9 ms·

You're welcome! Basic answer: $250/h + benefits and 4 days/week "off". Plus, working in the ER at night is the most fun job I've ever had or probably ever will

You're welcome! Basic answer: $250/h + benefits and 4 days/week "off". Plus, working in the ER at night is the most fun job I've ever had or probably ever will have. (Programming is second.) Despite this, I plan to pivot to my telemedicine business full-time within the next year. I know I am not invincible and the older I get, the more mistakes I am likely to make and the more working nights will become a risk factor for heart disease, diabetes, and the like. Plus, working nights wreaks havoc on the family, but it's the only option to work stable days each week in the ER. (Ie, most ER docs either work all nights or work a random rotating schedule of first, second, and third shifts.)

leaferino 2y ago
What's your telemedicine business?
- hundreddaysoff 2y ago
  Main telemedicine gig right now is diagnosing and managing HIV and other STDs. Patients love it as it's super private, and even testing can be done discreetly at home with a mailed kit. Currently completing an online fellowship in obesity medicine and plan to start my own online practice or collaborate with midlevels who do so. Will probably get into tele-urgent care as well. I've learned a little about all aspects of medicine as an ER doc, and it's exciting to apply that knowledge to telemedicine. Telemedicine is the Wild West right now. COVID-19 just opened it up a couple years back. We don't really know how to maximally benefit patients with it, but there are all kinds of new models being tried. When it works, it really works, without all the bloat and entrenched rentiers that can make brick & mortar medicine awful for both doctors and patients. Reminds me of the state of the Internet around 2000. Wide open.
el_benhameen 2y ago
Completely understand if you don’t have the time or desire to answer questions, but I’m curious whether you went programming -> MD or the other way around, and how you made the transition.
- hundreddaysoff 2y ago
  1. Grow up in the 90s and play too many video games and read the Extropians list too much. 2. Decide I want to be, like, the Hagbard Celine of pharmaceuticals and cure death, or something. 3. Learn programming because I still need a job if I fail at (2) and anyway programming is fun and people are scary. 4. Double major in CS and Bio, do bioinformatics research for minimum wage. 5. Move to Berkeley, learn more programming working at a random startup for minimum wage. 6. Get a job as a bioinformatics programmer at a lab; learn lots more programming and some bench biology and publish papers, under the theory that I need papers and a PhD to start a pharmaceutical company. 7. Look around and decide I don't want to be postdocking in SF for $40k/y when I'm in my 40s and have kid(s). 8. Enter an MD/PhD program (MSTP, ie combined and debt-free degrees) as a lowish-resistance hedge even though I dislike premeds and also the entire bloated medical system. 9. (8 years later) Do residency in Emergency Medicine because it's really fun and all the other specialties bore me. (Except radiology, but that's no fun with chronic sciatica.)
  - p1esk 2y ago
    Why do you say emergency medicine is fun? I imagine you often see people in pain, life degrading injuries, and all kinds of other sad things.
    - hundreddaysoff 2y ago
      Well, here's how an ideal night goes for me. https://forums.studentdoctor.net/threads/patients-per-hour.1490403/post-24173260 https://forums.studentdoctor.net/threads/patients-per-hour.1... (Writing this in the middle of the night from that critical access ER I mention.) I just don't think there's any other medical specialty that has a job as action-packed and gratifying as my job is for me. Surgery would be gratifying, for sure, but also I hate formal clinic and I have a weak bladder, so no. Yeah, I guess I see lots of sad things. But (1) often patients are sad about things that could've happened but didn't actually happen, and I can cheer them up just by telling them the truth. (2) Often I can make patients happier if actual sad things happen to them, at least in the moment, and that makes me happy too. And (3) if I got sad every time I saw a sad thing, I'd be too sad to do my job and then I'd get fired. So, like, these things don't really make me sad because I'm here to do my job, not to get big feelings? Does that make sense, or too facile?
ibatindev 2y ago
Having worked as an MSI (Medical Specialized Interpreter) at $4/h, I've noticed that patients are still very reluctant to accept telemedicine for anything other than reviewing lab results.Do you possess a strategy to overcome this challenge? LATAM Subcontractor for Teleperformance/LanguageLine Solutions/Pacific Interpreters.
- hundreddaysoff 2y ago
  The strategy I possess is to use telemedicine in novel and directed ways when it suits the purpose. Most telemedicine roles I have interest in start with a very directed patient population and a limited set of interventions. Patients at risk for HIV, obese patients, etc. In this context, these subsets of patients are happy to accept special-purpose telemedicine, in my experience. I personally would not want to see a primary doctor or surgeon over the Internet, and if I needed follow-up testing in the lab right next door anyway, I would prefer to go in person to both places in one "quick" trip rather than dicking around with the Internet before going out to the lab anyway. Patients are right to be reluctant. Telemedicine offers a lot of benefits, but it can never be as thorough as time in person with a primary doctor. (But this in-person time is just not possible to get for your average patient in my experience.)
Sparkyte 2y ago
250/h thats solid.

leaferino 2y ago

What's your telemedicine business?

hundreddaysoff 2y ago
Main telemedicine gig right now is diagnosing and managing HIV and other STDs. Patients love it as it's super private, and even testing can be done discreetly at home with a mailed kit. Currently completing an online fellowship in obesity medicine and plan to start my own online practice or collaborate with midlevels who do so. Will probably get into tele-urgent care as well. I've learned a little about all aspects of medicine as an ER doc, and it's exciting to apply that knowledge to telemedicine. Telemedicine is the Wild West right now. COVID-19 just opened it up a couple years back. We don't really know how to maximally benefit patients with it, but there are all kinds of new models being tried. When it works, it really works, without all the bloat and entrenched rentiers that can make brick & mortar medicine awful for both doctors and patients. Reminds me of the state of the Internet around 2000. Wide open.

el_benhameen 2y ago

Completely understand if you don’t have the time or desire to answer questions, but I’m curious whether you went programming -> MD or the other way around, and how you made the transition.

hundreddaysoff 2y ago
1. Grow up in the 90s and play too many video games and read the Extropians list too much. 2. Decide I want to be, like, the Hagbard Celine of pharmaceuticals and cure death, or something. 3. Learn programming because I still need a job if I fail at (2) and anyway programming is fun and people are scary. 4. Double major in CS and Bio, do bioinformatics research for minimum wage. 5. Move to Berkeley, learn more programming working at a random startup for minimum wage. 6. Get a job as a bioinformatics programmer at a lab; learn lots more programming and some bench biology and publish papers, under the theory that I need papers and a PhD to start a pharmaceutical company. 7. Look around and decide I don't want to be postdocking in SF for $40k/y when I'm in my 40s and have kid(s). 8. Enter an MD/PhD program (MSTP, ie combined and debt-free degrees) as a lowish-resistance hedge even though I dislike premeds and also the entire bloated medical system. 9. (8 years later) Do residency in Emergency Medicine because it's really fun and all the other specialties bore me. (Except radiology, but that's no fun with chronic sciatica.)
- p1esk 2y ago
  Why do you say emergency medicine is fun? I imagine you often see people in pain, life degrading injuries, and all kinds of other sad things.
  - hundreddaysoff 2y ago
    Well, here's how an ideal night goes for me. https://forums.studentdoctor.net/threads/patients-per-hour.1490403/post-24173260 https://forums.studentdoctor.net/threads/patients-per-hour.1... (Writing this in the middle of the night from that critical access ER I mention.) I just don't think there's any other medical specialty that has a job as action-packed and gratifying as my job is for me. Surgery would be gratifying, for sure, but also I hate formal clinic and I have a weak bladder, so no. Yeah, I guess I see lots of sad things. But (1) often patients are sad about things that could've happened but didn't actually happen, and I can cheer them up just by telling them the truth. (2) Often I can make patients happier if actual sad things happen to them, at least in the moment, and that makes me happy too. And (3) if I got sad every time I saw a sad thing, I'd be too sad to do my job and then I'd get fired. So, like, these things don't really make me sad because I'm here to do my job, not to get big feelings? Does that make sense, or too facile?

ibatindev 2y ago

Having worked as an MSI (Medical Specialized Interpreter) at $4/h, I've noticed that patients are still very reluctant to accept telemedicine for anything other than reviewing lab results.Do you possess a strategy to overcome this challenge? LATAM Subcontractor for Teleperformance/LanguageLine Solutions/Pacific Interpreters.

hundreddaysoff 2y ago
The strategy I possess is to use telemedicine in novel and directed ways when it suits the purpose. Most telemedicine roles I have interest in start with a very directed patient population and a limited set of interventions. Patients at risk for HIV, obese patients, etc. In this context, these subsets of patients are happy to accept special-purpose telemedicine, in my experience. I personally would not want to see a primary doctor or surgeon over the Internet, and if I needed follow-up testing in the lab right next door anyway, I would prefer to go in person to both places in one "quick" trip rather than dicking around with the Internet before going out to the lab anyway. Patients are right to be reluctant. Telemedicine offers a lot of benefits, but it can never be as thorough as time in person with a primary doctor. (But this in-person time is just not possible to get for your average patient in my experience.)

Sparkyte 2y ago

250/h thats solid.