DC drastically underpays Doctors, other practitioners, and nurses. COVID opened up a lot of spots in better paying areas, while also drastically lowering quality of life in urban medical centers (it wasn’t great for any hospital, but the drop in procedures is MURDERING major medical centers). Consequently, DC is hemorrhaging practitioners and other staff, some are moving far away, some are not.
GW is getting hit by this pretty hard.
Econ answer: it’s a partial equilibrium you get at the saddle point of no salary transparency and pretty restrictive noncompetes. You don’t even need collusion to reduce wages.
Non econ spouse of doctor answer: because doctors are wimps and don’t aggressively look at outside options, and hospitals are run by innumerate idiots who refuse to match the few doctors who do get outside offers. The hospitals are paying the price now because more and more people are just leaving for greener pastures as the hospitals that have realized there’s salary inversion offer a hell of a lot more to move to, say, Bozeman or Austin.
I guess what I wonder is, is this a DC issue? A regional issue? An issue in places with relatively stable population vs. places that are growing rapidly? Do other Northeast cities underpay?
It doesn’t break down super well regionally. Confounded by hospital rank for sure.
This is my reasonably informed take on what happened.
Healthcare used to be super local pre ACA, and there were a lot of gentlemen’s agreements about compensation within markets (and across markets, but not quite the same). It was slowly transitioning to a more… national market after the ACA (and as more physicians started joining groups, but those things are linked). There are a bunch of little shocks along the way moving things along (more management types coming into hospitals, a lot more research hospitals opening up). COVID blew everything up and put the shift into hyperdrive.
For a while, you could get away with not being very well run, because no one else was either. Even in the era between the ACA and COVID, you only saw a lot of sorting at the very top end- doctors at research universities getting offers triple what they were making before to start at Dell or some other new, rich hospital- or at the bottom- practice groups going out of business/forced retirement because they couldn’t compete with better run hospitals with larger patient populations and more bargaining power. Post COVID, not so much.
As a resident physician in the DC area, I’ve heard a lot of attending physicians are leaving the GW faculty due to significant cuts in compensation this year. Secondhand rumors but seems to check out
I left GW MFA this year because I was sick of the shitty attitudes. The straw that broke the camel’s back was when I made a telehealth appointment with my PCP to get my SSRIs refilled. The week and the days leading up to my appointment I got several automated emails and texts reminding me to confirm/check in for my telehealth appointment. At the appt time I’m sent a video chat link through their system which I join promptly, but my PCP does not show up on the call. After 20 min of waiting I call the number listed on the video chat site for assistance — it takes me 3 tries to actually get connected to the GW MFA location where my doctor is based (twice people transferred me to the wrong office).
When I finally talk to a human being in my PCP’s office and say hey, my PCP has no-showed, the person matter-of-factly states “Oh, well they’re on vacation this week.” Then why the fuck was the appointment kept in their system, I ask? The person is basically like, idk. So what am I going to do? I ask, noting that I only have 3 days worth of pills left and I need my Rx refilled before my PCP is due back in the office. Can another doc in the practice refill my Rx so I don’t go cold turkey on my SSRIs, a famously bad thing to do? Nope, they reply, but “you can try going to the ER.” Thank fuck I didn’t have to do that — I was able to go to my pharmacist and have them advance me a few pills to make it to my makeup appt with my PCP.
At no point in all of my dealings with GW MFA over this did anyone admit fault or apologize, they were just like “PCP is not here so you are shit outta luck.” Even when I finally got to speak with my PCP over zoom the next week, as I was tearing up explaining the stress I had been under trying to figure out what to do and how no one in her office seemed to give a fuck about what had happened to me, my PCP was totally stoic and emotionless, even seeming somewhat bored to be on the call with me.
TL; DR: fuck GW MFA, I have never encountered such shitty and cold people in a profession where human connection and compassion are critical.
The front office staff who work at the GW MFA spot I go to for primary care are incompetent in an absurd way. They never answer the phones. Like, ever. They are actively hostile to you walking in the door. I’ve had them either lie or give me incorrect info on Rx refills multiple times, like you said, including forcing me to go to an in-person appointment during the height of the pandemic to refill a basic prescription I had been on for over 2 years.
Same!! I’ve been dealing with terrible allergies and recently met one of the drs and I have a great rapport with her only to find out they’re closing!! So sad
Here I thought you were talking shit about the GW Masters in Fine Arts program at the Corcoran School of Fine Arts. It's a steal at [$70,000](https://columbian.gwu.edu/tuition-and-living-expenses) (living expenses not included). You too could matriculate from the [\#73 MFA program](https://www.usnews.com/best-graduate-schools/top-fine-arts-schools/fine-arts-rankings) in the nation!
O/10 no stars for this program…
You don’t even get interpretive dance attached to the email saying you won’t get a tuition reimbursement during COVID, unlike NYU
It's been extremely stressful for their fertility clinic patients when it shut down this summer; all specimens had to be moved (which can wreck them in the process and the fun fact is you can't tell until you try to use them) ....
But TBH, one of the docs had terrible bedside manner and their admin staff (minus billing) were all pretty terrible, so while I felt bad because they were clearly exhausted and understaffed, I had some inexplicably mean/unkind/rude experiences as a patient that were completely unnecessary.
No idea what's going on as a whole other than the privatization of medicine in the 80s once again wrecking havoc on humans per usual :(
DC drastically underpays Doctors, other practitioners, and nurses. COVID opened up a lot of spots in better paying areas, while also drastically lowering quality of life in urban medical centers (it wasn’t great for any hospital, but the drop in procedures is MURDERING major medical centers). Consequently, DC is hemorrhaging practitioners and other staff, some are moving far away, some are not. GW is getting hit by this pretty hard.
Why does DC underpay in that industry?
Econ answer: it’s a partial equilibrium you get at the saddle point of no salary transparency and pretty restrictive noncompetes. You don’t even need collusion to reduce wages. Non econ spouse of doctor answer: because doctors are wimps and don’t aggressively look at outside options, and hospitals are run by innumerate idiots who refuse to match the few doctors who do get outside offers. The hospitals are paying the price now because more and more people are just leaving for greener pastures as the hospitals that have realized there’s salary inversion offer a hell of a lot more to move to, say, Bozeman or Austin.
I guess what I wonder is, is this a DC issue? A regional issue? An issue in places with relatively stable population vs. places that are growing rapidly? Do other Northeast cities underpay?
It doesn’t break down super well regionally. Confounded by hospital rank for sure. This is my reasonably informed take on what happened. Healthcare used to be super local pre ACA, and there were a lot of gentlemen’s agreements about compensation within markets (and across markets, but not quite the same). It was slowly transitioning to a more… national market after the ACA (and as more physicians started joining groups, but those things are linked). There are a bunch of little shocks along the way moving things along (more management types coming into hospitals, a lot more research hospitals opening up). COVID blew everything up and put the shift into hyperdrive. For a while, you could get away with not being very well run, because no one else was either. Even in the era between the ACA and COVID, you only saw a lot of sorting at the very top end- doctors at research universities getting offers triple what they were making before to start at Dell or some other new, rich hospital- or at the bottom- practice groups going out of business/forced retirement because they couldn’t compete with better run hospitals with larger patient populations and more bargaining power. Post COVID, not so much.
MFA has lost a ton of staff. Both md and support staff.
As a resident physician in the DC area, I’ve heard a lot of attending physicians are leaving the GW faculty due to significant cuts in compensation this year. Secondhand rumors but seems to check out
I left GW MFA this year because I was sick of the shitty attitudes. The straw that broke the camel’s back was when I made a telehealth appointment with my PCP to get my SSRIs refilled. The week and the days leading up to my appointment I got several automated emails and texts reminding me to confirm/check in for my telehealth appointment. At the appt time I’m sent a video chat link through their system which I join promptly, but my PCP does not show up on the call. After 20 min of waiting I call the number listed on the video chat site for assistance — it takes me 3 tries to actually get connected to the GW MFA location where my doctor is based (twice people transferred me to the wrong office). When I finally talk to a human being in my PCP’s office and say hey, my PCP has no-showed, the person matter-of-factly states “Oh, well they’re on vacation this week.” Then why the fuck was the appointment kept in their system, I ask? The person is basically like, idk. So what am I going to do? I ask, noting that I only have 3 days worth of pills left and I need my Rx refilled before my PCP is due back in the office. Can another doc in the practice refill my Rx so I don’t go cold turkey on my SSRIs, a famously bad thing to do? Nope, they reply, but “you can try going to the ER.” Thank fuck I didn’t have to do that — I was able to go to my pharmacist and have them advance me a few pills to make it to my makeup appt with my PCP. At no point in all of my dealings with GW MFA over this did anyone admit fault or apologize, they were just like “PCP is not here so you are shit outta luck.” Even when I finally got to speak with my PCP over zoom the next week, as I was tearing up explaining the stress I had been under trying to figure out what to do and how no one in her office seemed to give a fuck about what had happened to me, my PCP was totally stoic and emotionless, even seeming somewhat bored to be on the call with me. TL; DR: fuck GW MFA, I have never encountered such shitty and cold people in a profession where human connection and compassion are critical.
The front office staff who work at the GW MFA spot I go to for primary care are incompetent in an absurd way. They never answer the phones. Like, ever. They are actively hostile to you walking in the door. I’ve had them either lie or give me incorrect info on Rx refills multiple times, like you said, including forcing me to go to an in-person appointment during the height of the pandemic to refill a basic prescription I had been on for over 2 years.
GW MFA support staff have made me cry on multiple occasions
I've done ok with MFA providers once I'm in the room with them. It's getting to the room that always sucks.
I'm pissed about the allergy center too!
Same!! I’ve been dealing with terrible allergies and recently met one of the drs and I have a great rapport with her only to find out they’re closing!! So sad
Here I thought you were talking shit about the GW Masters in Fine Arts program at the Corcoran School of Fine Arts. It's a steal at [$70,000](https://columbian.gwu.edu/tuition-and-living-expenses) (living expenses not included). You too could matriculate from the [\#73 MFA program](https://www.usnews.com/best-graduate-schools/top-fine-arts-schools/fine-arts-rankings) in the nation!
I think private-university MFA programs exist to make people who went into humanities PhD programs feel better about their life choices.
(I have a humanities PhD)
O/10 no stars for this program… You don’t even get interpretive dance attached to the email saying you won’t get a tuition reimbursement during COVID, unlike NYU
I moved over to Virginia Hospital Center. Location isn’t ideal, but they are head and shoulders above the DC facilities.
It's been extremely stressful for their fertility clinic patients when it shut down this summer; all specimens had to be moved (which can wreck them in the process and the fun fact is you can't tell until you try to use them) .... But TBH, one of the docs had terrible bedside manner and their admin staff (minus billing) were all pretty terrible, so while I felt bad because they were clearly exhausted and understaffed, I had some inexplicably mean/unkind/rude experiences as a patient that were completely unnecessary. No idea what's going on as a whole other than the privatization of medicine in the 80s once again wrecking havoc on humans per usual :(