Current job market

[TheLoneWolf]

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Anyone else noticing that in the past half year or so, most hospitals and groups have staffed up and have very limited locums to fill gaps in the schedules.

Two oddities I have noted.

1. Several hospitals in my area are not hiring. Not even for call takers. State facilities and places offering pensions tell me they have a large line of applicants hounding them for a position. They pay either less than or at MGMA. Nondesirable large city.

2. Hilariously, each hospital recruiter and PP group in my area had inquired of me if I knew any CRNAs were available as none could be found.

I wonder if hospital employment with higher supervision ratios is the admin endgame.

Even the group that offered me 325,000 for 40 hours a week, straight face in 2023 is all staffed up save for a desperate need for CRNAs

 

[dizzy21]

Haven’t noticed a letup in the locums market here in northeast. I have met locums from Texas and Florida who travel up here because they say the market is terrible with horrible pay in those areas. Depends on your location, but still plenty of locums demand nationwide.

If anything the rates continue to inch up…

 

[Howard888]

Yeah my phone still rings non stop for locums.

Yes CRNAs are short. Some of the locums I get called for are for temporary Md only in a setting that used to be only Md direction as they can’t get CRNAs.

And yes…higher supervision ratios are definitely the end game. At least until the salary of CRNA’s is almost equal to mds.

Now a 1099/locum crna can make as much as many MDs especially MDs in academics or those being abused by an amc. But w2 salaries of CRNAs are still much less than w2 salaries of MDs in most markets and so hospital admins are looking for higher supervision ratios still.

The bigger problem is that all anesthesia provider types combined don’t get close to covering all of the increasing needs out there so there aren’t enough MDs to sit rooms either. Or AAs.

One of the items that I think is also at play here is that the cost of moving is so high. Most professionals have houses at sub 4 or 3% interest rates. So moving, even for higher salaries, isn’t worth the exchange of homes for one at 7%. So this basically leaves locums as the primary option for many to take advantage of the market but locums isn’t for probably half the workforce….

Complicated issue but demand isn’t going away anytime soon

 

[aneftp]

Anyone else noticing that in the past half year or so, most hospitals and groups have staffed up and have very limited locums to fill gaps in the schedules.

Two oddities I have noted.

1. Several hospitals in my area are not hiring. Not even for call takers. State facilities and places offering pensions tell me they have a large line of applicants hounding them for a position. They pay either less than or at MGMA. Nondesirable large city.

2. Hilariously, each hospital recruiter and PP group in my area had inquired of me if I knew any CRNAs were available as none could be found.

I wonder if hospital employment with higher supervision ratios is the admin endgame.

Even the group that offered me 325,000 for 40 hours a week, straight face in 2023 is all staffed up save for a desperate need for CRNAs

I just got offered $9000 for 24hr in dfw proper with recruiter who accidentally texted me. Lol

It’s so hilarious. We started the coversation “do I know you? “Who is this”. It was truly an mis sent text Than we just started texting each other.

Because I had done some locums 18 years ago with a spin off of the same recruiting company. And she was asking if I still did cardiac in California. Which I did. So she put two and two together and remembered me.

Don’t settle guys (and gals). And docs in Dallas are settling for $5000/24 hr calls flat. (I know some of them).

And I don’t even have a Texas medical license.

So all you guys claiming Dallas is a tough market. It is a tough market.
But you aren’t searching hard enough. My bff is gonna to hit 1.4? This year. In Dallas.

You gotta work it. Nothing is given.

Now I don’t know how hard this $9000/24 hr is.

I like easy money. I like to sleep while on call.

But the money is there to make.

 

[psychbender]

One of the items that I think is also at play here is that the cost of moving is so high. Most professionals have houses at sub 4 or 3% interest rates. So moving, even for higher salaries, isn’t worth the exchange of homes for one at 7%.

As someone going through this right now, it sucks. I would have been ok with locums, but not my family, so I'm instead taking a new job in academics for quite a bit more than I make now (slightly more hours, and I'll have to go back to taking some call). We have a home at 2.375%, and don't think we'll sell it any time soon, since comparable rents in our area are much higher than our mortgage. Instead, we may rent to a surgeon here, or another family looking to relocate to our neighborhood for at least the next few years. The new mortgage rate will be just over 7%, and I nearly vomited when I saw just how much we'll be paying for a very similar sized house in the new area (not a particularly HCOL).

 

[aneftp]

Haven’t noticed a letup in the locums market here in northeast. I have met locums from Texas and Florida who travel up here because they say the market is terrible with horrible pay in those areas. Depends on your location, but still plenty of locums demand nationwide.

If anything the rates continue to inch up…

1 million in Florida with multi gigs is easy to find in and 12 weeks off. More if u want to work more

The people who claim Florida’s is not good. Good. Stay out of Florida. lol.

My jr buddy 32 yo 2023 newer grad. I’ve taught him the ways. He’s gonna to be a Jedi soon. Completely raping west side of Florida this week for big money $430/hr plus 80 hrs. All guaranteed money. 100% supervision 1:3 or 1:2. lol. It’s so funny when people say there aren’t any jobs in Florida. They aren’t searching hard enough.

And he made 42k last week on the east side of Florida. 110k in May. Not bad. Taking 1 week off.

He follows my lead. No kids. East west north. Only tight spot is Miami proper. But u can find pockets outside of Miami if you wanna to drive.

The student has become the master in less than 2 years.

 

[aneftp]

As someone going through this right now, it sucks. I would have been ok with locums, but not my family, so I'm instead taking a new job in academics for quite a bit more than I make now (slightly more hours, and I'll have to go back to taking some call). We have a home at 2.375%, and don't think we'll sell it any time soon, since comparable rents in our area are much higher than our mortgage. Instead, we may rent to a surgeon here, or another family looking to relocate to our neighborhood for at least the next few years. The new mortgage rate will be just over 7%, and I nearly vomited when I saw just how much we'll be paying for a very similar sized house in the new area (not a particularly HCOL).

Agree keep the 2.375% mortgage if you don’t need move.. That’s close to free money. And renting it out but only to well known people. Renters suck.

 

[TheLoneWolf]

I just got offered $9000 for 24hr in dfw proper with recruiter who accidentally texted me. Lol

It’s so hilarious. We started the coversation “do I know you? “Who is this”. It was truly an mis sent text Than we just started texting each other.

Because I had done some locums 18 years ago with a spin off of the same recruiting company. And she was asking if I still did cardiac in California. Which I did. So she put two and two together and remembered me.

Don’t settle guys (and gals). And docs in Dallas are settling for $5000/24 hr calls flat. (I know some of them).

And I don’t even have a Texas medical license.

So all you guys claiming Dallas is a tough market. It is a tough market.
But you aren’t searching hard enough. My bff is gonna to hit 1.4? This year. In Dallas.

You gotta work it. Nothing is given.

Now I don’t know how hard this $9000/24 hr is.

I like easy money. I like to sleep while on call.

But the money is there to make.

That makes my $400 for OR call and $4000 for 24 hr in house OB (crazy busy) look paltry. Bravo

 

[aneftp]

That makes my $400 for OR call and $4000 for 24 hr in house OB (crazy busy) look paltry. Bravo

Nah. The docs are making 11-12k per 24 hrs with a 2 crnas in house in Florida Doc gets to sleep Non trauma hospital.


$9000/24 hr probably solo in Dallas ain’t worth nothing to me.

You want easy money.

 

[ucladoc2b]

Anyone else noticing that in the past half year or so, most hospitals and groups have staffed up and have very limited locums to fill gaps in the schedules.

Two oddities I have noted.

1. Several hospitals in my area are not hiring. Not even for call takers. State facilities and places offering pensions tell me they have a large line of applicants hounding them for a position. They pay either less than or at MGMA. Nondesirable large city.

2. Hilariously, each hospital recruiter and PP group in my area had inquired of me if I knew any CRNAs were available as none could be found.

I wonder if hospital employment with higher supervision ratios is the admin endgame.

Even the group that offered me 325,000 for 40 hours a week, straight face in 2023 is all staffed up save for a desperate need for CRNAs

Almost everywhere is still hiring. Most places may be “better staff” with the new residents/fellows coming out of training. But this will change.

 

[amyl]

I wanted to share this job post that I found on GasWork.com https://www.gaswork.com/post/523520

San Angelo Texas has upped their offer 750-800k, 10-12 weeks vacation for solo cases….. 3 calls per month from home… I’m sure there’s some sort of devil in the details. I frequently hear from 4 different locums recruiters for this site…. Must be sick of the $ and the insufficient supply of drs.

 

[aneftp]

I wanted to share this job post that I found on GasWork.com https://www.gaswork.com/post/523520

San Angelo Texas has upped their offer 750-800k, 10-12 weeks vacation for solo cases….. 3 calls per month from home… I’m sure there’s some sort of devil in the details. I frequently hear from 4 different locums recruiters for this site…. Must be sick of the $ and the insufficient supply of drs.

20k cases a year is a lot.
MD only?

Need set defined hours.

 

[Ashers]

I wanted to share this job post that I found on GasWork.com GasWork.com - Reference #523520

San Angelo Texas has upped their offer 750-800k, 10-12 weeks vacation for solo cases….. 3 calls per month from home… I’m sure there’s some sort of devil in the details. I frequently hear from 4 different locums recruiters for this site…. Must be sick of the $ and the insufficient supply of drs.

There are 10 of us locums here this week. There are CRNAs -- they work under the surgeon/proceduralist license; it's on the anesthesia consent.

I love this hospital. If I weren't single and had friends outside the hospital (everyone here in the hospital is lovely), I'd move here. It's also hot, and I'm tired of hot.

 

[NightyNight]

Almost everywhere is still hiring. Most places may be “better staff” with the new residents/fellows coming out of training. But this will change.

Meaning like the new grad will quit in a 1 year or so? I’ve heard that a small yet significant portion of youngins are resigning in Chicago area megacorp jobs like Advocate. Thus the cycle of locums continues.

 

[aneftp]

There are 10 of us locums here this week. There are CRNAs -- they work under the surgeon/proceduralist license; it's on the anesthesia consent.

I love this hospital. If I weren't single and had friends outside the hospital (everyone here in the hospital is lovely), I'd move here. It's also hot, and I'm tired of hot.

Basically like an Iowa situation?

Crna “solo” under surgeon and
Anesthesiologist solo
That will probably be the future.

 

[amyl]

Why? I don’t get this at all. If the surgeons and hospitals are okay with surgeons supervising why would they hire anesthesiologists? This makes no sense. Run 4:1 medical direction, bill more, cover more rooms

 

[psychbender]

Why? I don’t get this at all. If the surgeons and hospitals are okay with surgeons supervising why would they hire anesthesiologists? This makes no sense. Run 4:1 medical direction, bill more, cover more rooms

Technically, running everyone solo, they can cover more rooms, as there's no one outside of the rooms directing. Also, billing is identical for solo physician and solo CRNA. Its only the >1:4 supervision that is paid at the lower rate.

My thought is that there are a lot of surgeons that just don't give a ****, as long as their cases aren't delayed and the patients don't die, so they get the solo CRNAs. The ones that do give a **** opt for the physicians.

 

[DoctwoB]

Basically like an Iowa situation?

Crna “solo” under surgeon and
Anesthesiologist solo
That will probably be the future.

Surgeon here. You mean I assume liability for the CRNA? No way I'm touching that (maybe if the REEEALLLY make it worth my while)

 

[Lab Lover]

Surgeon here. You mean I assume liability for the CRNA? No way I'm touching that (maybe if the REEEALLLY make it worth my while)

Depends on state law, institution bylaws and contracts.

 

[centdoc]

And if the surgeon even knows the hospital is straddling them with the liability. I’m sure many surgeons don’t even know they’re holding all of the liability.

 

[aneftp]

Surgeon here. You mean I assume liability for the CRNA? No way I'm touching that (maybe if the REEEALLLY make it worth my while)

The rules are loose. Hospital will say there is an anesthesiologist immediate available whatever that means.

Who knows how this are billing qz?

I’m not there but sometimes indigent hospital don’t care Becuase there is sovereign immunity involved

 

[DocMcCoy]

I wanted to share this job post that I found on GasWork.com https://www.gaswork.com/post/523520

San Angelo Texas has upped their offer 750-800k, 10-12 weeks vacation for solo cases….. 3 calls per month from home… I’m sure there’s some sort of devil in the details. I frequently hear from 4 different locums recruiters for this site…. Must be sick of the $ and the insufficient supply of drs.

This is my job. Ain’t no devil.

 

[anonperson]

Basically like an Iowa situation?

Crna “solo” under surgeon and

F that .

Had a routine hysteroscopy recently. Reasonable health other then obesity, maybe BMI 35 or so

Patient desatted significantly during induction. Laryngospasm from what anesthesiologist told me.

He handled it like a pro and case went on.

Why would I want an inferior "provider" doing anesthesia? Why would I want to touch any of that liability?

 

[aneftp]

This is my job. Ain’t no devil.

Are u working 45 hr-50 hr a week? For 750k? Inclusive of calls. I rate beeper calls as almost equivalent of regular calls because it’s your time.

 

[DocMcCoy]

Are u working 45 hr-50 hr a week? For 750k? Inclusive of calls. I rate beeper calls as almost equivalent of regular calls because it’s your time.

Hours are Less. I won’t put that specific number out loud, but less. Including regular call, which aren’t 24hrs, with a post call day off.

The net numbers are accurate, as in what all of us that are full time will see on our W2.

 

[ambiturner]

In my area a lot of permanent jobs are staffed up with MDs but can’t find any CRNAs who want to sign a contract for anything but locums/per diem/pick their spots gigs. They then may use locums MDs to cover the CRNA deficit. CRNA locums rate is essentially the same as an employed MD and all the major players offered large signing bonuses that tied in the new hires for at least a few years, so little turnover at places that went employed in last 12-18 months. Still a lot of turnover at established places, rates for locums and permanent staff more or less the same or just tracking up with inflation.

 

[aneftp]

In my area a lot of permanent jobs are staffed up with MDs but can’t find any CRNAs who want to sign a contract for anything but locums/per diem/pick their spots gigs. They then may use locums MDs to cover the CRNA deficit. CRNA locums rate is essentially the same as an employed MD and all the major players offered large signing bonuses that tied in the new hires for at least a few years, so little turnover at places that went employed in last 12-18 months. Still a lot of turnover at established places, rates for locums and permanent staff more or less the same or just tracking up with inflation.

The issue is
1. Crnas who do full time locums want total control of their schedule the ones I talk to. Surprisingly top hourly pay per hour is not the top priority. Obviously they don’t want to get underpaid. Say $160/hr. But they will settle for $190/hrs (in Florida) over $225/hr if the $225/hr requires a more rigid 4 (10h) and not let them pick their day off

2. MD daytime docs is more reliable 5 days a week. But I find most Md daytime slots are hard to fill these days. Most mommy docs want 7-3 and only 3 days a week.

Hardly anyone wants to work 5 days a week these days. Unless they are 0.5 fte.

So the MD daytime doc to cover crna locums 1099 equivalent sounds great on paper. But it doesn’t work in real life.

Like I said. Some executives sit in a board room and think of these “great” ideas. Hey. 500k W2 MD salary doc solo in place of crna locums 500k equivalent after locums fees

Just doesn’t work. These executives who makeup these schedules should try working 5 days a week solo in rooms 7-3. Do it for even 2 weeks in a row. It will drive them nuts. And they want a doc to do it for 42-44 weeks out of the year? Gtfo. I’m serious.

 

[psychbender]

Just doesn’t work. These executives who makeup these schedules should try working 5 days a week solo in rooms 7-3. Do it for even 2 weeks in a row. It will drive them nuts. And they want a doc to do it for 42-44 weeks out of the year? Gtfo. I’m serious.

To each their own. I only work solo in the OR, generally 7-3 (unless 4-day week due to holiday, then I do 7-5), no call, and have no problem doing this for several weeks in a row. I also work in the ICU, so my general groove was OR 2-3 weeks, ICU, off, back into the OR for a week or two, then off again, repeat. I was doing <1900 hours a year, 17 weeks off, only weekends in the unit. It was great, highly sustainable, lots of professional satisfaction. The only reason I'm leaving is because hospital admin are deciding to **** around with my group. My group leadership has continued to offer me what we agreed, but my former colleagues are becoming increasingly upset with the new deal with the hospital, and I quite frankly would not want to be a patient here any longer (the only major hospital for an hour in any direction).

Just because you don't like something does not mean it's a bad deal.

 

[aneftp]

To each their own. I only work solo in the OR, generally 7-3 (unless 4-day week due to holiday, then I do 7-5), no call, and have no problem doing this for several weeks in a row. I also work in the ICU, so my general groove was OR 2-3 weeks, ICU, off, back into the OR for a week or two, then off again, repeat. I was doing <1900 hours a year, 17 weeks off, only weekends in the unit. It was great, highly sustainable, lots of professional satisfaction. The only reason I'm leaving is because hospital admin are deciding to **** around with my group. My group leadership has continued to offer me what we agreed, but my former colleagues are becoming increasingly upset with the new deal with the hospital, and I quite frankly would not want to be a patient here any longer (the only major hospital for an hour in any direction).

Just because you don't like something does not mean it's a bad deal.

2-3 weeks and icu is different. U are breaking the OR continuous weeks.

Try OR 42-44 weeks.

You aren’t even close to 42-44 weeks OR. Closer to 20-26 weeks in the OR

Icu coverage is different. You should know this.

 

[amyl]

This is my job. Ain’t no devil.

Good I’m very glad to hear they are treating you well. They should - How’s San Angelo?

 

[psychbender]

2-3 weeks and icu is different. U are breaking the OR continuous weeks.

Try OR 42-44 weeks.

You aren’t even close to 42-44 weeks OR. Closer to 20-26 weeks in the OR

Icu coverage is different. You should know this.

Right, ICU coverage is more hours (7a-7p M-Su). 42 wks at 40hrs/week is only 1680hrs/yr, when I'm doing 1840-1900 (25 weeks OR, 10 weeks ICU). Working M-F 7-3 is not "grinding it out." That's an easy week.

 

[aneftp]

Right, ICU coverage is more hours (7a-7p M-Su). 42 wks at 40hrs/week is only 1680hrs/yr, when I'm doing 1840-1900 (25 weeks OR, 10 weeks ICU). Working M-F 7-3 is not "grinding it out." That's an easy week.

You aren’t doing straight OR. Day in and day out.

You get a break with icu

ICU has tons of downtime as you know. 7a-7p icu 7 days isn’t that grueling.

But everyone handles work and stress differently. And every icu workload is different.

My point is you aren’t doing straight OR 42-44 weeks 5 days a week no calls no weekends.

You aren’t gonna to find many docs at 450-500k (whatever salary you think is comparable for
1099 crna daytime) for 5 days a week continuously.

 

[DocMcCoy]

Good I’m very glad to hear they are treating you well. They should - How’s San Angelo?

Yes, it was a long time coming. But it is San Angelo. It’s hot, it’s dry, and there isn’t much to do compared to even other 100k cities. Great for a family. Otherwise it’s a tough sell. Money, lifestyle, location. 2/3 ain’t bad.

 

[aneftp]

Lots of hospitals seem fully staffed, making locum jobs harder to find. The part about CRNAs being in demand while regular jobs are harder to get is interesting - maybe hospitals want more oversight with stricter staffing models. Also, the places not hiring even for basic roles and still getting tons of applicants says a lot about how some areas just have too many people chasing too few spots.

Good. It’s a free market. If the docs are happy with their current position. Than anesthesia admin or hospital admin is doing something right

Not all w2 jobs are bad.
Most of the 1099 gigs I go to especially downtown or suburban cities are very easy fixes

Reasons why they aren’t fixed

1. The current w2 docs like to keep manipulating the systems to their advantage either to make more money or work less and use locums

2. Current chief completely manipulates
The schedule to their advantage (non clinical days, 3 days weekends 3 weeks out of the month)

These situations are clear as day

It’s hardly Becuase docs are overworked. Most of the time it’s management and bad management at that.

 

[psychbender]

You aren’t doing straight OR. Day in and day out.

You get a break with icu

ICU has tons of downtime as you know. 7a-7p icu 7 days isn’t that grueling.

But everyone handles work and stress differently. And every icu workload is different.

My point is you aren’t doing straight OR 42-44 weeks 5 days a week no calls no weekends.

You aren’t gonna to find many docs at 450-500k (whatever salary you think is comparable for
1099 crna daytime) for 5 days a week continuously.

Only one of us does both and has the ability to judge relative stress. My 84 hour ICU weeks are far more draining than my 40 hour OR weeks. The idea that they have so much downtime, and thus offer a break from the OR is laughable.

I think you'll find more docs willing to work those conditions than you think. Until very recently, many in PE practices and academics had only 8 weeks off, and had call on top of 45-50 hour weeks in order to make those numbers. While there are early-adopters like you to the make piles of cash with locums movement, far more are still just going to keep grinding away at whatever fulltime job they have. If you offer them fewer hours than they're currently working for the same total pay, they may actually take it.

Further, I'm seeing more docs getting tired of the constant push to direct nurses at every increasing ratios, and would welcome doing their own cases. The major gripe I hear from my former partners is that they no longer get to do their own cases outside of call (we used to be about 60/40 solo/direction back when I joined a few years ago).

 

[aneftp]

Only one of us does both and has the ability to judge relative stress. My 84 hour ICU weeks are far more draining than my 40 hour OR weeks. The idea that they have so much downtime, and thus offer a break from the OR is laughable.

I think you'll find more docs willing to work those conditions than you think. Until very recently, many in PE practices and academics had only 8 weeks off, and had call on top of 45-50 hour weeks in order to make those numbers. While there are early-adopters like you to the make piles of cash with locums movement, far more are still just going to keep grinding away at whatever fulltime job they have. If you offer them fewer hours than they're currently working for the same total pay, they may actually take it.

Further, I'm seeing more docs getting tired of the constant push to direct nurses at every increasing ratios, and would welcome doing their own cases. The major gripe I hear from my former partners is that they no longer get to do their own cases outside of call (we used to be about 60/40 solo/direction back when I joined a few years ago).

Every practice location is different. Every region is different. The icu docs in Florida where I’m at. Don’t particularly work hard. And I see them daily. 3 of them live in my same neighborhood. We see each other in the same hospitals. One week clinical 7a-7p like you. 7 days a week. One week “consult” daytime. 2 weeks off. Totally chill. They aren’t working hard. The np covers the nights. The icu docs are available if np has issues at night during their clinical weeks.

Your work mileage will vary in terms how hard you work. Only you can figure how hard your work is.

Just like regular anesthesia folks. Some of them get killed daily. And some have it easy. Sometimes perception is reality. Even in the same zip code hospitals function differently.

I think the docs in general work too hard out west in urban areas and up north particularly the north east. I’ve experienced that for the first part of my career.

So a doc working hard grinding away with q4/5 calls being up all night than getting chance to work just days may feel relief. It’s all relative.

Vs a doc sleeping at night most of the time. Getting tons of time off. Double the time off as the day docs. Those days docs start to realize. Why am I slaving away at 36 hrs a week solo with no calls and no weekends but working 5 days a week and only 10 weeks off making the same 500k as the night float doc who sleeps all the time with a crna doing the cases for him and who has 26 weeks off and only works 45 hrs/per week in those 2 weeks they actual work.

Everything is relative to your cohort. And how much they work.

 

[nimbus]

the night float doc who sleeps all the time with a crna doing the cases for him and who has 26 weeks off and only works 45 hrs/per week in those 2 weeks they actual work.

Seems like a good way to show hospitals and CRNAs that we are unnecessary.

 

[aneftp]

Seems like a good way to show hospitals and CRNAs that we are unnecessary.

Well everyone slept last night. Lol. Guess we are all unnecessary.

Crna has chill schedule also. Makes 250k working 8 days a month plus 11 weeks off. Basically working 22 weeks out of the year. Most of those crnas make 350-400k since they have tons of time off to moonlight elsewhere.

And that’s why all the night docs and 24 hr crna slots are filled. And the day docs and day crna slots are not filled.

 

[Ashers]

Yes, it was a long time coming. But it is San Angelo. It’s hot, it’s dry, and there isn’t much to do compared to even other 100k cities. Great for a family. Otherwise it’s a tough sell. Money, lifestyle, location. 2/3 ain’t bad.

I'm trying to convince my parents to come out here, so I'd have someone here aside from The Gym. My social network where I tied myself to by buying a house (because I'm dumb and was tired of traveling all the time) is much bigger. My dad doesn't want to leave PHX, which I understand.

When I first started working here, I looked up things to do, and one of the top 10 things to do was to visit the Visitor's Center. I've done a few of the recommended things -- Brothel museum, train museum, look at the sheep statues around town, murals, drive 300 miles in one trip looking at wild flowers (in the spring). 😀

 

[dannyboy1]

Every practice location is different. Every region is different. The icu docs in Florida where I’m at. Don’t particularly work hard. And I see them daily. 3 of them live in my same neighborhood. We see each other in the same hospitals. One week clinical 7a-7p like you. 7 days a week. One week “consult” daytime. 2 weeks off. Totally chill. They aren’t working hard. The np covers the nights. The icu docs are available if np has issues at night during their clinical weeks.

Your work mileage will vary in terms how hard you work. Only you can figure how hard your work is.

Just like regular anesthesia folks. Some of them get killed daily. And some have it easy. Sometimes perception is reality. Even in the same zip code hospitals function differently.

I think the docs in general work too hard out west in urban areas and up north particularly the north east. I’ve experienced that for the first part of my career.

So a doc working hard grinding away with q4/5 calls being up all night than getting chance to work just days may feel relief. It’s all relative.

Vs a doc sleeping at night most of the time. Getting tons of time off. Double the time off as the day docs. Those days docs start to realize. Why am I slaving away at 36 hrs a week solo with no calls and no weekends but working 5 days a week and only 10 weeks off making the same 500k as the night float doc who sleeps all the time with a crna doing the cases for him and who has 26 weeks off and only works 45 hrs/per week in those 2 weeks they actual work.

Everything is relative to your cohort. And how much they work.

“Slaving away” is 36 hours a week no nights/weekends for 500k? My, how far we have come….

 

[aneftp]

“Slaving away” is 36 hours a week no nights/weekends for 500k? My, how far we have come….

Different times.

Like i said. Do you want to grind it out and become blockbuster the old way?

Or be Netflix and keep reinventing yourself?

Become forward thinking.

Why do you think psych is the hottest field these days? Workload.

Employed w2 36 hrs 5 days a week is trash these days (from my perspective (

Give them a 3/4 day bi weekly split (7 days) in a 2 week period and 36 hrs average. That would be golden (for now). Monday -Thursday. Than Wednesday-Friday the next week. Plus 10 weeks off

Perfect for md only 7-3. 500k w2

Or else people will just do 1099. Pick your poison.

 

[cchoukal]

Only one of us does both and has the ability to judge relative stress. My 84 hour ICU weeks are far more draining than my 40 hour OR weeks. The idea that they have so much downtime, and thus offer a break from the OR is laughable.

I think you'll find more docs willing to work those conditions than you think. Until very recently, many in PE practices and academics had only 8 weeks off, and had call on top of 45-50 hour weeks in order to make those numbers. While there are early-adopters like you to the make piles of cash with locums movement, far more are still just going to keep grinding away at whatever fulltime job they have. If you offer them fewer hours than they're currently working for the same total pay, they may actually take it.

Further, I'm seeing more docs getting tired of the constant push to direct nurses at ever increasing ratios, and would welcome doing their own cases. The major gripe I hear from my former partners is that they no longer get to do their own cases outside of call (we used to be about 60/40 solo/direction back when I joined a few years ago).

I’m with you. Even though my ICU weeks had downtime, the constant accountability, and the occupational exposure to sadness, day in and day out, weighed on me and by Thursday, my wife couldn’t stand being around me. Not that I love 7-3 every day in the same place either, but it’s way easier. Fortunately, we have a range of venues, as well as OB and call to break things up.

 

[aneftp]

I’m with you. Even though my ICU weeks had downtime, the constant accountability, and the occupational exposure to sadness, day in and day out, weighed on me and by Thursday, my wife couldn’t stand being around me. Not that I love 7-3 every day in the same place either, but it’s way easier. Fortunately, we have a range of venues, as well as OB and call to break things up.

Agree. Icu 7a-7p or whatever plus being beeper for nights can be annoying. You don’t know what to expect throughout the day or what’s thrown at you.

Variety is good in terms of work schedule.

Bur have yet have any one chime in and say 7-3 (5 days a week) is do able 42-44 weeks a year solo.

Someone will do it. But the only guys I know who do it are at the VA hospital with 100% supervision. And they are literally just collecting a paycheck at age 62/63/66. They refuse to do solo. All claiming bladder bph for reasons they can’t do a solo case.

 

[gunnershow]

Agree. Icu 7a-7p or whatever plus being beeper for nights can be annoying. You don’t know what to expect throughout the day or what’s thrown at you.

Variety is good in terms of work schedule.

Bur have yet have any one chime in and say 7-3 (5 days a week) is do able 42-44 weeks a year solo.

Someone will do it. But the only guys I know who do it are at the VA hospital with 100% supervision. And they are literally just collecting a paycheck at age 62/63/66. They refuse to do solo. All claiming bladder bph for reasons they can’t do a solo case.

You are sorely lacking in perspective. Working solo 7-3 5 days a week is preferable to just about anything else in medicine. I'm not trying to grind through 60 clinic patients or 30 ED patients or 100 CTs in a shift. Deal with inbox messages, insurance auths, etc. It's as stress free as it gets.

And to your point, I do like 48 weeks, ~80h a week with in-house call. Most nights are chill, just an epidural or section. With fast surgeons and friendly OR/PACU staff, my job is a breeze. Rooms usually done by 7. I sit my own cases 50% of the time (and overnight) and those days are far easier than supervision. Probably the only thing I could do to make my job chiller is be 100% solo.

 

[aneftp]

You are sorely lacking in perspective. Working solo 7-3 5 days a week is preferable to just about anything else in medicine. I'm not trying to grind through 60 clinic patients or 30 ED patients or 100 CTs in a shift. Deal with inbox messages, insurance auths, etc. It's as stress free as it gets.

And to your point, I do like 48 weeks, ~80h a week with in-house call. Most nights are chill, just an epidural or section. With fast surgeons and friendly OR/PACU staff, my job is a breeze. Rooms usually done by 7. I sit my own cases 50% of the time (and overnight) and those days are far easier than supervision. Probably the only thing I could do to make my job chiller is be 100% solo.

Well I hope ur compensation is well into the mid 1.3-1.4 million range. You are doing equivalent of 2.0 fte

And

 

[gunnershow]

Well I hope ur compensation is well into the mid 1.3-1.4 million range. You are doing equivalent of 2.0 fte

And

Yeah something like 1.2 depending on how much I actually work. It's all W2 which blows but the calls are so chill it's hard to give it up to 1099 somewhere else.

 

[aneftp]

Yeah something like 1.2 depending on how much I actually work. It's all W2 which blows but the calls are so chill it's hard to give it up to 1099 somewhere else.

Well money is money. As long as it’s easy money.

Those who save a ton on 1099 do the usual deductions mostly on retirement pretax which eventually have to be taxed. Or get creative putting kids on payroll. (Still paying payroll taxes on that money). Regardless if you make 1.2 1099 or 1.2 w2. You will pay taxes.

Only the most aggressive stormy Daniels tax deductions guys can drive their effective tax rate down to 10-12%. Most will still end up paying around 20-25% effective tax rate as 1099 with that high of an income. There are only so many strip clubs, flat screen tvs, and tax deductible vacations you can take once you get into the 7 figure range 1099.

 

[ToKingdomCome]

As someone going through this right now, it sucks. I would have been ok with locums, but not my family, so I'm instead taking a new job in academics for quite a bit more than I make now (slightly more hours, and I'll have to go back to taking some call). We have a home at 2.375%, and don't think we'll sell it any time soon, since comparable rents in our area are much higher than our mortgage. Instead, we may rent to a surgeon here, or another family looking to relocate to our neighborhood for at least the next few years. The new mortgage rate will be just over 7%, and I nearly vomited when I saw just how much we'll be paying for a very similar sized house in the new area (not a particularly HCOL).

Can you DM me the job info and is it icu/or?

 

[Coffee PRN]

Agree. Icu 7a-7p or whatever plus being beeper for nights can be annoying. You don’t know what to expect throughout the day or what’s thrown at you.

Variety is good in terms of work schedule.

Bur have yet have any one chime in and say 7-3 (5 days a week) is do able 42-44 weeks a year solo.

Someone will do it. But the only guys I know who do it are at the VA hospital with 100% supervision. And they are literally just collecting a paycheck at age 62/63/66. They refuse to do solo. All claiming bladder bph for reasons they can’t do a solo case.

7-5 or 7-7 here, 5 days a week, 46 weeks a year. All solo. Been on this schedule more than a year.

 

[aneftp]

7-5 or 7-7 here, 5 days a week, 46 weeks a year. All solo. Been on this schedule more than a year.

Wow. More power to u. As long as it’s 1099. That’s fine. W2 is no good with the 7-5/7-7p schedule.

I can’t do that anymore. (The 5 days a week in a row 10/12 hrs a day) w2 wise. Must be hourly.

I like my time off as well.

I’m off 7 weeks in summer alone