I've been told since the first day I started working at the Division of Hospital Medicine at @UCSF that my work doesn't bring in $ to cover my salary. It's a narrative of manufactured scarcity, a common tactic in capitalism. The CEO is making $1.85 million plus bonuses.

— Rupa Marya, MD (@DrRupaMarya) November 4, 2022

A Hospitalist’s economic value is in what we *save* the system in terms of quality-driven care and patient throughput (DC/unit time), not in how much we bring in through profees. Because of how the system is structured, you’ll only see our value when we aren’t there.

— Rupa Marya, MD (@DrRupaMarya) November 4, 2022

This sounds a lot like hospitalists fall under David Graeber's thesis in Bullshit Jobs that the more necessary and useful you are the less you're likely to get paid and be valued.

I suspect the ability to track an employees' direct level of productivity also fits into this thesis. One can track the productivity of an Amazon warehouse worker or driver, but it's much more difficult to track the CEOs direct productivity.