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  • StateOfMyHead
    replied
    Originally posted by SLC OB View Post

    Gotcha...
    I tell all my teen patients to not let the teenage boy put his penis inside until he has figured out how to give her an orgasm first... so of course I had to teach my boys that too!
    This seems like an unusual conversation but hopefully that tidbit is reserved for after the birth control and STD education​​​​​.

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  • AR
    replied
    Originally posted by SLC OB View Post

    Gotcha...
    I tell all my teen patients to not let the teenage boy put his penis inside until he has figured out how to give her an orgasm first...
    Well, that will definitely buy some time. Maybe a lot of time.


    so of course I had to teach my boys that too!
    I can't even imagine that conversation. You really need to write that book.

    I also talk with my kids without looking at them... meaning when we are driving somewhere or I would trail run and he would mountain bike... lots of good conversations when he was younger about truth or dare games, etc. Obviously, if I need eye contact, I make it. But they are often more open to talk when not looking right at you.
    I think I should embrace this more. Both my kids like to avoid eye contact when we're discussing certain things. I guess as long as they're listening, that is the important thing.

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  • SLC OB
    replied
    Originally posted by AR View Post

    I kind of assumed bolded and if you had said it was your daughter, I'd have been impressed also but less so (I think my wife and daughter will be pretty close to that). I didn't think it would transfer much to sons as I would have expected most of your professional experience to be with teen girls. But that is probably my own bias creeping in and perhaps it's not as different as it feels like to me.
    Gotcha...
    I tell all my teen patients to not let the teenage boy put his penis inside until he has figured out how to give her an orgasm first... so of course I had to teach my boys that too! I also talk with my kids without looking at them... meaning when we are driving somewhere or I would trail run and he would mountain bike... lots of good conversations when he was younger about truth or dare games, etc. Obviously, if I need eye contact, I make it. But they are often more open to talk when not looking right at you.

    Leave a comment:


  • jfoxcpacfp
    replied
    Originally posted by AR View Post

    This has been 100% my experience. Granted it was only 2 CPAs, but in both cases I did the Roths myself. All they had to do was prepare the taxes. They couldn't get form 8606 correct. And this was after I had a conversation about back door Roth with them prior to hiring them. One of them billed me extra to fix the mistake after I pointed it out.

    Maybe I just got unlucky with those two. Now I do Turbo Tax. Don't see myself going back. My taxes are admittedly quite easy, though.
    I hope you didn’t pay that bill.

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  • AR
    replied
    Originally posted by jfoxcpacfp View Post

    I’m not talking about being aggressive in the least. I’m just talking about bad advice ... don’t know anything about a backdoor Roth.
    This has been 100% my experience. Granted it was only 2 CPAs, but in both cases I did the Roths myself. All they had to do was prepare the taxes. They couldn't get form 8606 correct. And this was after I had a conversation about back door Roth with them prior to hiring them. One of them billed me extra to fix the mistake after I pointed it out.

    Maybe I just got unlucky with those two. Now I do Turbo Tax. Don't see myself going back. My taxes are admittedly quite easy, though.

    Leave a comment:


  • jfoxcpacfp
    replied
    Originally posted by Hank View Post

    Seems pretty uncommon for the CPA to be more aggressive than the client.

    Not sure what one would argue about with a back door Roth IRA contribution. With the possible exception of Michael Kitces, it seems like folks either are informed about the back door Roth or ignorant of it. (Kitces was perhaps the only generally well informed commentator who took an erroneous position against the back door Roth IRA prior to Congressional clarification.)
    I’m not talking about being aggressive in the least. I’m just talking about bad advice, the kind I hear regularly when I listen to doctors in an initial consult. That includes CPAs telling doctors they make too much money to put money in a Roth and don’t know anything about a backdoor Roth. I”m not making this up. Writing off cars is a regular recommendation to save money. Along with setting up an s-corp to get more write-offs or to be able to set up a retirement plan. Need I go on? All within the last few months (until we quit taking new appts).

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  • Tim
    replied
    Likely should actually depend on the professionalism and value of the services. You do know that CPA's and FA's make decisions to fire clients as well.
    If you have doubts, don't do it. If you can keep the two relationships separate and feel the FA/CPA can as well, make your choice.

    Leave a comment:


  • Hank
    replied
    Originally posted by jfoxcpacfp View Post
    What if your new CPA recommends you write off a car through your practice, even though you just commute? Or argues with you about a backdoor Roth? That just seems awkward to me, especially if it’s a small town.
    Seems pretty uncommon for the CPA to be more aggressive than the client.

    Not sure what one would argue about with a back door Roth IRA contribution. With the possible exception of Michael Kitces, it seems like folks either are informed about the back door Roth or ignorant of it. (Kitces was perhaps the only generally well informed commentator who took an erroneous position against the back door Roth IRA prior to Congressional clarification.)

    Leave a comment:


  • jfoxcpacfp
    replied
    What if your new CPA recommends you write off a car through your practice, even though you just commute? Or argues with you about a backdoor Roth? That just seems awkward to me, especially if it’s a small town.

    Leave a comment:


  • Tim
    replied
    Originally posted by SLC OB View Post

    Interesting thought... maybe I should write a book.
    My sister in law gets on her kids phone, reads all texts, etc. Her kids have completely rebelled. I give them some grace and am there for them when they fall. Super open about everything. But some of that comes with how I was raised and my specialty. I have to speak with teens all the time about being safe, orgasms, etc.
    Have you considered a reality TV show? Interesting side gig, it has potential $$$!

    Leave a comment:


  • AR
    replied
    Originally posted by SLC OB View Post

    Interesting thought... maybe I should write a book.
    My sister in law gets on her kids phone, reads all texts, etc. Her kids have completely rebelled. I give them some grace and am there for them when they fall. Super open about everything. But some of that comes with how I was raised and my specialty. I have to speak with teens all the time about being safe, orgasms, etc.
    I kind of assumed bolded and if you had said it was your daughter, I'd have been impressed also but less so (I think my wife and daughter will be pretty close to that). I didn't think it would transfer much to sons as I would have expected most of your professional experience to be with teen girls. But that is probably my own bias creeping in and perhaps it's not as different as it feels like to me.

    Leave a comment:


  • SLC OB
    replied
    Originally posted by AR View Post

    If you ever write a book on how you cultivated such a level of openness that your teenage son is comfortable telling his mom when he is having sex, I'd absolutely read it. I hope to get there with my own kids but I expect to fail.
    Interesting thought... maybe I should write a book.
    My sister in law gets on her kids phone, reads all texts, etc. Her kids have completely rebelled. I give them some grace and am there for them when they fall. Super open about everything. But some of that comes with how I was raised and my specialty. I have to speak with teens all the time about being safe, orgasms, etc.

    Leave a comment:


  • F0017S0
    replied
    Originally posted by Nysoz View Post

    It's all areas of gray for non Psychiatrists IMO. What if the surgeon never operated and only saw the person once a year ago? What if the EM physician was staffing an urgent care and saw a person once for sniffles?

    https://www.ama-assn.org/delivering-...ships-patients

    I think former patients would be ok given a long enough time frame between final contact and the historical professional relationship doesn't have influence on the current personal one.

    Current patients are right out.
    When is "long enough"? Seems really squishy and fraught with enormous peril in the current era where a complaint is a few clicks away if the relationship sours, then all of a doc's hard work is at risk (I would argue the same applies to any high-paying profession). Some would say the possible outcome of a good relationship is worth the "risk", but the outcome might have a very low order of probability with a very high risk of failure and other adverse sanctions.

    Leave a comment:


  • AR
    replied
    Originally posted by SLC OB View Post

    So my son came home from a house his friend was house sitting at. Two girls and him, playing games (my kid is honest, tells me when he drinks, having sex, etc. so I believe him).
    If you ever write a book on how you cultivated such a level of openness that your teenage son is comfortable telling his mom when he is having sex, I'd absolutely read it. I hope to get there with my own kids but I expect to fail.

    Leave a comment:


  • StateOfMyHead
    replied
    Originally posted by tndoc View Post
    What's even worse... is seeing a spouse of your staff. Most times I have done this it has been fine, but some just don't understand boundaries. I have stopped doing this (and feel a bit guilty at times for not being as "doctorly" or compassionate as I maybe should be) after two of them started giving me daily update's about their spouse's BP control and what adjustments were needed.
    Or still even worse... your own staff. Some were already patients of our practice when I joined years ago. Getting a text on the weekend about an acute issue is totally inappropriate. I am sure there are instances of this being totally fine, but many just don't understand proper boundaries and channels of communication. I hear often about patients getting a "z pack" or steroids from the physician or midlevel they work with. I just don't want to do that. Maybe I'm getting too jaded in my middle-aged years ?

    Recent example... staff member (and pt of another physician) calls answering service on weekend requesting antibiotic (which I NEVER do, I am as useless as feasibly possible while on call for many reasons that you know already). I usually don't return these calls for refill request or antibiotic as the recording clearly says we don't do that. A few hours later office manager texts me asking if I received the message from the office staff. Relayed they need proper evaluation and testing as may be something else. Office mgr agreed that was completely inappropriate. They were checked out the next day and had covid -- so by not complying I saved half of my office from being in very close contact to COVID because you know they would have showed up for work that day if I had sent an antibiotic (I just have bronchitis not covid!)
    Yes and in my opinion also inappropriate for the office manager to have texted you to follow up on the other staff's inappropriate message.

    Leave a comment:

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