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Comment by planet-and-halo | Hacker News Reader

This is very reductive and I assume means you've never worked somewhere with an actually decent culture. I understand your cynicism: there are indeed a lot of bullshitters out there. But there are some good places to work here and there, places where the bosses listen and respect the humanity and autonomy of the people around them. Frequently this occurs at a local level rather than across an entire company, but it does happen. (Note: I'm not saying it's an excuse to underpay people, I'm saying this can be an issue entirely independent of pay.)

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I have worked for places with amazing culture and benefits. I still left and went somewhere else for a 50% pay increase. At the end of the day I look at the extra amount I am saving and what it does to my retirement account. The place I left to was by no means horrible but was not at the same level in terms of culture/vacation.

Also I did end up returning to that company after 4 years and was able to get an even bigger raise upon my return. As always the best way to increase your pay is by leaving, so sad to be honest.

It's one thing to move from amazing to not bad for 50% more pay. It's another to move from a good work culture to one that abuses your off time, expects you never to take time off, or forces frequent overtime.

I just recently moved from a place with very good culture and benefits to a contracting company with much worse benefits. Just going from five weeks vacation to two weeks alone really stings. And my pay only went up 10% ... it wasn't only the money, it was because I wanted something new, but I still have a growing sense of regret.

Why don't you go ask for your old job back? Worst case they say no.

I would say that money is more than just personal pay. It’s paying for enough personnel that people aren’t overworked, and can safely take a day or two off if they need it for mental health. Its in paying for the items and tools and spaces to make the job easier/less stressful for the employees, instead of nickel and diming. I agree that there are culture people who aren’t just bullshitters out there, but a lot of that comes in them being able to argue upward to the top brass for the resources the employees need to be comfortable enough for a good work culture to take place. There are other things a good culture person has to do of course, but as always resources are so foundational that its hard for other things to matter if money isn’t taken care of first.

In the case of hospitals, it’s almost always the top brass’s lack of willingness to hire more people that causes the greatest pressure of culture. Without a person willing to argue that the admins should be paid less so that each individual doctor has more time for each patient, the culture will remain toxic due to the stress that causes the doctors.

Modern healthcare requires administrators to deal with finance, facilities, IT, compliance, HR, etc. Most hospitals can probably trim a little admin waste but it's not going to solve the fundamental systemic problems. In nonprofit hospitals that take a lot of uninsured and Medicare / Medicaid patients there's still going to be a lack of revenue no matter how they slice the pie. Real solutions will require realigning incentives at the state and federal government levels.

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