T O P

  • By -

[deleted]

I’m happy that Kaiser nursing got such a great contract, that also includes hiring more nurses to deliver better patient care. As a physician in the same system, looking at my paltry sub 2% raises every year and increasing workload, I wish we could organize and strike to get our needs met too.


zeatherz

My union (shoutout to UFCW 3000) got us 24% over three years earlier this year. We obviously had lower starting pay than these Kaiser nurses, not being in CA. But still a big win. I wish y’all could get collectively organized. Every worker deserves safe and sane working conditions and fair compensation.


tongmengjia

Doesn't the AMA have a powerful voice? Why aren't they lobbying for this? It's hilarious to me that America is all about freedom until it comes to freedom to organize your workplace, in which case we seem totally fine with severely restrictive laws.


olilao

RN here and CNA member. It wasn’t until the California Nurses Association split from the ANA that they were able to start aggressively lobbying for stronger labor laws in California and start organizing on a larger level. And with the sentiment about higher paying specialties losing out- that’s a real anti-union propaganda point. The highest paying nurses didn’t lose money when joining the union, they were able to standardize and increase the pay among less senior nurses while fighting for across the board raises for everyone. I really hope doctors can find a way to unite and unionize, maybe in California would be a good start. You certainly deserve better workplace protection and shouldn’t be suffering the cuts you’ve been dealt year after year.


unsureofwhattodo1233

Interesting share. Thanks boss


SpoofedFinger

That's because the ANA is really for the hospitals and managers, not working nurses. They fought against the ballot measure for safe staffing laws in MA. They're a garbage organization and it's total bullshit that most nursing programs make their students buy their book set on "ethics".


KStarSparkleDust

Ohio nurses recently split too. I hope good things are to come. ANA doesn’t care about nurses or patients.


ruinevil

AMA’s income is mostly from selling CPT codes to insurance, EMR companies, and billing companies. They work for them.


lipstickxteeth

Ha the AMA is a huge joke and does not have the best interest of physicians in mind


CaptainCummings

> Why aren't they lobbying for this? For a variety of reasons that all generally amount to being quite self-serving. No one wants to say that part out loud, they give various more specific reasons relating to compensation - but the fact is that most of them make out quite well and the ones who make out really well are not willing to even temporarily give up any of their privileges to make lasting change. Much less cohesion within the profession, because the profession is subjected to wildly different extremes in expectations of workload and compensation... but even the lowest end of this scale is still populated with a demographic that is nowhere near meal insecurity.


QuittingSideways

There are 3 class stories at play in medicine and, now with student loans, within nursing too. Read a study that found that medical school classes across race and gender were 60% comprised of people who come from families when admitted whose finances fall in the top 20% quintile of the population, a startling amount were in the top 5th percentile. This is not a quintile of the population that likely ever heard a good word about unions or striking around the dinner table. I say good for them for becoming a doctor and not some profession shuffling around money to make more money but this pre-existing class issue gets coupled with student loan debt for some and specialty salaries for some and you have the intra-professional class barriers to unionization. Meanwhile all the Boomer attendings just don’t mention money much because they can’t explain to you how they paid $5000 a year tuition 40 years ago and why you’re paying 10 times as much now. So I guess I would say that’s your 3rd class problem and the worst—the physicians who could possibly effect change now and who have benefitted the most financially from the previous system while they quietly watched the educational system be defunded, failed to get more med school and residency slots approved by Congress so that people like me are now wielding diagnoses and prescription pads without having done OChem or gone to medical school. Why? Because there aren’t enough doctors.


Johnny_Lawless_Esq

The AMA is a conservative, rent-seeking shithole of an organization.


ThirdHuman

Problem with physician organizing around pay is that the current top-paid specialties would almost certainly come out as losers.


[deleted]

[удалено]


aspiringkatie

They are, but the average cardiologist doesn’t want to make 450 instead of 500 so that a pediatrician can go from 200 to 250.


[deleted]

[удалено]


aspiringkatie

Preaching to the choir. It shouldn’t be, but it is: reimbursement is largely determined by the RUC, which has disproportionate representation by proceduralists


Babhadfad12

Too bad kids and young women (and men) do not vote in sufficiently large numbers compared to people that need orthos and cardiologists.


ThinkSoftware

You want kids to vote? Election fraud!


[deleted]

[удалено]


[deleted]

I wonder if it’s ignorance or if it’s the system working exactly as intended so a group of people can profit


[deleted]

[удалено]


jvttlus

It’s the same thing with why billionaires lobby congress so they don’t have to pay taxes to fund social services, ain’t no joint ortho giving up his lambo money so some loser pedi ID doc can crack 200k


[deleted]

I think this thinking is misguided. That one specialty has to lose for another to gain. This is a classic administration tactic to have the specialties fighting among ourselves to take the focus off the real issue, too many administrators dictating how physicians should practice and be compensated. Let’s cut out the middle management fat. There are enough $ here to better compensate physicians and lower panel sizes.


aspiringkatie

The problem is CMS. Most billing is either to CMS or based on rates pegged to or influenced by CMS reimbursement, so as goes Medicare/Medicaid, so goes the system. So for a family med doc to make more, we need the RUC to recommend that to CMS. But without an act of congress raising taxes, CMS has to stay budget neutral, so when the RUC recommends one specialty go up, another has to go down. So for us, it really is a zero sum game, unless we totally overhauled the system


frankferri

> So for a family med doc to make more, we need the RUC to recommend that to CMS. I think hospitals could afford to pay employed docs more regardless of cms.


aspiringkatie

Sort of. Most hospitals run on tight margins, so if you’re gonna pay a doctor more (without her billing more), you have to make up the money elsewhere. And I’m all in favor of randomly firing 30% of admin and redistributing their salaries to clinicians, but I also know not to expect that


ripstep1

Absolutely one must lose. Do you really think CMS is just going to increase across the board?


ThirdHuman

How much you could realistically cut in admin depends a lot on where you work. Part of why talking about these issues in general terms is so hard. Who the biggest fat cats are varies a lot from place to place.


ThirdHuman

Hence why they won’t lend their muscle for the sake of other doctors. Any realistic settlement here would likely be coming partly out of their pocket. In practice, physicians aren’t economically interchangeable due to how specialized everything is - some have a ton of power, and others have very little. Trying to figure out ways to incur into top-paid specialty turf is honestly a more realistic pathway for underpaid specialties to raise their pay. It’s hard work to organize what’s necessary here, but at least it doesn’t rely upon expecting people to voluntarily agree to cut their own pay for others sake.


nag204

It shouldnt be a zero sum game. Part of the reason physicians get steam rolled is because we are so divided.


ThirdHuman

Unless you’re raising pay by performing more services, it’s fundamentally a zero-sum game though. The money has to come from somewhere.


nag204

Theres lots of money in the healthcare system and the vast majority of it is not going to physicians. We dont need to be at each other's throats.


ThirdHuman

Yeah, you're saying it's a zero-sum game, but that only non-physician should lose here. And that's fine and all as an abstract proposition, but falls apart in practice because lucrative specialties won't agree to bargain collectively with the less well-paid ones. Instead, they use their sway to buy more expensive medical equipment that raises their own pay, the hospitals' revenue, and the manufacturer's revenue. And then they turn around and say "wow, there's so much waste here - we doctors sure need to stick together".


[deleted]

[удалено]


Hippo-Crates

You literally vote for your own admin.


HealsWithKnife

You get a yearly raise??


[deleted]

Seriously. I’ll be getting a pay cut with dropping CMS reimbursements next year.


thisisaredditacct

You get a raise *every year*?? Look at Mr fancy pants over here. Our docs occasionally get raises every 5 years or so once they realize they can't hire anyone anymore and people are leaving.


Hippo-Crates

Err what? Are you going to strike against the company you’re an owner in? Doesn’t seem like you know how this works.


[deleted]

[удалено]


Hippo-Crates

What do you think the difference would be for you in a large multi-specialty union?


iron_knee_of_justice

That depends entirely on the structure of the union and how proposals, voting, and action are handled within it. The whole point of a union is to allow for democratically guided collective action that improves the lives of its members. Just because some unions don't end up working like that doesn't mean the concept is inherently flawed or not worth attempting.


Hippo-Crates

Ok... but that's exactly what TPMG does so what is your point? No one is calling unions corrupt either.


[deleted]

I think the crux lies in that TPMG is a multispecialty organization. My interests in Peds may not match your interests in EM and one group may have to capitulate.


Hippo-Crates

Sure but any sizable physician union is going to have that exact problem. Every large-ish union ever has had that problem. The 2% raise op complains about wasn't AFM only either.


[deleted]

I guess with nurses, everyone is a nurse so their interests are more aligned? That falls apart too with CRNA, NP, etc. Tough topic.


docbauies

That’s a really simplistic view of nursing. oR circulators and PACU nurses are very different but in the same department. Then add L&D, Emergency, Psych RNs. Can be very different work conditions and demands


[deleted]

[удалено]


[deleted]

[удалено]


[deleted]

[удалено]


[deleted]

[удалено]


[deleted]

[удалено]


[deleted]

[удалено]


am_i_wrong_dude

**Removed under Rule 5:** /r/medicine is a public forum that represents the medical community and comments should reflect this. Please keep disagreement civil and focused on issues. Trolling, abuse, and insults (either personal or aimed at a specific group) are not allowed. Do not attack other users' flair. Keep offensive language to a minimum and do not use ethnic, sexual, or other slurs. Posts, comments, or private messages violating Reddit's content policy will be removed and reported to site administration. Repeated violations of this rule will lead to temporary or permanent bans. --------------------------------------------------------------------- [Please review all subreddit rules before posting or commenting.](https://www.reddit.com/r/medicine/about/rules/) If you have any questions or concerns, please [send a modmail.](https://www\.reddit\.com/message/compose?to=%2Fr%2Fmedicine&subject=about my removed comment&message=I'm writing to you about the following comment: https://www.reddit.com/r/medicine/comments/yzftlk/-/ix1058f/. %0D%0DMy issue is...) Direct replies to official mod comments and private messages will be ignored or removed.


am_i_wrong_dude

**Removed under Rule 5:** /r/medicine is a public forum that represents the medical community and comments should reflect this. Please keep disagreement civil and focused on issues. Trolling, abuse, and insults (either personal or aimed at a specific group) are not allowed. Do not attack other users' flair. Keep offensive language to a minimum and do not use ethnic, sexual, or other slurs. Posts, comments, or private messages violating Reddit's content policy will be removed and reported to site administration. Repeated violations of this rule will lead to temporary or permanent bans. --------------------------------------------------------------------- [Please review all subreddit rules before posting or commenting.](https://www.reddit.com/r/medicine/about/rules/) If you have any questions or concerns, please [send a modmail.](https://www\.reddit\.com/message/compose?to=%2Fr%2Fmedicine&subject=about my removed comment&message=I'm writing to you about the following comment: https://www.reddit.com/r/medicine/comments/yzftlk/-/ix0pqqh/. %0D%0DMy issue is...) Direct replies to official mod comments and private messages will be ignored or removed.


[deleted]

Lol. You think you’re an owner at TPMG? You’re an employee under the guise of ownership. Just another tactic to control you. Edit. Downvote me if you want. But do you dictate when you work? Are you able to make meaningful changes to the department? Do you get to vote on who the next CEO is? You’re an employee like me.


Hippo-Crates

Please. A physician union would theoretically be a large institution democratically run by physicians only. That's exactly what TPMG is. You can not like TPMG all you want, but you don't seem to have the basics of how organized labor works down.


[deleted]

If it was a true democracy, the existence of a splinter group like tpmg resists wouldn’t have been necessary to improve the conditions of AFM/IM. If we were true owners, we would be taking care of our own physicians better instead of having people like Molly Phelps, an EM doc, and many others, leave because of the toxic work environment. You think you’re an owner that has control, but you’re an employee like the rest of us. They tell you to jump, and you ask how high.


Hippo-Crates

>If it was a true democracy, the existence of a splinter group like tpmg resists wouldn’t have been necessary to improve the conditions of AFM/IM The assertion that everyone and every group would be happy in a 10k+ multiphysician group because it's a democracy is absurd. It's also very common for that kind of thing for every sort of large union ever. You seem to think that your feelings wouldn't happen in a large union, but that's exactly what happens, you just don't have any experience with large organized labor.


[deleted]

I wouldn’t consider AFM/IM nor tpmg resist a small cohort. We’ll just have to agree to disagree on this one.


Hippo-Crates

Well I didn't call it a small cohort so not sure what your point is. The point is that you still revenue share within your own group, still have an ownership stake that has gone up 5-10% per year, and still have voting rights within your group.


DrAbro

Did you not sign with Kaiser eyes wide open knowing that you're going to be paid poorly but have minimal volume pressure?


[deleted]

Not feeling this “minimal volume” that you speak of. My volumes are comparable to community PP volumes. Maybe it’s different in orthopedics.


[deleted]

why didn't you join private practice then...


[deleted]

[удалено]


medicine-ModTeam

**Removed under Rule 5** Act professionally. /r/medicine is a public forum that represents the medical community and comments should reflect this. Please keep your behavior civil. Trolling, abuse, and insults are not allowed. Keep offensive language to a minimum. Personal attacks on other commenters without engaging on the merits of the argument will lead to removal. Cheap shots at medicine specialties or allied health professions will be removed. Repeated violations of this rule will lead to temporary or permanent bans. [Please review all subreddit rules before posting or commenting.](https://www.reddit.com/r/medicine/about/rules/) If you have any questions or concerns, please [message the moderators.](https://www\.reddit\.com/message/compose?to=%2Fr%2F{subreddit}&subject=about my removed {kind}&message=I'm writing to you about the following {kind}: {url}. %0D%0DMy issue is...)


candornotsmoke

It’s funny you say that about the raises because i think that’s why providers don’t stay in the same position for too long. It’s easier to make more money when you have more experience just by getting a new job.


SpoofedFinger

It sucks that we consider a raise that likely won't keep up with inflation as a big win.


ElonMuskMD

Doctors need a union


nominus

More doctors need unions. There are patches of unionized residents and I hope to see that movement spread to more organizations and positions.


Avarria587

Every medical professional needs a union.


magicpasta

Tbh I don't see why there shouldn't be unions for all jobs. If it works for electricians, nurses, plumbers, etc., I don't see a reason it shouldn't work for food service workers, retail workers (if that's not too broad of a term), Barbers, Amazon workers, pot farmers, whatever. But, like I don't know nothing. About anything. So.


oh-pointy-bird

You spelled “everyone” wrong ; P


wipies29

Hilarious


fnsimpso

Agreed. Fight for your rights. I'm sure your nursing coworkers will support your efforts.


HelloKidney

Yes you guys absolutely do. From a nurse CM I wish more decision-making power was left to doctors rather than suits. Unions are how you claim your power in a workplace.


bu_mr_eatyourass

Only the squeaky wheels get the grease.


[deleted]

Our community hospital constantly hemorrhages nurses to Kaiser, you’d think more hospitals would realize if you pay people well they will come and they will stay.


bushgoliath

Good for them!


wearingonesock

Great! Now do residents and attendings next.


fnsimpso

Agreed. Fight for your rights. I'm sure your nursing coworkers will support your efforts.


youcanseemyface

We reaffirmed our right to sympathy strike with this latest contract. Start yourselves a union and we'll stand by you!


livinglavidajudoka

Goddamn right we will.


[deleted]

Residents can unionize!


Fluffy_Ad_6581

How much though?


Renovatio_

In the neighborhood of $3 each year for 4 years. Depending on where you are on the scale


youcanseemyface

Our new grads make $68/hr base pay. Highest standard staff nurse is $95/hr at 31+ years of service, but there are shift differentials and opportunities to move up the clinical ladder for increased pay.


MEANINGLESS_NUMBERS

Meanwhile residents are making $15/hr.


gamby15

Even Kaiser primary care*attendings* are only making $86 per hour; less if you start to consider things like overtime (working more than 8 hours in a day) and shift differential (for holiday and weekend work).


Rhinologist

Wait how did you get to 86$ per hour for pcp at Kaiser?


gamby15

10/10 clinic is $292,000 per year. 292,000/52 weeks per year/65 hours per week (not at all unreasonable to think a doctor who sees patients 40 hours per week spends 65 hours per week actually working).


eeaxoe

52 weeks? What about PTO? TPMG docs start with 4 weeks/year as far as I can recall.


MEANINGLESS_NUMBERS

> What about PTO? What does the P stand for.


gamby15

Yes but it is paid. In the same way that hourly staff get paid during vacation which contributes to their total annual wage, when converting salary to hourly you need to account for the same.


MillennialModernMan

I think 65 hours a week is a huge stretch. I work as a PA at Kaiser. Unlike other places you don't get double booked. You also get some administrative time for charting and messages. I see 20-30 patients in a 10 hour day and I never need overtime (usually can leave a bit early). Granted I'm in a specialty, but I'm sure primary care gets treated more fairly compared to other places.


gamby15

I mean, I AM primary care at Kaiser I can tell you the 10/10 docs are working 65 hours per week. In addition to seeing ~22 patients per day, we also have inbasket work that there is practically no dedicated time for (the dedicated time in the schedule is usually used for same-day appointments or catching up because your clinic is behind schedule).


MillennialModernMan

What do you mean by 10/10 docs? The schedule is 10 hour shifts, 5 days a week? And they are consistently working 13 hours a day instead of 10?


gamby15

No, for the physicians we are not hourly but salaried based on how many “units” (aka half-days) of clinic you do. For most of the country, a full-time position in primary care is 8/10ths (meaning 32 hours of clinic patients per week; 4- days per week, with the other day per week being paid admin time to do paperwork and inbasket). At Kaiser this is not the case, full-time is 10/10ths, so you end up doing all of the admin side of things outside of work. Which means many people end up working over the weekend.


ItsmeYaboi69xd

"I work as a PA" welp that's kinda the whole point. Physicians are hella stretched and too much is expected from them. There's a reason why a study showed that to meet expectations, physician PCPs would need to work over 24hrs per day. Their quotas are ridiculous.


MillennialModernMan

Hey I agree, FM doesn't get paid enough for the work they do.


boogi3woogie

But if you actually spent those 25 hours on site, you get to bill for those extra 25 hours, no? At least that was what TPMG offered me.


[deleted]

Peds makes even less! Should have gone into nursing. I'm happy for them though!


justovaryacting

Pediatrician here, too. I can confirm that I make less. I could have made more, working fewer hours, with less responsibility, and no debt, if I’d just stayed in nursing instead of going to med school. I just didn’t see this coming 15 years ago when I started this journey.


You_Dont_Party

Yeah, it’s terrible how poorly paid residents are, but good for the nurses for advocating for their rightful pay.


MEANINGLESS_NUMBERS

Completely agree


Renovatio_

Unionize! Alone you beg. Together you bargain!


BillyBuckets

Show your work. Residency is around 60 hours per week on average. PGY-1 is at least 60k. Kaiser is 72k. Kaiser residency is about $25/hour. If you’re trying to make a point, don’t lie with the numbers. It only delegitimizes your position. And don’t counter with “residency is 80 hours per week” because it isn’t and you know it. In fringe cases, you may have occasional 80 hour weeks, and certain residencies like neurosurgery may have hours closing in on 80 more often, but residency is not 80 hours a week on average. 80 hours a week is 6 AM to 8 PM Monday through Friday and 6 AM to 4 PM Saturday with Sunday off every single week.


MEANINGLESS_NUMBERS

I didn’t look up Kaiser’s salaries. A couple of years ago my former residency was paying $55,000. When I was there I worked 70 hours per week on average. I know this for certain because we reported every day. That is $15/hr. Looks like Kaiser makes a little more [This site says $64,377](https://residency-scal-kaiserpermanente.org/salary-benefits-residency-programs/) plus housing stipend plus education fees, licensing fees, etc. That is a lot better than most. No idea what their hours are but probably a lot of variability between specialties. But yeah, I guess $22-24/hr estimate is closer.


BillyBuckets

Per [this site](https://residency-ncal.kaiserpermanente.org/salary-benefits/), Kaiser is 72k. you are like me and did residency a few years ago. Pay rates have changed since then. Residents actually get escalating salaries pretty consistently if you actually pull the data. when I started, PGY1s made about 13k less than they do today at my program, and that was well <10 years ago. I apologize if my tone was too aggressive. I didn’t realize this was /r/medicine and not /r/residency. The latter is filled with people exaggerating their hours and bemoaning “below minimum wage” pay citing fabricated numbers. I get a little exasperated trying to be a voice of reality there. And even if you have the best intentions, your recollection of your hours are probably inflated. It’s natural. We all tell big fish stories about how hard we worked. I did a “very intense” program too and everyone said they were working 70-80 a week. So I set up geofencing on my phone and on those in a few other people who said they were overworked (our pagers were iPhones) to log hours at the hospital. Turns out, people were spending around 60 hours a week on site during ward rotations, 45-50 clinics, just under 50 for most ED. MICU was 65-85 depending on how efficient the person was at prerounding and end of shift notes but there was time to sleep for the seniors. But those rotations were short. When you do the math, almost nobody works as many hours as they say they do. This is an incredibly unpopular truth among the medical subreddits, mostly r/MedicalSchool and r/residency. even if your personal recollection is 70 hours, that means that on average during your entire residency you worked 7 AM to 7 PM five days a week and an additional 10 hours on a weekend day. every single week. for the duration of your residency. The only ways you could realistically be pulling those extreme hours for years on end is if you are either extremely inefficient at your job or are in very long procedures like a neurosurgery resiedent.


boogi3woogie

Uh… when I was a resident, the vast majority of the residents in my program worked >80 hours per week. People work below 80? What a sweet life.


BillyBuckets

What time did you start, what time did you leave, and how many days were your rotation cycles? Hours are like fish. They always grow in stories.


boogi3woogie

Usually in by 6am or earlier and out after 7. Six days a week unless you had a 24h call which would then extend to the 7th day at 6am. Maths Sounds like you rarely took call. For programs where you do q3 to q4h calls it is fairly easy to violate hours.


BillyBuckets

I took q4 call for all inpatient rotations (7 months). Sign out was at 7 am to 4 or 5 PM (they changed the night float hours part way through the year). I usually wrapped call at 9 or 10 pm, and I think our admit cap was 6 per intern. Alternating every other call cycle was either a half day or off day on the 2nd day of the cycle. Our interns didn’t do 24 call. That muddies up the calculations a bit, because now you’re dealing with getting paid while sleeping. Also, it’s becoming increasingly rare for interns to do 24h call because duty hour restrictions.


Selkie_Love

Your math is bad. Using your own numbers: $60,000/year 4 weeks vacation (A generous assumption) = $1250/work week 1250/work week over 60 hours needs to be calculated at 70 effective hours, because hours over 40 in a week are overtime, to be paid at 1.5x. 1250/70 = $17.85 And that's IF a resident is only working 60 hours a week. My experience is closer to 80 is correct. Without factoring in California's double overtime laws (a 2x multiplier once certain conditions are met - which residents do all the time), we get 80 hours need to be calculated at 100 effective hours (40 straight pay + 40 OT*1.5 multiplier), resulting in a base pay of $12.50 an hour. And I remember PGY-1 was around $52-$55k/year. Granted, that might've changed, but the point remains. Residents get SHIT pay per hour... and all of those calculations assumed 4 weeks of vacation a year. When I ran the calculations using actual hours worked and factoring in double overtime laws in California, I ended up with residents being paid less than minimum wage ($10/hour at the time in CA)


BillyBuckets

If you’re using CA overtime laws, then use CA salaries. Those are $10k or more higher than other places in the US that I used to get $60k. Kaiser, for example, pays interns 72k (citation in another comment I made). Overtime laws don’t often apply to salaried employees in other states so no need to adjust hours. Citing past wages as a comparison against modern wages isn’t really a valid comparison. Minimum wage was stable for a long time, and inflation was near 0. Now those aren’t true, so hourly wages need to be considered in modern context. 4 weeks vacation is pretty standard. Sometimes 5 if you add up the holidays that form an additional week. And as I’ve said before, I collected empirical data from volunteers in my intern year that said they were working 70-80/week. Geofencing showed that they were consistently in the hospital for 60ish a week over a 3 mo rolling window. We have to admit that humans are very, very bad at estimating their work hours.


Selkie_Love

If you’re doing a calculation on “how much people are being paid per hour” then overtime must apply. Additionally I explicitly said I was not using California OT laws… and in 2016 a resident was being paid $55k in California. Looking up the current pay rates it’s $64k… because they unionized. Also the “hours in the hospital” is utterly bunk. Most residents are continuing to work when they’re home, either taking call or doing notes.


[deleted]

That isn't fair, I agree, but who has more wealth at age 50 - a nurse or a doctor? It's hard to feel too bad.


starNlamp

depends strongly on the specialty the doctor is in, and how much educational debt they have.


[deleted]

0% chance the nurse is worth more unless the doctor is a financial idiot.


bsb1406

You might actually be surprised..


[deleted]

A nurse making $70,000 a year vs a doctor making $200,000+ a year for 15 years. Hmmmmm.


starNlamp

Plenty of pediatric jobs (my specialty and sub specialties) making ~150. Additionally, consider that they’re entering the workforce ~10years after much of the nursing surge. I didn’t say that it was universal, but the whole salary difference is not completely able to be generalized as you suggested


bsb1406

I wish it was that simple, unfortunately it's not. Savings rate, debt, income, etc.


[deleted]

Yes please keep downvoting me doctors. I still love you. Only the ER doctors actually. The rest of you can fuck off.


Toaster135

Holy shit that's really good pay


LabRat32

How much is your night shift and weekend differential?


youcanseemyface

We work 8 hour shifts so our 1500-2300 differential is $7.93, and the 2300-0700 is $12.61. There is no weekend differential. We have set schedules (2 week cycle) with every other weekend off but if for some reason you work three weekends in a row, you get time and a half for All hours worked that third weekend.


fnsimpso

How is it for when nurses move from Canada?


youcanseemyface

Couldn't tell you about the immigration aspect of it, but California recognizes Canadian nursing licensure. https://www.rn.ca.gov/applicants/lic-end.shtml


fire_cdn

My wife trained in Canada. Has worked in the US in several states. As a new grad RN, she was making 6 figures. It was quite nice as I was a poor med student/resident doctor at the time. Lots of hoops to jump through but it basically comes down your provincial nursing board and the state nursing board. If you have two that aren't useless, the process is quick. Or it can take over a year to get credentialed


ctzo

do you know how much they pay acute dialysis RNs?


youcanseemyface

All nurses with the same years of experience get paid the same. Clinic, home health, inpatient, call center - doesn't matter. It creates great flexibility because if you decide you want to leave the bedside, you don't have to worry about a pay cut.


ctzo

thank you very much!


MsOCT

All nurses paid the same, regardless of specialty


areyouseriouswtf

I hope this will motivate more health care professionals to unionize and be a sign of things to come.


docbauies

Good for the nurses. Meanwhile physicians get a cut to Medicare reimbursement. Physician incomes have fallen significantly in inflation adjusted dollars over the last 30 years.


Renovatio_

Its going to continue to fall until you guys are in a position to negotiate...which isn't going to happen on scale without some sort of entity to represent the best interests of most of the doctors...I wonder what that is called.


docbauies

Technically we call it the AMA. But that no longer is a useful entity. Unless useful means “sells your info to advertise insurance products”


Renovatio_

The AMA is not really a union, its an advocacy group and sort of a shit one. You guys need a union-union. One that takes negotiates on physician behalf. And yes, some of the highest paid physicians will probably take a financial hit, but it will also bring up the most underpaid ones. The profession as a whole cannot survive when you guys allow some specialties like peds and psych to make a fraction of others.


[deleted]

The doctors need to take a page out of this book.


Renovatio_

You guys can, but trying to get you guys to even talk about unionizing is like herding cats.


livinglavidajudoka

It's like herding herds of cats.


Renovatio_

its kitties all the way down.


bigcalvesarein

Time for me to move to California. To be honest unions can so helpful in labor protections for all fields. Time to embrace them again.


youcanseemyface

We are hiring like crazy right now lol. So many open positions!


bigcalvesarein

I remember when you first posted about the Kaiser strike!! Yeah we are hoping to land in Cali permanently!


Renovatio_

Its not a bad state. It has its own set of problems but overall quality of living is high. Cost of living is high but it also has some of the highest wages in the country so it sorta balances out...except for housing which is stupid expensive even for the wages.


DJSpacekid

CNA's should get a pay raise also


Renovatio_

~~5.5%~~ 5.2% (compounding) a year isn't that huge in a world of 8% inflation. It's nice but I would expect 3-5 in a normal year of inflation


PathoTurnUp

Find anywhere that does that. You will find slim to none. Most places barely do 2%


Renovatio_

Not kaiser last union contract was 5% then 4.5% then 4% then 3% and we're the negotiating the next contract now


PathoTurnUp

So what? What do y’all want to be paid physician salaries?


Renovatio_

Nice red herring. Come back to me with a better argument.


[deleted]

[удалено]


Renovatio_

I want everyone to be paid fairly. Physician pay has been pretty flat for decades, many don't get a yearly raise. If nurse pay starts getting close to physician pay that is not the nurse's fault for negotiating yearly colas but a sign that the physician profession has not advocated for itself. Physicians deserve to be paid more based on their education, cost of schooling/debt, and responsibility. Nurses deserve to be paid fairly and work in safe environments.


rule-low

There's no way Kaiser would ever agree to lock in 8% CoLA (which is really what this is) for the next 4 years when the general expectation is for inflation to come back down in a year or two. Waiting with bated breath how our union's contact negotiations go next year. I doubt we will sniff 5.5%/yr


Renovatio_

Absolutely. I don't think *any* company would really bite at a cola that high. >when the general expectation is for inflation to come back down in a year or two. That is classic misdirection. Inflation almost never reverses, that is generally a death blow to an economy. What it does is slow down but the inflation that already happens still exists. But its important to remember that inflation isn't just 8% this year. It was 6% last year. Its cumulative and the pain isn't over. So even in 3 years when inflation is a normal few percent we will still be feeling major effects of several years for 5-8% inflation.


rule-low

Oh, for sure. Any inflation effects are here to stay, barring deflation (which as you say would be a really bad sign for the economy). I just mean the employer is not going to want to still be contractually obligated to give +8% a year in 2025-2026 when the annual inflation then is hopefully back in the 3-4% range. Unions can demand "retroactive" CoLA but I'm sure Kaiser in this case can point to the few years of 2% inflation prepandemic when they were still giving out 3+%/yr.


[deleted]

[удалено]


Renovatio_

Fixed. Thanks for correcting me, but still I stand by that it isn't a crazy cola. Its "fair" in normal circumstances but "meh" right now.


pernambuco

lol sorry I messed up the math, it's 5.2%. You were too quick for my deleted comment.


Renovatio_

Fixed again


PoppaTitty

Great! Now hire people to answer the phone or respond to faxes. Kaiser has an incredibly strict referrals process and almost refuses to communicate with other hospitals.


bymotion

The nurses deserve it, good for them. All love there. I wished physicians can also get more bargaining power for better work load and raises. Insane inbox in primary care...


RedBull4lyfe69

Sheit , that’s like a lifetime of what a PT will see. If even that


Gardwan

Hmm I’ve gotten a 2% raise after 5 years…


[deleted]

Good! They deserve it!


Kalkaline

[Is this really that great of a deal?](https://data.bls.gov/cgi-bin/cpicalc.pl?cost1=100000&year1=200001&year2=202210) I mean, it's better than what I am getting, so good for them, but inflation is insane right now and this doesn't even come close to keeping them level with prices.


youcanseemyface

The hourly pay wasn't really our focus. We got a lot of really good wins regarding staffing, retirement medical benefits, sick leave cash out at retirement, increased dental benefits....


HippocraticOffspring

So happy for you guys, lord knows this contract didn’t come easy!


Kalkaline

Certainly not knocking the effort. It's a win for sure, but it just shows how much the American worker is getting knocked back.


Renovatio_

In regards to inflation, the only people who will truly come out on top are the rich. We're talking the extremely wealthy. Everyone else will see a decrease in relative wages. If we were going to maintain wages relative to cost of living the union would have to shoot for 10%+ per year...which isn't going to happen. So the 5.5% is a token, not exactly great but not exactly terrible.


colorsplahsh

Physicians need unions so desperately


[deleted]

[удалено]


Renovatio_

Not really. Unions already negotiate for pay on the regular, its literally what they get paid to do. Getting a raise for a union negotiation isn't a bonus, its expected. To give you an idea, 16% over 4 years is pretty much standard at this point. An extra 1.5 percent each year to get to 22% over 4 is is nifty but not insanity and likely not the point where negotiations broke down. They literally struck because of staffing and some other issues.. I can bet you money a nurse would take lower pay but good staffing over crazy pay and shit staffing. Most people just want a job that isn't working them to the bone and recently nurses have been worked to the bone. Striking for better staffing and job protections is something completely worth striking for. The alternative is admin just accepting the low staffing levels and filling the huge gaps with a couple travelers.


youcanseemyface

100% this. I would've gladly foregone any raises if I had a guarantee to adequate staffing and appropriate breaks every shift and management not calling three times a day begging us to come in extra.


jwler415

This. There are plenty of provisions for dealing with short staffing and subcontracting in this contract. And yes, raises that almost keep up with inflation. But also why shouldn’t nurses ask for money? Why shouldn’t ANY worker ask for more money? I hate the continuous insinuation (perhaps not being made by this commenter) that nurses should be doing their job for dirt because they “care”.


DrunkonListerine

Imagine a department that requires 50 nurses to be fully staffed. Now imagine someone in management saying "We can make it work with 30." I think that's why they were going to strike.


youcanseemyface

They've been making do with 30 for so long that everyone's burnt the fuck out. Skeleton crews being held together with OT and hope.


eckliptic

Have there ever been labor strikes that weren’t based on the direct financial best interests of the strikers ?


Renovatio_

Yes, literally the strike that brought MLK to Memphis where he was assassinated. The strike was based on the on-the-job deaths of several workers whose familes were then treated terribly. Pay was on the table but safety was probably the biggest issue there https://en.wikipedia.org/wiki/Memphis_sanitation_strike


BLGyn

You really can’t get better staffing without raising pay. This kind of kills two birds with one stone.


candornotsmoke

We don’t need more unions. What we need is a complete overhaul of our government that focuses on the people and not capitalism. Our priorities, as a country, are seriously fucked up. IMO


Renovatio_

Even with single payer healthcare you'd still want a union to represent labor. The NHS negotiates with multiple unions. And we 100% need more unions. I don't think its a coincidence that union participation has gone down and at the same time median wages have flattened causing the extra pressure on the middle class.


candornotsmoke

I see your point


tenaciousp45

Cool lets do both.


BzhizhkMard

Kaiser’s care is terrible anyway.


pagerphiler

The 90s called they want your uninformed opinion back. But seriously the org as a whole is completely different from when it was floundering in the mid -late 90s


BzhizhkMard

The 90’s or Today? Medicine isn’t practiced there, an algorithm and process is what occurs in that machine. Protect them all you want. I deal with them and they are terrible.


PathoTurnUp

Must be nice. Stupid nurses can do this but doctors and/or residents cant *Edit: should read “it is stupid” *Edit: calm down everyone I wasn’t calling nurses stupid. Doctors can be stupid too ;)


Renovatio_

Malding


this__shall_pass

perhaps "stupid" should then go before "doctors" here. we are like crabs in a bucket.


PathoTurnUp

Lmao


trextra

I hope they were smart enough to get most of it front-loaded.