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schilling0455

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Jun 4, 2022
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Most people don't realize that to practice medicine in the US, you not only need to graduate from medical school but also complete a residency program. (The residency program is what you specialize in whether it's family medicine, internal medicine, surgery, etc.) In addition, you need to get a medical license from the medical board of state you want to practice in. And in general, you also need to sit and pass the boards for your specialty so that you can become "board-certified." (These boards are not the same as the general medical boards which you needed to pass in order to graduate medical school and get your license.)

For likely profiteering reasons, this "board-certification" has become a gold standard within the past several decades or so and one cannot find employment if they are not BE/BC (board eligible/board certified). (BE is when someone finished residency but either hasn't taken that final specialty board exam or took it but failed and need to retake it.)

Can you guess where this is leading to? I did the college, the med school, and part of the residency. And then I couldn't take it anymore. How sick the system is, how sick the patients are, how we as doctors really really really suck at helping them because imho, we're just glorified drug dealers.

Anyway, I also got my medical license. My plan was to open a private practice and do cash pay (since many health insurance companies also don't wanna work with us lowly non-board-certified docs). I hopped onto the bandwagon of a physician who promised everyone could open up their dream private practice. It didn't work out for me. Partially because I got in my own way.

Life has been rough. PTSD from medical education and quite likely childhood PTSD as well. I'm intent on that not getting in my way. I'm currently unemployed (again) so my current goal is finding any old job to pay for my bare minimum and for better therapy while figuring out how I can track into the fastlane.

That's it. There's obviously a lot more but just wanted to share the bare bones of what's been going on.

And I swear, MJ's thoughts and ideas have pulled me out of a depressive funk more than once.
 
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4BOOG

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Most people don't realize that to practice medicine in the US, you not only need to graduate from medical school but also complete a residency program. (The residency program is what you specialize in whether it's family medicine, internal medicine, surgery, etc.) In addition, you need to get a medical license from the medical board of state you want to practice in. And in general, you also need to sit and pass the boards for your specialty so that you can become "board-certified." (These boards are not the same as the general medical boards which you needed to pass in order to graduate medical school and get your license.)

For likely profiteering reasons, this "board-certification" has become a gold standard within the past several decades or so and one cannot find employment if they are not BE/BC (board eligible/board certified). (BE is when someone finished residency but either hasn't taken that final specialty board exam or took it but failed and need to retake it.)

Can you guess where this is leading to? I did the college, the med school, and part of the residency. And then I couldn't take it anymore. How sick the system is, how sick the patients are, how we as doctors really really really suck at helping them because imho, we're just glorified drug dealers.

Anyway, I also got my medical license. My plan was to open a private practice and do cash pay (since many health insurance companies also don't wanna work with us lowly non-board-certified docs). I hopped onto the bandwagon of a physician who promised everyone could open up their dream private practice. It didn't work out for me. Partially because I got in my own way.

Life has been rough. PTSD from medical education and quite likely childhood PTSD as well. I'm intent on that not getting in my way. I'm currently unemployed (again) so my current goal is finding any old job to pay for my bare minimum and for better therapy while figuring out how I can track into the fastlane.

That's it. There's obviously a lot more but just wanted to share the bare bones of what's been going on.

And I swear, MJ's thoughts and ideas have pulled me out of a depressive funk more than once.
I am dating a young lady in the process of taking her MCAT and trying to get into Med school. I appreciate you sharing this and being so open. I wish you the best in all your future endeavors!
 

MJ DeMarco

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Most people don't realize that to practice medicine in the US, you not only need to graduate from medical school but also complete a residency program. (The residency program is what you specialize in whether it's family medicine, internal medicine, surgery, etc.) In addition, you need to get a medical license from the medical board of state you want to practice in. And in general, you also need to sit and pass the boards for your specialty so that you can become "board-certified." (These boards are not the same as the general medical boards which you needed to pass in order to graduate medical school and get your license.)

For likely profiteering reasons, this "board-certification" has become a gold standard within the past several decades or so and one cannot find employment if they are not BE/BC (board eligible/board certified). (BE is when someone finished residency but either hasn't taken that final specialty board exam or took it but failed and need to retake it.)

Can you guess where this is leading to? I did the college, the med school, and part of the residency. And then I couldn't take it anymore. How sick the system is, how sick the patients are, how we as doctors really really really suck at helping them because imho, we're just glorified drug dealers.

Anyway, I also got my medical license. My plan was to open a private practice and do cash pay (since many health insurance companies also don't wanna work with us lowly non-board-certified docs). I hopped onto the bandwagon of a physician who promised everyone could open up their dream private practice. It didn't work out for me. Partially because I got in my own way.

Life has been rough. PTSD from medical education and quite likely childhood PTSD as well. I'm intent on that not getting in my way. I'm currently unemployed (again) so my current goal is finding any old job to pay for my bare minimum and for better therapy while figuring out how I can track into the fastlane.

That's it. There's obviously a lot more but just wanted to share the bare bones of what's been going on.

And I swear, MJ's thoughts and ideas have pulled me out of a depressive funk more than once.

Welcome aboard, sorry to hear about the medical journey which sounds more like a racket than a profession. Glad my work has been a small piece in some solace.
 

schilling0455

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Jun 4, 2022
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Just finished reading Millionaire Fastlane . Been meaning to read it since about 2020 when I first heard of it and glad I finally got to it--thank you to my most recent employer for force-resigning/terminating me.

The specific example about lead generation for plastic surgery offices really struck me. I never really thought about medical practices having difficulty getting patients, especially since they're usually listed on insurance panels, google, and whatnot. I know that if I were to (and when I did try to) have my own private practice doing cash-pay only, it's definitely harder to get patients since they're used to the traditional model with insurance and co-pays. I also didn't know how to sell myself and help them see that they'd actually get a full hour of me, less interrupting, more listening, and so forth.

Mind is opening up again...
 
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saint_kilda

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May 12, 2020
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Sounds rough and it's so unfortunate that the medical system in the US treats their doctors so poorly compared to other countries. Seems like you're picking yourself back up and you'll get to where you wanna go in no time!
 

NeoDialectic

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Most people don't realize that to practice medicine in the US, you not only need to graduate from medical school but also complete a residency program. (The residency program is what you specialize in whether it's family medicine, internal medicine, surgery, etc.) In addition, you need to get a medical license from the medical board of state you want to practice in. And in general, you also need to sit and pass the boards for your specialty so that you can become "board-certified." (These boards are not the same as the general medical boards which you needed to pass in order to graduate medical school and get your license.)

For likely profiteering reasons, this "board-certification" has become a gold standard within the past several decades or so and one cannot find employment if they are not BE/BC (board eligible/board certified). (BE is when someone finished residency but either hasn't taken that final specialty board exam or took it but failed and need to retake it.)

Can you guess where this is leading to? I did the college, the med school, and part of the residency. And then I couldn't take it anymore. How sick the system is, how sick the patients are, how we as doctors really really really suck at helping them because imho, we're just glorified drug dealers.

Anyway, I also got my medical license. My plan was to open a private practice and do cash pay (since many health insurance companies also don't wanna work with us lowly non-board-certified docs). I hopped onto the bandwagon of a physician who promised everyone could open up their dream private practice. It didn't work out for me. Partially because I got in my own way.

Life has been rough. PTSD from medical education and quite likely childhood PTSD as well. I'm intent on that not getting in my way. I'm currently unemployed (again) so my current goal is finding any old job to pay for my bare minimum and for better therapy while figuring out how I can track into the fastlane.

That's it. There's obviously a lot more but just wanted to share the bare bones of what's been going on.

And I swear, MJ's thoughts and ideas have pulled me out of a depressive funk more than once.

On the bright side, your education and your possible future employment as doctor opens many doors to great entrepreneur opportunities that others don't have. Your job as a fastlane disciple is now to think about how to apply MJ's principles and leverage your situation to maximize your chances of success.

You can do it!

Sounds rough and it's so unfortunate that the medical system in the US treats their doctors so poorly compared to other countries. Seems like you're picking yourself back up and you'll get to where you wanna go in no time!
That's an interesting take. Just like with many other parts of the USA economy, the model the USA chooses may have disadvantages but one of the advantages is the doctors that make it end up making alot more than these other countries that you claim are treating doctors better. Are there trade off's? Yea. But it may be a bit myopic to say with a blanket statement that doctors in the USA are treated poorly compared to other countries.

Just my 2c
 

schilling0455

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So I noticed there was something wrong with the goals I've been making but I couldn't put my finger on what it was. Today I realized it's that I've been in the educational system for so long that the goals I set are usually by deadline. I want to have a net worth of zero by 2030 (my nw is very negative due to student loans); I want to get a job by the end of this month; etc. Reading some of the other posts and seeing people reiterate that providing value is more important/a better driving goal than making x amount of money has been clarifying. I realized it a few days ago that I've been too focused on the money numbers when that's never been a main value of mine. It's definitely led me astray. Typing this is reminding me how so many people thought I went into medicine for the money or because my parents made me but I actually went into it because I truly wanted to help people. I also wanted to hear their stories and solve the puzzle of the diagnosis and help them feel better/suffer less. I was also conscious of the fact that I didn't want to face the real world yet so this would delay my entry into it for another few years... Started reading Unscripted yesterday and it made me realize I also continued in education simply bc it was familiar and therefore easy in that way. By the time I graduated med school and entered residency, I would half-joke that my best skill was taking multiple choice exams.

My mind is all over the place but just wanted to share these thoughts/reflections.

Also, wonderful reminder from MJ's text today about the barrier of overthinking. Definitely guilty there.
 

technobubble

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Sep 21, 2018
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Thanks for sharing! With medicine studies in some countries we have mobbing, resident doctors are taken down by their superiors and similar things. We were talking with my friend about the medical work opportunities in the US (we're from Europe), great wage etc. but I think we will go to Germany, Austria or Switzerland. Also, is it true that in the US it's like you need to watch your every move while working because you could easily get a lawsuit? Some more thoughts - working with medical devices / instruments is quite profitable, public tenders etc. still helping people but through another way though as I understand you want to continue your current path. Keep strong and wish you all the best!
 

UK_Mike

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Sep 10, 2020
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Also, is it true that in the US it's like you need to watch your every move while working because you could easily get a lawsuit?
I kind-of want my doctor to be watching their every move regardless of whether they're easy to sue. (I had a smiley face here, but it turned out massive so I removed it).

But it'll be interesting to hear the proper responses to this - as I read it there's a general reputation for doctors in the US being at the mercy of law suits but I'm not sure how that stacks up as a percentage of actual work done, nor how it compares to anywhere else. It's more prevalent here in the UK than it was, and there's a "blame the US" culture for how everyone wants to sue for compensation over the tiniest little thing which may or may not be deserved (and not just medical related).
 
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Ronnie Bryan

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Most people don't realize that to practice medicine in the US, you not only need to graduate from medical school but also complete a residency program. (The residency program is what you specialize in whether it's family medicine, internal medicine, surgery, etc.) In addition, you need to get a medical license from the medical board of state you want to practice in. And in general, you also need to sit and pass the boards for your specialty so that you can become "board-certified." (These boards are not the same as the general medical boards which you needed to pass in order to graduate medical school and get your license.)

For likely profiteering reasons, this "board-certification" has become a gold standard within the past several decades or so and one cannot find employment if they are not BE/BC (board eligible/board certified). (BE is when someone finished residency but either hasn't taken that final specialty board exam or took it but failed and need to retake it.)

Can you guess where this is leading to? I did the college, the med school, and part of the residency. And then I couldn't take it anymore. How sick the system is, how sick the patients are, how we as doctors really really really suck at helping them because imho, we're just glorified drug dealers.

Anyway, I also got my medical license. My plan was to open a private practice and do cash pay (since many health insurance companies also don't wanna work with us lowly non-board-certified docs). I hopped onto the bandwagon of a physician who promised everyone could open up their dream private practice. It didn't work out for me. Partially because I got in my own way.

Life has been rough. PTSD from medical education and quite likely childhood PTSD as well. I'm intent on that not getting in my way. I'm currently unemployed (again) so my current goal is finding any old job to pay for my bare minimum and for better therapy while figuring out how I can track into the fastlane.

That's it. There's obviously a lot more but just wanted to share the bare bones of what's been going on.

And I swear, MJ's thoughts and ideas have pulled me out of a depressive funk more than once.
Thank you so kindly for posting how much work is actually put into getting a medical degree.It shows the importance of paying our dues.Praying you find a employer who treats you firm but fairly.
 

schilling0455

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Yes, I think the US is known for practicing "defensive medicine" because of how willing to sue people are. I think it's pretty likely that it has influenced other countries. I notice that while we are taught that documentation (charting) is mainly to be able to communicate what went on in the patient visit, the truth is that it's to prevent lawsuits. As such, I've been taught as early as med school during rotations that one should sometimes fudge it a little to protect oneself :blank: That was one of the cases of cognitive dissonance and moral injury that I felt. (Wow these emojis are big haha)

I think the statistic in the US is that on average, a doctor will get sued once in their lifetime. I don't have a source so it could be some made-up thing from school that we just blindly took as truth... I stopped critically thinking in year one of med school because I couldn't get any straight or good answers when questioning why we did outdated things. That's when I started to feel like a robot getting pumped into med school on one end as a human being and pumped out the other end as a doctor. Sorry for all the words--it feels good to get it out.

I hope I answered some of your questions. If not, feel free to ask for clarification!

I'm currently working with a government-funded job placement agency and am hopeful we can help me find a place that does treat me better! I like that--firmly but fairly.
 

schilling0455

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In the meantime, I was planning to go to the mall today and see if I could get hired on the spot for any old job.
 
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Chris Sciora

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Can you guess where this is leading to? I did the college, the med school, and part of the residency. And then I couldn't take it anymore. How sick the system is, how sick the patients are, how we as doctors really really really suck at helping them because imho, we're just glorified drug dealers.

Anyway, I also got my medical license. My plan was to open a private practice and do cash pay (since many health insurance companies also don't wanna work with us lowly non-board-certified docs). I hopped onto the bandwagon of a physician who promised everyone could open up their dream private practice. It didn't work out for me. Partially because I got in my own way.

I've been interacting with White Coat Investor and the WCI forum crowd for several years. Completely understand where you're standing now. It's probably in a hole about $300K - $600K deep. For what it's worth, I truly believe the future of private practice for people like yourself is either concierge practices or DPC subscription plans like this physician is offering in our area. It's hardly the world's greatest website, but she's sincere and it comes across well.


It happens that I understand the business side of the practice (50% overhead to chase down insurance claims. WTF?!?), but the reality is that people with money hate dealing with the medical bureaucracy even more than you do. We're happy to pay for physicians that actually show up on time for appointments and don't race out the door after 15 minutes. Yep, I'm completely willing to pay for DPC out of pocket on top of insurance premiums solely to reduce the BS and complete waste of my time that happens in most practices.

Taking our two dogs to vet appointments is about 1000x better than almost any medical provider visit.
 

Chris Sciora

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In the meantime, I was planning to go to the mall today and see if I could get hired on the spot for any old job.

Getting a job at the mall is flat out giving up. You will be lightyears away from helping anyone. I don't understand how "I got my medical license" can happen without finishing residency, but so be it. Lord Almighty, take a telemedicine gig making $200 / hour or locum tenens work before selling iPhone cases from a kiosk.


If you got into medical school, you're already in the 0.01%.
 

Happyheart

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There are many different options other than running around in a hospital and living on 2 hours of sleep per night. There are medical professions and residencies, that may even be compatible with life.
Think about family medicine, laboratory medicine, radiology, or even research. You would also have little problems getting a well-paying job if you so wish as a pharmaceutical representative.

But you are on the fastlane forum, so I assume that you have other aspirations? Working at the mall is hardly something you want to pursue. There are a lot of people with good advice here, but you should take a deep breath and think again about the middle way between working yourself to death at a high-end medical job and working at the mall. Even better, work on a fastlane plan.
 
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schilling0455

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It's probably in a hole about $300K - $600K deep. For what it's worth, I truly believe the future of private practice for people like yourself is either concierge practices or DPC subscription plans like this physician is offering in our area. It's hardly the world's greatest website, but she's sincere and it comes across well.
Yep, it's in that range. Thank you, that's good to hear, especially that there are people willing to pay for it on top of premiums. I'll take a look at her website and am especially curious how her sincerity comes across!

I don't understand how "I got my medical license" can happen without finishing residency, but so be it. Lord Almighty, take a telemedicine gig making $200 / hour or locum tenens work before selling iPhone cases from a kiosk.
That's what I was trying to explain/help people understand in my first intro post. My state changed its laws though so now one needs to finish residency to get their license. Every state is different. I've looked into many telemedicine gigs and they all need BE/BC. Locums typically does too but have been looking at ones without the requirement. The barrier now is the application where it wants references when I don't trust my former boss to give me a good reference and where I worked pretty much solo in the past. Also, that I'll likely need to relocate and I've moved 3 times in the past 3 years. It's probably all sounding like excuses and they kind of are. I've been having recurrent burnout since med school. I'm looking for a job just to pay bills. It's a temporary thing while I recover some more and figure out what's next.

To add more information: when I had a brief respite from the burnout/self-doubt/etc early last year, I formed a professional S-corp and had a vision for helping people taper from a certain class of medications which have been found to be not as safe as they've been advertised to be and to cause dependency as well. I talked to a doctor who had done this before and felt scared of malpractice. Suicide rates can be high on and coming off of the drugs. Anyway, long story short, I haven't done anything with it. I've thought about dissolving it but realized that I'm not in a good place to make sound decisions.

Also, just with the feedback from here and my own thoughts offline, I do still want to practice medicine in some form, even if it would turn to health coaching to reduce liability and costs.

Got back from the mall and will make myself apply to one of the places where I got to talk to the manager. Pays less than another place at the mall but only needs to work part-time, 20 hours min, to get benefits. We'll see if I get it. The being a doctor thing on my resume seems to be ...?menacing?
 

schilling0455

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There are many different options other than running around in a hospital and living on 2 hours of sleep per night. There are medical professions and residencies, that may even be compatible with life.
Think about family medicine, laboratory medicine, radiology, or even research. You would also have little problems getting a well-paying job if you so wish as a pharmaceutical representative.

But you are on the fastlane forum, so I assume that you have other aspirations? Working at the mall is hardly something you want to pursue. There are a lot of people with good advice here, but you should take a deep breath and think again about the middle way between working yourself to death at a high-end medical job and working at the mall. Even better, work on a fastlane plan.
Thank you! I definitely agree.

My current plan is to find a job to pay my bills and feel secure/ease my money anxiety. Hope to get a part-time job so I can have enough space and energy to also work on fastlane pursuits.
If you got into medical school, you're already in the 0.01%.
Thank you for the reminder--helps my imposter feeling. Your whole response actually shook me to tears. I do feel like I've given up in some ways and it's a tough pill to swallow. However, in other ways, I know I won't give up. I do need to find a new direction though, whether in medicine or not.

I sometimes regret not listening to others when I was in college and they warned me about how expensive med school was and I'd respond that I didn't care and would pay it off eventually anyway. Or they warned me about how hard it would be but I believed in myself and my ability to get through it. I did but not without a lot of emotional scarring. So, I guess maybe now, I'm trying to be less naive and idealistic. Actually, I can't even afford to be so anyway.

Life has a funny way of teaching us things
 

Chris Sciora

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The barrier now is the application where it wants references when I don't trust my former boss to give me a good reference and where I worked pretty much solo in the past.
Think about some low effort ways of practicing for 6 - 12 months to earn a better reference.

One of my doc friends is doing telemedicine at the moment, but has worked/volunteered in the Ironman Triathlon med tent for twenty years and still counting. You could look at helping out with local race events, high school and university competitions, urgent care facilities, non-profit community health care and even downshifting to picking up paramedic shifts. There's plenty of places around that would love to have a licensed physician on hand and will never care what you did or didn't do last month or last year.
 

NeoDialectic

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I kind-of want my doctor to be watching their every move regardless of whether they're easy to sue. (I had a smiley face here, but it turned out massive so I removed it).

But it'll be interesting to hear the proper responses to this - as I read it there's a general reputation for doctors in the US being at the mercy of law suits but I'm not sure how that stacks up as a percentage of actual work done, nor how it compares to anywhere else. It's more prevalent here in the UK than it was, and there's a "blame the US" culture for how everyone wants to sue for compensation over the tiniest little thing which may or may not be deserved (and not just medical related).
I can't speak from a Doctor perspective, but my wife is a Dentist which is kind-of-ish the same type of field. It is TRUE that there is always a looming thread of lawsuit..... But in reality, like most things it is WAY overblown and shouldn't be a big deal. It will likely happen to you sooner or later, but that is why you carry malpractice insurance. Don't do anything truly reckless and take notes of everything you do and if something happens, insurance will take care of it. That isn't to say that on a personal level it SUCKS having to deal with it. I know first hand from just being in business that when anyone threatens to sue, whether you have insurance or not, it is stressful.

But the point is that unless you are doing something grossly negligent, there is nothing to worry about financially.
 

schilling0455

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I can't speak from a Doctor perspective, but my wife is a Dentist which is kind-of-ish the same type of field. It is TRUE that there is always a looming thread of lawsuit..... But in reality, like most things it is WAY overblown and shouldn't be a big deal. It will likely happen to you sooner or later, but that is why you carry malpractice insurance. Don't do anything truly reckless and take notes of everything you do and if something happens, insurance will take care of it. That isn't to say that on a personal level it SUCKS having to deal with it. I know first hand from just being in business that when anyone threatens to sue, whether you have insurance or not, it is stressful.

But the point is that unless you are doing something grossly negligent, there is nothing to worry about financially.
I agree. It's really the relationship that's important and owning up when mistakes happen.

Yeah, I need to build up capital again to get new malpractice insurance. When I'd wanted to go 100% telemedicine, apparently it wasn't cool with traditional carriers and nontraditional ones required ~$5000 upfront for a year which I couldn't and still can't afford.
 
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schilling0455

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Happy to report I've been feeling more like the better version of myself since about a week ago. Not sure what changed--maybe stopping a supplement, maybe picking up Unscripted and finding immediate resonance, maybe just time...

My mind has many ideas. One that occurred as I finished up Unscripted was creating an online course to help doctors pay off their debt faster. Not sure if it's a viable idea but first step is to find channels and ask/test... Might as well give it a goo

I have to admit I did buy an overpriced online course from a doctor who would teach us how to make online courses. That was about 2 years ago and I didn't do much with it. Something I could do is actually follow it. His suggestion is to go into facebook groups and have target audience fill out a survey.

Also, wanted to update that I'll be having some interviews to get doctor-level jobs so yay! I plan to work part-time so I can have enough time/energy to work on the process to a successful productocracy :)
 

schilling0455

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Suspecting the idea I came up with isn't such a good one after all. Looked at White Coat Investor reviews on Amazon and read the lower ratings to see what the critiques were and if there were any problems that I may be able to find solutions for. Most of those were about how it was too basic and many people knew the basic principles already. Also complaints of how it was clearly geared to funnel people towards his website which has much more information. On the flip side, while I didn't read too much of the 4-5 star reviews, it did seem like for some people, this was a good introduction... So perhaps there is more market for it? I'm not sure now as I type this out. I'm leaning towards the negative reviews and of people mentioning there's so much free information on budgeting and such on the internet. Hmm
 

schilling0455

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18
8
Had a few interviews as a physician at places but some are understandably concerned that I'm not board-eligible or certified. Hoping for some good news just to get steady income. At the same time, this really makes me just want to start my own practice.

Also, a couple of my friends wanted me to order labs for them and I do get a discount with Quest. When I have them bill it to me versus to them directly or to their insurance, the cost is way cheaper. I've noticed there are sites/services out there that do offer patients to order labs for themselves at a discount. I actually used it myself quite a few years back. I wonder if I can still enter that market and somehow do it better. Of course, I need to first see if it passes the CENTS test.
 
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Haji Mastan

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PTSD from medical education
oh wow haha. as an ex.mil i am familiar with the PTSD and that it can be from many sources.

on another positive note, I am switching careers and starting med school (albeit here in Europe) in October.

There are a few doctors here in FLF that are absolutely killing it.
 

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