Worst Jobs-Biggest Rip Offs

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Dr. Rude said:
Maybe. But the perception of risk of fresh/recent grads is very high. Perhaps they are mistaken.
There still is the risk of being assimilated by the hospital, exploitive senior partners, the partnership that you are working towards being a "sub-partnership" that is not revealed until you put your time in, etc.
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The PERCEPTION is high. Many of the employed docs I talk to - its shocking how little they actually know about the business, yet maintain a high level of pessimism and perceived expertise of the business side.

Something like a "sub partnership" would be revealed to you before you started. Same with "buy ins". None of that stuff will be a surprise.
Sometimes an AMC/Hospital/Employed gig makes more sense.

But I think what happens is impatience. "Im done waiting" and you take the bird in hand with the employed job vs investing in the right thing for the long-term. And then this decision is rationalized by the ideas you gave above.
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Arch Guillotti said:
I’m guessing you don’t have kids. It’s not as easy as it sounds.
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I moved around as a child and I somehow managed. And know people who have.
Some of y’all act like kids make your decisions for you quite frankly. Whatever they want or say goes.
It is sometimes confusing who the parents and decision makers are. I plan on having one and not gonna let her make our decisions.
 
chocomorsel said:
I moved around as a child and I somehow managed. And know people who have.
Some of y’all act like kids make your decisions for you quite frankly. Whatever they want or say goes.
It is sometimes confusing who the parents and decision makers are. I plan on having one and not gonna let her make our decisions.
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lots of things happen in your childhood that you dont want your own kids to go through.
why would you want to do that to your child when you dont have to?
sounds very selfish, but if one day you do have kids maybe you will understand how your priorities change.
 
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chocomorsel said:
I moved around as a child and I somehow managed. And know people who have.
Some of y’all act like kids make your decisions for you quite frankly. Whatever they want or say goes.
It is sometimes confusing who the parents and decision makers are. I plan on having one and not gonna let her make our decisions.
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dont know why but this reminded me of when old school surgeons tell their residents.. "i worked 120 hours in my days, why cant you do it too?"
Hoya11 said:
lots of things happen in your childhood that you dont want your own kids to go through.
why would you want to do that to your child when you dont have to?
sounds very selfish, but if one day you do have kids maybe you will understand how your priorities change.
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Dr. Rude said:
Maybe. But the perception of risk of fresh/recent grads is very high. Perhaps they are mistaken.
There still is the risk of being assimilated by the hospital, exploitive senior partners, the partnership that you are working towards being a "sub-partnership" that is not revealed until you put your time in, etc.
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Agree wholeheartedly. Unless you are joining an average paying, 4:1 supervising employed practice, you are at risk of increasing supervision ratios, pay cuts, and being bought/assimilated. If your practice is already a crap sandwich, well I guess it’s a known crap sandwich.

My former group went through pretty much every bad thing you hear about here - buyout I didn’t get, big ramp up of CRNA supervision, stagnant pay, tiered salary structure, etc. I think you come out of that looking for fairness and stability above all else, but it makes you very skeptical that the old guy partners won’t sell you out at any moment to fund their own retirement.
 
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Hoya11 said:
lots of things happen in your childhood that you dont want your own kids to go through.
why would you want to do that to your child when you dont have to?
sounds very selfish, but if one day you do have kids maybe you will understand how your priorities change.
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While I agree with you somewhat about things happening that you don’t want, I don’t believe moving schools is as traumatic as many parents act like it is.

And life isn’t all about getting what you want. You teach kids that from a young age and they will end up in an adult world of disappointment.
 
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Hoya11 said:
The PERCEPTION is high. Many of the employed docs I talk to - its shocking how little they actually know about the business, yet maintain a high level of pessimism and perceived expertise of the business side.

Something like a "sub partnership" would be revealed to you before you started. Same with "buy ins". None of that stuff will be a surprise.
Sometimes an AMC/Hospital/Employed gig makes more sense.

But I think what happens is impatience. "Im done waiting" and you take the bird in hand with the employed job vs investing in the right thing for the long-term. And then this decision is rationalized by the ideas you gave above.
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....its shocking how little they actually know about the business, yet maintain a high level of pessimism and perceived expertise of the business side.....Something like a "sub partnership" would be revealed to you before you started.

Non business savvy docs who don't know much might just hear the word "partnership" and not drill down further. Also there is a concept known as "LYING".
 
Dr. Rude said:
....its shocking how little they actually know about the business, yet maintain a high level of pessimism and perceived expertise of the business side.....Something like a "sub partnership" would be revealed to you before you started.

Non business savvy docs who don't know much might just hear the word "partnership" and not drill down further. Also there is a concept known as "LYING".
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that's why you reach out to people you already know or have connections to. Former residents, former attendings, etc that you have a personal connection to. If a group hasn't lied before, it's unlikely to start lying now.

I always recommend people do residency geographically somewhat near where they ultimately want to live/work for that specific reason.
 
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chocomorsel said:
While I agree with you somewhat about things happening that you don’t want, I don’t believe moving schools is as traumatic as many parents act like it is.

And life isn’t all about getting what you want. You teach kids that from a young age and they will end up in an adult world of disappointment.
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But it sounds like your getting what you want .. at their expense .. I moved schools at a young age and it sucked
 
chocomorsel said:
While I agree with you somewhat about things happening that you don’t want, I don’t believe moving schools is as traumatic as many parents act like it is.

And life isn’t all about getting what you want. You teach kids that from a young age and they will end up in an adult world of disappointment.
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I do hear what you're saying in your post and it's cliche to say "you'll think different when you have your own" but honestly, I think you will. When you're watching them thrive in an environment it's a tough decision to just decide to pull them out of it and if you're going to do it, the earlier the better. Middle school and high school is when the cliques start forming and I understand why the people who don't like their jobs but have teenagers in school just grind it out until they graduate.

Edit: Shout out to @Arch Guillotti ......and Kanye. I should've known better

 
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Twiggidy said:
I do hear what you're saying in your post and it's cliche to say "you'll think different when you have your own" but honestly, I think you will. When you're watching them thrive in an environment it's a tough decision to just decide to pull them out of it and if you're going to do it, the earlier the better. Middle school and high school is when the clicks start forming and I understand why the people who don't like their jobs but have teenagers in school just grind it out until they graduate.
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I'm a kid that moved as many times as I was years old up until about age 32. Yeah it wasn't always the greatest time and I have no childhood friends. But you know what I do have? A fierce independence that means I don't have to rely on anyone and never fell into the trappings of clicks in school. I'm highly adaptable and can easily transition from one thing to the next.

My wife grew up in the same house her whole life until college. Still has close contact with childhood friends. That's both a blessing and a curse though, as only probably 50% of them are beneficial while the others seem to only drag her down, but she can't offload those. Moving for my residency caused a severe depression and homesickness despite only a 6 hour drive to her family.

We're back much closer to her family (but not too close) and she's much happier. I'm hoping my current job becomes my only job and we can stay in the same house for all of my daughters life. But if we do have to move? My daughter will be ok.

All in all I think there's positives and benefits to being at either spectrum. The middle ground where it's only one or two moves I think is likely much tougher on kids as long term bonds are being torn apart.
 
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all very subjective. I’ve done a fair amount of locums work while being in the military for both private practices and AMC’s. My favorite place to moonlight was not my highest paying option at all but I never felt destroyed when I left (this was for an AMC where I got to sit my own cases). BUT I would never work that same gig full time, it was only a good deal as a locums. So many variables in anesthesia which is a great problem to have, gives you lots of options!
 
Hoya11 said:
But it sounds like your getting what you want .. at their expense .. I moved schools at a young age and it sucked
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Well let’s see possibly, a better job, happier parent, happier spouse, better location, likely more money. What’s better for the family? A temporary whiny kid.

Do you still blame your parents and can’t stand them for making you move?
Are you still traumatized? If so have you gotten therapy?

That’s why some of y’all are on here sending money to grown adult children so they can live in fancy apartments. Come on. The way so many people raise kids in this country is disturbing and leads to whiny adults who complain about the dumbest ****.

Guess what? Life ain’t all gonna be rosy and peachy. Tough decisions need to be made at others expense sometimes.
 
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DocVapor said:
I'm a kid that moved as many times as I was years old up until about age 32. Yeah it wasn't always the greatest time and I have no childhood friends. But you know what I do have? A fierce independence that means I don't have to rely on anyone and never fell into the trappings of clicks in school. I'm highly adaptable and can easily transition from one thing to the next.

My wife grew up in the same house her whole life until college. Still has close contact with childhood friends. That's both a blessing and a curse though, as only probably 50% of them are beneficial while the others seem to only drag her down, but she can't offload those. Moving for my residency caused a severe depression and homesickness despite only a 6 hour drive to her family.

We're back much closer to her family (but not too close) and she's much happier. I'm hoping my current job becomes my only job and we can stay in the same house for all of my daughters life. But if we do have to move? My daughter will be ok.

All in all I think there's positives and benefits to being at either spectrum. The middle ground where it's only one or two moves I think is likely much tougher on kids as long term bonds are being torn apart.
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Man where have you been hiding this whole time?

People act like moving is so so traumatizing. You know what’s traumatizing? Moving continents. Moving to a whole new culture. Yeah, that sucks. But I as an adult understand why it was done. And don’t fault my parents for it.
I need to see studies of military kids compared to other kids who didn’t move much and see if they are messed up adults because of that.
 
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chocomorsel said:
Man where have you been hiding this whole time?

People act like moving is so so traumatizing. You know what’s traumatizing? Moving continents. Moving to a whole new culture. Yeah, that sucks. But I as an adult understand why it was done. And don’t fault my parents for it.
I need to see studies of military kids compared to other kids who didn’t move much and see if they are messed up adults because of that.
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SDN time has been cut due to my 12 week old daughter, and work has been busy. Can't really say I'm totally missing this place.
 
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DocVapor said:
SDN time has been cut due to my 12 week old daughter, and work has been busy. Can't really say I'm totally missing this place.
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I feel like at 4 months things improve drastically
 
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nimbus said:
I like kids and grown children but I do not like babies. They’re a pain in the a**!
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Yes they can be. But they are soo cute. Smell so good when they aren’t pooping. All cute and fluffy and cuddly. And smiley when they aren’t all colicky or hungry or pissed.
 
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chocomorsel said:
Yes they can be. But they are soo cute. Smell so good when they aren’t pooping. All cute and fluffy and cuddly. And smiley when they aren’t all colicky or hungry or pissed.
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I got PTSD from helping baby burp after midnight.
 
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chocomorsel said:
Yes they can be. But they are soo cute. Smell so good when they aren’t pooping. All cute and fluffy and cuddly. And smiley when they aren’t all colicky or hungry or pissed.
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And generally they don’t talk back.
 
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chocomorsel said:
Yes they can be. But they are soo cute. Smell so good when they aren’t pooping. All cute and fluffy and cuddly. And smiley when they aren’t all colicky or hungry or pissed.
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Yup. It is why we have the urge to take care of them.
 
chocomorsel said:
Yes they can be. But they are soo cute. Smell so good when they aren’t pooping. All cute and fluffy and cuddly. And smiley when they aren’t all colicky or hungry or pissed.
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Not as cute as puppies and puppies are a lot less work.
 
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With regards to people not moving to better jobs, a lot of folks just don't know any better. As someone who's been at a few different places, you'd be surprised at the number of times I talk to a colleague and they think their job is better than what's out there. Lots of people don't look elsewhere and plenty just stick where they did residency.

It's safe and easy and everything looks better when you're a resident.
 
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Ronin786 said:
With regards to people not moving to better jobs, a lot of folks just don't know any better. As someone who's been at a few different places, you'd be surprised at the number of times I talk to a colleague and they think their job is better than what's out there. Lots of people don't look elsewhere and plenty just stick where they did residency.

It's safe and easy and everything looks better when you're a resident.
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they afraid of being ripped off. there are a lot of "lies" in the job interview process
 
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Having been through the job search in the past year and jumping ship from a s//t job to what I hope is not such a s//t medium sized private practice job I can tell you that MOST jobs are s//t. NAPA, USAP, etc have tons of openings. The good private practices, not so much. Even with everyone on here saying that the job market is hot, there were like 20 people applying for the two spots where I am about to start.

Lots of friends got jobs at Kaiser making in the 300s out of residency. Another college took a PP track for 3 years making 350k a year. The northern Va jobs are real, they honestly do pay in the 3xx'k which is a joke. The DMV is a crap market. Florida is a s//t show. New England blows in my opinion with the amount of supervision most jobs entailed.

It's not easy at all to find a good job. It's honestly a lot of work and it ends up costing you a lot too if you are trying to re locate as they want interviews in person. The good groups are still very picky and very inbred.

I would consider anything W2 under 400k a bad bad deal...esp in Cali as it appears most of the people posting here are from. Take home is like 200k a year after all those taxes. Good luck getting by with that.
 
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Why is it there is so much obfuscation in things like total compensation and call responsibilities in MD jobs, but not so much in mid level jobs? They are clear cut as hell. Work this many hours, make this much. Call is worth extra, no mind games. It’s like they think it’s easier to mess with the physicians, even in the midst of an overall worker shortage.
 
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Ronin786 said:
With regards to people not moving to better jobs, a lot of folks just don't know any better. As someone who's been at a few different places, you'd be surprised at the number of times I talk to a colleague and they think their job is better than what's out there. Lots of people don't look elsewhere and plenty just stick where they did residency.

It's safe and easy and everything looks better when you're a resident.
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Fear of the unknown. Especially if you've been somewhere a long time. It takes a leap of faith
 
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chocomorsel said:
Well let’s see possibly, a better job, happier parent, happier spouse, better location, likely more money. What’s better for the family? A temporary whiny kid.

Do you still blame your parents and can’t stand them for making you move?
Are you still traumatized? If so have you gotten therapy?

That’s why some of y’all are on here sending money to grown adult children so they can live in fancy apartments. Come on. The way so many people raise kids in this country is disturbing and leads to whiny adults who complain about the dumbest ****.

Guess what? Life ain’t all gonna be rosy and peachy. Tough decisions need to be made at others expense sometimes.
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Are you talking confidently and incorrectly about something you have no experience with?

if you need to move, you move. personally, i dont need to move all the time to be happy. especially at the expense of my kid.
 
chocomorsel said:
Man where have you been hiding this whole time?

People act like moving is so so traumatizing. You know what’s traumatizing? Moving continents. Moving to a whole new culture. Yeah, that sucks. But I as an adult understand why it was done. And don’t fault my parents for it.
I need to see studies of military kids compared to other kids who didn’t move much and see if they are messed up adults because of that.
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I'm with you. I was a Navy brat, moved every two to three years until I went to college, lived on both coasts and three continents, and rather enjoyed the experience. I, then, joined the Army, and between the military, training, and civilian jobs, my son lived in four states by the time he was three years old. Moving didn't affect the children, but my wife (who lived in the same house almost her entire life, and didn't move away from family until grad school) did not appreciate it. We're happy to be stationary for once, but I have to say, I'm so used to moving, and have been here long enough that I'm thinking, "what's next?"
 
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gasresident1 said:
Having been through the job search in the past year and jumping ship from a s//t job to what I hope is not such a s//t medium sized private practice job I can tell you that MOST jobs are s//t. NAPA, USAP, etc have tons of openings. The good private practices, not so much. Even with everyone on here saying that the job market is hot, there were like 20 people applying for the two spots where I am about to start.

Lots of friends got jobs at Kaiser making in the 300s out of residency. Another college took a PP track for 3 years making 350k a year. The northern Va jobs are real, they honestly do pay in the 3xx'k which is a joke. The DMV is a crap market. Florida is a s//t show. New England blows in my opinion with the amount of supervision most jobs entailed.

It's not easy at all to find a good job. It's honestly a lot of work and it ends up costing you a lot too if you are trying to re locate as they want interviews in person. The good groups are still very picky and very inbred.

I would consider anything W2 under 400k a bad bad deal...esp in Cali as it appears most of the people posting here are from. Take home is like 200k a year after all those taxes. Good luck getting by with that.
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The irony is ‘good’ jobs that don’t rely on subsidies have not seen an increase in pay because their revenues haven’t gone up, unless they have non-clinical revenue streams. Only thing they can really do for new hires is to decrease the partnership track or increase associate pay at the partners expense. In my area $300-350 is standard for track years with partners at 400-500 w2, working hard.

Thus, any group paying substantially more is either getting bigger hospital subsidies or is a large AMC/academics/employed system that is now simply ripping you off less. In my area, these places are disasters, but ironically now pay more than the good jobs. But for how long?
 
chocomorsel said:
I plan on having one and not gonna let her make our decisions.
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I was going to ask how you knew it would be a girl. As soon as I thought of my question, I noticed the ad directly below your post. I thought it was funny.



1AE8A5BF-C174-47F9-9D1D-FB2B99388AFC.jpeg
 
ambiturner said:
The irony is ‘good’ jobs that don’t rely on subsidies have not seen an increase in pay because their revenues haven’t gone up, unless they have non-clinical revenue streams. Only thing they can really do for new hires is to decrease the partnership track or increase associate pay at the partners expense. In my area $300-350 is standard for track years with partners at 400-500 w2, working hard.

Thus, any group paying substantially more is either getting bigger hospital subsidies or is a large AMC/academics/employed system that is now simply ripping you off less. In my area, these places are disasters, but ironically now pay more than the good jobs. But for how long?
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Yikes so really bad insurance rates?
 
ERRES2288 said:
Yikes so really bad insurance rates?
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Yeah very bad rates and payer mix. The employed jobs offer more bc they’re targeting market rate and just subsidizing.

To psychobender’s point, rates have not kept up with inflation, especially since Medicare is stagnant. If a practice is 50% Medicare and the inflation rate is 8%, the commercial rates would need to rise 16% to keep the blended unit on track. To justify going from $200 to $300/hr for locums commercial rates would have to double.

Clearly that’s not happening and the big increases are coming from somewhere else. Maybe bad for independent practices long term but on a positive note it shows the hospitals value what we do and know they can’t skimp on the OR.
 
ambiturner said:
Yeah very bad rates and payer mix. The employed jobs offer more bc they’re targeting market rate and just subsidizing.

To psychobender’s point, rates have not kept up with inflation, especially since Medicare is stagnant. If a practice is 50% Medicare and the inflation rate is 8%, the commercial rates would need to rise 16% to keep the blended unit on track. To justify going from $200 to $300/hr for locums commercial rates would have to double.

Clearly that’s not happening and the big increases are coming from somewhere else. Maybe bad for independent practices long term but on a positive note it shows the hospitals value what we do and know they can’t skimp on the OR.
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Medicare is not just stagnant but they are cutting. I'm being threatened with a further 9% cut on already terrible rates if I don't report measures for "quality".
 
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ambiturner said:
Yeah very bad rates and payer mix. The employed jobs offer more bc they’re targeting market rate and just subsidizing.

To psychobender’s point, rates have not kept up with inflation, especially since Medicare is stagnant. If a practice is 50% Medicare and the inflation rate is 8%, the commercial rates would need to rise 16% to keep the blended unit on track. To justify going from $200 to $300/hr for locums commercial rates would have to double.

Clearly that’s not happening and the big increases are coming from somewhere else. Maybe bad for independent practices long term but on a positive note it shows the hospitals value what we do and know they can’t skimp on the OR.
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rates aren't the only variable that determines revenue. Payer mix can change (for good or bad) over time as can case volumes and complexities. Even a small improvement in payer mix can make a big difference in total revenue.
 
Mman said:
rates aren't the only variable that determines revenue. Payer mix can change (for good or bad) over time as can case volumes and complexities. Even a small improvement in payer mix can make a big difference in total revenue.
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That ain’t happening.
 
Arch Guillotti said:
That ain’t happening.
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ours has improved slowly but continually for years. Benefits of starting out at a low point, but also being a growing area with more and more jobs.
 
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Hoya11 said:
The PERCEPTION is high. Many of the employed docs I talk to - its shocking how little they actually know about the business, yet maintain a high level of pessimism and perceived expertise of the business side.

Something like a "sub partnership" would be revealed to you before you started. Same with "buy ins". None of that stuff will be a surprise.
Sometimes an AMC/Hospital/Employed gig makes more sense.
Click to expand...

People lie. All the time. Skepticism is healthy.
 
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