BFE Jobs: BFE defined?

[repititionition]

Question:

The "BFE" wage differential is often referenced on the board. Blade did today, in fact, in reference to a 15 year loan payoff schedule, or 3 years if one went to "BFE".

I've always wondered.... what constitutes BFE? How dramatic is the wage differential?

I'm not asking for a strict definition - obviously impossible - but if someone had specific markets as examples, so much the better.

Rather, I'd just love a sense of a catchment area size or other features (# beds, etc.) that define the BFE practice environment (and associated differential).

---

Members don't see this ad.

 

[aneftp]

I consider BFE as more than 2 hours from a major international airport.

When I did locums. There was this hospital in university town (about 50k population/100k if surrounding area) almost 2.5-3 hrs from San Francisco that paid $550k plus 7 weeks of vacation paid.

Vs working across the bay bridge for maybe 300k.

That's the BFE wage differential.

 

[pgg]

I think it is usually used to imply working in flyover country, away from desirable coastal cities.


But it's a relative term. Drive 2 hours inland from Los Angeles and you'll see pay rise dramatically and a far lower cost of living. Of course, you have to live and work in the central valley, which may have some drawbacks, depending on what you want out of life.



I'll also add that there's another potential problem with working in BFE that doesn't often come up in these threads. These places have trouble attracting physicians and nurses, which is a big reason why the pay is better. But that also means they'll often hire any warm body with a license. I've seen substantially more weak links, from surgeons to hospitalists to ward nurses to ancillary services, compared to big city life.

To an extent, the risk they add becomes your risk too.

 

[kazuma]

I think it is usually used to imply working in flyover country, away from desirable coastal cities.


But it's a relative term. Drive 2 hours inland from Los Angeles and you'll see pay rise dramatically and a far lower cost of living. Of course, you have to live and work in the central valley, which may have some drawbacks, depending on what you want out of life.



I'll also add that there's another potential problem with working in BFE that doesn't often come up in these threads. These places have trouble attracting physicians and nurses, which is a big reason why the pay is better. But that also means they'll often hire any warm body with a license. I've seen substantially more weak links, from surgeons to hospitalists to ward nurses to ancillary services, compared to big city life.

To an extent, the risk they add becomes your risk too.

Great point, definitely something to think about.

 

[sevoflurane]

This hasn't been my experience, but it may be the exception. All of our surgeons (except a couple of new-bs) are rockstars.

• 40 min. C/S.
• 40 min. knees (our orthopods run 2 rooms all the time).
• 30 minute gallbladders and appys.
• Robotic Hysterectomies in 2 hrs.
• On pump CABG X 3 in 5 hrs, done by 10ish am if it's a valve and don't have to take down the lima. Extremely low bring back rate (4ish per year).
• Hybrid ORs with >85% of AAAs done endovascularly.
• I don't know how they come up with this number, but our CT program is rated 3/3 stars as per the society of thoracic surgeons... top 87% nation wide (again not sure how they come up with this, but the billboards around town and on the highways state this).
• One of our surgeons can bang out a lap/hand assisted partial colectomy in one hour... OR an SBO in even less time (I'm talking about simple cases where the bowel isn't matted down).
• ERCPs done in 30 minutes (I've painfully sat thorugh 5 hour ERCPs in academics).
• 2-3 level ACDF in 1.5 hours
• 3-4 level posteriors still take a while. 7:30-1-2pm
• EP ablations still take some time... especially if they are using the Sensei Robotic Catheter system.
• We are gaining speed on our robotic thoracotomies... but there is room for improvement.

Remarkable difference btw/ academic and PP in terms of speed... of course a lot of this is due to lack of residents.

Although what PGG stated might be correct in certain locations, it's not unanimous across the board.

Long gone are the days of the 2 hr. gallbladder. 😉

 

[pgg]

This hasn't been my experience, but it may be the exception. All of our surgeons (except a couple of new-bs) are rockstars.

Man am I jealous. I'd say about 1/2 the surgeons are great. Most of the rest are fine, maybe a little slow. The problematic ones are a small minority (four guys leap to mind), but outside what I hope is the norm. The stories I could tell. Speaking of my moonlighting job here. I've been blessed with solid surgeons at the .mil joint - most of those are right out of residency, and at worst are just a bit slow.

 

[MTGas2B]

This hasn't been my experience, but it may be the exception. All of our surgeons (except a couple of new-bs) are rockstars.

I'm guessing this is the difference between Central Valley farm towns and Rocky Mountain ski towns.

 

[sevoflurane]

Rocky Mountains is the second home.
🙁

 

[sevoflurane]

Great place though... 🙂

2.5% loan with 1/2 down.

Def. a great way to diversify your portfolio in this market and something I will use well into retirement.

 

[chudat]

Great place though... 🙂

2.5% loan with 1/2 down.

Def. a great way to diversify your portfolio in this market and something I will use well into retirement.

Sevo is sylvester stallone in "cliffhanger"

 

[jetproppilot]

Great place though... 🙂

2.5% loan with 1/2 down.

Def. a great way to diversify your portfolio in this market and something I will use well into retirement.

SEVO....WHATEVER YOU DO....DON'T. LOOK. DOWN!!!!!

Holy @#%# I'm having anxiety just looking at the pic LOL

 

[W222]

I looked into three BFE jobs recently and interviewed at two. The place I didn't interview at was coastal south in a small town about two hours from the larger cities. They were paying 450+ a generous benefits package but call was q4 and you did almost everything, vacation was only 4 weeks. Looked at another in small rural northeast town, smallish hospital and they apparently thought I was stupid and low balled me on top of giving me a "sign on bonus" that was in reality a loan. I passed on that immediately. The last place I interviewed at was in fly over country in the west. Decent offer but again only 4 weeks vacay and a five year mandatory commitment. I think some of these hospital
Admins think because times are uncertain they can screw people with gimmicks.

 

[deleted126335]

I looked into three BFE jobs recently and interviewed at two. The place I didn't interview at was coastal south in a small town about two hours from the larger cities. They were paying 450+ a generous benefits package but call was q4 and you did almost everything, vacation was only 4 weeks. Looked at another in small rural northeast town, smallish hospital and they apparently thought I was stupid and low balled me on top of giving me a "sign on bonus" that was in reality a loan. I passed on that immediately. The last place I interviewed at was in fly over country in the west. Decent offer but again only 4 weeks vacay and a five year mandatory commitment. I think some of these hospital
Admins think because times are uncertain they can screw people with gimmicks.

Yes they do. Yes they can. Yes they will. No gimmick. The market is what it is. Why pay above market price? If you are buying a house do you care that the seller is under water and that you are paying considerably less than you had to a few years ago? It should make you happy that you have a stronger negotiating position.

 

[deleted109597]

The definition of BFE is the same for all specialties.
If the job ad mentions lots of things (convenient to big city, 4 real seasons, lots of outdoors, access to Division X college sports) without actually naming a geographic location, then it's a BFE job.

 

[ssmallz]

Yes they do. Yes they can. Yes they will. No gimmick. The market is what it is. Why pay above market price? If you are buying a house do you care that the seller is under water and that you are paying considerably less than you had to a few years ago? It should make you happy that you have a stronger negotiating position.

Yea but 400k w q4 call is way below market rate for bfe. You can make that in a prime location taking that much call. I wouldn't take anything less then 550 for that type of call in that type of location. Hospital CEO needs to realize that if he wants to attract top talent to an undesirable area he needs to up the $$ otherwise he can have fun w a non Bc Doc or an Indi CRNA while you're enjoying life in your location of choice. There's a reason Lebron, Howard and Melo are in Miami, LA, and NYC

 

[aneftp]

Many small town and "under served hospitals even in major metro areas" get millions in subsidies.

Remember that when u negotiate. Obviously up to administrators whether to give any to various depts including anesthesia.

There was a small hospital outside a major metro area (like 45 min away) in the South that was given over 18 million. The anesthesia dept got over 3 million plus bill for whatever the want and receive.

 

[Mman]

This hasn't been my experience, but it may be the exception. All of our surgeons (except a couple of new-bs) are rockstars.

• 40 min. C/S.

• 
  
  When I watch residents do c-sections, that would be a rockstar time. When I go to small private hospital, it's median time under 20 minutes from incision to dressing on. Sometimes 14 or 15 mins. The room time is usually 30 minutes and most of that is getting them positioned and putting in the spinal and doing the timeout.
  
  And they aren't coming back from bleeding... Gotta tell those OBs to step up and learn how to do a c-section 🙂