Dr PayItBack @DrPayItBack Twitter profile

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Dr PayItBack

8 days

This is what FI by 50 looks like. No hurry, no deprivation. Assumes saving 1/3 of gross pay (more like 40% right now but may not want to do that forever) and nominal 8.5% annual returns (or ~5% real)

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Dr PayItBack

@DrPayItBack

3 years

I didn’t want the vaccine bc I didn’t want to put anything unnatural in my body

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3 years

Don’t do this

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3 years

that's not where the NG tube goes

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2 years

MRI denial today; called <1 hr after denial received and was told that the window for reconsideration had expired. When I asked what that window was they hung up on me. There is no negative consequence of single payer that would outweigh burning these companies to the ground.

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3 years

Kevlar vests do NOT protect against bullets I was shot in the chest and I have a BRUISE

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5 months

Be kind to your neurosurgeon

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3 years

I am going to become the joker Wordle 234 X/6 ⬜🟩🟩⬜🟩 ⬜🟩🟩⬜🟩 ⬜🟩🟩⬜🟩 ⬜🟩🟩⬜🟩 ⬜🟩🟩⬜🟩 ⬜🟩🟩⬜🟩

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Dr PayItBack

@DrPayItBack

2 years

Random person in admin reached out today to let me know that I RVSP “no” to outlook meeting invites faster than any other physician in the hospital

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Dr PayItBack

@DrPayItBack

2 years

I’ve been jogging 3-5 days a week for almost 6 months now, and I’ve come to the inescapable conclusion that either people who run for pleasure are brain damaged or I have a congenital lack of endorphins.

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Dr PayItBack

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3 years

One of my favorite things to ask trainees is what kind of implant this is.

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3 years

My 2yo has learned my first name and he is now ungovernable

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Dr PayItBack

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3 years

I regret to announce that after 12 years I have received notice of my rejection from Sidney Kimmel Medical College at Thomas Jefferson University. Please hold me in your thoughts at this difficult time.

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2 years

Every airplane seat has a barf bag, but I have never in 30 years seen someone vomit on a plane. Were the 1960s just full of people spewing all over the place and they decided never again?

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2 years

By age 30 you should have: - An anxiety disorder - $300k in debt - Excellent job prospects in 5 to 10 years

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3 years

Can we all please agree that the shoulder is the worst joint. This is absolute nonsense.

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2 years

“Why are you on gabapentin?” “Pain” “Does it help?” “No” “Why are you still taking it?” “I don’t know” “Why are you on cyclobenzaprine?” “Pain” “Does it help?” “No” “Why are you still taking it?” “I don’t know” “Why are you on meloxicam?” “Pain” “Does it help?” “No” “Why are y

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3 years

The spinal cord is just cranial nerve 13

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10 months

@SandyEggHoHoHo @madisontayt_ Paying $500 for $640 is actually not about tipping culture HTH

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2 years

No I don’t want Wi-Fi on my fucking washing machine

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2 years

Wife (w education degree but stay at home for past few years) is looking into subbing when boys go to school. Pay per full school day would be about what I make in 35 minutes. This does not feel like a state/country investing in its future.

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3 years

Two things can be true 1. Substituting vecuronium for versed is as close to ‘unthinkable’ as any medical error I’ve ever heard 2. It is extremely unlikely that there is anything to be gained for patient safety (that’s the point, right?) by criminal prosecution of the individual

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3 years

Brits be like good morning I’m your ænæsthæsiœlœgist

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2 years

12 years after starting medical school, 8 years after graduation, 3 years after finishing training. My medical school loans are gone.

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3 years

I accept the burden of dealing w people who don’t know what an actual HIPAA violation is, or what non-contemporaneous sharing is. Let the hate flow through you.

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3 years

@johnlimouze The agents had had a tough day and Neo was being rude, actually.

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4 years

@DGlaucomflecken Read the EKG

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2 years

The tango lessons are really paying off

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3 months

Born too late for $600 medical school, born too early for free medical school

Johns Hopkins University

@JohnsHopkins

3 months

Beginning in the fall of 2024, Johns Hopkins University will provide tuition-free Medical School for most medical students and expand aid for future nurses and public health pioneers. Learn more:

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3 years

It’s a crazy coincidence that my ADHD went completely undiagnosed until I got into med school

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2 years

Core strengthening improves low back pain. CORE. STRENGTHENING. IMPROVES. LOW BACK PAIN. (Core strengthening improves low back pain)

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2 years

Allegedly one of the local hospitals is offering an anesthesia gig for $650k and 30 (three zero) weeks of vacation. Schedule is 7p-7a trauma. There really is a job for everyone in this specialty.

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3 years

Painful pulseless leg is not an appropriate diagnosis for outpatient pain management referral

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2 years

Sad news

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7 months

@Dermin_ Me, with the highest level of education on skin of anyone in human history: “Seems like other folks don’t know much about skin”

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3 years

Tylenol 3000mg q4hrs is too much. FYI.

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3 years

When I say “live like a resident”, I mean a nursing home resident. Bingo and soup at 4pm.

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8 months

The good thing about going to medical school in your 20s is that you don’t see your connection to youth and pop culture slowly slip away, you just go in the box and come out 8-10 years later like Captain America coming out of the ice.

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2 years

When I was 17 I got my wisdom teeth taken out and they gave me 60 tablets of Vicodin, can u imagine

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3 years

New first: Walked in the exam room and was asked by the patient if I could step out for a moment because he was on an important phone call.

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2 years

I really respect people w huge career and/or academic aspirations, but I think it would be great to just help people and get paid a bunch of money and hide out mostly unnoticed and unhassled for 30 years.

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3 years

Stealing scrubs from the hospital is part of your salary, like a 401k match. Don't leave money on the table.

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3 years

Making friends on twitter dot com

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3 years

@DGlaucomflecken Whenever anyone interrupted me I’d say “Can I Finnish?” and then start speaking Finnish

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3 years

Simply cannot believe I didn’t caption this ‘thoracic outlet mall syndrome’

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3 years

You are stealing: HIPAA. You are playing music too loud: HIPAA, right away. Driving too fast: HIPAA. Slow: HIPAA. You are charging too high prices for sweaters, glasses: HIPAA. You undercook fish? Believe it or not, HIPAA.

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2 years

My wife bought brand name Tylenol today and I feel like I’ve failed either medically or financially or both

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3 years

Why are there Americans on the TL saying orthopaedic. Stop it. We won a war for this.

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7 months

What’s a medical specialty where the treatment works every time and the patients get better and they love you.

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3 years

Life before vaccines

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6 months

Getting appropriate fiber is literally like having a tapeworm.

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2 years

I think if a PA from another department copies my HPI word for word, I should get paid royalties.

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2 years

I had an attending that would ask pts to say “1 2 3” after extubation from neuro cases. Once a patient wouldn’t respond so eventually I said “Sir, please say anything”. He opened his eyes, stared at me, and said “Go fuck yourself” Attending: “That’s why I ask them to say 1 2 3”

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4 years

@Caulimovirus This feels like reading about Kanye's antics to me. It's funny until it starts to feel more and more like mental illness instead of just a bit.

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2 years

Shout out to the PCP who refused to prescribe gabapentin for diabetic neuropathy bc they “don’t do pain management”

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3 years

Saying “it feels like a pinched nerve” has 100% positive predictive value for it not being a pinched nerve.

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@DrPayItBack

3 years

The neurosurgeons I started residency with are graduating this weekend. I did a fellowship and have been practicing for two years. Hat tip.

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3 years

Lumbago 35,000 feet in the air. Earlier today, on our flight to Phoenix, a middle aged man in his 50s passed out. Screams of panic by onlookers was quickly followed by announcement of a medical emergency. 1/

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Dr PayItBack

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3 years

If you see a doctor and your instinct is to say “this is the first doctor to really listen to and care about me”, you��re probably just encountering a normal doctor whose practice is set up in a way that allows adequate time for proper evaluation and education.

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3 years

Our system lost our first nurse to covid this week. Unvaccinated and per report infected and killed her unvaccinated mom as well. Strong work everyone.

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@DrPayItBack

11 months

4 years 4 months of attendinghood. About $700,000 for retirement, the rest in cash, home and 529s.

Dr PayItBack

@DrPayItBack

2 years

Next year, at age 37, I’m going to be a millionaire.

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@DrPayItBack

2 years

Once I’ve maxed out the 403b, 457, IRAs, 529s, and put $10k a month into the brokerage, I’m basically living paycheck to paycheck. I shouldn’t have to live like this.

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@DrPayItBack

2 years

I never watched the show, but is it actually true that ER had a character get his arm chopped off by a helicopter, and then in a separate episode, in a separate season, get crushed to death by a separate helicopter?

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3 years

Can’t decide if the report got cut off or the read is just very concise

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@DrPayItBack

2 years

Age 0-70: You’re too young for joint replacement surgery, the implant will wear out Age 70+: You’re too old for joint replacement surgery, the anesthesia would kill you

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@DrPayItBack

2 years

My favorite thing is trying to get records from the patient’s last pain doctor and it turns out they’re in prison.

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2 years

For the first time ever I'm getting a fresh PGY-1 on July 1 and I'm going to make him draw the brachial plexus from memory

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10 months

I got a 1 star patient review today bc “their nurses faked death certificates during the government pandemic” I work in outpatient pain management.

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@DrPayItBack

3 years

My first annual bonus. The legends are true.

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3 years

@DGlaucomflecken Have they tried PT

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2 years

Please settle an argument and tell me this is easily identifiable

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4 years

@HeheWaitWhut The worst day of your life *so far*

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3 years

2yo got nursemaid elbow from big brother at the science museum today. In other news, reduced my first nursemaid elbow. Can confirm it is as cool as advertised. And vacation saved from an urgent care visit.

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Dr PayItBack

@DrPayItBack

6 months

People think that making $400k is a lot, but once you take out taxes, save for retirement/college, and pay for housing, utilities, food, insurance, travel, kids, and entertainment, you rarely have anything left over.

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@DrPayItBack

7 months

I am becoming entirely radicalized on fiber. Two scoops of psyllium husk powder per day and I have the metabolism of a college student again. I can eat whatever I want and I’m finally losing COVID weight without losing muscle. I’m going to go on Joe Rogan to talk about fiber.

Dr PayItBack

@DrPayItBack

9 months

I’m not saying that increasing your dietary fiber will cure every health problem that you have, but it is possible.

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2 years

Going from renting to owning a home is like going from residency to your first attending job. I’ve learned more about wood and tools and water and wiring in a month than I have in 17 years of living on my own.

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@DrPayItBack

2 years

If I went to 0.9 FTE and took Friday afternoon off every day for the rest of my life I would take a ~$40k/year (pre-tax) paycut. Seems…worth it.

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2 years

$960,000 net worth increase in 3.5 years since becoming an attending. When I get to a million I’m treating myself to a latte.

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3 years

@onebadmamaijama They tried hard and believed in themselves

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3 years

The biggest anesthesia group in the region has been hemorrhaging docs and is trying to poach me. Thinking about asking for 7 figures and seeing what happens.

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@DrPayItBack

7 months

PAY PRIMARY CARE AND INTERVENTIONAL PAIN DOCTORS AND PEDIATRICIANS MORE

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@DrPayItBack

3 years

@DGlaucomflecken Had a patient recently describe the different sexual positions that did and did not make his back hurt

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3 years

Hopefully closing on sale of my dad’s house in the next 30 days. W what I’ve received so far + proceeds, total inheritance will be close to $200k. I’m of course fortunate that he had that much to leave. It was because he still had a lot of living planned. I’d rather have my dad.

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@DrPayItBack

3 years

There are countless wonderful things about having kids, but hearing 5yo and 2yo talk to each other when they don’t know anyone is listening is near the top.

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5 years

@DGlaucomflecken Money laundering is a crime, book ‘em Glauc

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@DrPayItBack

9 months

I’ve been practicing medicine independently for 4.5 years now, and not once have I ever intentionally made someone’s day miserable. It’s been super easy, which raises a lot of questions for me about med school and residency.

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Dr PayItBack

@DrPayItBack

3 years

Here's the story. Importance of constantly strengthening systems in medicine. This isn't the fault of one person.

Inadvertent insertion of nasogastric tube into the brain stem and spinal cord after endoscopic...

Abstract A significant number of neurosurgical patients require feeding tube placement via a nasogastric route. It is used as a temporary access for enteral feeding until patients are able to swall…

entokey.com

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@DrPayItBack

2 years

The hip doctor says my hip pain is coming from my back and the back doctor says my back pain is coming from my hip.

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@DrPayItBack

3 years

As of today we have our house down payment saved 🏡

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3 months

please don't taper chronic opioids without evidence of inefficacy, harm, or diversion, just because you feel like it. the possibility that starting them 20 years ago was the wrong decision doesn't mean that stopping them now is the right decision.

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@DrPayItBack

3 years

I think I feel a special kinship w ER docs bc there probably aren’t a lot of other specialties besides pain that get told “go fuck yourself” w any regularity.

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@DrPayItBack

3 years

LADIES AND GENTLEMEN, START YOUR GOALPOSTS

The New York Times

@nytimes

3 years

Breaking News: The FDA is aiming to give full approval to Pfizer’s Covid-19 vaccine on Monday, according to people familiar with the agency’s planning. The move is expected to pave the way for a series of vaccine mandates.

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3 years

Two mentors now w rare cancer diagnoses seems as good a reason as any to think about early retirement from daily fluoro exposure. 30 years is a long time.

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3 years

5yo says he is a vegetarian for moral reasons, but he will eat 'cows and chicken and bacon' but not fish. is there a term for this?

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3 years

@DShadowgazer If insulin is free people will just use it to get high.

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3 years

@mistermoviespod Pain doc. I inject meds, burn nerves, and modulate sensation to make the physical act of being a little more bearable.

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2 years

Owning a house is like taking care of an ICU patient; if you notice something is off and say “that’s probably nothing, I’ll check again later”, you’re in for a bad time.

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@DrPayItBack

3 years

I just found out my colleague is still avoiding Ancef for penicillin allergies. Lord give me strength.

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10 months

The deranged mid-tier program director trying to punch above their weight class <—> desperate sycophantic IMG ouroboros is something I would never have been exposed to w/o Twitter, so thank you.

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@DrPayItBack

9 months

I didn’t have a single abstract, publication, or presentation as a med student. Stop making people do that.

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@DrPayItBack

7 months

Remember med students, every one of you has the chance to take a career where you don’t ever work on Saturday morning.

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