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Joel Shatzky

Joel Shatzky

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Educating for Democracy: If Doctors Were Treated Like Teachers

Posted: 11/ 2/10 01:10 PM ET

I originally posted a similar column in The Examiner almost a year ago (12/09/2009). I'm afraid, if anything, the situation has become even more dire for the teaching profession in the past year. Mayor Bloomberg's plan to publish the "ratings" of teachers in the press -- on the basis of test scores -- is one more example of the public humiliation many of the best New York City teachers have to endure in the interest of "educational reform. " Perhaps the following article can put this absurd situation into perspective.

If doctors were treated like teachers:

1. "Charter hospitals" could certify "smart people" as qualified to begin practicing medicine without any prior experience in the field if they had had "some business background."
2. Since a "doctor" can "doctor" anything, a cardiologist would be on staff at a hospital in place of a urologist when there was a shortage of urologists. The cardiologist could "learn on the job." Of course, a general practitioner could be used in the place of any specialist since such a doctor would have "general knowledge" of anything involving medicine.
3. Whenever a doctor gave a patient a prescription, the patient's parents could come to the doctor's office demanding he or she change the prescription since the parents "knew better."
4. Because of a shortage of doctors, Mayor Bloomberg would institute a summer "crash course" in medicine for people who had no background in the field but "liked playing doctor" when they were little. Those who got through the six-week course would then be considered qualified to care for the most severely ill patients since no other doctors would want to do the job.
5. Doctors would qualify for "permanent license" if they showed by their rates of patient survival that they were "improving their scores." In order to do so, doctors would only treat the healthiest patients and refuse to treat the sicker ones to keep their rates of successful treatment high.
6. Many "Charter hospitals" would be established in which unlicensed doctors could practice the latest techniques on their patients, using the funds of public hospitals to subsidize them. Of course, only the healthiest patients, whose relatives cared enough about their condition to place them in a charter hospital would be admitted. Any patient exhibiting signs of serious illness would be immediately discharged and placed in a public hospital.
7. The average longevity of a doctor's career would be considered "normal" if he or she practiced for no more than five years.
8. If a hospital proved to have a poor "patient survival record," it would be closed down and three new hospitals would be created in the same building with nothing to do with each other but with three times as many bureaucrats running them.
9. Any patient who entered a doctor's care when already terminally ill would be expected to make a full recovery -- or the doctor would be considered incompetent.
10. A special program -- "Heal for America" -- would recruit students who graduated from the top colleges in the country but with no background in pre-medicine to "try to make a difference" by being placed in the most severely crowded and understaffed clinics and hospitals so they could know "what it feels like" to be a doctor, if only for a few years.
11. The American Medical Association would be condemned by politicians and health "experts" for "protecting incompetent doctors" on the basis of mortality rates in high-risk neighborhoods and the organization would be disbanded as a "menace to public health."

 
 
 
I originally posted a similar column in The Examiner almost a year ago (12/09/2009). I'm afraid, if anything, the situation has become even more dire for the teaching profession in the past year. May...
I originally posted a similar column in The Examiner almost a year ago (12/09/2009). I'm afraid, if anything, the situation has become even more dire for the teaching profession in the past year. May...
 
 
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Skeptical Patriot
08:14 PM on 12/02/2010
If doctors were treated like teachers...

1) They would take summers off and only work 180 days a year
2) They would be able to treat patients after completing an undergraduate education and a standardized tests that is set at 8th grade reading and math competencies (Praxis I)
3) They would achieve tenure after 1-2 years and couldn't be fired
4) They would be able to commit scandalously poor medicine and their union contracts would stop the hospital from firing them
5) Exceptional doctors would be paid exactly the same as the worst doctors
12:14 PM on 12/31/2010
1.) Not true. Teachers take more work home than most professions, and VASTLY more than any job with comparable pay. The 180 6-hour days when they're in front of teachers represent, for many teachers, less than half of the time spent on the job. And because of the low pay, many are forced to get additional jobs during the summer.
2.) True. But to keep their doctor's licenses, they'd be required to continue to go to school, at their own expense, for their entire career, eventually ending up with more education than doctors are currently required to have.
3.) Not true. Tenure usually takes longer than 2 years, and grants only the right to due process. Tenured teachers can be and are fired if they're not doing their jobs.
4.) Not true. See #3.
5.) Sort of true, within one hospital. But doctors in wealthy areas, where people can afford to pay attention to their own health and are educated enough to do so, would be rated as exceptional and paid accordingly. Doctors in impoverished areas would be called "the worst," even if they were actually more knowledgeable and skilled, and paid much less.

Probably a good idea to become informed before discussing stuff like this. It never makes you look good to spout common misinformation about something you don't understand.
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02:00 AM on 12/01/2010
I'm a charter school co-founder and administrator. Let me clarify a couple of things. First, charter laws are vastly different from state to state. In California, most districts do put you through a pretty rigorous and long authorization process, in which one must demonstrate experience, expertise, prior results, and capacity to run an organization. People that refer to "charter schools" as a blanket statement are lazy, just are those who say "all teachers" or "all hospitals". There are good charters, there are bad charters. The key is: bad charters get shut down if they fail to perform. It's called accountability. I have parents that tell me the number one reason they go to my school is because we don't offer tenure. They know that accountability will keep the school on its toes. As for some other assertions...teachers make $30-$35k...maybe in Iowa. In California, NY, NJ and other places, most teachers start in the $47k-$50k range. They get up to $65k after just 7-10 years. Look it up...that's significantly more than the average salary for adults with a bachelor's degree. (2006 Census Bureau). Teach for America has done a good job of injecting more talent into our field. Again, some are good, some are bad. Professor, I'd like you start a school from scratch, hire and manage 40+ employees, get great results, and then come back and write something from a position with more perspective. It's not so simple.
12:21 PM on 12/31/2010
Most charters perform worse than most public schools, and most charters are not closed for underperforming. Charter proponents always point to the fact that they CAN be closed down for failing, conveniently avoiding the fact that this oversight is rarely exercised.

I'm sure that you have parents who choose your school because there's no tenure. That's because tenure has been demonized in the media, and so they don't understand what it means. The due process rights provided by tenure are one of the reasons that traditional public schools do a better job educating students than charters do: in traditional public schools, a tenured teacher can be fired for not doing his job (and this is much more common than a charter school being closed for poor performance). He can't be fired because the principal's niece just graduated and wants a teaching job.

As for teacher pay: yes, teachers in places with a very high cost of living, like NY, are paid more than the average college graduate, who lives and works in middle-America with a much lower cost of living. That's a deliberately misleading comparison. Compare teachers to other professionals in the same area, and you can't argue that teachers are well paid.
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teacher39years
Educational Reformers need to be "Reformed."
01:48 PM on 11/26/2010
Mayor Bloomberg is the third richest man in the United States. As mayor, he completely controls NYC schools. He appointed Joel Klein to head these schools who recently quit . Rupert Murdoch, who owns Fox News and the Wall Street Journal, hired Joel Klein to work for his News Corp . On the same day, Rupert Murdock bought an Educational Company. Bloomberg then appoints a Media Executive to head the schools. Small World.
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05:28 PM on 11/22/2010
Great article. Bloomberg, Duncan and Obama are all jerks!
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MarcEdward
likes all cats more than most people
10:05 AM on 11/17/2010
LOL
What a great piece.
08:43 AM on 11/17/2010
Thank you for this. I'll be printing it out to share with some of my fellow Elementary Ed majors. I nearly fell out of my chair when our professor (a former public school teacher and principal) said we should all see Waiting for Superman because it's inspiring and Michelle Rhee is a hero. Fortunately, I wasn't the only one in my class who objected to this logic.
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onionboy
Blessed are the Cheese Makers
03:10 PM on 11/15/2010
I'm a parent. I educate my child. Their school helps, but they get them for an average of a nine-month stretch for a teacher, maybe a few years for the school or district. The school, while well-meaning, does not actually have to worry about anything but the short-term outcome (tests). Long-term outcome and consistent teaching are, and should be, left to parents. Schools, teachers, school districts...are just tools to help. I think more parents need to stop blaming schools.

The saddest part is that there are plenty of kids out there without a parent or guardian at all. Who watches out for their long-term goals?
09:31 PM on 11/19/2010
Can we clone you?
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onionboy
Blessed are the Cheese Makers
10:58 PM on 11/19/2010
Thanks. It's sad that our position, because my wife is lockstep with me on this, seems so extraordinary. And thank you for not taking offense. I've told this to some teachers and they get defensive, and this is not to belittle teachers at all. When I say that they are tools...they are the alan-wrench and my kids are Ikea furniture (let's call them STUDIKA). They're essential, I can't do the job without them, and they're better in their skill set than the tools I have. To complete the metaphor, however, PARENTS have to put the darn thing together.
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dbishop76
Left of liberal Texan.
12:12 PM on 11/15/2010
I think you are comparing apples to hot dogs. Education, unlike medicine, is not a science. Perhaps a better comparison to teaching would be a doctor's bed side manner.

And frankly, some of what you suggest does happen in medicine. For instance, my daughter comes down with strep and I KNOW Amoxicillin does not work for her, so yes, I DO tell the doctor to prescribe a different antibiotic. Furthermore, when you have tried something your doctor prescribes and it doesn't work, you go back and try something else. They don't continue to give you the same treatment regardless of the failure or success of the outcome.

What's more, you don't get a new doctor every year that insists on trying the same failed medicine that has not worked for you and who refuses to listen when you tell them, "Hey, this doesn't work, but this does!"

As well, when you walk into a doctor's office they generally diagnose you before they start prescribing remedies to fix what's wrong with you.

In medicine, much like in education, you have your general practitioner and your specialist. We have reading specialists,speech pathologists, behavioral specialists etc. Much like there are Cardiologists and Dermatologists.

Perhaps the biggest flaw in your argument is that when you don't like your doctor or the diagnoses, you can either find a new one or seek a second opinion.
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dbishop76
Left of liberal Texan.
01:02 PM on 11/15/2010
I also feel compelled to add that in medicine they have differential diagnoses and doctors realize that the same symptoms can actually be the result of a myriad of problems. Not ever person that walk into their office gets the same treatment.

Doctors do not generally blame poor parenting for a child's ailments and thank goodness they don't- I would hate to think that a doctor would look at my asthmatic child and say, "Well, that's the result of poor parenting, they are un-treatable."

I also admit my bias. My sister is a first-year teacher with Teach for America and I think she should be lauded for her willingness TO make a difference in education. In a time when teachers are leaving the profession in droves, you have someone who gave up a job making six figures to take one making in the low $40's because she felt like she could change something. Perhaps you could liken it to a Red Cross volunteer who goes to a third world country to distribute vaccines.
08:43 PM on 11/15/2010
Obviously you do not understand public education. It is not some easy major to receive in college, at least where I went. Teach for America is a joke of a program. It has good intentions, but someone who is "smart" in some degree unrelated to education does not mean he or she are going to be good teacher or right for the most difficult cases in America. I applaud her ambition, but if she wanted to be a teacher and make a difference, be educated in it first. Teachers screw up, there are bad teachers out there and yes your child does get a new teacher every year. However, all teachers talk. We know more about your child walking that door than you think we do. We want to hear your concerns as parents and appreciate your input, but the way that parents communicate with us, such as talking down results in us feeling inadequate. If we don't have success one way, we will find another "prescription". People put down educators all the time. A doctor ran me into the ground with a preexisting condition, and I suffer for it now with serious health issues. She is not going to hear about it, but I hear about it everyday like its my fault when I make a mistake. I care about my students and to make me seem like the bad guy out there, that insults me. It also insults your intelligence. Maybe you can blame the teachers.
09:37 PM on 11/19/2010
I will be curious to see how long your sister stays with our profession.

If a doctor was being held responsible and criticized for the number of ailments that a child has and how many prescriptions he has to write, he will start looking closer at reasons.
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MarcEdward
likes all cats more than most people
10:11 AM on 11/17/2010
"Education, unlike medicine, is not a science."

Medicine is hardly a "science", it's more like a religion. The fact is most doctors don't know all that much. Your general practice doctor does what exactly? Give you check ups (most everything they do a nurse can do), if you have a cold they over-prescribe anti-biotics (which has done more harm than good, and a computer program could do the same thing). Otherwise if it's something they can't handle, they refer you to a specialist (which a nurse could do). If you think doctors are practicing a science, you've bought a bill of goods sold to you by the medicine-men at the AMA. Most of the ills your body gets will heal on their own, without a doctors help. Most of the "cures" a doctor offers were invented long ago by other people. Most doctors I know are no better at diagnosing an illness than your average person with Internet access (often they are worse).
Don't even get me started on specialists. If you had a pain in your gut, the "diagnosis" would depend on whom you see. If you happen to see an OBGYN, they will say "You need a hysterectomy", if you saw a proctologist he's say "you need a colonoscopy". Most specialists aren't interested in you other than how much money they can pull out of you - when they look at you, they are really figuring how big a monthly payment they can afford for a new luxury car.
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dbishop76
Left of liberal Texan.
10:21 AM on 11/17/2010
Three kids, in fact....
12:06 AM on 11/12/2010
I love this! Bravo!
04:41 PM on 11/09/2010
This is an appropriate analogy spelled out even more thoroughly than I had seen it before. As for trying to compare schools to Wal-Mart or any other business, there's simply no comparison. Unless we want to start talking about children as products, we need to stick to framing the discussion as one of societal importance. One point I'd add to the list: All patients, no matter how ill, would be expected to be treated and sent home in a matter of hours. In-patient hospitalization would not be an option, as it would interfere with sports, jobs, church, video games, sleep, and everything else that comprises over 2/3 of the patient's day.
01:17 PM on 11/09/2010
How many doctors would be able to keep their licenses if more than half their patients didn't make it? How many hospitals would remain open if they had the same problem (i.e. districts)? How many doctors would continue to earn their full salaries even if they didn't see any patients and were not allowed to see patients for one reason or another, i.e. NYC's Rubber Room? www.corbetteducation.wordpress.com
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10:30 PM on 11/10/2010
How many doctors would be able to keep their licenses if more than half their patients didn't make it?

It depends on what type of illness they are suffering from and how far along that illness was when they first stepped in the doctor's office.

How many hospitals would remain open if they had the same problem (i.e. districts)?

It depends on where the hospital is located, what each individual patient's medical history is and how long they have been going to the same hospital. What if most of your patients didn't speak English to tell you what was wrong with them, but you are not allowed to speak any language other than English in your examining room and their health or lack thereof could get you fired? What if they had no insurance to boot?

The education situation is way more complex than your response to this article indicates. It is obvious that you have not taught in a public school.
02:56 PM on 11/12/2010
Actually, doctors do not automatically lose their license for malpractice. It actually takes repeated examples of malpractice or a serious intent to injure.
One of the major misunderstanding regarding the rubber room is that it is the fault of the union. Teachers are in the rubber room pending an investigation by the board of education. If they dedicated the required number of investigators to do the job properly, people would not be stuck in the rubber room for such longs periods of time. Remember that teachers in these rooms often do not even know the accusations that have put them there and they are indeed waiting for due process. I've always heard that people are innocent until proven guilty. Do teachers not also deserve this right? Would you be comfortable if you lost your job and pay for an unsubstantiated claim from just anybody? There are cases where teachers are in the rubber room due to accusations from vindictive administrators for personal rather than professional reasons.
When a teacher is proven to have committed a serious crime, they lose their jobs. They have the right to defend themselves like everybody else. Teachers have actually been fired for numerous things including comments written on facebook and sleeping in class.
And, yeah, if a doctor worked with terminally ill patients, 100% of their patients would die. Does that make them incompetent compared to a general practitioner?
08:48 AM on 11/08/2010
Doctors would be required to maintain a graduating average or 65%, be completely uninsured in their given profession and only take 5 years of school with zero focus in sciences and float by taking childrens literature and the philosophy of art as their core disciplines.
03:31 PM on 11/07/2010
If Walmart was operated like a public school:

1. Employees would never be fired, irrespective of performance, attitude or abilities. They'd practically have to murder someone first.
2. They'd get raises almost every year. If they didn't, they'd go on strike.
3. They'd get summers off with pay.
4. The entire community would be taxed to pay for Walmart, its products, its employees (and their summer breaks), no matter whether you buy from Walmart or not.
5. People would be forced to buy from Walmart under the threat jail time. Officers would keep track of you and how frequently you attended.
6. If you refused to pay your Walmart tax, they would kick you out of your home and give it to someone else.
7. Walmart employees would have total pay and benefits averaging nearly twice that of the community that supports them.
8. Anyone daring to speak against Walmart's tyranny or offering an alternative would be portrayed as being a heartless, knuckle-dragging troll who wants to eat children.
9. You could only buy what Walmart employees thought you needed, not what you really wanted.
10. Everything in Walmart would cost about 10 times as much as it should, but Walmart would be routinely broke, out of pencils, and unable to meet its budgets.
11. Walmart employees would be constantly (and laughably) comparing themselves to professional athletes, astronauts, doctors and other very highly skilled people.
12. Walmart employees would go apopleptic when presented with these truths.
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Joel Shatzky
04:14 PM on 11/07/2010
Seth: Let me take your rant point by point since it is so wrong-headed and misinformed that it needs to be systematically refuted.
To use Walmart as an analogy to teaching considering that Walmart employees are not required to have a degree of any kind to be employed as an "associate" is revealing since it has an historically bad record of employee treatment but here goes:
1.Teachers can be and some are fired all the time. But it takes administrators who are determined, thorough and informed of what good and bad teaching is to do so effectively and fairly.
2. TEACHERS CANNOT LEGALLY GO ON STRIKE. In NYC a teacher will lose her job if she does so.
3. Teachers are paid for ten months a year but can opt to have their monthly paychecks reduced during the school year so they can have income during the summer.They are NOT ELIGIBLE for unemployment compensation during the summers.
4. Everyone is taxed for certain public services including fire and police even if they have a private arrangement. IT'S CALLED DEMOCRACY!
5. I don't know of any case in which parents who chose to send their children to private schools were jailed for doing so. And, unfortunately truancy is rampant in many communities.
6. Property taxes and municipal taxes provide revenue for running government services: all of them.
7. The average salary of a starting teacher is in the $30-35,000 range.Where's your community: in Borneo? To be continued.
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Joel Shatzky
04:39 PM on 11/07/2010
Continued re: Seth's rant.
8. Among the roster of people who have recently criticized public school teachers or have supported summarily firing them are: President Obama, Michelle Rhee, Chancellor Joel Klein, Mayor Bloomberg and most everyone on Fox network including, probably, the doorman. I haven't heard that any of them have been "portrayed as being a heartless, knuckle-dragging troll who wants to eat children."
9. Are you a teacher, Seth? If you are, I would love to know what school you teach at in which the teachers were given the freedom to teach the way they wanted and what they wanted, that is, in a regular public school. Many teachers now have "scripted" classes from which they deviate on pain of discipline or worse. That is due to the "test-prep" mania that is infecting the nation's public school system and driving teachers out of the profession.
10. If you're correct that everything in the public schools "cost about 10 times as much as it should " some private suppliers must be making quite a fortune. I would suggest you check on your numbers before you make such a statement.
11. As far as "athletes, astronauts, doctors and other very highly skilled people" are concerned, unless I am self-deluded, they ALL WERE TAUGHT THEIR SKILLS BY TEACHERS, unless, of course, like your statements, their knowledge came out of thin air. Albert Einstein made his living as a teacher.
12. I'm not apoleptic: just saddened by your ignorance.
05:55 PM on 11/07/2010
Moreover…

1. Teachers are evaluated annually and when administrators subjectively don’t approve of lesson plans, discipline, test scores, etc., the teacher will not get contract renewal. This has happened to coaches of poorly scoring teams that do well in the classroom and to provide nepotistic hiring due to too few teachers.
2. Many states froze raises this year due to poor tax revenues and less corporate donations after the economic downturn. Where were the massive strikes?
Plus, the raise is less than a percent from the meager starting salary.
3. Teachers are paid for their days in the classroom, often 180. The choice to get 10 or 12 monthly checks still provides the same meager total.
During most summer breaks, teachers are now forced to spend THEIR SALARIES on graduate courses, workshops, and conferences in order to keep their teaching license.
4. Less than 10% of taxes get directed at education. Don’t even try to make this a tax issue.
5. Truancy would be enforced for the children under 17 that do not attend school, but parents can declare “home-schooled” and no one gets jail-time. It is mostly used for teenagers that skip. Would like those freedom-fighters to hang out around your home during working hours?
6. …again with the taxes. Don’t worry; lots of it goes to political retirement after voting down teacher pay raises. Teachers have to put away for their own after much more than a four-year term.
11:41 PM on 11/08/2010
Don't know about where you're from, but according to the State of California department of finance, "While it has changed over time and changes somewhat from year-to-year, about 52 to 55 percent of the State General Fund Budget is spent on K–12 and Higher Education."
02:08 PM on 11/07/2010
Wow, this is so true. I am in charge of 29 little people's lives. I have been given some curriculum, a pacing plan and not enough time in the day to teach all there is to teach. I may not be adequately prepared, I may not have adequate support or the appropriate materials, but by God I better get precise results or the public has the right to throw me out. It is craziness!! I don't know what people expect to achieve by continuing in this crazy manner. I started teaching 21 years ago. I honestly don't see how anyone would want to take this job right now, other than that they are desperate for a paycheck and are willing to give it a try, even if it doesn't last. Is this what we really want??

As a side, I don't see this article as a complaint about doctor's pay. What I think it is saying is that the schools take anyone with a degree, doesn't adequately prepare them, and then expects them to achieve miracles, even though they have very little control over major components, such as curriculum, pacing of lessons, or even discipline. The field of medicine would never take people who are not trained and put them in charge of areas they have no expertise. Education does this all the time.
11:31 PM on 11/06/2010
This may be a bit tangential to the topics of the original blog post, which I realize were not necessarily drawing comparisons between teachers and doctors in a direct way. However, as a current 3rd year medical student racking up literally hundreds of thousands of dollars in student loan debt, I have to argue the right to my 'exorbitant' salary. While a lot of my classmates certainly bring in tuition checks written by their multi-generational physician family, myself and many other of my fellow students are not doing this. Show me a teacher with my loan debt and my rigorous schooling, and I will gladly support a comparable salary for them. I spent 70+ hours in the hospital this week. Add about 20 hours per week to that when I start residency in a year and a half, which could be anywhere from 3-6 years of my life, plus a few years of fellowship, if I choose to specialize even further. I don't believe the same workload is demanded of student teachers working on their master's degree. I do not claim to understand or follow all of the politics that dictate the average teacher's salary, but as a future physician I am sick of being told that the personal and financial sacrifices I am making to complete my education are comparable to those made for other professions.
08:43 AM on 11/07/2010
As a teacher, I would never argue for a similar salary as that of a doctor. Most teachers wouldn't, as we are well-educated people who realize how much time and money are spent on education for those in the advanced medical fields. I would, however, argue for a salary that meets the time and money spent on MY education... 5 years of schooling, plus a state-mandated 18 credits in the first 6 years of my career (while teaching), plus 6 additional credits every 5 years for the rest of my career. This additional schooling is paid for out of my pocket. I spend between $200 and $500 on supplies for my classroom each year - supplies that are supposed to be covered by the district but have been reduced or eliminated due to budget constraints. I arrive at school 1/2 hr before school and work an additional 2 hours after school, making phone calls to parents, attending professional development classes and meetings, and preparing lessons for the days, weeks and months ahead. Grading adds an additional 10-15 hours per week. Teachers working on a master's degree are both working all of these hours, plus attending classes and doing homework for those degrees - we don't typically stop teaching while we work on additional degrees. We know that becoming a doctor takes more time and money - we just want a wage that "fits" our particular job requirements. Guessing you'll start closer to $100,000 - I started at $31,000.
12:52 PM on 11/07/2010
Docs deserve their pay, for all the reasons you've outlined. After 25 years in the classroom and a master's degree plus 36 credits, I think I deserve the $68,000 a year I make also. I am not asking to be paid more, but I certainly don't think I deserve less. I agree with your statement from my vantage point also: I am sick of being told that the personal and financial sacrifices I have made to complete (and continue) my education (and the years of service and far more than a 40-hour work week) are comparable to those made for other professions. I actually have a (sarcastic) solution to the school funding crisis. They can reduce the qualifications necessary to become a teacher to equate to a 2-year associate's degree. They can then continue to require that these new teachers use only the "scripted" curricula that are continually being forced upon us (and see how well THAT works for EVERY child). Since a monkey could be "trained" to apply these strategies, they can reduce teacher pay by half for the new 2-year degree teachers. The rest of us "old dinosaurs" will eventually age-out of the public school systems, and staff salaries will no longer eat up 85% of the budget. Problem solved. However, they will get what they pay for.