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> The center for Medicare and Medicaid is the primary source of graduate medical education (residency) funding. Per the Graham Center interactive GME data tool

> The center for Medicare and Medicaid is the primary source of graduate medical education (residency) funding. Per the Graham Center interactive GME data tool Mt. Sinai received around $175k a year per resident, and pays them a salary of $84,479\year, leaving 90K to pay for their “education.” This is straight up fraud and should be treated as such. My wife wanted to be a nurse her whole life, went to school and got a good job, after 3 years at the hospital she had to quit for her own sanity. Every nurse and resident in her circle had a similar story. U.S. hospitals are for profit assembly lines. Managers with MBAs that have never worked a shift on the floor in their life see staff as fungible. Throwing a pizza party when patient quotas are met, instead of you know, hiring more to relieve overworked and stressed employees. Seemingly every motivated and caring person in this field is systematically chewed up and spit out.

anon291 2y ago
According to https://en.wikipedia.org/wiki/Mount_Sinai_Hospital_(Manhattan) https://en.wikipedia.org/wiki/Mount_Sinai_Hospital_(Manhatta..., Mt Sinai is a 'non-profit', but in my opinion, we need a much more expansive definition of 'for-profit'. It's true that there are no shareholders, but the salaries the executives make is a form of profit, and ought to be treated as such. In some ways it's worse because in a company, the board sets the CEOs and execs compensation, and can adjust it according to their own financial interests (which means there's less desire by CEOs to 'waste', because waste means the board / shareholders make less money, and then their compensation is lowered -- theoretically). In a non-profit, the board uses arbitrary criteria, the board is incentivized to waste all money on executive compensation, because that means the execs throw them excellent parties, galas, soirees, and other social events where they can network with more people to make more profit in their for-profit ventures. Ask me how I know.
- steveBK123 2y ago
  Hospital donations are also interesting to me as you get billionaires donating amounts of money that.. a FAANG engineer could feasibly have left to give on their demise. Or giving amounts similar to like their 3rd homes value and getting a wing named after them (though the donation clearly only pays for a small fraction of the construction). Similarly I have a friend whose spouse is extremely talented with a PHD (not MD), and has worked in admin roles at a big nonprofit NYC hospital as well. They have at times had pretty similar compensation, one working at a hedge fund and the other working at a nonprofit hospital. Interesting that. Each side can argue they need to attract talent, and one can argue that hospital admin is closer to doing good for society. It is just surprising to see nonprofit and very high compensation.
- cycomanic 2y ago
  I find this notion completely alien. Paraphrasing (with some exaggeration): "it's outrageous we are paying people working at hospitals/schools/non-profits high salaries, they really should be doing it from the goodness of their hearts. The only people that should be earning big bucks are the engineers devolving the tech to keep us addicted to social media, the ad tech that extracts more value from every person and the fiance people to extract the maximum from the general economy to funnel it into some rich pockets! Really people working on things that are actually good for society, should be happy with that and work for free! "
  - philwelch 2y ago
    The comment was about high salaries for nonprofit executives. If you claim to be a nonprofit but pay your CEO $10 million a year, are you really a nonprofit or are you just as guilty of “funneling money” into “rich pockets” as anyone else?
  - anon291 2y ago
    Please re-read my comments. I am not against corporations (for-profit or non-profit), however I don't think we can simply say there is no profit motive in non-profits simply because there are no shareholders. I'm arguing that executive compensation is a form of profit and that -- contrary to what they are held up to be -- non-profits often suffer from an even more personal form of greed than for-profits. As I said above, for-profit entities are at least nominally forced to look out for the profit of the CEO + the shareholders, whereas non-profits are incentivized to look after just the CEO's compensation. In no way does this mean no non-profit should ever pay someone well.
salawat 2y ago
It's a systematic thing. As long as management is decoupled from actually doing the job one is expected to manage, that outcome will be inevitable as a consequence of the overarching fiscal optimization function being applied Procrustean Bed style to all fields of capitalistically orchestrated human endeavor.
deleted 2y ago
[deleted]
pc86 2y ago
You're talking about two unrelated things. Non-clinical MBAs running hospitals is very obviously dumb, but so is pretending the only cost of a resident is the salary they're paid directly. > Every nurse and resident in her circle had a similar story. Most don't quit after 3 years. > U.S. hospitals are for profit assembly lines. Absolutely true, regardless of the actual IRS profit classification.
Aurornis 2y ago
> This is straight up fraud and should be treated as such. Running a residency program takes resources, staffing, and people. If you expect everyone in the doctor education and residency chain to work for free, there wouldn’t be much of a residency program to speak of. It’s a reality of life: doing things within a business takes money. I know some people scoff at the idea of health care being a business, but even in government-run programs there are still budgets to be managed and costs to be paid. > U.S. hospitals are for profit assembly lines. Managers with MBAs that have never worked a shift on the floor in their life see staff as fungible. Throwing a pizza party when patient quotas are met, instead of you know, hiring more to relieve overworked and stressed employees. Your view is very US-centric, but this is a common story in other countries too. Healthcare is a very complicated and demanding field, and it has high turnover rates outside the US as well. The harsh reality is that these organizations are operating like any other: They compensate as necessary to reach the supply/demand equilibrium. As long as new people continue to seek out and take the jobs at a high enough rate to keep the organization running, they’re not going to arbitrarily increase compensation. That’s always the answer: It’s supply and demand equilibrium. We can complain all we want about who “should” be paid more or similar musings, but as long as the jobs are filled sufficiently at the current rate and the system keeps chugging along, that’s how it will be.
phkahler 2y ago
>> This is straight up fraud and should be treated as such. They have to cover overhead for that person. In e gineering that adds 30 to 50 percent. I think doctors have additional overhead, like malpractice insurance, and since this is an educational environment more oversight. 2x doesn't seem bad.
deleted 2y ago
[deleted]
77pt77 2y ago
> see staff as fungible It's like that in almost every field.

anon291 2y ago

According to https://en.wikipedia.org/wiki/Mount_Sinai_Hospital_(Manhattan) https://en.wikipedia.org/wiki/Mount_Sinai_Hospital_(Manhatta..., Mt Sinai is a 'non-profit', but in my opinion, we need a much more expansive definition of 'for-profit'. It's true that there are no shareholders, but the salaries the executives make is a form of profit, and ought to be treated as such. In some ways it's worse because in a company, the board sets the CEOs and execs compensation, and can adjust it according to their own financial interests (which means there's less desire by CEOs to 'waste', because waste means the board / shareholders make less money, and then their compensation is lowered -- theoretically). In a non-profit, the board uses arbitrary criteria, the board is incentivized to waste all money on executive compensation, because that means the execs throw them excellent parties, galas, soirees, and other social events where they can network with more people to make more profit in their for-profit ventures. Ask me how I know.

steveBK123 2y ago
Hospital donations are also interesting to me as you get billionaires donating amounts of money that.. a FAANG engineer could feasibly have left to give on their demise. Or giving amounts similar to like their 3rd homes value and getting a wing named after them (though the donation clearly only pays for a small fraction of the construction). Similarly I have a friend whose spouse is extremely talented with a PHD (not MD), and has worked in admin roles at a big nonprofit NYC hospital as well. They have at times had pretty similar compensation, one working at a hedge fund and the other working at a nonprofit hospital. Interesting that. Each side can argue they need to attract talent, and one can argue that hospital admin is closer to doing good for society. It is just surprising to see nonprofit and very high compensation.
cycomanic 2y ago
I find this notion completely alien. Paraphrasing (with some exaggeration): "it's outrageous we are paying people working at hospitals/schools/non-profits high salaries, they really should be doing it from the goodness of their hearts. The only people that should be earning big bucks are the engineers devolving the tech to keep us addicted to social media, the ad tech that extracts more value from every person and the fiance people to extract the maximum from the general economy to funnel it into some rich pockets! Really people working on things that are actually good for society, should be happy with that and work for free! "
- philwelch 2y ago
  The comment was about high salaries for nonprofit executives. If you claim to be a nonprofit but pay your CEO $10 million a year, are you really a nonprofit or are you just as guilty of “funneling money” into “rich pockets” as anyone else?
- anon291 2y ago
  Please re-read my comments. I am not against corporations (for-profit or non-profit), however I don't think we can simply say there is no profit motive in non-profits simply because there are no shareholders. I'm arguing that executive compensation is a form of profit and that -- contrary to what they are held up to be -- non-profits often suffer from an even more personal form of greed than for-profits. As I said above, for-profit entities are at least nominally forced to look out for the profit of the CEO + the shareholders, whereas non-profits are incentivized to look after just the CEO's compensation. In no way does this mean no non-profit should ever pay someone well.

salawat 2y ago

It's a systematic thing. As long as management is decoupled from actually doing the job one is expected to manage, that outcome will be inevitable as a consequence of the overarching fiscal optimization function being applied Procrustean Bed style to all fields of capitalistically orchestrated human endeavor.

deleted 2y ago

[deleted]

pc86 2y ago

You're talking about two unrelated things. Non-clinical MBAs running hospitals is very obviously dumb, but so is pretending the only cost of a resident is the salary they're paid directly. > Every nurse and resident in her circle had a similar story. Most don't quit after 3 years. > U.S. hospitals are for profit assembly lines. Absolutely true, regardless of the actual IRS profit classification.

Aurornis 2y ago

> This is straight up fraud and should be treated as such. Running a residency program takes resources, staffing, and people. If you expect everyone in the doctor education and residency chain to work for free, there wouldn’t be much of a residency program to speak of. It’s a reality of life: doing things within a business takes money. I know some people scoff at the idea of health care being a business, but even in government-run programs there are still budgets to be managed and costs to be paid. > U.S. hospitals are for profit assembly lines. Managers with MBAs that have never worked a shift on the floor in their life see staff as fungible. Throwing a pizza party when patient quotas are met, instead of you know, hiring more to relieve overworked and stressed employees. Your view is very US-centric, but this is a common story in other countries too. Healthcare is a very complicated and demanding field, and it has high turnover rates outside the US as well. The harsh reality is that these organizations are operating like any other: They compensate as necessary to reach the supply/demand equilibrium. As long as new people continue to seek out and take the jobs at a high enough rate to keep the organization running, they’re not going to arbitrarily increase compensation. That’s always the answer: It’s supply and demand equilibrium. We can complain all we want about who “should” be paid more or similar musings, but as long as the jobs are filled sufficiently at the current rate and the system keeps chugging along, that’s how it will be.

phkahler 2y ago

>> This is straight up fraud and should be treated as such. They have to cover overhead for that person. In e gineering that adds 30 to 50 percent. I think doctors have additional overhead, like malpractice insurance, and since this is an educational environment more oversight. 2x doesn't seem bad.

deleted 2y ago

[deleted]

77pt77 2y ago

> see staff as fungible It's like that in almost every field.