SBAR: How hard should a pain doc work to make $1 million/yr?

[Ducttape]

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before you spout ridiculousness about Buttigieg, you probably should know his policies. for example the private option.

Pete Buttigieg on Health Care

the rest of your "discussion" is the standard conservative cognitive dissonance spiel about socialism.

American liberals do not want socialism in the form you advocate. they are not advocating a Marxist system.

a summary for those who are not so fixated on their opinion only - ie cognitive dissonance - is on the Wikipedia site.

Modern liberalism in the United States - Wikipedia

en.wikipedia.org

speaking of the Frankfurt school, this is from Wikipedia on that:

In contemporary usage, the term Cultural Marxism is an antisemitic conspiracy theory of the far right-wing, which claims that the Frankfurt School is part of a continuing academic and intellectual effort to undermine and destroy the culture of the Western world.[49] In the US, Cultural Marxism is a culture-war argument of religious fundamentalists and paleoconservatives, such as William S. Lind, Pat Buchanan, and Paul Weyrich, and of the alt-right and white nationalists, Neo-Nazi organizations and the neo-reactionary Dark Enlightenment movement.[50][51] Beginning in the late 1990s, the conspiracy theorists claimed that the Frankfurt School advocated the Counterculture of the 1960s and multiculturalism, progressive politics, and political correctness in order to undermine traditionalist conservatism and Christianity, and so overthrow the West.[52][53][54]

the political scientist Heidi Beirich said that right-wing political discourse uses the accusation of Cultural Marxism to politically de-legitimize their different opponents in the left wing.




fwiw, you might consider not posting any more history. the more you post, the more fantastical your comments become...

 

[SSdoc33]

I think the longer the impeachment hearings go on, the stronger it makes Trump. I think this is his plan. Nothing burger. Shiff = joke.
Bloomberg is best bet unless Starbucks guy comes back or another name jumps in that is a viable candidate. Current dems are all horrible.

No man can predict the future. I don't think anyone can say for sure who the next president will be.



What's wrong with Nebraska? Omaha is a good town that has a very good insurance mix. It is cold as hell there, that is for sure. However, I would assume that the practices are decent. One person's home may be considered a dump to others (Im not from Nebraska).

The best incomes are in the Midwest and southeast; some people like living there, others do not. That is the part of the trade off in desirability of an area vs income.

Mid levels are great for medicine management and follow ups. I don't know of any efficient practice that does not use them in some capacity; NPs have become a reality for most providers. My NPs always made money, even in one area in which the payer mix was not great.

Perhaps you should read a little more history- it is not always what we have presumed it to be. Heroes of the past are sometimes not that heroic in reality and the origins of what we believe can be rather shocking. Perhaps a little reading on the Frankfurt School could be enlightening, as it is an interesting topic. It is very interesting to find that many Hollywood liberals were very pro-Nazi (including Sean Penn's father) right up to the time they invaded the Soviet Union. Papa Joe Kennedy was pro-Nazi and JFK was having an affair with a Danish Nazi spy; when discovered, the "deal" between Hoover and Joe Kennedy was to ship him off to the Pacific, where he became a war hero. PT-109 is a great read; I actually like JFK, despite him having a very shady social history, although that was common at the time. The only guy in that period who could keep his pants on was Truman. Even Ike, Patton, FDR, and MacArthur were lechers. Lord Mountbatton was a pervert who not only had many affairs, but apparently diddled young boys.

not sure how we got from a discussion about single payer to JFK's affairs, but you do point out some interesting tidbits

Inga Arvad - Wikipedia

en.wikipedia.org

anyway, my point is that the changes you suggest arent really possible for many of us. nothing is "wrong" with nebraska -- other than their college football team these days -- but it is not a place many of use (or our wives) would like to move to.

 

[deleted993114]

not sure how we got from a discussion about single payer to JFK's affairs, but you do point out some interesting tidbits

Inga Arvad - Wikipedia

en.wikipedia.org

anyway, my point is that the changes you suggest arent really possible for many of us. nothing is "wrong" with nebraska -- other than their college football team these days -- but it is not a place many of use (or our wives) would like to move to.

Nebraska football is indeed in dire straits. Omaha is actually not a bad town, as you can "escape" with a good airport. It is a typical midsize (I think the whole metro is 1 million) town with a good economy, bad weather, and a nice zoo. It is no Asheville, NC or Charleston SC, but many people don't mind it.

I certainly understand that pain physicians today are facing greater challenges than those of 25-30 years ago. There is pressure for less reimbursement and pre-authorizations that make pain much more challenging. I do think that physicians can continue to practice and make a difference, it is just not going to be as "fat" as it was in the past. IF pain docs take the lead in the changes in the era of quality contracts, they can make a huge difference in controlling costs and thus themselves garner new sources of revenue while improving quality. Very few, if any, quality contracts have enrolled pain perameters, thus there is an opportunity for all of you.

Regarding Kennedy, single payer, Truman, ect.................... your mind (mine, not yours) starts to randomly wander when you get older, thus the inclusion of such irrelevant issues. The good thing is that people will excuse you for it and just assume it is early onset dementia and not take issue. That Truman was quite a guy. He was an artillery captain in WW1 and hoped the US would roll into Germany and conquer it. He was heavily supported by the Kansas City mafia in his political career and was a concession by FDR to organized crime to keep the docks and factories running smoothly during WW2. Wallace of Iowa was discarded as VP (being too far left as well). After gaining office, however, Truman did a "180" and turned his back on organized crime (an honest politician- what a concept), thus he was poor when he left office (no pay for play with him). It is for that reason that presidents are given a pension after leaving office. His "terse" letters to the Russians are a little scary- he made no bones about the fact he would use nukes on them if necessary.

 

[Ferrismonk]

I love history. The political history of what happened at the 1944 DNC convention and how Truman got the Vice Presidency is an interesting read:

1944 Democratic Party vice presidential candidate selection - Wikipedia

en.wikipedia.org

FWIW, I'm not a big fan of JFK (except for the manned space program), however this is an interesting and relevant read for pain doctors:

John F. Kennedy’s Unsuccessful Back Surgeries and Chronic Back Pain

The authors uncovered information proving to be the tip of the iceberg revealing more about JFK's chronic back pain and possibly his death.

www.spineuniverse.com

 

[clubdeac]

Being a Nebraska native, born and raised and having spent six yeas of my adult life in Kansas City, this Nebraska and Kansas City talk is quite entertaining. Keep it up 😉 I agree though, horrible weather. I now live half way between Asheville and Charleston and couldn't be happier

 

[SSdoc33]

Being a Nebraska native, born and raised and having spent six yeas of my adult life in Kansas City, this Nebraska and Kansas City talk is quite entertaining. Keep it up 😉 I agree though, horrible weather. I now live half way between Asheville and Charleston and couldn't be happier

with the weather that is. i thought you didnt like your job

 

[deleted993114]

Being a Nebraska native, born and raised and having spent six yeas of my adult life in Kansas City, this Nebraska and Kansas City talk is quite entertaining. Keep it up 😉 I agree though, horrible weather. I now live half way between Asheville and Charleston and couldn't be happier

Between Asheville and Charleston? So you are in Columbia? Both Charleston and Asheville are great, but that western and central South Carolina is nothing to write home about as far as scenery. Nonetheless, it is whatever you become accustomed to and what you like. I imagine you spend quite a few weekends at Kiawah or to the west in the Blue Ridge, which is very nice. We used to go to Charleston once a year when we were younger, but spend our vacations in the national parks now. We used to own a house on the peninsula in Charleston that was cool- too touristy and too many Yankees there now. When you walk around the peninsula you hear way too many northeast accents.

Every area has its pluses and minuses and it is just what you make of it.

No knocks on KC and Omaha. Both are nice towns in my opinion and have a lot to offer for a Midwesterner. I can see how someone from the south or either coast wouldn't like either.

 

[lonelobo]

Between Asheville and Charleston? So you are in Columbia? Both Charleston and Asheville are great, but that western and central South Carolina is nothing to write home about as far as scenery. Nonetheless, it is whatever you become accustomed to and what you like. I imagine you spend quite a few weekends at Kiawah or to the west in the Blue Ridge, which is very nice. We used to go to Charleston once a year when we were younger, but spend our vacations in the national parks now. We used to own a house on the peninsula in Charleston that was cool- too touristy and too many Yankees there now. When you walk around the peninsula you hear way too many northeast accents.

Every area has its pluses and minuses and it is just what you make of it.

No knocks on KC and Omaha. Both are nice towns in my opinion and have a lot to offer for a Midwesterner. I can see how someone from the south or either coast wouldn't like either.

Judge much?

 

[clubdeac]

Between Asheville and Charleston? So you are in Columbia? Both Charleston and Asheville are great, but that western and central South Carolina is nothing to write home about as far as scenery. Nonetheless, it is whatever you become accustomed to and what you like. I imagine you spend quite a few weekends at Kiawah or to the west in the Blue Ridge, which is very nice. We used to go to Charleston once a year when we were younger, but spend our vacations in the national parks now. We used to own a house on the peninsula in Charleston that was cool- too touristy and too many Yankees there now. When you walk around the peninsula you hear way too many northeast accents.

Every area has its pluses and minuses and it is just what you make of it.

No knocks on KC and Omaha. Both are nice towns in my opinion and have a lot to offer for a Midwesterner. I can see how someone from the south or either coast wouldn't like either.

actually Charlotte... so not exactly 1/2 way between the two

 

[clubdeac]

with the weather that is. i thought you didnt like your job

Well currently it's a great gig. However they keep saying that we will be going away from wRVU to "value based care" which I can only imagine will mean less pay

 

[lobelsteve]

actually Charlotte... so not exactly 1/2 way between the two

Charlotte is a fun city. I was up there last year for a kids lacrosse tournament. I love the way they light up all the buildings at night.

 

[deleted993114]

actually Charlotte... so not exactly 1/2 way between the two

Charlotte is a great town. You are also pretty damn close to the Blue Ridge (Linville Gorge rocks), which is cool. It is the home of the longest taxi time in the US at the airport, which is kind of weird. Great town, however. Lots of good hiking and white water rafting to the west of you. I would run across people hiking in the mountains who were from Charlotte and said it was the first time they had ever been in the mountains! You are only about three hours from Charleston too, which is a pretty cool place. It will take a little time for you to get to Asheville, as there is not a straight road to get there; we used to drive 26 to get there, which was nice and straight.

You can be a leader in the value arena, as you have a lot of experience and expertise that can be quite valuable in a value based setting. The cash you can save in inappropriate imaging, evidence based pain management, and directing patients appropriately for surgical care is HUGE. Don't minimize your value in such a system.