Big beautiful bill effect on locums market

[brominator]

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Curious wether changes from the new legislation will negatively impact need for locum anesthesiologists and rates

 

[aneftp]

No changes. If anything. Hospitals are just like the govt and just printing money. I have no clue where the money is coming from. Neither do they

I’m getting uber surge pricing next week at 90% Medicare/medicaid place for $550/hr with 12 hrs guaranteed all supervision.

My young Jedi in training 32 yo apprentice just price gouge another Medicare facility for $777/hr for a Sunday shift from his own house lol. All guaranteed money bruh.

 

[aneftp]

Don’t worry about the future. I barely think about the next day. As the saying goes. Tomorrow is never promised.

If you are worried about this bill on anesthesia and locums, you got a lot of other issues to resolve first in your life.

 

[Potatoman1800]

My young Jedi in training 32 yo apprentice just price gouge another Medicare facility for $777/hr for a Sunday shift from his own house lol. All guaranteed money bruh.

Jeeeez where?

 

[aneftp]

Jeeeez where?

Everyone always asks. These are things all negotiable. I live in what the locums all call “low paying “ locums state (Florida). Sure. Go work in upstate New York or PA and make money also. Money is everywhere. That’s what I keep telling people.

You can negotiate almost anywhere in any state you want. It doesn’t magically happen automatically You can go in at low rate like young Jedi in training and renegotiate. Even way past his prime doc I met. I had to tell him what to demand. He was horrible at negotiating. Now he gets paid to sleep outside the hospital at full regular hourly rate instead of beeper call rate. He’s happy. No clue why he’s even working though. He got massive buyout from management company, house paid off, kids grown was making 800-900k in the 2000s era before the buyout in 2014. So even some old timers don’t know the current locums market

You can do any deal depending on the level of desperation. Get a feel for an area you are working at. You can predict staffing shortage weeks in advance

 

[DolphinVA]

Everyone always asks. These are things all negotiable. I live in what the locums all call “low paying “ locums state (Florida). Sure. Go work in upstate New York or PA and make money also. Money is everywhere. That’s what I keep telling people.

You can negotiate almost anywhere in any state you want. It doesn’t magically happen automatically You can go in at low rate like young Jedi in training and renegotiate. Even way past his prime doc I met. I had to tell him what to demand. He was horrible at negotiating. Now he gets paid to sleep outside the hospital at full regular hourly rate instead of beeper call rate. He’s happy. No clue why he’s even working though. He got massive buyout from management company, house paid off, kids grown was making 800-900k in the 2000s era before the buyout in 2014. So even some old timers don’t know the current locums market

You can do any deal depending on the level of desperation. Get a feel for an area you are working at. You can predict staffing shortage weeks in advance

Again, these rates are either hyperbole or there is some other important information missing (close relationship with hospital admin, direct exclusive gig with hospital after established relationship, dangerous work environment that no one else would cover...). These rates are NOT available out on the market to an unknown negotiating with the hospital or locums agency, no matter how good your negotiating skills are. Case in point: I'd travel to Florida to cover those beeper call shifts for $500/hr in a second as would most other people reading. Your friend may be great but no hospital will pass up the $200+/hr savings and your friend would be undercut in five seconds flat.

 

[aneftp]

Again, these rates are either hyperbole or there is some other important information missing (close relationship with hospital admin, direct exclusive gig with hospital after established relationship, dangerous work environment that no one else would cover...). These rates are NOT available out on the market to an unknown negotiating with the hospital or locums agency, no matter how good your negotiating skills are. Case in point: I'd travel to Florida to cover those beeper call shifts for $500/hr in a second as would most other people reading. Your friend may be great but no hospital will pass up the $200+/hr savings and your friend would be undercut in five seconds flat.

Correct. U gotta get in the door first. Get a feel for things. Remember you can always renegotiate your current contract. It’s all based on laws of supply and demands in this market.

This is what NFL football players do all the time.

And like I said numerous times. Don’t be a one trick pony. Have multiple side gigs at the same time.

Young Jedi got canceled last min last week at west side Florida. (They are gonna to be having to pay him at last 75% that guarantee rate currently for cancellations under 30 days. And he simply hop on to another gig that same week elsewhere. I gave him one of my days as well cause I wanna to get a head start on another vacation driving to 30A beaches.

 

[dabears505]

Is there an application process to join your jedi school?

 

[aneftp]

Is there an application process to join your jedi school?

Young Jedi owes 450k student loans and trying to pay for his wedding. He’s hungry the for cash.

 

[ryanjmy]

I'd travel to Florida to cover those beeper call shifts for $500/hr in a second as would most other people reading. Your friend may be great but no hospital will pass up the $200+/hr savings and your friend would be undercut in five seconds flat.

No you wouldn’t. You’re not getting a state liscense, getting credentialed, 2 days of travel plus one day of working at a facility you’re not familiar with for $12k. At least I wouldn’t.

These are one off situations where an admin is faced with overpaying vs shutting down a service line. $12k is chump change especially when your spending someone else’s money.

 

[aneftp]

No you wouldn’t. You’re not getting a state liscense, getting credentialed, 2 days of travel plus one day of working at a facility you’re not familiar with for $12k. At least I wouldn’t.

These are one off situations where an admin is faced with overpaying vs shutting down a service line. $12k is chump change especially when your spending someone else’s money.

One off has been going on a long time.

Anyways. I don’t think it’s worth doing down. That’s why the Michigan guys stay up in Michigan. The California guys stay in California. My dallas buddy stays in Dallas with his 1099 gigs

You lose travel time chasing. Like 2 days as you mentioned. And I agree with you.

Find your local niche places to work at. It does take some networking. But this kid been out only since 2023 and only started doing locums since last May 2024. He’s building his own network of places to work at. He tried a new place in April. He didn’t like it. So he aborted it. A lot of it is trial and error (and luck).

 

[DolphinVA]

No you wouldn’t. You’re not getting a state liscense, getting credentialed, 2 days of travel plus one day of working at a facility you’re not familiar with for $12k. At least I wouldn’t.

These are one off situations where an admin is faced with overpaying vs shutting down a service line. $12k is chump change especially when your spending someone else’s money.

Plenty of people (myself included) already have the license, have a clean record and can receive emergency credentialing within 24 hours, and don't mind the 2 hour flight to (allegedly) sit in a hotel room and make $777/hr. Or $500, maybe lower.

Don't get me wrong, I applaud these rates. But they are rare and have specific reasons behind them. More right-place-right-time than master negotiating.

 

[aneftp]

Plenty of people (myself included) already have the license, have a clean record and can receive emergency credentialing within 24 hours, and don't mind the 2 hour flight to (allegedly) sit in a hotel room and make $777/hr. Or $500, maybe lower.

Don't get me wrong, I applaud these rates. But they are rare and have specific reasons behind them. More right-place-right-time than master negotiating.

No master negotiator. Just tons of privileges everywhere

I don’t depend on any one source of income stream.

Full time long term locums does have its advantages such as stable guaranteed 40-60 hrs.

A standard locums long term contract is 50 hr guaranteed per week. Plus 1 24 hr call guarantee per week as well if you want to add that to the contract. Everything is negotiatabe

The difference between a doc and a crna full time locums is crnas are so picky. They want 40 hrs plus a Fridays off. The doc 1099 wont be that picky

But getting back to the original topic.

It’s business as usual for locums anesthesia. It’s gotta take a lot to close a hospital. The first hospitals that would be a hca type of rural hospital like one in the southeast (not florida) my friend covers 1099 for 500k with 26 weeks off. 7 calls every 4 weeks. It’s a horrible deal. I don’t know why he covers it. 168 hrs on call even if it’s light call averages it out to $114/hr plus he’s got a to work 1-2 hrs sometimes post call cause couple of the docs are weak and can’t handle 4 rooms and gi preops.

 

[ToKingdomCome]

Young Jedi owes 450k student loans and trying to pay for his wedding. He’s hungry the for cash.

Young Jedi a competent anesthesiologist with his locum job being his first real job rather than being In a real department ?

 

[dabears505]

Young Jedi a competent anesthesiologist with his locum job being his first real job rather than being In a real department ?

The young jedi was actually employed full time at a place with lots of mentors doing big cases and doing a ton of learning but no pay, but he was seduced to the dark side by aneftp with prospects of millions of dollars, dollars not possible with full time

 

[AppTrail]

Young Jedi owes 450k student loans and trying to pay for his wedding. He’s hungry the for cash.

Haha also interested in applying to young Jedi program, how much is tuition?

 

[Dr. Anonymouss]

@aneftp When are you going to come out with a guide teaching us young bucks how you do it? Help out the younger generation lol

 

[cchoukal]

@aneftp When are you going to come out with a guide teaching us young bucks how you do it? Help out the younger generation lol

There's no curriculum, you just gotta, as Rat says to Mike Damone in FTARH, "You put the vibe out to 30 million chicks, something's gonna happen." you just gotta want it less than they do.

 

[aneftp]

There's no curriculum, you just gotta, as Rat says to Mike Damone in FTARH, "You put the vibe out to 30 million chicks, something's gonna happen." you just gotta want it less than they do.

Correct. Gotta be like Jake Paul. Hitting on everything on insta. He nailed it with the Dutch Olympic speed skater Jutta Leerdam probably after he DM’d 1000 girls.

Someone will bite on the locums marker if you send out tons of DMs.

 

[GassYous]

Correct. Gotta be like Jake Paul. Hitting on everything on insta. He nailed it with the Dutch Olympic speed skater Jutta Leerdam probably after he DM’d 1000 girls.

Someone will bite on the locums marker if you send out tons of DMs.

999 nos and a one yes is still a yes

 

[Account1]

Correct. Gotta be like Jake Paul. Hitting on everything on insta. He nailed it with the Dutch Olympic speed skater Jutta Leerdam probably after he DM’d 1000 girls.

Someone will bite on the locums marker if you send out tons of DMs.

Can confirm, heavy rejection and multiple feelers is the only way to get a good deal.

 

[aneftp]

Can confirm, heavy rejection and multiple feelers is the only way to get a good deal.

The key is to get ur foot in the door first.

The other issue is some people are true full time locums so can’t afford to be without work for 2-4 weeks with no work

They can’t play the game of chicken like I do where I have a hybrid 500k with 20 true weeks off plus another 10 weeks where I can cover another place 7-430p if needed

True locums need some consistency and I get that. It’s better to get 20k of income revenue coming in each week for 3-6 months or whatever contract they get rather than gamble for a big 50k-60k week of work with pop up once in a while.

 

[Dr. Anonymouss]

The key is to get ur foot in the door first.

The other issue is some people are true full time locums so can’t afford to be without work for 2-4 weeks with no work

They can’t play the game of chicken like I do where I have a hybrid 500k with 20 true weeks off plus another 10 weeks where I can cover another place 7-430p if needed

True locums need some consistency and I get that. It’s better to get 20k of income revenue coming in each week for 3-6 months or whatever contract they get rather than gamble for a big 50k-60k week of work with pop up once in a while.

So I understand what you are saying in terms of compensation. Asking for above market rates and willing to walk if they refuse, but what a lot of us need to know are all the other things you experienced locums guys ask for in your contacts which make it a more lucrative gig. I guess I am saying things you have learned over time that you definitely want included in your contract or things they typically try to throw in your contracts that you know you want removed.

 

[DesiredMemberName?]

The key is to get ur foot in the door first.

The other issue is some people are true full time locums so can’t afford to be without work for 2-4 weeks with no work

They can’t play the game of chicken like I do where I have a hybrid 500k with 20 true weeks off plus another 10 weeks where I can cover another place 7-430p if needed

True locums need some consistency and I get that. It’s better to get 20k of income revenue coming in each week for 3-6 months or whatever contract they get rather than gamble for a big 50k-60k week of work with pop up once in a while.

Are you saying you work 22 weeks per year for 500k? “20 true weeks off plus another 10 weeks…”

I’d just work 2 of those jobs for 1mil w 10 weeks off. Forget the locums.

 

[aneftp]

So I understand what you are saying in terms of compensation. Asking for above market rates and willing to walk if they refuse, but what a lot of us need to know are all the other things you experienced locums guys ask for in your contacts which make it a more lucrative gig. I guess I am saying things you have learned over time that you definitely want included in your contract or things they typically try to throw in your contracts that you know you want removed.

I won’t do beeper call unless I have guarantees. Stupid to sit around for $100/hr or whatever they offer u $1000-1200/beeper ($2000-2400 24 hr beeper) plus call back $400/hr or whatever

Id just rather work 10-12 hrs and go home.

So it’s not just asking for above market rate. I rarely ask for above market rate unless I sense desperation. It’s all about guarantee money on call.

 

[Coffee PRN]

I won’t do beeper call unless I have guarantees. Stupid to sit around for $100/hr or whatever they offer u $1000-1200/beeper ($2000-2400 24 hr beeper) plus call back $400/hr or whatever

Id just rather work 10-12 hrs and go home.

So it’s not just asking for above market rate. I rarely ask for above market rate unless I sense desperation. It’s all about guarantee money on call.

Same. Pager fee is a pittance. Get all the hours guaranteed even for pager call.

 

[dabears505]

Beeper call can be a great deal if it's very rare call back, you live close by and don't do drugs or alcohol on your time off. It's free money

 

[aneftp]

Beeper call can be a great deal if it's very rare call back, you live close by and don't do drugs or alcohol on your time off. It's free money

Agree. That’s the only time it works (the beeper) . Within 10-15 min. Even than I’d just do 12 hr and go home and be home and wind down the ask for $1000/1200 for the night.

I understand money is money to 99% of people. And. Easy beeper money is still easy money. Just depends how you value your time.

 

[Coffee PRN]

Beeper call can be a great deal if it's very rare call back, you live close by and don't do drugs or alcohol on your time off. It's free money

hard to gauge if it will be a good deal if it is a new site to you. The callback rates recruiters will give you are probably wildly inaccurate

 

[aneftp]

hard to gauge if it will be a good deal if it is a new site to you. The callback rates recruiters will give you are probably wildly inaccurate

one of the disadvantages of full time or semi full time (2 week per month) locums when places need beeper call coverage

Hospitals may not accept you as candidate for facilities without call coverage. So you are in catch-22

 

[amyl]

If these hospitals and recruiters are so desperate- as they seem to be these days…. How about they push for streamlining the process for all of us? National license and dea that’s good anywhere? Hospital credentialing that’s not a total pain in the ass. The hospitals can approve your file the second it’s complete if they want to… I know I’ve signed off on peoples privileges before. Bloated useless lazy admins - ridiculous -
States could still make money charging you 1000$ to verify your National license

 

[A Deep Breath]

Are there people who pull off the aneftp life without involving a locums agency? i.e. Being credentialed and available for PRN at a bunch of local hospitals?

 

[aneftp]

Are there people who pull off the aneftp life without involving a locums agency? i.e. Being credentialed and available for PRN at a bunch of local hospitals?

I use locums agencies. It’s a pain to go direct.