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  • #31
    A zebra is a rare medical condition.  If you hear hoofbeats it is likely a horse but it could be a zebra.

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    • #32




      A zebra is a rare medical condition.  If you hear hoofbeats it is likely a horse but it could be a zebra.
      Click to expand...


      Thank you, figured it was an insider term. I googled but it got me to Africa.
      Our passion is protecting clients and others from predatory advisors. Fox & Co CPAs, Fox & Co Wealth Mgmt. 270-247-6087

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      • #33
        Option C-Can you add the commute time to your current job by adding another 1/2 or full day?  Income should increase.  Instead of commute time, you are spending it working which I would prefer.  If you wouldn't do that, I would stay pat and not commute.  Remember as doctors our schedules rarely end reliably at a given time.  You may be trading hardly seeing your kids on the days you commute for money.

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        • #34


          And the drive itself is so long, I just don’t like spending that much time in the car. I have podcasts, and books, and catch up with siblings and parents but still….. Oh, and we live where I have at least 5-10 days per winter that I am driving to work on ice or 4+ inches of unplowed snowy highway since I leave so early so that really affects my decision!
          Click to expand...


          Long commute time has two issues

          1. Medically unproductive, non- reimbursed time.

          2. Increased risk of accidents due to long driving distances, adverse road conditions as mentioned above due to unusual timings, and tiredness and drowsiness that leads to lack of concentration.

          Even though my driving time to office is less than 5 minutes I have an additional 25 minutes drive in the morning taking my daughter to school. But it is an enjoyable father -daughter bonding time where I get to hear about her achievements, fears and expectations. And listen to her taste in music ( who knew that with a name like the Chainsmokers you can produce number one hits and I'm in love with the shape of you can be a hit song for a teenager  :P ).

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          • #35





            Maybe it is 70 minutes to research a zebra before the next morning report. 
            Click to expand…


            research a zebra?
            Click to expand...


            This is from a medical school teaching point. In the US, horses are more common than zebras. If you see an animal on 4 hooves here, suspect a horse before a zebra.

            Some disorders are more common than others. Holding all else equal, one of the common disorders is likely to be the correct diagnosis. Don't think first of rare disorders (zebras).

            I think this analogy is used universally in medical schools. I may have read this first in House of God way back when. In any event, it was used on rounds at my institution.
            Erstwhile Dance Theatre of Dayton performer cum bellhop. Carried (many) bags for a lovely and gracious 59 yo Cyd Charisse. (RIP) Hosted epic company parties after Friday night rehearsals.

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            • #36


              ome disorders are more common than others. Holding all else equal, one of the common disorders is likely to be the correct diagnosis. Don’t think first of rare disorders (zebras).
              Click to expand...


              And it used to be emphasized that an uncommon presentation of a common medical condition is more likely than the common presentation of an uncommon condition.

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              • #37





                Maybe it is 70 minutes to research a zebra before the next morning report. 
                Click to expand…


                research a zebra?
                Click to expand...


                I know it's been explained already but I had to dig up this clip ☺️

                 

                https://youtu.be/-Y9C3-DCrjM

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                • #38








                  Maybe it is 70 minutes to research a zebra before the next morning report.
                  Click to expand…


                  research a zebra?
                  Click to expand…


                  I know it’s been explained already but I had to dig up this clip

                  https://youtu.be/-Y9C3-DCrjM
                  Click to expand...


                  lol, thanks, i just wasted 10 minutes of my workday watching clips from Scrubs. That was awesome.
                  Our passion is protecting clients and others from predatory advisors. Fox & Co CPAs, Fox & Co Wealth Mgmt. 270-247-6087

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                  • #39
                    Let me ask about one more possibility...

                    What about a 2 hour commute each way (all highway and no traffic) if it were three nonconsecutive days per week and resulted in more income (maybe 200k increase) and an end to the frustration of dealing with a shady administration in the current job?

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                    • #40




                      Let me ask about one more possibility…

                      What about a 2 hour commute each way (all highway and no traffic) if it were three nonconsecutive days per week and resulted in more income (maybe 200k increase) and an end to the frustration of dealing with a shady administration in the current job?
                      Click to expand...


                      You must have very easy work days. Derm?

                      I couldn't even consider adding 2 hours to each end of my day. I wouldn't be able to function. Not possible.
                      Erstwhile Dance Theatre of Dayton performer cum bellhop. Carried (many) bags for a lovely and gracious 59 yo Cyd Charisse. (RIP) Hosted epic company parties after Friday night rehearsals.

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                      • #41
                        2 hours each way on non consecutive days sounds terrible.

                        Would be better to do them consecutive and get a cheap ****************** apartment to stay in. Save 8 hours of driving and wear and tear and use savings to get somewhere to sleep. Or get the job to subsidize it.
                        An alt-brown look at medicine, money, faith, & family
                        www.RogueDadMD.com

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                        • #42
                          An extra 200k is pretty impressive, although each person has their limits. At two hours each way three days a week, you're looking at 12 hours a week commuting. I don't know what your current commute and schedule is, but if it's the average American commute (25 minutes each way), it's 4.17 hours a week. So you'd be getting paid an extra 200k for an extra 7.83 hours a week. Let's say you work 48 hours a work after vacation and CME time. That comes to $532/hour before taxes. That's a pretty solid hourly rate. But, everyone has their breaking point and four hours a day in a car is rough. Cheap apartment is also an option as mentioned above depending on the COL in your area.

                          Another important issue would be the call situation... would you be on call from two hours away? That doesn't sound feasible

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                          • #43
                            I hate commuting, and I love my free time. Pulling any lever that increases the former, decreases the latter (and vice versa).

                            Time lost commuting can never be made up. Lost wages from a distant job can.

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                            • #44
                              Remember you already make 700K. Even 200K would be less than 1/3 increase in a already high income and half of it will go to taxes.

                              No way will I commute 4 hours each day for 3 days.

                              What about the other 4 days a week. Will you be off on those days?

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                              • #45
                                Yes I would be off those days

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