might wanna go and re-read that thread again.
I actually have knowledge of that world.
My statements were corroborated by psych. 99% of the business of a Ketamine clinic fails to meet the true clinical indications; and that's what keeps the doors open.

As for UM, the entire purpose is to increase the profit of health insurance companies. I don’t blame individual doctors for working for them but it does not add to the societal good.

See below comment from @AlmostAnMD.

But I can tell this isn’t going to be a fruitful discussion either way since you have positioned yourself as the moral arbiter regarding people’s side gigs, so I’m going to tap out.

Okay.