Cardiac anesthesia locum

[deleted684261]

Hey all, ingot offered a cardiac only locum in a midwest city. They are offering 1800 for 8hrs day. 200 weekday and 1800 weekend pager fee. OT and call back rate of 250. Is this pretty inline with the current rates or am I being low balled? I feel like call back rate is low ....but I am not sure ....appreciate any inputs

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[caligas]

Hey all, ingot offered a cardiac only locum in a midwest city. They are offering 1800 for 8hrs day. 200 weekday and 1800 weekend pager fee. OT and call back rate of 250. Is this pretty inline with the current rates or am I being low balled? I feel like call back rate is low ....but I am not sure ....appreciate any inputs

Tell them you’ll do it for $2200/8hrs and if they bump the weekday pager fee to $500.

But I don’t really know what I’m talking about, I just like negotiating.

 

[dabears505]

That's not bad for a city. You could do better im some really rural place, but city it will be hard to get better rates. Especially in these times.

 

[Zekchar]

Hey all, ingot offered a cardiac only locum in a midwest city. They are offering 1800 for 8hrs day. 200 weekday and 1800 weekend pager fee. OT and call back rate of 250. Is this pretty inline with the current rates or am I being low balled? I feel like call back rate is low ....but I am not sure ....appreciate any inputs

Rates are appropriate but never take the first offer. Can always ask for 2k/8hr and settle on 1900. Make sure car, hotel, flight, and malpractice are covered.

 

[chocomorsel]

Tell them you’ll do it for $2200/8hrs and if they bump the weekday pager fee to $500.

But I don’t really know what I’m talking about, I just like negotiating.

You know what you are talking about. Want to help me negotiate?

 

[chocomorsel]

Hey all, ingot offered a cardiac only locum in a midwest city. They are offering 1800 for 8hrs day. 200 weekday and 1800 weekend pager fee. OT and call back rate of 250. Is this pretty inline with the current rates or am I being low balled? I feel like call back rate is low ....but I am not sure ....appreciate any inputs

Those numbers are low. Those are generalist numbers.

 

[vector2]

$2k per day for cardiac locums is a minimum, imo. The pager and callback rate is fine. Is it with CRNAs or MD only?

 

[secretasianman]

U are cardiac it should be higher.

 

[deleted684261]

$2k per day for cardiac locums is a minimum, imo. The pager and callback rate is fine. Is it with CRNAs or MD only?

would be solo MD thats my understanding ...

 

[deleted684261]

Thank guys. Have been difficult to find 2000 a day locum gig especially with the current covid situation. This would be my first time venturing out and trying to not rookie mistakes.

 

[KENY1]

$1800 Is more like for regular anesthesia, cardiac should be $2000.

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[dchz]

Agree with bump up in weekday pager. why is weekend pager call worth 9x the weekday? is that normal for you guys?

 

[Sonny Crocket]

Come on guys. None of us are doing this for the money. We do it for the pure joy of proving a service for surgeons.

 

[pgg]

Agree with bump up in weekday pager. why is weekend pager call worth 9x the weekday? is that normal for you guys?

There are a couple factors that make pager fees higher on the weekends.

One, people generally value weekend hours more than weeknight, so it's not completely crazy.

Two, cardiac pager call generally has really low call-in rate. It's not like general call or god forbid OB which often amounts to an expected overnight in-hospital shift. $200 for holding the pager and $250/hr with a 2 hr minimum for call backs is quite reasonable IMO for rare call-ins.

Three, locums people who book a week or a two at a time are going to be present during the week, probably doing nothing but hanging out in a hotel room. A smaller fee, with a near-zero call-in rate, when you're staring at the wall in a hotel room anyway, is where that market naturally settles. But weekends are different. Before/after a week's work, a locums might not even want to be in town at all. It's common to show up Sunday night to start working Monday, or to GTFO of town the minute that work ends on Friday. If you want a locums to spend the weekend in your town, you need to pay more money.


I think the reasonableness of those call rates really depends on how often you get called in on those weeknights and weekends. The $250/h callback rate is solid, provided there's a minimum hour count for any callback. If they call you in and then decide not to operate after all, they should owe you more than a 15 minute increment of the hourly rate.

 

[ryanjmy]

I’ve got a side gig that almost exactly fits the description of the op except I would call it a very small city. $300/hr guaranteed 8hrs.

Take that with a grain of salt though as I negotiated that back in January and I doubt there was any competition. I suspect the market is entirely different now.

 

[JiPo]

Question about locums - it is a completely different hospital, you have no idea where things are located, charting could be completely different. Are you given some sort of orientation on your first day before you are thrown into OR? And I assume you are paid for the orientation time as well?

 

[chocomorsel]

Every hospital is different. Some just throw you in, some give you an hour or so of orientation. And yes, you are paid starting as soon you set up in hospital.

 

[Twiggidy]

I'm wondering if it's going to be a bit of a "buyers market" the next few months given the back log of cases. I agree that you should negotiate up especially if it's in a place that struggles to get coverage.

 

[46Long]

Question about locums - it is a completely different hospital, you have no idea where things are located, charting could be completely different. Are you given some sort of orientation on your first day before you are thrown into OR? And I assume you are paid for the orientation time as well?

Back in the day the orientation was here is the OR, the cafeteria is on the 2nd floor, the lounge is over there and the crapper is over there. 10 min orientation.

I did a couple months of locums at a place last year, 1 week of epic training and orientation at the tune of 14k for the week. Just for orientation. LOL. And it was BS orientation. I spent 2 FULL days (9 hours each day) in a lecture hall with epic trainers. ANd still had no clue what i was doing when i started working with epic.. The system is BLOATED. I am not even including badge access, learning all the different codes to get into pixis, anesthesia cart, ob door, locker room door, Or door, signature codes. And each one of these has a diff administrator for each. Its a disaster

 

[pgg]

I once got paid to sit at home and do online training modules for an EMR. They just told me to fill out a timecard for however many hours it took me.

Usually it's at most an hour or two the first day to get shown around, get a badge, computer access. The places with their act together hand me a badge and a post-it with computer codes when I walk in the door. Or Sunday afternoon or evening I stop by the hospital and walk around with the call guy for a bit.

 

[pgg]

I'm wondering if it's going to be a bit of a "buyers market" the next few months given the back log of cases. I agree that you should negotiate up especially if it's in a place that struggles to get coverage.

I think it could go either way. A lot of people have been out of work, or underemployed during this thing. I bet a lot of regulars won't be taking vacation in the near future, and may be looking for extra days and extra call. I sure will be.

Wouldn't surprise me if the locums market was absolute crap for the next year.

 

[kidthor]

Wouldn't surprise me if the locums market was absolute crap for the next year.

Agreed - I bet locums won't be a great avenue for about a year.

 

[46Long]

I think it could go either way. A lot of people have been out of work, or underemployed during this thing. I bet a lot of regulars won't be taking vacation in the near future, and may be looking for extra days and extra call. I sure will be.

Wouldn't surprise me if the locums market was absolute crap for the next year.

i think quite the opposite, i think after this thing people will be bailing completely. The ones who were on the edge.
And if you got screwed by envision, everyone is looking for the exit 1st chance they get.

 

[deleted684261]

There are a couple factors that make pager fees higher on the weekends.

One, people generally value weekend hours more than weeknight, so it's not completely crazy.

Two, cardiac pager call generally has really low call-in rate. It's not like general call or god forbid OB which often amounts to an expected overnight in-hospital shift. $200 for holding the pager and $250/hr with a 2 hr minimum for call backs is quite reasonable IMO for rare call-ins.

Three, locums people who book a week or a two at a time are going to be present during the week, probably doing nothing but hanging out in a hotel room. A smaller fee, with a near-zero call-in rate, when you're staring at the wall in a hotel room anyway, is where that market naturally settles. But weekends are different. Before/after a week's work, a locums might not even want to be in town at all. It's common to show up Sunday night to start working Monday, or to GTFO of town the minute that work ends on Friday. If you want a locums to spend the weekend in your town, you need to pay more money.


I think the reasonableness of those call rates really depends on how often you get called in on those weeknights and weekends. The $250/h callback rate is solid, provided there's a minimum hour count for any callback. If they call you in and then decide not to operate after all, they should owe you more than a 15 minute increment of the hourly rate.

I was able to negotiate call back rate up to 275/hr. There is only one CT surgeon so I can't imagine call back will be that terrible. But no idea. PGG if you are signing on for a longer time perior like 1 2 months, do you normally try to negotiate your rate up? My experience recently been covid 19 has eliminated a lot of locum positions and it has been hard to negotiate the rate upward as there are also a lot of out of work gas docs ....

 

[deleted684261]

i think quite the opposite, i think after this thing people will be bailing completely. The ones who were on the edge.
And if you got screwed by envision, everyone is looking for the exit 1st chance they get.

I hope you are right but as of now, it has been the opposite for me looking for locum work. Maybe things will change in a few months.

 

[pgg]

I was able to negotiate call back rate up to 275/hr. There is only one CT surgeon so I can't imagine call back will be that terrible. But no idea. PGG if you are signing on for a longer time perior like 1 2 months, do you normally try to negotiate your rate up? My experience recently been covid 19 has eliminated a lot of locum positions and it has been hard to negotiate the rate upward as there are also a lot of out of work gas docs ....

I'm not the best person to ask because my circumstances are so weird, and I'm deployed overseas right now so I have very little sense of what's going on back home, in terms of what's available in the CT locums world. I suspect almost nothing because cardiac surgical volume has plummeted. But I don't know.

I got my current main cardiac locums gig a little over a year ago, and negotiated a rate directly with the hospital. $2100 for an 8 hour day + 270 OT, weeknight pager call $315, weekend pager call was $1400; hourly rate added to the call-ins. Call-in frequency at that hospital is about 4-5 times per year total; it's a pretty low key, low risk cardiac surgery program. Nothing wild.

Unfortunately the hospital system got bought out and has made everyone employees, and has declared that now their cardiac PRN rate is $210/hour. No room for negotiation. I live a few minutes away from that hospital so it's a perfect moonlighting deal for me being on active duty, mainly because I don't have to spend my limited Navy vacation time to work there. I'll probably just suck it up and take it when I get back, because the proximity means I can do the pager call from my own home.

I have two other hospitals where I'm credentialed and can work at a higher rate but both require travel. Having spent the last 8 months living in a sort of dormitory, I've got one word for more travel right now and it's an obscene one. Also, a big part of the reason I do locums in the first place is to supplement the meager cardiac case load I get from the Navy and the VA. So for now I'm willing to work for less if it means I can be at home and get a good cardiac case load.

To answer your question from a different angle, I really haven't found that it's easy to negotiate a higher rate by agreeing to a longer term. I've had a place tell me (and this is almost verbatim) "yeah locums rates are higher, but that's locums, if you're going to be here a long time you'll be a PRN employee, and we won't pay locums rates for PRN people" and I walked. If I have to live in a hotel they're going to Pay Me.

 

[vector2]

To answer your question from a different angle, I really haven't found that it's easy to negotiate a higher rate by agreeing to a longer term. I've had a place tell me (and this is almost verbatim) "yeah locums rates are higher, but that's locums, if you're going to be here a long time you'll be a PRN employee, and we won't pay locums rates for PRN people" and I walked. If I have to live in a hotel they're going to Pay Me.

I’m not sure how difficult the recruiting is at the gig where you walked, but I know of two places in my neck of the woods that have been paying cardiac locums big $$$$$ for years instead of just recruiting a FT person and paying them fairly. It’s truly mind boggling how much money they would have saved long term just by paying a FT doc 80-90% of the locums rate.

 

[AdmiralChz]

In April the cardiac surgery volume at our pseudo-academic hospital was down 90%. Little to no demand for locums right now, and having a diversified (not 100% cardiac) practice has been a very good move.

 

[sethco]

I’m not sure how difficult the recruiting is at the gig where you walked, but I know of two places in my neck of the woods that have been paying cardiac locums big $$$$$ for years instead of just recruiting a FT person and paying them fairly. It’s truly mind boggling how much money they would have saved long term just by paying a FT doc 80-90% of the locums rate.

Out of curiosity, how much are they paying and what part of the country is this. Just asking for a friend, haha

 

[caveat87]

judging by the fact that I got 5 calls today from recruiters, I'd say the demand for locums work is pretty hot and most experienced docs with ample savings are just riding this out. whatever you do dont let the recruiters get away without a negotiation. As far as I'm concerned these guys/gals are bottom feeders easily upcharging groups and hospitals >$80 per hour of your time while assuming none of the malpractice risk

 

[Twiggidy]

In April the cardiac surgery volume at our pseudo-academic hospital was down 90%. Little to no demand for locums right now, and having a diversified (not 100% cardiac) practice has been a very good move.

this is so true. In a normal world, if you did a cardiac fellowship doing all hearts all the time would seem like the perfect setup until a pandemic hits and people stop doing heart surgery. Now, some surgeons can claim all their heart surgeries are urgent and certainly a case can be made, but as in most things financial being diversified is definitely a benefit.

I do think in the locums world there is money to be made given the backlog of cases. I would say even for us with pretty stable jobs there is going to be a big opportunity to get extra work to make up for 2 months of low/no income. It really just depends on the schedule and how much you want to work.