Anesthesia peak of competitiveness?

[Dr. Rude]

No worries. We will just import poorer people who have no qualms about living on less. Anything is an upgrade from where they came and so they are more than comfortable reproducing.

While some of that will be going on, there is also likely to be some reversal of the multi decade trend of diminishing share of corporate revenue going to workers as wages.

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[Fpg1245]

While some of that will be going on, there is also likely to be some reversal of the multi decade trend of diminishing share of corporate revenue going to workers as wages.

Once in a generation where labor gets the best of capital. Notice how fast they are to let all the plebs know AI is on the way.

 

[Dr. Rude]

Once in a generation where labor gets the best of capital. Notice how fast they are to let all the plebs know AI is on the way.

Let me know when AI can fix a roof, weld, wait tables, help bathe an elderly person, etc.

 

[Fpg1245]

Let me know when AI can fix a roof, weld, wait tables, help bathe an elderly person, etc.

Just saying it’s scare tactic. If they didn’t need you then you’d already be out of a job

 

[anbuitachi]

“

Gen Zers and millennials say they can't afford to have families​

“

Yes it’s difficult but not impossible.

Cut tv/Netflix /Hulu/Disney etc. that saves $100 easy. Maybe $200 if they have YouTube tv/cable as well.

Cut Amazon prime as well, instacart, Uber eats. Tons of markup with these delivery services. Well Amazon prime Probabiy better value than instacart 30% markup.

i dont got tv, netflix, hulu, disney.
all i got is amazon prime which is like 150 a year or so. uber eats bc saving > 9.99 monthly cost, bc i have to order food at work (no cafeteria, and no time to cook)

 

[anbuitachi]

Come on, man

A normal family of four isn't spending $25,000 - $36,500 a year for FOOD. They're just not. They're not spending half that. They're maybe spending a quarter of that. Maybe.

it really depends on how much you want to starve them and what type of food you are buying. you can save a lot if you just eat sliced bread with jam all day. or go to the clearance grocery section, where food is damaged and bit rotten.

but for a family of 4, for low income, nyc already provides 939$ limit to food benefit and this is meant to be a supplement. thats 11268$ a year on supplemental food benefit. i have a fam of 3, and our monthly meal cost is ~2000$. we dont eat anything fancy... and i dont eat breakfast most of the time.

Check out ur grocery bills. Even at Costco or Publix. Each week is at min $250 a month that’s at min. That’s $1000 and that’s being cheap.

Food prices are through the roof. 3 gallons of milk each week is $12 already and that’s not the organic type each.

Add kids lunches at schools $3-5 a day.

my toddler drinks so much milk, the cost is insane. its 6.99 for half gallon organic here. a bit cheaper for non organic but bc of his crazy allergies we choosing organic and paying for it

 

[anbuitachi]

I don't disagree many services are marked up and there is room for savings, but lets be real freeing up $2k/year will not help anyone have children. Having a kid for many means upgrading apartment from a 1br to a 2br. In my MCOL area that is going from $1200 rent to $1700 rent. That is $6000 more per year in rent alone. This is just living space, not even a discussion of actual child expenses. Netflix savings will not get you there.

The reason Gen Z and millenials can't afford families is not because of convenience services. It is because the astronomical cost of housing, childcare, medical care, and stagnant wages that have not kept to inflation in the last 20-30 years.

1200 -1700 for a 1-2br is MCOL????! sounds super low to me. what is LCOL price then? im understanding todays rental market is crazy

 

[anbuitachi]

nyc just took over 60000 migrants in the last year... so the population isnt gonna go down anytime soon over here.. nyc projected to spend like 4.3B a year on them (and the # keep increasing). Thats 71.6k per person per year. not per household. per PERSON.

so it feels like the government here are choosing illegal immigrants over their own in terms of affording life/kids

 

[abolt18]

1200 -1700 for a 1-2br is MCOL????! sounds super low to me. what is LCOL price then? im understanding todays rental market is crazy

Not sure what it's like today, but my first 2 years of med school in a VLCOL we had a 3BR for $575/month. Moved to St Louis for clinical rotations and rented a 3BR 2.5bath townhome with a basement for $1200/month in a nice area (Kirkwood). This was only back in 2017.

 

[anbuitachi]

Not sure what it's like today, but my first 2 years of med school in a VLCOL we had a 3BR for $575/month. Moved to St Louis for clinical rotations and rented a 3BR 2.5bath townhome with a basement for $1200/month in a nice area (Kirkwood). This was only back in 2017.

oh i didnt realize you just graduated from residency hahaha

but thats insanely cheap !!

 

[Dr. Anonymouss]

Not sure what it's like today, but my first 2 years of med school in a VLCOL we had a 3BR for $575/month. Moved to St Louis for clinical rotations and rented a 3BR 2.5bath townhome with a basement for $1200/month in a nice area (Kirkwood). This was only back in 2017.

That’s very cheap. I live in a low cost of living city and rent for a 3BR house is about 1200

 

[crash2500]

Not sure what it's like today, but my first 2 years of med school in a VLCOL we had a 3BR for $575/month. Moved to St Louis for clinical rotations and rented a 3BR 2.5bath townhome with a basement for $1200/month in a nice area (Kirkwood). This was only back in 2017.

Inflation is 25% since then.

Also, st. Louis is one of, if not THE lowest cost 'cities' in the country.

 

[anbuitachi]

also funny most of my patients on labor delivery have many kids... they can 'afford it' despite being very low income class. sometimes being in the middle is bad, better to be wealthy, or poor and get government support

 

[abolt18]

oh i didnt realize you just graduated from residency hahaha

but thats insanely cheap !!

Finished in 2021. Did a year as attending then CT fellowship (last day is tomorrow). Moving Friday to start working with @OTCAwesome

 

[HemeOncHopeful19]

but for a family of 4, for low income, nyc already provides 939$ limit to food benefit and this is meant to be a supplement. thats 11268$ a year on supplemental food benefit. i have a fam of 3, and our monthly meal cost is ~2000$. we dont eat anything fancy... and i dont eat breakfast most of the time.

my toddler drinks so much milk, the cost is insane. its 6.99 for half gallon organic here. a bit cheaper for non organic but bc of his crazy allergies we choosing organic and paying for it

I’m sorry but I don’t think I should have to pay for someone else’s toddlers to dine on only the finest of “organic milks.”

Also does your $939 include WIC benefits, etc.?

 

[aneftp]

Miami rents are comparable to San Francisco rents
these days

Why this Florida city may actually be more unaffordable than the Bay Area

Rent prices in Miami are rising fast and quickly approaching those of the Bay Area — making the Florida city more unaffordable than the Bay Area, a report found.

www.sfchronicle.com

Of course that’s Miami proper not the suburbs of miami.

So low cost of living is all relative. Because Miami surrounding areas are still much cheaper than San Francisco surrounding area.

Makes no sense with housing.

 

[epidural man]

Finished in 2021. Did a year as attending then CT fellowship (last day is tomorrow). Moving Friday to start working with @OTCAwesome

Good job!

 

[JOHNBROCHILL]

1200 -1700 for a 1-2br is MCOL????! sounds super low to me. what is LCOL price then? im understanding todays rental market is crazy

Yep I did a quick search online and that was the cheapest I could find. It was outdated, no amenities, but in a safe area of town. Your view is definitely skewed from nyc.

 

[BLADEMDA]

I get your point but I find these graphs misleading. What is the rate of growth in this particular chart ? I’ve seen some snow a 12 percent growth rate which is extremely unrealistic. Even 7 percent is optimistic. It’s probably much closer to 4-6 percent growth. If you consider inflation you have to subtract 3 percent. Just trying to be realistic. We start making money later , usually in higher tax bracket , and start with loans. We have a lot of fincancial barriers that work against us

Are you trying to justify your spending instead of investing? I know it's hard out there. I killed myself, literally, saving the money I invested. I regret the long hours, extra calls, etc but I have the money. Was it worth it? No. But, I have enough to leave my kids a big sum of money likely sooner than later. I highly recommend you save as much as possible WITHOUT killing yourself. But, retirement requires discipline and must be earned. I agree on balance in life but the path to FIRE Does require some sacrifices. Good Luck.

 

[Simba1711]

No im agreeing with you. It takes a lot of work especially if you live in vhcol area like me. I’m just saying those graphs are extremely misleading since those numbers are skewed. It’s not that useful if you don’t provide the growth rate. You often have to invest more than that growth suggest. I do the same as you. Few years Out of training pick up extra call. I put 20 percent of my paycheck into investments every month.

 

[anbuitachi]

I’m sorry but I don’t think I should have to pay for someone else’s toddlers to dine on only the finest of “organic milks.”

Also does your $939 include WIC benefits, etc.?

well yes, thats why im paying for it out of my own pocket, for my toddlers regular organic milk

I do not think it include wic, but im not an expert, since i dont get any of these benefits

Apply for SNAP

Apply for the Supplemental Nutrition Assistance Program & buy healthy food for you & your family when money is tight.

www.ny.gov

What is SNAP?

The Supplemental Nutrition Assistance Program (SNAP) issues electronic benefits that can be used like cash to purchase food. SNAP helps low-income working people, senior citizens, the disabled and others feed their families.

What can I purchase with SNAP?

Food for your household to eat, such as:

• breads and cereals
• fruits and vegetables
• meats, fish and poultry
• dairy products

You can also purchase seeds and plants, which produce food for your household to eat.

What can’t I purchase with SNAP?

• beer, wine, liquor, cigarettes or tobacco
• any nonfood items, such as:
  • pet food
  • soap, paper products
  • household supplies
  • vitamins and medicine
• food that will be eaten in the store
• hot foods

 

[anbuitachi]

Are you trying to justify your spending instead of investing? I know it's hard out there. I killed myself, literally, saving the money I invested. I regret the long hours, extra calls, etc but I have the money. Was it worth it? No. But, I have enough to leave my kids a big sum of money likely sooner than later. I highly recommend you save as much as possible WITHOUT killing yourself. But, retirement requires discipline and must be earned. I agree on balance in life but the path to FIRE Does require some sacrifices. Good Luck.

definitely wont be leaving much for my kids. im raising my kids to be adults who can make a living who wont need my support.. at most i pass down my property probably (except i dont have any right now). A lot of people who purchased regular homes a few decades ago in nyc, those are all worth like 1m+ now. so just passing down primary residence is HUGE compared to if your parents got nothing.

 

[ambiturner]

While we’re on the topic, is there any actual evidence that organic milk confers any actual benefits to children? I feel like an idiot every time I pay twice as much for organic milk, free range eggs, etc.

 

[anbuitachi]

While we’re on the topic, is there any actual evidence that organic milk confers any actual benefits to children? I feel like an idiot every time I pay twice as much for organic milk, free range eggs, etc.

i dont think so. i was in the camp of organics do nothing for most of my life. i recently a few years ago made the switch to some organic, but especially organic milk. the taste is just so so much better. very rich taste. i have no idea if it has any benefits otherwise. it may even have harm. i used to drink 1% or 2% milk and occasionally whole milk. now i switched to whole organic milk only and i drink a lot more cause it tastes better. may be increasing my risk of cancer...

 

[HemeOncHopeful19]

While we’re on the topic, is there any actual evidence that organic milk confers any actual benefits to children? I feel like an idiot every time I pay twice as much for organic milk, free range eggs, etc.

I’m pretty sure for Organic it’s basically so they can mark everything up 50-100% and market it to upper middle class white and Asian families… or at least that is my impression the few times I’ve went by Whole Foods to return an Amazon package. UpToDate actually has an article on it if you’re interested.

The free range thing is more about you (and my wife) feeling better for the chickens.

 

[abolt18]

i dont think so. i was in the camp of organics do nothing for most of my life. i recently a few years ago made the switch to some organic, but especially organic milk. the taste is just so so much better. very rich taste. i have no idea if it has any benefits otherwise. it may even have harm. i used to drink 1% or 2% milk and occasionally whole milk. now i switched to whole organic milk only and i drink a lot more cause it tastes better. may be increasing my risk of cancer...

I'm all about that whole milk. It's the good stuff. Though, I buy the cheapest brand available at the store (Kroger, great value, or Costco usually).

 

[anbuitachi]

I'm all about that whole milk. It's the good stuff. Though, I buy the cheapest brand available at the store (Kroger, great value, or Costco usually).

used to drink regular whole milk. still way worse than organic whole milk. it makes other stuff better too when i add organic milk instead of regular whole, such as to coffee or tea

 

[anbuitachi]

I’m pretty sure for Organic it’s basically so they can mark everything up 50-100% and market it to upper middle class white and Asian families… or at least that is my impression the few times I’ve went by Whole Foods to return an Amazon package. UpToDate actually has an article on it if you’re interested.

The free range thing is more about you (and my wife) feeling better for the chickens.

well organic does cost more to produce. so there is for sure a markup

 

[nimbus]

I used to go to a gym where a lot of the guys would drink whole milk, some would drink 1gallon per day. They specifically drank nonorganic conventional milk because they thought the rBST would help them get swole.

 

[GassYous]

I used to go to a gym where a lot of the guys would drink whole milk, some would drink 1gallon per day. They specifically drank nonorganic conventional milk because they thought the rBST would help them get swole.

Isn't too much milk bad because it messes with absorption and leads to anemia

 

[pgg]

Finished in 2021. Did a year as attending then CT fellowship (last day is tomorrow). Moving Friday to start working with @OTCAwesome

Congrats!

 

[private practice warrior]

Temporarily. Next year it'll be back to $200/hr tops.

No it won’t be. The nadir in anesthesia supply isn’t projected to hit until 2028. Shortages are not going away. PE is going to be a big loser in this since anesthesia has to be paid more and there won’t be money left for their 20% off the top. It’s already started with Envision declaring bankruptcy last month. Presently one hospital in Portland is so desperate for “providers” that they are offering cRNa’s $265/hr to supplement their PP group anesthesiologists and cRNa’s since that group can’t hire almost anyone. It’s the same all across the country and market pressure rules.

 

[CubsDynasty]

Talking to friends in the farming industry the term organic for the most part is a joke.

 

[nimbus]

Isn't too much milk bad because it messes with absorption and leads to anemia

To me it seems bad for many reasons.

 

[GassYous]

Talking to friends in the farming industry the term organic for the most part is a joke.

I think organic milk tastes very different

And I see cows all the time when driving around. The organic cows are prancing around hilly green fields chilling under the trees while the non organic cows are fenced closely together on some dirt floor and no tree cover.

 

[Dr. Rude]

I think organic milk tastes very different

And I see cows all the time when driving around. The organic cows are prancing around hilly green fields chilling under the trees while the non organic cows are fenced closely together on some dirt floor and no tree cover.

Sounds like the difference between a senior/owner/partner/AMC owner doc and an employee doc.

 

[Simba1711]

I think organic milk tastes great.

 

[forchinet121]

In the late 80s some specialties were making as much as professional athletes. Medicine had unequaled compensation but took a big hit in 1993 (I believe the absolute peak of competitiveness) when Clinton proposed national healthcare. Went down but rebounded when the sky turned out not to be falling (completely).

A lot of my anesthesia attendings who graduated med school circa 1985-1990 were stellar, AOA types from top schools. Lots of good technology and developments were coming into the field and it was a much more humane residency than surgery before duty hours. A lot of them said they would have done surgery had they graduated in the 80-hour era.

How was a doctor making 5M+? (Like an athlete)

 

[pgg]

I think organic milk tastes very different

I think organic milk tastes great.

It's pasteurized differently. Shorter time, higher temperature. This affects the sugars and makes organic milk sweeter. I think it tastes better also.

Unless you're going full blown hippie on your organic milk and getting it raw, in which case the flavor difference probably comes from the life-threatening bacteria you're consuming.

 

[pgg]

The whole "organic" thing is pretty ridiculous. Marketing. Higher costs, lower yields. No actual health benefit that anyone but the gullible believe.

If you really want cleaner, healthier, better tasting produce - the real answer is to buy local from smaller producers. It's picked closer to ripe, and the varieties are selected for qualities like taste as opposed to shelf life and ease of storage/shipping.

Fruit that comes from a local orchard, even if that orchard was saturated with industrial grade pesticides, is worlds better than "organic" stuff that had to be picked early and shipped.

Most of the stuff we grow ourselves are hybrid varieties that we liberally treat with Sevin. Because we're more interested in good yields and great taste than unscientific hippie **** about heirloom seeds and mother nature.

 

[CubsDynasty]

And the accreditation to be certified organic is comparable to a visit from JCAHO

 

[GassYous]

How was a doctor making 5M+? (Like an athlete)

I know at least three people who still are

 

[forchinet121]

I know at least three people who still are

How

 

[ambiturner]

How was a doctor making 5M+? (Like an athlete)

Professional athlete compensation has drastically outpaced inflation. NBA league average in the mid 80s was under $500k, about the same as the average cardiac surgeon. Highest paid player in the mid 80s was Magic Johnson making around $2.5. So it’s not that they made current NBA money, but at the time it was pretty close.

 

[forchinet121]

Professional athlete compensation has drastically outpaced inflation. NBA league average in the mid 80s was under $500k, about the same as the average cardiac surgeon. Highest paid player in the mid 80s was Magic Johnson making around $2.5. So it’s not that they made current NBA money, but at the time it was pretty close.

Makes sense thx for explaining

 

[Sriddymopboi]

No it won’t be. The nadir in anesthesia supply isn’t projected to hit until 2028. Shortages are not going away. PE is going to be a big loser in this since anesthesia has to be paid more and there won’t be money left for their 20% off the top. It’s already started with Envision declaring bankruptcy last month. Presently one hospital in Portland is so desperate for “providers” that they are offering cRNa’s $265/hr to supplement their PP group anesthesiologists and cRNa’s since that group can’t hire almost anyone. It’s the same all across the country and market pressure rules.

Wow which practice is this? It isn’t OAG is it? They seem like a great group from what I’ve read about them. Also, do you have a source for that 2028 number? Would be a good read!

 

[anbuitachi]

completely irrelevant to the topic.but read this the other day. interesting read. here we are surprised by 5m md salarys when its probably like only a few in the country that make that much out of hundreds of thousands.

the real MDs are on wall street. and apparently their salary isnt outpacing inflation either (median of 2m or so it seems)

On Wall Street, Lawyers Make More Than Bankers Now

Superstar attorneys can rake in more than $15 million a year, while compensation for bankers has hardly budged.

www.wsj.com

 

[aneftp]

completely irrelevant to the topic.but read this the other day. interesting read. here we are surprised by 5m md salarys when its probably like only a few in the country that make that much out of hundreds of thousands.

the real MDs are on wall street. and apparently their salary isnt outpacing inflation either (median of 2m or so it seems)

On Wall Street, Lawyers Make More Than Bankers Now

Superstar attorneys can rake in more than $15 million a year, while compensation for bankers has hardly budged.

www.wsj.com

At the end of the day. We gotta work and work almost daily for our money. It’s a very solid living.

But I talked to one of my friends. Their ex spouse can make 30k in one hour as entertainment/sports booking agent. Now that’s crazy money. Barely a community college associates then turn into a full bachelors degree in communication after 6 years of school. School or hard knocks. College degree at age 29. The long way around. Dude pulls 8-10 mil a year. It’s kinda of shady what they do. But it’s all business. They will book a famous person for a 200k appearance fee normally take a 10% cut. Sometimes they will lie to the celebrity’s own agent say the venue will only give him 200k when they venue is really offering 250k. So they pocket the extra 50k.

But that’s just the way the world work. Now the most shady people are the New York Mets, charlotte hornets new owner. Former SAC hedge funds guys yet only one dude really went to jail and he is married to a doctor.

 

[nimbus]

The whole "organic" thing is pretty ridiculous. Marketing. Higher costs, lower yields. No actual health benefit that anyone but the gullible believe.

If you really want cleaner, healthier, better tasting produce - the real answer is to buy local from smaller producers. It's picked closer to ripe, and the varieties are selected for qualities like taste as opposed to shelf life and ease of storage/shipping.

Fruit that comes from a local orchard, even if that orchard was saturated with industrial grade pesticides, is worlds better than "organic" stuff that had to be picked early and shipped.

Most of the stuff we grow ourselves are hybrid varieties that we liberally treat with Sevin. Because we're more interested in good yields and great taste than unscientific hippie **** about heirloom seeds and mother nature.

For sure. I’ve eaten some crappy organic peaches but the farmers market peaches are insanely good. Same for tomatoes.

 

[aneftp]

Hospitals are in a free fall with anesthesia services costing millions over budget to staff. Either pay the amc, or private group. Or take it in house w2 model.

I saw a in house proposal w2 (well hospital created a shell w2 company solely own by the hospital) to staff anesthesiologists and CRNA ) Probably for legal protection. The numbers with guarantee annual bonus are getting higher and higher

With the sign on bonus it’s equivalent of 525k w2 and 9 weeks off. Based on 40 hour week plus plus weekend and weeknight night intensive.

So actual numbers likely 650k with standard 1 call every 8 days.

It’s getting close to what true market rate for full doc doc. 700-750k w2 with 9-10 weeks off with approx 50 hours work.

That’s the only way to get rid of locums docs who know they can make 800k 50 hours a week with 10 weeks off approximately