Travel Teams

[Ohitshoggle]

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I am considering working for one of the travel teams and wanted to know what they are like from someone who has actually worked for one of the companies like Envision, TH, etc.

 

[DO3]

Most of the time you can make close to the same money working somewhere full time that’s actually worth a darn to work at. I thought about it too until I found out that I could make within $5-10/hr at a great community shop with low turnover. Unless you’re making $300+/hr, I wouldn’t put up with the aggravation.

 

[alpinism]

Have multiple friends who did the USACS firefighter travel team. Generally speaking they got paid a premium to help staff their most dysfunctional hospitals where they had trouble hiring full time physicians. Nearly everyone does it until they pay off loans then gets out as fast as possible.

 

[Groove]

Strike teams are smoke and mirrors:

Let's say they offer you $300/hr to do strike. Meanwhile, another CMG in town wants to pay you $250/hr to work locally. You're all excited to knock out some loans and have goo goo eyes for that $300/hr thinking you'll never find a local job that would pay you that much. Well, let's do the math...

It takes you 45 mins to get to the airport, another hour to get checked in and make it to the gate and actually board the plane. 3-4 hours flight. 30 mins to get your luggage and 15 mins to pick up and get settled in your rental car. 1.5 hours ride to your site. Total "travel" time = 7 hours each way at a "premium" of $300/hr. (If you say there's no way there would be that much travel time for a "strike" job, you haven't done enough of them.) You fly out and do 2-3 blocks per month. Let's be conservative and say you do 2 big blocks each month for 28 hours of travel time/mo for 120 hours of "paid" work each month. 120 hours/month @ $300/hr = 36K divided by 148 hours (120 + 28 hours of non paid travel time = 148 hours) = $243/hr compensation. That's $7/hr less than the job right down the street that has you sleeping in your own bed each night.

I won't even get into the dumpster fire ERs they are desperately trying to staff that they send you to each month with malignant hospital admin, nursing and consultants.

Now, I'm not saying there aren't sweeter gigs out there but please sit down and do the math before you jump into a "firefighter gig". Most of the time, it's not worth it and you only realize it a couple years later when you finally sit down at your desk and dust off the calculator.

 

[Alvarez13]

Just do locums. Why people want to do the exact same locums assignment with being forced into 140 hr/mo contract helping the enemy is something I will never understand. I work at 3 CMG staffed sites as an independent locums. I make more than their special ninja firefighters and I can work any amount of hours I want. Went to Iceland last mo. These assignments are for chumps.

 

[Alvarez13]

Strike teams are smoke and mirrors:

Let's say they offer you $300/hr to do strike. Meanwhile, another CMG in town wants to pay you $250/hr to work locally. You're all excited to knock out some loans and have goo goo eyes for that $300/hr thinking you'll never find a local job that would pay you that much. Well, let's do the math...

It takes you 45 mins to get to the airport, another hour to get checked in and make it to the gate and actually board the plane. 4 hours flight. 30 mins to get your luggage and 15 mins to pick up and get settled in your rental car. 1.5 hours ride to your site. Total "travel" time = 7 hours each way at a "premium" of $300/hr. (If you say there's no way there would be that much travel time for a "strike" job, you haven't done enough of them.) You fly out and do 2-3 blocks per month. Let's be conservative and say you do 2 big blocks each month for 28 hours of travel time/mo for 120 hours of "paid" work each month. 120 hours/month @ $300/hr = 36K divided by 148 hours (120 + 28 hours of non paid travel time = 148 hours) = $243/hr compensation. That's $7/hr less than the job right down the street.

I won't even get into the dumpster fire ERs they are desperately trying to staff that they send you to each month with malignant hospital admin, nursing and consultants.

Now, I'm not saying there aren't sweeter gigs out there but please sit down and do the math before you jump into a "firefighter gig". Most of the time, it's not worth it and you only realize it a couple years later when you finally sit down at your desk and dust off the calculator.

This is a huge part too. Especially for the new grads that haven't settled down they're targeting. You wanna get sued? That's how you get sued.

 

[emergentmd]

Firefighters must be one of the worse jobs possible. For an extra $25/hr you get to

1. Work in crappy places with crappy EMRs
2. Get moved around and have to relearn new EMRS, consults, systems
3. Work nights, weekends, holidays that can't be covered
4. Work next to someone who is doing locums and making more than you
5. Live in a suitcase and spend your free days flying.

Yeah... sign me up. Do they give new grads some magic drink to take these jobs? Seriously why are some docs so gullible?

 

[Fox800]

These super special ops firefighter teams are a tool the CMGs use to knock off democratic groups when they take over contracts. Don’t do it.

 

[GonnaBeADoc2222]

I do it. There are pluses and minuses. Definitely not "one of the worst jobs possible." There are specific situations when this job makes sense, and when it does not. It is not a "forever job." If you are geographically strapped for familial or other reasons, and have to live in an area of the country where the EM market sucks (like I am, right now), then it makes sense to do this until you can move to a better market. If you are lucky (I have been, others not so much) you don't get bounced around so much. The locums at the site I am currently at only make $10 more per hour than I do - really not a big deal, and they don't have guaranteed hours like I do. I haven't had to fly anywhere - again, other people have. Yes, I have to work nights, weekends and holidays. However, I pick the days I work and block my shifts however I want. No circadian rhythm issues as I block all my nights together. The schedule flexibility is fantastic.

I looked at a couple full time jobs where I live and, yeah, they suck. Less money for more required hours. Nah.

If you have to live in a crappy market and don't have kids, I would consider it. In a short while when I am less geographically limited, I will stop doing it.

If you have the flexibility to move wherever, then I wouldn't do this job.

People will call you a "scab" or whatever. I don't pay them much mind. You gotta do what's best for you and your family.

 

[miacomet]

I don't know why people do this. Maybe this is what CMG residency trained grads do? Do people like the term "firefighter" and think they are cool? Slick marketing? Why sign a contract when you can be a free agent doing locums for more money with more control?

We will have only ourselves to blame when our profession implodes. Jeez.

 

[Brigade4Radiant]

Travel is only good if you can control it and they pay you +50 more if not then I would just do Locums and credential at all your nearby hospitals and then work like that. (Consider it job insurance)

With a firefighter you have to work 14 shifts and you are used to rotate at many sites. You also are not allowed to ask for extra compensation when need be.

That being said I do know some envision embassadors that make 275-325 but you also have factor travel time and see if you ultimately have more time to yourself.

 

[Brigade4Radiant]

People blame new grads for a lot but the thing is we don’t teach about the business of medicine remember having a family on 50k working tons of shifts while studying and doing presentations.

Residency program directors here please teach people about rates and to ask their fellow EM physicians what they make.

Not discussing pay only hurts you

 

[GonnaBeADoc2222]

Travel is only good if you can control it and they pay you +50 more if not then I would just do Locums and credential at all your nearby hospitals and then work like that. (Consider it job insurance)

With a firefighter you have to work 14 shifts and you are used to rotate at many sites. You also are not allowed to ask for extra compensation when need be.

That being said I do know some envision embassadors that make 275-325 but you also have factor travel time and see if you ultimately have more time to yourself.

I work 11 or 12 shifts.

I don't rotate at "many sites."

I travel the day of my first shift in a block (or the night before if it's a morning shift).

Who says I can't ask for more compensation? I've asked for it many times when they are looking for last minute coverage. If they are desperate, they pay it and I work. If not, I stay home.

I don't go to meetings or do other admin tasks. I have tons of free time.

 

[Brigade4Radiant]

I work 11 or 12 shifts.

I don't rotate at "many sites."

I travel the day of my first shift in a block (or the night before if it's a morning shift).

Who says I can't ask for more compensation? I've asked for it many times when they are looking for last minute coverage. If they are desperate, they pay it and I work. If not, I stay home.

I don't go to meetings or do other admin tasks. I have tons of free time.

It was on the team health firefighter bulletin points.

I’m not against travel at alll I would say it’s better than local in some cases you just have to negotiate

 

[Ohitshoggle]

So I would like to talk with someone that has worked with one of the groups so I can get a better idea of what it is like from first hand knowledge. Could you PM me if you have? Thanks

 

[MechEDoc]

So I would like to talk with someone that has worked with one of the groups so I can get a better idea of what it is like from first hand knowledge. Could you PM me if you have? Thanks

PM me if you'd like. 2+ years with TH, some with Envsion. Locums as well. Mixed views regarding the whole experience.

 

[emergentmd]

I work 11 or 12 shifts.

I don't rotate at "many sites."

I travel the day of my first shift in a block (or the night before if it's a morning shift).

Who says I can't ask for more compensation? I've asked for it many times when they are looking for last minute coverage. If they are desperate, they pay it and I work. If not, I stay home.

I don't go to meetings or do other admin tasks. I have tons of free time.

Your set up being a "firefighter" is essentially a local full time job with the caveat of having to move around if needed. There is no guarantee that they will not move you.

Why don't you just sign up with them for a year at your current rate and mitigate any concerns for being bounced around? It sounds like you have a lot of leverage if they have to use firefighters.

3-5 yrs ago, I would say Locums is 10x better with better pay. But as things have dried up, and it is more difficult to get shifts, I would not recommend locums unless you are financially secure.

 

[GonnaBeADoc2222]

Because that doesn't exist.

 

[GeneralVeers]

When I first started as an EmCare firefighter they were paying $75/hr extra as a "travel bonus" over the site's regular rates. Finding a site where they paid close to $300/hr for their regular rate paid off, as I was routinely making $350-$370/hr before any last minute bonuses. Their contracts have since changed and the max they will pay is $325/hr for ANY site, and you don't get the choice of site or days off. It's not worth my time to fly in, then have to drive 2-3 hours to get to a site. That was a deal killer for me and one reason I quit working with them.

 

[miacomet]

It all ends up being bait and switch, one way or another.

 

[deleted497653]

We always wonder who is the enemy but we are our own worst enemies. These positions are invented my cmgs as a way for them to manage costs and make sure they are always staffed. Don’t help cmgs more than you have to.... let them hire locums if they need extra help.

 

[MechEDoc]

When I first started as an EmCare firefighter they were paying $75/hr extra as a "travel bonus" over the site's regular rates. Finding a site where they paid close to $300/hr for their regular rate paid off, as I was routinely making $350-$370/hr before any last minute bonuses. Their contracts have since changed and the max they will pay is $325/hr for ANY site, and you don't get the choice of site or days off. It's not worth my time to fly in, then have to drive 2-3 hours to get to a site. That was a deal killer for me and one reason I quit working with them.

Any ideas on what has changed? I've seen a down turn in the market but I'm not entirely sure what it causing it.

 

[RustedFox]

Any ideas on what has changed? I've seen a down turn in the market but I'm not entirely sure what it causing it.

I'm willing to bet that their stock stumble, along with them expanding the bloat and hiring more fatcat admins made them penny-pinch some.
Funny; they apply this "lean model" to physician staffing, but not admin staffing.
Good for the goose, good for the gander - I say.

I hate a lot of things.
In no particular order.

1. Broccoli.
2. Nancy Pelosi.
3. My mother-in-law.
4. Noo Yawk City and people that refer to it as "the city". There's a bunch of cities; many that are much cleaner than Noo Yawk.
5. EmCare/Envision.
6. That feeling when static electricity sticks my hair to my forehead.
7. The Talking Heads.
8. People that park in handicapped spaces (and have the appropriate tags) when get out of their car and walk with no apparent debility whatsoever to the grocery store/post office/whatever and back. Having cerebral palsy is a disability, being old and fat is not... snowbirds.
9. The Washington Capitals.
10. Paper-pushing admins who contribute nothing to patient care, but have access to benefits that we don't, like health insurance and a 401K match.
11. My mother-in-law (it bears repeating).
12. MLPs who think they have academic equivalence, but clearly demonstrate that they have no idea what they're doing.
13. People who have memorized a list of prime numbers up to (generally) 100.

That's enough for now.

 

[GeneralVeers]

I'm willing to bet that their stock stumble, along with them expanding the bloat and hiring more fatcat admins made them penny-pinch some.
Funny; they apply this "lean model" to physician staffing, but not admin staffing.
Good for the goose, good for the gander - I say.

I hate a lot of things.
In no particular order.

1. Broccoli.
2. Nancy Pelosi.
3. My mother-in-law.
4. Noo Yawk City and people that refer to it as "the city". There's a bunch of cities; many that are much cleaner than Noo Yawk.
5. EmCare/Envision.
6. That feeling when static electricity sticks my hair to my forehead.
7. The Talking Heads.
8. People that park in handicapped spaces (and have the appropriate tags) when get out of their car and walk with no apparent debility whatsoever to the grocery store/post office/whatever and back. Having cerebral palsy is a disability, being old and fat is not... snowbirds.
9. The Washington Capitals.
10. Paper-pushing admins who contribute nothing to patient care, but have access to benefits that we don't, like health insurance and a 401K match.
11. My mother-in-law (it bears repeating).
12. MLPs who think they have academic equivalence, but clearly demonstrate that they have no idea what they're doing.
13. People who have memorized a list of prime numbers up to (generally) 100.

That's enough for now.

You're in a mood again today I see. You forgot Press-Ganey, no drinks in "patient care areas" and Dominic Bagnoli.

 

[Apollyon]

13. People who have memorized a list of prime numbers up to (generally) 100.

In the words of Elle Woods, Esq, "what, like it's hard?"

 

[Tenk]

I'm willing to bet that their stock stumble, along with them expanding the bloat and hiring more fatcat admins made them penny-pinch some.
Funny; they apply this "lean model" to physician staffing, but not admin staffing.
Good for the goose, good for the gander - I say.

I hate a lot of things.
In no particular order.

1. Broccoli.
2. Nancy Pelosi.
3. My mother-in-law.
4. Noo Yawk City and people that refer to it as "the city". There's a bunch of cities; many that are much cleaner than Noo Yawk.
5. EmCare/Envision.
6. That feeling when static electricity sticks my hair to my forehead.
7. The Talking Heads.
8. People that park in handicapped spaces (and have the appropriate tags) when get out of their car and walk with no apparent debility whatsoever to the grocery store/post office/whatever and back. Having cerebral palsy is a disability, being old and fat is not... snowbirds.
9. The Washington Capitals.
10. Paper-pushing admins who contribute nothing to patient care, but have access to benefits that we don't, like health insurance and a 401K match.
11. My mother-in-law (it bears repeating).
12. MLPs who think they have academic equivalence, but clearly demonstrate that they have no idea what they're doing.
13. People who have memorized a list of prime numbers up to (generally) 100.

That's enough for now.

But broccoli is so good. 8)

 

[deleted497653]

Any ideas on what has changed? I've seen a down turn in the market but I'm not entirely sure what it causing it.

It changed because hospitals and cmgs figured how to cut costs by hiring their own independent contractors, have their own internal locums and how to demand that locums work the shifts available. The best times for locums where you could name your price was 4 years ago. Now some locums looks just like a regular job.. you have to compromise more than in the past.

 

[GonnaBeADoc2222]

It changed because hospitals and cmgs figured how to cut costs by hiring their own independent contractors, have their own internal locums and how to demand that locums work the shifts available. The best times for locums where you could name your price was 4 years ago. Now some locums looks just like a regular job.. you have to compromise more than in the past.

Right so why would someone be incentivized to "just do locums" when they pay is marginally higher and every month is a potential PITA to coordinate all the shifts you want to generate the income you desire?

Maybe large hospital systems and SDGs in currently less desirable markets should start paying more to attract people. Why is it the responsibility of new grads to save EM?

 

[GeneralVeers]

Right so why would someone be incentivized to "just do locums" when they pay is marginally higher and every month is a potential PITA to coordinate all the shifts you want to generate the income you desire?

Maybe large hospital systems and SDGs in currently less desirable markets should start paying more to attract people. Why is it the responsibility of new grads to save EM?

Exactly which is why I left doing it after 5 years. Just wasn't worth the hassle anymore.

 

[Old_Mil]

I am considering working for one of the travel teams and wanted to know what they are like from someone who has actually worked for one of the companies like Envision, TH, etc.

Just say no.

Generally speaking they got paid a premium to help staff their most dysfunctional hospitals where they had trouble hiring full time physicians.

Pretty much. Once you factor in the time involved in travel and the fact that every dollar of that premium is going to be taxed at your highest marginal rate, it's not worth it.

 

[RustedFox]

You're in a mood again today I see. You forgot Press-Ganey, no drinks in "patient care areas" and Dominic Bagnoli.

For the record, I was stone-cold sober when I wrote that.
You are in no way incorrect, and I now wish that I had included one of those items in my list instead of listing my mother-in-law twice; as
that's just lazy comedy.

The "no drinks in patient care areas" item has never been a problem for me.
I've been confronted by ClipboardNurse57, BA BS RN MSN S M L XL about that only once at one of my job sites.
I gave her "the look" without really knowing that I was doing so.
Think: two parts Henry Rollins, one part Unabomber in a poorly pressed white coat.
She seriously turned around and walked away. No additional words were said.
I think it helped that it was middle-of-the-night and the department was throbbing.
I'm a small man (5'6''), too. I must have just scared the $hit out of her.


On a similar note, I have now been twice asked by ClipboardRN.exe (different girl, mind you) about why I was admitting "this drunk again" with his BAL of 450+. On the second time, the conversation went like this:

Fox: "What is your concern?"

ClipRN: "Well, if all they're going to do is sober up and sign-out AMA, then they can do that down here in the ER."

Fox: "I'm going to stop you right there."

[pause]

Fox: "Its now 1 AM. How many nurses do I have in this department? Answer in a whole number."

ClipRN: "Three, but I can get a sitter to-"

Fox: This @sshole is going to assault the sitter at some point, and bother him/her every 15 minutes. I have already given him 10mg of haldol, 4mg of ativan, and 50mg of Benadryl. He's still misbehaving. When the sitter is bothered, the RN is bothered. Now I have two nurses. How many do you have up there on 3-main?"

[ I didn't allow her time to answer ]

Fox: "More than three? That's what I thought. Now, neither my conscience nor my good sense is going to get me to change my answer."

She simply closed her eyes, bowed her head, and said - "I see your point."

Moral of the story: Sometimes you just have to get aggro, man.

I love you, Veers; but I get the sense that you're rather passive in your interactions.
You commonly type phrases like "this is not worth my energy" or "I just walk away and we're done."
I can be wrong. If I am, tell me. I mean this in no affront.
I have tried so hard to be like you for a good six months or so over the past year.
It didn't work. At all.
People barked at me. They tried to steamroll me. The nurses got pissy-pants when I asked them politely to do their job. The patients blew me off like I was a teenager when they didn't like what I had to say (doesn't help that I'm 37 and look 26).
I abandoned that approach, and let the dog bark and snarl.
I don't have those problems now.

 

[Hercules]

I think each of us does what works for us. I don’t do the bark and snarl routine. For me, it’s extra effort and it leaves me more agitated and angry while not really improving the outcome. My nurses can probably count on one hand the number of times I’ve raised my voice in the past decade. I lean towards pleasant, polite, and emotionally detached. I’ll start off friendly and polite, but I don’t negotiate and I’m happy to show a difficult patient to the door. There’s no yelling or threatening (at least on my part). I have no emotion tied up in drug seekers, malingerers, system abusers, etc. I handle patient confrontation in matter of fact tones and deliver the message at times in the dad voice (I have 4 children who I think act more adult like than some of the patients). I haven’t had the experience of getting steamrolled, but I would probably change my tactics if that became an issue.

 

[EctopicFetus]

Don't forget your risk of being sued goes up when you are new. You don't know the system, you don't know the nuance or the EMR. In the end while people on here know I hate the CMGs more than most I also appreciate the fact that each of our #1 needs is to provide for ourselves and our families.

Why would you do this for an extra $25 when the math makes no sense I have no idea. Also, each hospital you are credentialed at requires you to hold onto lots of info to get credentialed at the next one. I feel for you guys doing this and living that CMG life. the firefighters are trash jobs but someone has to do it and if the job wasn't crap they wouldn't pay your travel, room and board etc. Im happy to sleep in my house every night and make a great living doing the SDG thing.

 

[Brigade4Radiant]

Can I have some evidence on the risk of working at a new place you are more likely to be sued?

I would think the opposite since you can’t work as fast and are more careful.

 

[GonnaBeADoc2222]

Don't forget your risk of being sued goes up when you are new. You don't know the system, you don't know the nuance or the EMR. In the end while people on here know I hate the CMGs more than most I also appreciate the fact that each of our #1 needs is to provide for ourselves and our families.

Why would you do this for an extra $25 when the math makes no sense I have no idea. Also, each hospital you are credentialed at requires you to hold onto lots of info to get credentialed at the next one. I feel for you guys doing this and living that CMG life. the firefighters are trash jobs but someone has to do it and if the job wasn't crap they wouldn't pay your travel, room and board etc. Im happy to sleep in my house every night and make a great living doing the SDG thing.

Don't need your faux sympathy lol as the job has allowed me almost complete control over my schedule, given me the ability to pay off all my student loans less than two years out of residency, achieve a 40% savings rate, and travel whenever I want. But you're right, I should have taken that 50k / yr pay cut and work more hours out of principle.

 

[MechEDoc]

Don't need your faux sympathy lol as the job has allowed me almost complete control over my schedule, given me the ability to pay off all my student loans less than two years out of residency, achieve a 40% savings rate, and travel whenever I want. But you're right, I should have taken that 50k / yr pay cut and work more hours out of principle.

Exactly. Which company are you with? The ones that I had experience with gave you almost zero control of your schedule.

 

[dadaddadaBATMAN]

Can I have some evidence on the risk of working at a new place you are more likely to be sued?

I would think the opposite since you can’t work as fast and are more careful.

I don’t have any specific data but it’s pretty intuitive.

Not being able to work as fast is going to increase your waiting room time and piss people off (both patients and nurses). That’s probably going to lead to cutting corners.

You’re also surrounded by staff and a system you don’t know, meaning you have less of an idea what the regional standard of care is. And people aren’t going to cover your mistakes, talk patients down, or help things go away, they’re going to crucify you. Soft call admissions are gonna get bounced as you have zero political capital, etc

 

[GonnaBeADoc2222]

I don’t have any specific data but it’s pretty intuitive.

Not being able to work as fast is going to increase your waiting room time and piss people off (both patients and nurses). That’s probably going to lead to cutting corners.

You’re also surrounded by staff and a system you don’t know, meaning you have less of an idea what the regional standard of care is. And people aren’t going to cover your mistakes, talk patients down, or help things go away, they’re going to crucify you. Soft call admissions are gonna get bounced as you have zero political capital, etc

Yeah can't say I've experienced any of that.

 

[GonnaBeADoc2222]

Pretty much. Once you factor in the time involved in travel and the fact that every dollar of that premium is going to be taxed at your highest marginal rate, it's not worth it.

So no one should ever pick up more work because you "have to pay taxes" ? lol

 

[MechEDoc]

So no one should ever pick up more work because you "have to pay taxes" ? lol

It's pretty simple. I've been there and have turned down work. Say you've made $400k so far in the year and want some time off to spend doing things you like. That next shift will see you make 10 hours
× $250 / hr × (1 - 0.37 - 0.113*) = $1292.50. However, you're a travel / locums physician and would be happy to work 12 hours per day, therefore your effective rate is now $1292.50 ÷ 12 hr = $107.71/hr. Since you're already sitting pretty on $400k and would like to do something else, that $2500 doesn't look so attractive.

Those tax-and-spend politicians don't even realize that they're f-ing the whole county by placing you on the wrong side of the Laffer curve. Society winds up with under utilized resources by excessively penalizing the activity they wish to encourage. Tax the rich only goes so far before it is impractical. The alternative minimum tax came out of an era in which marginal tax rate range from 70-91%.

* You are working your marginal shift in California.

PS Anyone seen my neighbors wallet? I want to call 911, get a pregnancy test and a turkey sandwich. My tooth hurts too. Can you fix it? I know you're not a dentist, but I ain't go no money for that and I'm waiting on insurance and they don't take Medicaid.

 

[miacomet]

EM doctors are certainly not the rich...and the rich aren't paying very much in taxes.

 

[MechEDoc]

EM doctors are certainly not the rich...and the rich aren't paying very much in taxes.

I agree, but not in the view of everyone else.

 

[GeneralVeers]

EM doctors are certainly not the rich...and the rich aren't paying very much in taxes.

Wrong. The rich pay almost all the taxes in the country. The top 10% pay 30% of all income taxes and the top 30% pays 2/3. The"middle class" pays almost nothing in taxes after factoring in child tax credits and other deductions.

 

[dadaddadaBATMAN]

Yeah can't say I've experienced any of that.

You're probably a likable, good doc. If you're good, you're good. My point is that people don't trust who they don't know, and theyre less likely to help out a stranger than a known quantity.

If your goal is to minimize malpractice risk, it seems like a poor choice. And if you're slow, people are gonna hate you, but thats just a universal constant.

 

[MechEDoc]

Wrong. The rich pay almost all the taxes in the country. The top 10% pay 30% of all income taxes and the top 30% pays 2/3. The"middle class" pays almost nothing in taxes after factoring in child tax credits and other deductions.

Agree. I'm still looking for a sticker that says something like "F the proletariat". The irony is that me and the lady went to socialist paradise (Cuba) and visited the beach. There were only the bourgeois there, whereas upon return to Miami the beaches were overrun with mouth breathing, music pumping proletariat. The beaches in workers paradise were so nice, the health care not so much. I guess the tide has to rise in order to lift all boats.

 

[RustedFox]

It's pretty simple. I've been there and have turned down work. Say you've made $400k so far in the year and want some time off to spend doing things you like. That next shift will see you make 10 hours
× $250 / hr × (1 - 0.37 - 0.113*) = $1292.50. However, you're a travel / locums physician and would be happy to work 12 hours per day, therefore your effective rate is now $1292.50 ÷ 12 hr = $107.71/hr. Since you're already sitting pretty on $400k and would like to do something else, that $2500 doesn't look so attractive.

PS Anyone seen my neighbors wallet? I want to call 911, get a pregnancy test and a turkey sandwich. My tooth hurts too. Can you fix it? I know you're not a dentist, but I ain't go no money for that and I'm waiting on insurance and they don't take Medicaid.

So much this.
I don't make Veers-caliber money, but I have turned down shifts back before the Trump tax-cuts because "it seemed silly" and my wife wanted to go see a movie. Or eat Mexican food. Or watch a baseball game.

Its funny. You tax me less, and I work more. Speaking of baseball games...

During March, I usually cut my hours back to 100 or less, because I am going to a spring training game on every day that I can. I'm that "awful" of a baseball guy. 10 hours/shift x 10 shifts = 100 hours. That's good enough, and its far cooler to see Bryce Harper smack a home run from the third row (I always sit on the first-base side). I can make up the shifts that I missed over the next month or so.

True story:

Enough time has passed for me to post this.

I took care of a few of the Pirates and Orioles during their spring training stretches in the ER. I've been a fan of the Pirates since I could locate my penis. I wear an enamel "Pittsburgh Pirates" pin on my ID badge at work. The players that I cared for pointed that out, as if I didn't recognize their name from the tracking board. Pitchers aren't that smart. You can tell. They are men of few words because.... they don't actually know that many words. Middle infielders are bright. After all, they gotta pay attention at all times. Nobody waits on them. Took care of a middle infielder's girlfriend once about X or so spring trainings ago. Walked in the room, looked to the right, and saw a 2B/SS sitting there that I didn't expect to see. Took care of girlfriend. Dude! I've been watching you since the minors! Good luck this season! We got to B.S.'ing about the game and other related things. Gave them my number and said: "Hey, if you guys run into any trouble; give me a call. No pressure; no sweat."

Two days later, my phone rings. I don't recognize the number, so I ignore it. Voicemail indicator pops. I check it. It's 2B/SS.

Called them back. Answered some questions. Y'all good ? Yeah. She can take more of that medicine. Its not a problem. Give it another day before we reconsider things. Cool; call anytime, amigo. Good luck tomorrow.

"Hey; let me leave some tickets for you and your wife at will call."

Aw, man. I can't make any games this weekend. I'll be there next week, but the wife has a broken wrist and she doesn't wanna go. I'll shout atcha from the first base side.

"Cool. Thanks, and goodnight."

Showed up at the game next Wednesday. Shouted at 2B/SS during warmups. He sees me and pops his fist into his glove.

"Dude! Thanks so much for helping us out!"

Homeboy runs over and signs some autos for me and the surrounding fans.

"Hey; I'll see you here after the game. I want to tell you how things are going, and give you a proper thanks."

Sure, man. Sounds good. Have a good game.

I hang out after the game until the stands are empty. 2B/SS keeps his promise.

Dude! Good game!

"Hey; follow me!"

453 steps later, I'm in the locker room of the Pittsburgh Pirates. We bull**** for a bit. Homeboy tells me to sit down wherever and grab some water and Dubble Bubble while he showers up. He'll be right back. Locker room is empty anyways, so make yourself comfy.

GUYS: I'M IN THE LOCKER ROOM OF MY FAVORITE CHILDHOOD BASEBALL TEAM. I'M SITTING IN ANDREW MCCUTCHEN'S CHAIR. I'M LOOKING UP AT HIS SIGNATURE BLACK AND GOLD OAKLEY SUNGLASSES. I CONSIDERED TOUCHING THEM, BUT I DARE'D NOT. TO MY IMMEDIATE RIGHT IS STARLING MARTE'S LOCKER. A CARDBOARD BOX FILLED WITH 45 PERFECT BASEBALLS IS SITTING BELOW.

Psst. I took one.

2B/SS comes back in slacks and a CoolBase t-shirt.

I say: "Hey, whatcha up to tonight? I'll buy you a beer if you're game; the bar two blocks away has got *good stuff* (pitcher joke)."

"Sure."

2B/SS and I stroll two blocks away to LocalBrewery. Turns out, he loved the Red Sox as a kid, and absolutely hates Dallas Keuchel because he thinks he's rude to catchers. I was also a 2B/SS in middle/high school, so we have got plenty to talk about.

"Dude, my DAD was one of those suicidal third basemen that keep walking towards the plate. He got scouted in high school; but then he got rheumatic fever and it was all over. He can still throw a man out at first with ease, and he's like 60."

"I hate it when they ask me to play the hot corner. You're going to get hurt at some point; that's for sure."

Beers are had. Beanbags are thrown. 2B/SS declines second beer in favor of rum and coke. Says Coca-cola is a big deal back home with the factory right there are all.

"Dude; where's your wife? You said something about her."

She's home with a broken wrist. Feels awful.

"Bummer. I would have liked to meet her."

We live eight minutes away from the field. I have actually timed it. If you wanna meet Mrs. Fox - get in the Elantra.

"You sure she's okay with a stranger showing up?"

You're not a stranger, dude. We have watched you for a few years now.

...


Next thing you know; we spin the five miles away to Casa de Fox in the Elantra. 2B/SS is operating the stereo like he owns the vehicle. I didn't object.

DING-DONG.

Wife opens the door. I am hiding behind 2B/SS in a deliberate prank.

Mrs.Fox: "Wwwhaaaaaat?!" [she immediately recognized him]

I pop out from behind 2B/SS.

"Hi Wifey! I brought your favorite baseball player home to see you!"

She's wearing a nightie and slippers. Excuses herself. He is really her favorite "Pirate".

COME ON IN!

Wifey walks out of her office, now appropriate. Laughs are had. Drinks are poured. Dirt is dished. Gregory Polanco is so particular about his coffee that he is the object of ridicule. Pictures are taken of me getting batting tips over a dinner plate serving as home plate.

"Hey; this has been fun - but I gotta get back to the apartment. We have an early workout."

No problem, bud. We'll get you an UBER, as we've both been drinking.

2B/SS signs a bat/ball and takes pics with us.

Hey, call me anytime if you need some quick medical advice, or just wanna drink beers.

"See you next week, bud."


I saw 2B/SS the next week, with wife in stands. We exchanged a few sentences. We still text on occasion, but not with regularity. Homeboy was traded in the offseason. Good luck, homeboy.



Moral of the story? Don't work too much. Work is cool; but other things are cooler.

 

[hundreddaysoff]

Agree. I'm still looking for a sticker that says something like "F the proletariat". The irony is that me and the lady went to socialist paradise (Cuba) and visited the beach. There were only the bourgeois there, whereas upon return to Miami the beaches were overrun with mouth breathing, music pumping proletariat. The beaches in workers paradise were so nice, the health care not so much. I guess the tide has to rise in order to lift all boats.

Well, now you're begging a question: Where were all the Cuban proles if not the beach? Does the system make them work more than the bourgeois, too much so to enjoy the beach? Or does the socialist culture result in less need for class signaling so everyone looks pretty bourgeois to an American? Or maybe the gov't just bans them from the beach in order to attract more foreign SWPLs there?

 

[miacomet]

Trump is right: Jeff Bezos is a genius at not paying taxes

And, sure, he also dislikes Bezos because he owns The Washington Post.

www.marketwatch.com

Regardless, even the highest-paid EM docs are UMC at best. Real wealth isn't found through employment, but ownership. Real wealth is not contingent on selling the power of your labor to others. I don't understand why doctors can't seem to understand this.

 

[miacomet]

Wrong. The rich pay almost all the taxes in the country. The top 10% pay 30% of all income taxes and the top 30% pays 2/3. The"middle class" pays almost nothing in taxes after factoring in child tax credits and other deductions.

I don't see how anyone can think of EM docs as anything but UMC, and yes we pay plenty of taxes. The truly wealthy are business owners with massive tax deductions. Investment income is taxed at a much lower rate, of course. Remember what Buffet said- he pays a lower rate of income tax than his secretary; he certainly doesn't see the need to not work.

We are in a service industry- we service the rich and the poor. We don't own our own businesses (for the most part, and they are easily sold because we don't add much value) and we are generally interchangeable. This is not the road to true, multigenerational wealth.

 

[Apollyon]

I've said it before - doctors and lawyers, the best we'll ever be is upper middle class, for one simple reason: we have to go to work every day. We don't work, and we don't get paid. When you are able to not work, by choice, then you are upper class.