Owning a business

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I have no financial planner
I have these assets in the permanent portfolio and golden buttery portfolio right now...

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Stocks still going down for 10 yrs straight?...

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In one of my buckets I have about 40% Bonds what are the thoughts of the members here about converting them to Stocks right now since the prices are...

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Why not buy more stocks at this point considering they are so much cheaper?

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Would you put the other 30% in treasuries? Mid to long term ?...

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Right I don’t see any better options but people suggest Bitcoin gold cash REITs etc...

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So if retirement is like 15 yrs away do members here recommend getting out of stocks ? And bonds too ?...

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I thought Byzantine is the adjective used to describe toxic bureaucracy.

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Same here...

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https://www.whitecoatinvestor.com/10...wn-a-business/
just read this amazing article on WCI , it’s a great primer into pros of business ownership...

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Again I’m not suggesting removing them completely from their practice nor am I suggesting lower compensation for services they are rendering
but...

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Classic case of whataboutism...

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I’m not defending the role of midlevels but that’s not something which you or I can change but I don’t see how adding more less qualified candidates...

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MDs who don’t match are different issue altogether, do we really want doctors without residency to be managing patients ? Let’s save that for another...

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Please tell me more about this , which healthcare system is this ?
thanks...

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Only if you are plumber onboard a SSBN otherwise I’m not sure it’s deserved...

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No I didn’t mean same pay as midlevel
but consider then
3 days you do your regular FP stuff
2 days you jam pack your schedule with...

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As it says on the tin
what do you guys think , I’m a pcp myself not meant to be offensive
rather than specialists use NP PA for frontline...

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There is a fundamental difference there is no direct invasion threat to US homeland and we still have the largest military by far...

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No he’s not
even China is not Alaric
************************ even USSR wasn’t in the heyday of Cold War
USA was the Alaric if British were the Roman...

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I turned down Locum once as they wanted to do ekg on every kid for sports physical! The office manager told me that’s what parents want
I said...

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See the ND down the street and get your antimony and molybdenum blood levels...

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Is this based on actual recommendations of some medical society?...

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After how many yrs of service do you become eligible for this plan ?
let’s say someone starts with Kaiser at 50 will they be eligible by 65? And...

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Thanks
it’s really hard to compete with cash buyers so no guarantee I’ll get it...

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Rent indefinitely or until a crash 💥...

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So what will make me ready ?...

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Can but cons are
slightly less payment but boss much less happy

no idea when or if market goes down so how long should we rent ? As...

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Sorry
not sure if I follow...

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20k debt
income 300k
attending approx 10 yrs...

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600k house
approx 140k overpriced per precovid numbers
its exactly the house you want
you need a house now as family needs it
...

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Kamban
you are describing a private practice model , other than that there is no hope for employed family /primary care medicine doctors?

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Very true
it sickening...

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Coming back to this
any comments suggestions are welcome...

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I think this an existential threat to PCP only because the quality of care MD DO provide is hard to quantify with most metrics that are currently used...

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Do midlevels exist in Europe Australia and japan ?...

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Yes but question is for how long ? And what factors are preventing big organizations from scrapping MDs altogether?...

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So why isn’t this happening faster ?
in future will we need to put compete with midlevels by agreeing to less pay ?...

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Yes that’s exactly what I was alluding to
How can we keep ourselves relevant strictly from a business perspective...

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No a puppy , and he writes his obituary with puppy tears...

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What is stopping all the bighealthcare companies from replacing primary care doctors wholesale with mid levels ?
This is not another mid level bashing...

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Dr Strangelove one of the best movies ever...

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Ditto
self fulfilling prophecy will haunt the Russians
even the neutrals will not line up to join NATO...

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In a decentralized battle environment even if they did have air superiority it would not make much of a difference...

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To an extent yes I agree

but media directs us where it wants
there is / was a long running war in Yemen and a great humanitarian...

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We in the west have to shoulder a lot of the blame on one hand encouraging Ukraine to show Russians defiance and now doing nothing to stop them
...

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In this case arming citizen is just asking for a mass slaughter by red oops Russian army
isn’t it illegal under international law ?and I know...

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It’s like a new religion either you tow the official line or get ready to be branded a heretic and burned at the proverbial stake...

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Warmongers in both parties must have a hard on right now. Hopefully the president has the sense to show restraint.

There is lies on both...

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Your detailed reply is much appreciated...

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Poland was within Warsaw Pact so it was easier...

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It’s a calculated gamble on Putin part he understands no one in the west will risk all out war for Ukraine...

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Can you please elaborate what kind of data specifically?
Thanks...

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Yeah Bismarck said Americans are very lucky they are surrounded by fish and weak neighbors

but at the same time let’s not start ww3 just...

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Hi
so I have been asked to advise in the research and development of a medical device for remote patient monitoring
the developers ( who are...

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Every castle can be breached with the right weapons...

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Agreed
remember we went to ww1 based on Zimmerman telegram fearful Mexico might retake what we took from them ?
personally I feel more needs...

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The problem with current events is that nobody can judge them based on available information today
True picture of a major international crisis...

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CNA work a lot harder than RN generally speaking
they can be taught all this...

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CNA can be made to act like RN too , What functions can RN Perform which they cannot?...

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How is the nursing lobby more powerful than doctor lobby ?...

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What can we do to alleviate the shortage of RN ? Can we have medical assistants go through a crash course in 3 months and become ersatz RN ?

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Gone are the days of reading books cover to cover , unless it’s a really niche field...

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I use my partners airline card , she gets a ton of points
its a win win...

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Joke ! Relax
ive been to ironwood...

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“ l know right !” Wtf does this mean ?
“ I know my body” ugh you need a magician then not a physician
” carbs on carb” stop judging...

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We already occupy upper peninsula Michigan which seems like Canada to me...

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That’s right ! Unless those pesky canuckistanis rebel against us...

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Slavs in many ways are the most oppressed people in history
we in the western world have demonized them as ruffians far too long
My dad who...

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Slavic conflicts are not all like Balkan conflicts...

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Difference is 1939 Germany was a weak nation with nothing to lose by disrupting the status quo in Europe

Russia a established nuclear power...

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Protectorate of USA...

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Isn’t it better to buy cheaper but higher interest rate ? Esp if you are buying for forever house and not starter home ?...

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Good point

how big of a house are you looking at ?...

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APN started as physician extenders too just tools to increase physician productivity...

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I agree that there is too much inertia in medical field and machines are overhyped as they are considered sexy or futuristic but
If both ( APN and...

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https://www.smithsonianmag.com/innov...web-165260940/
seems like a “Saul trying to become Paul” case...

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Remote patients monitoring is like that too...

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Physical exam
subjective tests for wellness not relying on scores
reimbursement based on time...

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I can show you many primary care MDs ( 20 yrs in practice ) who can’t properlyread ekg dont even get me started on APN
point is nobody is saying...

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How many primary care midlevels can ?...

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I don’t think physicians of any kind need to be threatened by AI in the near future but I don’t see how it cannot be a substitute for Midlevels in...

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Buy a fixer upper
look for properties not on MLS...

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Agree 100% that rural areas should get more importance
and race gender and religion should have no role in picking candidates
And I belong...

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Expect the unexpected
forget that your life is ever going to be the same again
Put your time in silos , multi tasking rarely works...

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Isn’t that what a lot of “ providers” do anyway ?...

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Yes indeed we sound like the battleship admirals before World War I talking about submarines...

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Is it possible with existing technology to replace mid level primary care providers with AI based robots ? I’m not talking about a human looking one...

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Ideally yes but what’s the harm in sharing some tips...

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How long can the business show losses and still get tax benefits or write offs?

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General question to all FP/IM
Can one open a FP/IM practice where you only see certain conditions NOT all diagnosis ( eg if you have syncope I...

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Evolution of God by Robert Wright...

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Bump...

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I had to do it when my dad was living with me he had a lot of health problems it actually worked out really well
I don’t think I want to at this...

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What is your opinion of cash only practices ? I feel like that’s not for the faint hearted...

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That is about as evil as it can get
esp since for many people gas money is a big issue...

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Your position is far better than an average FP IM who goes into PP usually straight out of training
Again specialty practice is much different...

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If one tried it for atleast a few yrs and it didn’t make enough money to offset your costs then it’s a failure regardless of how it’s sugar coated...

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What kind of characteristics such an area should have in your opinion...

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What would be the fidelity equivalent of BND ? Like a total bond fund
is something like that more diversified thus less volatile than long term...