RNs make more than pediatricians at Kaiser Permanente on an hourly basis

[BPlaysItCool]

Kaiser docs get may benefits. One of many is that the referral system flows smoothly. All of them, no matter what specialty, work for the same team. In addition to their base salary (and benefits which are unrivaled) they get production bonuses. What makes Kaiser somewhat different as an HMO is that it is owned by physicians. They have a business wing, but it's decisions are secondary to medical practice. And so as for Bigz, the world's most knowlegible premed, he should note that in this instance, most of the top execs are docs.

And while it's true that Kaiser is heavily unionized and that this causes some equalization of wages. What the OP presents is oversimplified, exagerated, and not accurate.

As others have said. 40 hours a week is the norm. When you have a whole panopoly of highly paid staff, delegation of many of your time-wasting tasks makes the hours less and more about medicine itself.

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[todds]

Kaiser docs get may benefits. One of many is that the referral system flows smoothly. All of them, no matter what specialty, work for the same team. In addition to their base salary (and benefits which are unrivaled) they get production bonuses. What makes Kaiser somewhat different as an HMO is that it is owned by physicians. They have a business wing, but it's decisions are secondary to medical practice. And so as for Bigz, the world's most knowlegible premed, he should note that in this instance, most of the top execs are docs.

And while it's true that Kaiser is heavily unionized and that this causes some equalization of wages. What the OP presents is oversimplified, exagerated, and not accurate.

As others have said. 40 hours a week is the norm. When you have a whole panopoly of highly paid staff, delegation of many of your time-wasting tasks makes the hours less and more about medicine itself.

Just out of curiosity, what are some of the benefits that you speak of working for an HMO like Kaiser?

I just always heard how terrible it was that HMOs are taking over and practicing in a place with less HMO penetration was better so just looking for another opinion

 

[boulux]

1) Don't go into peds or IM
2) Don't work at Kaiser Permanente
3)??
4) Profit

 

[BPlaysItCool]

Just out of curiosity, what are some of the benefits that you speak of working for an HMO like Kaiser?

I just always heard how terrible it was that HMOs are taking over and practicing in a place with less HMO penetration was better so just looking for another opinion

I think cleveland Clinic is another example of physician run HMO's. Or maybe Mayo. In other words, there's other models out there that would flesh out the Kaiser comparison. Shareholders and private corporations are a completely different scenario. Although the nonprofit status of giants like kaiser is dubious, I'll admit most readily.

The main benefit I've heard is descibed in terms of work flow. Imagine making a couple of clicks to prescribe something. To order a test or make a referral to another specialist. And then answering an email from a patient and having full access to all of those updates in a matter of a click or two. It's just a very user friendly system. comprehensive EMR with no competition among comprehensive in house services.

There is also some beefy retirement benefits after so many years of service that is some hearty fraction of your full salary and lifetime medical benefits for you and your spouse I beleive. I know less of the specifics and more of the general sense that I've heard when asking physicians if they were happy with their choice of practice there.

There's also profit sharing.

It can be political. And bureaucratic. And not as entreprenuerial and independent as some private practice options. But is much easier. With cushier hours. It's a trade off. One that becomes more attractive in my mind as things go forward and downward in this economy. Botique practice options excepted.

I am no economist. Just a picker of brains I encounter.

 

[officedepot]

Your post is just rude. When you're old in a nursing home guess who's going to wipe your butt....a CNA or an RN...not an MD so choose your words wisely.

RN's are not "janitors", they do so much for patients to comfort them while the doctors are gone and report to the doctors what sometimes doctors fail to see....they are the residents "best friend" becuase they HELP them alot with procedures/protocols etc. Anyway, whatever the argument is about how much RNs, CNA, MDs make is irrelevant....what matters is that you do what you "LOVE" to do and not just doing it for the money or priviliges that come along with a "MD" title.

Seriously, I actually think you have a really great attitude. Hopefully you won't lose it.

But after working in the hospital now in med school 3rd year I can say that my original post is pretty much the nurse's role. They chart urine output, pick people up off the toilet, clean puke, answer the phone, etc etc etc. It isn't glamorous. In fact most of what a MD does isn't glamourous either. A peds MD (hosp+clinic for example) will probably do the following: go to hospital at 8; round on patients; put in orders; go to clinic; see patient after patient 20 min each doing a very quick exam and only stopping if there is something unusual; dictate notes; rinse and repeat for 20-30 years.

So yeah that's just the way it is. Yes I am simplifing it in its most basic sense and you'll get more out of it if you like what you do than what I imply. But the job is fairly mundane for the most part. More exciting fields include emergency medicine, some surgical fields, etc. Even nursing has more interesting fields like being a NP in surgical fields, neuro, etc or being a critical care nurse in the ICU isn't as bad either. I am more referring to your every day floor nurse.

 

[loveoforganic]

There's also profit sharing.

I'm glad someone mentioned this. No idea how much it typically runs for Kaiser, but I doubt nurses have any part in it, at least RNs anyway.

 

[45408]

The peds MD in this case can see patients in the clinic for maybe 5 hours and round on his/her patients in the hospital for a couple hours and then call it day. RNs in the hospital must sit there all day and answer calls from their annoying patients about puke, getting water, getting food, going to the bathroom, etc and then they have to go at a set time to take vitals, give meds, transport patients, etc. On top of that they have to clock in (which sucks) and report at a certain time or they'll get in big trouble. MDs don't have to do that crap.

Yeah, because those things are so simple and easy. Those nurses getting annoying phone calls from their patients then make annoying phone calls to the physicians. I got paged about 3 minutes ago about a patient going to the bathroom.

And no, physicians don't clock in or out, which means that you can work much longer hours without anyone sending you home for too much overtime.

 

[BlackHouse]

1) Don't go into peds or IM
2) Don't work at Kaiser Permanente
3)??
4) Profit

 

[MixedUpCody]

I think this debate is framed weird. The issue should be that the doctor is not making enough, not that the nurse is making too much. I think a 75k salary for a college educated worker in a large city is fairly reasonable.

 

[Dr Oops]

This is the same bs argument everyone makes. But no one has any substance to it. There are plenty of people who want to go to medical school define the "best" you mean the people who go into derm, optho and ortho surgery? These fields won't be hurting for applicants. Osteopathic doctors have lower stats yet are of the same quality as allopathic physicians. Also there are tons of IMG and FMG doctors to import as well as plenty of US medical students who still find the path to being a doctor attractive. SDN does not represent most medstudents

It was already happening with primary care. Less and less students wanted to do it. After all the talk about fixing primary and making it a focus, the number of recent grads choosing primary care has increased and been the highest it has in a while.

Go to this topic.
http://forums.studentdoctor.net/showthread.php?t=817247&highlight=MGMA

Why should they get paid more than they already do? Because another worker gets paid more?

The world isnt stagnant, there are thing like inflation to consider. Most other people's income increase as standard of living and inflation increase. Physician payments have either been stagnant or decreased.

So really the more apt and relevant question is why should physicians get paid less than they do? Because aside from primary care, most talk has been about slashing physician payments not the other way around.

 

[todds]

I think cleveland Clinic is another example of physician run HMO's. Or maybe Mayo. In other words, there's other models out there that would flesh out the Kaiser comparison. Shareholders and private corporations are a completely different scenario. Although the nonprofit status of giants like kaiser is dubious, I'll admit most readily.

The main benefit I've heard is descibed in terms of work flow. Imagine making a couple of clicks to prescribe something. To order a test or make a referral to another specialist. And then answering an email from a patient and having full access to all of those updates in a matter of a click or two. It's just a very user friendly system. comprehensive EMR with no competition among comprehensive in house services.

There is also some beefy retirement benefits after so many years of service that is some hearty fraction of your full salary and lifetime medical benefits for you and your spouse I beleive. I know less of the specifics and more of the general sense that I've heard when asking physicians if they were happy with their choice of practice there.

There's also profit sharing.

It can be political. And bureaucratic. And not as entreprenuerial and independent as some private practice options. But is much easier. With cushier hours. It's a trade off. One that becomes more attractive in my mind as things go forward and downward in this economy. Botique practice options excepted.

I am no economist. Just a picker of brains I encounter.

I wonder how much stuff like this skews salary data? For example, if a person is getting paid $130K in salary, but is getting actually $80K in benefits (like the amount put to retirement, health insurance, fitness center etc..), i wonder if a salary survey would just claim 130K - IMO this would skew what people think how much a particular speciality usually makes especially if certain specialites are more likely to work in HMOs or things like it than others.

In contrast, if someone reports making 250K, but get no benefits and no retirement....The first and second salary would probably closer than most think except it would skew the perception of medical students like us

 

[osumc2014]

They may make more at Keiser per hour, but they make less in total in the year. Also pediatrician that makes 170,000 is pretty darn good!

 

[ccmonopolies]

I'm not sure what state you are talking about, but most people don't pay THAT much in taxes. THere are deductibles and the taxable income is not going to be actually $200K. In most states, at the most itll be 50K in taxes. So lets say around 200K income - 50K for loans for 10 years and then = 150K before you take out taxes and then - around 50K in taxes = 100K. That can go very far as long as you are not living in San Fran or NYC.

Okay, let's say you live in a state with no state tax like Florida, you would only have 142k after taxes. Then you pay your loans. You don't pay your loans before you pay taxes. So 142k-50k = 92k a year.

Your Pay Check Results
Annual Gross Pay $200,000.00
Federal Withholding $50,204.00
Social Security $4,485.60
Medicare $2,900.00
Florida $0.00
NetPay
Net Pay $142,410.40
Calculation Based On
Check Date 06/13/2011
Gross Pay $200,000.00
Gross Salary YTD $0.00
Pay Frequency Annual
Federal Filing Status Single
# of Federal Allowances 0
Additional Federal Withholding $0.00
State for withholding Florida

Let's say you live in a state with moderate state taxes like Connecticut. You get 133k after taxes. 133k-50k = 83k a year to spend.

Your Pay Check Results
Annual Gross Pay $200,000.00
Federal Withholding $50,204.00
Social Security $4,485.60
Medicare $2,900.00
Connecticut $9,800.00
NetPay
Net Pay $132,610.40
Calculation Based On
Check Date 06/13/2011
Gross Pay $200,000.00
Gross Salary YTD $0.00
Pay Frequency Annual
Federal Filing Status Single
# of Federal Allowances 0
Additional Federal Withholding $0.00
State for withholding Connecticut

Now, if you live in California, with very high state income taxes: you get 124k after taxes, which means 124k-50k = 74k a year. Harsh reality when your 200k pretax income becomes 74k a year eh?

Your Pay Check Results
Annual Gross Pay $200,000.00
Federal Withholding $50,204.00
Social Security $4,485.60
Medicare $2,900.00
California $17,565.30
SDI $1,119.79
NetPay
Net Pay $123,725.31
Calculation Based On
Check Date 06/13/2011
Gross Pay $200,000.00
Gross Salary YTD $0.00
Pay Frequency Annual
Federal Filing Status Single
# of Federal Allowances 0
Additional Federal Withholding $0.00
State for withholding California

By the way, you end up paying even more taxes as your income increases. Sure you'll have some deductions like having a kid or on your mortgage interest, but most likely you won't be able to deduct more than 10% of your income. I'm just saying, people focus too optimistically on the pre-tax income. The reality is not so nice.