Board-certified orthopedic surgeon. Solo private-practice hand surgeon (NJ/NY). Breaking down physician pay, Medicare, insurers & policy. Not medical advice.
Fort Lee, NJ
Joined October 2026
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Residents at Rhode Island Hospital just ratified their first union contract. Before it, the union said many made about $16 to $18 an hour.
Good for them. The hospital runs on resident labor.
A union contract sets your next 3 years. Where you choose to work after training sets the next 30.
Source: Rhode Island Current, Oct 20, 2026: rhodeislandcurrent.com/2026/…
Since 2010, federal law has blocked doctors from opening new hospitals. Hospital systems can buy our practices. We can't build the competition.
H.R. 2191 / S. 1390 would let physicians open hospitals in rural areas with none nearby and let existing physician-owned hospitals expand.
Doctors, send your House member and senators this:
"I'm Dr. ___, a ___ in ___. Please support H.R. 2191 / S. 1390, the Physician Led and Rural Access to Quality Care Act. Patients need physicians who can compete with hospital systems, not just work for them. Thank you, Dr. ___"
New practice owners: start in network.
When I opened my practice, credentialing with the big insurers took 4 to 6 months, so start that paperwork early.
Build a reputation and a patient base first. Then start dropping the insurances that pay poorly.
A hospital system is buying Surgery Partners for $5.7 billion, with Bain Capital staying in. That's 200+ sites and about 5,000 affiliated physicians.
The press release promises "the right care, in the right setting."
Most of my cases already go to a surgery center or my office.
Surgeons: what changed when your center was sold?
Source: Surgery Partners / HealthSpan Partners release, Oct 26, 2026 ir.surgerypartners.com/news-… ; Fierce Healthcare fiercehealthcare.com/provide…
Residents: Medicare counts a patient as new only if no one of your specialty in your group has seen them in 3 years.
Moderate new patient visit: 2.60 work RVUs. Established: 1.92.
Join a big group and your partners' patients come to you as established. Factor that into any RVU target.
Source: CMS Medicare Claims Processing Manual, Ch. 12, sec. 30.6.7 (new patient = no professional service from the physician or group, same specialty, in 3 years) cms.gov/regulations-and-guid… ; work RVUs from the CMS 2026 PFS relative value file (RVU26D) cms.gov/medicare/payment/fee…
My employment contract had a one-year noncompete with a distance limit. To go independent, I had to open outside it.
The Workforce Mobility Act would ban most noncompetes. H.R. 10215 in the House, S. 2031 in the Senate.
Doctors, residents, med students: ask your lawmakers to sign on. Template below.
This bill bans most noncompete agreements and still allows them when someone sells a business or leaves a partnership. It has sponsors from both parties.
Please sign on.
Sincerely,
[Name, credentials]
[City, state]
Find your House member: house.gov/representatives/fi…
Find your senators: senate.gov/senators/senators…
House bill: congress.gov/bill/119th-cong…
Senate bill: congress.gov/bill/119th-cong…
Of 47 NBA players who had surgery for a meniscus tear, 43 returned (Nosrat et al, J Sports Sci Med 2025).
Minutes and efficiency recovered by year two.
A knee scope with up to two months out often points to the meniscus, but nothing has been confirmed for Edwards.
Source: espn.com/nba/story/_/id/5030… ; study: pubmed.ncbi.nlm.nih.gov/4046…
Med students: starting July 2026, new borrowers can take at most $200,000 in federal loans for med school. Grad PLUS is gone. The rest comes from private lenders, with fewer protections.
My debt was $300,000. My advice is to go to the cheapest school that accepts you. Debt can really drag your career.
Source: Federal Student Aid, loan limits for new borrowers after July 1, 2026: fsapartners.ed.gov/sites/def… ; rates: studentaid.gov/understand-ai… . Not financial advice.
About 1 million Medicare Advantage patients lose their plan on Jan 1. Two of the biggest insurers are leaving hundreds of counties.
For practices, that means a wave of new insurance cards in January, and patients mid-treatment landing on plans you may not take.
Check 2027 coverage before you book January surgery, not after.
Sources: CBS News cbsnews.com/news/humana-unit… ; KFF kff.org/medicare/medicare-ad…
