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-- Are You Paying the Wal-Mart Tax? (http://forums.ukcdogs.com/showthread.php?threadid=87316)

The doctors I know drive cars that your not gonna be able to afford making 39 thousand a year.

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In the beginning of a change, the Patriot is a scarce man, brave, hated and scorned. When his cause succeeds, however, the timid join him, for then it costs nothing to be a patriot."
-- Mark Twain

Well kinda on the job training, but we did that for 2 years in medical school. Med school is 2 years of lecture and 2 years of on the job training (after already having a 4 year degree to get there).

On May the 6th I will be a MD, so I am a doctor then and do not have to go back to school or anything. I have already taken and passed step I and step II of the United States Medical Liscensing exam. I will be in charge of the care of my patients, but I will have senior residents and attendings available to help if needed and to supervise, watch and make sure I don't get in over my head. Experience is a large part of being a good doctor. Knowledge without experience is deadly.

The Residency is the specalty training to be board eligible. To get the liscense to practice medicine in the US you must do at least 1 year of Residency and passed Step III. Then you can go out into private practice but you wouldn't be board certified in any specailty. You would just be a liscensed private practice doctor.

I want to be a board certified Surgeon.

Yes, after my residency I will make very, very good money. However, even in large chunks will I ever catch up to the total I would have made had I stayed in the workforce? After all I will be 42 before I can start my practice.

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Sheep, here is some info to help educate yourself some more.

To put it in football terminology for you. Think of a doctor during residency as drawing the NFL minimum salary. As the doctor finishes his residency and gains more experience and skills, his salary increases.

http://en.wikipedia.org/wiki/Medical_residency

buckshot,
good article, always read it and use it as frame of reference for social stratification... real eye opener as to what some things pay.... indicates what a society values and is willing to pay $$$ for, course $$$ not the only thing, look at the 3ps ( property-power-prestige ) as measures of stratification and impacts of same... well worth reading, good suggestion...

Ooooooooohhhhhhhhh I see says the blind sheep.

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In the beginning of a change, the Patriot is a scarce man, brave, hated and scorned. When his cause succeeds, however, the timid join him, for then it costs nothing to be a patriot."
-- Mark Twain

Very good link Buckshot. The salary of the Resident increases a very little during Residency, I think Senior Residents get like 10.80 or 11.20 or so per hour. The salaries are regulated by the ACGME so they are all very, very close with geographical variation due to cost of living etc. They are right around 35-40 grand a year now and at 80 hours per week (average for residents) that comes to 10 bucks an hour. Now AFTER Residency is completed and you sit for your boards you can begin to make some real money.

I do know that some used to be in it for the money, but the money isn't there like it used to be. If they can get into medical school they can do any thing they want to do so those go on to professions where the money is unlimited such as Business or Law. (Contrary to what you thought the AMA does not control the docs, the Lawyers do as well as several government agencies, review boards etc now.) We still have a self diciplinary board, but that has become almost obsolete. The politicians want to turn it into a trade because then they can do away with the strict academic requirements and broad training of medical school and train people for their one procedure. The care will be gone but the cost will be cheaper. God help you if you have something different or unusual because the trade trained procedurist wouldn't have a clue what to do. They will only know their one procedure.

The reason the medical schools aren't turning out more primary care doctors is because between the insurance companys and the government it is a proposition for bankruptcy, especially with the student loans etc that it takes to get through med school. Did you notice the pay for the scopes I posted earlier, how a Family doc only got 2-3 hundred dollars for it?

It is to the point that many of the primary care doctors are actually shutting down their practice and starting over and going through the hell known as Residency again in a different specailty just to be able to make it. Consequently more FP residencys are lowering their standards and taking more Foreign Medical Grads, thus making Family less marketable and less respected in the medical community. It is a vicious downward cycle for that specialty right now. In reality the FP has to have the largest breadth of knowledge out there to know when to properly refer patients and treat the myirad of problems that come up every day. There are still many, many great FP's that are awesome doctors and some of the most intelligent I have ever met in any field. However they are beginning to see the writing on the wall as well. We still have brillant doctors go into Family every year, but they are getting less and less due to the logistics of it.

That's the reason I am doing Surgery(other than just loving actually operating). I was always going to do Family Medicine and be just Doc in some small hole in the wall and actually TREAT my patients instead of consult for everything (another cause for rising health care costs used to be for reciprocity but now mostly needed for legal reasons). Now a Family Practice doctor can still do surgery (the MD degree says Medicine and Surgery) but he won't be board certified. The first time there was a complication it wouldn't matter if the FP had 10,000 great outcomes for that appendectomy he would lose the lawsuit because he wasn't "board certified".

If I do Surgery I can still be that old timey, do everything doctor like I origionally wanted to do. So, I will not only be a Surgeon, but also a Primary Care doctor. Since Surgeons handle normal every day problems for their surgery patients it leaves less room for a Surgeon to get sued treating Diabetes than for a FP to get sued doing appendectomys.

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Rip,
sure you will do great and be a great asset no matter what your speciality is... lawyers-most don't really make the big bucks, some do, most don't... the world of business does provide a lot of $$$ potential with very few risks compared to medicine... you're making me think being a poor old teacher may not be so bad after all-lo... do have a lot of respect for someone able to endure the rigors of medical school, a real accomplishment, now for the zinger, is med school front end loaded, very-very tough entrance criteria making less likely not completing... the filtering is in place so those who get in must be worthy and thus complete the program, a lower rate of dropout than in some other high level education programs, kind of a question.... remember talking to my cousin about med school, he also has a phd in bio-chemistry, he said the phd program more difficult, not in time, but over-all, course maybe he just wanted me to feel good... he graduated number 1 in his class in med school, etc... but would never tell anyone that, very non-pretentious and did not do it for the $$$, married a girl worth many-many-many millions, guess a benefit of being an md, teachers only get to meet poor girls... once again, congrats. on completing med school, Dr....

Sheepster

What Rip says sounds legit. It's a long road and a lot of education $'s outlay before you start making money in this field.

If you are a graduating high school senior that wants to be a doctor, you've got college ahead of you, you've got med school ahead of you, you've got residency ahead of you (5 years of low pay and extremely heavy hours). You're 30+, and deep in debt, before you can even think about making any money. Figure on 12 years of hard work before you can even start to benefit from that hard work. It's a long hard road before you can reap any benefits.

I certainly seem to disagree with Rip on political issues (I'm sure we'll continue to disagree) but , I do respect his work ethics and commitment. It's a major commitment, and he's just a little past half-way there (residency coming). I commend him for his commitment (and he's doing it at a much later age, meaning a smaller window of benefit). That's to be commended.

As a matter of fact, it sounds like Rip may be the comitted type of doctor that I'd consider hiring for our practice when he completes his residency. We could go hunting, and minus all the circle trees. I'll need to do some training. My good dogs are all old.

You should know me good enough by now to know I will always be Rip. Nobody has to call me Dr., and I still got 51 more days before I get that title anyway LOL.

It is front end loaded and the drop out rate is low. We started with 60 (not counting those that dropped back to our class from the year above). We will be graduating 54. We lost about 6-8 total and picked up about 2 from the class above when it was all said and done. Only about 4 or 6 were lost to academics/conduct/health.

However, the competition is not over once in. As that web site explained you have to prepare for The Match and that goes on your boards and grades etc. If you want a residency in a competitive field you have to have the scores against the competition of the other doctors to get it.

Match day is tomorrow and I am tickled to death that I matched. Any of the programs I ranked I would be happy with, but my top choice was to stay here at Quillen.

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This thread lost its original start by the end of the first page.LOL I was just curious RIP, if you would be providing FREE services to the uninsured employees of Wally World? It would be a great experience for you and help all of the local tax payers out by reducing the burden on us to help pay for those without insurance. Remember this will be an entry level job for you until you start to make the BIG BUCKS. I guess without your added benefits you would be just like the people at Wally World, just trying to feed the family. I am not trying to be mean I'm just making an observation. With the money Wal-Mart makes they could own the insurance company that would provide their workers with healthcare.

Honalieh, I am truly flattered. Thanks for the kind words.

You said "hire for our practice", what kind of practice are you in? You can PM me if you want.

I do care about my patients and even though I am not truly responsible for them yet I have laid awake many nights thinking about them and if I missed anything about their condition. I honestly try and treat every patient like my mother/father, son/daughter.

I won't always do the right thing, but it won't be from not caring it will be an honest mistake.

You will be surprised to know that many of my very closest friends are the exact opposite of me in political views.

We would get along just as good too. If I am ever up that way I may hit you up for a hunt (if I can ever get away).

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quote:

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Originally posted by moh
This thread lost its original start by the end of the first page.LOL I was just curious RIP, if you would be providing FREE services to the uninsured employees of Wally World? It would be a great experience for you and help all of the local tax payers out by reducing the burden on us to help pay for those without insurance. Remember this will be an entry level job for you until you start to make the BIG BUCKS. I guess without your added benefits you would be just like the people at Wally World, just trying to feed the family. I am not trying to be mean I'm just making an observation. With the money Wal-Mart makes they could own the insurance company that would provide their workers with healthcare.

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boy, maybe I should institute a charity for the poor doctors-lo..
it is a long-long haul, tough road that should have reward at the end... my cousin, plastic surgeon has been very-very-very successful financially, now he only practices on a limited basis, but all pro bono, sure many others do the same... has to be very tough dealing with life-death on a daily basis... great that a person who is compassionate-empathetic such as Rip has earned the opportunity to practice medicine...
Rip, appreciate your thoughts about the study to be published today in the New Enbgland Journal of Medicine, done by Rand Health Research Institute about the medicore health care in the U.S.... study of about 7,000, actually 6,712, it is random sample conducted over two years in only very large metropolitian areas, indicates care provided is consistent based upon race-income-gender-age etc... attempts to measure standard of care provided for 439 common chronic-acute conditions, overall the results indicate 55% of recommended steps for top quality care provided, some variation in defined category measures, but consistency in the overall uniformity of below par care provided, significant gap between care deserved and what was provided... not supporting this research, but wonder from your perspective concerning validity, it is skewed since only large metro areas and not represenatative... greatly appreciate your thoughts, does reflect a national profile, is it different in less metro settings, do people in areas where you have studied-practiced have more care-concern-understanding and provide higher quality of care, on-on... appreciate your thoughts when-if you get time, glad you got a great match, high quality people usually get the same in location matches...

quote:

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Originally posted by Rip
Sheep, do you not understand the meaning of an entry level job?

Those do not come with healthcare benifits because what they do is not worth the cost of providing them. I didn't get healthcare benifits when I worked at McDonalds either. Nor when I hauled hay or cut tobacco, or all the other entry level jobs I had.

Entry level jobs are where you go to learn how to be a good employee and use your track record there as a stepping stone to a better job.

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I didn't say the PEOPLE were not worth health care. Read it again and don't let it be tainted by emotions.

I said the JOB they were doing was not worth providing health care for. Their job is worth the pay they are getting.

I didn't get health care on those jobs either. McDonalds didn't pay a dime for health insurance for me. Hardees didn't pay insurance for my brother. When I worked those entry level jobs I had to buy it myself or be self pay. They can do the same thing. It's not an employers job to be a momma to all it's employees. They have to be self sufficient and provide for themselves. If they want to continue to work at Wal Mart and want better insurance then they can work for it and pay for it themselves. They are free to find another job too. There is this thing called PERSONAL RESPONSIBILITY. If they can't pay themselves they can come to some bad, mean doctor such as myself that will treat them for free.

Entry level jobs are just that, entry level jobs. They are not meant to live your entire life and raise a family on. They are stepping stones to self improvement and better, permanant jobs.

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Doc, after the Match today I will try and check out that study. I have to get ready for that. I can't wait to find out where I am going. All I know now is that I matched, it could have been at any one of the 13 programs that I ranked. I find out at 1pm WHERE I matched at.

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Rip,
good luck in your match session this afternoon.. sure whoever-whatever will be very fortunate to have you coming on board... hope the match and location make you and your family
happy... great to see someone deserving reap the reward of their
labor...

quote:

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Originally posted by Rip
I didn't say the PEOPLE were not worth health care. Read it again and don't let it be tainted by emotions.

I said the JOB they were doing was not worth providing health care for. Their job is worth the pay they are getting.

I didn't get health care on those jobs either. McDonalds didn't pay a dime for health insurance for me. Hardees didn't pay insurance for my brother. When I worked those entry level jobs I had to buy it myself or be self pay. They can do the same thing. It's not an employers job to be a momma to all it's employees. They have to be self sufficient and provide for themselves. If they want to continue to work at Wal Mart and want better insurance then they can work for it and pay for it themselves. They are free to find another job too. There is this thing called PERSONAL RESPONSIBILITY. If they can't pay themselves they can come to some bad, mean doctor such as myself that will treat them for free.

Entry level jobs are just that, entry level jobs. They are not meant to live your entire life and raise a family on. They are stepping stones to self improvement and better, permanant jobs.

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Walmart tax

Here at our local Walmart there is a housing developement going up behind Walmart and and the needed to put a road beside walmart and the only way it passed was to pay walmart extra tax.. Our city tax is 7.35% and we pay a full 8% at walmart just for that housing division. I quit shopping there because of this.

mr. fulton,

you make a valid point... should job type-wage level determine human worth and thus who can-should get adequate health care... understand Rip's position, but do not believe one can measure human-worth dignity based upon employment... some may do to circumstances have to work in fast food-walmart, etc. should this invalidate them as human beings and deny them health care... agree if we only measure from the perspective of employment that health care would be limited to those higher up the wage scale... that is why I believe some national heallth plan is mandated, now not sure how-what-where, just that it gets beyond politics and philosophy and gets done... kudoos to your wife, teaching the greatest of professions, often undervalued-always underpaid... coure this comes from an old teacher...

Well, I got my FIRST CHOICE. I get to stay here at Quillen for my Residency.

Albert, you can try to question my dedication to health care all you want to. Fact is my track record speaks for itself. I have dedicated a lifetime to others and have already done lots of great work for the uninsured, less fortunate even though I MYSELF AM IN THE EXACT SAME BOAT THEY ARE. If I didn't truly care about everyone I wouldn't have went through all I have to get here and I sure wouldn't be doing Rural Surgery with lots of free care.

You are mixing economics with emotions. You have to be objective about things and that's what I am being when I say the JOB isn't worth that. The PEOPLE are, but the JOBS in question don't produce enough to be worth the cost of the employer paying for health insurance. If they did that the employer would LOSE MONEY and then CLOSE THE DOORS and nobody would have a job to have the opportunity to pay their own way. It's not "well I didn't have so they shouldn't have" it's that I have been there, done that, and understand the economic reasons WHY it can't be done.

I understand that if I hire a carpenter to build me some cabinets I can't afford to pay for his health insurance too. I will pay for the job and if he wants health insurance he can obtain that himself. "Forcing" entry level jobs to pay for health insurance is no differnent that forcing me to pay for the insurance of the carpenter I hire.

As I have said numerous times before, if a company CAN afford to pay for health care they should do it out of the goodness of their heart, but they should NEVER be forced to pay for it, that's the same as robbery.

You speak of your wife, and thank God for good biology teachers. However, there are some in her class less fortunate. Would you support FORCING her to buy all of those unfortunate children note books, etc. out of her pay check no matter how much it cost, even if it means she actually has to spend more than she is paid?

I am almost 100% positive she has done so out of the goodness of her heart, but she should NEVER be forced to. Same for anybody else, whether they are a teacher or own a business.

That's not even including the fact that people should be responsible FOR THEMSELVES. If they want to waste their money on cigarettes it's their business. Many of the uninsured would have enough money to pay for it if they used the money they spent every day on cigarettes on insurance. However, it's their choice, and their responsibility to make those decisions, not the government or some business.

Anyway, lots of things going on today, need to go. Just wanted to share the excitement of getting to stay here with Doc and got sidetracked LOL.

Doc I'll get on that research sometime today or tomorrow. I have other engagements etc for today.

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[QUOTE]Originally posted by sheepster
No, I'd call it "FACTS". Whether you like it or not. But you call it whatever you want to Jim if it makes you feel better. [/QUOTEI AGREE SHEEP IF IT WASNT FOR OUR GREAT GRANDADDYS AND GRANDADDYS FIGHTING FOR THE UNION NO ONE WOULD MAKE THE MONEY THEY EVEN MAKE TODAY NOT TO CAUSE ENEMYS BUT IM UNION TILL THE DAY I DIE I OWE THAT TO MY GREAT GRANDADDY WHO WAS ALOT SMARTER MAN THAN I AM AND TO PROVE IT HE PREDICTED ALL THIS WOULD HAPPEN ON HIS DEATH BED

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Rip,
glad to hear you got the match of your choice, sure you have earned it...your explanations-analogies explain how an employer may not be able to afford health insurance depending upon the $$$ value provided by employees, can't pay more or even as much as they bring to the business in $$$ value.. do believe many businesses today that can afford to provide are in fact not doing so or cutting back in heath insurance and also pension benefits... should we deny the person only able to work at lower wages adequate health care... that is why don't believe it can only be tied to wage earning-employment and a national plan is needed, now should it be insurance- national-state local, private, not sure don't really know, but do know when we can afford to spend billions to provide subsidy to the most affluent that we need to be more inclusive when it comes to health care..
don't lilke to pay taxes, but willing to do so for programs that help the many and not just the fortunate few, a national health policy is one such situation...

Socialism sucks!!!!

I never would have thought that there would be this many socialists on a coon hunting message board. One thing about socialist is that they sure like to tell everybody else how to give their hard earned money away.

This whole issue boils down to main points, economics and freedom.

The economics of the issue are that those particular jobs that do not have health care benefits do not rate them. The simple fact is that those companies do not have to offer those benefits to attract workers to those jobs, thus they do not offer them. By the same token all of those workers are free to gain skills and experience to use to get a job that offers health care. Big bad Wal-mart is not forcing anybody to work, they are simply offering jobs and saying here this is how much we will pay you to do this particular job. Secondly on that subject insurance coverage is not required for medical treatment. In fact it is illegal for a hospital to refuse emergency treatment to anyone regardless of ability to pay. Also the last time I check all hospitals are more than willing to set up generous payment plans to fit any budget, often interest free.

The second point I had alluded to is freedom. What should give you or the government the right to go into a private business and tell them how much they should compensate their workers?

Something no one on the socialist side of this issue has taken into consideration is the sheer number of jobs that a company like Wal-mart supplies. Often times they are providing jobs to people who would other wise be unemployable at most other places. For example you have a large number of high school kids with little to no experience who have jobs there as well as many elderly people who work there after retiring from another job. The fact is that they provide jobs that other wise would not exist and provide a much-needed boost to the overall economy. You fail to take into account what will happen when Wal-Mart is required to pay more benefit cost and thus can not afford to carry as many people on the payroll.

The people advocating that Wal-mart should be forced to provide health care are in my opinion part of the over all problem with this country today. Instead of making people accountable for themselves they feel as though the government and or big corporations should shelter them through out their lives. People need to get off their lazy butts and make their own way in life. If people want a good paying job and health care benefits then they should work hard and or seek some higher education in order to acquire the skills that will acquire them those benefits.

The Constitution does not guarantee every citizen will succeed in life it is simply a document that tries to keep the government off ones back so that they will have the opportunity to thrive based on their hard work, skills or in some cases just plain good luck. Life is not fair, people need to get off their @#$es and deal with what life has given them.

The original article looks like a nice smear piece by the Unions who would like to get their corrupt hands on some more dues.

Rip you are an inteligent young man . Maby you will mellow in your views when you become my age,and see a little bigger picture. Good luck in all that you do.