Locum Tenens: Too good to be true?

[usermike8500]

Locum Tenens hospitalist work seems to me to be the best career on the planet...

I found many positions where wage is $150/hour with travel and LODGING expenses covered!

So basically, one could make a career out of traveling the country, serving diverse patient populations, 7 on 7 off with plenty of time to see the sights while earning $300,000/year ($150 x 12 hours x 14 days x 12 months) with NO housing or travel expenses?

There has to be a catch somewhere to this plan right? Otherwise, hospitalist IM would be considered the ultimate "lifestyle" specialty, ahead of Derm, Rads, GI etc.


www.hospitalistworking.com

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[catch23]

ultimate lifestyle career, if you're willing to move all around and not settle down: http://www.kevinmd.com/blog/2013/02/year-locum-tenens-physician.html

 

[usermike8500]

ultimate lifestyle career, if you're willing to move all around and not settle down: http://www.kevinmd.com/blog/2013/02/year-locum-tenens-physician.html

That was a helpful blog thanks!

Do you think working locum tenens for a few years after graduation would look bad on the CV? Would potential employers down the road think, "woah this guy just held a bunch of temp jobs over the last 2 years, there must be something wrong with him".

 

[Trogghunter]

That was a helpful blog thanks!

Do you think working locum tenens for a few years after graduation would look bad on the CV? Would potential employers down the road think, "woah this guy just held a bunch of temp jobs over the last 2 years, there must be something wrong with him".

my stepdad did locums for a few years and he loved it-though he worked roughly in the same area...he did not have any trouble in finding work when he settled back down. currently he is a hospitalist on the east coast, makes ~400k and has been at that practice for 8 years. he and his partners urge me to go that route 'as long as i dont **** up and knock someone up'
-true story

 

[rokshana]

That was a helpful blog thanks!

Do you think working locum tenens for a few years after graduation would look bad on the CV? Would potential employers down the road think, "woah this guy just held a bunch of temp jobs over the last 2 years, there must be something wrong with him".

i dont think its a bad idea (but i'm biased since its what i decided to do for the 2 yrs between residency and fellowship ) esp if you are thinking about becoming a Hospitalist as a long term career.

It has been discussed on another thread, but not all hospitalist programs are the same in structure and culture, so working a couple of years at different places does give you some exposure. But, as the blog cited in the post above, places that utilize locums are in a bit of chaos and so may not be a true depiction of hospitalist work.

I vaguely remember someone saying that 30% of residents are unhappy with the 1st job they take out of residency and change within 3 yrs...exploring different systems for a couple of years may give you a chance to gain a bit more knowledge about the business of medicine (which we are woefully unprepared for coming out of residency) and what type of practice best suits you.

there are pros and cons to doing locums and yes i have met people who are basically career locums and they love it...the travel has been fun (i have more points and preferred status that i can probably use) but it does get tiring...looking forward to being in one place for the next 2 yrs, but i'm glad that i spent the last couple of yrs as locums during my bridge time.

 

[JohnSmiley]

Any other thoughts on how this might affect you if you decide to go into a competitive fellowship (cards, GI) down the road? If anyone has real experience I'd love to hear it.

 

[gutonc]

Any other thoughts on how this might affect you if you decide to go into a competitive fellowship (cards, GI) down the road? If anyone has real experience I'd love to hear it.

The biggest downside with doing locums if you're planning a future fellowship application is that it will be difficult to do anything to increase the competitiveness of your application like do some research with the cards/GI department during your off weeks. If you've already got a strong app for that specialty it's probably not that big of a deal but something to think about.

I'll also offer some advice from my experience reviewing apps for fellowship this year. A lot of the (more senior) people reviewing apps questioned what was wrong with applicants that worked for a year or more as a hospitalist before applying. Their assumption was that their app wasn't strong enough or they were indecisive and weren't dedicated to our specialty. The two of us who were recent grads tried to explain how common this was but we failed I fear.

This is an N of 1 to be sure but worth consideration.

 

[tartesos]

Locum Tenens hospitalist work seems to me to be the best career on the planet...

I found many positions where wage is $150/hour with travel and LODGING expenses covered!

So basically, one could make a career out of traveling the country, serving diverse patient populations, 7 on 7 off with plenty of time to see the sights while earning $300,000/year ($150 x 12 hours x 14 days x 12 months) with NO housing or travel expenses?

There has to be a catch somewhere to this plan right? Otherwise, hospitalist IM would be considered the ultimate "lifestyle" specialty, ahead of Derm, Rads, GI etc.


www.hospitalistworking.com

My main dislike as a locums is the independent contractor status( you pay your own taxes) and you pay your own medical insurance etc.( that's just me, I don't like to owe that much money to the mafia(IRS).
but it is very enticing and some people use it to find the right opportunity, try it and then stay if the relationship is mutually beneficial...
Or if you knock someone upon town as one poster already said lol

 

[michaelrack]

My main dislike as a locums is the independent contractor status( you pay your own taxes) and you pay your own medical insurance etc.( that's just me, I don't like to owe that much money to the mafia(IRS).
l

I don't see that as a downside, but the self-employment tax/lack of benefits does need to be taken into account when considering salary/reimbursement. I recommend not accepting any less than a 12.5% premium in reimbursement for locums/1099 work to take in account for this.

 

[tartesos]

I don't see that as a downside, but the self-employment tax/lack of benefits does need to be taken into account when considering salary/reimbursement. I recommend not accepting any less than a 12.5% premium in reimbursement for locums/1099 work to take in account for this.

Too complicated!
Lol
I prefer my job Pay Uncle Sam for me on a w2 . I claim zero and single and save a ton of Vaseline and all my receipts ready for spring.
Lol

 

[nope80]

I thought this would be a great way to work part time while doing research to get into fellowship during the year off. From what I understand, you can create your own schedule re how many days you want to work - is that correct? If so, it seems like a great opportunity. Also, what is the range of pay? For a lot of us that want to do research on the year off we need a mechanism to pay bills and this seems like a great way to make it happen. Also, is it hard to find these positions if you are geographically restricted?

 

[tartesos]

I thought this would be a great way to work part time while doing research to get into fellowship during the year off. From what I understand, you can create your own schedule re how many days you want to work - is that correct? If so, it seems like a great opportunity. Also, what is the range of pay? For a lot of us that want to do research on the year off we need a mechanism to pay bills and this seems like a great way to make it happen. Also, is it hard to find these positions if you are geographically restricted?

Now that's another story altogether!
It's perfect for moonlightning while doing fellowship or research. And it would supplement your income nicely.
You work the week( or weekends weekdays night you want and you in most cases can choose like 3 no the in advance your hours.) and you can easily set aside some money to pay Uncle Sam or pay quarterly taxes( forget about h/r block and ****, get you an accountant or tax person.
One big advantage is that you can deduct from your taxable income( deduct 100% before taxes) a lot of expenses that allow you to do your work as long as YOU paid for them not a locums company ie: medical License, work clothes, medical society membership boards and board review fees, all your medical books, and means of learning( up to date etc), cell phone, your miles and in some circumstances even your car lease, a home office can take away part of your rent, Internet and phone bill etc, and all job hunting expenses.
If you are organized you can actually make more money this way( you can deduct more things 100% before taxes instead of certain caps/ limits on a w-2.
Again, get a tax person for advice. Don't play with the mafia( IRS).

it's diff when its your sole way of earning money making 3-500 k a year( easily done doing locums like crazy. Forget about 1 w off) and should you ever slack off on taxes... Irs might come back for a debt of 90-120 k easy. And that's scary bro.
I'm not as organized and I Cringe that last scenario.

 

[tartesos]

I thought this would be a great way to work part time while doing research to get into fellowship during the year off. From what I understand, you can create your own schedule re how many days you want to work - is that correct? If so, it seems like a great opportunity. Also, what is the range of pay? For a lot of us that want to do research on the year off we need a mechanism to pay bills and this seems like a great way to make it happen. Also, is it hard to find these positions if you are geographically restricted?

Ah money is varied by region and employer, but in the south where I'm at Hospitalist work avg 120/hr and in some places it goes up to 150/hr. but check on your area with some recruiters or online.
Pm if you need help with this.

 

[jabreal00]

Locum Tenens hospitalist work seems to me to be the best career on the planet...

I found many positions where wage is $150/hour with travel and LODGING expenses covered!

So basically, one could make a career out of traveling the country, serving diverse patient populations, 7 on 7 off with plenty of time to see the sights while earning $300,000/year ($150 x 12 hours x 14 days x 12 months) with NO housing or travel expenses?

There has to be a catch somewhere to this plan right? Otherwise, hospitalist IM would be considered the ultimate "lifestyle" specialty, ahead of Derm, Rads, GI etc.


www.hospitalistworking.com

Ditto, if one is unattached and willing to live sort of a bohemian life style it's not bad. My cousin, who's a nurse, is doing that now. She is working locums at different locations around the country. It's giving her an opportunity to travel and she seems fairly content.

 

[LovelyBRass]

Locum Tenens hospitalist work seems to me to be the best career on the planet...

I found many positions where wage is $150/hour with travel and LODGING expenses covered!

So basically, one could make a career out of traveling the country, serving diverse patient populations, 7 on 7 off with plenty of time to see the sights while earning $300,000/year ($150 x 12 hours x 14 days x 12 months) with NO housing or travel expenses?

There has to be a catch somewhere to this plan right? Otherwise, hospitalist IM would be considered the ultimate "lifestyle" specialty, ahead of Derm, Rads, GI etc.


www.hospitalistworking.com

The physician featured in 20 Questions seems to have no complaints. Also offers some advice: http://studentdoctor.net/2013/04/20-questions-kathie-m-horrace-voigt-do/

 

[Socrates25]

I did locums (peds) for awhile -- overall good experience.

Here are the cons:

1. Each location is different so the learning curve can be steep in terms of logistics and politics.

2. Have to learn a new EMR everywhere you go -- that sucks

3. At some places the established attendings will try to dump on the locums person so they can be lazy.

 

[tartesos]

I did locums (peds) for awhile -- overall good experience.

Here are the cons:

1. Each location is different so the learning curve can be steep in terms of logistics and politics.

2. Have to learn a new EMR everywhere you go -- that sucks

3. At some places the established attendings will try to dump on the locums person so they can be lazy.

They do dump on you, specially if they think they won't be following any of your shifts in the future.

 

[michaelrack]

They do dump on you, specially if they think they won't be following any of your shifts in the future.

The dumping is fine, as long as you are paid on an hourly rate, and have negotiated a high enough rate of pay.

 

[tartesos]

The dumping is fine, as long as you are paid on an hourly rate, and have negotiated a high enough rate of pay.

It's doable/manageable, but not fair. It pisses me off when I come in at 6 pm and the day guy leaves me to admits from 11 to 12 mid day for me to see.
Makes me want to bitch slap somebody.

 

[rokshana]

The dumping is fine, as long as you are paid on an hourly rate, and have negotiated a high enough rate of pay.

no its not....is shows a lack of respect....sure if there were a ton of admissions throughout the day or a bunch of admissions come within the last hour or 2...no problem...but when the person before you admitted only 2 or 3 or 4...and leaves just as many or more...poor form...

 

[bronx43]

It's doable/manageable, but not fair. It pisses me off when I come in at 6 pm and the day guy leaves me to admits from 11 to 12 mid day for me to see.
Makes me want to bitch slap somebody.

You should just leave the next guy to admit the ones from 11pm to 12am.

 

[tartesos]

You should just leave the next guy to admit the ones from 11pm to 12am.

The issue is the next guy has nothing to do with this. They usually do it when they won't follow your shift...
I'm ok with pay back to the same guy, but if he's not on after me it's not fair.
"Do unto others as you wish done upon yourself" my grandpa always said.

 

[flipmd]

I see this as one advantage of doing locum tenens. You could tell on that A-hole to the hospitalist director without worry of backlash, since you won't be there long anyway.

 

[gutonc]

I see this as one advantage of doing locum tenens. You could tell on that A-hole to the hospitalist director without worry of backlash, since you won't be there long anyway.

On the flip(md) side, the hospitalist director won't give a flying f**k what you think since you'll be gone a day/week/month. And he might not use your locums company again.

 

[flipmd]

On the flip(md) side, the hospitalist director won't give a flying f**k what you think since you'll be gone a day/week/month. And he might not use your locums company again.

I like what you did there.

At least at my program now, our director will not tolerate that BS and will probably not renew a hospitalist's contract who worked like that, especially if there are multiple reports of similar incidents. Locums people have the advantage of not caring about blowback as a whistle-blower cases like these. Maybe some other directors wouldn't give a rats ass - those places would be crapshoots anyway regardless.

 

[robin082006]

It depends on location, I got 90$/h in Orange County CA, 100/hour in LA downtown, 110 hour/hour in Ventura County,135/h in Bakersfield.