Really glad I’m no longer running a private California medical practice

[bedrock]

New California law raises minimum wage to $25 for health care workers

California’s minimum wage for health care workers will rise to $25. Gov. Newsom signed the law after hospitals struck a deal with unions.

calmatters.org

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[willabeast]

The Guv sets reimbursement and sets employee pay. Sort of like a proxy war on your income.

 

[bedrock]

The Guv sets reimbursement and sets employee pay. Sort of like a proxy war on your income.

Yep.

How about the government places limits on what universities can charge for medical training?

Or the government if the government wants to get involved with healthcare pay then maybe they should guarantee a minimum income for those who spend 11+ years sacrificing to become a physician?

Im rather glad not to no longer live in the quasi communist state of California

 

[callmeanesthesia]

Doesn’t directly apply to private practices with less than 25 docs as of the last time I read it. However definitely will affect local market wages if they can get $21-$25/hour at the local hospital, urgent care, or community health clinic. The only hope for us is that the wage hikes will creat such a squeeze on those bigger employers, who have to pay that wage to every janitor, cafeteria worker, and gift shop employee, that they’ll mercilessly cut staff and drive their existing employees twice as hard. I suspect though that they’ll end up getting some sort of special boost to their reimbursements to compensate and keep them afloat, at the expense yet again of physician fees.

 

[nvrsumr]

The problem is that it’s termed physician fee, misnomer. no one gets that pays for everything and everyone in a practice not just the docs salary

None of my staff make less than 25/hr

 

[SSdoc33]

Its really kaiser that bent. That is b4 the law was even enacted

 

[Ducttape]

just out of curiosity, is there some reason other than your bottom dollar where you do not want healthcare workers to get a livable wage?


it is phased in over the next 4-5 years. $25 doesnt come in to play until 2028.

 

[MitchLevi]

just out of curiosity, is there some reason other than your bottom dollar where you do not want healthcare workers to get a livable wage?


it is phased in over the next 4-5 years. $25 doesnt come in to play until 2028.

Yes, bc everyone who disagrees with the govt dictating what one must pay his or employees is evil, cruel and bad.

 

[Agast]

just out of curiosity, is there some reason other than your bottom dollar where you do not want healthcare workers to get a livable wage?


it is phased in over the next 4-5 years. $25 doesnt come in to play until 2028.

It’s hard for private practice because our reimbursements have declined relative to inflation. Medicare cuts every year while inflation goes up and salaries go up is making things difficult. I see my collections dwindling as a practice owner and it sucks. Meanwhile I still have to provide the same degree of care, the liability hasn’t gone down, and the documentation requirements have gone up. And you can’t complain because it makes you “greedy” when all I’m asking for is to not make less than I did two years ago for the same amount of work…

 

[MitchLevi]

It’s hard for private practice because our reimbursements have declined relative to inflation. Medicare cuts every year while inflation goes up and salaries go up is making things difficult. I see my collections dwindling as a practice owner and it sucks. Meanwhile I still have to provide the same degree of care, the liability hasn’t gone down, and the documentation requirements have gone up. And you can’t complain because it makes you “greedy” when all I’m asking for is to not make less than I did two years ago for the same amount of work…

Obviously...

 

[GoBeers]

So just to confirm, this doesnt apply to small private practice groups right

 

[Sig123]

just out of curiosity, is there some reason other than your bottom dollar where you do not want healthcare workers to get a livable wage?


it is phased in over the next 4-5 years. $25 doesnt come in to play until 2028.

Remind me what the conversion factor increase was this year?

 

[Ducttape]

Remind me what the conversion factor increase was this year?

have you tried to live on $10/hr? $15/hr?

fortunately, i have not, but have friends who did.

 

[Pain Applicant1]

It’s hard for private practice because our reimbursements have declined relative to inflation. Medicare cuts every year while inflation goes up and salaries go up is making things difficult. I see my collections dwindling as a practice owner and it sucks. Meanwhile I still have to provide the same degree of care, the liability hasn’t gone down, and the documentation requirements have gone up. And you can’t complain because it makes you “greedy” when all I’m asking for is to not make less than I did two years ago for the same amount of work…

Don't forget to mention that your overhead is increasing. Rents up, mortgages up, COG up, etc.

Why waste time discussing this with someone who has absolutely no experience starting or running a business? It's like someone asking me to give them advice on how to learn Greek. It would be pointless.

 

[Ducttape]

i always look out for "the tired, the poor, the huddled masses"....


i would think if you blithely ignore the needs of those you hire, it would be difficult to keep them.


your prior posts suggest that you do not. as do agast's.

im not so sure about other pain practices.

 

[Pain Applicant1]

i always look out for "the tired, the poor, the huddled masses"....


i would think if you blithely ignore the needs of those you hire, it would be difficult to keep them.


your prior posts suggest that you do not. as do agast's.

im not so sure about other pain practices.

You're right, I definitely do not ignore the needs of my one employee. I protect her and look out for her because she's my responsibility since she works for me. I'll throw a patient out long before he or she disrespects her.

How about this for the Bernie Sanders of the world? Start your own business and treat your employees as you feel they should be treated. Lead by example. If you have the experience, better chance of others taking your opinion to heart.

I do agree with you though, I hate seeing people get taken advantage of. It drives me crazy and triggers me for some reason.

 

[MitchLevi]

Not only has every cost across the board increased, we are under pressure from local healthcare systems buying up our entire state. Try competing with a hospital that can pay far more than you can for an XRAY tech bc they bring in far more than you for the same service, and that's before we talk about the difference in leverage a healthcare system has relative to PP with regard to insurance contracts. Retention of staff is becoming harder to do. There's no way to compete with a hospital.

We lost 8 XRAY techs recently.

Know how much it costs to own and maintain an EMR? IT support isn't free. Routine maintenance of your buildings FFS.

 

[Sig123]

have you tried to live on $10/hr? $15/hr?

fortunately, i have not, but have friends who did.

No healthcare workers is getting paid $10 per hour.

Your post misses so many fundamental issues about private medical practices struggling to remain financially viable in the face of massive cost increases across the board with subsequent decreases in reimbursement.

 

[SSdoc33]

Not only has every cost across the board increased, we are under pressure from local healthcare systems buying up our entire state. Try competing with a hospital that can pay far more than you can for an XRAY tech bc they bring in far more than you for the same service, and that's before we talk about the difference in leverage a healthcare system has relative to PP with regard to insurance contracts. Retention of staff is becoming harder to do. There's no way to compete with a hospital.

We lost 8 XRAY techs recently.

Know how much it costs to own and maintain an EMR? IT support isn't free. Routine maintenance of your buildings FFS.

all of this is true. the SOS differential is a big problem and needs to be reduced.

that being said: hospitals cant keep staff either. nobody can.

also, how many medicaid patients does your practice see?

 

[MitchLevi]

Your post misses so many fundamental issues about private medical practices struggling to remain financially viable in the face of massive cost increases across the board with subsequent decreases in reimbursement.

Being employed by a hospital or major healthcare system is like my laundry.

It's amazing.

In the AM when I go to work, my dirty clothes hamper is full, only when I come home those EXACT SAME CLOTHES are washed and folded neatly on my bed!!!

I don't have to do anything but go to work, see pts and do my job.

 

[Ducttape]

yes this is a systemic problem that is what is wrong with US Healthcare, even as some of us defend it so vehemently.


and i get that you feel that it is hard to make ends meet.



yet on other threads, we have some pain docs posting about the multiple expensive 3rd and 4th sports cars or lux motorboats in their possession.

obviously there is some discontinuity in this idea that staff cannot make a liveable wage yet some of us have so much disposable income.

No healthcare workers is getting paid $10 per hour.

Your post misses so many fundamental issues about private medical practices struggling to remain financially viable in the face of massive cost increases across the board with subsequent decreases in reimbursement.

true. the average healthcare worker in the US is getting $16 per hour.

https://www.ziprecruiter.com/Salaries/Health-Care-Worker-Salary--in-California#:~:text=As%20of%20Oct%209%2C%202023,(75th%20percentile)%20in%20California.

 

[Ducttape]

You're right, I definitely do not ignore the needs of my one employee. I protect her and look out for her because she's my responsibility since she works for me. I'll throw a patient out long before he or she disrespects her.

How about this for the Bernie Sanders of the world? Start your own business and treat your employees as you feel they should be treated. Lead by example. If you have the experience, better chance of others taking your opinion to heart.

I do agree with you though, I hate seeing people get taken advantage of. It drives me crazy and triggers me for some reason.

1. this would do nothing to change the structural problem of healthcare in the US.

2. it would stop me from seeing those patients who are underserved from a pain standpoint, and run counter to my ethos of providing care for those who need it, because it would not be financially viable to do so in the private sector - medicaid is not a well paying insurance.

 

[MitchLevi]

all of this is true. the SOS differential is a big problem and needs to be reduced.

that being said: hospitals cant keep staff either. nobody can.

also, how many medicaid patients does your practice see?

I don't have an exact percentage off the top of my head but we see SOME Medicaid. Not a ton, but we see Medicaid pts.

 

[Doctodd]

have you tried to live on $10/hr? $15/hr?

fortunately, i have not, but have friends who did.

yea when they were in high school. But so what? Their life choices are not our concern, and they shouldnt be the government's concern either.

 

[Doctodd]

yes this is a systemic problem that is what is wrong with US Healthcare, even as some of us defend it so vehemently.


and i get that you feel that it is hard to make ends meet.



yet on other threads, we have some pain docs posting about the multiple expensive 3rd and 4th sports cars or lux motorboats in their possession.

obviously there is some discontinuity in this idea that staff cannot make a liveable wage yet some of us have so much disposable income.



true. the average healthcare worker in the US is getting $16 per hour.

https://www.ziprecruiter.com/Salaries/Health-Care-Worker-Salary--in-California#:~:text=As%20of%20Oct%209%2C%202023,(75th%20percentile)%20in%20California.

again with the shaming on successful people who invested and gambled on their careers with hours and hours of study and work, paid off their student loans in full, yet they dont deserve the fruits of their labor? So Bernie Sander's deserves a $200k Audi v10 for talking and taking things away from others, but doctor's dont? By the way, I made the money to buy that car by selling my boats. Not by being a doctor.

 

[Doctodd]

No healthcare workers is getting paid $10 per hour.

Your post misses so many fundamental issues about private medical practices struggling to remain financially viable in the face of massive cost increases across the board with subsequent decreases in reimbursement.

that is what the govt wants.....that is how socialized medicine works.

 

[MitchLevi]

yet on other threads, we have some pain docs posting about the multiple expensive 3rd and 4th sports cars or lux motorboats in their possession.

obviously there is some discontinuity in this idea that staff cannot make a liveable wage yet some of us have so much disposable income.

...and sooooooo what?

No staff member works anywhere close to how much I work, and none shoulder any of the risk.

I spent probably two months driving around to every doctor's office in driving distance to our locations. No one else did that. No MA did that. The ASC nurses didn't do that.

I'm the one that has to travel to cadaver labs and learn new procedures so our practice can grow. That's time away from my family.

No one goes on Google and makes up BS about one of my staff members, but they will drag me across the coals knowing I cannot defend myself online due to HIPAA. I've had people call me all sorts of names on my reviews, none of which are true. This directly impacts my ability to bring new pts into the practice.

I paid off 265K in student loans in 35 months, and spent 13 years learning how to be doctor. That 265k is just tuition and loan money. Me and my wife spent thousands flying around to interviews for med school, internship, residency and fellowship. Thousands of dollars in testing and test prep, with CME requirements ongoing. I had to move my family 3 times.

If my practice goes under, I can't just walk around the corner and get another job. It's far more complicated than that.

An unbelievable amount of work goes into this.

BTW - I begrudge no one a Porsche, and FTR I drive an Accord Hybrid because my testosterone is absurdly high and I need something to bring it down a little...

The vast majority of our staff drives nicer cars than I do. We have young staff members driving Chargers and big Ford trucks that cost 80k and guzzle gasoline like hell and I'm in an Accord Hybrid with a big savings account.

You spend all year trying to stay as lean as possible and maximize the working conditions of your employees, THEN you throw an expensive Christmas Party and only half show up...

 

[Pain Applicant1]

1. this would do nothing to change the structural problem of healthcare in the US.

2. it would stop me from seeing those patients who are underserved from a pain standpoint, and run counter to my ethos of providing care for those who need it, because it would not be financially viable to do so in the private sector - medicaid is not a well paying insurance.

There you go, it would not be financially viable to do so. That's why you have to be careful about supporting an increase in wages for employees - because increased wages can prevent a business from being financially viable. It's not easy to start a business to begin with and increasing employee wages makes it even more difficult. Could come to the point where people just won't assume the risk of starting a business. Then what? Someone has to start a business to generate the tax dollars to pay for the Medicaid pts so you can get paid and your pts can be seen.

 

[Pain Applicant1]

yea when they were in high school. But so what? Their life choices are not our concern, and they shouldnt be the government's concern either.

again with the shaming on successful people who invested and gambled on their careers with hours and hours of study and work, paid off their student loans in full, yet they dont deserve the fruits of their labor? So Bernie Sander's deserves a $200k Audi v10 for talking and taking things away from others, but doctor's dont?

Not to toot this dude's horn but doctodd is a genius. Well put my friend.


Sanders
- worth about 2.5 million
- owns 3 homes
- donated about 3% of his income to charity.

 

[callmeanesthesia]

all of this is true. the SOS differential is a big problem and needs to be reduced.

that being said: hospitals cant keep staff either. nobody can.

also, how many medicaid patients does your practice see?

About 30%

 

[MitchLevi]

Not to toot this dude's horn but doctodd is a genius. Well put my friend.


Sanders
- worth about 2.5 million
- owns 3 homes
- donated about 3% of his income to charity.

That's what I've never understood...Who is allowed to be rich?

 

[bedrock]

have you tried to live on $10/hr? $15/hr?

fortunately, i have not, but have friends who did.

I had all of $150 per month to live on after paying for rent, food, books, insurance, travel during my 4 years of medical school.

I was paid far less than $15 per hour during my 5 years of residency.

So no the answer to your question is no!

People with a year or less of education after high school do not deserve to automatically make $25/hr just by showing up while that government simultaneously takes an enormous amount of money from the physician who sacrificed and lived on next to nothing for 13 years during their education.

 

[Pain Applicant1]

That's what I've never understood...Who is allowed to be rich?

That's an easy one as it's the same with addressing climate change. Sacrifice only applies to everyone else.

 

[MitchLevi]

...while that government simultaneously takes an enormous amount of money from the physician who sacrificed and lived on next to nothing for 13 years during their education.

...and while the govt backs student loans, thereby giving medical schools a virtual blank check in tuition, and that's in addition to college tuition, which tons of people went into debt for prior to med school.

 

[SSdoc33]

kudos to us all.

we are all rich by both global and domestic standards.

yet we still manage to complain about the poor.....

 

[SSdoc33]

Not to toot this dude's horn but doctodd is a genius. Well put my friend.


Sanders
- worth about 2.5 million
- owns 3 homes
- donated about 3% of his income to charity.

again with the shaming on successful people who invested and gambled on their careers with hours and hours of study and work, paid off their student loans in full, yet they dont deserve the fruits of their labor? So Bernie Sander's deserves a $200k Audi v10 for talking and taking things away from others, but doctor's dont? By the way, I made the money to buy that car by selling my boats. Not by being a doctor.

SMH. you *****.

that isnt bernie sanders.

Did Bernie Sanders Buy a $172,000 Car with Campaign Donations?

A set of photographs was used to suggest that Democratic presidential candidate Bernie Sanders had purchased an Audi luxury automobile with campaign funds.

www.snopes.com

he has published a bunch of books, and is 70-something years old. 3M net worth is really not all that remarkable.

oh, and he donated the proceeds of one of his books. i assume that 3% number was pulled from some random tax return....

 

[SSdoc33]

studendoctor doesnt even let me say m-o-r-o-n?

what about freedom of speech?

 

[Doctodd]

SMH. you *****.

that isnt bernie sanders.

Did Bernie Sanders Buy a $172,000 Car with Campaign Donations?

A set of photographs was used to suggest that Democratic presidential candidate Bernie Sanders had purchased an Audi luxury automobile with campaign funds.

www.snopes.com

he has published a bunch of books, and is 70-something years old. 3M net worth is really not all that remarkable.

oh, and he donated the proceeds of one of his books. i assume that 3% number was pulled from some random tax return....

SHAME ON YOU. Let's be clear on your fact checker link. Nobody here said the car was bought with campaign donations, which is what your linked article argues. The article goes on to say they have no evidence that it was Bernie Sanders....they almost go out of their way to NOT SAY it wasnt him. Smells like something ive heard before. "We have no evidence this is Hunter Biden's laptop" or "We have no evidence contradicting the Trump Russian dossier." The extra bull**** journalism i put in bold. It didnt "look like an R8"....it definitely WAS an R8.

"The claim that presidential candidate Bernie Sanders spent campaign donations on a sports car worth $172,000 wasn't based on any factual information or documented evidence, but instead on nothing more than a blurry photograph of a man who bore a passing resemblance to the Democratic presidential candidate driving a car that looked like it might have been an expensive Audi R8, in an area that didn't look anything like Arizona on a day when Sanders was stumping in that state. Even if Sanders actually was the one driving the car, it was unclear how commenters would know that he owned it and how he had paid for it simply from a series of grainy photographs."

Pretty sure that's an R8. And Bernie isnt blurry at all.

 

[SSdoc33]

SHAME ON YOU. Let's be clear on your fact checker link. Nobody here said the car was bought with campaign donations, which is what your linked article argues. The article goes on to say they have no evidence that it was Bernie Sanders....they almost go out of their way to NOT SAY it wasnt him. Smells like something ive heard before. "We have no evidence this is Hunter Biden's laptop" or "We have no evidence contradicting the Trump Russian dossier." The extra bull**** journalism i put in bold. It didnt "look like an R8"....it definitely WAS an R8.

"The claim that presidential candidate Bernie Sanders spent campaign donations on a sports car worth $172,000 wasn't based on any factual information or documented evidence, but instead on nothing more than a blurry photograph of a man who bore a passing resemblance to the Democratic presidential candidate driving a car that looked like it might have been an expensive Audi R8, in an area that didn't look anything like Arizona on a day when Sanders was stumping in that state. Even if Sanders actually was the one driving the car, it was unclear how commenters would know that he owned it and how he had paid for it simply from a series of grainy photographs."

Pretty sure that's an R8. And Bernie isnt blurry at all.
View attachment 377829

The Jalopnik mainframe (located in a bunker underneath Delta Burke’s Athens, GA-area training dojo) determined that the driver is Bernie Sanders, but noted that the refractive index on the windows and body did not match expected parameters for an Audi R8 in the apparent lighting.

We Discovered The Truth Behind That Bernie Sanders Driving An Audi R8 Photo

Over the past day or so, a picture that’s allegedly of Bernie Sanders driving a roughly $160,000 Audi R8 has been circulating online, along with the allegations that he purchased the car with donor money. Is any of this even remotely true?

jalopnik.com

wrong again. it must be very really hard to ALWAYS be wrong. i mean, even a stopped clock is right 2x/day

 

[SSdoc33]

About 30%

and how does CA medicaid (is it called medi-cal?) pay?

as i understand it, in some states it is on par with medicare

 

[Pain Applicant1]

SMH. you *****.

that isnt bernie sanders.

Did Bernie Sanders Buy a $172,000 Car with Campaign Donations?

A set of photographs was used to suggest that Democratic presidential candidate Bernie Sanders had purchased an Audi luxury automobile with campaign funds.

www.snopes.com

he has published a bunch of books, and is 70-something years old. 3M net worth is really not all that remarkable.

oh, and he donated the proceeds of one of his books. i assume that 3% number was pulled from some random tax return....

3 mil for a socialist is. That's lots of money that could be used to house and feed many people as opposed to being hoarded by one family. Lead by example and set a standard for others to follow.

From Bernie Sanders website, he donates proceeds from one book only, The Speech. I wonder why he chose that one and not his bestseller. Sounds like so he can convince people that he's not a hypocritical cheapskate.

How about his 3 homes? That really doesn't sound hypocritical to you when other people don't have affordable housing. He's taking up 3 homes --> fewer homes on the market --> lower supply availability --> increase home costs --> less affordable to everyone else

Random it is not. Through a decade of his tax returns:
- income ranged from $205,617 to $1.1 million
- charitable giving < 1 percent to just over 4 percent

My broke-ass Christian patients give 10 percent of whatever they have to their church alone not to mention other givings and they don't complain.

Not sure how people fail to see the hypocrisy.

 

[Ducttape]

...and sooooooo what?

No staff member works anywhere close to how much I work, and none shoulder any of the risk.

I spent probably two months driving around to every doctor's office in driving distance to our locations. No one else did that. No MA did that. The ASC nurses didn't do that.

whaa whaa whaa. sorry to be so rude... and i cut out the dribble at the end of the post to save SDN some bytes.

this is not about you. not about your upper middle class problems, or your self centered upper middle class colleagues.


this is about allowing those health care workers and lower paid Americans - who are essentially forced to a low socioeconomic class - a living wage.

so maybe they dont have to rely on medicaid for their health insurance. so maybe they can save for their retirement so they are not relying solely on their pension and other government handouts. so they can actually afford to contribute to economic growth of the country instead of relying on SNAP or other government handouts.

There you go, it would not be financially viable to do so. That's why you have to be careful about supporting an increase in wages for employees - because increased wages can prevent a business from being financially viable. It's not easy to start a business to begin with and increasing employee wages makes it even more difficult. Could come to the point where people just won't assume the risk of starting a business. Then what? Someone has to start a business to generate the tax dollars to pay for the Medicaid pts so you can get paid and your pts can be seen.

the only thread here worth responding to.

again, this is a societal problem that the US has to face. just like i would not be able to change the culture as a solo future businessman who pays well and sees poorly paying insurance, you cannot change the culture if you paid low wages.

we, America as a whole, can affect change.

if we dont as a society increase wages, we have more and more people reliant on government to provide basic necessities. and businesses will not be able to get any business because noone can afford it.

catch-22 - suppress worker wages to keep business financially lucrative, but noone buys anything. in a businessman's mind, increasing workers wages means their business struggles because it cannot afford costs...




unless business picks up because more people have disposable income....

 

[MitchLevi]

whaa whaa whaa. sorry to be so rude... and i cut out the dribble at the end of the post to save SDN some bytes.

this is not about you. not about your upper middle class problems, or your self centered upper middle class colleagues.


this is about allowing those health care workers and lower paid Americans - who are essentially forced to a low socioeconomic class - a living wage.

so maybe they dont have to rely on medicaid for their health insurance. so maybe they can save for their retirement so they are not relying solely on their pension and other government handouts. so they can actually afford to contribute to economic growth of the country instead of relying on SNAP or other government handouts.



the only thread here worth responding to.

again, this is a societal problem that the US has to face. just like i would not be able to change the culture as a solo future businessman who pays well and sees poorly paying insurance, you cannot change the culture if you paid low wages.

we, America as a whole, can affect change.

if we dont as a society increase wages, we have more and more people reliant on government to provide basic necessities. and businesses will not be able to get any business because noone can afford it.

catch-22 - suppress worker wages to keep business financially lucrative, but noone buys anything. in a businessman's mind, increasing workers wages means their business struggles because it cannot afford costs...




unless business picks up because more people have disposable income....

You have no idea what you're talking about...By raising the floor and lowering the ceiling there is no growth bc there's no one around to invest in business or start new businesses. Why would anyone take on the risk and headache of opening up a business if there's no potential for profit, and in some cases insane amounts of profit?

You said Americans are "forced" into poverty bc their jobs don't pay well enough?

Haha...

Leave the market alone. The job pays what it pays. If no one takes the job the employer raises the salary or offers other incentives. Your idea results in fewer employed ppl and creates more govt reliance.

 

[Pain Applicant1]

whaa whaa whaa. sorry to be so rude... and i cut out the dribble at the end of the post to save SDN some bytes.

this is not about you. not about your upper middle class problems, or your self centered upper middle class colleagues.


this is about allowing those health care workers and lower paid Americans - who are essentially forced to a low socioeconomic class - a living wage.

so maybe they dont have to rely on medicaid for their health insurance. so maybe they can save for their retirement so they are not relying solely on their pension and other government handouts. so they can actually afford to contribute to economic growth of the country instead of relying on SNAP or other government handouts.



the only thread here worth responding to.

again, this is a societal problem that the US has to face. just like i would not be able to change the culture as a solo future businessman who pays well and sees poorly paying insurance, you cannot change the culture if you paid low wages.

we, America as a whole, can affect change.

if we dont as a society increase wages, we have more and more people reliant on government to provide basic necessities. and businesses will not be able to get any business because noone can afford it.

catch-22 - suppress worker wages to keep business financially lucrative, but noone buys anything. in a businessman's mind, increasing workers wages means their business struggles because it cannot afford costs...

I think most economists agree that increased wages will benefit the economy overall for the reasons you mention although I'm not sure how to compete against foreign countries that pay their workers so much less. I no longer buy blades, saws, drill bits etc. from harbor freight in the US now that I can get them for a fraction of the price from Temu in china. I trade ford back and forth so I've been following them. They say they're maxed out on offering any more concessions to the union. If they do, they won't be able to compete and survive.

Honestly, I don't really have a strong opinion about it. I will say that not wanting to deal with government regulations influenced me to not want to expand my practice. Does gov policy that prevents people like me from expanding their businesses adversely impact the economy? Who knows? Someone else who doesn't mind dealing with it will probably just move in to fill the void.

 

[MitchLevi]

I think most economists agree that increased wages will benefit the economy overall for the reasons you mention although I'm not sure how to compete against foreign countries that pay their workers so much less. I no longer buy blades, saws, drill bits etc. from harbor freight in the US now that I can get them for a fraction of the price from Temu in china. I trade ford back and forth so I've been following them. They say they're maxed out on offering any more concessions to the union. If they do, they won't be able to compete and survive.

Honestly, I don't really have a strong opinion about it. I will say that not wanting to deal with government regulations influenced me to not want to expand my practice. Does gov policy that prevents people like me from expanding their businesses adversely impact the economy? Who knows? Someone else who doesn't mind dealing with it will probably just move in to fill the void.

When you employ 400 people and they're demanding at least 25/hr with benefits, the money has to come from somewhere to pay all of that.

The only way you can do it is to fire 50 of them and hire PRN staff so you don't have to give them full benefits.

Trust me - PRN staff are inefficient and have no skin in your game.

 

[Baron Samedi]

...and sooooooo what?

No staff member works anywhere close to how much I work, and none shoulder any of the risk.

I spent probably two months driving around to every doctor's office in driving distance to our locations. No one else did that. No MA did that. The ASC nurses didn't do that.

I'm the one that has to travel to cadaver labs and learn new procedures so our practice can grow. That's time away from my family.

No one goes on Google and makes up BS about one of my staff members, but they will drag me across the coals knowing I cannot defend myself online due to HIPAA. I've had people call me all sorts of names on my reviews, none of which are true. This directly impacts my ability to bring new pts into the practice.

I paid off 265K in student loans in 35 months, and spent 13 years learning how to be doctor. That 265k is just tuition and loan money. Me and my wife spent thousands flying around to interviews for med school, internship, residency and fellowship. Thousands of dollars in testing and test prep, with CME requirements ongoing. I had to move my family 3 times.

If my practice goes under, I can't just walk around the corner and get another job. It's far more complicated than that.

An unbelievable amount of work goes into this.

BTW - I begrudge no one a Porsche, and FTR I drive an Accord Hybrid because my testosterone is absurdly high and I need something to bring it down a little...

The vast majority of our staff drives nicer cars than I do. We have young staff members driving Chargers and big Ford trucks that cost 80k and guzzle gasoline like hell and I'm in an Accord Hybrid with a big savings account.

You spend all year trying to stay as lean as possible and maximize the working conditions of your employees, THEN you throw an expensive Christmas Party and only half show up...

It's going to pain you to learn this, but we drive the same car.

 

[MitchLevi]

It's going to pain you to learn this, but we drive the same car.

Your T insanely high too?

The stereo is nice and TSwift jams in that car.

My hybrid battery uses T to recharge it. Since I bought the car in 2019, my T has gone from AT LEAST 5800 down to AT MOST 80.

 

[bedrock]

You have no idea what you're talking about...By raising the floor and lowering the ceiling there is no growth bc there's no one around to invest in business or start new businesses. Why would anyone take on the risk and headache of opening up a business if there's no potential for profit, and in some cases insane amounts of profit?

You said Americans are "forced" into poverty bc their jobs don't pay well enough?

Haha...

Leave the market alone. The job pays what it pays. If no one takes the job the employer raises the salary or offers other incentives. Your idea results in fewer employed ppl and creates more govt reliance.

Yep. Duct basically wants to be a communist and conveniently forgets how all of those economies went down in flames.

Why do you think that most important and financially successful startups happen in america instead of socialist countries?

 

[Doctodd]

The Jalopnik mainframe (located in a bunker underneath Delta Burke’s Athens, GA-area training dojo) determined that the driver is Bernie Sanders, but noted that the refractive index on the windows and body did not match expected parameters for an Audi R8 in the apparent lighting.

We Discovered The Truth Behind That Bernie Sanders Driving An Audi R8 Photo

Over the past day or so, a picture that’s allegedly of Bernie Sanders driving a roughly $160,000 Audi R8 has been circulating online, along with the allegations that he purchased the car with donor money. Is any of this even remotely true?

jalopnik.com

wrong again. it must be very really hard to ALWAYS be wrong. i mean, even a stopped clock is right 2x/day

I guess the satire on jalopnik was way over your head? You are not a car guy, so do you know the difference between an Audi and a Ford? It’s clearly an Audi R8…..here’s jalopnik’s explanation…..

And I bet you think this chick is attractive….

 

[Doctodd]

whaa whaa whaa. sorry to be so rude... and i cut out the dribble at the end of the post to save SDN some bytes.

this is not about you. not about your upper middle class problems, or your self centered upper middle class colleagues.


this is about allowing those health care workers and lower paid Americans - who are essentially forced to a low socioeconomic class - a living wage.

so maybe they dont have to rely on medicaid for their health insurance. so maybe they can save for their retirement so they are not relying solely on their pension and other government handouts. so they can actually afford to contribute to economic growth of the country instead of relying on SNAP or other government handouts.



the only thread here worth responding to.

again, this is a societal problem that the US has to face. just like i would not be able to change the culture as a solo future businessman who pays well and sees poorly paying insurance, you cannot change the culture if you paid low wages.

we, America as a whole, can affect change.

if we dont as a society increase wages, we have more and more people reliant on government to provide basic necessities. and businesses will not be able to get any business because noone can afford it.

catch-22 - suppress worker wages to keep business financially lucrative, but noone buys anything. in a businessman's mind, increasing workers wages means their business struggles because it cannot afford costs...




unless business picks up because more people have disposable income....

Who do you think pays more for a big Mac when McDonald’s increases hourly rates to $10 an hour?