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The Artemis II crew named a lunar crater after Commander Reid Wiseman's late wife, Carroll. What a beautiful and touching moment. I'm not crying, you're crying 🤧

@AlecLundragon @FiSurgi Lmao you’re right! I can’t read, also busy making breakfast for the family. 💀💀💀

@ichiisan @FiSurgi Holy shit you are retarded. The AA admit doc thought Nana was calling him a demon, when Nana is on his side. I hope to god you are not a fucking doctor.

Damn that’s a first. Someone called me a Demon.

@ElkJob75180 @randolphkwatson @ContrarianSaver @LaurenceBSiegel Asks for proof, gets proof, “no, it doesn’t count.” Makes argument, gets refuted, never mentions it again. Makes new argument. Repeat ad nauseam. All things fail, make pedantic nitpicks. Typical playbook of someone coping. Sad!

@ichiisan @randolphkwatson @ContrarianSaver @LaurenceBSiegel muted him too. Can’t even come up with any decent reasoning.

This doctor actually believes $450k/year is insulting. How out of touch can you possibly be? This is why health care costs have spiraled in the U.S.

@randolphkwatson @ElkJob75180 @ContrarianSaver @LaurenceBSiegel You’re moving the goal posts. No wonder you quit law. You are terrible at formulating and defending an argument. This is embarrassing (for you) and a waste of time. Even for someone retired like me. Muted.

@ichiisan @ElkJob75180 @ContrarianSaver @LaurenceBSiegel LOL one mention do doctors in a laundry list

@randolphkwatson @ElkJob75180 @ContrarianSaver @LaurenceBSiegel Different firms call it differently and it also depends if the firm has forced retirement or not. I specifically have worked with “partner emeritus” at two biglaw firms: Cravath and Paul Weiss, so it definitely exists. You are thoroughly beclowning yourself here.

@ichiisan @ElkJob75180 @ContrarianSaver @LaurenceBSiegel Also while I’m sure “partner emeritus” exists *somehere* it’s not something I ever heard of in four years at two Biglaw firms with 1,000+ lawyers across dozens of offices. Of Counsel is a thing, but partner emeritus not really.

@randolphkwatson @ElkJob75180 @ContrarianSaver @LaurenceBSiegel It takes five seconds bro.

@ichiisan @ElkJob75180 @ContrarianSaver @LaurenceBSiegel Show me those doctor layoff headlines

@randolphkwatson @ElkJob75180 @ContrarianSaver @LaurenceBSiegel LOL doctors and RNs and even PAs are infinitely more essential to society than your entire grift career arc of Law / PE / IBD. If doctors don’t deserve the pay, lawyers, private equity grifters, and banking retards definitely do not. Have some self-awareness.

@ichiisan @ElkJob75180 @ContrarianSaver @LaurenceBSiegel If you really think about it, much of what we spend is essential. Food is essential. Shelter is essential. Electricity, infrastructure, all essential. So this whole “health is special” take is just made up nonsense to justify outrageous doctor pay.

@randolphkwatson @ElkJob75180 @ContrarianSaver @LaurenceBSiegel You said only doctors are cartels, but other professions also exhibit cartel-like behavior. You said law firms don’t keep on lawyers who don’t do any work, but they do. And I’m the liar? That you’re a lawyer is a the 🍒 on top, the finishing mascara on your 🤡 face.

@ichiisan @ElkJob75180 @ContrarianSaver @LaurenceBSiegel You’re just full of shit. AMA is totally unique because when a new med school wants to be added or an existing med school wants more slots, it needs approval from AMA liaison committee. Other professions have nothing like this. Stop lying.

@randolphkwatson @ElkJob75180 @ContrarianSaver @LaurenceBSiegel It’s the common standard now in medicine to tie doctor pay to the revenue they bring in. See: RVUs. HC is essential (or you die) and highly inelastic. The population is also growing (thus demand), so it’s not a surprise that UE rates are low. This incudes RNs and PAs, too.

@ichiisan @ElkJob75180 @ContrarianSaver @LaurenceBSiegel Not sure I agree with the premise there, that doctors have revenue tied to their pay and are deemed to be “bringing it in”. But regardless, I’ve met unemployed people from every sector but medicine.

@randolphkwatson @ElkJob75180 @ContrarianSaver @LaurenceBSiegel There’s literally a title for this in law, it’s called being a partner emeritus. In any case money doesn’t grow on trees and no one is keeping a doctor employed who doesn’t see patients.

@ichiisan @ElkJob75180 @ContrarianSaver @LaurenceBSiegel For some time. Not for long.

@randolphkwatson @ElkJob75180 @ContrarianSaver @LaurenceBSiegel All licensed professions operate like a cartel—using licensing, barriers to entry, and self-regulation to limit competition and maintain high prices or wages. This includes lawyers, CPAs, electricians, plumbers, and more. So your simple fact is simply wrong.

@ElkJob75180 @ichiisan @ContrarianSaver @LaurenceBSiegel Doctors have a cartel and other professions don’t. Simple fact.

@ElkJob75180 @randolphkwatson @ContrarianSaver @LaurenceBSiegel This also happens in law and banking. In the former it’s common to keep a senior partner, who doesn’t do any actual work, employed for marketing reasons or to tap their niche knowledge / reputation.

@ElkJob75180 @randolphkwatson @ContrarianSaver @LaurenceBSiegel There are situations where doctors are employed and don’t bring in enough to cover their pay—but usually this is due to the hospital needing them to meet Level certifications (or community needs) and obviously the overall hospital still needs to be profitable to make it work.

@randolphkwatson @ElkJob75180 @ContrarianSaver @LaurenceBSiegel Is your argument that doctors who bring in less revenue than their pay—that is, they are a net cost to their employer—are not at risk of losing their jobs?

@ElkJob75180 @ContrarianSaver @LaurenceBSiegel Oh please. I know lawyers and bankers who’ve lost their jobs because they didn’t bring in enough revenue. In some cases that’s the end of the career as they know it. Zero doctors, unless running their own practice, have anything like that going on.

@VBotoku @chriswithans Provider vs non-provider costs. Some of the non-provider costs are justified, but again the greater point is that doctors (and non-MD providers) represent a minority share of the cost structure at a hospital while doing the majority of work for direct patient care.

@ichiisan @chriswithans Why not compare to the salaries of the actual managers you say are the cause of healthcare bloat?

This is why we’ll never get “affordable healthcare” in America. Established, stable non-profit hospital offers $440,000 a year for a doctor and they act like it’s poverty wages. No one’s forcing them to accept but they hate the idea that’s a floor for their earnings.

@VBotoku @chriswithans I mention the inflation to show that Doctor compensation has actually fallen over time, which supports my broader argument that your anger is being misdirected as Doctor compensation is not the reason for healthcare in-affordability. Please think and do some research little bro.

@ichiisan @chriswithans Also why are you using this bs inflation metric? Are doctors uniquely affected by inflation? Jesus Christ this discussion is actually getting on my nerves.

@VBotoku @chriswithans I mention Meta because people are getting mad based on the nominal pay (which btw the posting doesn’t include benefits), which is relatively lower than specialist roles in other industries. A senior meta engineer gets paid millions for working less and not saving any lives.

@ichiisan @chriswithans We aren't talking about Meta though? I won't be in immediate risk from not using a Meta product, I will be if I avoid the doctor when I get sick because of costs and a condition which could be managed becomes terminal.

@VBotoku @chriswithans You’re conflating people like nurses and pharmacists, who I and doctors agree add value, with the managerial layer that has no direct relation with delivering care and has bloated in size: hospital executives, strategy personnel, HR personnel, marketing people, etc.

@ichiisan @chriswithans The non providers are what makes the doctor's work easier, if they were gone doctors would complain about doing more work and ask for money money and nothing would really change.

@VBotoku @chriswithans When doctors complain about administrators, they’re talking about people like program managers, hospital executives, etc. not really PAs and nurses. Also doctors only control for these things in a private practice, not at the hospital. The former has declined vs the latter.

@ichiisan @chriswithans I think it's entirely bs how doctors pass PAs, billing, and maintenance as useless administrators doing nothing in offices while they do all the hard work. Doctors aren't one to keep useless things around their workplace so this deflection is wholly dishonest.

@VBotoku @chriswithans The broader point is that hc affordability is not driven by physician pay, which is dwarfed by the costs of everything else & has actually fallen when adjusted for inflation. If you’re mad at an MD getting 400K wait until you find out how much ad-optimizers get paid at Meta.

@VBotoku @chriswithans It depends on how you classify administration & what categories, etc are measured & included, but it’s directionally correct in that non-provider costs & headcount has grown disproportionally compared to doctors. Your article says the same, it just disagrees on the exact count.