The Great Resignation and Pain Medicine

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$17/hr = $33k/yr to do all that.

And people wonder why there's a labor shortage. Employees are catching on to the scam.
As if you know anything about my practice.

It ends up being less since I don't work full-time anymore in my med practice. I consider myself semi-retired from medicine.

She is welcome to come and go as she pleases but she sticks around for some reason. I'm not the one wondering or complaining about a labor shortage and my previous staff members told me they'd come back if I needed them and decided to go full-time again. I wonder why that is.

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Every production bonus and ASC check I get yields $250-500 for both my MAs. That is 8 tax-free additional checks per yr (VISA gift cards).

I cannot have them leaving me bc my practice would fall apart. We get along well and have a lot of fun at work. They answer phone calls and know exactly what I will do in most situations and it keeps me off the phone and in exam rooms.

They've even done P2P for me.

I would encourage those of you that can afford it (all of you) to do the same.
 
She's very appreciative of what i give her. To first time I bonused her she cried and told me the most she ever received on xmas was a frozen turkey. Kind of funny. Now i just give her an envelope when she's leaving and tell her not to make it weird and mushy.

I thought about how I'm going to behave towards my staff prior to opening my practice. I enjoy reading history and as ridiculous as it sounds I thought about the French Revolution. I thought about what got these people so charged up. It wasn't really the discrepancy in wealth. It seems that people in a sense like having royalty and rich people around. Look at the queen of england, kardashians, and elon musk. What really helped ignite it was rouseeau quoting "let them eat cake" even though it was never said. They felt disrespected and neglected so I decided to treat my staff as peers. Probably not the best way to run a business but I'm comfortable with it and it works for me.

i always thought it was marie antoinette who said "let them eat cake"

turns out, it probably was about Marie-Therese, a spanish princess as first quoted by Rousseau. who knew?


definitely more useful info in the attached article than in these recent threads....
 
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it is your responsibility to check what is reported and to contest it.
almost all of the companies will correct their reporting.


also, maybe you guys are working with the people who have come to expect the gifts. i give out holiday gifts and have received multiple thanks.

of course, im salaried and not making oodles like you all. typically, it has been things like massages, or float body sessions, along with a little trinket i find at one of the summer festivals (hand made pens or slippers previously, but not the past 2 years due to COVID cancelling almost all of them).
 
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As if you know anything about my practice.

It ends up being less since I don't work full-time anymore in my med practice. I consider myself semi-retired from medicine.

She is welcome to come and go as she pleases but she sticks around for some reason. I'm not the one wondering or complaining about a labor shortage and my previous staff members told me they'd come back if I needed them and decided to go full-time again. I wonder why that is.

So your defense for not paying her is "I am a really nice guy" and "she can leave if she doesn't like it."

This is why people are seeking new employment, folks. Being loyal to your employer screws you, and the best way to secure your own finances is to bounce around. This is a perfect example.

17/hr. What a joke. Five Guys employees make more than that.
 
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i always thought it was marie antoinette who said "let them eat cake"

turns out, it probably was about Marie-Therese, a spanish princess as first quoted by Rousseau. who knew?


definitely more useful info in the attached article than in these recent threads....
Crazy how one person with a gift for writing or speaking can rile up people so easily and change the course of history, even if based on lies. Scary too. People need to be very careful of what they put out to the public as they often don't see the future consequences of their words and actions.

Another interesting historical figure who I find interesting is Rasputin. This one to me just does not make any sense.
 
Crazy how one person with a gift for writing or speaking can rile up people so easily and change the course of history, even if based on lies. Scary too. People need to be very careful of what they put out to the public as they often don't see the future consequences of their words and actions.

Another interesting historical figure who I find interesting is Rasputin. This one to me just does not make any sense.
LOVE rasputin

russian history is pretty great
 
So your defense for not paying her is "I am a really nice guy" and "she can leave if she doesn't like it."

This is why people are seeking new employment, folks. Being loyal to your employer screws you, and the best way to secure your own finances is to bounce around. This is a perfect example.

17/hr. What a joke. Five Guys employees make more than that.
Thanks but no thanks for your business advice, Bernie Sanders. How many people do you employ in your private practice and how much do you pay them in your private practice?

It's called a free market. That's how things work and how prices are determined.

#1 I always tell my staff to never put my company first and that they should always place themselves first and do what's best for them and not the practice as I mentioned in my above post
#2 when she first started working for me she was making far more than the average of where I live. I'm not sure about now as I'm assuming wages have increased quite a bit over the past few months
#3 You have no concept of how my office runs. I've streamlined things to make them as simple as possible for her and me. I ran my office by myself for 2 months when covid first hit. I know her tasks firsthand and I've simplified them. The only thing I couldn't do was fluoro-guided procedures for obvious reasons.

I'm obviously offering something that keeps her here and makes my other employees want to return. With all the help-wanted signs around, they're aware of what's out there.
 
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LOVE rasputin

russian history is pretty great
I don't want to go off on a tangent, sorry, but please explain to me how this situation makes any sense. A perfect storm including the need for answers and a mother's strong emotions towards her sick child led to this person's influence. He impacted the russian revolution, WW1 and its aftermath WW2, the almost spread of communism through Europe via the front lines of the WW1 soldiers, etc. This country bumpkin (with mystical powers??) was kind of the fuse for this. Is it fate? It's hard to understand. What do you think?
 
You love him for the physical resemblance.

(This was inappropriate and I apologize). Legend has it he had the anti Dillinger male anatomy)
i can assure you that there is no physical resemblance... unfortunate for me
 
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I don't want to go off on a tangent, sorry, but please explain to me how this situation makes any sense. A perfect storm including the need for answers and a mother's strong emotions towards her sick child led to this person's influence. He impacted the russian revolution, WW1 and its aftermath WW2, the almost spread of communism through Europe via the front lines of the WW1 soldiers, etc. This country bumpkin (with mystical powers??) was kind of the fuse for this. Is it fate? It's hard to understand. What do you think?

if i remember my AP modern european history correctly, he was somehow able to calm down the little czar kid (some nicholas or something) and make him stop bleeding from hemophilia. im sure there was no actual science to it, but by doing so he was able to ingratiate himself to the mom and therefore had a huge effect on policy. this is what happens when we start listening to the dr. oz types.

im more interested in the story of his death....
 
I don't want to go off on a tangent, sorry, but please explain to me how this situation makes any sense. A perfect storm including the need for answers and a mother's strong emotions towards her sick child led to this person's influence. He impacted the russian revolution, WW1 and its aftermath WW2, the almost spread of communism through Europe via the front lines of the WW1 soldiers, etc. This country bumpkin (with mystical powers??) was kind of the fuse for this. Is it fate? It's hard to understand. What do you think?
Sounds like the origin of Chiropractic.
 
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if i remember my AP modern european history correctly, he was somehow able to calm down the little czar kid (some nicholas or something) and make him stop bleeding from hemophilia. im sure there was no actual science to it, but by doing so he was able to ingratiate himself to the mom and therefore had a huge effect on policy. this is what happens when we start listening to the dr. oz types.

im more interested in the story of his death....
Oh yeah, I forgot about that. Supposedly shot, drowned, suffocated, locked up, and still survived and escaped until the ultimate end.
 
Oh yeah, I forgot about that. Supposedly shot, drowned, suffocated, locked up, and still survived and escaped until the ultimate end.

and poisoned.


i heard one account that he has shackled, shot, then thrown off the bridge. his body was found miles downstream and he was out of his shackles. however, the GSW to the forehead does put a bit of a hole (pun intended) in that story

from wiki:

Assassination attempt​

On 12 July [O.S. 29 June] 1914 a 33-year-old peasant woman named Chionya Guseva attempted to assassinate Rasputin by stabbing him in the stomach outside his home in Pokrovskoye.[60] Rasputin was seriously wounded, and for a time it was not clear if he would survive.[61] After surgery[62] and some time in a hospital in Tyumen,[63] he recovered.

Guseva was a follower of Iliodor, a former priest who had supported Rasputin before denouncing his sexual escapades and self-aggrandizement in December 1911.[64][65] A radical conservative and anti-semite, Iliodor had been part of a group of establishment figures who had attempted to drive a wedge between the royal family and Rasputin in 1911. When this effort failed, Iliodor was banished from Saint Petersburg and was ultimately defrocked.[64][66] Guseva claimed to have acted alone, having read about Rasputin in the newspapers and believing him to be a "false prophet and even an Antichrist".[67] Both the police and Rasputin, however, believed that Iliodor had instigated the attempt on Rasputin's life.[64] Iliodor fled the country before he could be questioned, and Guseva was found to be not responsible for her actions by reason of insanity.[64]

Death​


Felix Yusupov, husband of Princess Irina Aleksandrovna Romanova, the Tsar's niece, 1914
A group of nobles led by Prince Felix Yusupov, Grand Duke Dmitri Pavlovich, and right-wing politician Vladimir Purishkevich decided that Rasputin's influence over the tsarina threatened the empire, and they concocted a plan in December 1916 to kill him, apparently by luring him to the Yusupovs' Moika Palace.[68][69]


Basement of the Yusupov Palace on the Moika in St. Petersburg where Rasputin was murdered

The wooden Bolshoy Petrovsky Bridge from which Rasputin's body was thrown into the Malaya Nevka River
Rasputin was murdered during the early morning on 30 December [O.S. 17 December] 1916 at the home of Felix Yusupov. He died of three gunshot wounds, one of which was a close-range shot to his forehead. Little is certain about his death beyond this, and the circumstances of his death have been the subject of considerable speculation. According to historian Douglas Smith, "what really happened at the Yusupov home on 17 December will never be known".[70] The story that Yusupov recounted in his memoirs, however, has become the most frequently told version of events.[71]


Rasputin's body with a bullet wound in forehead
Yusupov said he invited Rasputin to his home shortly after midnight and ushered him into the basement. Yusupov offered Rasputin tea and cakes which had been laced with cyanide. Rasputin initially refused the cakes but then began to eat them and, to Yusupov's surprise, appeared unaffected by the poison.[72] Rasputin then asked for some Madeira wine (which had also been poisoned) and drank three glasses, but still showed no sign of distress. At around 2:30 am, Yusupov excused himself to go upstairs, where his fellow conspirators were waiting. He took a revolver from Dmitry Pavlovich, then returned to the basement and told Rasputin that he'd "better look at the crucifix and say a prayer", referring to a crucifix in the room, then shot him once in the chest. The conspirators then drove to Rasputin's apartment, with Sukhotin wearing Rasputin's coat and hat in an attempt to make it look as though Rasputin had returned home that night.[73] Upon returning to the Moika Palace, Yusupov went back to the basement to ensure that Rasputin was dead.[74] Suddenly, Rasputin leaped up and attacked Yusupov, who freed himself with some effort and fled upstairs. Rasputin followed Yusupov into the palace's courtyard, where he was shot by Purishkevich. He collapsed into a snowbank. The conspirators then wrapped his body in cloth, drove it to the Petrovsky Bridge, and dropped it into the Malaya Nevka River.[75]
 
Thanks but no thanks for your business advice, Bernie Sanders. How many people do you employ in your private practice and how much do you pay them in your private practice?

It's called a free market. That's how things work and how prices are determined.

#1 I always tell my staff to never put my company first and that they should always place themselves first and do what's best for them and not the practice as I mentioned in my above post
#2 when she first started working for me she was making far more than the average of where I live. I'm not sure about now as I'm assuming wages have increased quite a bit over the past few months
#3 You have no concept of how my office runs. I've streamlined things to make them as simple as possible for her and me. I ran my office by myself for 2 months when covid first hit. I know her tasks firsthand and I've simplified them. The only thing I couldn't do was fluoro-guided procedures for obvious reasons.

I'm obviously offering something that keeps her here and makes my other employees want to return. With all the help-wanted signs around, they're aware of what's out there.

I'm not trying to give you business advice.

Do you think it is ethical to pay a employee, whom you said runs your clinic and you'd be screwed without, such a poor salary? A person you said would be near impossible to replace? A woman who, you said, literally cried when you gave her a Christmas bonus?

You say its just business and "free market" but its literally your employee's livelihood. Its got to suck to care about your folks so little.
 
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I'm not trying to give you business advice.

Do you think it is ethical to pay a employee, whom you said runs your clinic and you'd be screwed without, such a poor salary? A person you said would be near impossible to replace? A woman who, you said, literally cried when you gave her a Christmas bonus?

You say its just business and "free market" but its literally your employee's livelihood. Its got to suck to care about your folks so little.
Do I care about my staff = straw man/red herring = nice try

I tell her I can't replace her but everyone is replaceable, including me. I also tell her how important she is to the practice and how I couldn't operate without her. It's true to a degree and makes her feel important. I want her to feel good about herself and keep her morale high. It doesn't mean that someone else can't do the job.

I don't agree that it's a poor salary. It was much higher than the average salary paid locally and higher than what the hospital paid. I'm not sure about now as I haven't looked but I'm assuming wages have gone up.

Either way, I can't just give raises every 3 months because then they come to expect it. I have to keep her motivated and her expectations realistic. If my revenue gets cut I just can't turn around and lower her salary and this inflationary induced wage bump is likely only temporary. If wages overall decrease, my employee can price herself out. If someone else is willing to do the work for less it will create resentment towards her from me and I don't want that. On the other side, if she feels she is underpaid it can create resentment towards me from her. Right now, my office runs harmoniously and everyone is very happy.

I also have a construction business. You remind me of those people who know nothing about construction yet critique and criticize someone else's work on a home remodel. Start a business and hire some employees. Until then, hush.
 
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If the difference between paying your sole prized employee $33k/yr vs $50k/yr is enough to put you in financial ruin, you are less of a business guru than you are claiming to be.

You're right that I don't run a private practice. I do directly supervise 16 employees though and advocate for them any chance I get, especially when it comes to their wages. Not a single employee of mine, including the brand new front desk guy, makes less than your golden goose.
 
If the difference between paying your sole prized employee $33k/yr vs $50k/yr is enough to put you in financial ruin, you are less of a business guru than you are claiming to be.

You're right that I don't run a private practice. I do directly supervise 16 employees though and advocate for them any chance I get, especially when it comes to their wages. Not a single employee of mine, including the brand new front desk guy, makes less than your golden goose.
I know you don't run a private practice. It's clear.

Reread my posts. I always post that I am not a good business owner and tell others not to follow what I do. I can make a lot more money if I wanted to in medicine. I don't. I'd rather focus on my construction company.

Go and advocate for the employees you supervise. You're a real champ. It's always hard to be generous with someone else's money. Typical.
 
total comp per MA at my solo PP is 60K.

Aint no fun if the homies cant have none.
 
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If you're not signing the checks your opinion doesn't count.
 
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Exactly where is the link between child labor laws and this conversation?

You are proposing if you are not a person's employer that you shouldn't be interested in their well-being or critical of their treatment. This is faulty logic and the reason we have labor laws, including those against most forms of child labor.
 
You are proposing if you are not a person's employer that you shouldn't be interested in their well-being or critical of their treatment. This is faulty logic and the reason we have labor laws, including those against most forms of child labor.
Incredible leap, unworthy of discussion.
 
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You are proposing if you are not a person's employer that you shouldn't be interested in their well-being or critical of their treatment. This is faulty logic and the reason we have labor laws, including those against most forms of child labor.
Straw man first and now virtue signaling. Brilliant.

How much do you make at your job? I'm guessing somewhere between 350 and 500k. That's a stark difference from the people you supervise. Why not be a true advocate and not a phony one and tell your employer that you are willing to take less so your employees can have more? Let me guess, those you supervise don't need more because they're paid just right and so are you. Those paid less are being paid too little and those paid more are being paid too much. You just happen to set the standard because that's what benefits you.

If you want someone to be paid more, go ahead and start a practice and pay them more. Experience what it takes to start a business before offering worthless critiques.
 
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Straw man first and now virtue signaling. Brilliant.

How much do you make at your job? I'm guessing somewhere between 350 and 500k. That's a stark difference from the people you supervise. Why not be a true advocate and not a phony one and tell your employer that you are willing to take less so your employees can have more? Let me guess, those you supervise don't need more because they're paid just right and so are you. Those paid less are being paid too little and those paid more are being paid too much. You just happen to set the standard because that's what benefits you.

If you want someone to be paid more, go ahead and start a practice and pay them more. Experience what it takes to start a business before offering worthless critiques.

This year I made $140k.

I think you should pay your employee and so do several of your peers in this thread. You can ignore that opinion if you want. As you said, it's your business, run it as you want.
 
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This year I made $140k.
Now I feel for you the way you're feeling for my employee. You're getting hosed and someone is definitely taking advantage of you unless it's for charitable purposes. Are you an interventional pain doc? Do you work full-time?

If you're getting paid this because you're doing charitable work then hats off to you. You're a much better person than I am and I admire you. You've earned my respect! If not, give me a call because I'd like to give you some tips on how to negotiate better. I don't like seeing people getting taken advantage of.
 
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Now I feel for you the way you're feeling for my employee. You're getting hosed and someone is definitely taking advantage of you unless it's for charitable purposes. Are you an interventional pain doc? Do you work full-time?

If you're getting paid this because you're doing charitable work then hats off to you. You're a much better person than I am and I admire you. You've earned my respect! If not, give me a call because I'd like to give you some tips on how to negotiate better. I don't like seeing people getting taken advantage of.
clearly VA
 
Active duty military.
Definitely a better person than me. Hats off to you!!

I'll ignore your edited comment but just to keep things in perspective about my area my wife is an attorney and she was offered a job at $15/hr.
 
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So your defense for not paying her is "I am a really nice guy" and "she can leave if she doesn't like it."

This is why people are seeking new employment, folks. Being loyal to your employer screws you, and the best way to secure your own finances is to bounce around. This is a perfect example.

17/hr. What a joke. Five Guys employees make more than that.
Yup. The old generation got away with a lot of BS but it doesn’t look like it will fly anymore. Then these semi-retired guys come lecture younger doctors about how medicine is a calling yada yada yada
 
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Yup. The old generation got away with a lot of BS but it doesn’t look like it will fly anymore. Then these semi-retired guys come lecture younger doctors about how medicine is a calling yada yada yada
Am I considered part of the old generation? I don't think so. I'm only in my 40s. Besides, I wouldn't say something like that calling thing anyway.

Nothing BS about my situation anyway and there's a big difference between my employee's earnings and the baron guy had he been working in the private sector. My employee is making more than fair market value for what she is doing but no matter where baron is in the country, except for a charitable cause or in this case the military, he would be considered to be well below fair market value.

I live in a rural underserved area. I already mentioned what my wife was offered as an ivy league educated attorney and property taxes are about 1/10 of those in NYC. It's not the same as a city or suburb.
 
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Am I considered part of the old generation? I don't think so. I'm only in my 40s. Besides, I wouldn't say something like that calling thing anyway.

Nothing BS about my situation anyway and there's a big difference between my employee's earnings and the baron guy had he been working in the private sector. My employee is making more than fair market value for what she is doing but no matter where baron is in the country, except for a charitable cause or in this case the military, he would be considered to be well below fair market value.

I live in a rural underserved area. I already mentioned what my wife was offered as an ivy league educated attorney and property taxes are about 1/10 of those in NYC. It's not the same as a city or suburb.
Attorneys screwed themselves. They opened up a ton of law schools. Too many lawyers graduating, not enough work..err..meaningful work. You can get a PI job or an insurance defense job if you snap your fingers. Most people don’t want to do that work, but many of them do because they have to. Law jobs= luck or you gotta know somebody who knows somebody. I know all this because my wife is a lawyer and has been unemployed for 4 years now. Partly by choice, and partly cause the market is just really really bad. It’s an abusive environment, and they can abuse because of so many graduates looking to work for peanuts.
 
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Attorneys screwed themselves. They opened up a ton of law schools. Too many lawyers graduating, not enough work..err..meaningful work. You can get a PI job or an insurance defense job if you snap your fingers. Most people don’t want to do that work, but many of them do because they have to. Law jobs= luck or you gotta know somebody who knows somebody. I know all this because my wife is a lawyer and has been unemployed for 4 years now. Partly by choice, and partly cause the market is just really really bad. It’s an abusive environment, and they can abuse because of so many graduates looking to work for peanuts.
I don't think it's the lawyers screwing themselves, it's the schools who are screwing over the lawyers. Same thing is happening with CRNAs and medical schools that are opening everywhere but there aren't enough residency spots for all the graduates. Schools like to graduate professional degrees because it gives them prestige and a ton of money.
 
I don't think it's the lawyers screwing themselves, it's the schools who are screwing over the lawyers. Same thing is happening with CRNAs and medical schools that are opening everywhere but there aren't enough residency spots for all the graduates. Schools like to graduate professional degrees because it gives them prestige and a ton of money.
Agree. And unfortunately it is now ridiculous easy to become a lawyer. Means about as much as a bachelors degree to me unless they went to a tier 1 law school.

All the new medical schools are not screwing over their US graduates as much as they are making it more harder for IMGs to obtain a US residency. There are still plenty of residency spots for US graduates. If graduated from a US MD/DO school and didn't match, then you either reached too far without backup residency choice, or must have a major personal/educational deficit that caused you not to matched.

I'd still much rather be a graduating medical resident than a graduating lawyer right now.
 
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Medicine is not a calling? Why do it then?
Season 7 Nbc GIF by The Office
 
Attorneys screwed themselves. They opened up a ton of law schools. Too many lawyers graduating, not enough work..err..meaningful work. You can get a PI job or an insurance defense job if you snap your fingers. Most people don’t want to do that work, but many of them do because they have to. Law jobs= luck or you gotta know somebody who knows somebody. I know all this because my wife is a lawyer and has been unemployed for 4 years now. Partly by choice, and partly cause the market is just really really bad. It’s an abusive environment, and they can abuse because of so many graduates looking to work for peanuts.
One reason why there are so many lawsuits.
 
Anyone else think higher education to some degree is a bit of a scam? There are so many majors that really don't help you land a job. Critical thinking skills and worldly knowledge are important but should you spend that much money on it to not really have a tangible employable skill when all is said and done, especially when you can probably get the same education at your local library? I think higher ed needs to take some lessons from the trade schools.
 
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Anyone else think higher education to some degree is a bit of a scam? There are so many majors that really don't help you land a job. Critical thinking skills and worldly knowledge are important but should you spend that much money on it to not really have a tangible employable skill when all is said and done, especially when you can probably get the same education at your local library? I think higher ed needs to take some lessons from the trade schools.
Higher ed has the same problem as medicine - it's immensely over-bloated and most of the people employed (mostly admin) produce little to no value to the end consumer. Therefore, to just survive and feed the many useless mouths, higher education has no choice but to expand and to add frivolous degrees in order to extract resources from unwitting students and the federal government. As complex systems grow, it requires even greater amounts of resources simply to maintain its internal structure. Unfortunately, it outpaces the ability of its environment to support it.

Both medicine and higher ed have already reached this critical threshold, IMO. The only possible outcome is to shrink and decrease the size of both industries.
 
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Anyone else think higher education to some degree is a bit of a scam? There are so many majors that really don't help you land a job. Critical thinking skills and worldly knowledge are important but should you spend that much money on it to not really have a tangible employable skill when all is said and done, especially when you can probably get the same education at your local library? I think higher ed needs to take some lessons from the trade schools.

still need that piece of paper, though
 
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Anyone else think higher education to some degree is a bit of a scam? There are so many majors that really don't help you land a job. Critical thinking skills and worldly knowledge are important but should you spend that much money on it to not really have a tangible employable skill when all is said and done, especially when you can probably get the same education at your local library? I think higher ed needs to take some lessons from the trade schools.
That's a bit of an understatement. Our education system is a cultural relic from the time when books and professors and knowledge required a pilgrimage to a place of higher learning and condensed, dedicated study. It's all in our phone now, carried in our pockets and yet we still send people away to live in dorms and get parchment degrees.

It's a relic and a tribute to humanity's utter inability to move forward. Ironically, "progressives" are mostly responsible for maintaining and promoting the outdated education system.
 
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Higher ed has the same problem as medicine - it's immensely over-bloated and most of the people employed (mostly admin) produce little to no value to the end consumer. Therefore, to just survive and feed the many useless mouths, higher education has no choice but to expand and to add frivolous degrees in order to extract resources from unwitting students and the federal government. As complex systems grow, it requires even greater amounts of resources simply to maintain its internal structure. Unfortunately, it outpaces the ability of its environment to support it.

Both medicine and higher ed have already reached this critical threshold, IMO. The only possible outcome is to shrink and decrease the size of both industries.
The real outcome will be more money thrown at universities with zero cost controls and then politicians will "forgive" the student loans for their voters.
 
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The real outcome will be more money thrown at universities with zero cost controls and then politicians will "forgive" the student loans for their voters.
Yeah, probably. Governments will always choose stimulus and hence inflation over allowing the system to shed its useless sectors. This approach, when taken to its logical conclusion, always ends badly.
 
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