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The planning of U.S. physician shortages (2020)

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Re: The planning of U.S. physician shortages (2020)

#321

Post by [deleted] »

PheonixPharts wrote: post #257
candiddevmike wrote: post #244

Earlier quoted context omitted.

I do hiring for small companies, no one is paying that much. 130-150k is base for seniors. Also seeing a decrease in US based developer jobs, lots of offshoring happening. I'm halfway considering moving to Costa Rica and running a firm down there.

They must be very small because I don't know of anyone hiring senior devs in that range. Even those smaller, early stage companies I know are offering at least 150-190k base, and they struggle to hire. However if you're dealing with dev roles that are being actively outsourced I suspect you're dealing with an entirely different class of software jobs.

[deleted]

Re: The planning of U.S. physician shortages (2020)

#322

Post by sarchertech »

haldujai wrote: post #307
sarchertech wrote: post #293

Earlier quoted context omitted.

When it comes to value, when my wife interviews for a job (she’s a physician) they fly her out and spend a day taking her to see the sights, so they convince here how great the city is. Then they take her out to a fancy dinner and woo her some more. When I interview at a new job as a very senior engineer (and relatively well known I in my area), I get to jump through 7 rounds of interviews where someone asks me the e…

> When it comes to value, when my wife interviews for a job (she’s a physician) they fly her out and spend a day taking her to see the sights, so they convince here how great the city is. Then they take her out to a fancy dinner and woo her some more. Interesting, are these in underserved areas? I just went through interviewing for a new job and despite being in an in-demand subspecialty with desperate employers the…

>Interesting, are these in underserved areas? I just went through interviewing for a new job and despite being in an in-demand subspecialty with desperate employers the most I got was a dinner after the 2nd round interview but no one covered my travel. Do you mind if I ask what kind of physician she is? I clearly picked incorrectly.

Pediatric Emergency Medicine. All in cities large enough to have a children’s hospital, so basically minimum metro populations of 500k or so.

>is there age-ism

I’m sure there is, but not really at the principal engineer level from what I’ve seen. Mostly there’s an assumption that staff plus engineers will skew a good bit older.

I think the issue is that everyone cargo cults FAANG interviews. They get so many applicants that they can afford to treat very senior people like new grads, and that attitude trickles down to most other companies.

From what I observed early in my career, there was definitely a time when higher level engineers escaped the FAANG style hazing process. But slowly more and more companies have started putting everyone through the whole thing.

I’ve been at companies where leadership tried to force very well known engineers with decades of experience, hugely popular open source projects, multiple famous talks/blogs/podcasts etc… to do weed out take home assignments.

Re: The planning of U.S. physician shortages (2020)

#323

Post by haldujai »

sarchertech wrote: post #322
haldujai wrote: post #307

Earlier quoted context omitted.

> When it comes to value, when my wife interviews for a job (she’s a physician) they fly her out and spend a day taking her to see the sights, so they convince here how great the city is. Then they take her out to a fancy dinner and woo her some more. Interesting, are these in underserved areas? I just went through interviewing for a new job and despite being in an in-demand subspecialty with desperate employers the…

>Interesting, are these in underserved areas? I just went through interviewing for a new job and despite being in an in-demand subspecialty with desperate employers the most I got was a dinner after the 2nd round interview but no one covered my travel. Do you mind if I ask what kind of physician she is? I clearly picked incorrectly. Pediatric Emergency Medicine. All in cities large enough to have a children’s hospita…

> Pediatric Emergency Medicine. All in cities large enough to have a children’s hospital, so basically minimum metro populations of 500k or so.

Interesting, pediatrics is so underfunded and poorly respected in Canada that I'm genuinely shocked (and pleasantly surprised) to read about a paediatrician not being treated like refuse.

Kudos to your wife though, that's a very challenging field and anecdotally my interactions with peds ER physicians have been overwhelmingly positive. They all seem to have a very well-developed sixth sense about when something is "off" despite many of their patients not being able to talk.

> They get so many applicants that they can afford to treat very senior people like new grads, and that attitude trickles down to most other companies.

Is it just during the interview process or do you find bias against older engineers in hiring decisions and the work environment as well?

Re: The planning of U.S. physician shortages (2020)

#324

Post by haldujai »

nradov wrote: post #319
haldujai wrote: post #307

Earlier quoted context omitted.

> When it comes to value, when my wife interviews for a job (she’s a physician) they fly her out and spend a day taking her to see the sights, so they convince here how great the city is. Then they take her out to a fancy dinner and woo her some more. Interesting, are these in underserved areas? I just went through interviewing for a new job and despite being in an in-demand subspecialty with desperate employers the…

In the corporate world it's routine for employers to cover travel expenses for job applicants coming to interviews that farther than driving distance. Did you ask about that? Sometimes if you don't ask, you don't get.

> Did you ask about that? Sometimes if you don't ask, you don't get.

I did not. I think I'm so conditioned to being treated poorly by hospitals I just assume I'm going to be taken advantage of but you're probably right and I should have asked.

Re: The planning of U.S. physician shortages (2020)

#325

Post by kevinventullo »

mrep wrote: post #270
lucaspm98 wrote: post #264

Earlier quoted context omitted.

Do Google and Facebook really only match half of 401(k) contributions up to 7%? I thought employers competing on benefits were moving towards dollar for dollar or better matching. This is especially important for high income earners who'd be maxing out, because the 401(k) contribution limit for 2023 is $22,500 for employee contributions but $66,000 for combined employee and employer contributions.

Each is slightly different but it amounts to $10,250 worth of match if you max it out and then you can hit the $66,000 limit through the mega backdoor roth.

Right, and the mega backdoor you can fund yourself. So there’s not much point in cos juicing the match versus just paying people more, which big tech is not afraid to do.

Re: The planning of U.S. physician shortages (2020)

#326

Post by kevinventullo »

haldujai wrote: post #269
kevinventullo wrote: post #201

Earlier quoted context omitted.

The defined-contribution matching is not actually that significant. Google and Facebook e.g. match half of what one contributes up to 7%, so they’re paying at most 3.5%. More importantly, employees can only contribute up to the annual 401(k) max; that’s $22,500 in 2023. Thus, the matching is worth at most $11,250, even for execs with a seven-figure base salary.

Thanks for sharing, I'm still learning how retirement works in the US and was unaware of that detail. I also wasn't sure how to value benefits (at least health/dental + disability if that's included) and PTO (including sick days and mat/pat leave which are unpaid for this subset of physicians), do you have a ballpark on what that is worth for accounting purposes? Overall I think the biggest hidden line item in any ph…

I agree benefits are hard to measure. Honestly, as a tech employee I think I value the free and convenient meals quite a bit more than paid sick days. I suppose one could try to put a dollar amount on it, but it’s really just a nice quality-of-life perk. One less thing I have to think about.

Re: The planning of U.S. physician shortages (2020)

#327

Post by haldujai »

sarchertech wrote: post #290
haldujai wrote: post #146

Earlier quoted context omitted.

From my job search as a physician. Literally no private practice job I’ve interviewed at or heard of provides defined-benefit retirement, if you know one let me know. Similarly I don’t know of many non-medicine jobs that still offer this either, but they do offer defined-contribution plans and GlassDoor suggests Google matches 7%. The super high income (radiology) jobs people are alluding to here (500k-1m) are struct…

Sorry I invented the term fixed benefit to be in opposition to defined benefit. What I meant was defined contribution. My wife is a physician, as are many of our close friends. They nearly all work for private groups, and they mostly have some kind of employer matched plan. My wife’s group just directly contributes up to 13% of her salary to her retirement plan through profit sharing. I know a far higher percentage o…

> My wife is a physician, as are many of our close friends. They nearly all work for private groups, and they mostly have some kind of employer matched plan. My wife’s group just directly contributes up to 13% of her salary to her retirement plan through profit sharing.

Knowing that your wife is in PEM now I expect she's not in the 500k-1M category (if she is kudos again but I definitely made a career mistake) and presumably a large/whole-hospital billing group?

In this setting there tends to be more benefits because the group is so large the costs are diluted and you need to retain certain lower-billing specialties to maintain coverage requirements (peds EM being a good example) but overall compensation tends to be on the lower end, kind of like an academic-lite environment but less non-clinical work hours so comp is better but I really can't imagine the average specialist in a paediatrics or hospital-based group is taking home 500k-1M while providing benefits.

The majority of physicians billing >500k purely for clinical work (especially as you go up) will be 'high income specialties' (proceduralists/surgeons) where the setting is much smaller specialty-based partnerships, or billing as single-individuals, where benefits don't exist as they more directly come out of your pocket and you don't need to 'subsidize' a specialty to keep them employed/eating and your contract in place.

Re: The planning of U.S. physician shortages (2020)

#328

Post by bruce511 »

chaostheory wrote: post #295
bruce511 wrote: post #81

Earlier quoted context omitted.

I don't know for sure, but I feel like you're possibly conflating socialism with communism? They are really quite different political models, although I'll grant you that both have a spectrum of examples. Equally capitalism, socialism and communism are all (somewhat) tangential to government organisation (single party, two party, multiparty, monarchy, dictator etc.) And I understand here that I'm painting with a very…

Communism is just late stage socialism. Besides even if they were two separate things, by design in socialism nearly everything is centrally planned. Corruption just spreads much faster in systems where you centralize power from the start ie you want the groups running the media, producing goods, and managing the laws to be separate entities

I think we'll gave to agree to disagree there. In my understanding socialism and communism are two very different animals.

Communism is about the absolute equality of all - no rich, no poor. Socialism is about caring for the poor, with no upper bound on the rich.

In other words one squeezes from the top down. The other pushes from the bottom up.

Re: The planning of U.S. physician shortages (2020)

#329

Post by mrep »

kevinventullo wrote: post #325
mrep wrote: post #270

Earlier quoted context omitted.

Each is slightly different but it amounts to $10,250 worth of match if you max it out and then you can hit the $66,000 limit through the mega backdoor roth.

Right, and the mega backdoor you can fund yourself. So there’s not much point in cos juicing the match versus just paying people more, which big tech is not afraid to do.

Sort of. The employee + employer match can go into regular 401k or roth 401k whereas the mega backdoor roth is only roth.

Thus you can put ~33,000-66,000 into roth ones and only 0-33,000 into pre-tax ones whereas if the employer match got you up to the full 66,000, you could fully customize it to pre or post tax however you like.

Re: The planning of U.S. physician shortages (2020)

#330

Post by weatherlite »

dangwhy wrote: post #309
JJMcJ wrote: post #180

Earlier quoted context omitted.

A 50 year old physician or lawyer, if they are good, is at the absolute top of their profession and can 90% expect work another ten or twenty or more years still earning top dollar. A 50 year old non-management programmer? Look forward to having 23 year olds asking if you know what an array is for the rest of your work life.

> A 50 year old non-management programmer? Look forward to having 23 year olds asking if you know what an array is for the rest of your work life. Fuck. That made anxious. I am close to that age. Also, my middle manager friends are having much harder time finding a job than programmer types. Don't know if its just them or if its a trend.

A.I is gonna change the job market so deeply I wouldn't worry much. It's futile to worry, we simply don't know what's coming we only know it will change everything.
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