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THE MORNING RANT: Healthcare Executives, Traveling Nurses, and RNs who won’t work for “the wage they deserve”

I’ve spent a lot of time recently bashing corporate executives, so I am going to start off with a disclaimer…

There are many thousands of executives in corporate America doing great work, inspiring loyalty among their employees, showing reciprocal loyalty to those employees, and growing their companies through inspired leadership. A great many of them built those enterprises or rose through the ranks of the companies they now lead, which provided them motivation to proudly lead the only company they’d ever want to helm. The most valuable education they brought to their role was expertise in both their industry and within that specific company, and these exemplary executives typically leave their companies stronger when they retire.

But today’s rant is not about them.

No, today I’m going to focus again on awful executives, specifically those whose elite business school training has created a nurse staffing crisis in this country, putting in place all the worst incentives, and creating high turnover that is detrimental to patient care.

In my post a few days ago about the UAW strike, I touched on the obscene pay of auto company executives, focusing on Ford CEO Jim Farley, whose $21 million compensation has nearly doubled in two years, despite Ford recording multi-billion dollar losses under Farley’s EV-focused mismanagement. A discussion of executive pay ensued in the comments. Among them was this witty exchange regarding America’s nursing mess:

Travel Nurse Comments at Ace.JPG

Commenter Mike Hammer succinctly summarized the management formula of the elite MBAs running health care companies, noting that the hypothetical executive earns his $20 million annual compensation without even needing to understand the industry. Instead, his role is simply to reduce services and cut costs, because that is now the recipe for profit among our business elite.

Commenter Bruce Wayne then pointed out the predictable, yet destructive, result of that hypothetical health care executive’s cost cutting. ”Deciding not to give nurses a 6% raise so they all quit, then hiring them back as travel nurses at rates that are MUCH higher than the asked increase. That’s what he does.”

This is exactly what is happening! And the executives are clueless about how they are incentivizing this.

In my circle of friends, family, and professional acquaintances, there are quite a few Registered Nurses, several Doctors, and a handful of managers/executives in businesses that employ nurses.

One executive I know is outraged at the nurses who keep quitting, because they refuse to work for “the wage they deserve,” which in turn is causing their hospitals to spend a fortune on travel nurses, who not only cost more, but also need to be trained on systems and protocols. This has the effect then of making operations less efficient, which impacts productivity goals, and also negatively affects survey results, which are apparently very critical to hospital operations.

High turnover of nurses might even impact patient care, but that, of course, is a much lower priority than goals, efficiencies, and surveys.

The RNs I know often find that they must change jobs to get a raise. For instance, a nurse making $30 per hour cannot get the raise to $33 an hour at her current employer, because that would be a 10% raise and they don’t give double-digit percentage raises. So, she quits to go work elsewhere for $33 an hour, at which time her old employer must now hire an all-new nurse – who must be trained – for at least $33 per hour, to replace the fully trained nurse who they would not pay the same amount.

When it comes to their own pay, these executives are very principled free marketeers, but somehow when it comes to paying front line workers, they reject the reality of supply and demand pricing, and instead they quote their industry-produced market surveys of what healthcare workers should get paid. ”Thirty dollars per hour is the going wage for an RN” says the executive who can’t keep his RNs from quitting for higher pay.

All this has created the “travel nurse” market distortion. Healthcare providers that can’t keep their operations staffed, and who are desperate to suppress the compensation of nurses they actually employ, plug the emergency staffing need with travel nurses hired on a contract basis. These travel nurses aren’t simply making more per hour than their full-time peers, they are making a LOT more money.

Travel nurses can work part time and make more money in fewer hours. Plus, they can often control their schedule and availability, whereas that may not be the case for nurses employed full time.

“With travel nurses making $150 an hour, hospital systems are forced to innovate” [CNBC – 3/28/2023]

The national average pay for travel nurses was $150 an hour in early 2022, which analysts say tempted more nurses to leave staff jobs, increasing turnover and exacerbating shortages.

As hospitals have become increasingly reliant on contract nurses, travel nurse expenditures have risen more than 250% since the start of the pandemic.

“There continues to be significant volatility in hourly wages paid to registered nurses, which represent a significant share of overall labor costs,” said Flint Brenton, CEO of Syntellis Performance Solutions.

At the same time, using high-paid workers from travel-nursing agencies also made for a vicious circle when it comes to staffing.

“Agency staff were paid significant salary rates and had complete control of their work schedules,” explained Carol Boston Fleischhauer, managing director and chief nursing officer at the Advisory Board, and as result “more in-house nurses left their permanent positions for external opportunities, increasing turnover.”

An individual that I respect greatly is an executive at a small operation that employs RNs, and he has expressed his frustration about how the big hospitals’ mismanagement of nursing compensation has created problems that go beyond pay. He states that his operation will pay whatever it takes to hire full-time nurses, and they do pay significantly better than hospitals, but they still suffer from turnover because of the appeal of the scheduling freedom that travel nurses have. Plus, when there is such a demand for their labor, they know they can quit if they want a break, and then just come back and get a job whenever they desire.

It pleases me that nurses have options to go seek better remuneration than cost-cutting executives want them to have. But as a health care consumer, it also saddens me that there is such a market distortion causing high turnover in this critical health care field.

[buck.throckmorton at protonmail dot com]

Posted by: Buck Throckmorton at 11:00 AM




Comments

(Jump to bottom of comments)

1 Rant time.

Posted by: Grumpy and Recalcitrant at September 22, 2023 11:00 AM (qPw5n)

2 The MBA was an even worse idea than direct election of Senators and the Federal Reserve. "You have to quit to get a significant raise" is true in every industry as far as I'm aware.

Posted by: Ian S. at September 22, 2023 11:02 AM (2ocoG)

3 Helloooooo, nurse!

/I've got nothin'

Posted by: spindrift at September 22, 2023 11:03 AM (EGPRf)

4 hiya

Posted by: JT at September 22, 2023 11:03 AM (T4tVD)

5 The kids figured this out about jobs in general a couple of decades ago with the "Make your own raise" strategy (switching employers/jobs every 2 to 3 years.) The amount of waste in training time and lost knowledge is staggering.

Posted by: Grumpy and Recalcitrant at September 22, 2023 11:03 AM (qPw5n)

6 Nurse Ratchet has to be a traveling nurse.

Posted by: Pudinhead at September 22, 2023 11:04 AM (pLaQB)

7 Nearly every big American business was started by people with no formal business training and then ruined by people who did have that training.

Posted by: Ian S. at September 22, 2023 11:05 AM (2ocoG)

8 You couldn't pay me enough to be a nurse and deal with people's bodily fluids and effluvia. Ewwwww.

But I'm glad somebody can do it.

Posted by: Bulgaroctonus at September 22, 2023 11:05 AM (xTRSc)

9 Nurse Ratchet has to be a traveling nurse.


She works for Big Sea Otter.

Posted by: Bulgaroctonus at September 22, 2023 11:06 AM (xTRSc)

10 Born on the backseat of Greyhound bus -
Headed down Highway 41...

Posted by: Pudinhead at September 22, 2023 11:07 AM (pLaQB)

11 They didn't teach this in 911 operator class. F35 pilot calls 911.

https://tinyurl.com/y9kjnuwb

Posted by: Anonosaurus Wrecks, Is this the real life? Is this just fantasy? at September 22, 2023 11:07 AM (FVME7)

12 This is exactly what is happening! And the executives are clueless about how they are incentivizing this.
++++
Are they? Or do they look at it differently? That quarter's results will look good. At least 2/3 of the staff will stick around anyway, and the traveling nurses are expensive but they come out of a different budget. Besides, it's not like there are any limits because the market is captive.

Posted by: Joe Mannix (Not a cop!) at September 22, 2023 11:07 AM (t0OGg)

13 Just wait till they figure out how to outsouce all this to slaves in China!

Posted by: Inogame at September 22, 2023 11:07 AM (53oGX)

14 Little Jonny lit a rocket
That was in a nurse’s pocket
Now she is a traveling nurse
He said as he ran off with her purse

Posted by: Buzz Adrenaline at September 22, 2023 11:08 AM (wu87C)

15 Hospitals are like colleges - raise the prices and get paid.

Posted by: Pudinhead at September 22, 2023 11:08 AM (pLaQB)

16 >>”Deciding not to give nurses a 6% raise so they all quit, then hiring them back as travel nurses at rates that are MUCH higher than the asked increase. That’s what he does.”

This is of a piece with the rocket surgeons at my company who create our expense policy whereby they will not let us pre-pay for fuel from the rental company, which they typically charge at 90pct of whatever the national average is.

I have no Idea why this policy exists but it does and someone thought it was a good idea.

Posted by: Thomas Bender at September 22, 2023 11:08 AM (rc3Z7)

17 Nurse Ratchet has to be a traveling nurse.
Posted by: Pudinhead at September 22, 2023 11:04 AM


She only travels in one direction, though.

Posted by: RedMindBlueState at September 22, 2023 11:08 AM (aQy7p)

18
I do not even know how I ended up here, but I thought this post was good. I do not know who you are but certainly you're going to a famous blogger if you aren't already
-- Even our spammers are flattering! [CBD]


Yes, but they are no Machines4Sale.

Posted by: Krebs v Carnot: Epic Battle of the Cycling Stars (TM) at September 22, 2023 11:09 AM (xG4kz)

19 The RNs I know often find that they must change jobs to get a raise. For instance, a nurse making $30 per hour cannot get the raise to $33 an hour at her current employer, because that would be a 10% raise and they don’t give double-digit percentage raises. So, she quits to go work elsewhere for $33 an hour, at which time her old employer must now hire an all-new nurse – who must be trained – for at least $33 per hour, to replace the fully trained nurse who they would not pay the same amount.
++++
This isn't just nurses. This happens in many industries.

My office was being closed once and the company wanted me to move to Nebraska. I was working nights at the time, with a 12% shift differential (as 12% bonus every pay check, basically). I told them that I would do it - if they put me on a dayshift and didn't cut my pay. They told me they couldn't give me a 12% raise. I told them the amount of money exiting the company's pocket and entering mine would be unchanged. They replied that be that as it may, they couldn't give me a raise that big. The biggest raise they could give was 5%, not 12%.

I didn't move to Nebraska.

Posted by: Joe Mannix (Not a cop!) at September 22, 2023 11:09 AM (t0OGg)

20 "You have to quit to get a significant raise" is true in every industry as far as I'm aware.
Posted bglitches.

Yes, this! I do a fair bit of hiring and much of it is internal to the company because it's easier than getting a direct promotion and often comes with a bigger pay bump. And if they're not successful... just go to our competitor down the street. Then maybe come back later for the next bump. Allocating more dollars and effort toward compensating our current employees than recruiting their replacements might just be too logical

Posted by: She Hobbit (out and about in Middle Earth) at September 22, 2023 11:09 AM (dSSkB)

21 Nurses are dealing with the same corporate bullshit the rest of us do, but the difference is they have the leverage and options to get what they want anyway. The rest of us don't...or at least we aren't hitting as hard.

Though I wonder if that's starting to change.

Posted by: Brother Tim sez Max Headroom for President! at September 22, 2023 11:09 AM (OUMaO)

22 SIL is in this camp. She had to quit for 6 weeks to not become a full time employee.
Makes outrageous money.
Not just contract labor, gets travel expenses and a per diem.

Posted by: MkY at September 22, 2023 11:09 AM (dWUm0)

23 I was born a ramblin' nurse...

Posted by: Pudinhead at September 22, 2023 11:09 AM (pLaQB)

24 The RINOs are charging!

Key Republicans Warn Government Shutdown Could Slow Biden Impeachment Inquiry

Posted by: Anonosaurus Wrecks, Is this the real life? Is this just fantasy? at September 22, 2023 11:11 AM (FVME7)

25 "You have to quit to get a significant raise" is true in every industry as far as I'm aware.
Posted bglitches.
---
Where I work, you don't have to quit to get a bit raise, but you do have to change departments. You are unlikely to see a significant raise if you stay within the same department, but you can negotiate for one if you change jobs to a different department.

Or if you are going to quit, you may get a counteroffer to stay that can be considered a significant raise. I managed to get one of those about 4 years ago.

Posted by: "Perfessor" Squirrel at September 22, 2023 11:11 AM (YIVH2)

26
"Deciding not to give nurses a 6% raise so they all quit, then hiring them back as travel nurses at rates that are MUCH higher than the asked increase. That’s what he does.”


How do these actions play into California's SB-5 law, under which independent contractors are obliged to join some sector / organization of the unionized work force?

This stinks to high heaven in so many ways.

Posted by: Krebs v Carnot: Epic Battle of the Cycling Stars (TM) at September 22, 2023 11:12 AM (xG4kz)

27 "The RNs I know often find that they must change jobs to get a raise."

That's nothing new or unique to nursing; it's the same in high-tech, and probably many other industries.

Posted by: Bacon Jeff at September 22, 2023 11:12 AM (VGRuw)

28 Yes and no. Yes, it costs the same as the raise likely to hire a new employee. But, considering salary + 30% benefits, if you assume a rate of $30/hr, so long as the traveling nurse costs

I'm not saying their right. Just that there are trade-offs. They only really care about the bottom line, less so about efficiency of having people who are less knowledgeable of operations/procedures, because they pay from the insurance company/government is the same whether they are highly effective or not. Hospitals are highly variable in the procedures they see on a daily basis, so effectiveness isn't always critical.

Posted by: TXDude at September 22, 2023 11:13 AM (8Z9hv)

29 I've met more than a few Travelling Nurse types in the course of my work.

Not only is this entire post correct, but further, those nurses network like hell, and they keep each other appraised as to where the hot markets are, which hospitals are offering the highest "desperation pay", and more.

Travelling Nurses are a RIPE market for enterprising CPAs and Tax Professionals, to dig in and create strategies to maximize earnings and minimize taxes.

Most those T.N.s pay fortunes for short term apartments, rental cars and all manner of other "high-overhead" expenses. A smart one will drive a Class A or C, self-contained RV, tow a commuter car, and pay a much lower "rent" at an area RV park, vs. glitzy apartment with bloodletting rents.

Plus, the entire rig is a business deduction. As are most of it's miles, as it's driven from one contract to the next.

I'm not a CPA or a Tax Professional, but one who his could build a niche market, plush with a flow of highly affluent customers. And if YOU fill that market niche, well, now you owe me a good steak dinner. Hey, it's a write-off!


Jim
Sunk New Dawn
Galveston, TX

Posted by: Jim at September 22, 2023 11:13 AM (e6UQI)

30 I have hired and employed these folks before and they are great in general, not always, but itinerant gypsies traveling in RVs from place-to-place making lots of money and having no real life.

It's hard to beat combination of very high pay, total schedule control, and geographic flexibility.

Posted by: San Franpsycho at September 22, 2023 11:14 AM (RIvkX)

31 It works the same way in my business. Some VP on Mahogany Row bitches about the cost of integrating new systems/equipment, or retrofitting existing systems/equipment on the aircraft.

Some Director decides we can do design without ever visiting the aircraft, because models! or we don't need to do analyses up front because this stuff has already been demonstrated and this integration isn't THAT different. The Engineering Manager says hey, wait a minute...but Programs NEVER schedules anything realistically.

Then production makes stuff and things don't fit, so we hire extra designers and draftsmen to get the paper updated. The cost to get the temps up to speed on engineering processes and procedures and drafting practices isn't insignificant. Or we do the analyses and lo, the system and it's interfaces are in fact substantially different and we need to redesign them...then redo the analyses.

Posted by: CrotchetyOldJarhead at September 22, 2023 11:14 AM (YRsIm)

32 This is not a unique situation in Medical Industry. MBAs do this in Microelectronics as well. They will balk at a wage earner asking for a $3/hr increase. They'll let the fully trained and skilled person walk out the door and then turn around and pay $6k for outside services that aren't necessarily up to our internal standards. That $6k being the raise the wage earner wanted.
Absolutely insane.
They'll do the same thing to good engineers as well. An engineer will point out that they are performing 10-15 times the amount of work than they should be and would like to be compensated for it. MBAs give the speech about salaried employees are expected to pick up the slack and work more hours for the increased work. Somehow a salary makes you a slave in the eyes of the MBA. Said talented engineer leaves and takes all the knowledge with them. Takes another 9-12 months to fill that position. Spending the money on recruiters that could have gone to the engineer. Often paying any new engineer found more than what the previous engineer was asking.
MBAs are horrible at management.
Golden Handcuffs are the way to keep good employees.

Posted by: Spiff The Spaceman at September 22, 2023 11:14 AM (evaxF)

33 If there is one piece of advice I give to young people starting their careers, it's this:

Do not ever give one single fuck about the company you work for, unless you started the company. Get every penny you can from them, don't work more than you're paid for, always look for better opportunities and whatever you do, forget loyalty.

Now that sounds horrible, but that's my response to how companies now treat employees

Posted by: AlaBAMA at September 22, 2023 11:14 AM (5xURv)

34 11 They didn't teach this in 911 operator class. F35 pilot calls 911.

https://tinyurl.com/y9kjnuwb

Posted by: Anonosaurus Wrecks, Is this the real life? Is this just fantasy? at September 22, 2023 11:07 AM (FVME7)


Double check link? That one seems to go to the BLM felon getting his bicep blown off.

Posted by: Grumpy and Recalcitrant at September 22, 2023 11:14 AM (qPw5n)

35 Well said, Buck.

I've been working with VA Medical Centers and Clinics for 10 years, and have been stunned at the turnover rate of the nurse employees. The few who stick around are elderly, near retirement, and just waiting to collect their fully-vested pensions.

Posted by: ShainS -- Deplorable AND Listless Vessel AND Overimaginative Scamp at September 22, 2023 11:14 AM (FMZCR)

36 There is a shortage of health care workers in general. Then covid got a lot of people fired which exacerbated the shortage. They had to staff so they went to staffing companies and started paying a lot more, sometimes for the same people. Yes they would allow a staffing company nurse to not have to follow their hosp requirements for vaxx because they were temp. 3 Mos or less. Some nurses could Travel work three months and make as much as they would have in an entire year. Less benefits otherwise. The people running this shit show want it to fail and convert all Healthcare workers to got employees.

Posted by: So that's how stupid the elites are at September 22, 2023 11:14 AM (c58hN)

37 Weird, it cut out part of my comment. this is what the first paragraph was supposed to say.

Yes and no. Yes, it costs the same as the raise likely to hire a new employee. But, considering salary + 30% benefits, if you assume a rate of $30/hr, so long as the traveling nurse costs less than or equal the traveling nurse rate, or even if higher, but you can better control hours/availability, then overall cost may still be lower.

Posted by: TXDude at September 22, 2023 11:14 AM (8Z9hv)

38 Ok I looked it up because I was confused. Apparently he *did* pass on yet another joint session for Zelensky.

My guess isn't that the Irish Travellers of the GOP plan to stop profiting from this sweet sweet grift, but that this Traveller wants to spare the Party another grotesque display of Zelensky-triggered estrus in the middle of a campaign season where nobody supports the new deathgrift.

Posted by: Yudhishthira's Dice at September 22, 2023 11:14 AM (0FoWg)

39 Uh oh.

The Clintons Set Their Sights on Ukraine

-
Plenty or good money to be made by supplying the army with the tools of its trade.

Posted by: Anonosaurus Wrecks, Is this the real life? Is this just fantasy? at September 22, 2023 11:15 AM (FVME7)

40 Also funny are the investment firms that buy companies in leveraged buyouts then X out underperforming units then sell the company they just bought claiming they are masters of the turnaround.

Dude, that’s not rocket science and in many cases those underperforming units served a necessary function (such as supplying extremely hard to make parts).

Posted by: MAGA_Ken at September 22, 2023 11:15 AM (IV/p/)

41 12 This is exactly what is happening! And the executives are clueless about how they are incentivizing this.
++++
Are they? Or do they look at it differently? That quarter's results will look good. At least 2/3 of the staff will stick around anyway, and the traveling nurses are expensive but they come out of a different budget. Besides, it's not like there are any limits because the market is captive.
Posted by: Joe Mannix (Not a cop!) at September 22, 2023 11:07 AM (t0OGg)

- - - - - -

Budget/Buckets. It's a "Somebody Else's Problem" (SEP) issue, something I see as the tragedy of the commons.

On various forums like Reddit, you'll see a lot of postings about these bad bosses who:
1) Have 0.001% of a unit of Power, and abuse it tyrannically.
2) Screw over their employees and/or employer because of some monetary benefit, mostly through bonuses.
These are not mutually exclusive.

Worse, it always seems impossible for these miscreants to get fired. Either they're the good friend (sometimes with benefits) of another higher-up, or it's just hard to fire someone one rung up from the bottom because... incompetence or something.

Posted by: Another Anon at September 22, 2023 11:15 AM (hwP7U)

42 OT, but this morning's Telegraph newspaper has this uh-oh lead editorial headline:

Europe is on the verge of surrendering Ukraine to Putin
Poland has given Kyiv all it can. With the war dragging on, doubt is beginning to creep in

Posted by: Huck Follywood at September 22, 2023 11:16 AM (OfSkg)

43 31>>> Then the VP and the Director leave for a higher paying position based on them 'growing' the company.

Posted by: CrotchetyOldJarhead at September 22, 2023 11:16 AM (YRsIm)

44 It's not just big hospital. Rundown Small Town nursing homes are playing the same stupid game.

"We are a small rundown nursing home. We can't afford to hire you for x$. We will have to hire a travelling nurse for $3x instead. Feel sorry for us."

Posted by: Diesel Jones, Biologist at September 22, 2023 11:17 AM (FSK6u)

45 Damn it! I said the military is not woke!

Veterans Affairs Training Video Promotes Abortion, Suggests Men Can Get Pregnant

Posted by: General Miley at September 22, 2023 11:17 AM (FVME7)

46 OT, but this morning's Telegraph newspaper has this uh-oh lead editorial headline:

Europe is on the verge of surrendering Ukraine to Putin
Poland has given Kyiv all it can. With the war dragging on, doubt is beginning to creep in
Posted by: Huck Follywood at September 22, 2023 11:16 AM


"Son...you're on your own."

Posted by: RedMindBlueState at September 22, 2023 11:17 AM (aQy7p)

47
From an ad displayed here on my page:
Dream Singles Unites Thousands Of Singles Monthly


This sounds not unlike a motto for a money counting operation of a drug cartel, only instead of "thousands" they process "millions".

Posted by: Krebs v Carnot: Epic Battle of the Cycling Stars (TM) at September 22, 2023 11:18 AM (xG4kz)

48 Or we do the analyses and lo, the system and it's interfaces are in fact substantially different and we need to redesign them...then redo the analyses.
Posted by: CrotchetyOldJarhead

Wait, do you sit next to me?

Posted by: She Hobbit (out and about in Middle Earth) at September 22, 2023 11:18 AM (dSSkB)

49 Used to be companies accepted the profit they made from their products or services.

Now they find profit in cheap toilet paper, never remodeling and charging employees for parking.

MBAs could work on better products or making their products better but fuck that, I can get a bonus if I force all the employees to wipe their asses with sandpaper.

Posted by: AlaBAMA at September 22, 2023 11:19 AM (5xURv)

50 OT, but this morning's Telegraph newspaper has this uh-oh lead editorial headline:

Europe is on the verge of surrendering Ukraine to Putin
Poland has given Kyiv all it can. With the war dragging on, doubt is beginning to creep in
Posted by: Huck Follywood at September 22, 2023 11:16 AM (OfSkg)

Cue the WSJ- time for more above-the-fold cover stories about the unexpected tragedy of winter coming to the Ukraine!!! Only more US $$$$$$$ can save them!!!!

Posted by: LASue at September 22, 2023 11:20 AM (YDB6U)

51 If there is one piece of advice I give to young people starting their careers, it's this:

Do not ever give one single fuck about the company you work for, unless you started the company. Get every penny you can from them, don't work more than you're paid for, always look for better opportunities and whatever you do, forget loyalty.

Now that sounds horrible, but that's my response to how companies now treat employees

Posted by: AlaBAMA at September 22, 2023 11:14 AM (5xURv)

------------

This.

I was employed in the software industry by over 50 different employers, some as an independent contractor, over 25 years.

I quit numerous jobs primarily because I had little tolerance for asshole coworkers, managers, and/or customers -- and because I could because my skill set was in high demand, and indeed that is how I was able to continually increase my compensation over the years.

Posted by: ShainS -- Deplorable AND Listless Vessel AND Overimaginative Scamp at September 22, 2023 11:20 AM (iW/cS)

52 Double check link? That one seems to go to the BLM felon getting his bicep blown off.
Posted by: Grumpy and Recalcitrant

Mea culpa.

https://tinyurl.com/yudr2emu

Posted by: General Miley at September 22, 2023 11:21 AM (FVME7)

53 You also have the problem of Nurses hiring bonuses, you get a 20,000. 1st year you get 10,000 then on your second year you get the rest of your 10,000 bonus and as soon as the check clears they put in their 2 weeks and on to the next job that offers a bonus.

Posted by: Patrick From Ohio at September 22, 2023 11:21 AM (2v4qT)

54 35. I've been working with VA Medical Centers and Clinics for 10 years, and have been stunned at the turnover rate of the nurse employees. The few who stick around are elderly,* near retirement, and just waiting to collect their fully-vested pensions.
Posted by: ShainS -- Deplorable AND Listless Vessel AND Overimaginative Scamp

Yes, the way of the federal government & the VA. Always has been & always will be when it comes to the actual hands on working staff including CNAs, orderlies, food service workers, etc. BTW, union is AFGE.

*And essential during C19 in the wards.

Posted by: L - Practice makes perfect. They know their enemies at September 22, 2023 11:21 AM (GshMh)

55 The daughter of a good friend was a travel nurse in LA making $200k / year. The only mitigating factor is that she gets no pension from that work, so she has to pay it all herself.

This is part of a larger problem, in which MBAs destroy the quality of whatever product their company makes, all so they can claim to have made the company more efficient. The fact that they've simultaneously destroyed the brand name of the company doesn't seem to interest them.

Posted by: Archimedes at September 22, 2023 11:22 AM (I/Qkd)

56 53 You also have the problem of Nurses hiring bonuses, you get a 20,000. 1st year you get 10,000 then on your second year you get the rest of your 10,000 bonus and as soon as the check clears they put in their 2 weeks and on to the next job that offers a bonus.
-----------------
This sounds sweet.

Posted by: Pudinhead at September 22, 2023 11:22 AM (pLaQB)

57 *Now that sounds horrible, but that's my response to how companies now treat employees.*

It's not personal. It's business.

Posted by: How to look at it at September 22, 2023 11:22 AM (NBVIP)

58 Wait, do you sit next to me?

Posted by: She Hobbit (out and about in Middle Earth) at September 22, 2023 11:18 AM (dSSkB)

*snort* We must work for the same people.

But no, unless you're that lil pup that sleeps and snores under the desk in my office.

Posted by: CrotchetyOldJarhead at September 22, 2023 11:22 AM (YRsIm)

59
How about we turn Ukraine into one big parking lot so when the winter snows come, European yoots can hone their skills at doing doughnuts with their motorized vehicles?

Posted by: Krebs v Carnot: Epic Battle of the Cycling Stars (TM) at September 22, 2023 11:23 AM (xG4kz)

60 Could the Historic Hollywood Strike Be Ending Soon?

-
I'm waiting with bated breath.

Posted by: Anonosaurus Wrecks, Is this the real life? Is this just fantasy? at September 22, 2023 11:23 AM (FVME7)

61 You also have the problem of Nurses hiring bonuses, you get a 20,000. 1st year you get 10,000 then on your second year you get the rest of your 10,000 bonus and as soon as the check clears they put in their 2 weeks and on to the next job that offers a bonus.
Posted by: Patrick From Ohio at September 22, 2023 11:21 AM (2v4qT)
++++
Golden handcuffs have to be renewed, or they stop being handcuffs.

In high tech, the golden handcuffs usually take the form of stock grants that vest over a three year period. Keep your performance up, and you keep getting new grants that start a year from now and run for three years. Walk away, though, and your unvested shares go poof.

Posted by: Joe Mannix (Not a cop!) at September 22, 2023 11:23 AM (t0OGg)

62 This happened with my dad back in the 90s. The company he worked for wanted to cut some staff. But didn’t want the negative publicity of layoffs. So instead they offered buyouts to employees. Veeeeeery generous buyouts. My dad took one. It was a lump sum amount, enough to pay off the mortgage and a lifetime pension. My dad was 50ish at the time. And still getting that yearly chunk of change. It’s not adjusted for inflation so it’s not much today but still.

Then a few months later, because so many people took the deal they hired back about 1/2 they as consultants. At an hourly rate that was eh equivalent to a 50% raise of their old salary.

Top men!! Lol.

Posted by: Montec at September 22, 2023 11:23 AM (bWsRe)

63 Also funny are the investment firms that buy companies in leveraged buyouts then X out underperforming units then sell the company they just bought claiming they are masters of the turnaround.

Dude, that’s not rocket science and in many cases those underperforming units served a necessary function (such as supplying extremely hard to make parts).
Posted by: MAGA_Ken at September 22, 2023 11:15 AM (IV/p/)
=================
Today, it's far more common for firms to buy a "platform" company and establish a "theme investment", to which they can then buy add-on companies and rapidly expand product portfolios. There might be some jobs lost in those combinations but those are usually in HR and accounting type functions, where costs can easily be shared.

But, however its done, steroid driven investing strategies almost always fall flat after thee initial sugar-rush. That's why investors are so often quick sellers and rarely buy-and-hold.

Posted by: Huck Follywood at September 22, 2023 11:23 AM (OfSkg)

64 https://tinyurl.com/y9kjnuwb
Posted by: Anonosaurus Wrecks,

Link goes to wrong story.

Posted by: Cheri at September 22, 2023 11:23 AM (oiNtH)

65 The RNs I know often find that they must change jobs to get a raise. For instance, a nurse making $30 per hour cannot get the raise to $33 an hour at her current employer, because that would be a 10% raise and they don’t give double-digit percentage raises. So, she quits to go work elsewhere for $33 an hour, at which time her old employer must now hire an all-new nurse – who must be trained – for at least $33 per hour, to replace the fully trained nurse who they would not pay the same amount.
++++

———

The only big raises I have gotten in my 27 year career have been when I changed companies.

Well I did get a 10% raise at one company when they had a headcount reduction, fired a guy and combined his (maintenance manager) and my position (project engineer) into one so double the work load. They got a good deal from me for about 3 years then I started treating the job as two part time jobs for a year or so then left for another company last year.

Posted by: MAGA_Ken at September 22, 2023 11:23 AM (IV/p/)

66 Let’s not forget the push to get rid of nurses that only have a 2 year degree in favor of 4 year degrees. My wife was made to go back to school so she could get a her BSRN for some dumb reason.

Posted by: Patrick From Ohio at September 22, 2023 11:24 AM (2v4qT)

67 It can be lunch time

Posted by: Skip at September 22, 2023 11:25 AM (tEOCu)

68 Europe is on the verge of surrendering Ukraine to Putin

Weird. I heard Ukraine was curbstomping Russian forces thanks to drones. Drones, you guys! Drones! Saying "drones" means you're smart!

Posted by: spindrift at September 22, 2023 11:25 AM (EGPRf)

69 MBAs are horrible at management.

Posted by: Spiff The Spaceman



That assumes they view management as their job. I think most of them are interested ONLY in maximizing their own salary. I don't blame them for that, but I would then expect the company to say "sorry, you aren't working out".

Posted by: Archimedes at September 22, 2023 11:25 AM (I/Qkd)

70
My dad took one. It was a lump sum amount, enough to pay off the mortgage and a lifetime pension. My dad was 50ish at the time. And still getting that yearly chunk of change. It’s not adjusted for inflation so it’s not much today but still.

Then a few months later, because so many people took the deal they hired back about 1/2 they as consultants. At an hourly rate that was eh equivalent to a 50% raise of their old salary.

Top men!! Lol.
Posted by: Montec


You are describing DuPont from the mid-80s to very nearly the end of the 90s.

Posted by: Krebs v Carnot: Epic Battle of the Cycling Stars (TM) at September 22, 2023 11:26 AM (xG4kz)

71 "This is exactly what is happening! And the executives are clueless about how they are incentivizing this."

This is true, generally, but I would also add that any good administrators left that aren't MBA-mill locusts earn their salaries by being in legal jeopardy with increasingly ham-fisted regulators.

Posted by: somedood at September 22, 2023 11:26 AM (PHukT)

72 The only big raises I have gotten in my 27 year career have been when I changed companies. ...
Posted by: MAGA_Ken at September 22, 2023 11:23 AM (IV/p/)
++++
Most of my big raises came at the same company, but that's unusual. There have to be some specific conditions met, which were in my case.

First, you have to be good. That ain't enough, but it is a prerequisite. Second, the company has to be a very particular part of its lifecycle. Specifically, it has to be a young (but not new) company on a rapid growth curve, where you happen to be hired in before the inflection point but after the founders and early employees are already paid off in a big way. You're there for rapid growth and can have really high performance, and the amount of money sloshing around is so huge that it finds its way into your pocket.

I got tremendously lucky.

Posted by: Joe Mannix (Not a cop!) at September 22, 2023 11:26 AM (t0OGg)

73 69 MBAs are horrible at management.

MBZA: Management By Zooming Around.

Posted by: How to look at it at September 22, 2023 11:27 AM (NBVIP)

74 Study: Lockdowns Had "Zero to Negative" Impact on Excess Deaths

-
Well, hush my mouth!

Posted by: Anonosaurus Wrecks, Is this the real life? Is this just fantasy? at September 22, 2023 11:27 AM (FVME7)

75 24 The RINOs are charging!

Key Republicans Warn Government Shutdown Could Slow Biden Impeachment Inquiry
Posted by: Anonosaurus Wrecks, Is this the real life? Is this just fantasy? at September 22, 2023 11:11 AM (FVME7)

- - - - - - -

But wouldn't the shutdown stop the RINOs from charging, by taking away their credit cards?

Posted by: Another Anon at September 22, 2023 11:27 AM (hwP7U)

76 In high tech, the golden handcuffs usually take the form of stock grants that vest over a three year period



Mine have always been 4 years. 25% cliff in year one then 1/48 each subsequent month. There would have been nicer 😀

Posted by: Montec at September 22, 2023 11:27 AM (bWsRe)

77 Today, it's far more common for firms to buy a "platform" company and establish a "theme investment", to which they can then buy add-on companies and rapidly expand product portfolios. There might be some jobs lost in those combinations but those are usually in HR and accounting type functions, where costs can easily be shared.

But, however its done, steroid driven investing strategies almost always fall flat after thee initial sugar-rush. That's why investors are so often quick sellers and rarely buy-and-hold.
Posted by: Huck Follywood at September 22, 2023 11:23 AM (OfSkg)

——-

I’ve seen that too, they consolidate corporate services in financial, HR, sometimes engineering and safety and claim efficiency improvements.

Posted by: MAGA_Ken at September 22, 2023 11:27 AM (IV/p/)

78
Saying "drones" means you're smart!
Posted by: spindrift


Me saying, "AI", trumps you saying, "drones".

Posted by: Krebs v Carnot: Epic Battle of the Cycling Stars (TM) at September 22, 2023 11:28 AM (xG4kz)

79 This hits a very raw nerve. I'm an MD, living through this cluster. My hospital system's current CEO is one of these MBA whiz kids whose first move 6 years ago was to slash ancillary staff (housekeeping, food services) and push early retirement for senior RNs to save $$...and then proceeded to go on a hospital and clinic buying spree (to the tune of ~$ 500M) to "capture market share." Meanwhile, his flagship hospital (where I work at) has shitty food, unmade beds, etc., and OR turnovers are impaired by lack of housekeepers to clean them.

Then COVID hits, and already overworked RNs and a fair number of MDs of my vintage get more work dumped on them. Predictably, not a few join the Great Retirement, or resign, and become travelers and locums docs, working half time for previous fulltime $$. Despite all this, Whiz Kid CEO tries to renegotiate service contracts with my group and other hospital-based MDs that are significantly UNDER market, "cuz you MDs are overpaid and midlevels can do your job." 20% of my group leaves before the admin wakes up to the fact that more attrition will close their ORs, like a neighboring hospital learned. They grudgingly renegotiated.

Posted by: Dr. Mabuse at September 22, 2023 11:28 AM (uY1j2)

80 Posted by: Joe Mannix (Not a cop!) at September 22, 2023 11:26 AM (t0OGg)

Mic check!

Posted by: CharlieBrown'sDildo at September 22, 2023 11:28 AM (lQONO)

81 "Europe is on the verge of surrendering Ukraine to Putin
Poland has given Kyiv all it can. With the war dragging on, doubt is beginning to creep in
Posted by: Huck Follywood at September 22, 2023 11:16 AM"

Poland said they had to slow transfers to focus on arming themselves, as they're largely tapped out. If there is doubt about the spin on this, it's not going to take long to figure out what's actually going on. Gell-Mann Amnesia is a thing precisely because everyone keeps forgetting it.

Posted by: somedood at September 22, 2023 11:28 AM (PHukT)

82 Veterans Affairs Training Video Promotes Abortion, Suggests Men Can Get Pregnant
Posted by: General Miley

Where is that found?

Posted by: Cheri at September 22, 2023 11:29 AM (oiNtH)

83 The only big raises I have gotten in my 27 year career have been when I changed companies.

Posted by: MAGA_Ken at September 22, 2023 11:23 AM (IV/p/)

That only works a few times. Frequent job changes are a red flag on your resume. Potential employers look at that and correctly predict that you'll only stick around for a few years.

Posted by: Bacon Jeff at September 22, 2023 11:29 AM (VGRuw)

84 Can't recall how many times I've looked at a poorly designed product or stupid company policy and said: "I'd bet money there was someone at that company who warned against this, but his superiors ignored him due to their egos or incompetence."

Posted by: whatever at September 22, 2023 11:29 AM (wyMRg)

85 Weird. I heard Ukraine was curbstomping Russian forces thanks to drones. Drones, you guys! Drones! Saying "drones" means you're smart!
Posted by: spindrift at September 22, 2023 11:25 AM


Drones.

To quote The AK Guy, this generation's PTSD brought to you by Best Buy.

Posted by: RedMindBlueState at September 22, 2023 11:29 AM (aQy7p)

86 Saying "drones" means you're smart!
Posted by: spindrift

Me saying, "AI", trumps you saying, "drones".


Pffffft.

Posted by: Machine Learning at September 22, 2023 11:30 AM (I/Qkd)

87 "I’ve seen that too, they consolidate corporate services in financial, HR, sometimes engineering and safety and claim efficiency improvements.
Posted by: MAGA_Ken at September 22, 2023 11:27 AM (IV/p/)"

It's the MBA-locust equivalent of the class-action rackets in the legal industry. People, or groups of them even, set out to do this intentionally; they're bullshit artists that add nothing of value and just pad out their wallets and resumes.

Posted by: somedood at September 22, 2023 11:30 AM (PHukT)

88 The $20M pay package isn't designed to compensate the CEO. It's not supposed to be some amount that the CEO is "worth."

What obscene CEO pay is supposed to do is motivate those BELOW the CEO, to encourage them to work hard and smart, in the hope that they will one day rise through the ranks and reap the big CEO pay.

That's the model and theory. It may have worked once. I don't think it works any more because they're all fucking morons and so captured by government it doesn't matter even if they are smart and innovative.

The Japanese have different models and theories, which is why their CEO pay is much lower than ours.

Posted by: Elric Blade at September 22, 2023 11:30 AM (iFTx/)

89 These employees are disloyal, lazy and stupid. If they were worth $33 an hour their employer would pay them $33 an hour! This is the problem with all these Millennial and Zoomer who just don't want to work! Lazy thieving scum!

Posted by: Dave Ramsey, boomer meme incarnate at September 22, 2023 11:31 AM (lR6tR)

90 What group or institution in America is worthy of trust anymore??? Truth is, the destruction of trust might well be part of the Op…

Posted by: tubal at September 22, 2023 11:31 AM (PCK5/)

91 It's great when employees can vote with their feet; it's part of the supply/demand in the system. It would be STUPID for a nurse who, buy simply changing jobs, to get the equivalent of a 10% pay raise (especially with all this inflation) to stay at the same job, unless the benefits outweighed the downsides of doing so.

Posted by: jim (in Kalifornia) at September 22, 2023 11:31 AM (ynpvh)

92 90 What group or institution in America is worthy of trust anymore??? Truth is, the destruction of trust might well be part of the Op…
Posted by: tubal at September 22, 2023 11:31 AM (PCK5/)

========

Assume all of our institutions are trustworthy.

Should you trust them?

Posted by: TheJamesMadison, searching for more with John Huston at September 22, 2023 11:32 AM (LvTSG)

93 I know some hospitals are closing beds because they don’t have enough staff. Most Nursing managers have not worked the floor so they don’t know what’s going on or don’t care and just want to pad their resume

Posted by: Patrick From Ohio at September 22, 2023 11:32 AM (2v4qT)

94 {64} Link goes to wrong story.

Posted by: Cheri at September 22, 2023 11:23 AM (oiNtH)


He corrected that in reply to me in #52, though he was wearing a General Miley sock at the time:
https://tinyurl.com/yudr2emu

Posted by: Grumpy and Recalcitrant at September 22, 2023 11:33 AM (qPw5n)

95 Saying "drones" means you're smart!
Posted by: spindrift

Me saying, "AI", trumps you saying, "drones".

Pffffft.

Posted by: Machine Learning


*sighs*
I was once a hot young thing.

Posted by: Nanotechnology at September 22, 2023 11:33 AM (I/Qkd)

96 The healthcare system is collapsing. Preventative healthcare has turned your local doctor's office into nothing more that a referral site to specialists, worthless checkups, and writing prescriptions. They prevent nothing, solve nothing, and exist to push the latest drugs. Up the chain, it is not much better. Add it that most doctors and staff are oblivious to the actual costs of what they are providing.

Posted by: WOPR at September 22, 2023 11:33 AM (WFJRS)

97 Walk away, though, and your unvested shares go poof.
Posted by: Joe Mannix (Not a cop!) at September 22, 2023 11:23 AM (t0OGg)

In finance/M&A golden handcuffs (which I believe is where the term first originated so, so many decades ago) refers to the 3 plus year hold restriction on selling your stock as applied to the participants in a tax-free re-org. Meaning, you can't cash in when you are merged or have your assets merged with another company for quite some time without incurring heavy taxes and thus handcuffed o help the newly formed merged company perform.

After that, I started seeing it applied to options for employees...

Posted by: Boswell at September 22, 2023 11:33 AM (K+UlC)

98 Oh look I'm famous!

Posted by: BruceWayne at September 22, 2023 11:33 AM (cdNls)

99 1 of 2 William Shatner gets Portnoyed by a Liberal ho from the private broadcaster, CTV:
Kim @KimSmithGtown Sep 20
@WilliamShatner I just watched your interview with Sandie Rinaldo. Very disappointed in you that's all i can say.

William Shatner @WilliamShatner Sep 20
Yes well, it appears she had an agenda. Her @CTVNews producer called begging for a 30 min interview. I relented and said OK when I usually only give national outlets 15-20 mins. She then took an hour asking ridiculous questions. I feel it was to get a bad interview so she could play victim for ratings. Read her article.
@CTV should be ashamed for airing the embarrassment of their employee’s agenda. I am ashamed of the yellow journalism that Canadian news reporters appears to stoop to for eyeballs. CTV won’t be interviewing me again after this - so you have nothing to worry about. 🙄

Posted by: andycanuck (krqg6) at September 22, 2023 11:34 AM (krqg6)

100 96 The healthcare system is collapsing. Preventative healthcare has turned your local doctor's office into nothing more that a referral site to specialists, worthless checkups, and writing prescriptions. They prevent nothing, solve nothing, and exist to push the latest drugs. Up the chain, it is not much better. Add it that most doctors and staff are oblivious to the actual costs of what they are providing.
Posted by: WOPR at September 22, 2023 11:33 AM (WFJRS)

========

This is the fault of the free market. The government should pass a law. I wish Obama had passed a law to fix it.

Posted by: TheJamesMadison, searching for more with John Huston at September 22, 2023 11:34 AM (LvTSG)

101 Veterans Affairs Training Video Promotes Abortion, Suggests Men Can Get Pregnant
Posted by: General Miley

Where is that found?
Posted by: Cheri

https://tinyurl.com/24rc5hbn

Posted by: Anonosaurus Wrecks, Is this the real life? Is this just fantasy? at September 22, 2023 11:34 AM (FVME7)

102 2 of 2 Chris Pauley @EvilTwinMusic Sep 20
He was on his fucking phone in the middle of an interview. If that's not rude (and adolescent of him) I don't know what is.

William Shatner @WilliamShatner Sep 20
No. Her people were filming before the interview began during set up. If you notice I asked the camera guy after it starts airing where was he cutting me. I ask that BEFORE every interview begins. Not after.

I thought we were having small talk which is why I looked up the word.

It’s just unprofessional. 😖Then again the pre-roll with the questions she asked others including Clint Eastwood - chiding and insinuating he was choosing to not being a part of his son’s life? 🙄🤷🏼 She seems proud of that question. 😞

Posted by: andycanuck (krqg6) at September 22, 2023 11:34 AM (krqg6)

103 The Japanese have different models and theories, which is why their CEO pay is much lower than ours.
Posted by: Elric Blade at September 22, 2023 11:30 AM (iFTx/)

What is the Japanese model?

In my experience, most CEO compensation packages here are tied to some objective metric, like stock price. And/or a majority of the compensation is in the form of stock options, which basically accomplishes the same thing.

Posted by: LASue at September 22, 2023 11:34 AM (YDB6U)

104 "88 The $20M pay package isn't designed to compensate the CEO. It's not supposed to be some amount that the CEO is "worth."
...
The Japanese have different models and theories, which is why their CEO pay is much lower than ours.
Posted by: Elric Blade at September 22, 2023 11:30 AM (iFTx/)

The real distinction people miss is between industries that plod along with low margins (whether due to capital or regulatory requirements) and industries print obscene amounts of money. Of the latter you have marketing driven bullshit (ex.- movies) and real golden-egg-layers (ex. - successful games)

Plodding low-margin industries and high-margin industries driven by marketing BS are, oddly enough, both very susceptible to drive-by MBA's wrecking them to suck money out before moving on.

Posted by: somedood at September 22, 2023 11:35 AM (PHukT)

105 I I suspect nurses are not the only medical personnel in this pinch, therapists and a whole lot more are in this mess.

Posted by: Skip at September 22, 2023 11:35 AM (tEOCu)

106 Pffffft.
Posted by: Machine Learning


My company used to have a senior vp whose job, as far as I could tell, was to surf slashdot, pick up the latest buzzwords, and say "We need to do this." If he were still here, I imagine we'd be pissing away resources trying to shoehorn AI into a product where it makes no sense at all.

Posted by: Oddbob at September 22, 2023 11:35 AM (nfrXX)

107 90 What group or institution in America is worthy of trust anymore??? Truth is, the destruction of trust might well be part of the Op…
-----------------
Umm, this is the point of Color Revolutions. Sow distrust and sow despair.

Posted by: Pudinhead at September 22, 2023 11:36 AM (pLaQB)

108 They do this in lots of different industries. Medical, legal, technical, services...you want better pay you have to get a new job. And it costs the former employer more money in recruitment costs and training to get a replacement than if they'd just bumped the pay. It's penny-wise and pound foolish in action.

Posted by: Why are these people so dumb? at September 22, 2023 11:36 AM (lR6tR)

109 What slays me about this in my field is that in most cases the CEO, the VP, or the HMFIC can't generate a single deliverable like a model, a drawing, an analysis, an inspection, or whatever it takes to return the aircraft to service. But that guy has a 4 year (or a graduate) degree and 'experience'.

Posted by: CrotchetyOldJarhead at September 22, 2023 11:36 AM (YRsIm)

110 "Europe is on the verge of surrendering Ukraine to Putin
Poland has given Kyiv all it can. With the war dragging on, doubt is beginning to creep in
Posted by: Huck Follywood"



So we will be fighting the Russians here soon after, right? I'll bet they are planning the landing invasion now.

Posted by: Ripley at September 22, 2023 11:36 AM (JojsZ)

111 And to add, the US has a serious business culture problem with execs who deliberately wreck companies to line their own pockets, but then - unlike simple corruption in third world shitholes - parade around as if they added value.

Posted by: somedood at September 22, 2023 11:37 AM (PHukT)

112 The Japanese have different models and theories, which is why their CEO pay is much lower than ours.

I think the days of praising the Japanese model are over. They're just now coming out of over 2 decades of stagnation.

Posted by: Archimedes at September 22, 2023 11:37 AM (I/Qkd)

113 What group or institution in America is worthy of trust anymore??? Truth is, the destruction of trust might well be part of the Op…
Posted by: tubal at September 22, 2023 11:31 AM (PCK5/)

God. Family (some). Morons.
That's about it.

Posted by: LASue at September 22, 2023 11:37 AM (YDB6U)

114 There has always been a nurse shortage that, historically, has been filled by recruiting foreigners. You may be wondering why so many senior nurses -- to the extent they are still working -- are Irish. That's because Irish nurses were recruited in the 1970s and 80s. More recently, nurses are from Philippines, Jamaica, or India. There's always been a shortage of Americans willing to go into nursing. So much so that in some countries (Philippines) the people have capitalized on that and actively go into nursing to get jobs (and citizenship) overseas.

Posted by: Elric Blade at September 22, 2023 11:37 AM (iFTx/)

115 Whiz Kid CEO tries to renegotiate service contracts with my group and other hospital-based MDs that are significantly UNDER market, "cuz you MDs are overpaid and midlevels can do your job." 20% of my group leaves before the admin wakes up to the fact that more attrition will close their ORs, like a neighboring hospital learned. They grudgingly renegotiated
==
There is a graph showing the growth of admin staff at ccf over time. As it grows exponentially, so does the money made, but, as an insider, the quality of care and work experience is inverse. Many early retirement. They want systems to fail, so they will consolidate and more easily control the few mega systems. The megas are in on it because they think they will be the tall hogs at the trough. And then they think they can monopolistic control prices. However the govt will then have them by the balls and will nationalize Healthcare. Boom. Meanwhile the administrators got rich.

Posted by: So that's how stupid the elites are at September 22, 2023 11:38 AM (c58hN)

116 Daughter is an ER nurse in DC, and struggles with ALL of this.
What keeps her at her job, instead of going travel, is that, in spite of the pay differential, the travel nurses have zero benefits.
With health issues, and a small child, she sucks it up on the one hand to retain the healthcare security on the other.

Posted by: barbarausa at September 22, 2023 11:38 AM (enw9G)

117 You're there for rapid growth and can have really high performance, and the amount of money sloshing around is so huge that it finds its way into your pocket.

I got tremendously lucky.
Posted by: Joe Mannix (Not a cop!) at September 22, 2023 11:26 AM (t0OGg)

———

All my employers were large established companies.

The good news is that the job I have now is very good and not demanding at all. I work from home and travel a few days every two weeks. Plus I make more than ever with a 20% raise over my previous salary when hired.

Posted by: MAGA_Ken at September 22, 2023 11:38 AM (IV/p/)

118 I've never heard the term "travel nurse" before now.

Posted by: Bertram Cabot, Jr. at September 22, 2023 11:38 AM (63Dwl)

119 That only works a few times. Frequent job changes are a red flag on your resume. Potential employers look at that and correctly predict that you'll only stick around for a few years.
Posted by: Bacon Jeff at September 22, 2023 11:29 AM

Yep. It' a red flag for me if I see 3 jobs in 5 years etc. Unless they are just starting out. But if it's a mre seasoned potential employee that does that it goes in the garbage can. Why spend all that money and time to train someone who is gone in a few years.

Posted by: Minnfidel at September 22, 2023 11:38 AM (kzu4f)

120 What obscene CEO pay is supposed to do is motivate those BELOW the CEO, to encourage them to work hard and smart, in the hope that they will one day rise through the ranks and reap the big CEO pay.

Posted by: Elric Blade at September 22, 2023 11:30 AM (iFTx/)

Well that's....one theory. No, that's not why pay is obscene. Those guys just below the CEO are making out like bandits as well. They usually have golden parachutes as well. No, what it is is a class of people who overrate their value and see no issue with gutting the company for which they are supposed to be stewards.

Posted by: WOPR at September 22, 2023 11:39 AM (WFJRS)

121 110

So we will be fighting the Russians here soon after, right? I'll bet they are planning the landing invasion now.
Posted by: Ripley at September 22, 2023 11:36 AM (JojsZ)

“ The Russians are Coming
The Russians are Coming”…

funny old movie from the Long Ago Times I ran into a while back… The Cold War mindset dies slow with many people…

Posted by: tubal at September 22, 2023 11:39 AM (PCK5/)

122 I've never heard the term "travel nurse" before now.
Posted by: Bertram Cabot, Jr. at September 22, 2023 11:38 AM

My friends daughter is one, decided to take a job in Hawaii all winter last year. It's a pretty good gig.

Posted by: Minnfidel at September 22, 2023 11:39 AM (kzu4f)

123 112 The Japanese have different models and theories, which is why their CEO pay is much lower than ours.

I think the days of praising the Japanese model are over. They're just now coming out of over 2 decades of stagnation.
Posted by: Archimedes at September 22, 2023 11:37 AM (I/Qkd)
_________

I didn't praise the Japanese model. I just said it's different, which it is. I don't know if it's capable of comparison because the people, culture, regulatory environment, and business structures are so different.

Posted by: Elric Blade at September 22, 2023 11:40 AM (iFTx/)

124 I've never heard the term "travel nurse" before now.
Posted by: Bertram Cabot, Jr. at September 22, 2023 11:38 AM (63Dwl)

That's a new one on me, too. I would use the term "temp agency nurse" to describe the phenomenon.

Posted by: Alberta Oil Peon at September 22, 2023 11:40 AM (HZA8l)

125 118 I've never heard the term "travel nurse" before now.
Posted by: Bertram Cabot, Jr. at September 22, 2023 11:38 AM (63Dwl)

Hmmm…. maybe a euphemism??

Posted by: tubal at September 22, 2023 11:40 AM (PCK5/)

126 My daughter is a traveling radiologist for the same reason. It sucks that the fucking bean counters have screwed out our country so badly, and with no checks or balances.
SMOD, where are you?

Posted by: sTevo at September 22, 2023 11:41 AM (k3qPP)

127 Our small hospital (owned by a big outfit) has closed the obstetrical unit "due to" a shortage of nurses. (BTW, lost money on OB for the last 10 years)

For several years a vicious cycle has developed, treat local nurses like crap and bring in contract nurses to cover the gap. Give to hours to the travelers with contracted minimum hours and starve the locals. Locals quit and go to full time work an hour away, now more travelers needed.

OB was the first to fall, soon inpatient services will cease for the same reason and the hospital will be a glorified ER. And the "Inflation Reduction Act" offers $2m a month to hospitals that reduce to outpatient only.

Posted by: Hal Dall MD at September 22, 2023 11:41 AM (mhRvo)

128 Too many chiefs, not enough braves. Government and big corps all have this problem.

Posted by: Minnfidel at September 22, 2023 11:41 AM (kzu4f)

129 Two kids who mowed down retired police chief are being charged as adults.

https://tinyurl.com/2e6jnk4f

"Shortly after that, Keys can be heard saying, "Get his a**," just before Ayala mows down Probst who was riding a bike on the side of the road with his vehicle.
"'That n*gger knocked out!' one of the teens declared from the vehicle."

-
Although the victim was a white person of the caucasion persuasion with a white person name, Andreas Probst.

Posted by: Anonosaurus Wrecks, Is this the real life? Is this just fantasy? at September 22, 2023 11:42 AM (FVME7)

130 Nursing in Oregon is controlled by the state board, which has stringent restriction on entry and training. Part of the shortage is due to this bottleneck.

Also, any MBA is going to look at future requirements and may figure a higher cost today is cheaper than an ongoing pension obligation for decades in the future.
Nasty and heartless, and probably incompetent, but there it is.

The whole industry is controlled by a form of state-enforced cartels that only control entry and prevent cost undercutting, and seem to serve the insurance companies best. We get shitty service with few alternatives for inflated prices. Which is the actual goal of cartels.

Posted by: Kindltot at September 22, 2023 11:42 AM (xhaym)

131
Having Volodymyr Zelenskyy show up in DC is like having the prime example of trailer park living in your family show up for a holiday dinner.

Posted by: Krebs v Carnot: Epic Battle of the Cycling Stars (TM) at September 22, 2023 11:42 AM (xG4kz)

132 {96} The healthcare system is collapsing. Preventative healthcare has turned your local doctor's office into nothing more that a referral site to specialists, worthless checkups, and writing prescriptions. They prevent nothing, solve nothing, and exist to push the latest drugs. Up the chain, it is not much better. Add it that most doctors and staff are oblivious to the actual costs of what they are providing.

Posted by: WOPR at September 22, 2023 11:33 AM (WFJRS)


Canada's provincial collection of death-care euthanasia-pushers has entered the chat.

"Hey, have we got a cost effective deal for you!"

Posted by: Grumpy and Recalcitrant at September 22, 2023 11:43 AM (qPw5n)

133 I sometimes think that “ medicine “ is a giant scam… but I am sure there is a pill for my cynicism..

Posted by: tubal at September 22, 2023 11:43 AM (PCK5/)

134 98 Oh look I’m famous!


So does this mean an upgrade in your membership from Cardboard Level to Poster Board?

Posted by: Bulgaroctonus at September 22, 2023 11:43 AM (xTRSc)

135 120 What obscene CEO pay is supposed to do is motivate those BELOW the CEO, to encourage them to work hard and smart, in the hope that they will one day rise through the ranks and reap the big CEO pay.

Posted by: Elric Blade at September 22, 2023 11:30 AM (iFTx/)

Well that's....one theory. No, that's not why pay is obscene. Those guys just below the CEO are making out like bandits as well. They usually have golden parachutes as well. No, what it is is a class of people who overrate their value and see no issue with gutting the company for which they are supposed to be stewards.
Posted by: WOPR at September 22, 2023 11:39 AM (WFJRS)
____________

Yes, that's the theory. Books have been written about it. And I didn't say only those immediately below the CEO. It's to motivate EVERYONE below the CEO, all the way down to the intern. There are huge step-ups in pay as you go up the ladder, as an incentive to those lower on the ladder. You will note I said above I don't agree with it. But that's the theory and has been in America for decades.

Posted by: Elric Blade at September 22, 2023 11:43 AM (iFTx/)

136 One defense of hospitals is that as I understand it they often have rates set on a yearly basis with third party payers. So they are actually at a disadvantage in a high inflation environment because they can't raise prices as readily as some other industries. Now many of them probably would have been better served by taking a loss for a period of time on nurses labor and keeping those nurses until they could renogtiate reimbursement rates.

On the other hand, I'm not sure what they are doing doesn't make sense economically. If only 5% of your nurses will quit to travel, then paying them 30% more (it's not at high as the wage looks b/c they don't have benefits to pay) is way cheaper than giving everybody a 10% raise.

Some hospitals make the traveling nurse deal less attractive by refusing to hire anybody as a traveling nurse that has ever worked their before and refusing to hire any traveling nurse that is within a 60 mile or whatever radius of the hospital. So you pretty much have to have the hassels of paying for temporary housing or whatever to get the elevated pay, which is a weird dynamic where there isn't any negotiating in the middle.

And as people have mentioned,

Posted by: johnson85 at September 22, 2023 11:43 AM (JuHk4)

137 "I think the days of praising the Japanese model are over. They're just now coming out of over 2 decades of stagnation.
Posted by: Archimedes at September 22, 2023 11:37 AM (I/Qkd)"

Stagnant or not, you're not going to see a Japanese parcel worker on your front door cam dropkick the package onto your porch and then flip you off.

The longer this goes on, the more evident it will be that the Japanese made the right decision to eat the consequences of first-world demographic trends rather than import a bunch of barbarians - if they can stick to that. GDP can't purchase a functional civilization.

Their biggest mistake was not being aggressive enough, soon enough, about subsidizing couples having kids.

Posted by: somedood at September 22, 2023 11:44 AM (PHukT)

138 Then a few months later, because so many people took the deal they hired back about 1/2 they as consultants. At an hourly rate that was eh equivalent to a 50% raise of their old salary.

Top men!! Lol.
Posted by: Montec at September 22, 2023 11:23 AM (bWsRe)


Boeing did that.

Posted by: LASue at September 22, 2023 11:44 AM (Ed8Zd)

139 Ithere were some traveling nurses who came to town for 6 months and bought Mercedes to drive back home. The regular nurses were not amused.

Posted by: Eromero at September 22, 2023 11:44 AM (z3WCn)

140 travel nurses have been around for a while, but ballooned during lockdown.
All the shortages with the hysteria and the vax wars created an opportunity, and a "need", to helicopter people in all over, at high pay.
And the "let's have a pizza party to show our appreciation" MBAs upstairs ran the numbers to see that paying more per hour for people who, yes, needed to be trained in specifics or were not certified in others, was cheaper than providing them benefits, and here we are.

Posted by: barbarausa at September 22, 2023 11:44 AM (enw9G)

141 This is of a piece with the rocket surgeons at my company who create our expense policy whereby they will not let us pre-pay for fuel from the rental company, which they typically charge at 90pct of whatever the national average is.

I have no Idea why this policy exists but it does and someone thought it was a good idea.
Posted by: Thomas Bender at September 22, 2023 11:08 AM


The choice is "Buy one tank of fuel at 90%" vs "replace fuel you have used". At $3/gal and a 10 gallon tank, you pay $27 for the pre-pay. If you use less than 9 gallons, you are overpaying versus filling up before returning. Granted, this saves the traveler the hassle of stopping at a gas station and the time to find one and fill up, but overall the pre-pay is on average a waste of money.

Posted by: Chuck C at September 22, 2023 11:45 AM (xttsV)

142 I stayed with a couple employers longer than I should have.

Right now I am staring into the face of a little rescue boxer. The elders have abandoned me. Snoozing.

The best thing you can do for a dog is another compatible dog.

Posted by: JEM at September 22, 2023 11:45 AM (8erNz)

143 The apex of the management culture are companies like McKinsey. No matter how wrong they are, whether the company that hired them goes belly up or whether the school district produces horrible students based on their advice, McKinsey gets paid. Secretary Buttplug is an alumni

Posted by: Smell the Glove at September 22, 2023 11:45 AM (YdEHa)

144 Two kids who mowed down retired police chief are being charged as adults.

From the link: Keys' mother, who wished to remain anonymous, had a different approach than the Ayala family to the murder and told the outlet: "My son's side of the story will be told, ‘the truth,’ not the inaccuracies the media will try to portray."


I can't wait to hear how he's not a monster. *rolls eyes*

Posted by: Archimedes at September 22, 2023 11:45 AM (I/Qkd)

145 I've never heard the term "travel nurse" before now.
-----------
They suture for the money you throw!

Posted by: andycanuck (krqg6) at September 22, 2023 11:45 AM (krqg6)

146 113 What group or institution in America is worthy of trust anymore??? Truth is, the destruction of trust might well be part of the Op…
Posted by: tubal at September 22, 2023 11:31 AM (PCK5/)

God. Family (some). Morons.
That's about it.
Posted by: LASue at September 22, 2023 11:37 AM (YDB6U)

God maybe but not the churches. Can't trust the schools, courts, government agencies, cops, legislatures, political parties, medical providers either.

Posted by: Nobody left at September 22, 2023 11:45 AM (lR6tR)

147 So does this mean an upgrade in your membership from Cardboard Level to Poster Board?

Posted by: Bulgaroctonus at September 22, 2023 11:43 AM (xTRSc)


Quality Corinthian Bristol board.

Posted by: Grumpy and Recalcitrant at September 22, 2023 11:46 AM (qPw5n)

148 Boeing did that.
Posted by: LASue

More than once.

Posted by: She Hobbit (out and about in Middle Earth) at September 22, 2023 11:46 AM (dSSkB)

149 Did they know he was a cop, and had a beef? Or were they just looking to kill a random whitey?

Posted by: Yudhishthira's Dice at September 22, 2023 11:46 AM (0FoWg)

150 Another victim of climate change!

F-35 pilot ejected from $100M jet over South Carolina due to ‘bad weather’ as experts reveal why plane couldn’t be tracked

Posted by: Anonosaurus Wrecks, Is this the real life? Is this just fantasy? at September 22, 2023 11:47 AM (FVME7)

151 103 The Japanese have different models and theories, which is why their CEO pay is much lower than ours.
Posted by: Elric Blade at September 22, 2023 11:30 AM (iFTx/)

What is the Japanese model?

In my experience, most CEO compensation packages here are tied to some objective metric, like stock price. And/or a majority of the compensation is in the form of stock options, which basically accomplishes the same thing.
Posted by: LASue at September 22, 2023 11:34 AM (YDB6U)
_______

Japanese model is to more align the CEO (and executive) pay with what they actually produce and contribute. There's much less of a gap in pay and benefits as you go up the ladder.

That model worked for generations. I'm not sure it still works, because it relies heavily on honor, prestige, and self-respect. I think today's generation of Japanese execs are more thinking "why should I work my ass off to rise to the next step, maybe not even getting there, when the next step is only a little bit more in pay?" You can see where the American model has some advantages over this, at least in theory.

Posted by: Elric Blade at September 22, 2023 11:48 AM (iFTx/)

152 145 I've never heard the term "travel nurse" before now.
-----------
They suture for the money you throw!


me suture you long time!

Posted by: saigon street nurse at September 22, 2023 11:48 AM (sGtp+)

153 149 Did they know he was a cop, and had a beef? Or were they just looking to kill a random whitey?
Posted by: Yudhishthira's Dice at September 22, 2023 11:46 AM (0FoWg)

Their motives will never be known… if you listen to the Po-Po…

Posted by: tubal at September 22, 2023 11:48 AM (PCK5/)

154 And I'm not convinced you can really trust God either. Look how bad he fucked Job over.

Posted by: Nobody left to trust at September 22, 2023 11:48 AM (lR6tR)

155 Frequent job changes are a red flag on your resume. Potential employers look at that and correctly predict that you'll only stick around for a few years.
Posted by: Bacon Jeff at September 22, 2023 11:29 AM

Not if each move meant better title, higher pay and more responsibility. But frequent lateral moves are discouraged.

Posted by: Boswell at September 22, 2023 11:48 AM (K+UlC)

156 Did they know he was a cop, and had a beef? Or were they just looking to kill a random whitey?
Posted by: Yudhishthira's Dice

Target of opportunity.

Posted by: Anonosaurus Wrecks, Is this the real life? Is this just fantasy? at September 22, 2023 11:49 AM (FVME7)

157 150 Another victim of climate change!

F-35 pilot ejected from $100M jet over South Carolina due to ‘bad weather’ as experts reveal why plane couldn’t be tracked
Posted by: Anonosaurus Wrecks, Is this the real life? Is this just fantasy? at September 22, 2023 11:47 AM (FVME7)

Uh-Huh.. let’s go with that.

Posted by: tubal at September 22, 2023 11:49 AM (PCK5/)

158 https://tinyurl.com/2e6jnk4f

"Shortly after that, Keys can be heard saying, "Get his a**," just before Ayala mows down Probst who was riding a bike on the side of the road with his vehicle.
"'That n*gger knocked out!' one of the teens declared from the vehicle."

-
Although the victim was a white person of the caucasion persuasion with a white person name, Andreas Probst.
Posted by: Anonosaurus Wrecks, Is this the real life? Is this just fantasy? at September 22, 2023 11:42 AM (FVME7)

Sadly, neither one of those shitbags will face the death penalty.

Posted by: Alberta Oil Peon at September 22, 2023 11:49 AM (HZA8l)

159 The longer this goes on, the more evident it will be that the Japanese made the right decision to eat the consequences of first-world demographic trends

I still want to be paid to impregnate vast quantities of Japanese girls.

Posted by: JEM at September 22, 2023 11:49 AM (8erNz)

160 Good post Buck.

I believe this is repeat of some decades ago when trained, skilled nurses were brought in from countries such as India. And then again, to some degree, as Somali migrants came to the US and trained in skilled nursing.

At present, I know of some areas (East Coast) where New Grad RN salary begins at $107,263 per year. I also know of some new RNs, less than 3 years on-the-job with (reported to be) excellent hospital systems, who've recently signed contracts to become traveling nurses in Colorado, Montana, Wyoming. (I doubt this is a lot different from the tech people who went to the West Coast years ago & lived very meagerly in order to accumulate $$$ for their futures.) They're young, want to build savings, and travel.

And, unfortunately, like the VAHs, and so many other sites & in so many other careers, the older, more experienced hand-on staffs get stiffed.

Posted by: L - Practice makes perfect. They know their enemies at September 22, 2023 11:50 AM (GshMh)

161 From the link: Keys' mother, who wished to remain anonymous, had a different approach than the Ayala family to the murder and told the outlet: "My son's side of the story will be told, ‘the truth,’ not the inaccuracies the media will try to portray."

-
Damn that lying video!

Posted by: Anonosaurus Wrecks, Is this the real life? Is this just fantasy? at September 22, 2023 11:50 AM (FVME7)

162 The longer this goes on, the more evident it will be that the Japanese made the right decision to eat the consequences of first-world demographic trends rather than import a bunch of barbarians - if they can stick to that. GDP can't purchase a functional civilization.

Their biggest mistake was not being aggressive enough, soon enough, about subsidizing couples having kids.


I hate that we now have no border, but I am always impressed by the work ethic of the Hispanics I've hired to work on my house. Is that the majority? I have no idea. But it does occur to me that we probably couldn't get native-born Americans to do those jobs nearly as well for anything remotely like what the illegals charge. There are certainly other costs to their presence, though.

I actually agree with subsidizing couples. (I know, that isn't done here.)

Posted by: Archimedes at September 22, 2023 11:50 AM (I/Qkd)

163 Much of the wage/price differential for Traveling Nurses is because it comes out of a "Different Budget" and does not include long term health ins/benefits/retirement. In my area (NW Ohio/SE Mich) fulltime/local nurses have been unionized, and are part of the UAW.

Posted by: birddog at September 22, 2023 11:50 AM (1E8/t)

164 Not if each move meant better title, higher pay and more responsibility. But frequent lateral moves are discouraged.
Posted by: Boswell

Meh, I'm leary of the climber set, they're just as likely to leave soon after training and often leave destruction in their wake.

Posted by: She Hobbit (out and about in Middle Earth) at September 22, 2023 11:50 AM (dSSkB)

165 And of course, you have to throw inflation into the mix. A 5% "raise" might not even cover the cost of living skyrocketing in some areas.

Posted by: pookysgirl, not employed but has a 24/7 job at September 22, 2023 11:51 AM (dtlDP)

166 Travel nurses are important... they travel to meet shortages, but also when nurses are striking. They get paid a lot. I dated a lady who worked at organizing these chicks, flying them in and housing them and seeing to their contracts. That firm mostly did strike breaking. Lucrative business.

Posted by: Yudhishthira's Dice at September 22, 2023 11:51 AM (0FoWg)

167 154 And I'm not convinced you can really trust God either. Look how bad he fucked Job over.




Um, he actually restored everything to Job, and then some.

Posted by: Bulgaroctonus at September 22, 2023 11:51 AM (xTRSc)

168 First, I fully accept any and all charges of being a pisant suck up.
That out of the way, I have got to express my total admiration for and envy of our very own Buck Throckmorton. To have risen from lowly commentater, and likely from far more lowly lurker before that, to the pinnacle of prime time mid-morning CoB bedazzles the mind.
My heartiest congratulations, Buck.

Posted by: From about that Time at September 22, 2023 11:51 AM (4780s)

169 How about travel French maids?

Posted by: Bulgaroctonus at September 22, 2023 11:52 AM (xTRSc)

170 That only works a few times. Frequent job changes are a red flag on your resume. Potential employers look at that and correctly predict that you'll only stick around for a few years.
Posted by: Bacon Jeff at September 22, 2023 11:29 AM (VGRuw)

————

My tenure was 14 years (plant closure), 3 years, 9 years so far.

I’d recommend to change jobs every 5 to 6 years if you feel like you are not compensated correctly.

Posted by: MAGA_Ken at September 22, 2023 11:52 AM (IV/p/)

171 The nursing shortage is one mess they have created. But we have another one coming fast--shortage of primary care physicians. My internist of 29 years just fired me because he doesn't want to take Medicare. More and more PCP are setting up 'concierge' practices because they can make more money and they don't have to deal with insurance. With all the free health care the US govt has given out there are too few primary care doctors. I wonder why the creators of ObamaCare never thought about that or Biden letting in millions of illegals and giving them healthcare.

Posted by: John at September 22, 2023 11:53 AM (1lQyy)

172 You can see where the American model has some advantages over this, at least in theory.
Posted by: Elric Blade at September 22, 2023 11:48 AM (iFTx/)

In theory, but look at what actually happens. Colossal fuckups get into these positions because they went to the right schools with the right people, their families and Board members' families met up at the yacht club every weekend for 20 years, or more increasingly these days they have a particular set of superficial characteristics (skin color, genitalia) that improves the company's diversity quota. They proceed to be total fuckups and get paid vast sums of money for it. You can be brilliant, savvy, hardworking, and never get promoted because you don't know the right people or have the right genitals or the right skin color. So it's a myth perpetrated on the rubes to keep them working hard for no personal upside to them.

Posted by: It's a Big Lie at September 22, 2023 11:53 AM (lR6tR)

173 Frequent job changes are a red flag on your resume



This is out of date thinking. And if an employer sees job hopping as a red flag, fuck that employer. You don’t want to work there anyway.

2-3 years then jump. That the modern career.

Posted by: Montec at September 22, 2023 11:53 AM (bWsRe)

174 So traveling nurses are part of the Gig Economy..

Posted by: tubal at September 22, 2023 11:53 AM (PCK5/)

175 169 How about travel French maids?
----------------
Au Pairs? I feel childish.

Posted by: Pudinhead at September 22, 2023 11:53 AM (pLaQB)

176 About 15 years ago I dated an RN who had her regular job and also worked as a travel nurse. She never told me exact numbers, but did say that the 2 or 3 "travel" shifts she did in any given week paid out 3-4x as much as her regular job. Plus they paid her mileage and hotel while she was traveling as well as a per diem for food, so it was incredibly lucrative for her to "travel" as much as she could.

She lived about a 90 minute drive out of the city, and her "travel" was to the city itself. She could easily have gone home any given day, but figured if they were gonna pay for her to be in the city anyway, why not take advantage of it?

Posted by: pkudude99 at September 22, 2023 11:54 AM (2+RwL)

177 That dude who killed the cyclist should not be wasting oxygen now. He should have been done at the spot he was collected

Posted by: JEM at September 22, 2023 11:54 AM (8erNz)

178 For a couple of gold bars, Sen. Menendez can get legislation passed to restrict nursing "portability." Free market politics, Baby!

Posted by: Peabody Z. Libertarian at September 22, 2023 11:54 AM (Eqssc)

179 2-3 years then jump. That the modern career.
---------------
Pretty much.

Posted by: Pudinhead at September 22, 2023 11:54 AM (pLaQB)

180 F-35 pilot ejected from $100M jet over South Carolina due to ‘bad weather’ as experts reveal why plane couldn’t be tracked
Posted by: Anonosaurus Wrecks, Is this the real life? Is this just fantasy? at September 22, 2023 11:47 AM (FVME7)

Couldn't he/she just haul back on the stick, and firewall the throttle to get above the storm?

Posted by: Alberta Oil Peon at September 22, 2023 11:54 AM (HZA8l)

181 But we have another one coming fast--shortage of primary care physicians. My internist of 29 years just fired me because he doesn't want to take Medicare.

Can you blame him? Medicare doesn't reimburse enough to cover the cost of care. The government just expects doctors to eat the difference.

Posted by: Archimedes at September 22, 2023 11:54 AM (I/Qkd)

182 "Another victim of climate change!
Posted by: Anonosaurus Wrecks"


Is climate change going to become the new go-to excuse for to protect people from criticism?" It was/is covid. If you claimed you have covid your boss can't fire you for missing wor repeatedly (with a hangover) Now climate change is why you were late to work.

Posted by: Ripley at September 22, 2023 11:54 AM (JojsZ)

183 I still want to be paid to impregnate vast quantities of Japanese girls.
Posted by: JEM at September 22, 2023 11:49 AM (8erNz)


———

I’m turning Japanese, I think so.

Posted by: MAGA_Ken at September 22, 2023 11:54 AM (IV/p/)

184 Report: U.S. and Israel Will Assist Saudi Arabia With Enriching Uranium

-
Another Biden foreign policy triumph!

Posted by: Anonosaurus Wrecks, Is this the real life? Is this just fantasy? at September 22, 2023 11:55 AM (FVME7)

185 177 That dude who killed the cyclist should not be wasting oxygen now. He should have been done at the spot he was collected
-----------------
Killing him would be helpful to stop Climate Change.

Posted by: Pudinhead at September 22, 2023 11:55 AM (pLaQB)

186 I think in aviation, especially in the segment where customization and special mission configuration is the primary deliverable, most folks work history would look like a 70's rock concert tour T shirt.

Posted by: CrotchetyOldJarhead at September 22, 2023 11:55 AM (YRsIm)

187 Meh, I'm leary of the climber set, they're just as likely to leave soon after training and often leave destruction in their wake.
Posted by: She Hobbit (out and about in Middle Earth) at September 22, 2023 11:50 AM (dSSkB)

Limited employee contracts with NDAs resolve "training in proprietary systems" then flight issues usually, though many states discourage enforcement. But its every employee's right to climb the corporate hierarchy for better pay/benefits and more responsibilities. Employment is always a two-way street.

Posted by: Boswell at September 22, 2023 11:55 AM (K+UlC)

188 174 So traveling nurses are part of the Gig Economy..
Posted by: tubal at September 22, 2023 11:53 AM (PCK5/)

Sort of, but they weren't created by the gig economy. Travel nurses have been around for decades.

Posted by: Not a new phenomenon but perhaps a more visible one now at September 22, 2023 11:56 AM (lR6tR)

189 172 You can see where the American model has some advantages over this, at least in theory.
Posted by: Elric Blade at September 22, 2023 11:48 AM (iFTx/)

In theory, but look at what actually happens. Colossal fuckups get into these positions because they went to the right schools with the right people, their families and Board members' families met up at the yacht club every weekend for 20 years, or more increasingly these days they have a particular set of superficial characteristics (skin color, genitalia) that improves the company's diversity quota. They proceed to be total fuckups and get paid vast sums of money for it. You can be brilliant, savvy, hardworking, and never get promoted because you don't know the right people or have the right genitals or the right skin color. So it's a myth perpetrated on the rubes to keep them working hard for no personal upside to them.
Posted by: It's a Big Lie at September 22, 2023 11:53 AM (lR6tR)
_________

I don't disagree, but you listed modern phenomena that have distorted the entire incentive system. The model is based on fair competition and a merit-based approach to promotion. That existed once, more or less. Not anymore.

Posted by: Elric Blade at September 22, 2023 11:56 AM (iFTx/)

190 I know a travel tart, almost made arrangements for Bora Bora with her, she'd have done very well from that but Covid and travel shutdowns...

Posted by: JEM at September 22, 2023 11:57 AM (8erNz)

191 The labor market in the US has been distorted by too much immigration, both legal and illegal.

When retried from the Navy in 1979, the average network engineer made $67K per year, in 2023? $93K per years... a total increase of 28%.. but total cumulative inflation since then? 322% (no, I did not leave out a decimal place).

Why so low? Why not even CLOSE to inflation? Immigration especially through the H1B program. Washington is destroying its own citizens, by allowing in outsiders.

Posted by: Romeo13 at September 22, 2023 11:57 AM (QPmu4)

192 The same issue with administrative staffing of medical facilities. A good admin(s) can make or break a medical facility, yet the turn over is staggering and there is a constant shuttling admins in these facilities which leads to poor service and sometimes tragic events as referrals are dropped or patients not contacted about life threatening issues.

Posted by: Beartooth at September 22, 2023 11:57 AM (azYCi)

193 Be nice to your nurses. They deserve it.

Posted by: Lithiated gp For Refreshment at September 22, 2023 11:57 AM (MvF+J)

194 2-3 years then jump. That the modern career.



Gads, no. I hate looking for a new job. I'm doing it now because I was laid off, but it is not a fun process.

It's like getting divorced every 2-2 years and then having to enter the chaos of the dating scene all over again.

Give me stability, and a decent salary, and for the most part I'm happy.

Posted by: Bulgaroctonus at September 22, 2023 11:58 AM (xTRSc)

195 Be nice to your nurses. They deserve it.

Why do they deserve it any more than anyone else?

Posted by: Archimedes at September 22, 2023 11:59 AM (I/Qkd)

196 Carolina Panthers’ Transgender NFL Cheerleader Hopes to Influence Youth: “I’m Setting Things up for the Younger Generation”

-
Well, at least s/he/it didn't run down a bicyclist.

Posted by: Anonosaurus Wrecks, Is this the real life? Is this just fantasy? at September 22, 2023 11:59 AM (FVME7)

197 That dude who killed the cyclist should not be wasting oxygen now. He should have been done at the spot he was collected
Posted by: JEM at September 22, 2023 11:54 AM (8erNz)

Both of them. Driver and passenger. And also the cunt mama of the passenger.

Posted by: Alberta Oil Peon at September 22, 2023 11:59 AM (HZA8l)

198 194 Job hunting is the most miserable, humiliating, bizarre, insulting experience I can think of. So glad to be retired.

Posted by: Lithiated gp For Refreshment at September 22, 2023 11:59 AM (MvF+J)

199 171. With all the free health care the US govt has given out there are too few primary care doctors. I wonder why the creators of ObamaCare never thought about that or Biden letting in millions of illegals and giving them healthcare.
Posted by: John at September 22, 2023 11:53 AM

They did. They have 'concierge' medical, even through government. See RBG, Fetterman, Jimmy Carter.

SE PA, up to a six month wait to see primary care doctor taking new patients because retirements, hospital closures.

Posted by: L - Practice makes perfect. They know their enemies at September 22, 2023 12:00 PM (GshMh)

200 Anniversary of the Preliminary Emancipation Proclamation. Lincoln's announcement noted that slavery would end in the United States on Jan. 1, 1863 — the date his proclamation would take effect.

You won't see that in the MSM. They don't want you to remember.

Posted by: Marcus T at September 22, 2023 12:00 PM (oZhq1)

201 96 The healthcare system is collapsing. Preventative healthcare has turned your local doctor's office into nothing more that a referral site to specialists, worthless checkups, and writing prescriptions. They prevent nothing, solve nothing, and exist to push the latest drugs. Up the chain, it is not much better. Add it that most doctors and staff are oblivious to the actual costs of what they are providing.
_____________________________________________
The healthcare system is rigged to maximize opacity for the big players (hospitals, Big Pharma, medical device companies, insurers). As an MD, I know what my group *charges* for my services, but also know that it bears little or no relation to what a free market valuation is. Much more so for hospital charges. Obamacare never would have passed without the implicit support of the hospital lobby, Big Pharma, and health insurers, who all lobbied for sweetheart deals. Notice how Trump's attempt at injecting more transparency into healthcare billing withered away?

And the move to more non-MD primary care providers will not change the issues with preventative care you allege. Huge #s of specialty referrals from PAs and NPs.

Posted by: Dr. Mabuse at September 22, 2023 12:00 PM (uY1j2)

202 The longer this goes on, the more evident it will be that the Japanese made the right decision to eat the consequences of first-world demographic trends rather than import a bunch of barbarians - if they can stick to that. GDP can't purchase a functional civilization.

Their biggest mistake was not being aggressive enough, soon enough, about subsidizing couples having kids.
Posted by: somedood
---------
Yes but they are also really introducing robots as well to such things as the care industry. I would trust a robot over some of the characters that I have seen.

Posted by: whig at September 22, 2023 12:01 PM (l7GJm)

203 Well she's flyin' through the 'verse
For better or for worse
Workin' as a travelin' nurse
ooh yeah

Posted by: John Fogerty first draft at September 22, 2023 12:01 PM (EGPRf)

204 LOL. “the wage they deserve,” is whatever the market will bear.

Posted by: Chatterbox Mouse at September 22, 2023 12:01 PM (JkeTM)

205 There's the phenomena of the "travel nurse" but also the "private nurse" that's also eating away at the industry. What's a private nurse? It's a nurse hired by a wealthy family to care for a sick and usually elderly family member. It's high pay -- usually cash -- and most of the time, it's easy work. The job is more like a personal chaperone than a medical job.

Many nurses in cities with a lot of rich families are working private as much as they can, while remaining on payroll (and benefits) of "regular" jobs. But they are taking only the absolute minimum number of hours at the regular job. That's cutting down on total hours, significantly.

Posted by: Elric Blade at September 22, 2023 12:01 PM (iFTx/)

206 F-35 pilot ejected from $100M jet over South Carolina due to ‘bad weather’ as experts reveal why plane couldn’t be tracked
Posted by: Anonosaurus Wrecks, Is this the real life? Is this just fantasy? at September 22, 2023 11:47 AM (FVME7)

I have a feeling we aren't really going to know what happened to that plane until we know the color or sex or sex orientation of the pilot.

Which means we might never, because I'm betting my left big toe he/she/it ain't a white hetero male.

Posted by: BurtTC at September 22, 2023 12:01 PM (/Nh0a)

207 I hope the dog helicopter pilots are more competent than F-35 pilots!

Hot news @TheNewsTrending 1h
Helicopter K9s track down suspect after shots fired at officers in Upper Darby, 2 officers injured.

Posted by: andycanuck (krqg6) at September 22, 2023 12:01 PM (krqg6)

208 Why do they deserve it any more than anyone else?
Posted by: Archimedes

Because they're holding the syringes.

Posted by: She Hobbit (out and about in Middle Earth) at September 22, 2023 12:01 PM (dSSkB)

209 198 194 Job hunting is the most miserable, humiliating, bizarre, insulting experience I can think of. So glad to be retired.
Posted by: Lithiated gp For Refreshment at September 22, 2023 11:59 AM (MvF+J)

It completely sucks. It's kaleidoscopically insane. Nothing about it makes any logical sense whatsoever.

Posted by: Lots of changes and not for the better at September 22, 2023 12:02 PM (lR6tR)

210 Obamacare never would have passed without the implicit support of the hospital lobby, Big Pharma, and health insurers, who all lobbied for sweetheart deals. Notice how Trump's attempt at injecting more transparency into healthcare billing withered away?

And the move to more non-MD primary care providers will not change the issues with preventative care you allege. Huge #s of specialty referrals from PAs and NPs.
Posted by: Dr. Mabuse
--------
And that is why the Republicans did failure theater on Obamacare repeal--it screwed their constituents but the campaign donors and the congress critter nepot spawn love it.

Posted by: whig at September 22, 2023 12:02 PM (l7GJm)

211 nood

Posted by: Lithiated gp For Refreshment at September 22, 2023 12:02 PM (MvF+J)

212 I have a feeling we aren't really going to know what happened to that plane until we know the color or sex or sex orientation of the pilot.
----------------------
Yep.

Posted by: Pudinhead at September 22, 2023 12:02 PM (pLaQB)

213 I'd raise marginal tax rates a lot on Fortune 1000 executives.

Posted by: mr tmz at September 22, 2023 12:02 PM (rJ48h)

214 LOL. “the wage they deserve,” is whatever the market will bear.
Posted by: Chatterbox Mouse at September 22, 2023 12:01 PM (JkeTM)

Which would be true, in a market economy.

Healthcare Industrial Complex, ain't a market economy.

Posted by: BurtTC at September 22, 2023 12:02 PM (/Nh0a)

215 Do insurance companies still employ nurses, like Thelma Ritter in "Rear Window?"

Posted by: Bulgaroctonus at September 22, 2023 12:02 PM (xTRSc)

216 I hate that we now have no border, but I am always impressed by the work ethic of the Hispanics I've hired to work on my house.

That's been my experience also. But the Hispanics I hire are legal.

Posted by: Ian S. at September 22, 2023 12:03 PM (2ocoG)

217 206 F-35 pilot ejected from $100M jet over South Carolina due to ‘bad weather’ as experts reveal why plane couldn’t be tracked
Posted by: Anonosaurus Wrecks, Is this the real life? Is this just fantasy? at September 22, 2023 11:47 AM (FVME7)

I have a feeling we aren't really going to know what happened to that plane until we know the color or sex or sex orientation of the pilot.

Which means we might never, because I'm betting my left big toe he/she/it ain't a white hetero male.
Posted by: BurtTC at September 22, 2023 12:01 PM (/Nh0a)
_____________

I'll throw some money down on the pilot being a Uke trainee. But otherwise, I agree it wasn't a hetero white male.

Posted by: Elric Blade at September 22, 2023 12:03 PM (iFTx/)

218 Why do they deserve it any more than anyone else?
Posted by: Archimedes

Because they're holding the syringes.


Fair.

Posted by: Archimedes at September 22, 2023 12:04 PM (I/Qkd)

219 That's been my experience also. But the Hispanics I hire are legal.

I'm not legally allowed to ask, so I just assume that a male in his 20s-30s who only speaks Spanish is probably illegal.

Posted by: Archimedes at September 22, 2023 12:06 PM (I/Qkd)

220 I have a guest room with an en suite bathroom that I rent to traveling nurses through a website just for traveling nurses to find housing. There is a shortage of fully furnished rooms available for short term rentals, especially with the issues VRBO and AirBNB are experiencing in some cities. Depending on the length of their contract they pay weekly, bi weekly or monthly. They like having a safe home to be at when not at work, but they make so much money per hour they tend to maximize their work hours. When they're not working, they're typically asleep or travel back to their home for a visit. Very quiet and very neat and I get charge almost twice what I was renting the room for previously. They're around for 6 weeks to 6 months and it's been a great way to pay off credit cards and get out of debt. Highly recommend if you have the space and need some extra cash.

Posted by: Getting good at getting by at September 22, 2023 12:07 PM (ipZEl)

221 My daughter is a nurse. Her big thing is violence and abuse by patients. It happens. Drugged out, homeless people, whatever, they lash out. She's been punched in the face more than once.

The response from management? Deal with it. We don't want to get sued by the patient, so let them punch you.

Seriously. No repercussions at all. No charges filed. No security guard stationed. You can punch a woman clean in the face, if you are a patient, and nobody lifts a finger.

If it were me, punching a nurse would be grounds for the patient to get tossed out on their ass. Hell, verbally abusing the staff would be grounds.

Posted by: Garbled memo at September 22, 2023 12:07 PM (NR7jv)

222 Why do they deserve it any more than anyone else?
Posted by: Archimedes
------------
Because pissing off the help actually goes into your medical record btw. The Docs don't appreciate it either when you treat staff shittily.

Then, remember, they may be sticking a catheter where the sun don't shine or big whopping ass needles into your bod. Piss them off, you might just get some special treatment.

Goes the same for restaurant staff.

Always treat the help with respect and politeness even when you may not receive it back from them is a wise doctrine. In the Air Force, a wise pilot treated his crew chief and the mechanics with kindness and politeness---they literally had that pilot's life in their hands.

Posted by: whig at September 22, 2023 12:07 PM (l7GJm)

223 The MBA was an even worse idea than direct election of Senators and the Federal Reserve. "You have to quit to get a significant raise" is true in every industry as far as I'm aware.
Posted by: Ian S. at September 22, 2023 11:02 AM (2ocoG)

Is it the MBA itself, or is it society's idolization of credentials?
The credential itself seems to be the "keys to the golden crapper" everyone worked an entire career for previously. Where you had to prove your worth to a company for a period of time in the past, a credential is considered a suitable stand-in for experience now.

Posted by: Cold and timid soul who'll know neither victory nor defeat at September 22, 2023 12:07 PM (FCbAQ)

224 .

Posted by: OneEyedJack at September 22, 2023 12:08 PM (FCbAQ)

225 181 But we have another one coming fast--shortage of primary care physicians. My internist of 29 years just fired me because he doesn't want to take Medicare.

Can you blame him? Medicare doesn't reimburse enough to cover the cost of care. The government just expects doctors to eat the difference.
------------------------------------------------------
Not just primary care MDs; lots of specialties are graying, including mine (anesthesiology). The median age of a lot of groups is now early 50s.

And Medicare + Medicaid reimbursement is horrible, which is one reason why a lot of MDs in high government payor markets either drop Medicare if they can (no such luck for hospital-based MDs), or sell their practices to hospital systems, becoming serfs for big systems and "enjoying" seeing 30 patients a day. The smart ones, like my internist, go the concierge medicine route, attracting a panel of patients that they charge an annual subscription fee, providing more personalized care, and keeping their sanity.

Posted by: Dr. Mabuse at September 22, 2023 12:10 PM (uY1j2)

226 And that is why the Republicans did failure theater on Obamacare repeal--it screwed their constituents but the campaign donors and the congress critter nepot spawn love it.
Posted by: whig
------------------------------------------
Yup. The $$ thrown around by the AHA, Big Pharma, and device manufacturers DWARFS anything coming from MD lobbying outfits.

Posted by: Dr. Mabuse at September 22, 2023 12:19 PM (uY1j2)

227 Excellent and true Rant, Buckster. I work at a $2.5B durable goods manufacturer and our management team and CEO are outstanding.

Health care was severely disrupted by the 2010 passage of Ocare effectively taking over the majority non-profit hospital management. Remember over half of medical spending is Medicaid and Medicare which means health care is now managed by a government mindset which is really scary. You will note this with completely unsound mask mandates and shitty protocols(Remdesivir) for nothing more than government money infusions.

Posted by: Danimal28 at September 22, 2023 12:20 PM (klw0w)

228 201 And the move to more non-MD primary care providers will not change the issues with preventative care you allege. Huge #s of specialty referrals from PAs and NPs.

NPs/PAs tend to focus on checklists and referrals more than many doctors, especially if less experienced. This largely due to less rigorous training, but also how they are trained. (Newer docs have more issues with this as well)

Posted by: Hal Dall MD at September 22, 2023 12:22 PM (mhRvo)

229 does this mean an upgrade in your membership from Cardboard Level to Poster Board?

Posted by: Bulgaroctonus at September 22, 2023 11:43 AM (xTRSc)

Quality Corinthian Bristol board.
Posted by: Grumpy and Recalcitrant

Ooooh fancy. I'll take it!

Posted by: BruceWayne at September 22, 2023 12:28 PM (MGB5H)

230 As a nurse, I’m retired and too old to take advantage of this

I thought I was doing good making $60/hour

Posted by: Gonzotx at September 22, 2023 12:31 PM (MwHgU)

231 Too many people blame to collapse of America on hippies or progs or tech or whatever. The fact of the matter is that this collapse - moral and economic - began with the insane rise of the MBA in the 1980s. Suddenly everyone needed an MBA - and the result is these insane business models that put people last, technology second-to-last (I've been in tech since starting with IBM in 1977 outta college), and salaries for the destroyers with the approved business models first. It's why there was an article last week asking if McKinsey is the Deep State (Yes). It's why we have so many people and industries doing what they can without asking if they should. It's why Western Civ is collapsing.

Posted by: Alexander Scipio at September 22, 2023 12:57 PM (NX5U7)

232 And the executives are clueless about how they are incentivizing this.


Naw, it's just that they don't give a shit.

Posted by: lurk at September 22, 2023 12:57 PM (Cq8oj)

233 The wage nurses deserve is the wage a free market is willing to pay.

Posted by: Chuck Martel at September 22, 2023 01:06 PM (fs1hN)

234 The problem is that while hiring the traveling nurses at a higher hourly rate seems more expensive - it does actually usually save money b/c the employer isn't usually paying the costs of benefits, such as health care.

Yes, all the other downsides still exist that were mentioned in the original post, but the executives don't look at those things, they only look at the easily quantifiable costs, not extrinsic costs like high turnover or having to constantly train new nurses in your procedures or morale. As long as it looks like they saved money on paper, they are happy.

Posted by: I forgot my name b/c I haven't posted in 6 months at September 22, 2023 01:09 PM (ky+MF)

235 Too many people blame to collapse of America on hippies or progs or tech or whatever. The fact of the matter is that this collapse - moral and economic - began with the insane rise of the MBA in the 1980s. Suddenly everyone needed an MBA - and the result is these insane business models that put people last, technology second-to-last (I've been in tech since starting with IBM in 1977 outta college), and salaries for the destroyers with the approved business models first. It's why there was an article last week asking if McKinsey is the Deep State (Yes). It's why we have so many people and industries doing what they can without asking if they should. It's why Western Civ is collapsing.

This! And, it is the same in a lot of industries. Education is a perfect example. Most public schools now require a "masters" in education. Well - for the colleges to keep selling the need for an "education masters", they need to keep coming up with new theories and paradigms - like new math. Same with business schools - they have to keep coming up with new theories and models. So, every 5 years like clockwork some new fad explodes in the business world and in education.

Posted by: I forgot my name b/c I haven't posted in 6 months at September 22, 2023 01:13 PM (ky+MF)

236 To be fair, there is NO aspect of the healthcare system that isn't fucked.

Posted by: deadrody at September 22, 2023 01:24 PM (mpSFp)

237 The fundamental problem is the customer is the person who pays for it, and the guy on the ground getting his head sewn back on isn't the one who controls whether they get paid or not.

And the ones who do, honestly don't care about success of treatment; just that they don't get billed for anything that's not already been paid for.

Posted by: Voyager at September 22, 2023 01:52 PM (gdJPU)

238 My wife is an RN and has had a lot of exposure to traveling nurses. In addition to the hourly amount, the employer must provide room, board and local transportation for them.

Posted by: Chascarp at September 22, 2023 02:13 PM (5Iqh4)

239 Who has gone up to an RN asking to be treated because “I’M HEALTHY!!!” ???

Posted by: Catch Thirty-Thr33 at September 22, 2023 02:31 PM (8sMut)

240 “Provider” - because using the great massive vocabulary of the English language is JUST TOO HARD.

Posted by: English Is Dead at September 22, 2023 02:34 PM (8sMut)

241 Alsowhatishealthcare?

Posted by: English Is Dead at September 22, 2023 02:34 PM (8sMut)

242 Interesting thread, sorry I missed it while live.

CEOs pay spiked with the attempts by the Clinton admin to cap executive pay. Stock options were born to circumvent them, and they got very generous. Prices went up exponentially. Now in fairness, the CEO job sucks, you have no free time at all, you are owned by the company, and you need to have a very forgiving family - or you will lose them. I'd never take that job.

The MBA problem is they essentially took financial management and threw out all the rest. Finance folks should never be in charge of companies, operations folks should be. If all you know how to do is work off spreadsheets and complain about some costs, you'll never be successful. If your company has grown to the point where that is all the CEO does, it's either in insurance or banking/finance, where that is the product and the CFO background is appropriate; the company has grown unwieldy and needs to be broken up.

And hospital executives are the worst, way overpaid, and not interested in operations. I believe still to this day the most prominent consulting class in a hospital is a revenue billing expert.

Posted by: Black JEM at September 22, 2023 02:48 PM (GZYu7)

243 NPs/PAs tend to focus on checklists and referrals more than many doctors, especially if less experienced. This largely due to less rigorous training, but also how they are trained. (Newer docs have more issues with this as well)
Posted by: Hal Dall MD
---------------------------------
Agree. There are fundamental differences in how MDs are schooled and trained (at least there USED to be) vs. NPs and PAs. Leaving aside 4 years of medical school, even the "short" specialty training programs are 3 years long, vs. 1-2 years for midlevels. Plus MDs in training get a lot more stick time in learning clinical care, especially if you're in a surgical specialty or a procedure-heavy specialty. I had 5 years post-med school, including a fellowship year.

Besides the time, MDs traditionally spend a lot of time learning how to diagnose and consider all the possible options in diagnosis and treatment. Knowing what NOT to do is often as important as knowing what to do. Nursing training focuses on different stuff.

Posted by: Dr. Mabuse at September 22, 2023 03:07 PM (uY1j2)

244 Good thing you ignored the actual reason for the issues, the perverse incentives to healthcontrol executives created by government-regulated-employer-provided healthcontrol laws, regulations and policies.

This is like wanting to eat the rich banksters after government banking regulators incentivize them to make risky loans on shaky investments.

Businessmen are going follow their human natures.

Posted by: insurgens ad opus at September 22, 2023 03:11 PM (uL7Ez)

245 240 “Provider” - because using the great massive vocabulary of the English language is JUST TOO HARD.
Posted by: English Is Dead
------------------------------------
The only physicians I know who refer to themselves and other MDs as "providers" are either in administration or politically-correct fellow travelers.

I'm a PHYSICIAN. My nurses are NURSES. As I only half-jokingly tell others, "That's DOCTOR Evil! I didn't spend 9 years of evil medical training to be Mister Evil!"

Posted by: Dr. Mabuse at September 22, 2023 04:12 PM (uY1j2)

246 I too am sorry I missed this post while it was live. I worked as an RN for many years, saw that it was changing (for the worst) in the late 1980s, and returned to school to seek a different direction. Regardless, much of the post and the comments are spot on. And that makes me so very sad. Medicine done correctly (sans government interference) was a wonderful thing. But even I now distrust the entire system, which makes it very challenging when seeking care. I truly feel sorry for those who lack any medical knowledge, for they are truly at the mercy of the professionals, most of whom have sold their souls for research $$, etc.

Posted by: Grateful at September 22, 2023 05:45 PM (IQ6Gq)

247 The travel-nurses at $150/hour pay their own Soc Sec taxes (double those paid by actual employees), pay their own healthcare, are not covered by unemployment comp, nor by disability insurance (unless they buy their own), sock away bunches of money in 401K plans for retirement, and pay their own travel expenses. There may be minor exceptions to those terms but in reality, they are 1099 people.

If they're able to get $75/hour or greater, they are in the green.

You did not raise the issue of "How to Be an RN" which involves passing a very difficult test. Before you rant about "SAFETY!!!" recall that most RN's in the 20th century became RN's by 'apprenticeship' in a given hospital, not by pencil/paper tests. That system died out around 1960 or so, but it's likely that your mother's maternity nurse did not pass a test.

So why the test?

TO LIMIT THE NUMBER OF RN'S--which raises the price paid to hire them. Look under 'monopolistic practices' in your Bus Ad book.

Posted by: dad29 at September 22, 2023 06:48 PM (GU/kd)

248 I see the same thing in the paraprofessional teaching market (teacher's aides, groups instructors, etc). They pay full-time parapros shit (like 11$ an hours when you annualize it)with no benefits, despite having to take the worst part of teaching off of the teacher's backs (grading, discipline, IEP support) while also teaching their own subjects and doing their own grading.

Then when they can't keep the positions filled, they have to pay subs at a daily rate double that of the parapros. The subs don't do anything but provide a warm body for groups (no IEP support, no access to grading or grade books) and recess duty. Often from a pool made of parapros that quit.

Posted by: AJ VanOrden at September 22, 2023 10:00 PM (KyRTl)

249 Its not just nurses that travel that make big bucks, surgical techs, xray, CT, Nuc med Cath lab, phlebotomists, all can grab the brass ring if they want to. I just got a text from a travel company, a rural hospital in Arizona is paying $3000 per week for a regular xray tech. Not CT, or Nuc med, or cath lab, just xray. I'm tempted to go for it myself. $12000 a month, most of which can be non taxable, if you set your contract up right.

Posted by: jasonj at September 22, 2023 11:25 PM (4Tpar)

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