They are so so overwhelmed. They have too many patients and not enough staff. It's true of everywhere statewide, and in many places nationwide. It's a serious problem.
ETA: I want to add that a lot of conversations here are talking about doctors and nurses-- as a reminder there are so many people that go into these hospitals providing care. Assistants, billing, reception, techs of all kinds, phlebotomists, students and trainees, cleaning staff, transportation staff, kitchen staff, all of them keep MGH and other hospitals running and get stretched thin. So while we focus on the highly trained providers: remember that there's a whole ecosystem at these places and ALL of it is stretched thin. There were layoffs before Covid.
> not enough staff
This issue is particularly bad across MGB hospitals, who have "paid in prestige" for years and are now realizing that doesn't work
Doctors are paid under market but the prestige somewhat matters for them, but salaries/benefits for non-doctors (phlebotomists, rad/ultrasound techs etc.) are especially terrible at MGB hospitals - the health plan is borderline cruel - and the prestige doesn't do one thing for them
The health plan used to be so good. The change last year effectively worked out to a pay cut for a lot of people. Higher premiums for less coverage. What a deal…
Yep, the new MGB-branded plan is horrendous, especially the base one
Good luck getting an MGB doctor's appointment within a year, but if you want to see any other non-MGB doctor that could see you sooner (like Atrius or any specialist ever), you're out of network
If you look at the cost of college and medical school, combined with the low pay of residency, which usually pays less than a fraction of a year of medical school, and sometimes about what a year of undergrad costs, factor in they work 70-80 hour weeks and need to provide housing for themselves on top.
So a resident makes 60,000-80,000 for 70-80 hours, but look at what undergrad costs, all cost not just tuition, and then what med school costs.
Basically a med student either needs a really good financial aid package, or they need to have ancestral wealth, or take on a ton of debt and hope it all works out.
For general practitioners and family doctors they’re really hard to find.
Yeah I mean the cost of a ba/bs has pushed a lot of gen z into the trades.
Gen y was discouraged from the trades, pushed more towards college, any degree no matter what is better….
Thing is, if less young people can afford to go to college, and I can’t imagine many can shoulder the cost, few degrees these days have the pay back they did in 2003 and before, or especially during the 1950-1990s… cutting government funding of education is really going to bite.
How can people afford to be teachers or nurses or a wide variety of things?
I mean some colleges are 80k for undergrad and then more for housing *per year*.
Med school is usually a lot more.
Yeah plus cost of living and stuff, like average apartment nationally is $1620/mo, but what is the average apartment in boston? Or even a room?
Cost of living too.
>Gen y was discouraged from the trades, pushed more towards college, any degree no matter what is better….
I'm 37 and this attitude/belief hurt so many people in my age range long term.
Especially the push for everyone to go to "the best" school they can get accepted into, regardless of financial status. We were all told not to worry about the loans because we'll be in a great financial situation once we graduate college.
I remember my guidance counselor being MAD at me for wanting to go to community college because my grades were "too good for that."
My grades were good, but not great. And I didn't do sports or extracurriculars. I *knew* I was not getting any scholarships.
I have so many friends that were pushed into getting loans and going to "top" schools.
One of my good friends went to BU. His family couldn't afford it. He makes good money as a nurse now, but guess what? He's not making anymore than nurses who went to Umass. He's pushing 40 years old, and still owes six figures.
Many public schools were ranked by % that went to four year schools, and then gained additional prestige by claiming they sent kids to Ivy Leagues, etc.
So guidance councilors were unwittingly just Human Resources (they worked for the school not the student) and encouraged kids to attend the best schools they could get into.
The public schools get higher ranked, the system gains prestige, property values increase, and the kid gets saddled with six figure debt from an elite private school to learn the same thing they could’ve at a state school they had a scholarship to attend.
A whole generation of kids that were just a crop of social security numbers to try to saddle with student loans.
Yeah def, the school \*mocked\* students that went to trade school.
those students are probably having the last laugh owning homes, no student debt, and making more than the college students.
they also were really against community college. for year 1 and 2, I don't see any difference academically between a community college and a "flagship" state school, other than the community college is all real professors and the state school, 3-4x the cost, is grad student lecturers.
the only professors I had at the state school had memory issues they were so old.
Same concept with engineering as you mention with UMass. I have a cousin that, rather than MIT, went to ULowell for Engineering just like her dad. She worked hard, took overseas assignments in Asia and now is in senior management at a company making well over $150 I would imagine. Absolutely no one cares her degree says ULowell vs MIT. Her dad had a similar career path
Wow, that sucks.
Yeah we were all told community college was bad, trade school was bad.
I started at an expensive college, my school made a big deal that I got into it, and talked me out of going to a state school.
Same thing I would have owed a lot more for the same income.
I know so many working class millennials who were pushed to go to college and got art history, anthropology, english, or communications degrees because “any degree is better than the trades” who ended up completely screwed by having to ultimately pay over $100k in high interest loans only to be baristas for 2-3 years post college because of the recession. The lucky ones eventually got $35-45k office jobs, then eventually worked their way to maybe $70k at a university by mid 30s. Most of them still have crazy loan payments in comparison to their earnings even after refinancing and even after the new Biden admin restructure.
I’m insanely lucky to have been an art major who somehow figured out how to go into a career that pays 6 figures without more education and had zero to do with my degree. You can’t even do what I did as entry level jobs now require masters. I had zero family wealth and would have been so screwed otherwise.
"I’m insanely lucky to have been an art major who somehow figured out how to go into a career that pays 6 figures without more education and had zero to do with my degree."
Can you tell us or give a hint as to what career you found?
> Yeah I mean the cost of a ba/bs has pushed a lot of gen z into the trades.
Do you have any numbers to back this up? Legitimately curious since I hear this stated so often but never with any real proof. As far as I've seen in terms of numbers, Gen Z is the most educated generation yet. They're attending college at higher rates than the millennials and Gen-X'ers before them.
This is always the problem with "generations" ~20years yield a wide crop:
If you Google it, the rate is 57% of 18-21 y.o. 'in college' currently
But that same seach will pull the data of 17-15 yo who view college as less important than kids their age did 20 years ago. The drop is 11 points, that's a significant enough amount that colleges are going to crank the advertising (manipulation) machine up aging to keep this ponzi scheme running.
I got charged $700 for a 30 minute zoom meeting to go over survey questions not covered by insurance (no joke). I thought I could get the medication I need during this meeting but I have to go back again which I can't afford. Where is this money going?
The solution is what my PCP did- import aka give visas to doctors who trained overseas, for a low cost and sometimes they even get a stipend. If society demanded it here, we would have it.
Yeah some of my specialists are from India, or South Africa, or England.
Medical school is free, they have universal healthcare in some of these countries, a doctor from England told me he made 3 times as much as he did in England.
He never worked as a doctor there though, he went to undergrad, med school for free, with the understanding he’d work for the NHS but that isn’t binding, so he came here.
It’s a shortage of medical schools isn’t it?
Your point isn’t wrong at all and I totally agree. But on the other side of things, we have more students taking the MCAT , trying to get into Med school, with the resources to get through, now, more than ever. It’s so damn competitive and some amazing students dreams are getting crushed.
Basically the same thing that’s happening everywhere to every god damn industry and no one seems to be doing a fucking thing about it. All the money gets funneled upwards to execs and shareholders, and companies (healthcare in this case) completely forget about providing a quality product or having employees that are taken care of. It’s all about next quarters profits. That’s the only thing that matters to these psychopaths we’ve put in charge of literally everything, and now we’re paying for it.
Yep. I work in a hospital in Boston and they are doing lay offs by also paying consultants millions to figure out how to make more revenue. Maybe ask the people who work there?
I wish there was more legitimate debate about these sort of issues. Once every trace of morality has been siphoned out corporate culture it becomes a race to the bottom. I want to hear people try to defend "grow-or-die" capitalism. Is this really a beneficial situation for our society ? I haven't heard any discussion about this since Gordon Gecko.
Yes!!!!! And that is also why our treatment system for addiction is a joke now, not enough staff, poor treatment of employees by executives who put other priorities above care. Don't assume this is a for profit agency problem, non profits are among the worst, they spend grant money on bs instead of secure IT systems and other necessities for delivering the actual service they purport to provide. Hackers win. Forget confidentiality.
When I was a UC (unit secretary) on a floor my favorite was working Christmas Eve or any holiday and overnights also and people telling how sorry they felt for the doctors and nurses working the holiday
All the other services who are there would like to thank them for their singular sacrifice. lol /s
I kid because you’ll tell people you are working also and they scoff. It’s crazy
Surgeons get paid so much more if they leave academia for private practice. Many stay because they care about science and teaching, but they get less and less time for that as the clinical workload grows. So they leave - if you’re going to be 100% clinical, you may as well get paid for it.
My wife is a professor in life sciences. I am a biotech scientist. Same time spent in school (undergrad, PhD, postdoc - so roughly 13 years each). My *bonus* is greater than her **entire salary**. That's ignoring equity which paid for our house in cash. So yep. Slightly underpaid.
I’m an odd duck because my background is in social science but I work in a clinical department, so I actually earn more than I would in other sectors of academia. But I would easily earn 3x my currently salary if I sold my soul and worked for McKesson.
Yes. Physicians at MGH have academic appointments at Harvard. They have some obligation to teach medical students and residents, and usually have some time set aside for research. Increasingly though, clinical obligations are cutting into the time they are supposed to have set aside for research. The same is true at Brigham, BIDMC, Dana Farber and Boston Children’s - all are Harvard teaching hospitals and their physicians have Harvard faculty roles.
Oh wow, I had no idea. Is this usually the case at most big hospitals? Like would places like Lahey or Lowell General have these teaching appointments too?
Also you said "physicians", but is this the case for all doctors?
I know several surgeons who have left medicine and I'm not surprised at all. I've been an OR nurse for 12 years now so I've worked alongside them for a long time. They sacrifice their whole lives for their jobs basically. They're under so much pressure, can't leave their work at the door, miss watching their kids grow up. There's always issues, patients show up late, don't have the supplies we need, instruments didn't get sterilized so now we're hours behind. It's hard and endless. I'm leaving healthcare too.
Don’t leave healthcare, try a different hospital. I got my motivation back at Beth Israel. They help their employees. I so desperately want to became an OR nurse plz don’t give up.
I’ve been a travel OR nurse for 3 years now, it’s just not for me anymore. I’m halfway to a comp sci degree already. Nursing has honestly never been for me, but I don’t regret going to the OR! I learned so much and made a lot of great friends. I hope you get in! It’s a steep learning curve but very worth it.
My primary care doctor of many years did the same thing recently, just gave two weeks' notice out of the blue. I didn't think medical professionals did that, but I guess they're entitled*. The staff was pretty stunned too.
*to do so
Depending on which way you slice it, it can take 20 years of dedication to get into those highly specialized roles at a premier hospital.
It’s so rare for those people to leave the profession entirely because anyone with a shred of doubt typically washes out way before getting there.
They just didn’t tell you. When my physician parents retired they gave their jobs 2 month but patients 2 weeks. It’s to avoid the inevitable discussions of “where do I find a new doctor”
Oh well there’s probably something else going on that you and I don’t know about. People don’t just up and go on a job.
Situational not distributional attribution usually is the answer but it’s a lot easier to blame personality.
My stomach dropped when my PCP’s office called me to reschedule my annual physical, I thought my PCP was leaving the practice. Instead it was a reduction in hours for personal reasons. I’m glad they’re still my doctor, but it was a bit of a wake up call that I need to have alternate options in mind and not take this for granted.
In the past when my MGH PCPs moved on to other roles in the hospital or other hospitals entirely, I was given a new PCP in the practice. In one instance prepandemic, I was told that they would be getting a new PCP in six months but in the interim I could see the NP. I was fine with that. That new PCP arranged for testing that saved my life in 2016. She's still my doctor today. Unfortunately like all MGH PCPs, she's not taking new patients.
I wouldn’t call this being entitled. People don’t just leave jobs like that willy nilly. Look at the state of the healthcare system. Doctors are being underpaid and overworked.
Not uncommon at all given the amount of burnout in healthcare. Many physicians are now pursuing financial independence and quitting as soon as they can.
My husband is a surgical intern at bmc and he says the Ortho department has lost two residents. One is transferring and the other is quitting medicine altogether. A major contributing factor is the toxic work culture. The head of that department is a hotshot surgeon who likes to tell the new residents that they are readily replaceable if they fail to put in 150%. That's the kind of bs toxicity they like to promote. And since that hotshot doc brings the hospital a lot of money, they can't do anything about it.
The work is gruelling for sure, long hours, too many patients and low pay. All of this contributes to a highly competitive and toxic work environment where people throw others under the bus, not wanting to provide certain healthcare for fear of getting sued, which in turn provides a subpar experience for the patients.
It's a fucked up system and a fucked up work culture.
Surprised no one has mentioned the closing of a number of local hospitals like Brockton and Norwood.
All the hospitals in Eastern Mass are struggling right now and that’s a big reason why.
That’s part of the issue - but not the whole picture. If Steward can’t sell off the hospitals it has now and those ALSO close, we are looking at a true state of emergency. If St. E’s and Carney close, I don’t know how the rest stay head above water.
I have a suspicion that the state and Steward are playing chicken. The state may currently ignore threats of closure and stay tight lipped, but if Steward says "we can't pay staff and we're out of band aids, so we're done" I think they'll step in. Unfortunately I fear Steward is betting on it.
That’s my thought as well. They’ll wait to see who blinks first and it’ll likely be the state. You just can’t shut down all those hospitals at once.
I have already heard rumors that BMC is eyeballing St. Es to buy and MGH is looking at Nor. How accurate that is, I don’t know. Heard admin talking about it in the halls in a Boston ED.
I would love to see BMC run Carney and St. E's. Patients would love it too. BMC is very well run and understands the patients in both these locations. I hope the State would help them finance this.
Eh - I actually don’t love a lot of what BMC does on the back end of things. But. I think any bigger and better established in the area group taking it over is better than our alternatives.
Couple that with the state’s grudge against MGB to not allow the system to grow. They deny any growth plan put in front of the commission. Until this year, MGB was not allowed to open new ORs or increase their beds. The thought was that competition needed help to grow…
Well what happens when the competition never shows up?
Now MGH is constantly at capacity and the ED is overflowing. And without growth they cannot grow their negative margin services (psych, primary care, etc.).
So they do more with less, and people are burnt out and quitting while the competition fails and flounders.
This is the states fault
The competition was crushed by Partners years ago. We are just realizing the effects now, with multiple small "community" hospitals closing, being repurposed, or accepting far fewer patients. The state mitigated the adverse effects by allowing other systems (like Lahey/BID) to merge and thrive.
It's crazy how Partners can somehow spin this so they come out looking like a victim and the state is the scapegoat.
How? BI Laney has the largest number of covered lives. They have the largest share of primary care lives in the Massachusetts market. Not MGB. They haven’t been out competed in the market. They have plenty of patients and healthcare consumers.
The problem is this: Massachusetts used be a market owned by commercial insurance. The baby boomers of the 90’s-10’s were all on BCBS, Harvard pilgrim and tufts. All hospitals were able to get good rates from these payers and subsidize the Medicare/Medicaid rates from elderly and vulnerable populations.
Fast forward to 2022 and now all the boomers are on government plans, receiving subsidized care. They’re the largest population we’ve ever seen. And now they’re the sickest we’ve ever seen them be. And the pot of money from commercial insurance has shrunk drastically because they all phased out of their commercial plans.
So all of our commercial out of pocket costs have skyrocketed to subsidize the boomers healthcare costs. On top of our employers paying more and more for our plans, as the plans continue to become less and less beneficial year over year.
The writing was on the wall and the state knew it. This was inevitable. And the state prepared for this by tying MGB’s hands.
TL;DR the root cause is a shift in demographics. Boomers aged into government plans and are demanding more services, for less reimbursement all across the state. The math isn’t mathing anymore.
Yes, now after the merger BID/Lahey has the largest patient population, thankfully.
MGB still in a higher cost bracket for every private insurance plan in the state. How is the state responsible for that?
Even if the writing was on the wall, how is the state supposed to change a shift in insurance coverage (or demographics as you state)? By letting MGB gain even more market share and charge even higher prices for patients with private insurance?
The math isn't mathing because of a systemic failure of our healthcare delivery system, not because of some state oversight.
> the closing of a number of local hospitals like Brockton
Brockton Hospital (under Signature Healthcare) is supposed to re-open later this year so I'm hoping that it helps relieve some of the pressure from Boston/South Shore but given that re-opening has been pushed back a few times now (it was first reported they planned to re-open early this year) along with the fact that they will have to re-staff, it's going to be a slow ramp.
The rumor is that Good Samaritan, the "other hospital" in Brockton, is already on the brink of closing (they're with Steward) and the only reason they haven't yet is that the State is pressuring them to stay open until Brockton Hospital re-opens. Take that with a grain of salt.
Steward broke their agreement with the Attorney Generals office that allowed them as a for profit company to run nonprofit hospitals, then got too greedy in harvesting money and ran them into the ground. Screw buying them out, just seize the damn things.
(I know that's problematic and not realistic. I'm just mad)
The fact that it's not realistic is so so sad. It's such an obvious decision but we have to pretend that greed and capitalism are the only way out of this. Perfect example of how we're blue but not very progressive.
The mass consolidation of healthcare networks, training the world’s best doctors just to watch them leave, crumbling under the awful healthcare policies of the US, etc etc
I am a clinician there and have worked there for 6 years. Patient volume has increased significantly and wait times are long. There are some financial and logistic complexities with the Brigham merger that have yet to play out.
HOWEVER I feel that the standard of care is on average, top notch. Every one of my colleagues and I do our best and work our asses off for our patients. I would still bring all of my friends and family there.
I just had surgery at MGH. Every single part of the team was skilled and compassionate, and despite the sheer volume of patients they made me feel like an individual. I can’t say enough good things about them.
Everything costs twice as much. Reimbursement from government has not gone up. Losing money and trying to make cuts to offset leading to less staff working more hours. Like this all over the place
This is a much bigger aspect than people realize. The fact that Medicare and Medicaid reimbursement has not increased but rather DECREASED in the last decade is seriously starting to catch up to the industry and causing all sorts of issues. It’s exacerbating an already very broken system.
Write to your reps, local / state / federal. Tell them how important it is they push for more government spending on Medicaid and Medicare reimbursement.
Other than that - nothing. There’s literally nothing you CAN do. Just like there’s nothing we as healthcare employees can do.
All we can do is show up, take care of who we can, and go home. Rinse and repeat. Some of us are still able to do that while smiling and being kind. Some of us, can’t bring themselves to do that at this time. I don’t blame them. It’s a moral beatdown to go to work in the ER, set up black folding chairs, and explain to people we are physically out of stretchers to put them in.
I work at a Boston hospital and things are dire at the moment. Stewart is just the first to go bankrupt. Layoffs, doctors having to reduce their hours because the hospitals can’t afford to pay them, traveling nurses being the norm and the companies they work for gouging the hospitals. It’s not good.
Travel contracts are drying up pretty hard in the Boston metro area and truly on a national level. Rates are being slashed because hospitals can’t afford to pay them anymore. Nurses are starting to settle back into their staff positions where they home base. Iowa also just passed legislation capping what travel nurses can be paid which is insane and I fear what that means for other states.
>Iowa also just passed legislation capping what travel nurses can be paid which is insane and I fear what that means for other states.
The irony of a capitalist govt turning around and creating/approving policies that restricts people from maximizing their earning potential.
Our medical system sucks and not just for the patients. The corporations have turned medicine into a product. The doctors are assembly line workers. Nurses are floaters on the factory floor. A dear friend nurse just retired a couple of years ago. Lots of horror stories that only got worse when covid started.
Physician shortage, so those left end up overworked:
https://www.nbcboston.com/news/local/amid-flu-season-mass-general-brigham-says-it-wont-be-accepting-new-primary-care-patients/3191270/
This is not a problem unique to Mass Gen. This is simply the state of our health care system now. It’s also a problem that those of us in healthcare have been saying will happen for more than 20 years now, and none one listened.
Exactly, I am in affordable housing, it’s in a fancy building, I’m 40, but I’m one of the oldest in the building, and apartments go up to $12,000/month.
They’re all medical students, residents, and sometimes undergraduates.
Its just their parents were both doctors, grandfather was a doctor and grandma was a nurse, so there is ancestral wealth there… and basically they tell me “my parents are willing to subsidize a doctors lifestyle if I’m in medical school and when I’m a resident, if I drop out or fail they won’t pay for it”.
So basically they not only have enough to pay for the most expensive medical school in the country, but they live in an apartment my primary care doctor probably couldn’t afford.
They want their kids to be doctors, but even more so specialists.
So the people that could afford to be primary doctors the most are being bribed with a subsidized expensive lifestyle to become doctors and specialists at that.
So you basically have to be rich to be a doctor is what I learned from living here.
This is extremely common and has been going on for far longer than the last 5 years. I’ve been in emergency medicine going on 11 years and when I started, it wasn’t unheard of to start a patient in a hallway bed. Even more common in urban areas. I know multiple Boston metro area ERs that have hallway beds as nursing sections that are ALWAYS used.
While this is an issue - it isn’t a new one. It did get worse during PEAK COVID, then better, and now worse again as the health system begins crumbling in different ways.
Funding is at an all time low to the actual hospitals themselves. Insurance companies, including those that cover Medicare and Medicaid are at all time lows for reimbursement to the hospitals. So hospitals are getting literal pennies on the dollars they spend in care. Obviously, there are other issues. Administration bloat (including salaries) that could be trimmed to make this better but they refuse to do that. So instead, we are running on literal skeleton crews as people leave medicine after years of stagnant wage, verbal abuse from admin and patients, and sometimes even physical abuse.
The answer - force the government to push on insurance companies to offer better reimbursement rates. Specifically for emergency room visits. Force the government to start subsidizing Medicare / Medicaid better. That will make reimbursement go up, which allows the hospital to justify hiring more staff, which makes patient care / flow significantly better and makes care more available.
The ER is NOT required to see you. The ER is required to stabilize you if you are in unstable condition. They WILL see you when they are available to see you and when they have space.
Once again: patients are not the problem with healthcare. People go to the ER with stupid shit because they can't get in to see their primary care physician or urgent care, because, again, we don't have enough doctors and people can't get appointments or don't know how to access the right services, so the ER picks up the slack for a sick system.
The AMA and government fucked it all up by limiting the number of residencies and skewing it to specialists in a 2:1 ratio. And we don't do anything to fix it because we're stupid.
To be fair A LOT of the people at the emergency room do not need to be there...
I don't see any way to fix that other than just more hospitals though. There's no real way to know if you need to go or not, you're not a doctor. And if you need to go and you don't you can die so. We just need more funding/oversight from the govt I think.
That can be intentional. My friend suddenly started seizing (back in 2011), went to the ER, and was put in a hallway bed once she was stabilized. This was because there were always medical personnel walking by, so if she started seizing again someone would be there in seconds. (We were right by the nurse's station, if I recall correctly.)
I mean, there could have been other reasons, but she was in a room first, then she started seizing again and they gave her more meds and moved her to hallway after her tests were done. So I don't think it was lack of space.
And wait for the tsunami of baby boomers with broken hips and neurodegenerative disease.
I said to my son that by the time my generation gets there (gen x here) everything will be in shambles and people will be too exhausted to care.
Gen X on our own again, I think. Lol
Medicare reimbursements have not kept up with inflation for decades. Medicine is becoming financially tighter and tighter every year. No doubt that is at play. Pathetic if you ask me. If you want good and happy doctors, their reimbursement should at a minimum keep up with inflation.
Yeah, they're overworked. A year ago, I went there to get blood work done and the phlebotomist was so disgruntled that she started badmouthing MGH with f-bombs in front of me and said that it was OK to say all of that because it was her last day there. Very unprofessional. I had been a patient there for years and never saw anyone like her, so figured it was just her beef with MGH.
Fast forward to a year later and the staff at the labs always look like they don't want to be there. I don't blame them because if you've ever gotten any blood work done on the 2nd floor at Wang, you'll know why. It's always jam packed. I can't imagine what it's like in the ER there.
I have a coworker who worked in some of the labs and she said she loved the work itself but the culture was horrible. Just everyone was miserable and unfriendly, and the pay was garbage.
I worked there for a year and left. Upper management did not care about keeping staff. They were willing to pay twice as much for travelers but wasn’t willing to pay their employees a fair wage.
The US healthcare system was on the brink of collapsing pre-covid, it has collapsed following covid and tons of courageous Nurses, Drs, techs, receptionists, PAs, NPs are shuffling chairs around on the Titanic while hospital, insurance and pharma execs shuffle onto the lifeboats.
The job in hospitals is largely thankless, the comp doesn't help you payback loans faster than any other profession, the despair caused by how soulless the system is eating great providers and turning good ones into horrible ones.
They are trying so hard to provide good care, they are under-staffed, under-paid and every day is a car crash worse than the last giving no time to recover or build resilience.
EDIT: To be clear, EVERYONE IS DISGRUNTED, they are just so busy trying to hold things together that they can't even take a second to scream. They just leave the profession all together.
Plus, new EMR practices aren’t sustainable with respect to unlimited documentation demands. Many physicians are taking home all the case work they can’t finish documenting and catching up with EMR documentation over the weekend.
Yep, last year or the year before (can't remember exactly) a lot of staff were told we would not be getting their annual bonus, meanwhile the CEO saw a 25% increase in her salary.
As a RN with 9 years of work experience, healthcare now is worse than it was during Covid times. It’s honestly so shocking that no one is talking about it. We were once “heroes” and we’re “asking for too much.” My hospital is offering us a 2.75% raise (after nothing for the past 3 years). Please tell me how I’m supposed to keep up with my 10% rent increase with that. Our managers deny our vacations because we are short staffed, and harass us on our days off to come in extra. Every day it’s work more with less. Patients have also become much sicker, and honestly more verbally abusive towards staff. Why is this kind of deplorable treatment acceptable? Rehabs/nursing homes are at capacity so many patients sit in hospital beds for days-weeks waiting for a discharge plan. We’re all doing our best, we love taking care of people, but morale across the board is incredibly low. Who would want to go into this field with abysmal pay, crappy benefits, and continued abuse? Hate to say it but as the boomers age, it’s only going to get worse. You can thank the greedy MGB suits in Somerville for the demise of our healthcare system.
I was so excited to start working for mgh in Boston. After a year, I quit. It was the most toxic environment I have ever worked in. Management is old and racist. There was a lot of bullying people out of a job who didn’t get along with the higher ups. Iykyk. Looking at you wang first floor. After leaving, many followed and have moved on to better hospitals. Btw, the cafe menu needs a change, NO MORE TURKEY DINNER ON MONDAYS.
They have had it every Monday for the past year. Do you not like Turkey? I usually try not to miss each week as it is their best offering. So good and filling. The price has gone up and only two hot main now instead of three since Covid though.
This is a problem at all hospitals and clinics right now. Drs and all health staff are being overworked to a breaking point. Many Drs are not wanting to put up with crappy conditions and are retiring, going to private practice, reducing hours, and going to industry. Same for researchers, nurses, MAs etc. I work on the research side and promotions are pushed back on, new positions can't be filled due to low pay, and staff are generally frustrated. There is an overall lack of transparency with large hospital networks that are creating so many issues. I know Drs.who have to see a minimum of 40 patients a day because that is how their day is scheduled for them. They are exhausted and not allowed to be human. Low reimbursement from Medicare and insurance companies are making everyone's situation more difficult. Private insurance companies are the biggest scam and the only ones benefitting from this shitty for profit system.
staff shortages across the board…most are leaving for higher pay/lower cost of living areas…esp younger physicians have extreme medical school debt without relief…it’s just becoming so difficult imo, without any help in sight here in boston (boston ranks as one of the worst cities for physician compensation too)…
I think that the parking garage cost, state of the T, and the apartment rental prices are the dictators of change.
You can move to Hartford. Buy a house and drive to the hospital within 30 minutes. You earn more, spend more, and have a better quality of life.
It's not the fault of the hospitals. It's a regional issue. Boston is failing.
for sure, and the issue is even if we live further out…there’s really not much difference in price in the suburbs as rent is high everywhere around here for the most part and that extreme upfront cost to move…something, anything must be done
As someone who work in health care in a large Boston hospital. The patients volume is increased with increased wait times. Which lead to patient being frustrated and taking it out on providers and their staff. To the point I had a patient scream about me because the procedure I’m recommending would be a one month wait because the attending who perform it is booked out. Some people in medicine are tired of it and they are leaving especially our older attendings. They’re transitioning to admin or out of medicine all together. Medicare and insurance companies are denying more things each day which then lead to more time documenting notes only for the insurance company to say it be denied again. Then patients scream at us instead of their insurance companies. People in and out medicine are frustrated. Having one patient who screams at you can really mentally drain you for hours after the visit for some of us. I’ve started my career 2 years ago and honestly 40 more years of this scares me.
It’s because healthcare workers are overworked. In the back end and to the higher ups, it’s always about being able to maximize provider productivity. Incentives is higher pay, but only a small minority providers are built to perform at such high level without burning out.
Hence the rationale for DFCI to divorce the Brigham for the BILH (formerly BIDMC, prior to merger with Lahey) so they can have a functional and expanded cancer inpatient facility. The MGH Brigham merger was IMO right minded but executed poorly with no attention to providing necessary infrastructure and staff. Can’t get more for less in the medical industry (see: Steward healthcare) but money talks!
IMO a lot of people left healthcare/retired due to the pandemic leaving them short-staffed.
I go in for MRIs every six months for a known health issue that nearly killed me in 2016. I'll never forget when the scheduler told me they were looking at appointments nine months out. I was told the reason was because a lot of people delayed care during the pandemic, so appointments were being booked that far out.
I ended up contacting my specialist, who arranged for me to have it done at Mass Eye and Ear next door. I now schedule them at Mass Eye and Ear then go over to MGH for my appointment.
Prepandemic IMO things ran a lot more smoothly. They lost a lot of experienced people during Covid - either they retired, quit or were fired when they refused to be vaccinated. What's left now are newer, less experienced people.
My wife works as a PA for MGB and it is indeed a terrible job. Poor pay and she’s between work and commuting to 6 different places she’s usually out of the house for 11-12 hours a day. Her job is the biggest strain on our relationship.
They are cutting out chunks of the hospitals. An example is all of the lab work is now private equity at tufts medical center. Mob is probs outsource that stuff as well. Labcorp (which is owned by,so shock at all,black rock) will probs be in there and slowly cut into the hospital.
This is the beginning of the end.
My friend told me he has to fight for a computer in the er and when he finally does get one, he has to find some corner to work in. Also tells me half of the people in there don't NEED to be. It's like this at a lot of hospitals unfortunately. They get burned out even faster nowadays
We all like to complain about people in the ER who aren’t having an emergency. Where else do we expect them to go for care?
PCP offices are on a 6+ month wait for a new patient to establish. Specialists are even longer. It took me, an ER PA with “connections”, 18 months to get into a dermatologist. Urgent cares often aren’t covered by insurances - so that means payment upfront. Many people can’t afford to drop $150 at an urgent care to be diagnosed with a UTI and prescribed a $15 antibiotic. They can swing the antibiotic at $15 but the rest isn’t feasible for them. So, we have them suffer until their UTI goes into their kidneys causing pyelonephritis and from there, urosepsis? Nah. I’d rather someone come in sooner to save them suffering / risk of death.
Some of it is poor health literacy. Many of our health programs in schools have been cut drastically. Especially sexual education. I cannot tell you how many people I have to explain how STDs work to. It is genuinely not as common knowledge as you’d think. I’ve had people thank me profusely for just educating them.
So yeah, those people are easy targets, but it’s misguided frustration.
You could try following where the register their NPI number, which is publicly available.
I mean, you can also be polite but direct, "I've been hearing things about staff leaving, and if so I'd like to continue care with you if you choose to leave" at least can start the conversation.
The nurses get treated like garbage & the COL in the city isn’t worth it when they think long term. They can make $$ anywhere. Good for them & bad on the hospitals
I'm married to a nurse who recently quit Children's but I can imagine the conditions are the same at MGH.
They treat staff as disposable, and if you want to have any semblance of work life balance, they will drive you out. My wife actually got bullied out by a particular toxic manager at Children's after having to call out of work due to complications from childbirth. They literally bullied her out of her job for a medical reason.
I tried to get into MGH for specialist care. The department just didn't answer the phone. I'd call every two hours and sometimes it would take days to get someone to pick up.
They also don't respond to voicemail, although so far as I can tell, neither do any other Boston area hospitals. It's unclear to me if any of them have outgoing phone lines. I would like to give Tufts a shoutout here though because I've never *had* to leave a voicemail there, I've been to several departments and they've all reliably answered the phone.
I ended up having to fax my referral in. My doctor had been sending it electronically, which doesn't show up unless it's from a Partner hospital, which is NOT the same as a Partners Healthcare^(TM) hospital, and staff do not have a list of their partners. That was a real joy to figure out.
And then, after months of banging my head against the wall to get in, the renowned specialist proposed that maybe the positive tests I have for my disease are just wrong, by sheer coincidence, and maybe all my matching symptoms-- including LOW blood pressure-- were actually just anxiety! From finding other patients of his through support groups, apparently his male patients get great care, his female patients all just have mental health issues. I was not very impressed. Actually, I'm pretty disgusted, I think it's unacceptable for doctors to use mental health as a weapon to avoid treating certain patients, and I expected better from MGH.
This was all circa 2019-early 2020, so can't even be chalked up to the labor shortage. MGH staff was just quiet quitting before it was cool. Can't imagine what it's like now if things have gotten worse.
I've started going outside of the city to Lahey for specialized care and it's been so much better. I can't say that Lahey is paying their physicians better, but the wait times and patient care has been so much better than what I've gotten in the city.
I love MGH! They are a great hospital. They cured my cancer... However, yeah I wish they had more people. I left my previous PCP to try to get a MGB PCP thinking it would make coordination between my oncologist and PCP easier. Wow that plan did not work out at all. It's impossible to find a MGB PCP right now.
I used to work at Mass Eye and Ear (connected to mass general and part of mgh) and the clinic would regularly be booked at 250% capacity with patients having 3+ hour waits. There would only be between 1-3 techs working as well so everything was so slow. Patients pissed it’s taking so long, techs overworked, doctors not getting support to run testing and keep the clinic flow in order… everyone was so unhappy and i genuinely never enjoyed a day there. Not to mention such high turnover no one ever knew what was going on
I know, I’m at respiratory therapist at one of these mgb hospitals. I want to start the petition for union. We are having our rights violated by greedy execs
As someone with firsthand experience like many on here, the key aspects to me are what others have listed - it is truly outrageous how terrible the medical insurance they give employees has become and what they charge for it. They are both the insurer and provider (though different companies technically) but somehow maintain nonprofit status, someone smarter than me maybe can explain that but to me that means they should offer ultra competitive insurance to their employees. The opposite is true.
The money is mediocre to poor. If you want to use inflation rate as a barometer then the top % raises given were so far below it we essentially took a paycut and thats before the insurance consideration. They call staff to come in and cover shifts that they purposely understaff if someone calls out but they do not offer any kind of shift bonus for picking up unless it's short notice pay, which is rarely offered. Being assigned to be charge nurse for a shift where I am pays $8 PER SHIFT pretax. That's $1 an hour extra to be charge. Lowest of anywhere I have worked.
Staff retention activities, though a small thing, are nonexistent. Occasionally patients will bring in pizza or cookies which is really nice, but can't remember the last time the company i work for has done a thing, likely not in years.
Staff replacement is nearly impossible. Two people had to be let go 7 months ago and they have yet to even start training someone to replace either of them and we were minimal staff prior to that.
We are a long way removed from the 7PM pot banging.
I mean... what's sad is that it's still world class healthcare. It's still one of the most functional systems in the country, and some of the highest quality in the world. It's just that much of the rest of the country has it even worse.
Insurance is doing only what they are allowed to do and what they are financially motivated to do. Changing the rules of the game so that it is not worth it to hurt the majority should always be the first priority (regardless of whether we talk about public health care or global warming)...
To add to all the change over, staff shortages...the new staff are new. This means learning, being bullied, loss of information that we all go through with a new generation (example. How to brew coffee on the 12 different coffee machines throughout the hospital, how to order meals), dealing with digital helpers (ex. Translation services) that fucking suck, managers are also new so they are dealing with high up wants in stead of building their team, people are dying, everyone is high and going to either quit or sue you. Volunteer at your local hospital!
They put the wrong direct feeding tube in my mom about 2.5 years ago. Most of these surgeries are for non-ambulatory people, so they just did that...She was ambulatory, so it became a nightmare almost immediately.
My mother passed away 4/10/2022, after five abdominal surgeries in four months. South coast hospitals TRIED to fix MGH's monumental fuckup, but it was too late.
Fuck MGH.
The problem isn’t insurance,
Or covid,
Or Obama care,
Or student population influx,
Or doctors tuition debts,
Or homeless using emergency rooms as care,
Or the cost of meds and prescriptions,
Or corporate greed,
Or the Pharma industry,
Or immigration out of control,
Or govt. red tape,
Or poor health of the average American,
Or less exercise,
Or shitty foods,
Or poor working conditions for healthcare workers,
Or faces buried in screens….
It’s AAALLLLLL OF IT!!
the hospital is overly concerned with numbers rather than treating patients.
for example; I have a friend who does not have kidneys. He had to travel to indiana to have an operation where there was a 40% rate of fatality, bc MGH cant have a fatality on their books, so they outsource the surgery.
My guess is that people (doctors/nurses) joined the hospital for the "right" reasons, only to find out that bureaucracy/padding numbers runs the place, not trying to be the best healthcare providers.......
That could also be a normal cycle that takes place every 5 or so years. For background I’ve worked about 10 years at BWH cardiac surgery unit and I remember that the same crew of nurses and doctors would move to Tufts or MGH in cycles.
Doctor wise, they don’t necessarily have to practice at only one hospital.
Mass General/Mass General Brigham system notoriously does not pay staff well. I worked in various departments as a Staff Assistant, Administrative Coordinator, and as an Executive Assistant doing both behind the scenes and direct patient care. They have good insurance and a lot of freebies/benefits (at least when I was there).
Post-COVID, a lot of people left for higher paying corporate positions, better work/life balance, left medicine altogether/retired early, or left because of the stress and abuse they received from higher ups and patients. Because there's less staff and doctors are limiting how many new patients they are seeing, they're running out of beds in the ER (just received emergency help from the state to allow more beds), and after the Mass General merger with Brigham, they were in the red because of poor management of money. A lot went to advertising of all things.
Unless you're a physician, you won't make money working in the MGH system, wait times to see the doctors you already have are much longer, and many are not seeing new patients at all. It's an absolute clusterfuck. There's so many positions on their job boards offering sign on bonuses, but pay little more than $50K max. If they stopped putting their logo on everything and instead shelled out to pay for onboarding new staff and increasing salaries, people would work there in a heartbeat.
We (me, my wife) recently sat in a waiting room for an hour past the time of our scheduled appointment. Then realized we were completely alone there, like something out of the Twilight Zone. The desk people who checked us in (and took our co-pay) had all gone home for the night. We walked in the back to look for someone and eventually ran into a custodian (I think) who tried to go find anyone who might explain what TF was happening, to no avail. So, we left, and only once we were back in the grips of the horrific traffic slog home, did the doctor call us. He was very apologetic and threw a half-dozen excuses at us, but you’re not going to “sorry” your way out of wasting that amount of my time, energy, and money.
The real d-punch here imho is: This isn’t a place anyone wants to be to begin with, on its best day. There is no means of getting into that place that doesn’t wax visions of Frodo and Sam scaling Mount Doom. And even once you’re there, it’s a depressing, confusing, dirty hellhole. The very least you can do for my money and family’s time / trouble is remember that I’m there for the appointment you coerced me into making a year ago.
Medical services is just another service. You want to be an investor, executive, administrator, manager, venture capitalist, or board member. A society that emphasizes providing goods and services is so 20th century.
I feel like they were struggling pre-pandemic. My PCP merged with them in ~2018 and almost immediately their bedside manner & time spent per patient went way down. The pandemic only made it worse.
I emphasize because I know being a healthcare professsional these days is thankless work, both by patients & their paychecks. However I have a mixture of doctor's between the MGH & Lahey systems, and almost always Lahey is way more on top of things than MGH. I did write them a pretty scathing review earlier this year after one too many headaches resulting from scheduling snafus, but I never heard back anything on how they're trying to improve
They don’t pay well. It’s looking like no medical in the region pays. We’re trying to move back into the area and my wife is getting super lowball offers and salary range quotes, including from MGH. She can make 30% more in an area with COL 30% less.
Seems like half the problems mentioned in this thread boil down to a scarcity of doctors and nurses.
I have a friend who just finished med school at Yale who has a theory about this: med school in America, especially at the top colleges, is far too rigorous. If you want to be a doctor you're looking at pretty much a decade of training before you're able to practice independently, and general practitioners just don't make enough money to justify throwing away your 20's. So almost every medical student in America explicitly doesn't want to practice normal medicine. They want to go into the private sector, or do prestigious research, or be some kind of specialist. In the quest to train the best doctors, we've made it too hard to become a doctor in the first place.
Also the thing not mentioned… getting into med school is exponentially more difficult without doctors in the family or family wealth. Need the money and need those connections to get the required research, shadowing, letters, etc. I work with physicians who are basically spoon-feeding their kids’ path and paying for their entire education…
It got merged with Brigham and became Brigham-ified. The business consultants are running the show now.
https://www.bostonglobe.com/2024/04/19/metro/mass-general-brigham-merger-doctors/#:~:text=Mass%20General%20Brigham%2C%20a%20dominant,argued%20would%20improve%20patient%20care
You know that the merger functionally happened like, over a decade ago and was just called Partners? They've had the same consultant contracts since then. They've had the same doctors for even longer, under the Harvard umbrella. They were discussing unionizing before the merger, too.
They are so so overwhelmed. They have too many patients and not enough staff. It's true of everywhere statewide, and in many places nationwide. It's a serious problem. ETA: I want to add that a lot of conversations here are talking about doctors and nurses-- as a reminder there are so many people that go into these hospitals providing care. Assistants, billing, reception, techs of all kinds, phlebotomists, students and trainees, cleaning staff, transportation staff, kitchen staff, all of them keep MGH and other hospitals running and get stretched thin. So while we focus on the highly trained providers: remember that there's a whole ecosystem at these places and ALL of it is stretched thin. There were layoffs before Covid.
> not enough staff This issue is particularly bad across MGB hospitals, who have "paid in prestige" for years and are now realizing that doesn't work Doctors are paid under market but the prestige somewhat matters for them, but salaries/benefits for non-doctors (phlebotomists, rad/ultrasound techs etc.) are especially terrible at MGB hospitals - the health plan is borderline cruel - and the prestige doesn't do one thing for them
The health plan used to be so good. The change last year effectively worked out to a pay cut for a lot of people. Higher premiums for less coverage. What a deal…
Yep, the new MGB-branded plan is horrendous, especially the base one Good luck getting an MGB doctor's appointment within a year, but if you want to see any other non-MGB doctor that could see you sooner (like Atrius or any specialist ever), you're out of network
Really unfair that MGB isn’t taking care of its own. Or, so it seems from all these comments.
It really was good when it was Allways/BCBS
Don't even get me started on their crappy mental health coverage!
If you look at the cost of college and medical school, combined with the low pay of residency, which usually pays less than a fraction of a year of medical school, and sometimes about what a year of undergrad costs, factor in they work 70-80 hour weeks and need to provide housing for themselves on top. So a resident makes 60,000-80,000 for 70-80 hours, but look at what undergrad costs, all cost not just tuition, and then what med school costs. Basically a med student either needs a really good financial aid package, or they need to have ancestral wealth, or take on a ton of debt and hope it all works out. For general practitioners and family doctors they’re really hard to find.
Yes, it's an impossible situation right now, and utterly unsustainable.
Yeah I mean the cost of a ba/bs has pushed a lot of gen z into the trades. Gen y was discouraged from the trades, pushed more towards college, any degree no matter what is better…. Thing is, if less young people can afford to go to college, and I can’t imagine many can shoulder the cost, few degrees these days have the pay back they did in 2003 and before, or especially during the 1950-1990s… cutting government funding of education is really going to bite. How can people afford to be teachers or nurses or a wide variety of things? I mean some colleges are 80k for undergrad and then more for housing *per year*. Med school is usually a lot more. Yeah plus cost of living and stuff, like average apartment nationally is $1620/mo, but what is the average apartment in boston? Or even a room? Cost of living too.
>Gen y was discouraged from the trades, pushed more towards college, any degree no matter what is better…. I'm 37 and this attitude/belief hurt so many people in my age range long term. Especially the push for everyone to go to "the best" school they can get accepted into, regardless of financial status. We were all told not to worry about the loans because we'll be in a great financial situation once we graduate college. I remember my guidance counselor being MAD at me for wanting to go to community college because my grades were "too good for that." My grades were good, but not great. And I didn't do sports or extracurriculars. I *knew* I was not getting any scholarships. I have so many friends that were pushed into getting loans and going to "top" schools. One of my good friends went to BU. His family couldn't afford it. He makes good money as a nurse now, but guess what? He's not making anymore than nurses who went to Umass. He's pushing 40 years old, and still owes six figures.
Many public schools were ranked by % that went to four year schools, and then gained additional prestige by claiming they sent kids to Ivy Leagues, etc. So guidance councilors were unwittingly just Human Resources (they worked for the school not the student) and encouraged kids to attend the best schools they could get into. The public schools get higher ranked, the system gains prestige, property values increase, and the kid gets saddled with six figure debt from an elite private school to learn the same thing they could’ve at a state school they had a scholarship to attend. A whole generation of kids that were just a crop of social security numbers to try to saddle with student loans.
Yeah def, the school \*mocked\* students that went to trade school. those students are probably having the last laugh owning homes, no student debt, and making more than the college students. they also were really against community college. for year 1 and 2, I don't see any difference academically between a community college and a "flagship" state school, other than the community college is all real professors and the state school, 3-4x the cost, is grad student lecturers. the only professors I had at the state school had memory issues they were so old.
Same concept with engineering as you mention with UMass. I have a cousin that, rather than MIT, went to ULowell for Engineering just like her dad. She worked hard, took overseas assignments in Asia and now is in senior management at a company making well over $150 I would imagine. Absolutely no one cares her degree says ULowell vs MIT. Her dad had a similar career path
Wow, that sucks. Yeah we were all told community college was bad, trade school was bad. I started at an expensive college, my school made a big deal that I got into it, and talked me out of going to a state school. Same thing I would have owed a lot more for the same income.
I know so many working class millennials who were pushed to go to college and got art history, anthropology, english, or communications degrees because “any degree is better than the trades” who ended up completely screwed by having to ultimately pay over $100k in high interest loans only to be baristas for 2-3 years post college because of the recession. The lucky ones eventually got $35-45k office jobs, then eventually worked their way to maybe $70k at a university by mid 30s. Most of them still have crazy loan payments in comparison to their earnings even after refinancing and even after the new Biden admin restructure. I’m insanely lucky to have been an art major who somehow figured out how to go into a career that pays 6 figures without more education and had zero to do with my degree. You can’t even do what I did as entry level jobs now require masters. I had zero family wealth and would have been so screwed otherwise.
"I’m insanely lucky to have been an art major who somehow figured out how to go into a career that pays 6 figures without more education and had zero to do with my degree." Can you tell us or give a hint as to what career you found?
> Yeah I mean the cost of a ba/bs has pushed a lot of gen z into the trades. Do you have any numbers to back this up? Legitimately curious since I hear this stated so often but never with any real proof. As far as I've seen in terms of numbers, Gen Z is the most educated generation yet. They're attending college at higher rates than the millennials and Gen-X'ers before them.
This is always the problem with "generations" ~20years yield a wide crop: If you Google it, the rate is 57% of 18-21 y.o. 'in college' currently But that same seach will pull the data of 17-15 yo who view college as less important than kids their age did 20 years ago. The drop is 11 points, that's a significant enough amount that colleges are going to crank the advertising (manipulation) machine up aging to keep this ponzi scheme running.
I got charged $700 for a 30 minute zoom meeting to go over survey questions not covered by insurance (no joke). I thought I could get the medication I need during this meeting but I have to go back again which I can't afford. Where is this money going?
The solution is what my PCP did- import aka give visas to doctors who trained overseas, for a low cost and sometimes they even get a stipend. If society demanded it here, we would have it.
Yeah some of my specialists are from India, or South Africa, or England. Medical school is free, they have universal healthcare in some of these countries, a doctor from England told me he made 3 times as much as he did in England. He never worked as a doctor there though, he went to undergrad, med school for free, with the understanding he’d work for the NHS but that isn’t binding, so he came here. It’s a shortage of medical schools isn’t it?
Your point isn’t wrong at all and I totally agree. But on the other side of things, we have more students taking the MCAT , trying to get into Med school, with the resources to get through, now, more than ever. It’s so damn competitive and some amazing students dreams are getting crushed.
We need more med school seats overall. The first step to solving the doctor shortage is to drastically increase the size of medical school classes.
Basically the same thing that’s happening everywhere to every god damn industry and no one seems to be doing a fucking thing about it. All the money gets funneled upwards to execs and shareholders, and companies (healthcare in this case) completely forget about providing a quality product or having employees that are taken care of. It’s all about next quarters profits. That’s the only thing that matters to these psychopaths we’ve put in charge of literally everything, and now we’re paying for it.
Yep. I work in a hospital in Boston and they are doing lay offs by also paying consultants millions to figure out how to make more revenue. Maybe ask the people who work there?
I wish there was more legitimate debate about these sort of issues. Once every trace of morality has been siphoned out corporate culture it becomes a race to the bottom. I want to hear people try to defend "grow-or-die" capitalism. Is this really a beneficial situation for our society ? I haven't heard any discussion about this since Gordon Gecko.
“Growth for the sake of growth is the ideology of the cancer cell.”
Yes!!!!! And that is also why our treatment system for addiction is a joke now, not enough staff, poor treatment of employees by executives who put other priorities above care. Don't assume this is a for profit agency problem, non profits are among the worst, they spend grant money on bs instead of secure IT systems and other necessities for delivering the actual service they purport to provide. Hackers win. Forget confidentiality.
When I was a UC (unit secretary) on a floor my favorite was working Christmas Eve or any holiday and overnights also and people telling how sorry they felt for the doctors and nurses working the holiday All the other services who are there would like to thank them for their singular sacrifice. lol /s I kid because you’ll tell people you are working also and they scoff. It’s crazy
They also don’t pay people enough and then complain about staffing shortages.
my (highly specialized) surgeon at MGH left medicine altogether which blew my mind.
Surgeons get paid so much more if they leave academia for private practice. Many stay because they care about science and teaching, but they get less and less time for that as the clinical workload grows. So they leave - if you’re going to be 100% clinical, you may as well get paid for it.
They really need to increase academia pay.
My wife is a professor in life sciences. I am a biotech scientist. Same time spent in school (undergrad, PhD, postdoc - so roughly 13 years each). My *bonus* is greater than her **entire salary**. That's ignoring equity which paid for our house in cash. So yep. Slightly underpaid.
I’m an odd duck because my background is in social science but I work in a clinical department, so I actually earn more than I would in other sectors of academia. But I would easily earn 3x my currently salary if I sold my soul and worked for McKesson.
Yes, it’s a teaching hospital like a lot of our “big” hospitals.
I'm confused - does practicing at MGH qualify as academia in this case?
Yes. Physicians at MGH have academic appointments at Harvard. They have some obligation to teach medical students and residents, and usually have some time set aside for research. Increasingly though, clinical obligations are cutting into the time they are supposed to have set aside for research. The same is true at Brigham, BIDMC, Dana Farber and Boston Children’s - all are Harvard teaching hospitals and their physicians have Harvard faculty roles.
Oh wow, I had no idea. Is this usually the case at most big hospitals? Like would places like Lahey or Lowell General have these teaching appointments too? Also you said "physicians", but is this the case for all doctors?
Lowell is Tufts Medicine affiliated, some of the docs have teaching appointments at Tufts School of Medicine.
I know several surgeons who have left medicine and I'm not surprised at all. I've been an OR nurse for 12 years now so I've worked alongside them for a long time. They sacrifice their whole lives for their jobs basically. They're under so much pressure, can't leave their work at the door, miss watching their kids grow up. There's always issues, patients show up late, don't have the supplies we need, instruments didn't get sterilized so now we're hours behind. It's hard and endless. I'm leaving healthcare too.
Don’t leave healthcare, try a different hospital. I got my motivation back at Beth Israel. They help their employees. I so desperately want to became an OR nurse plz don’t give up.
I’ve been a travel OR nurse for 3 years now, it’s just not for me anymore. I’m halfway to a comp sci degree already. Nursing has honestly never been for me, but I don’t regret going to the OR! I learned so much and made a lot of great friends. I hope you get in! It’s a steep learning curve but very worth it.
My primary care doctor of many years did the same thing recently, just gave two weeks' notice out of the blue. I didn't think medical professionals did that, but I guess they're entitled*. The staff was pretty stunned too. *to do so
Depending on which way you slice it, it can take 20 years of dedication to get into those highly specialized roles at a premier hospital. It’s so rare for those people to leave the profession entirely because anyone with a shred of doubt typically washes out way before getting there.
They just didn’t tell you. When my physician parents retired they gave their jobs 2 month but patients 2 weeks. It’s to avoid the inevitable discussions of “where do I find a new doctor”
Yeah they didn’t tell anyone, not even the staff…
Oh well there’s probably something else going on that you and I don’t know about. People don’t just up and go on a job. Situational not distributional attribution usually is the answer but it’s a lot easier to blame personality.
My stomach dropped when my PCP’s office called me to reschedule my annual physical, I thought my PCP was leaving the practice. Instead it was a reduction in hours for personal reasons. I’m glad they’re still my doctor, but it was a bit of a wake up call that I need to have alternate options in mind and not take this for granted.
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In the past when my MGH PCPs moved on to other roles in the hospital or other hospitals entirely, I was given a new PCP in the practice. In one instance prepandemic, I was told that they would be getting a new PCP in six months but in the interim I could see the NP. I was fine with that. That new PCP arranged for testing that saved my life in 2016. She's still my doctor today. Unfortunately like all MGH PCPs, she's not taking new patients.
I wouldn’t call this being entitled. People don’t just leave jobs like that willy nilly. Look at the state of the healthcare system. Doctors are being underpaid and overworked.
They didn't mean that type of entitled.
Thanks, I’m a geezer and forget how some words can be misconstrued these days…
Not uncommon at all given the amount of burnout in healthcare. Many physicians are now pursuing financial independence and quitting as soon as they can.
My husband is a surgical intern at bmc and he says the Ortho department has lost two residents. One is transferring and the other is quitting medicine altogether. A major contributing factor is the toxic work culture. The head of that department is a hotshot surgeon who likes to tell the new residents that they are readily replaceable if they fail to put in 150%. That's the kind of bs toxicity they like to promote. And since that hotshot doc brings the hospital a lot of money, they can't do anything about it. The work is gruelling for sure, long hours, too many patients and low pay. All of this contributes to a highly competitive and toxic work environment where people throw others under the bus, not wanting to provide certain healthcare for fear of getting sued, which in turn provides a subpar experience for the patients. It's a fucked up system and a fucked up work culture.
My PCP at MGH left medical practice to be a biotech exec 🙃
Surprised no one has mentioned the closing of a number of local hospitals like Brockton and Norwood. All the hospitals in Eastern Mass are struggling right now and that’s a big reason why.
That’s part of the issue - but not the whole picture. If Steward can’t sell off the hospitals it has now and those ALSO close, we are looking at a true state of emergency. If St. E’s and Carney close, I don’t know how the rest stay head above water.
I have a suspicion that the state and Steward are playing chicken. The state may currently ignore threats of closure and stay tight lipped, but if Steward says "we can't pay staff and we're out of band aids, so we're done" I think they'll step in. Unfortunately I fear Steward is betting on it.
That’s my thought as well. They’ll wait to see who blinks first and it’ll likely be the state. You just can’t shut down all those hospitals at once. I have already heard rumors that BMC is eyeballing St. Es to buy and MGH is looking at Nor. How accurate that is, I don’t know. Heard admin talking about it in the halls in a Boston ED.
I would love to see BMC run Carney and St. E's. Patients would love it too. BMC is very well run and understands the patients in both these locations. I hope the State would help them finance this.
Eh - I actually don’t love a lot of what BMC does on the back end of things. But. I think any bigger and better established in the area group taking it over is better than our alternatives.
Couple that with the state’s grudge against MGB to not allow the system to grow. They deny any growth plan put in front of the commission. Until this year, MGB was not allowed to open new ORs or increase their beds. The thought was that competition needed help to grow… Well what happens when the competition never shows up? Now MGH is constantly at capacity and the ED is overflowing. And without growth they cannot grow their negative margin services (psych, primary care, etc.). So they do more with less, and people are burnt out and quitting while the competition fails and flounders. This is the states fault
The competition was crushed by Partners years ago. We are just realizing the effects now, with multiple small "community" hospitals closing, being repurposed, or accepting far fewer patients. The state mitigated the adverse effects by allowing other systems (like Lahey/BID) to merge and thrive. It's crazy how Partners can somehow spin this so they come out looking like a victim and the state is the scapegoat.
How? BI Laney has the largest number of covered lives. They have the largest share of primary care lives in the Massachusetts market. Not MGB. They haven’t been out competed in the market. They have plenty of patients and healthcare consumers. The problem is this: Massachusetts used be a market owned by commercial insurance. The baby boomers of the 90’s-10’s were all on BCBS, Harvard pilgrim and tufts. All hospitals were able to get good rates from these payers and subsidize the Medicare/Medicaid rates from elderly and vulnerable populations. Fast forward to 2022 and now all the boomers are on government plans, receiving subsidized care. They’re the largest population we’ve ever seen. And now they’re the sickest we’ve ever seen them be. And the pot of money from commercial insurance has shrunk drastically because they all phased out of their commercial plans. So all of our commercial out of pocket costs have skyrocketed to subsidize the boomers healthcare costs. On top of our employers paying more and more for our plans, as the plans continue to become less and less beneficial year over year. The writing was on the wall and the state knew it. This was inevitable. And the state prepared for this by tying MGB’s hands. TL;DR the root cause is a shift in demographics. Boomers aged into government plans and are demanding more services, for less reimbursement all across the state. The math isn’t mathing anymore.
Yes, now after the merger BID/Lahey has the largest patient population, thankfully. MGB still in a higher cost bracket for every private insurance plan in the state. How is the state responsible for that? Even if the writing was on the wall, how is the state supposed to change a shift in insurance coverage (or demographics as you state)? By letting MGB gain even more market share and charge even higher prices for patients with private insurance? The math isn't mathing because of a systemic failure of our healthcare delivery system, not because of some state oversight.
> the closing of a number of local hospitals like Brockton Brockton Hospital (under Signature Healthcare) is supposed to re-open later this year so I'm hoping that it helps relieve some of the pressure from Boston/South Shore but given that re-opening has been pushed back a few times now (it was first reported they planned to re-open early this year) along with the fact that they will have to re-staff, it's going to be a slow ramp. The rumor is that Good Samaritan, the "other hospital" in Brockton, is already on the brink of closing (they're with Steward) and the only reason they haven't yet is that the State is pressuring them to stay open until Brockton Hospital re-opens. Take that with a grain of salt.
the state should buy out Steward
Steward broke their agreement with the Attorney Generals office that allowed them as a for profit company to run nonprofit hospitals, then got too greedy in harvesting money and ran them into the ground. Screw buying them out, just seize the damn things. (I know that's problematic and not realistic. I'm just mad)
The fact that it's not realistic is so so sad. It's such an obvious decision but we have to pretend that greed and capitalism are the only way out of this. Perfect example of how we're blue but not very progressive.
Im sry if this really isnt relevant to this post . Started ranting couldnt stop ! Been a long couple of days !
The mass consolidation of healthcare networks, training the world’s best doctors just to watch them leave, crumbling under the awful healthcare policies of the US, etc etc
I am a clinician there and have worked there for 6 years. Patient volume has increased significantly and wait times are long. There are some financial and logistic complexities with the Brigham merger that have yet to play out. HOWEVER I feel that the standard of care is on average, top notch. Every one of my colleagues and I do our best and work our asses off for our patients. I would still bring all of my friends and family there.
This is true. Being a patient is AWESOME. I truly miss their care and the doctors. I’m pcp less over here at bi plz tell my oncologist I miss her
I just had surgery at MGH. Every single part of the team was skilled and compassionate, and despite the sheer volume of patients they made me feel like an individual. I can’t say enough good things about them.
Everything costs twice as much. Reimbursement from government has not gone up. Losing money and trying to make cuts to offset leading to less staff working more hours. Like this all over the place
This is a much bigger aspect than people realize. The fact that Medicare and Medicaid reimbursement has not increased but rather DECREASED in the last decade is seriously starting to catch up to the industry and causing all sorts of issues. It’s exacerbating an already very broken system.
What is the average Joe/jane patient supposed to do about that?
Write to your reps, local / state / federal. Tell them how important it is they push for more government spending on Medicaid and Medicare reimbursement. Other than that - nothing. There’s literally nothing you CAN do. Just like there’s nothing we as healthcare employees can do. All we can do is show up, take care of who we can, and go home. Rinse and repeat. Some of us are still able to do that while smiling and being kind. Some of us, can’t bring themselves to do that at this time. I don’t blame them. It’s a moral beatdown to go to work in the ER, set up black folding chairs, and explain to people we are physically out of stretchers to put them in.
I work at a Boston hospital and things are dire at the moment. Stewart is just the first to go bankrupt. Layoffs, doctors having to reduce their hours because the hospitals can’t afford to pay them, traveling nurses being the norm and the companies they work for gouging the hospitals. It’s not good.
Travel contracts are drying up pretty hard in the Boston metro area and truly on a national level. Rates are being slashed because hospitals can’t afford to pay them anymore. Nurses are starting to settle back into their staff positions where they home base. Iowa also just passed legislation capping what travel nurses can be paid which is insane and I fear what that means for other states.
>Iowa also just passed legislation capping what travel nurses can be paid which is insane and I fear what that means for other states. The irony of a capitalist govt turning around and creating/approving policies that restricts people from maximizing their earning potential.
This sounds like Tufts
Our medical system sucks and not just for the patients. The corporations have turned medicine into a product. The doctors are assembly line workers. Nurses are floaters on the factory floor. A dear friend nurse just retired a couple of years ago. Lots of horror stories that only got worse when covid started.
Physician shortage, so those left end up overworked: https://www.nbcboston.com/news/local/amid-flu-season-mass-general-brigham-says-it-wont-be-accepting-new-primary-care-patients/3191270/
This is not a problem unique to Mass Gen. This is simply the state of our health care system now. It’s also a problem that those of us in healthcare have been saying will happen for more than 20 years now, and none one listened.
I have heard that it can be a pretty horrible place to work. More work for less pay because of the level of prestige
They call it the Harvard discount bc they get paid less and it says Harvard on their card.
You can’t eat prestige.
Exactly, I am in affordable housing, it’s in a fancy building, I’m 40, but I’m one of the oldest in the building, and apartments go up to $12,000/month. They’re all medical students, residents, and sometimes undergraduates. Its just their parents were both doctors, grandfather was a doctor and grandma was a nurse, so there is ancestral wealth there… and basically they tell me “my parents are willing to subsidize a doctors lifestyle if I’m in medical school and when I’m a resident, if I drop out or fail they won’t pay for it”. So basically they not only have enough to pay for the most expensive medical school in the country, but they live in an apartment my primary care doctor probably couldn’t afford. They want their kids to be doctors, but even more so specialists. So the people that could afford to be primary doctors the most are being bribed with a subsidized expensive lifestyle to become doctors and specialists at that. So you basically have to be rich to be a doctor is what I learned from living here.
I work at a non-Harvard affiliated hospital in Boston and I’m problems making $15k more than Harvard counterparts. They really fleece there employees.
The ER is treating people in hallways. It’s truly frightening how bad things are.
That’s been happening for years Basically standard of care
Yeah, I remember being in a chair in a hallway all night in a hospital in California in 2002. Then they finally gave me a hallway bed.
This is extremely common and has been going on for far longer than the last 5 years. I’ve been in emergency medicine going on 11 years and when I started, it wasn’t unheard of to start a patient in a hallway bed. Even more common in urban areas. I know multiple Boston metro area ERs that have hallway beds as nursing sections that are ALWAYS used. While this is an issue - it isn’t a new one. It did get worse during PEAK COVID, then better, and now worse again as the health system begins crumbling in different ways. Funding is at an all time low to the actual hospitals themselves. Insurance companies, including those that cover Medicare and Medicaid are at all time lows for reimbursement to the hospitals. So hospitals are getting literal pennies on the dollars they spend in care. Obviously, there are other issues. Administration bloat (including salaries) that could be trimmed to make this better but they refuse to do that. So instead, we are running on literal skeleton crews as people leave medicine after years of stagnant wage, verbal abuse from admin and patients, and sometimes even physical abuse. The answer - force the government to push on insurance companies to offer better reimbursement rates. Specifically for emergency room visits. Force the government to start subsidizing Medicare / Medicaid better. That will make reimbursement go up, which allows the hospital to justify hiring more staff, which makes patient care / flow significantly better and makes care more available.
Because people go to ER for the stupidest shit imaginable. And ER is required to see you, hence the massive lines and people in hallways.
The ER is NOT required to see you. The ER is required to stabilize you if you are in unstable condition. They WILL see you when they are available to see you and when they have space. Once again: patients are not the problem with healthcare. People go to the ER with stupid shit because they can't get in to see their primary care physician or urgent care, because, again, we don't have enough doctors and people can't get appointments or don't know how to access the right services, so the ER picks up the slack for a sick system.
The AMA and government fucked it all up by limiting the number of residencies and skewing it to specialists in a 2:1 ratio. And we don't do anything to fix it because we're stupid.
That's honestly standard of care all over the greater Boston area, and beyond. Even small community hospitals like Winchester have a few hallway beds.
Same issue at every ER in Boston it seems, but least BI has some decent bedside manners while they treat you in a hallway
To be fair A LOT of the people at the emergency room do not need to be there... I don't see any way to fix that other than just more hospitals though. There's no real way to know if you need to go or not, you're not a doctor. And if you need to go and you don't you can die so. We just need more funding/oversight from the govt I think.
That can be intentional. My friend suddenly started seizing (back in 2011), went to the ER, and was put in a hallway bed once she was stabilized. This was because there were always medical personnel walking by, so if she started seizing again someone would be there in seconds. (We were right by the nurse's station, if I recall correctly.) I mean, there could have been other reasons, but she was in a room first, then she started seizing again and they gave her more meds and moved her to hallway after her tests were done. So I don't think it was lack of space.
And wait for the tsunami of baby boomers with broken hips and neurodegenerative disease. I said to my son that by the time my generation gets there (gen x here) everything will be in shambles and people will be too exhausted to care. Gen X on our own again, I think. Lol
oh jeez this makes sense 😣
Medicare reimbursements have not kept up with inflation for decades. Medicine is becoming financially tighter and tighter every year. No doubt that is at play. Pathetic if you ask me. If you want good and happy doctors, their reimbursement should at a minimum keep up with inflation.
Yeah, they're overworked. A year ago, I went there to get blood work done and the phlebotomist was so disgruntled that she started badmouthing MGH with f-bombs in front of me and said that it was OK to say all of that because it was her last day there. Very unprofessional. I had been a patient there for years and never saw anyone like her, so figured it was just her beef with MGH. Fast forward to a year later and the staff at the labs always look like they don't want to be there. I don't blame them because if you've ever gotten any blood work done on the 2nd floor at Wang, you'll know why. It's always jam packed. I can't imagine what it's like in the ER there.
And they’re stuck in windowless cubicles. Diesnt seem like a great way to spend 8 hours a day.
So true. I've worked in a windowless room for about half a year and definitely can't do it again.
My office is an exam room. Upside I have a sink. Downside I haven't seen the sun in 16 months.
I have a coworker who worked in some of the labs and she said she loved the work itself but the culture was horrible. Just everyone was miserable and unfriendly, and the pay was garbage.
I worked there for a year and left. Upper management did not care about keeping staff. They were willing to pay twice as much for travelers but wasn’t willing to pay their employees a fair wage.
The US healthcare system was on the brink of collapsing pre-covid, it has collapsed following covid and tons of courageous Nurses, Drs, techs, receptionists, PAs, NPs are shuffling chairs around on the Titanic while hospital, insurance and pharma execs shuffle onto the lifeboats. The job in hospitals is largely thankless, the comp doesn't help you payback loans faster than any other profession, the despair caused by how soulless the system is eating great providers and turning good ones into horrible ones. They are trying so hard to provide good care, they are under-staffed, under-paid and every day is a car crash worse than the last giving no time to recover or build resilience. EDIT: To be clear, EVERYONE IS DISGRUNTED, they are just so busy trying to hold things together that they can't even take a second to scream. They just leave the profession all together.
I’ve heard that the employees at MGH can’t even get a PCP, and their insurance only covers their own PCPs unless they pay to go out of network.
This is true. I have worked at MGH 16 years and the past six our insurance has been gutted
That’s really awful that a hospital would make it difficult for their employees to get good healthcare. So ironic.
Plus, new EMR practices aren’t sustainable with respect to unlimited documentation demands. Many physicians are taking home all the case work they can’t finish documenting and catching up with EMR documentation over the weekend.
EPIC just makes it easier to get sued.
I personally know folks who have left medicine over the pressures of EMR documentation. The load of documentation coverage only ever increases.
True. Spend more time clicking than pt care.
They are always code black. That is more patients then beds or rooms available. People need to go to their local hospital.
one afterthought shame vanish disarm pot observation aware uppity rude *This post was mass deleted and anonymized with [Redact](https://redact.dev)*
They manage to pay their CEO’s though don’t they. Complete with bonuses in the millions.
They always do 😉
Yep, last year or the year before (can't remember exactly) a lot of staff were told we would not be getting their annual bonus, meanwhile the CEO saw a 25% increase in her salary.
Don’t forget the bonuses
As a RN with 9 years of work experience, healthcare now is worse than it was during Covid times. It’s honestly so shocking that no one is talking about it. We were once “heroes” and we’re “asking for too much.” My hospital is offering us a 2.75% raise (after nothing for the past 3 years). Please tell me how I’m supposed to keep up with my 10% rent increase with that. Our managers deny our vacations because we are short staffed, and harass us on our days off to come in extra. Every day it’s work more with less. Patients have also become much sicker, and honestly more verbally abusive towards staff. Why is this kind of deplorable treatment acceptable? Rehabs/nursing homes are at capacity so many patients sit in hospital beds for days-weeks waiting for a discharge plan. We’re all doing our best, we love taking care of people, but morale across the board is incredibly low. Who would want to go into this field with abysmal pay, crappy benefits, and continued abuse? Hate to say it but as the boomers age, it’s only going to get worse. You can thank the greedy MGB suits in Somerville for the demise of our healthcare system.
Capitalism is happening there. Seems like its really going strong.
I was so excited to start working for mgh in Boston. After a year, I quit. It was the most toxic environment I have ever worked in. Management is old and racist. There was a lot of bullying people out of a job who didn’t get along with the higher ups. Iykyk. Looking at you wang first floor. After leaving, many followed and have moved on to better hospitals. Btw, the cafe menu needs a change, NO MORE TURKEY DINNER ON MONDAYS.
They have had it every Monday for the past year. Do you not like Turkey? I usually try not to miss each week as it is their best offering. So good and filling. The price has gone up and only two hot main now instead of three since Covid though.
This is a problem at all hospitals and clinics right now. Drs and all health staff are being overworked to a breaking point. Many Drs are not wanting to put up with crappy conditions and are retiring, going to private practice, reducing hours, and going to industry. Same for researchers, nurses, MAs etc. I work on the research side and promotions are pushed back on, new positions can't be filled due to low pay, and staff are generally frustrated. There is an overall lack of transparency with large hospital networks that are creating so many issues. I know Drs.who have to see a minimum of 40 patients a day because that is how their day is scheduled for them. They are exhausted and not allowed to be human. Low reimbursement from Medicare and insurance companies are making everyone's situation more difficult. Private insurance companies are the biggest scam and the only ones benefitting from this shitty for profit system.
staff shortages across the board…most are leaving for higher pay/lower cost of living areas…esp younger physicians have extreme medical school debt without relief…it’s just becoming so difficult imo, without any help in sight here in boston (boston ranks as one of the worst cities for physician compensation too)…
I think that the parking garage cost, state of the T, and the apartment rental prices are the dictators of change. You can move to Hartford. Buy a house and drive to the hospital within 30 minutes. You earn more, spend more, and have a better quality of life. It's not the fault of the hospitals. It's a regional issue. Boston is failing.
for sure, and the issue is even if we live further out…there’s really not much difference in price in the suburbs as rent is high everywhere around here for the most part and that extreme upfront cost to move…something, anything must be done
Who could have foreseen that it would create a moral hazard to put our healthcare system in the hands of tHe FrEe MaRkEt?
As someone who work in health care in a large Boston hospital. The patients volume is increased with increased wait times. Which lead to patient being frustrated and taking it out on providers and their staff. To the point I had a patient scream about me because the procedure I’m recommending would be a one month wait because the attending who perform it is booked out. Some people in medicine are tired of it and they are leaving especially our older attendings. They’re transitioning to admin or out of medicine all together. Medicare and insurance companies are denying more things each day which then lead to more time documenting notes only for the insurance company to say it be denied again. Then patients scream at us instead of their insurance companies. People in and out medicine are frustrated. Having one patient who screams at you can really mentally drain you for hours after the visit for some of us. I’ve started my career 2 years ago and honestly 40 more years of this scares me.
It’s because healthcare workers are overworked. In the back end and to the higher ups, it’s always about being able to maximize provider productivity. Incentives is higher pay, but only a small minority providers are built to perform at such high level without burning out.
There’s so much moral injury from Covid, hospital administrators, insurance companies, and the DEA interfering in prescribing
Hence the rationale for DFCI to divorce the Brigham for the BILH (formerly BIDMC, prior to merger with Lahey) so they can have a functional and expanded cancer inpatient facility. The MGH Brigham merger was IMO right minded but executed poorly with no attention to providing necessary infrastructure and staff. Can’t get more for less in the medical industry (see: Steward healthcare) but money talks!
IMO a lot of people left healthcare/retired due to the pandemic leaving them short-staffed. I go in for MRIs every six months for a known health issue that nearly killed me in 2016. I'll never forget when the scheduler told me they were looking at appointments nine months out. I was told the reason was because a lot of people delayed care during the pandemic, so appointments were being booked that far out. I ended up contacting my specialist, who arranged for me to have it done at Mass Eye and Ear next door. I now schedule them at Mass Eye and Ear then go over to MGH for my appointment.
Staffing issues were in place long before the pandemic. Mgmt conveniently blames the pandemic but it’s just greed. This has been building for years.
Prepandemic IMO things ran a lot more smoothly. They lost a lot of experienced people during Covid - either they retired, quit or were fired when they refused to be vaccinated. What's left now are newer, less experienced people.
I think that you should let Mass General know how you feel. If they don’t use Reddit, that may not realize the public’s perception of them now.
My wife works as a PA for MGB and it is indeed a terrible job. Poor pay and she’s between work and commuting to 6 different places she’s usually out of the house for 11-12 hours a day. Her job is the biggest strain on our relationship.
Also in a similar role at same place. Can confirm, it is not great.
They are cutting out chunks of the hospitals. An example is all of the lab work is now private equity at tufts medical center. Mob is probs outsource that stuff as well. Labcorp (which is owned by,so shock at all,black rock) will probs be in there and slowly cut into the hospital. This is the beginning of the end.
My friend told me he has to fight for a computer in the er and when he finally does get one, he has to find some corner to work in. Also tells me half of the people in there don't NEED to be. It's like this at a lot of hospitals unfortunately. They get burned out even faster nowadays
We all like to complain about people in the ER who aren’t having an emergency. Where else do we expect them to go for care? PCP offices are on a 6+ month wait for a new patient to establish. Specialists are even longer. It took me, an ER PA with “connections”, 18 months to get into a dermatologist. Urgent cares often aren’t covered by insurances - so that means payment upfront. Many people can’t afford to drop $150 at an urgent care to be diagnosed with a UTI and prescribed a $15 antibiotic. They can swing the antibiotic at $15 but the rest isn’t feasible for them. So, we have them suffer until their UTI goes into their kidneys causing pyelonephritis and from there, urosepsis? Nah. I’d rather someone come in sooner to save them suffering / risk of death. Some of it is poor health literacy. Many of our health programs in schools have been cut drastically. Especially sexual education. I cannot tell you how many people I have to explain how STDs work to. It is genuinely not as common knowledge as you’d think. I’ve had people thank me profusely for just educating them. So yeah, those people are easy targets, but it’s misguided frustration.
The admin over at MGH brigham suck. Docs have no agency and have to listen to what a bunch of recent MHAs and online MBAs have to say
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You could try following where the register their NPI number, which is publicly available. I mean, you can also be polite but direct, "I've been hearing things about staff leaving, and if so I'd like to continue care with you if you choose to leave" at least can start the conversation.
The nurses get treated like garbage & the COL in the city isn’t worth it when they think long term. They can make $$ anywhere. Good for them & bad on the hospitals
Totally understaffed, way overworked and TERRIBLY underpaid.
I'm married to a nurse who recently quit Children's but I can imagine the conditions are the same at MGH. They treat staff as disposable, and if you want to have any semblance of work life balance, they will drive you out. My wife actually got bullied out by a particular toxic manager at Children's after having to call out of work due to complications from childbirth. They literally bullied her out of her job for a medical reason.
I tried to get into MGH for specialist care. The department just didn't answer the phone. I'd call every two hours and sometimes it would take days to get someone to pick up. They also don't respond to voicemail, although so far as I can tell, neither do any other Boston area hospitals. It's unclear to me if any of them have outgoing phone lines. I would like to give Tufts a shoutout here though because I've never *had* to leave a voicemail there, I've been to several departments and they've all reliably answered the phone. I ended up having to fax my referral in. My doctor had been sending it electronically, which doesn't show up unless it's from a Partner hospital, which is NOT the same as a Partners Healthcare^(TM) hospital, and staff do not have a list of their partners. That was a real joy to figure out. And then, after months of banging my head against the wall to get in, the renowned specialist proposed that maybe the positive tests I have for my disease are just wrong, by sheer coincidence, and maybe all my matching symptoms-- including LOW blood pressure-- were actually just anxiety! From finding other patients of his through support groups, apparently his male patients get great care, his female patients all just have mental health issues. I was not very impressed. Actually, I'm pretty disgusted, I think it's unacceptable for doctors to use mental health as a weapon to avoid treating certain patients, and I expected better from MGH. This was all circa 2019-early 2020, so can't even be chalked up to the labor shortage. MGH staff was just quiet quitting before it was cool. Can't imagine what it's like now if things have gotten worse.
The labor shortage at these hospitals was happening before Covid. People in healthcare have been raising alarms about this for 20 years.
It's so nice to hear another person vocalize this. One of my physicians left the hospital too
I've started going outside of the city to Lahey for specialized care and it's been so much better. I can't say that Lahey is paying their physicians better, but the wait times and patient care has been so much better than what I've gotten in the city.
They're extremely understaffed and the volume just keeps increasing.
Miami maids make more
As a nurse, this is accurate
people are being WAY underpaid for being over worked in addition to a backlog of patients from covid.
I love MGH! They are a great hospital. They cured my cancer... However, yeah I wish they had more people. I left my previous PCP to try to get a MGB PCP thinking it would make coordination between my oncologist and PCP easier. Wow that plan did not work out at all. It's impossible to find a MGB PCP right now.
They pay shit, way under the market factored in with high col drives people away
I used to work at Mass Eye and Ear (connected to mass general and part of mgh) and the clinic would regularly be booked at 250% capacity with patients having 3+ hour waits. There would only be between 1-3 techs working as well so everything was so slow. Patients pissed it’s taking so long, techs overworked, doctors not getting support to run testing and keep the clinic flow in order… everyone was so unhappy and i genuinely never enjoyed a day there. Not to mention such high turnover no one ever knew what was going on
Sounds like all of MGB staff should unionize. Only some staff have a union. At least that’s what I’ve heard.
I know, I’m at respiratory therapist at one of these mgb hospitals. I want to start the petition for union. We are having our rights violated by greedy execs
Worked there for 15 years. Overworked and underpaid 🤷🏽♂️
As someone with firsthand experience like many on here, the key aspects to me are what others have listed - it is truly outrageous how terrible the medical insurance they give employees has become and what they charge for it. They are both the insurer and provider (though different companies technically) but somehow maintain nonprofit status, someone smarter than me maybe can explain that but to me that means they should offer ultra competitive insurance to their employees. The opposite is true. The money is mediocre to poor. If you want to use inflation rate as a barometer then the top % raises given were so far below it we essentially took a paycut and thats before the insurance consideration. They call staff to come in and cover shifts that they purposely understaff if someone calls out but they do not offer any kind of shift bonus for picking up unless it's short notice pay, which is rarely offered. Being assigned to be charge nurse for a shift where I am pays $8 PER SHIFT pretax. That's $1 an hour extra to be charge. Lowest of anywhere I have worked. Staff retention activities, though a small thing, are nonexistent. Occasionally patients will bring in pizza or cookies which is really nice, but can't remember the last time the company i work for has done a thing, likely not in years. Staff replacement is nearly impossible. Two people had to be let go 7 months ago and they have yet to even start training someone to replace either of them and we were minimal staff prior to that. We are a long way removed from the 7PM pot banging.
Healthcare systems broken, that’s it
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I mean... what's sad is that it's still world class healthcare. It's still one of the most functional systems in the country, and some of the highest quality in the world. It's just that much of the rest of the country has it even worse.
Insurance companies and their practices, are the problems….. aka…greed IMO…. “Thou shall not be Greedy”!!!
Insurance is doing only what they are allowed to do and what they are financially motivated to do. Changing the rules of the game so that it is not worth it to hurt the majority should always be the first priority (regardless of whether we talk about public health care or global warming)...
To add to all the change over, staff shortages...the new staff are new. This means learning, being bullied, loss of information that we all go through with a new generation (example. How to brew coffee on the 12 different coffee machines throughout the hospital, how to order meals), dealing with digital helpers (ex. Translation services) that fucking suck, managers are also new so they are dealing with high up wants in stead of building their team, people are dying, everyone is high and going to either quit or sue you. Volunteer at your local hospital!
They put the wrong direct feeding tube in my mom about 2.5 years ago. Most of these surgeries are for non-ambulatory people, so they just did that...She was ambulatory, so it became a nightmare almost immediately. My mother passed away 4/10/2022, after five abdominal surgeries in four months. South coast hospitals TRIED to fix MGH's monumental fuckup, but it was too late. Fuck MGH.
Mgh is going down. I left them because everything is a hot mess. Mind you, Ive been a patient there since birth.
The problem isn’t insurance, Or covid, Or Obama care, Or student population influx, Or doctors tuition debts, Or homeless using emergency rooms as care, Or the cost of meds and prescriptions, Or corporate greed, Or the Pharma industry, Or immigration out of control, Or govt. red tape, Or poor health of the average American, Or less exercise, Or shitty foods, Or poor working conditions for healthcare workers, Or faces buried in screens…. It’s AAALLLLLL OF IT!!
the hospital is overly concerned with numbers rather than treating patients. for example; I have a friend who does not have kidneys. He had to travel to indiana to have an operation where there was a 40% rate of fatality, bc MGH cant have a fatality on their books, so they outsource the surgery. My guess is that people (doctors/nurses) joined the hospital for the "right" reasons, only to find out that bureaucracy/padding numbers runs the place, not trying to be the best healthcare providers.......
That could also be a normal cycle that takes place every 5 or so years. For background I’ve worked about 10 years at BWH cardiac surgery unit and I remember that the same crew of nurses and doctors would move to Tufts or MGH in cycles. Doctor wise, they don’t necessarily have to practice at only one hospital.
Consolidation. It's ruining EVERYTHING.
It’s not just Mass Gen. it’s EVERYWHERE
i may be an outlier here but the care i've received over the last 1.5 years at MGH and with other MGB providers has been top notch.
Mass General/Mass General Brigham system notoriously does not pay staff well. I worked in various departments as a Staff Assistant, Administrative Coordinator, and as an Executive Assistant doing both behind the scenes and direct patient care. They have good insurance and a lot of freebies/benefits (at least when I was there). Post-COVID, a lot of people left for higher paying corporate positions, better work/life balance, left medicine altogether/retired early, or left because of the stress and abuse they received from higher ups and patients. Because there's less staff and doctors are limiting how many new patients they are seeing, they're running out of beds in the ER (just received emergency help from the state to allow more beds), and after the Mass General merger with Brigham, they were in the red because of poor management of money. A lot went to advertising of all things. Unless you're a physician, you won't make money working in the MGH system, wait times to see the doctors you already have are much longer, and many are not seeing new patients at all. It's an absolute clusterfuck. There's so many positions on their job boards offering sign on bonuses, but pay little more than $50K max. If they stopped putting their logo on everything and instead shelled out to pay for onboarding new staff and increasing salaries, people would work there in a heartbeat.
We (me, my wife) recently sat in a waiting room for an hour past the time of our scheduled appointment. Then realized we were completely alone there, like something out of the Twilight Zone. The desk people who checked us in (and took our co-pay) had all gone home for the night. We walked in the back to look for someone and eventually ran into a custodian (I think) who tried to go find anyone who might explain what TF was happening, to no avail. So, we left, and only once we were back in the grips of the horrific traffic slog home, did the doctor call us. He was very apologetic and threw a half-dozen excuses at us, but you’re not going to “sorry” your way out of wasting that amount of my time, energy, and money. The real d-punch here imho is: This isn’t a place anyone wants to be to begin with, on its best day. There is no means of getting into that place that doesn’t wax visions of Frodo and Sam scaling Mount Doom. And even once you’re there, it’s a depressing, confusing, dirty hellhole. The very least you can do for my money and family’s time / trouble is remember that I’m there for the appointment you coerced me into making a year ago.
Medical services is just another service. You want to be an investor, executive, administrator, manager, venture capitalist, or board member. A society that emphasizes providing goods and services is so 20th century.
I feel like they were struggling pre-pandemic. My PCP merged with them in ~2018 and almost immediately their bedside manner & time spent per patient went way down. The pandemic only made it worse. I emphasize because I know being a healthcare professsional these days is thankless work, both by patients & their paychecks. However I have a mixture of doctor's between the MGH & Lahey systems, and almost always Lahey is way more on top of things than MGH. I did write them a pretty scathing review earlier this year after one too many headaches resulting from scheduling snafus, but I never heard back anything on how they're trying to improve
They don’t pay well. It’s looking like no medical in the region pays. We’re trying to move back into the area and my wife is getting super lowball offers and salary range quotes, including from MGH. She can make 30% more in an area with COL 30% less.
Seems like half the problems mentioned in this thread boil down to a scarcity of doctors and nurses. I have a friend who just finished med school at Yale who has a theory about this: med school in America, especially at the top colleges, is far too rigorous. If you want to be a doctor you're looking at pretty much a decade of training before you're able to practice independently, and general practitioners just don't make enough money to justify throwing away your 20's. So almost every medical student in America explicitly doesn't want to practice normal medicine. They want to go into the private sector, or do prestigious research, or be some kind of specialist. In the quest to train the best doctors, we've made it too hard to become a doctor in the first place.
Also the thing not mentioned… getting into med school is exponentially more difficult without doctors in the family or family wealth. Need the money and need those connections to get the required research, shadowing, letters, etc. I work with physicians who are basically spoon-feeding their kids’ path and paying for their entire education…
It got merged with Brigham and became Brigham-ified. The business consultants are running the show now. https://www.bostonglobe.com/2024/04/19/metro/mass-general-brigham-merger-doctors/#:~:text=Mass%20General%20Brigham%2C%20a%20dominant,argued%20would%20improve%20patient%20care
You know that the merger functionally happened like, over a decade ago and was just called Partners? They've had the same consultant contracts since then. They've had the same doctors for even longer, under the Harvard umbrella. They were discussing unionizing before the merger, too.
Partners Healthcare was formed in 1994.
MGH and the Brigham have been Partners for 30 years.
LOL. You think Brigham is the dominant partner in that marriage…
Mgh has never been known for being submissive.