Per Diem endo anesthesia

[urge]

Spinoff from another thread.

What is a decent deal for per diem work at an endo facility? Let's say 20 personally performed cases.

Most ads I see are between 1.2 and 1.4/day. No malpractice paid on most. Mostly 1099, some w2.

Sounds like crappy pay to me

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[deleted171991]

20 per day for 1.2-1.4 and no malpractice/benefits? I would run, not walk... away.

10-12? Maybe. 20? No way. Especially for a per diem job, this is laughable.

The way I look at these jobs is:
1. Per diem, as needed, so they'd better pay 25-30% more than the average W2, including malpractice and benefits.
2. They make you lose skills, as an anesthesiologist (you are mostly a preop and propofol monkey).
3. They are more dangerous than the regular OR cases, because you are in a remote location, many times alone, with no real help for airway emergencies, and they do happen.
4. They are labor intensive. It's not a walk in the park when you do 12-20 cases.

I don't know the real "value", but this is the way I look at them. I remember Arch Guillotti saying something about 1.6 to 2/day when you do locums without a middleman.

 

[urge]

Perhaps I overestimated the cases. What is a normal amount for these arrangements? 10?

 

[deleted171991]

It depends how fast your GI doc is. I guess you can do even 20 in a long day with a good endoscopist and good admitting nurses. I have worked with a few good endoscopists who do uppers in less than 7 minutes and colons in less than 15-20 on average. Add less than 15 minutes for PACU/turnover/preop/induction, and you can do even 2 procedures/hour.

These are just my estimates. I have never worked in such an arrangement.

 

[aneftp]

Personally performed endo.

U need to ask how many they do per room.

If they are paying u $1200-1400 (u carry own malpractice). It better be 6-8 endo cases a day personally performed.

If you are expected to do 13-15 cases yourself. Forget it. Run. Don't walk.

On low end lets just say they average $300/case for endo (Medicare pays about $125). Private insurers pays $400. Mind you this is low end of things ($50-60/billing unit for private x. 7-9 units per case).

Most physican owned endo centers are 60% plus private insurance.

Do the math. You do 10 cases yourself. At the low end of things you are generating $4000 a day for whoever owns that contract.

And they want to pay u $1200-1400?

Now if you are only doing 6-8 cases and out the door by 12pm and they pay u full 8 hours, than I may consider it.

That's why a lot of endo ads these days are trying to pay docs minimum 6 hours now instead of 8.

The pay just keeps getting lower.

So ask how many cases each room does a day.

If you are personally doing cases yourself and expected to carry own malpractice. If they are doing 13-15 cases per room. $2000 isn't unreasonable to ask.

They are still going to make at least a $2000 profit off your work.

 

[dA pilot]

I work solo at a GI Center about 3x a month for my private practice group. I do probably 12-18 cases per day with a few doubles mixed in depending on scheduling/cancellation. On days with 18 cases + doubles, you are working nonstop with just time to use the bathroom or get a powerbar in. If I had a choice I would not work at the center but everyone in our group rotates. I would never volunteer to do per diem for 1.2 a day.

 

[aneftp]

Supervise for $1400 a day. Maybe.

But no way personally do own cases for $1400 a day if it involves more than 10 cases.

Heck i have a lot of CRNA friends (yes I have CRNA friends). The CRNA solo peeps won't do CRNA solo GI endo for less than $125/hr themselves 1099 carry own malpractice.

 

[deleted126335]

The market is what the market is. That could be the going rate in a year or three assuming we and the CRNAs keep pumping out the bodies.

 

[urge]

On low end lets just say they average $300/case for endo (Medicare pays about $125). Private insurers pays $400. Mind you this is low end of things ($50-60/billing unit for private x. 7-9 units per case).

How many units per case?

I thought it was 4 or 5.

 

[aneftp]

How many units per case?

I thought it was 4 or 5.

Depends on regional variations.

Down in south. Many colons start at 6 units plus time. Time being 15 minutes.