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yet another Microsoft blogger

# Sunday, March 28, 2004

San Francisco's got problems

As if this was a shocker, SFgate has an article on the city payroll.

San Francisco General Hospital police Sgt. Eric Cranston, who earned a $63,715 base salary last year, added $126,644 by working 2,556 extra hours. Anene Ugbaja, a security officer at the hospital earning a $56,979 base, worked 2,930 overtime hours for $122,126 in time-and-a-half pay.

I find this unbelievable. Why? Cause my wife is a Resident and employed by the State of California and the City of San Francisco. She gets paid a ridiculously low salary (far far less than the security officer's base pay) and works on average 80 hours a week. In fact, the federal government had to step in and mandate that any hospital that has residents working greater than an average of 80 hours per week would be in violation (yes that means she can work 90 hours one week, 70 the next, etc and still pass). So, she doesn't get overtime pay even though the city pays her based on an hourly rate of 40 hours per week (M-F 9-5). So, every hour that she is required by her program to work she is effectively not getting paid.

Oh, and did I mention, she works in a profession where the life of a patient is in her care? I really don't understand how a society that values the lives of it's individuals so much can afford to treat residents like this. Meanwhile, the security officer at SF general is earning quite a nice living on my dime.

I could go on about how Residents in this country are screwed each and every day. Not only are they usually carrying about $200,000 in debt, they typically can't pay off that debt till after their 3-6 year residencies where they get paid less than most any other municipal employee (and way less than nurses). They are essentially carrying this royally screwed up health care system forward and paying for the millions of uninsured Americans (the burden almost always falls on them).

 

Sunday, March 28, 2004 1:34:47 PM (Pacific Daylight Time, UTC-07:00)
"I really don't understand how a society that values the lives of it's individuals so much can afford to treat residents like this. Meanwhile, the security officer at SF general is earning quite a nice living on my dime."

That's the definition of a free market economy. Residents choose to be residents - we don't live in a planned economy where someone high up says "Da! You vill be a Resident."

I'm not saying Residents are paid fairly - they're not. But much like college tuition prices (which has already reached $160k for 4 years at places like Stanford), these things are set by the -market-. The far worse solution would be legislation.

An interesting thought: There are nurses unions... I wonder why there aren't resident or doctors unions.
Sunday, March 28, 2004 5:56:52 PM (Pacific Daylight Time, UTC-07:00)
That's not true. If you want to be an MD in this country you have to go through residency. The Govermment sets their salaries, so there is no motivation of any program to offer them a dime more. And of course, this is not true for any other aspect of the Health Care system. So it's in no way a free market system when uncle same is doling out their pay and passing the $$ on to the hospital to then pay the residents.
Sunday, March 28, 2004 6:02:39 PM (Pacific Daylight Time, UTC-07:00)
Hey, the remember me feature doesn't work. I guess I'm not memorable.

I wasn't aware that the Government sets the salaries. Now that's just totally broken then. :(
Monday, March 29, 2004 1:38:41 AM (Pacific Daylight Time, UTC-07:00)
Even if the government doesn't set their salaries, there's a societal interest in the standard of care given that we're talking about life-critical systems. Since you must be a resident in order to become a doctor, so you have (effectively) market manipulation by the hospitals. And since resident decision making can have a life-or-death impact on patients - patients who often don't get to participate in the decision-making, not even at the point of choosing a hospital or insurance provider - residents and doctors both should be able to say "no" to any extended non-emergency hours without fear of retaliation.

The proper free-market response of an understaffed hospital isn't to simply try to use whatever legal loopholes are available to work its existing staff harder for no more pay. It's not to lobby to import cheap labor from elsewhere, either. It's to try to lure more people and raise the incentives involved. Simple supply and demand: The supply of doctoring/residenting/nursing is scarce, demand is high, so doctoring/residenting/nursing get more expensive.

Oh, and I find the overtime numbers very hard to believe. (Not your quoting of them, Omar, but the numbers themselves.) The standard back-of-the-envelope work year is 2000 hours. 3000 hours of overtime means someone claimed to work around 5000 hours that year. That's 208 24-hour days, or 45 weeks of 16-hour days, 7 days per week. (About the only people I can imagine with a schedule like that are medical residents...)
Monday, March 29, 2004 2:56:40 AM (Pacific Daylight Time, UTC-07:00)
Yeah, who knows if the reporter did any fact checking or these people are just scamming the city... either way, it's beyond repair in any one's 4 year term...
Tuesday, April 06, 2004 12:17:03 PM (Pacific Daylight Time, UTC-07:00)
But she gets Adobe Photoshop at a discount, so it all works out in the end...
Tuesday, April 06, 2004 5:55:18 PM (Pacific Daylight Time, UTC-07:00)
LOL
Omar Shahine
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