Michael Cellini

@georgetolisjr Yeah but but how will device companies markup their products and make more money??

The biggest advantage of surgery vs PCI or TAVR is long term outcomes. Unfortunately, our field is trying to compete with IC by making incisions smaller and access more complex, often compromising the final product. Surgery will always lose the minimally invasive battle to IC.

@DrHarryDOesHep @ClarkJeffriesFP @averagemoneymd @olsonplanner It’s always been 6mo for me, but I’m conservative. Some say 3mo. Now my brokerage account is large enough where it doesn’t matter.

@ClarkJeffriesFP @dr_cellini @averagemoneymd @olsonplanner What is your number for a rainy day fund? 3 months monthly expense? 6? Does the number change with the type of industry? @dr_cellini as a radiologist can likely find a job reasonably quickly if he’s jobless for any reason.

Our investment brokerage account (~$500k) is our emergency fund. Prove me wrong @olsonplanner

@ClarkJeffriesFP @averagemoneymd @olsonplanner But that kind of decline has only happened like one time in 30+ yrs (Covid) and immediately shot up. The gains outweigh the risks

If you got laid off and markets were down 30-40%, then what? Eat the loss and sell to pay the bills? Use margin? Use a box spread? We live in a world of tradeoffs. There’s no silver bullet. I prefer to have a massive brokerage account and a big emergency fund. Not mutually exclusive at all.

@averagemoneymd Yeah I have them for both my young kids but no 529. Can’t decide if I want to do a 529 as well or what. Don’t really like how you can only rollover 35k into a Roth for unused funds.

@dr_cellini I haven’t yet and haven’t given it much thought to be honest, just the 529 for now. Are you doing them? What are your thoughts ???

Backdoor Roth IRAs x2 and Family HSA maxed for 2026. The 2026 Journey to save/invest $200k+ begins.

@cb_doge I’m willing to bet he didn’t see a doctor…if he went to any ER with abdominal pain, a CT scan would have been obtained.

WHEN GROK SAVED A MAN’S LIFE AFTER HIS DOCTOR MISSED A NEAR RUPTURED APPENDIX • A 49 year old man endured 24 hours of severe abdominal pain • An ER visit ended with antacids and dismissal due to a “soft” abdomen • Pain remained unbearable and worsened at home • He described his symptoms in detail to Grok in an ongoing chat • Grok flagged a perforated ulcer or atypical appendicitis • The AI warned that his symptom pattern was a red flag and urged immediate return • He went back to the hospital and requested a CT scan • Imaging revealed an inflamed appendix on the verge of rupture • Emergency laparoscopic surgery followed • The appendix was removed and the pain vanished Grok is saving lives ❤️

@doctors_squad Not sure but it looks like someone who has never used a three-way stopcock before…

Guess the procedure???

@MSharifpourMD Just bought a BMW. I had my kid with me. I told them I want to do nothing but drive the car off the lot. They handled literally everything, even calling my insurance to add the car. I went home put my kid for a nap, came back to pick up car and drove it off! It was perfect.

Purchasing a car is the 7th circle of hell! No matter what brand, no matter which dealership 🤦🏻‍♂️

@FranWalsh73 It’s a good option but definitely doesn’t move the needle substantially with limited annual contributions…

The HSA is the most underused wealth tool in the tax code. Triple tax-free. Portable. Never expires. Yet millions of eligible people still don’t take advantage who have the ability to. If you want to get ahead in 2026, here’s the playbook ↓

@averagemoneymd Yeah apparently every hotel these days is >$1200k/night

My wife and I are trying to book a spring break tropical vacation. The prices are now insane. Do people really spend $10k+ for a week vacation?

I love hearing Jensen Huang, CEO of $NVDA, randomly bring up future of Radiology and AI….

@shamitsdesai @averagemoneymd @Rick_Pescatore 1099. Only way to go

@dr_cellini @averagemoneymd @Rick_Pescatore You 1099? Or part of a group?

If I were an EM resident about to graduate, I’d use the next year to build flexibility and optionality, because no other generation of physicians has had this much opportunity and latitude. First, form an entity. PC, PLLC, or PA—depends on your state, but it’s worth it. Operating as an independent contractor gives you protection, legitimacy, and leverage. Stack locums contracts, explore telemedicine platforms like Amwell, and learn to think like a business, not an employee. That path isn’t for everyone. If you prefer a bit more stability, find a low-volume shop where you can run 12- or 24-hour shifts, rest, and build skills between cases. I know docs who used those hours to code, trade, or study—one even saw telemed patients during shifts (he was a scumbag, don’t do that). Either way, buy time and autonomy. Use it to , and use AI to learn how to bring your passions together. The physicians who seize this moment will never regret it.

@northwoods1980 Looks good tho

Any thoughts, comments, opinions regarding a non-cemented arthroplasty and un surfaced patella in a 92-year-old with osteoporosis?

@averagemoneymd $VOO, $VTI, $VUG + ITM calls.

Does this mean we are in a bubble? $VOO

@averagemoneymd @Rick_Pescatore @independentMDs I think I make well more than most partners, make my own schedule, don’t deal with any politics or any nonsense. Don’t have to work harder for the older partners who want to take a step back and still make the same. The list goes on…

Agree, complicated question, for me break even in partnership track was at least 6-7 years (4 year buy in), thought what if I switch to 1099, make $100k+ more a year and invest that instead…happy i made the choice…long term partnership would be more $$$ for sure tho but I am free

@averagemoneymd @Rick_Pescatore Same (radiology). Best decision I ever made

Five years out…gave up a partnership track (the last golden ticket in EM right?) to do exactly this…I am now free and in control of my schedule now…work how many shifts I want and when (for the most part) and at the same time building up telemedicine work. The freedom this model gives you is so worth it.

@northwoods1980 I mean I see this on every spine >60yrs old lol

Drives me nuts when a surgeon starts quoting "facts" and doesn't include a qualified radiologist in the discussion and then makes a statement "please accept as fact". Please invite qualified radiologist to weigh in and include Radiology literature"-Seattle science F

@canuc_57 Disagree, but happy we have people like you!

3:00AM emergency, there’s no life like it! #Seattle #vascularsurgery

@northwoods1980 US Stryker reps have to get paid somehow haha

I have my own biased jaded opinions about why motion preservation procedures are performed far less often than fusion. especially true when looking at significant discrepancy between C and L arthroplasty use in US vs Europe. I’d love to hear other views