Nurses making more than doctors

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I know I'm a bit out of my element here and probably am going to get chewed up but...

It might be that Family Practitioners aren't making a ton of money because there are several cheaper versions (albeit downgraded) out there such as NPs and PAs. Yes indeed they can't function independently (they will be pushing for that next), but a medical center can function about as effectively with 10 FP's as one with 5 FP's and 5 PAs but the latter one will have much less overhead, and that extra money that is saved will probably go where? Charity? Diabetes Research? Added to the salary of current FPs? Ha. PROBABLY to the administrators of that facility (notice I am merely speculating, but those people normally have business degrees and they do know economics and how to make money). Therefore, they can keep their overhead low by keeping the number of FPs at a minimum and fill in the rest with the cheaper PA option. IMO, this does put FPs in at least an indirect competition with PAs for jobs and salaries. NO, the PA can't demand the same salary or claim to do the same job, but the administrator can be more selective and pick the FP who is willing to work for the average or less instead of the $200k+ that they are really worth. Long story short, FPs' salaries are being driven down by the fact that someone else can do PART (notice I only said PART, meaning the ordinary, routine uncomplicated part) for 1/3 or 1/2 the money.

A CRNA is basically the same concept: just a cheaper, downgraded version of an anesthesiologist that is perfectly capable in uncomplicated arenas (yes i know, stating the obvious). Their training gets right down to it, and they learn in their 2 years in CRNA school exactly what they are going to be doing professionally and are spared the "wasted burden" (sarcasm) of completely learning medicine that the med student turned anesthesiologist has to bear before starting their specific professional training. Again, what is Mr. CEO going to think when doing the hiring? Well he's going to look at the cheaper CRNA option and "lick his chops" and make sure he is adequately staffed w/ nurses who can do the (simple,uncomplicated) jobs of doctors for 1/2 the price.

Any thoughts? Did I just state the obvious or am I understanding something wrong?

I think what you said makes complete sense.
 
I want to do family medicine or Primary Care for rural and underserved populations. My goal is to work a good job and volunteer some time out of work to treating some more disadvantaged populations. Yes I want money, but I want to be able tohelp and care for people as well.

I have wanted to work in Emergency Medicine as well. If I wished to do both family and Emergency Medicine, what is the logical path way for that?
 
Seriously, checkups and antihypertensives are a lot less expensive than a lengthy stay in the ICU with an intracranial hemorrhage and the long term care for a trached and PEG'd individual that once had a job and independence.

If someone is going to make the outrageous claim that preventative care is more expensive than damage control, please back that up.
http://www.nytimes.com/2008/10/07/h...=1&partner=rssuserland&emc=rss&pagewanted=all

Preventative care results in better health, but not lower costs.
 
I want to do family medicine or Primary Care for rural and underserved populations. My goal is to work a good job and volunteer some time out of work to treating some more disadvantaged populations. Yes I want money, but I want to be able tohelp and care for people as well.

I have wanted to work in Emergency Medicine as well. If I wished to do both family and Emergency Medicine, what is the logical path way for that?

Combined EM/FM residencies exist. If you are set on a rural community you can just do FM. In rural areas, FM doctors do staff ER's due to the lack of Emergency Room Physicians. In under-severed communities, you will make good money as well.
 
Hi Perrotfish thank you!

Yes I am actually planning on working in one of the areas that is on the loan forgiveness places, there are several places in my state. All of them I am fine with. Rural medicine is what I'd like to do because that's the kind of area I grew up in.

You are right though one can always change their interests. I believe I will not change mine, but with shadowing and such I am sure it's possible.

A
 
I want to do family medicine or Primary Care for rural and underserved populations. My goal is to work a good job and volunteer some time out of work to treating some more disadvantaged populations. Yes I want money, but I want to be able tohelp and care for people as well.

I have wanted to work in Emergency Medicine as well. If I wished to do both family and Emergency Medicine, what is the logical path way for that?

sorta off topic???

Anyway I have friends doing EM/FM residencies. I am not sure how well the two gel but that's better asked to someone doing the residency.

Good luck
 
I agree with you on the preventitive care. But in reality, nurses, doctors, mechanics are NOT the same thing. I am sure the guy at Mcdonalds works hellish days as well. But if you can see the difference in putting in the effort to recieve a doctorate degree then you are kidding yourself. I am sorry its different. If it wasnt different then my arse really is the same thing as my elbow.

But its not is it. Nor is an RN the same as an MD the same as a mechanic. 👎 Its a choice. It took me a long time to get here. It wasnt about money. I dont care about what nurses make. I care about PCPs getting paid more to make this failing healthcar system work better. And I hate it when people so casually play off like they dont care what they will be making. Wait till we have kids, cars etc. I bet have the yoke heads in this forum spouting off all the overly typical sentiment will end up in plastics or derm. But hey, I dont see anything wrong with that.

You must have completely misinterpreted what I wrote because that is exactly the point I made. I'm a little tired of those physicians, and not even physicians but some medical students that cry about how much more money someone else makes (and wouldn't you know it's always about nurses for some godforsaken reason!) after all the hard years of work and sex slave pay (which yeah, it is-no doubt about it). Those are the market forces at work shuggah, you may as well argue whether pro athletes, or actors, or hell even the Shamwow guy contribute enough hard work and value to justify their incomes. What premed doesn't know how much hard work and expense it is to go down this road? They all know! If there are a few that didn't take a real, hard look at what they are sacrificing for, or consider they may prefer another career which is "easier" and still pays great- sorry, but whose responsibility is that? By then it is too late to complain about the m'fcking nurses or the shamwow guy's income just being a tad too high for their liking. /end rant

The CBO says that preventive medicine will add to the costs of healthcare.

http://www.washingtonpost.com/wp-dyn/content/article/2009/08/07/AR2009080703822.html

http://www.nytimes.com/2008/10/07/h...=1&partner=rssuserland&emc=rss&pagewanted=all

Preventative care results in better health, but not lower costs.

Both articles made some good points, but are not proof that preventive medicine costs more than damage control- (the first article gives brief limited second hand data, and the second article has no data) These articles are also written in the context of healthcare reform (highly partisan, highly politicized issue).

For one thing, preventive medicine needs to be clearly defined, as the articles point out many screening tests and treatments are quite expensive, have low yield, and have their own inherent risks.

Interventions/health care practices what have you- including preventive practices are categorized and ranked by how strong the evidence has shown it to be effective/beneficial.

This helps to develop standards of care and cost-benefit analysis.

The second article points to the tendency to "overdiagnose" that is to say give undue significance to possibly benign abnormalities and then go on to "overtreat" with potentially harmful treatments. It is certainly a logical theory but is there any head to head data on patients with the same medical diagnoses, one group getting treated and the other not? There very well may be, but it isn't referred to. We all know how well that went for the syphilis patients in the Tuskeegee study. Ethics puts some limits on how we prove things in medicine, doesn't it?

Another thing to consider is why as a healthcare society are we pressured to overtest, and overtreat? Maybe that root should be identified. Could it be that our motives are often purely to CYA (Cover your ass?). Ah hellz yes. And why do we do that? Because there is that ever present threat of a lawsuit. And that dynamic has its own special story.

In these articles, it would have been nice to see how and which preventive tests/treatments were itemized as well as the figure representing the cost of not providing preventive care and how that is totaled. I wonder if secondary expenses were considered. Sure, a month in the ICU can rack up a million dollars, but what if that person can never return to work? Cha-ching add another item to the government's cost bill because now we have someone else dependent on social security/disability that could have been avoided. What if that person has dependents, cha- ching , cha-ching.... It adds up doesn't it?

Neither of these articles even touched the subject that we offer treatment to people (that is NOT preventive) who have very little chance to benefit from it, and in fact causes significant suffering. Please don't even ask for examples as there are way to many in my experience and is such a backward disheartening aspect of healthcare.

Without going on further....I will say interesting articles to read, but not by far the final word on the subject.
 
That article was written just to stir the pot. They compared apples to oranges. The job of a FM doc is very different that a CRNA. Why not compare the salary of the CRNA to the Anesthesiologist? Why not compare the salary of the FM doc to the FNP? Because comparing those salaries won't sell copy. If you compare more equivalent work (and billing practices), docs out earn nurses every time.
 
That article was written just to stir the pot. They compared apples to oranges. The job of a FM doc is very different that a CRNA. Why not compare the salary of the CRNA to the Anesthesiologist? Why not compare the salary of the FM doc to the FNP? Because comparing those salaries won't sell copy. If you compare more equivalent work (and billing practices), docs out earn nurses every time.

Exactly, you're comparing the highest paid nurses to the lowest paid doctors
 
I was pre-testing a hot Nursing Student who came in for an eye exam at lenscrafters today. She was telling me how nurses now are making more than doctors. I'm like, are you talking about CRNA's? She's like yea yea. That led to an interesting conversation...
 
Having nurse/murse parents I will never complain about nurse salary ;p
 
Nursing is brutal work if you aim to make any kind of serious money with it.

That's no lie! My mother = 11pm-7am, 3pm-11pm weekdays and made over 130,000. She had 5 kids and no husband so we still struggled for money but it coulda be worse 🙄
 
That's no lie! My mother = 11pm-7am, 3pm-11pm weekdays and made over 130,000. She had 5 kids and no husband so we still struggled for money but it coulda be worse 🙄
I'm calling lie. an RN making 130K anywhere is unheard of.
 
Thought exercise: I would like everyone here to imagine a world where everyone was trained in the same way medical professionals are trained. Let's imagine the training of a plumber in this world:

To become a Master plumber requires five year apprenticeship 10,000 hours plus 744 hours of class room studies re: codes, formulas, etc., then you work for a Master plumber for 5 years and once you have 10 years documented time in then you can take the 4 part masters exams.

Most skilled trades operate on a similar type of system.
 
Nursing is brutal work if you aim to make any kind of serious money with it.

My cousin is a nurse. She got a masters and apparently was making in the 90's doing shift work 3 days a week for 12 hours a shift. 90k isn't really serious money, especially in california, but 36 hour work week wasn't too bad.
 
My cousin is a nurse. She got a masters and apparently was making in the 90's doing shift work 3 days a week for 12 hours a shift. 90k isn't really serious money, especially in california, but 36 hour work week wasn't too bad.
90K is quite a bit higher than the national average for mastered prepared nurses. Sounds like she landed herself a good job.

I'm just confused as to why people think that doctors are supposed to be the highest paying career in the hospital? you should forget what the nurse is making, and focus on what the CEOs and admins are making (with no nights, no weekends, and no call to boot). And where is written that nurses aren't allowed to make a career or make decent money. How much should a CRNA get paid? And rather than bitch about how much money some nurses are making (when there are many docs making hundreds of thousands more) why isn't the focus on raising the salary for FPs and other low paying specialties? Oh SDN, you're so disconnected from reality.
 
BTW, against all logic if your goal is primary care in rural or underserved populations you will actually be making serious bank. Thanks to the hundreds of government incentives to try to generate rural docs small town FMs can easily make 250K with full loan forgiveness in an area where the most ostentatious mansion only costs 500. Meanwhile a New York FM will fight to break 150K with no loan forgiveness in an area where that barely covers the rent on a small apartment. Don't you love price fixing?

Can you cite some sources and example?

This might just push me toward becoming the first Asian FP in Utah.
 
90K is quite a bit higher than the national average for mastered prepared nurses. Sounds like she landed herself a good job.

I'm just confused as to why people think that doctors are supposed to be the highest paying career in the hospital? you should forget what the nurse is making, and focus on what the CEOs and admins are making (with no nights, no weekends, and no call to boot). And where is written that nurses aren't allowed to make a career or make decent money. How much should a CRNA get paid? And rather than bitch about how much money some nurses are making (when there are many docs making hundreds of thousands more) why isn't the focus on raising the salary for FPs and other low paying specialties? Oh SDN, you're so disconnected from reality.

Watch House MD Season 6: 9 to 5. It's an episode all about Cuddy ;p
 
I'm just confused as to why people think that doctors are supposed to be the highest paying career in the hospital? you should forget what the nurse is making, and focus on what the CEOs and admins are making (with no nights, no weekends, and no call to boot). And where is written that nurses aren't allowed to make a career or make decent money. How much should a CRNA get paid? And rather than bitch about how much money some nurses are making (when there are many docs making hundreds of thousands more) why isn't the focus on raising the salary for FPs and other low paying specialties? Oh SDN, you're so disconnected from reality.

agreed.gif
 
Can you cite some sources and example?

This might just push me toward becoming the first Asian FP in Utah.

I think read the same thing in the FP forum. I dunno man, from one Asian to another, it's gonna be hard to go to a place where the only Asian food is only the Lychee Garden buffet down the street.
 
Can you cite some sources and example?

This might just push me toward becoming the first Asian FP in Utah.
I'm not buying it. I work in an extremely undeserved area, or at least one that qualifies according to the federal govt, and the FP docs here make 130-150K (max- and that includes bonuses).
Watch House MD Season 6: 9 to 5. It's an episode all about Cuddy ;p
i hate house. 🙁
 
I'm calling lie. an RN making 130K anywhere is unheard of.

Call it a lie if you want LOL! what would be the point in lying? She had multiple jobs plus after taxes it's not that much
 
I'm just confused as to why people think that doctors are supposed to be the highest paying career in the hospital?...Oh SDN, you're so disconnected from reality.

Agreed. SDNers think the world is coming to an end because some nurses make more $ than some MDs. Either be that nurse, or don't be that MD...but quit bitchin' about it like some grave cosmic injustice is being perpetrated.

That article was written just to stir the pot. They compared apples to oranges. The job of a FM doc is very different that a CRNA. Why not compare the salary of the CRNA to the Anesthesiologist? Why not compare the salary of the FM doc to the FNP? Because comparing those salaries won't sell copy. If you compare more equivalent work (and billing practices), docs out earn nurses every time.

I agree and pointed out this fallacy on another recent thread.
 
After all is said and done, I'm looking to see where doctors' salaries will end up. Will we level out at 50% what they make now, or more like 70%? The whole future is unknown.

That said, if you have a smart business mind, you will be able to do well for yourself. I know a Psychiatrist in Ohio who has no office and makes well over $1mil a year just by visiting a lot of nursing homes and hospitals. And that profession has one of the lowest average salaries. There are ways to make money out there. The question is, will you be able to see it?
 
CRNA's require a BSN (4 years), 1 year working in an ICU setting (typically 2 years to get there for most people), and then 2 years of CRNA school. Minimum 7 years of studies, typically much more because people don't think of CRNA right away after nursing school (they wanna make money).

It's not a cakewalk.

A lot of advance degree health schools also require these "healthcare work experiences" that most pre-meds don't have... because they're too busy spending their time trying to understand Grignard reagents, Bernoulli's continuity of flow, and the pKa of a Tyrosine.

would you want someone making independent decisions on your life who never ever took organic chemistry or general chem with a lab? I sure wouldnt.
 
After all is said and done, I'm looking to see where doctors' salaries will end up. Will we level out at 50% what they make now, or more like 70%? The whole future is unknown.

That said, if you have a smart business mind, you will be able to do well for yourself. I know a Psychiatrist in Ohio who has no office and makes well over $1mil a year just by visiting a lot of nursing homes and hospitals. And that profession has one of the lowest average salaries. There are ways to make money out there. The question is, will you be able to see it?

Agreed. Find ways to augment your income. It may not be easy with regards to finding the time to do these things, but it isn't impossible.
 
would you want someone making independent decisions on your life who never ever took organic chemistry or general chem with a lab? I sure wouldnt.

You mean like... nurses...?
 
Money does matter, but you have to love what you do. You can't predict where the money will be in 5 or 10 years from now.

I asked a radiation oncologist who makes a million dollars a year how she chose that specialty. She said 20 years ago it was the only thing that an IMG could get into. She didn't know, nobody knew that it was destined to be a million dollar a year decision. So pick what you like doing so you don't hate your life (regardless of the money).

This is interesting. Maybe in 4th year you pick the booming specialty and by the time you're out of residency it's something else. My goal in life is to not hate my life.
 
I asked a radiation oncologist who makes a million dollars a year how she chose that specialty. She said 20 years ago it was the only thing that an IMG could get into. She didn't know, nobody knew that it was destined to be a million dollar a year decision. So pick what you like doing so you don't hate your life (regardless of the money).

Wow.

Wow.

Wow.

*Massive facepalm and fits of jealousy.*
 
Every specialty goes through periods of high income and then low income. Don't pick a specialty just because they are banking right now. Pick something you like. And for the most part, eventually it will become a sought after field after a period of time. Then all the new graduates will jump into that specialty, and the bubble will burst, and then the money will shift somewhere else. It is just a cycle.
 
I know I'm a bit out of my element here and probably am going to get chewed up but...

...A CRNA is basically the same concept: just a cheaper, downgraded version of an anesthesiologist that is perfectly capable in uncomplicated arenas (yes i know, stating the obvious). Their training gets right down to it, and they learn in their 2 years in CRNA school exactly what they are going to be doing professionally and are spared the "wasted burden" (sarcasm) of completely learning medicine that the med student turned anesthesiologist has to bear before starting their specific professional training. Again, what is Mr. CEO going to think when doing the hiring? Well he's going to look at the cheaper CRNA option and "lick his chops" and make sure he is adequately staffed w/ nurses who can do the (simple,uncomplicated) jobs of doctors for 1/2 the price.

Any thoughts? Did I just state the obvious or am I understanding something wrong?
Some points are missed. CRNAs are not cheaper than anesthesiologists. The payers (insurance companies/medicare/medicaid) pay the same rate, whether anesthesia is delivered by an anesthesiologist or a CRNA. They don't save any money. There is even a provision in the health care reform bills that won't allow "discrimination" in pay based on training. In addition, CRNAs work far fewer hours, leave at the end of the shift rather than when the case is done, are required to get regular breaks, don't take overnight call, get paid heavily on overtime and benefits, and many groups are starting to look for cheaper options, like anesthesia assistants. In addition to being just as expensive as anesthesiologists to the payers, they don't save hospitals much money, either.

Anesthesiologists are physician consultants. Algorithms break down far too often. Well, they don't break down, but they are used far beyond their intended populations, especially when those that use them don't understand the medicine behind the algorithm.

Anesthesia delivery didn't start becoming safe until physicians got into it and began experimenting. We aren't a right nor even a commodity. We are a brand, a type of anesthesia delivery utilizing physician consultants. I didn't fully understand what that meant even 6 months ago, but the more I learn, the more it is becoming clear to me. Our problem is we don't get the word out like we should.
 
Some points are missed. CRNAs are not cheaper than anesthesiologists. The payers (insurance companies/medicare/medicaid) pay the same rate, whether anesthesia is delivered by an anesthesiologist or a CRNA. They don't save any money. There is even a provision in the health care reform bills that won't allow "discrimination" in pay based on training. In addition, CRNAs work far fewer hours, leave at the end of the shift rather than when the case is done, are required to get regular breaks, don't take overnight call, get paid heavily on overtime and benefits, and many groups are starting to look for cheaper options, like anesthesia assistants. In addition to being just as expensive as anesthesiologists to the payers, they don't save hospitals much money, either.

Anesthesiologists are physician consultants. Algorithms break down far too often. Well, they don't break down, but they are used far beyond their intended populations, especially when those that use them don't understand the medicine behind the algorithm.

Anesthesia delivery didn't start becoming safe until physicians got into it and began experimenting. We aren't a right nor even a commodity. We are a brand, a type of anesthesia delivery utilizing physician consultants. I didn't fully understand what that meant even 6 months ago, but the more I learn, the more it is becoming clear to me. Our problem is we don't get the word out like we should.

could you elaborate? does that mean that physicians can administer anesthesia that a nurse could not?
 
Every specialty goes through periods of high income and then low income. Don't pick a specialty just because they are banking right now. Pick something you like. And for the most part, eventually it will become a sought after field after a period of time. Then all the new graduates will jump into that specialty, and the bubble will burst, and then the money will shift somewhere else. It is just a cycle.

I predict that the next highly-compensated field nobody went into will be Medical Genetics.
 
I'm just confused as to why people think that doctors are supposed to be the highest paying career in the hospital?

Because, without doctors, the hospital would serve no purpose. People don't come to the hospital for nursing. They don't come for the administration. They sure as hell don't come for the food (well, for the most part). They come to the hospital so that a doctor can address and hopefully fix/manage their problem.

I'm not saying that elements of the whole "patient experience" (e.g. good nursing care, good ancillary staff, a clean and efficiently-run hospital, hell, even decent hospital food) won't sway someone's decision to go to Hospital X vs. Hospital Y. But the bottom line is that if trained, licensed physicians aren't available to treat whatever conditions ail patients, all of the support/administrative/etc. staff in the world won't be able to make up for it.

If only physicians could remember this - THAT is the ace up your sleeve. You worked hard, jumped through all the hoops, took all the classes and tests, and got all of the requisite training and licensing. No amount of money can "buy" that (unless you are willing to let them buy you). Hospitals can hire all of the NPs, PAs, RNs, PTs, OTs, RTs, CNAs, administrators, executives, and other support staff that they want. YOUR TRAINING AND LICENSING IS NOT REPLACEABLE. They need you because you are the end-all-be-all of medical providers (i.e. you are the one who is ultimately responsible for the patients that are serviced there, regardless of what RN or PA saw them). What they give you in return for your service - e.g. a place to work, a fancy front-door shingle, a salary & benefits, etc. - is negotiable. To an extent, certainly. But still negotiable. (The problem is that you are still replaceable by other physicians who are willing to take less than you are.)

As an aside, the new legislature banning physician-owned hospital creation/expansion is such an abomination and so incredibly unconsitutional that sometimes I wonder wtf country I'm living in these days.
 
would you want someone making independent decisions on your life who never ever took organic chemistry or general chem with a lab? I sure wouldnt.

There's plenty of people who have lives in their hands every day who never took organic chem. I think that's an extremely stupid train of thought.
 
Because, without doctors, the hospital would serve no purpose. People don't come to the hospital for nursing. They don't come for the administration. They sure as hell don't come for the food (well, for the most part). They come to the hospital so that a doctor can address and hopefully fix/manage their problem.

I'm not saying that elements of the whole "patient experience" (e.g. good nursing care, good ancillary staff, a clean and efficiently-run hospital, hell, even decent hospital food) won't sway someone's decision to go to Hospital X vs. Hospital Y. But the bottom line is that if trained, licensed physicians aren't available to treat whatever conditions ail patients, all of the support/administrative/etc. staff in the world won't be able to make up for it.

If only physicians could remember this - THAT is the ace up your sleeve. You worked hard, jumped through all the hoops, took all the classes and tests, and got all of the requisite training and licensing. No amount of money can "buy" that (unless you are willing to let them buy you). Hospitals can hire all of the NPs, PAs, RNs, PTs, OTs, RTs, CNAs, administrators, executives, and other support staff that they want. YOUR TRAINING AND LICENSING IS NOT REPLACEABLE. They need you because you are the end-all-be-all of medical providers (i.e. you are the one who is ultimately responsible for the patients that are serviced there, regardless of what RN or PA saw them). What they give you in return for your service - e.g. a place to work, a fancy front-door shingle, a salary & benefits, etc. - is negotiable. To an extent, certainly. But still negotiable. (The problem is that you are still replaceable by other physicians who are willing to take less than you are.)

As an aside, the new legislature banning physician-owned hospital creation/expansion is such an abomination and so incredibly unconsitutional that sometimes I wonder wtf country I'm living in these days.

It's a double edged sword. If nursing care, housekeeping services, engineering, administration etc., isn't available, all the diagnosing and prescribing will not make up for those deficits. While there is no argument that a physician's education and training is of longer duration and greater expense than others in the healthcare industry, they don't function "independently" either.

You can make a case that due to the extent of their education and training that they are entitled to earn the highest salary, and that is a reasonable argument, but that is not how the market works. I know of dudes that own carpet cleaning companies that earn more than physicians. While statistically those with higher educations have higher income than those who don't, there is not a direct proportional relationship between education and income.

Take notice of hospital advertising these days. I see my hospital's advertising everywhere, newspaper, buses, signs, banners on the hospital wall. They don't feature Dr. Cooper (Nurse Jackie reference). They feature the "birth center", USN&WR standings, Da Vinci technology, and Magnet status (purely a nursing designation). The hospital spends a lot of money for all this advertising stuff, they also spend money to pay for market research experts to tell them what would attract customers (er patients) to Joe Mama Hospital. I did by the way recently hear a radio ad for Kaiser that focuses on acknowledging doctors.

The point is- you can get all worked up about the injustices heaped on med students, residents etc., but there are bigger cultural and value driven influences at play- plus now there is a heavier governmental influence at hand as well. Not trying to be a jerk, but your ace up the sleeve is the proverbial joker.
 
For me, if you think you were overworked, then it's safe to say you're not happy with what you're doing, there are some no matter how huge their workload is, they still enjoy working as its their passion.
 
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