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kiddiedoc

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I’m thinking about opening a position in Smith & Wesson (SWBI). P/E is under 5x. The dividend yield is 1.3% and the dividend coverage ratio is huge. But the biggest reason is that they are fleeing the northeast to set up shop in beautiful Blount County, TN. The earnings probably tank until their move is complete, but they have a nice cushion.

Buy and hold… not to flip.

Kyle Rittenhouse’s weapon of choice BTW.
I picked up some when I first heard of the move. It's been a solid choice, so far.
 
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Teladoc (TDOC) is off 10% today and 60% from earlier in 2021. It sure seems like a great business, but losing $7/share with the current trend is a bad look. They must be spending on expansion. They’ve had big name customers and partners. $20 billion market cap. How low can it go?
 

kiddiedoc

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Teladoc (TDOC) is off 10% today and 60% from earlier in 2021. It sure seems like a great business, but losing $7/share with the current trend is a bad look. They must be spending on expansion. They’ve had big name customers and partners. $20 billion market cap. How low can it go?
Maybe people are realizing that you can't practice great Medicine over a telephone.
 
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Maybe people are realizing that you can't practice great Medicine over a telephone.
Better than no medicine. Doctors are available 24/7 instead of M-F 9-5. Seems like a better way for initial screening and dealing with routine issues than waiting in an office for a couple of hours when you’ve got a sniffle. Not a substitute. A complement and a good way to reduce healthcare costs. The current system is broken.
 
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kiddiedoc

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Everyone knows you gotta use Zoom for proper exam. Not like you need real contact..:)
I did exactly 3 telemedicine virits back last March. It was so inadequate that I said I would change professions before stooping to that. You wouldn't believe how many problems turn out to be something totally different after a good physical exam. I could fill a novel with all the crazy stuff I've discovered that came in with seemingly simple complaints.

Two quickies: a suspected twisted ankle and limp was the presentation of a 5 yo with a brain tumor when I witnessed her foot drop. A screening physical before ADHD medication found a critical aortic stenosis when I heard a concerning heart murmur -- he had open heart surgery the next day and would have likely died if prescribed a stimulant by phone.
 

tntar heel

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Yeah I don't understand how physicians sign up to do those. The potential liability from one would scare me to death. The ortho surgeon I used to work for had patients get in a gown for all exams. One of the first times I worked with him, I asked why he did this and he responded that he wouldn't be able to sleep if he missed something because he was to rushed or lazy to actually do what the patients were paying him to do. After that, I loved working with him. In fact other nurses would buy my lunch to take his office sessions because he was always running late and they didn't want to hear the patients gripe about gowns.
 

kiddiedoc

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Yeah I don't understand how physicians sign up to do those. The potential liability from one would scare me to death. The ortho surgeon I used to work for had patients get in a gown for all exams. One of the first times I worked with him, I asked why he did this and he responded that he wouldn't be able to sleep if he missed something because he was to rushed or lazy to actually do what the patients were paying him to do. After that, I loved working with him. In fact other nurses would buy my lunch to take his office sessions because he was always running late and they didn't want to hear the patients gripe about gowns.
Yes! The liability for missed diagnosis is one of my biggest concerns.

No substitute for hands and stethoscope on the patient.
 
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There certainly will be the one in a thousand situations where a more serious problem wasn’t discovered because a physician wasn’t hands on with “tele” medicine, but there are probably going to be many, many more times that many that had serious problems discovered by seeing a doctor using modern technology from home rather than NOT physically walking into a practice facility at all for any diagnosis. Telemedicine is a great way to make healthcare more affordable and efficient.

To avoid liability there can be a few simple online statements and a required acknowledgement in order for patients to participate.

Some lives will probably be saved with things like the flu break outs. Lots of people walk in to doctor’s offices and walk out with illnesses picked up from other patients in waiting rooms.

With big tech’s R&D, screenings can become VERY robust. Apple Watch health apps are scratching the surface.

Insurance companies like Teladoc as it reduces their costs. Their costs would go up if their customers were getting sicker because of telemedicine.
 
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kiddiedoc

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There certainly will be the one in a thousand situations where a more serious problem wasn’t discovered because a physician wasn’t hands on with “tele” medicine
Yeah, you definitely have no idea what you're talking about. I'm not going to argue with you, but come spend a day in my office. I saw probably 20 patients yesterday that would have been impossible to diagnose properly by phone. And, it's a daily occurrence that I have to clean up a mess left by a telemedicine or walk-in clinic "visit."
 
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Yeah, you definitely have no idea what you're talking about. I'm not going to argue with you, but come spend a day in my office. I saw probably 20 patients yesterday that would have been impossible to diagnose properly by phone. And, it's a daily occurrence that I have to clean up a mess left by a telemedicine or walk-in clinic "visit."
I’m talking about these “one in a thousand” scenarios:

“Two quickies: a suspected twisted ankle and limp was the presentation of a 5 yo with a brain tumor when I witnessed her foot drop. A screening physical before ADHD medication found a critical aortic stenosis when I heard a concerning heart murmur -- he had open heart surgery the next day and would have likely died if prescribed a stimulant by phone.”

You can also order expensive imaging procedures on EVERY patient that walks in and find bigger problems on a few. Doesn’t mean you should do that to everybody that walks in.

Telemedicine will mean a lot more people will get seen and costs will be reduced. Hurts some bottom lines though.
 

kiddiedoc

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I’m talking about these “one in a thousand” scenarios:

“Two quickies: a suspected twisted ankle and limp was the presentation of a 5 yo with a brain tumor when I witnessed her foot drop. A screening physical before ADHD medication found a critical aortic stenosis when I heard a concerning heart murmur -- he had open heart surgery the next day and would have likely died if prescribed a stimulant by phone.”

You can also order expensive imaging procedures on EVERY patient that walks in and find bigger problems on a few. Doesn’t mean you should do that to everybody that walks in.

Telemedicine will mean a lot more people will get seen and costs will be reduced. Hurts some bottom lines though.
Like I said: it's not one in a thousand. Yesterday alone, four of my well checks had infections I treated, an earache ended up being a tonsil infection and possible early abscess, neck acanthosis triggered a screen for insulin resistance, etc.

Let's just agree to disagree.
 
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Like I said: it's not one in a thousand. Yesterday alone, four of my well checks had infections I treated, an earache ended up being a tonsil infection and possible early abscess, neck acanthosis triggered a screen for insulin resistance, etc.

Let's just agree to disagree.
Obviously more conditions can be found in person. That doesn’t cancel out the benefits of healthcare provided by tele-medicine versus zero care.

The one in a thousand comment is in reference to a life ending condition not being discovered.

Pediatrics isn’t going to be as suitable as children are more likely to lie or not understand. Adults do not need to run to an office every time that they have an annoying condition.
 

BP4Prez

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Better than no medicine. Doctors are available 24/7 instead of M-F 9-5. Seems like a better way for initial screening and dealing with routine issues than waiting in an office for a couple of hours when you’ve got a sniffle. Not a substitute. A complement and a good way to reduce healthcare costs. The current system is broken.
I don’t know. I can’t see it ever becoming a go to. There are convenient/urgent cares at every corner now for things outside of the normal hours.
 

BigOrangeMojo

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I don’t know. I can’t see it ever becoming a go to. There are convenient/urgent cares at every corner now for things outside of the normal hours.
Ive had more success getting items treated via Telemed video conference (with a M.D.) than via an in person CVS type minute clinic with a F.N.P.

Neither is a substitute for primary care physician though.
 

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