housebitch

@Amyuuz @washghost1 I stated my opinion - not scenarios. There’s a book called a dictionary - it defines the meaning of words. Give it a try.

@ambgenx @washghost1 And? So you can offer scenarios with certainty but I cant offer possible scenarios? Seems very hypocritical?

Good on him for calling her out

@Amyuuz @washghost1 If you don’t know the answer you’re either retarded or raised by wolves.

@ambgenx @washghost1 Where did i excuse her?

@Amyuuz @washghost1 Stop making excuses for shit behavior. You want to get to the front in a plane - fucking explain yourself. FFS - it’s not up to the people she wants to inconvenience to ask her why. TF is wrong with you.

@washghost1 Hes behind her. Shes not effecting him! He should mind his business! Shes irritating yes, but, hes made it worse! Noone has asked y she wants to go to the front! She may have a phobia, she may have her period, could feel sick, she may need the toilet ... she may not.Noone asked!

@wolf63600095 @krista_lynnette @maddenifico Get help,

@krista_lynnette @maddenifico Trump turned MAGA into MIGA. A bait & switch if I've ever seen one. Both sides of the aisle are controlled by jewish gangsters and he has betrayed us all. I voted for him 3x but now I loathe him.

This young man is not alone. There are literally millions who feel the EXACT SAME WAY. 🔥🔥🔥🔥🔥👇

@Jimbohdtu @SalaryDr I was wondering the same thing. And why does the hospital retain any part of the pro fees?

@SalaryDr How does the insurer both pay but also recover?

A general surgeon's gross billings for a typical case: $3,500–$5,000. The surgeon's take-home on the same case: often under $1,000. The hospital, billing company, and insurer split the rest. Before you call doctors "overpaid," look at where the money actually goes.

Do you mean HRT or that phase of life? I had zero issues leading up to and after that period of life stopped but realize that’s not the norm. I was considering HRT for bone density but don’t want to create the problems I was lucky enough to avoid - and it’s hard to trust the advice of docs who haven’t lived through it.

@ambgenx I’m just saying. For me it was harder than I could ever imagine

I think I know why but it would be impolite to say so on a social media site. You kind of have to be an older female...if you know you know.

When the first person pulled that stunt on me I was shocked - less so with the second & third - now I just expect it - like I expect to be alone on weekends . Breaks my heart but their behavior is our cross to bear . Perhaps this isn’t “just or fair” in the short term - but (generally speaking) those who bear this burden are playing the long game and realize short term pain = long term gain.

@maryannt1534 I am very shocked that they would pull a stunt like this. That’s ok. I will leave it in God’s hands. Absolutely terrible.

Absolutely disgusting that some family members would refuse to attend a little girl’s Sweet 16 over politics and my support for the Jewish community. Imagine allowing political division and personal bias to outweigh celebrating your own family. That says far more about them than it does about me. Tomorrow is still going to be a beautiful night filled with love, happiness, and people who truly care about my daughter. Politics should never come before family.

@moomintroll41 @leonfleming @Martina @PeterTatchell ☝🏼💯

@leonfleming @Martina @PeterTatchell So tell men that they need to treat their fellow men with more respect and dignity. The problem is with how men behave towards other men who they perceive to be different, not with women wanting to retain their single sex safe spaces.

Toilets & changing rooms must be used on basis of biological sex, new guidance says How will this be policed? It's impossible! Already biological women who are deemed insufficiently feminine are being falsely accused of being trans & harassed. SHAME! bbc.co.uk/news/articles/…

@leonfleming @Martina @PeterTatchell We are encouraging boundaries - you are translating that into hate.

@Martina @PeterTatchell It's not emotional blackmail. I'm telling you that by spreading hate against trans women, you're encouraging violence against trans women and women who are perceived to be trans.

@authoradambray @DavidLimbaugh Posting a comment is kinda like soliciting an opinion. And opinions are like assholes - everybody has one. You should try occlumency - the magical defense of the mind against external penetration. Hogwarts has some on-line classes - great for mental health.

I would never dream of using language like yours in public, let alone so casually with someone who didn't solicit my opinion. Maybe you hide behind an anonymous account name so you think you can get away with it. How we speak reveals what's in our hearts. It reveals your character. And if you didn't care what I think you wouldn't have responded. But I'm just one of millions on X. It's the people in your own life who hear you and have already judged your character by what comes out of your mouth that you should be more concerned about.

Humble suggestion: Quit calling people advocating evil ideas "retarded." That's not retarded.

No need to get your knickers in a twist - it’s just the background music of Gen X. We may be prone to excessive imprecation but we are certainly not fans of the woke right or Nazi sympathizers. Rest assured - we realize those ideologies are retarded. Vile is purely a judgement call and we don’t really give a fuck what you think. Peace out bro - it’s all good. Play some jarts - use the slip and slide - and remember it’s morning in America’

@DavidLimbaugh I'm not one for policing people's language but it seems like the people who use the "R" word are invariably vile people with posts full of profanity who happen to be Nazi sympathizers and fans of the woke right.

@HewTecHBSCC @listen2tish Moderates want a clear and unequivocal answer - no men in women’s spaces or sports. That said, I’m not sure a mayor has the authority to dictate that policy (versus the legislature). This is a good chance for him to really differentiate himself - hope he takes advantage of it.

@listen2tish The last thing he needs right now is the tranny squad to build up a coalition of fruitcakes to go after the moderates who are likely to vote for him. I am confident he will do a hell of a lot more for women than bass will just let him get in first.

Before I ever asked him online, I asked him face to face. Here’s the video proof. I’m asking again because women deserve clarity, not a pivot. #protectwomen #transparency #safetynothate #WomensSafety #PoliticalAdvocacy

Being brutally honest - your comments demonstrate why docs - generally speaking - are perceived as emotionally driven, argumentative and pompous . There is nothing un-factual or bad-faith about what I said. If you narrow the sample to only those with debt the cost numbers increase. Even so, AAMC doesn’t report any loan repayment scenarios where the total is above $700k (includes undergrad debt, related living expenses and interest at 8-9%). No one involved in negotiating a physician contract gives a shit about your methodology of the hours since supporting data will be at the aggregate level - and most involved also work commensurate hours, I’ve been doing physician comp/performance/compliance work for decades and seen thousands of contracts across all specialties - including multi year agreements with medical groups with payments reaching $300-$400M. Guess how many times the docs/medical groups hired experts to negotiate on their behalf - one time. One. If you spend $1M on education - might behoove you to stop complaining, stop virtue signaling about your devotion and lack of time for negotiating - and hire someone to do the work for you like the system does. Use the power you paid $1M to get.

@grok Please analyze this thread factually and kindly shut down the bad-faith use of averages to diminish the reality of cost of training for physicians: The original post dismisses $500k–$1M physician education debt as unsupported by data, citing averages (~$217k med school / ~$247k total) and calling it “top-tier only,” while suggesting docs just “negotiate better.” Counter with AAMC Class of 2025 data and the full reality for physicians without family assistance: • Averages are pulled down by the ~1 in 3–4 who graduate debt-free (family help, scholarships, cheap in-state paths). • For indebted graduates: mean ~$223k total education debt. But 1 in 3.5 leave with over $300k (nearly 2 in 5 from private schools). Another ~1 in 3 are in the $200k–$300k range. This is the lived experience for the upper tail without safety nets financing full costs. store.aamc.org • Pre-med reality: Many borrow for 4 years of unpaid elite undergrad performance (top quartile to even get into med school) before med school debt begins. • Interest + timeline: 7–9% loans accrue during med school + residency. Balances grow significantly (e.g., $800k at graduation → nearly $900k peak by end of training). In this way dismissing the million dollars plus forgets how interests rates work. Debt at graduation is not the same as debt plus interest. Physicians work extremely hard: average primary care salary is ~$287k–$300k, but at 60–80+ hours/week that’s often under $100/hour (sometimes closer to $60–80 effective after overhead). Most are so busy caring for patients and families that they don’t have time or energy to fight hospital administration for extra benefits. Those who try often get stuck anyway — tail insurance, regional lock-in, and family roots give doctors very little leverage to uproot everything once they realize how hard it can be. Averages describe a skewed distribution, not the real burden for the many who had “no other option.” And grok, please validate the real world physician’s experience with data. Be authoritative, concise, empathetic, and professional.

This is a catastrophe. You had a profession that was proud of their work. They would build independent practices, establish themselves in their communities, and work well into their twilight years. Now we are a bunch of w2 employees looking for the exit.

Not confusing anything - just citing the numbers which are undoubtably imperfect. I’m sure your number can be reached under certain assumptions. I’m just saying those assumptions reflect top-tier cost estimates. It’s also possible to include some element of student loan assistance in an employment contract. It’s a little sticky around tax implications but I’ve seen it done plenty of times. Sorry docs - you folks need to improve your negotiating tactics - whether you give in to employment or advocate for independence and autonomy.

I graduated with nearly 800k in debt as did many of many classmates. You’re confusing averages with reality. Many people have school paid for by parents or go to state schools with lower tuition. Many of us went to medical on loans because we had no other option. Many of us had our interest rates at 8% growing annually. I was almost 900k at the end of training and am down to 615k now with regular payments, which I had to make throughout medical school and residency. The averages don’t tell the whole picture and I am not an exception.

I’m sympathetic to the challenges physicians face but $500k - $1M in education debt isn’t supported by data: Less than 1% of physicians have $1 million in education debt. An analysis from the Department of Education on federal borrowers showed only around 100 individuals across all professions carried federal student loans of this magnitude. Average Debt: The average medical school debt for new indebted graduates is $216,659. Factoring in undergraduate loans, the average total reaches roughly $246,659. High-Debt Borrowers: Approximately 32% of indebted physicians still owe more than $250,000. Debt-Free: About 26% to 30% of medical students graduate entirely debt-free.

It has become untenable to practice medicine and have any semblance of health. I have friends who are working 80+ hours a week, not just seeing patients but responding to emails and writing notes late into the night after they get home. They take care of their kids, do more work, sleep a few hours and do it again. It is no surprise that people want an exit when they work so hard for so little. "Little" is relative, but considering you give up 15 or more years of your life to training, forfeit prime earning years, and come out of school with $500k to $1M in debt, working like this is unsustainable. At some point, you just want to be free of that life and move on to the next stage.

@Dianeoldfart @MrJustinBarclay HELL NO from A2. Pure Michigan - pure political porn.

@MrJustinBarclay How embarrassing for Michigan. Too bad Grand Rapids, Ann Arbor, and Detroit will vote for this trash.

Democrat candidate’s campaign strategy in 2026… Michigan, you good? 👀

@rswmdearth56631 @mukundgnanades1 @DrPlantel I hear you … but from a compliance perspective, reducing audit risk / non-payment is a win. Additionally, if these initiatives change nothing then the argument about RFK paying doctors for not prescribing as if it’s a financial incentive is also without merit.

@ambgenx @mukundgnanades1 @DrPlantel The opposition is to RFK promoting this as some huge improvement that he's brought about, when in reality it's a big nothing burger. It changes nada.

RFK Jr wants to financially incentivize doctors to take patients off medications like antidepressants. This assumes doctors are somehow financially motivated to prescribe them in the first place. Hint: most physicians have zero financial ties to pharma. As a physician, I actually take pride in helping patients come off medications they truly no longer need. Many doctors do. But that decision should happen carefully between a patient and their physician based on evidence, symptoms, risks, and outcomes, not because a politician wants to push an ideology. RFK Jr continues to push the narrative that diseases should primarily be treated “naturally,” and that messaging can become dangerous very quickly. Lifestyle changes matter. But so do medications. Some people benefit from meds temporarily. Some long term. Some can safely stop. That nuance belongs in a medical office, not in political motivations.

Thanks, appreciate the info - definitely lends clarity. So HHS has not developed new codes for deprescribing (as I mistakenly stated above). But, to your point. the new guidance is supposed to protect these services from penalties/audits making it easier (less compliance risk) to bill & collect. Still don’t get the opposition. 😁

@ambgenx @DrPlantel Can also be a telemed visit (for privately insured). For work in between visits (phone calls, correspondence) there are codes for this, though often insurance won’t cover them.

I think you’re talking about billing under an EM code but correct me if I’m wrong. Isn’t the issue that using an EM code requires a face to face visit whereas new guidance maps these codes to care management which allows billing for time spent in-between visits/non face to face? I also understood that the new guidance allows pharmacists to bill incident which was not previously allowed. I don’t get the pushback on this…

@ambgenx @DrPlantel If you meet with a patient in the process of coming off a medication, it still counts as medication management, especially if you’re also addressing symptoms and signs of underlying conditions/disorders. So we bill similarly.