locum pay

[qjj]

Can we have a realistic conversation about locum pay? I'm currently working a full time ED job in Miami for $215/hour, and hear rumors that I could make $300-350/hour if I do locum shifts. I'd happily quit my job and do full time locum if I could make $350/hour regularly, but as I email all of these locum shifts the pay actually seems to be LESS than my full time gig. What gives? Am I just a bad negotiator, or are the rumors I'm hearing just baseless? If the rumors are true: which jobs are offering this, and in which states?

I know, I know. There are other locum threads, but they're all years old and don't talk numbers nearly as specifically as I'd like.

---

Members don't see this ad.

 

[erdoc00]

My understanding is that you dont want the jobs that are paying these absurd amounts. From some of the stories ive heard about texas locums, these places are so bad that theyre not even worth the $350/hr theyre paying. High pt volumes, terrible staffing, unable to admit, and consultants are garbage. Thats just what I heard from people though as I searched it out like you are doing. I never actually found these high priced gigs; my results were similar to what youre finding.

 

[msgsk]

Check your PM

 

[Symmetry11]

could you share some info about the pm? is that kind of pay ($350/hr) available? is it consistent? is similar pay available for other specialties?

 

[qjj]

It doesn't seem like $300/hour is consistently available. I suspect the people who are telling me they make that much are talking about an isolated shift here and there were some hospital is really desperate at the last minute.

 

[Boatswain2PA]

PAs make about 1/3 what you guys make, and I have been offered upwards of $100/hr for taking those last minute shifts at a desperate hospital.

 

[NinerNiner999]

Completely unreliable and unpredictable. That sums up the locums business. If you are hoping for a regular schedule rotating between sites, and reasonable time between shifts for travel and transportation, expect a net of up to 25% higher rate than your local full-time job when averaged between all job sites you work (for 12 shifts per month, 3 may be at $300/hr, 3 may be at $250/hr, and 6 may be at $200/hr). Then subtract the time between shifts from the number of shifts you could work at a regular full-time gig and the benefit is even less. If you work a night shift in Texas, and take a flight for your next shift in Louisiana two days later, you have completely lost that time. Finally, remove the reliability of constant work, as once you are replaced with a full-time hire, you are looking for more work.

To me, the payout is not worth the stress of constantly being on the go. Locums work usually attracts three types of providers - those who want to supplement their current shift work with local work elsewhere, those who want to travel because they want to travel, and those who have recently lost their work and are buying time while looking for a full time job.

Ironically, it is the third group that often negotiates for the lowest rate (they need work), and the ones who have a full time job who negotiate for the highest (because they don't need to work). The group in the middle (those who want to travel) often get the median rates...

 

[GeneralVeers]

At $300/hour the benefit becomes much higher. In my home state of NV, most docs are making in the range of $140-$180/hr for the full time gigs. With benefits, the equivalent is about $200/hr. At $300/hour including travel days as "lost time", I'm still making far more than I could ever make at home. There are certainly enough jobs paying $250/hour or more to have consistent work. The key is to always work actively at at least two sites, and if one is drying up, then immediately start the process for another site. I've been full time locums for two years now, and never have had <100 hours per month for any month I've worked. It does take more work and research to do this, but the payoff and schedule flexibility more than make up for it.

 

[uhhhh]

my group is being taken over by locums. it's inspired me to start looking at locums positions. questions for the pros: so I hear it's smart to go directly to the group that's looking and cut out the middle man. so, say you find out the hourly employee rate and know the group uses locums -- how do locums people come in and decide what to ask for? they make more than the employees (at least where I work) so say I make $215, what would a smart locum ask for? Does this work in reverse, too, like for the employee to say I know locums make $xx, I want $xx? and what if you start working locums and another locum starts who makes more or the employees get a raise. Can you still negotiate as a locum once you've started?

 

[shookwell]

my group is being taken over by locums. it's inspired me to start looking at locums positions. questions for the pros: so I hear it's smart to go directly to the group that's looking and cut out the middle man. so, say you find out the hourly employee rate and know the group uses locums -- how do locums people come in and decide what to ask for? they make more than the employees (at least where I work) so say I make $215, what would a smart locum ask for? Does this work in reverse, too, like for the employee to say I know locums make $xx, I want $xx? and what if you start working locums and another locum starts who makes more or the employees get a raise. Can you still negotiate as a locum once you've started?

The answer to all of those questions is it depends on the specific hospital. One place I worked locums, we made almost double what the employees were making and most of them started leaving when the hospital wouldn't pay them a better rate. I usually ask for more than I think they are willing to pay, and sometimes just get a yes. One place was paying their locums $190 but I knew they were getting more desperate because there were so many holes in their schedule so I asked for $250 and they just said yes. Another place just didn't hire me when I asked for $10 more than they were currently paying.

There is very little consistency in this game, it helps if you have an experienced locums "guy" helping you.

 

[GeneralVeers]

Generally the locums companies throw up when I request $400/450 per hour. I've had better luck getting close to that by negotiating with the actual groups. Also waiting last minute and picking up shifts for bonus can easily get you high $$$. I try to keep one stable job that is high paying for a baseline number of shifts, then supplement with "bonus" shifts. Some months I do none of those, other months it's 4-5.

 

[TheOther]

Are full-time EM docs generally paid by the hour or salary?

 

[GeneralVeers]

Are full-time EM docs generally paid by the hour or salary?

Depends. Most places are hourly with an RVU component. Some academics/government jobs may be salaried.

 

[TheOther]

Depends. Most places are hourly with an RVU component. Some academics/government jobs may be salaried.

I see, thank you! I figured it depended, I was just curious what the spread was like. Could working hourly still include the same benefits as a salaried EM doc (if both settings were community)?

 

[shookwell]

Generally the locums companies throw up when I request $400/450 per hour. I've had better luck getting close to that by negotiating with the actual groups. Also waiting last minute and picking up shifts for bonus can easily get you high $$$. I try to keep one stable job that is high paying for a baseline number of shifts, then supplement with "bonus" shifts. Some months I do none of those, other months it's 4-5.

Picking up last minute shifts is a great way to score crazy money. I'm often offered 1.5x or double the usual hourly rate for last minute coverage.

 

[shookwell]

I see, thank you! I figured it depended, I was just curious what the spread was like. Could working hourly still include the same benefits as a salaried EM doc (if both settings were community)?

Yes, many places will pay hourly and give you benefits if you work at least a certain amount of hours monthly.

 

[TheOther]

Yes, many places will pay hourly and give you benefits if you work at least a certain amount of hours monthly.

Sweet, thanks! And are these locums gigs you guys land not as horrendous of conditions as I read about? Or is the pay just that good?

 

[uhhhh]

One or two of the locum guy that have started working at my (non-locums) gig have signed one year independent contractor contracts directly with the CMG I work with and their contracts look like mine with the exception of addendum noting paid travel expenses, etc. Are most contract negotiations still one year long? I know the length they need you varies, but how often are you negotiating your base hourly salary contract?

Thanks for your feedback

 

[emergentmd]

You will never get a CMG to contract you at 400+/hr. My current CMG base contract is 325/hr which is on the high side. But it is not hard to get incentives that boost you up to 500+/hr.

I picked up 15k last month doing 30 hrs. I could have worked 200 hrs at that rate if I had unlimited flexibility.