locums and the middle man

[HunterGatherer]

I understand that locum companies facilitate paperwork and possibly liability but is it possible for an ED doc to set up their own locums network as an individual?

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[GeneralVeers]

Yes. Myself and a group of other docs did just that. We work at a place that previously had locums (but no longer does). Both ourselves and the hospital cut out the middleman, and we all benefit. It takes a lot of phone work, research, and travel if you want to do it yourself.

 

[EvoDevo]

Yes. Myself and a group of other docs did just that. We work at a place that previously had locums (but no longer does). Both ourselves and the hospital cut out the middleman, and we all benefit. It takes a lot of phone work, research, and travel if you want to do it yourself.

So you basically set yourselves up as a "mini contract group"? Is this your primary site or a satellite facility?

 

[GeneralVeers]

So you basically set yourselves up as a "mini contract group"? Is this your primary site or a satellite facility?

Work at two hospitals, and soon to be more. While it has aspects of a contract group, we're hospital employees.

So far being a hospital employee has been leagues ahead of being in a CMG. I'm paid an hourly rate, the staffing levels are better (1.7 pts/hour) and I don't have to worry about the pyramid scheme of wealth redistribution that is in every CMG.

 

[EvoDevo]

Work at two hospitals, and soon to be more. While it has aspects of a contract group, we're hospital employees.

So far being a hospital employee has been leagues ahead of being in a CMG. I'm paid an hourly rate, the staffing levels are better (1.7 pts/hour) and I don't have to worry about the pyramid scheme of wealth redistribution that is in every CMG.

Hm...sounds pretty interesting. Do you worry any about being an employee?

 

[HunterGatherer]

Work at two hospitals, and soon to be more. While it has aspects of a contract group, we're hospital employees.

The bulk of the doctors that staff the hospital are in a CMG, democratic group, or are also hospital employees?

 

[GeneralVeers]

Hm...sounds pretty interesting. Do you worry any about being an employee?

No. My experience with CMGs where you are a "partner" is that you are just as much an expendable employee as when you are a hospital employee. I knew a lot of physicians who were shown the door from my prior CMG (EMP) rather quickly and without much due process. I experienced the process myself, though they backed down once I threatened litigation. I find that in places where I am hospital employee the staffing is better and the salary is consistent. I don't have to worry about billing or coding. I don't have to worry that some guy who's been in the group 20 years is leeching off of me.

I think that CMGS and private groups are among the walking dead in this era of government-run health insurance. Hospitals will increasingly need more control over their staffing and physicians in a way that a CMG cannot provide.

 

[EvoDevo]

No. My experience with CMGs where you are a "partner" is that you are just as much an expendable employee as when you are a hospital employee. I knew a lot of physicians who were shown the door from my prior CMG (EMP) rather quickly and without much due process. I experienced the process myself, though they backed down once I threatened litigation. I find that in places where I am hospital employee the staffing is better and the salary is consistent. I don't have to worry about billing or coding. I don't have to worry that some guy who's been in the group 20 years is leeching off of me.

I think that CMGS and private groups are among the walking dead in this era of government-run health insurance. Hospitals will increasingly need more control over their staffing and physicians in a way that a CMG cannot provide.

I think that you might be right in terms of the walking dead, but that future "all employee" model is probably at least a decade away.

Anyway, I just finished some locums work and found it enlightening on many levels. One of the insights that I had is that if I set up my own "locums" company (with myself as the locums doc) then I can make and keep a hell of a lot more money than I am currently making.

CMGs sure do skim a lot off of the top...

 

[GeneralVeers]

I think that you might be right in terms of the walking dead, but that future "all employee" model is probably at least a decade away.

Anyway, I just finished some locums work and found it enlightening on many levels. One of the insights that I had is that if I set up my own "locums" company (with myself as the locums doc) then I can make and keep a hell of a lot more money than I am currently making.

CMGs sure do skim a lot off of the top...

It sure is interesting. I'm making about $100/hour more than before by being independent contractor and negotiating for myself. I just don't see the "added value" that CMGs bring to the table when they have worthless positions like "Regional Director" and "Vice President of Diversity" draining 300K/year each from the partners.

 

[EvoDevo]

Yeah. One of my good friends is FM working in a group of about 15 docs. They apparently have a worthless CEO who for some reason drains $3,000 per DOC per MONTH for his salary. And for sure the guy does NOT add value to the group.