FSERs depend on if it is private owned or hospital owned. I would say there are 4 buckets and I have worked in all 4. Pay is contractors, have nothing to do with ownership, post covid, private does not take medicare/medicaid, hospital owned takes all similar to a hospital.
1. Private FSER that is slow - Pay typically 150-170/hr. You will typically see less than 10/24 hrs, most nights is sleep throughout but you will get unlucky sometimes. I would say for every 10 shifts, I would see more than 10 on one and get 6+hrs sleep 7/10 shifts. Not bad to pull in close to 4K seeing 7pts that are typically 80% fast track. If you have hobbies, this is a great place to get paid to do photo editing, reading, art stuff, music, etc. I know docs who do telemed during their shift and pull in another $150/hr. I did this once and pulled in an extra 2K on one shift.
2. Private FSER that is busy (relative) - Pay about 175-200/hr, and as they are profitable may do some profit sharing for 1099 workers. You will see 15-25/24 hrs. You will get 6 hrs sleep for 50% of the shift, same 80% fast track. Can't really do much hobbies but you get to watch alot of movies/sports although somewhat interrupted. Not bad making close to 5K/shift. Do 6/mo and you are making 360k/yr. Beats doing 12-15 hospital shifts seeing 2-3 sick pph.
3. Hospital based FSER that is slow. If CMG owns it, you will get pay screwed. I have seen $120-140/hr seeing less than 10ppd. But you get medicare/medicaid/uninsured so typically sicker and admission rate higher. Same % straight sleep as #1 but big difference in being awoke at 2am for a sore throat vs a 75 yr old with "headache/numbness". The later you are up 2-3 hrs and your night is shot.
4. Hospital Based FSER that are busy. Pay prob 175-200. You will not get any RVU/incentive/profit bonus. Volume similar to #2 but now you are seeing 25 pts with 75% medicare/medicaid so they are much more difficult than #2 shift. Sleep is worse than #2 b/c they tend to like coming in at night and workup are difficult. Winter royally sucks seeing 40+ pts and you are making less for the same work/more liability than going into the hospital. You may be seeing 1pph but you feel like you are up all the time b/c of the extended workups.
Transfers for #1/2, sans covid (like every other hospital), are easy. They are 90% insured, hospitals love these pts, and hospitals will send reps to the ER to make transfer easier. Covid was a diff beast b/c there just was no space and hospital owned sites had the same issues.
Transfers for #3/4 are just as easy outside of covid. They are connected, you know the hospitalist, its easier than 1/2 but all 4 environment never game me any transfer issues sans covid.
Depending where you are at in life. I am in the back end of my life so I would Rate it #1>#2>>>3>>>>>>>>4.
I would never Volunteer for #4. Some days you will see 40 pts,, have all the rooms full with medicare pts, poorly staffed, labs/rads takes forever due to poor staffing, unhappy staff, and you are the only doc. I rather work in the hospital than #4. 1-3 definitely beats the hospital.
