haldujai

36 ms·

421.
by haldujai 3y ago
Just for clarity I don't mean to suggest at all that radiologists aren't paid well-enough (other than in private equity sweatshops but I feel like that's the case for any industry they buy into). > I’m surely misunderstand
422.
by haldujai 3y ago
Hard to compare, the "high-income" specialties are either brutally intense (e.g. neurosurgery, cardiac surgery, vascular surgery), competitive (plastics, derm, radiology) or both (ortho). The competitive ones are variable with ~50
423.
by haldujai 3y ago
From the Royal College (our specialty accreditation society)[0]: > 11-18% of newly certified specialists cannot find work at the time of their certification. > 75% of those who are continuing training do so because they think this
424.
by haldujai 3y ago
Thanks for sharing, I'm still learning how retirement works in the US and was unaware of that detail. I also wasn't sure how to value benefits (at least health/dental + disability if that's included) and PTO (including s
425.
by haldujai 3y ago
Aside from procedures: We have multidisciplinary case conferences every day which can't be outsourced and perhaps most importantly you also want to know who your radiologist is. Reporting of anything remotely complex (e.g. oncological
426.
by haldujai 3y ago
I wouldn't say they're valued, the compensation is (with some nuance) based on a work-unit/fee-code which is the same for all of us. The academic component goes up for relevant physicians like it does for any professor-type r
427.
by haldujai 3y ago
> There's nothing in your 3-4 posts that is applicable to physicians that also isn't applicable to any other white collar job. Disagree in that most other white collar jobs don’t treat their employees as independent contractors
428.
by haldujai 3y ago
Could be. Could also happen in medicine (many think the golden era for compensation is nearing its end) A decade ago nephrologists in a dialysis unit were making high 6 figures until private-equity moved in and now they make 1-200k.
429.
by haldujai 3y ago
Yes, if you consider non NYC/SV salaries physicians come out ahead in the vast majority of cases, we earn more or less the same no matter where we live. I’m happy with my compensation but I’m also happy with my job/not optimizing
430.
by haldujai 3y ago
I don’t view it as adversarial. I’ve had productive conversations on HN including some which gave me NLP approaches I hadn’t considered. Engineers (including myself when I had a health-tech startup before my MD) tend to misunderstand the pr
431.
by haldujai 3y ago
You’re reading incorrectly and I also wasn’t very clear. It’s not a concern and I’m not saying we’re not well-compensated but 7% is something to consider when comparing total compensation across industries (and is one of the easiest line-it
432.
by haldujai 3y ago
What you’re describing is what a template does, I just dictate “stone” or “sludge” from a pick list and never a normal statement. There is also existing technology that creates a structured report from free dictations. Your math also doesn’
433.
by haldujai 3y ago
Even large corporations, Matt Lungren is a notable radiologist with a tech background and was hired at AWS and is now CMIO at Microsoft + Nuance.
434.
by haldujai 3y ago
I only know 1-2 NZ radiologists but I understand the system there is egregiously underpaid. Medicare/insurance reimbursement rates for MRI (the professional fee component) are less than Canada (a system I know). We scan outpatients nea
435.
by haldujai 3y ago
I remain optimistic that some people here are open to learning so I still try sometimes. - Also a radiologist who gets told I’m egregiously overpaid when [insert immature AI tech] can definitely do my job better.
436.
by haldujai 3y ago
The expensive labor isn’t physicians and infrastructure/capital expenditures aren’t the barrier either. It’s nursing costs and bed counts. Look at Canada for an example, we have unemployed surgeons and interventional radiologists/
437.
by haldujai 3y ago
From my job search as a physician. Literally no private practice job I’ve interviewed at or heard of provides defined-benefit retirement, if you know one let me know. Similarly I don’t know of many non-medicine jobs that still offer this ei
438.
by haldujai 3y ago
Sometimes they do, look at the UK strike for an example although the environment here is no where near as toxic. One of the shortage issues is that it takes 9-12 years to train a specialty physician. For example we need more radiologists to
439.
by haldujai 3y ago
Physicians are disposable too, look at what happened with primary care, nephrology, anesthesia and is starting in radiology where private equity firms move in and outsource physician care to allied health professions and create an “eat what
440.
by haldujai 3y ago
I agree, I left a FAANG and startup to pursue medicine (not that finances were my motivation) and my co-founder who went back to a FAANG is earning more than most physicians now. I’m far removed from this work environment now but at 10 year
441.
by haldujai 3y ago
Not true, some do (stereotypically the surgeon with 4 ex wives and children that don’t know them) but it really depends on your country/practice pattern. On one extreme Canadian physicians are (generally) ineligible for pension/re
442.
by haldujai 3y ago
It just is not a medically recognized disorder/disease/syndrome. There’s no ICD-10 code. To borrow from Wikipedia which does a better job at explaining the difference in simpler terms (and is accurate in this case): > “Leaky g
443.
by haldujai 3y ago
I must have missed the clinical practice guideline that said keep smoking just take a statin instead.
444.
by haldujai 3y ago
“However, the rate of true statin-induced hepatotoxicity is exceedingly low. Moreover, multiple retrospective studies have shown that statins are not only safe for use in patients with cirrhosis, but are also likely beneficial in reducing l
445.
by haldujai 3y ago
Not every post-menopausal patient will have sexual dysfunction. Testosterone is not the only (or first line) treatment for sexual dysfunction and is off-label/not FDA approved.
446.
by haldujai 3y ago
Unopposed estrogen (i.e. the old estrogen only HRT) is bad for women of all sizes, endometrial cancer sucks. Separately, obesity causes higher system estrogen levels and carries the same risks. What you may be referring to is the more recen
447.
by haldujai 3y ago
> at the cost of untold resources Not going to argue the methodology but it seems like a starting point is $22,000-37000/QALY[0-1]. > instead of This is a false dichotomy, guidelines all start with lifestyle modifications. [0] ht
448.
by haldujai 3y ago
> It would be part of HRT for menopause I was fixating on semantics but it's not the point. Not my area but for what it's worth UpToDate (KA Martin, RL Barbieri, JL Shifren @ MassGen Brigham) address it in expert opinion form:
449.
by haldujai 3y ago
> Many flawed guidelines are based on a desire to act even in the absence of evidence of benefit. Very true, I mostly intended to illustrate that many "good" or accepted guidelines are not necessarily based on randomized contro
450.
by haldujai 3y ago
Apologies, bad medicine habit to use ambiguous acronyms. I meant "randomized controlled trial" in this case (as the post). "Randomized clinical trial" is often used interchangeably but does not necessarily require a cont

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