Painful Cuts Coming to Pain...Elections Have Consequences

[Baron Samedi]

Must suck to be self righteous, complacent, naïve and deluded. If you aren't pissed about how much money the government steals from you, you haven't achieved some higher level of nirvana. You're just a *****. My 2c. At least im not deluded enough to play into the pandering and BLATANT lying coming from the left in order to capture your vote. The right is far from perfect I have no delusions, but given the current choice, I wouldnt vote democrat today if you put a gun to my head.

You seem to be a cynical person who projects all your anger onto anyone who doesn't have the same world view as you. You've resorted to childish name-calling. You've taken all your frustration with the world and government and applied it to a borderline-esque splitting of people you encounter.

I have a wonderful life and the government to thank for a big portion of it. The government is obviously far from perfect but that's why it's ever-evolving.

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[TeslaCoil]

this is pure projection.

you are jealous of his happiness.

I'm very happy. Happier than probably 99% of people. That's probably not saying much though. Id be a lot happier if my effective tax rate wasn't something like 55%. Not to mention the shrinking medicare reimbursements. The both of you must not be pain management doctors, because if you are, you should be pissed AF. No chance you can pay an effective tax rate like mine and not be just a tad pi$$ed off.

 

[TeslaCoil]

You seem to be a cynical person who projects all your anger onto anyone who doesn't have the same world view as you. You've resorted to childish name-calling. You've taken all your frustration with the world and government and applied it to a borderline-esque splitting of people you encounter.

I have a wonderful life and the government to thank for a big portion of it. The government is obviously far from perfect but that's why it's ever-evolving.

Far from perfect? man you are more deluded than I thought. Good for you, I'm not knocking you for your happiness. Im knocking you for being clueless.

 

[TeslaCoil]

You seem to be a cynical person who projects all your anger onto anyone who doesn't have the same world view as you. You've resorted to childish name-calling. You've taken all your frustration with the world and government and applied it to a borderline-esque splitting of people you encounter.

I have a wonderful life and the government to thank for a big portion of it. The government is obviously far from perfect but that's why it's ever-evolving.

You probably love the government because you obviously work for the government. So lemme get this straight, if you are a military physician something like 1/3 of your income is TAX FREE, is that correct? If so your opinion is meaningless on this thread considering most of the people you're talking to are private sector doctors who are getting financially raped.

 

[tombreaz]

You probably love the government because you obviously work for the government. So lemme get this straight, if you are a military physician something like 1/3 of your income is TAX FREE, is that correct? If so your opinion is meaningless on this thread considering most of the people you're talking to are private sector doctors who are getting financially raped.

I work for the government and hate it. The amount of bloat is sickening.

 

[TeslaCoil]

I work for the government and hate it. The amount of bloat is sickening.

Aha, a sensible person, I knew there were a few in here. I was mainly referring to military branch employed physicians. Must be nice not to pay taxes at all on 1/3 of your salary. And basically have no expenses.

 

[Baron Samedi]

Aha, a sensible person, I knew there were a few in here. I was mainly referring to military branch employed physicians. Must be nice not to pay taxes at all on 1/3 of your salary. And basically have no expenses.

Yes us military docs live such a pampered lifestyle!

 

[deleted131481]

I'm very happy. Happier than probably 99% of people.

I'm not doubting you and I don't know you. But the tone of your posts are full of anger, pessimism, and personal attacks.

Perhaps not what I'd expect in the happiest 1%.

 

[TeslaCoil]

Yes us military docs live such a pampered lifestyle!

well maybe not pampered, but privileged in certain ways. Therefore, you cant really comment here effectively. You clearly have no clue how most private sector pain physicians feel about the current reimbursement situation. Its a disaster. Period. Please read the name of the thread. In what way are you currently experiencing said reimbursement cuts exactly?

 

[TeslaCoil]

I'm not doubting you and I don't know you. But the tone of your posts are full of anger, pessimism, and personal attacks.

Perhaps not what I'd expect in the happiest 1%.

Wah. Cry me a river.

 

[Pain Applicant1]

well maybe not pampered, but privileged in certain ways. Therefore, you cant really comment here effectively. You clearly have no clue how most private sector pain physicians feel about the current reimbursement situation. Its a disaster. Period. Please read the name of the thread. In what way are you currently experiencing said reimbursement cuts exactly?

FWIW, he may not pay much in taxes- I don't know one way or the other - but it's a zero-sum game. He gets paid a lot less than pretty much everyone else in here so he's getting raked by govt.

You make more so you get taxed more. He makes less, a lot less, so his taxes may be a lot lower to be commensurate.

 

[Baron Samedi]

FWIW, he may not pay much in taxes- I don't know one way or the other - but it's a zero-sum game. He gets paid a lot less than pretty much everyone else in here so he's getting raked by govt.

You make more so you get taxed more. He makes less, a lot less, so his taxes may be a lot lower to be commensurate.

For the sake of transparency, last year I made(pre-tax) a total of $161k, $25k out of that was untaxed and the rest taxed normally.

Not sure where his "no expenses" comment comes into play. Certainly wish that was the case! Childcare, mortgage, house repairs, car payments, utilities, groceries...let me know how to get those paid for!

Would love to make more, obviously.

 

[TeslaCoil]

FWIW, he may not pay much in taxes- I don't know one way or the other - but it's a zero-sum game. He gets paid a lot less than pretty much everyone else in here.

You make more so you get taxed more. He makes less, a lot less, so his taxes may be a lot lower to be commensurate.

Okay so then he can go complain on the "Im an underpaid military doc" thread. This is the thread on painful cuts to pain medicine reimbursement. Something from which a military doc will suffer ZERO consequences. Are you starting to pick up what im putting down?

 

[TeslaCoil]

For the sake of transparency, last year I made(pre-tax) a total of $161k, $25k out of that was untaxed and the rest taxed normally.

Would love to make more, obviously.

Do you live on base? Also was that your base pay or total pay?

 

[Baron Samedi]

Do you live on base?

No. Not an option here.

 

[Baron Samedi]

Okay so then he can go complain on the "Im an underpaid military doc" thread. This is the thread on painful cuts to pain medicine reimbursement. Something from which a military doc will suffer ZERO consequences. Are you starting to pick up what im putting down?

But you brought it up?

 

[TeslaCoil]

No. Not an option here.

Well my condolences to you friend. And you like the government. smh. Other than serving your country why would you stay in that situation? And again, what do you know about Medicare reimbursement cuts?

 

[Pain Applicant1]

Okay so then he can go complain on the "Im an underpaid military doc" thread. This is the thread on painful cuts to pain medicine reimbursement. Something from which a military doc will suffer ZERO consequences. Are you starting to pick up what im putting down?

I understand. Threads sometimes move in many directions and I was responding more to the comment that he loves the gov't.

Also, FWIW, I'm in my own private practice that I started myself after fellowship so any cuts hit home, right on the bullseye. I don't personally care that much though. Whatev. I personally feel that I'm overpaid anyway, lol!

 

[Baron Samedi]

Well my condolences to you friend. And you like the government. smh. Other than serving your country why would you stay in that situation? And again, what do you know about Medicare reimbursement cuts?

I have a wonderful quality of life, have made lifelong friends, get to spend loads of time with my family and pursuing outside interests, enjoy going to work, get to train the next generation of pain docs, get to truly invest in my patient-physician relationships, don't have to worry about whether or not they can afford the treatment plan, don't have to deal with prior authorization or billing issues, get to see the world, get to treat people who suffered bad injuries for their country. The list goes on. Money isn't everything.

You're right, I am not affected by Medicare cuts but it's not like we have been on that topic for the last 6 pages of this thread, anyways.

For the record, I never said I "love the government" nor did I ever complain about my pay. Your words, not mine.

 

[TeslaCoil]

But you brought it up?

Yes, I did because as you know, in many instances being an active duty physician can be quite nice if you are ranked up and have bonus pay, and live on base with minimal expenses. In your case... not so much.

 

[TeslaCoil]

I have a wonderful quality of life, have made lifelong friends, get to spend loads of time with my family and pursuing outside interests, enjoy going to work, get to train the next generation of pain docs, get to truly invest in my patient-physician relationships, don't have to worry about whether or not they can afford the treatment plan, don't have to deal with prior authorization or billing issues, and get to see the world, get to treat people who suffered bad injuries for their country. The list goes on. Money isn't everything.

You're right, I am not affected by Medicare cuts but it's not like we have been on that topic for the last 6 pages of this thread, anyways.

Im glad you're having a blast. I would never sign up for that deal, but to each his own. I love my gig and my life. Im just tired of the blood sucking government stealing my money and blowing half of it on nonsense, whilst also cutting my pay constantly. Now, you speak very highly of the government, that really makes me question your judgement. Even given that you're a service member. I respect and support the military. Every one of my dollars spent on military funding is well spent. Still, I hate the government for all the other dollars of mine they spend on CRAP.

 

[Pain Applicant1]

For the sake of transparency, last year I made(pre-tax) a total of $161k, $25k out of that was untaxed and the rest taxed normally.

Not sure where his "no expenses" comment comes into play. Certainly wish that was the case! Childcare, mortgage, house repairs, car payments, utilities, groceries...let me know how to get those paid for!

Would love to make more, obviously.

I think it's great that you're military doc but how can you be getting paid so little? I imagine the government has to compete with the private sector to at least some degree. How would they be able to hire anyone by paying so little?

 

[Pain Applicant1]

I have a wonderful quality of life, have made lifelong friends, get to spend loads of time with my family and pursuing outside interests, enjoy going to work, get to train the next generation of pain docs, get to truly invest in my patient-physician relationships, don't have to worry about whether or not they can afford the treatment plan, don't have to deal with prior authorization or billing issues, get to see the world, get to treat people who suffered bad injuries for their country. The list goes on. Money isn't everything.

You're right, I am not affected by Medicare cuts but it's not like we have been on that topic for the last 6 pages of this thread, anyways.

For the record, I never said I "love the government" nor did I ever complain about my pay. Your words, not mine.

You actually just answered my question with this.

"...don't have to deal with prior authorization or billing issues.." This is probably the worst part about medicine. Not having to deal with this is priceless.

 

[TeslaCoil]

You actually just answered my question with this.

"...don't have to deal with prior authorization or billing issues.." This is probably the worst part about medicine. Not having to deal with this is priceless.

Priceless you say? So why dont you join him in the military and make 165k/yr

 

[VA Hopeful Dr]

I think it's great that you're military doc but how can you be getting paid so little? I imagine the government has to compete with the private sector to at least some degree. How would they be able to hire anyone by paying so little?

If you sign up for the military loan program. Some people like serving soldiers. Like the VA, pretty good benefits.

 

[Baron Samedi]

I think it's great that you're military doc but how can you be getting paid so little? I imagine the government has to compete with the private sector to at least some degree. How would they be able to hire anyone by paying so little?

The retention rate past the initial commitment(typically 4-7 years post-training) is exceptionally poor and a lot of that is due to compensation(other factors such as deployments play a role, too). Congress has tried to address this by approving additional pay and retention bonuses, but the individual branches have been slow to implement them.

I'm getting out in a year for family reasons. Debating staying in a govt role such as VA or DoD civilian, but those spots are coveted and may not be available. Might end up doing a group practice or ortho group for a bit and then come back to this thread and complain about Medicare rates then. 😄

 

[Pain Applicant1]

Priceless you say? So why dont you join him in the military and make 165k/yr

No, I can't work for anyone else at this time. It's too late for me as I've been too spoiled and I value independence, self-reliance, and autonomy too much...

...but in all honestly, I might close up completely and retire because of the payers. I hate the insurance companies. I mostly do my own billing through Athena so I see first hand how they operate.

I don't like getting slapped around without the ability to defend myself and I have no recourse against them. I spoke to an attorney one time and asked how what they do can be legal. He told me it's not but they get away with it because no one fights them except for the big guys. It's not worth his time or my money to take a case for less than $50,000 and I'll never be able to beat them pro se. Grrrrrrrrrrrrrr

 

[TeslaCoil]

No, I can't work for anyone else at this time. It's too late for me as I've been too spoiled and I value independence, self-reliance, and autonomy too much...

...but in all honestly, I might close up completely and retire because of the payers. I hate the insurance companies. I mostly do my own billing through Athena so I see first hand how they operate.

I don't like getting slapped around without the ability to defend myself and I have no recourse against them. I spoke to an attorney one time and asked how what they do can be legal. He told me it's not but they get away with it because no one fights them except for the big guys. It's not worth his time or my money to take a case for less than $50,000 and I'll never be able to beat them pro se. Grrrrrrrrrrrrrr

Well im glad somebody other than just myself is pissed about this reimbursement circus. How is there nothing we can do. How can I look my kids in the eye and tell them to aim for medicine as a career. Take on 350k in school debt, all to roll the dice on whether you land any kind of decent specialty, and even then roll the dice on whether it will continue to pay decently. Ridiculous.

 

[bedrock]

For the sake of transparency, last year I made(pre-tax) a total of $161k, $25k out of that was untaxed and the rest taxed normally.

Not sure where his "no expenses" comment comes into play. Certainly wish that was the case! Childcare, mortgage, house repairs, car payments, utilities, groceries...let me know how to get those paid for!

Would love to make more, obviously.

Not trying to provoke a fight. Honest question. I thought you stated in another thread that you made 350K/year at the VA?

I remember, because that was better than I expected for the VA.

 

[Pain Applicant1]

Well im glad somebody other than just myself is pissed about this reimbursement circus. How is there nothing we can do. How can I look my kids in the eye and tell them to aim for medicine as a career. Take on 350k in school debt, all to roll the dice on whether you land any kind of decent specialty, and even then roll the dice on whether it will continue to pay decently. Ridiculous.

It gets me livid and I don't like feeling this way. I usually get paid on nearly all my procedures but sometimes it's a fight and can literally take hours of jumping through their hoops. The payers have a monopoly on healthcare right now so I'm not sure what recourse I have. If you find out, do let me know.

I don't mind a decrease in reimbursement. I feel that it may be helping society as the current spending is unsustainable. I'm probably wrong and it's just my opinion but for whatever reason, it doesn't bother me that much. I guess I'm comparing myself to nearly everyone else in the country.

I just don't like getting schemed. That gets me fired up.

 

[Pain Applicant1]

Not trying to provoke a fight. Honest question. I thought you stated in another thread that you made 350K/year at the VA?

I remember, because that was better than I expected for the VA.

Not to answer for him but I don't think that's what he said. He's been pretty consistent. I think that was for a job he was considering.

 

[Baron Samedi]

Not trying to provoke a fight. Honest question. I thought you stated in another thread that you made 350K/year at the VA?

I remember, because that was better than I expected for the VA.

Sorry if I communicated poorly. I had said that the VA pays around $350k (I am currently job hunting for post-mil life). I am currently active duty military, not in the VA.

 

[bedrock]

Sorry if I communicated poorly. I had said that the VA pays $350k in my area and some others. But I am active duty military, not in the VA.

Understood. Thanks

 

[TeslaCoil]

I have nothing. After this last audit I also had a legitimate conversation with our lawyer, and he basically said no choice but to play nice.

 

[SSdoc33]

Sorry if I communicated poorly. I had said that the VA pays around $350k (I am currently job hunting for post-mil life). I am currently active duty military, not in the VA.

You didn't communicate poorly. He understood poorly. No need to apologize when you did nothing wrong

I appreciate your service

 

[SSdoc33]

Im glad you're having a blast. I would never sign up for that deal, but to each his own. I love my gig and my life. Im just tired of the blood sucking government stealing my money and blowing half of it on nonsense, whilst also cutting my pay constantly. Now, you speak very highly of the government, that really makes me question your judgement. Even given that you're a service member. I respect and support the military. Every one of my dollars spent on military funding is well spent. Still, I hate the government for all the other dollars of mine they spend on CRAP.

You support the military, but you do realize that the biggest area of gvt bloat is in the DOD. Its not food stamps, disability, and liberal pet projects, you know....

The trump administration spent money like a drunken sailor. Overspending is a bipartisan problem

 

[TeslaCoil]

You support the military, but you do realize that the biggest area of gvt bloat is in the DOD. Its not food stamps, disability, and liberal pet projects, you know....

The trump administration spent money like a drunken sailor. Overspending is a bipartisan problem

I never said it wasn’t. Who said I trust either party? The two party system is a failure. I think it may run us into the ground here in the next 20 years. That is if we dont annihilate the earth in a third world war, or fry ourselves within the carbon atmosphere we’re creating. I cant stand to watch the perversion of life, reality, and politics that is the democrat party. They have used far more dishonest means to establish power in my opinion. Not to mention that they have blatantly and openly abused said power for personal gain more than the republicans, and nobody does a damn thing about it. Their pandering and lying to interest groups that ultimately will never get what they are asking for disgusts me. I distrust the republicans, I downright cant stand the democrats. Unfortunately, today if you dont vote for one of those, you’re essentially not voting for anything.

 

[SSdoc33]

I never said it wasn’t. Who said I trust either party? The two party system is a failure. I think it may run us into the ground here in the next 20 years. That is if we dont annihilate the earth in a third world war, or fry ourselves within the carbon atmosphere we’re creating. I cant stand to watch the perversion of life, reality, and politics that is the democrat party. They have used far more dishonest means to establish power in my opinion. Not to mention that they have blatantly and openly abused said power for personal gain more than the republicans, and nobody does a damn thing about it. Their pandering and lying to interest groups that ultimately will never get what they are asking for disgusts me. I distrust the republicans, I downright cant stand the democrats. Unfortunately, today if you dont vote for one of those, you’re essentially not voting for anything.

Just dont go off the grid and become a doomsday prepper

 

[Baron Samedi]

Ranked choice voting, term limits, repeal Citizens United.

 

[hyperalgesia]

Ranked choice voting, term limits, repeal Citizens United.

Ranked choice makes sense and I guess it's working in some states.

Term limits also seem like a good idea although I think the entrenched special interests will prevail across generations. Politicians are just the puppets that can be traded out without any difference.

Citizen's United I think is a bogeyman. Who spent more money in politics in the last few elections? I don't think it matters that much, once you get name recognition. Look at how far Bloomberg got.

The biggest issue to me is the cancer of monopolistic leverage. You can't have a free market with it. That includes government monopolistic leverage. That includes unions. And it obviously includes corporations, utilities, etc.

 

[clubdeac]

You support the military, but you do realize that the biggest area of gvt bloat is in the DOD. Its not food stamps, disability, and liberal pet projects, you know....

The trump administration spent money like a drunken sailor. Overspending is a bipartisan problem

That’s incorrect. The biggest portion of govt spending is currently entitlement programs. It’s around 70%. DOD spending is 15%. Then again I know you’re likely huge proponent of these types of programs. As long as someone else pays for em

 

[Pain Applicant1]

I have nothing. After this last audit I also had a legitimate conversation with our lawyer, and he basically said no choice but to play nice.

It gets me so angry even thinking about it. I have one employee only and she's been out on maternity leave for the past few week. I've had the misfortune of having to deal with them more than I usually do since I only have temp help now.

I really feel that if more providers were more intricately involved in their billing something violent would take place at a corporate headquarters of the payers. I'm not condoning something like this but I think it would push at least one person over the edge.