Economics of outrageous Locum Tenens hourly rates

[Postictal Raiden]

You say this now. I said it "then" as well.

Its not do-able. The gulf from senior resident to attending is wide and deep.

I have no experience of being an EM physician but before med school I volunteered at an ER, so I could imagine how tough it would be to work 20, 12-hr shifts a month, especially at a busy ER. However, and again, I'm only fantasizing here, I think one could put up with such madness for one year. I mean, look at neurosurgery residents. They constantly work 70+ hours a week. One could pretend that he/she is a neurosurgery resident, earning 20x as much, for a year to pay off the loans. As someone who's looking at a 500k+ bill after a 3-year residency, I don't think there will be anything I won't do to get rid of my debt ASAP.

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[BoardingDoc]

I have no experience of being an EM physician but before med school I volunteered at an ER, so I could imagine how tough it would be to work 20, 12-hr shifts a month, especially at a busy ER. However, and again, I'm only fantasizing here, I think one could put up with such madness for one year. I mean, look at neurosurgery residents. They constantly work 70+ hours a week. One could pretend that he/she is a neurosurgery resident, earning 20x as much, for a year to pay off the loans. As someone who's looking at a 500k+ bill after a 3-year residency, I don't think there will be anything I won't do to get rid of my debt ASAP.

Was going to respond to this, but this issue has been addressed multiple times in multiple other threads.

Key points though:
Hours working as a NSGY resident != hours working in the ED. 70 hrs NSGY residency ~= 46 hrs ED time
Some people do do this
Most people find it unsafe to do so / they burn out rapidly

 

[da8s0859q]

I have no experience of being an EM physician but before med school I volunteered at an ER, so I could imagine how tough it would be to work 20, 12-hr shifts a month, especially at a busy ER. However, and again, I'm only fantasizing here, I think one could put up with such madness for one year. I mean, look at neurosurgery residents. They constantly work 70+ hours a week. One could pretend that he/she is a neurosurgery resident, earning 20x as much, for a year to pay off the loans. As someone who's looking at a 500k+ bill after a 3-year residency, I don't think there will be anything I won't do to get rid of my debt ASAP.

I'm halfway through residency. I've noticed that this idea of "oh, I can do such-and-such for a year" becomes increasingly unpalatable the closer I get to signing a contract for my first attending job.

It's a bit of an issue with opportunity cost. Working 20 12s with any real volume or acuity is basically getting your ass kicked even if it doesn't sound like it. The money would be delightful, yes. But then there are other issues: time with friends/family, time off for yourself, job satisfaction and "burnout" which quickly becomes real with too many hours, increased risk to your financial and legal well-being that can come with being burnt out and making suboptimal decisions, and so forth. Not to mention that attendinghood is, even from just looking from this point of view, a different ball game.

Even with me finishing out year two of three, the idea of working as hard or, realistically, harder than I did my first year or two of residency makes me want to eat the barrel of a gun. I also have a good chunk of change in student loans.

 

[RustedFox]

I have no experience of being an EM physician but before med school I volunteered at an ER, so I could imagine how tough it would be to work 20, 12-hr shifts a month, especially at a busy ER. However, and again, I'm only fantasizing here, I think one could put up with such madness for one year. I mean, look at neurosurgery residents. They constantly work 70+ hours a week. One could pretend that he/she is a neurosurgery resident, earning 20x as much, for a year to pay off the loans. As someone who's looking at a 500k+ bill after a 3-year residency, I don't think there will be anything I won't do to get rid of my debt ASAP.

Alright, I'll play:

I like the way that you think. After all, its the way that I used to think.

The part you're missing is just what you DO in those hours as a resident, versus what you do as an attending.

When you hit freshly-minted "attending" status, there's a thousand "small things" that now fall in your lap that you used to enjoy having your attendings complete; and you never even knew that these things had to be done. While you were cashed out, drinking a beer and saying "wow, what a shift" - your attending was still trying to sort through a small myriad of tasks that you never even thought of. Having all these new responsibilities hit you on top of trying out your new legs as an attending does not make it reasonable (let alone ideal) to work your bollocks off for "that first year to get out of debt". I'll go so far as to say that in my opinion, that its downright reckless to do so. I don't think that its a matter of "putting up with it for a year". I think its a matter of safety for yourself and your patients.

 

[RustedFox]

I'm halfway through residency. I've noticed that this idea of "oh, I can do such-and-such for a year" becomes increasingly unpalatable the closer I get to signing a contract for my first attending job.

It's a bit of an issue with opportunity cost. Working 20 12s with any real volume or acuity is basically getting your ass kicked even if it doesn't sound like it. The money would be delightful, yes. But then there are other issues: time with friends/family, time off for yourself, job satisfaction and "burnout" which quickly becomes real with too many hours, increased risk to your financial and legal well-being that can come with being burnt out and making suboptimal decisions, and so forth.

Even with me finishing out year two of three, the idea of working as hard or, realistically, harder than I did my first year or two of residency makes me want to eat the barrel of a gun. I also have a good chunk of change in student loans.

This.

I worked 167 hours in December. I have a 120 hour full-time gig, and I picked up plenty of "bonus!" shifts at my old gig. I was cooked, fast. Charting got piled up and didn't get done until "later". I got turbo-sick. Wasn't sure whether or not I was awake or asleep, or what day of the week it was. I won't make that mistake again.

 

[RustedFox]

Was going to respond to this, but this issue has been addressed multiple times in multiple other threads.

Key points though:
Hours working as a NSGY resident != hours working in the ED. 70 hrs NSGY residency ~= 46 hrs ED time
Some people do do this
Most people find it unsafe to do so / they burn out rapidly

This, too.

A good bit of the hourly "work" in other specialties is either "between-time", "down-time", or "hurry-up and wait time". In the ED, there is never something that does not need to be done right now, whether its "this patient needs more Zofran", "this guy wants to leave AMA", or "this guy needs to be seen". The nature of many other sub-specialty work is rather serial or linear. The ED is a seemingly ever-expanding parallel circuit, by comparison.

 

[link2swim06]

Alright, I'll play:

I like the way that you think. After all, its the way that I used to think.

The part you're missing is just what you DO in those hours as a resident, versus what you do as an attending.

When you hit freshly-minted "attending" status, there's a thousand "small things" that now fall in your lap that you used to enjoy having your attendings complete; and you never even knew that these things had to be done. While you were cashed out, drinking a beer and saying "wow, what a shift" - your attending was still trying to sort through a small myriad of tasks that you never even thought of. Having all these new responsibilities hit you on top of trying out your new legs as an attending does not make it reasonable (let alone ideal) to work your bollocks off for "that first year to get out of debt". I'll go so far as to say that in my opinion, that its downright reckless to do so. I don't think that its a matter of "putting up with it for a year". I think its a matter of safety for yourself and your patients.

I don't really follow your logic. Albeit I am not an attending.

There is a huge learning curve after residency. I get that.

Working fatigued is unsafe. I get that.

I don't understand how working a bunch of hours (with adequate sleep) makes anything unsafe. I work 50 hours in the department right now and have plenty of spare time. I would be fine doing this for a few years. Granted I don't have any other life stressors consuming my time (single, no kids, young, healthy, etc).

And what are all these small task you never even thought of?

 

[RustedFox]

Attendingland isn't as easy on the sleep schedule as resident life. Depending on your shop, you're very commonly "switching backwards" thanks to the chronic short-staffing, or working short turn-around shifts (say, off at 10pm, back at it at 6 am), or some other time-trap.

I'll start the list of small-task nonsense, and other attendings can chime in:

1.) Actually finishing all your charting (if you're a resident, you can't understand/appreciate this until you're actually responsible for the whole shebang).
2.) MLP supervision and being their "check-out guy" for all their cases: "Would you look at this film for me? What do you think about this belly pain?"
3.) MLP chart review and attestation.
4.) Radiology discrepancy resolutions (if you don't have an active rad reading all your films 24/7)
5.) Blood/Urine/GU/Wound culture follow-ups/callbacks
6.) QI projects
7.) Responding to patient complaint letters, charting queries, administration needs, etc.
8.) Responding to codes on the floor/ICU/etc.

... I gotta get going, but you get the idea. OtherAttendings, take it away.

 

[Plectron]

Quick question for those that find their own LT gigs and don't go through a recruiter/agency, what do you do about your malpractice insurance?

Agreed with RustedFox on all of those counts. #5 has to be the worst, because so often it requires you to go through the chart to find out what was going on.

 

[Arcan57]

So my life is mostly consumed by small tasks but I have significantly more admin requirements than most docs that are working FT hours. I will say that in residency a 50hr week still had a decent amount of free time. Kids suck up a lot of that time since all the sudden you have regular, recurring responsibilities that have to take place at a fixed time. Throw in attending the meetings that are required to keep the contract and suddenly everything looks less rosy. I finished a pretty chill 9-7 shift and got home at 8:30 yesterday. I had morning meetings and am dealing with a QI/peer review issue that occupied me until 3:30 today. My oldest is finishing up his homework and the youngest is about to wake up from his nap. They'll suck up any free time I have until they're in bed at ~745. I'll wake up at 0400 tomorrow to work my 5a-3p shift. So I'll have maybe 3 hrs on my "day off" to get actual life tasks done.

Also, I've had a couple of new grads doing what link2swim is proposing. I've had to have a talk with ALL of them about cutting down on hours because they started accumulating serious peer review dings as a result of fatigue.

 

[RustedFox]

Quick question for those that find their own LT gigs and don't go through a recruiter/agency, what do you do about your malpractice insurance?

Agreed with RustedFox on all of those counts. #5 has to be the worst, because so often it requires you to go through the chart to find out what was going on.

Yuuup. I especially hate number 5.... especially because not all the charting is done when you need to act on the callback/follow-up.

 

[Plectron]

Yuuup. I especially hate number 5.... especially because not all the charting is done when you need to act on the callback/follow-up.

I don't know how your shop is set up, but we dictate our notes so the info is always available, but you may have to sit through 5-7 minutes of it before getting what you need.

 

[GeneralVeers]

Malpractice is always paid for by each job/facility at which I work. It does not come off the top.

Also the nice thing about LT is that I don't have to do any QI projects, committees, meetings, etc. Those used to consume 4-5 hours of my week back when I was full-time. Now I don't have to waste my time with these un-reimbursed duties.

 

[RustedFox]

I don't know how your shop is set up, but we dictate our notes so the info is always available, but you may have to sit through 5-7 minutes of it before getting what you need.

Dic-tate ?

What's thaaat ?

EDIT: After some consideration, there are 2 or 3 very good reasons why charting isn't often "done and available" in these situations:

1.) Understaffing to the point where the docs are pulling multiple 12-hour back-to-back shifts during high-volume season (snowbird season, down here in Florida).

2.) A $hitty documentation system. Seriously, sometimes you hit that "hate-point" (like flashpoint) where you say "eff this; its going to wait until tomorrow when I can think clearly" because you know for a fact that you ARE smarter than the system, and its the system that is so redundant or "reminder-heavy" (my personal peeve) that it becomes nonsensical.

3.) 1 and 2 above.


- Also, addendum to my earlier post about "tasks that residents don't count on". I calculate that a simple signature on a MLP's chart takes me 14 separate clicks/scrolls/PINs/passwords/whatever on average; and that is at my 'old job' where the documentation system is pretty slick. For those of you playing along at home; that's 14 clicks/motions, times 20 to 30 or so charts per day. And you had better damn well read those charts.

 

[deleted109597]

Malpractice is always paid for by each job/facility at which I work. It does not come off the top.

Counterpoint is that some of those contracts often have the "Paid $Texas/hr minus $malpractice/hr=$net/hr". And depending on where you work, you might be able to get your own that costs less. CMG wanted ~$20/hr for malpractice, and on the private market (Medicus), mine costs ~$3/hr. That's an extra $15-20k year easily.

 

[radonc0756]

What is the standard overtime locum tenens rate? ( if at all you go over your regular hours)

 

[GeneralVeers]

What is the standard overtime locum tenens rate? ( if at all you go over your regular hours)

It's negotiable and depends. Did someone not show up for shift and you need to stay late? In general I charge my regular rate if it's an hour or two. I won't stay beyond 13-14 hours, as fatigue makes it dangerous.

As far as extra shifts, the closer in that they need it, means they are more desperate and the rate goes up. If it's a holiday/weekend/night it will also be more expensive. Generally I charge at least 1.5 X my usual rate.

 

[Old_Mil]

When you are looking at relative incomes, keep in mind that minimum wage in some places is $15, a Harley mechanic with a high school education and trade school is pulling $75-100, and the lawyer who sues you is billing 4-5 times that.

Unless you are in a really, really quiet place where your productivity is measured in patients per day - and by that i mean less than 10 - instead of patients per hour don't even consider picking up a chart for under $200 an hour and probably more than that.

Keep in mind the significant rate increase in health insurance premiums you will be paying compared to the pre Obamacare days.

 

[EctopicFetus]

I have been getting prodded by Locums folks since before I finished residency. I told them $400/hr. in AZ and TN no one has bitten. I have a great main job after leaving my last job. Maybe one day a locums place will bite. I am in no rush.

I hope ill never be desperate enough to work for "standard" CMG rates. Those poor saps sadden me.

 

[deleted109597]

I can get $450-600/hr without even trying. They're so desperate here in Texas that I can agree to their terms for those amounts. If I force the issue, I can get more than that. It's supply and demand. One day, the supply will be adequate. Once the ACA says midlevels are equivalent to doctors, or some other disaster happens (outlawing FSEDs or something), it will all go away. Until then, we make hay while the sun shines.

 

[BJJVP]

Which states tend to have the highest dollar per hour rates for locums physicians? Are there any drawbacks to working at these sites other than the usual (poor coverage, lack of good nursing, bad location, etc)?

 

[asdf123g]

Which would you pay off your loans faster, living the nomadic life for a few years doing locums (goodbye family/personal life) or doing one of those loan forgiveness programs in a rural setting?

 

[GeneralVeers]

Which would you pay off your loans faster, living the nomadic life for a few years doing locums (goodbye family/personal life) or doing one of those loan forgiveness programs in a rural setting?

Probably being a nomad. Even with loan forgiveness, the rural program is likely to pay about 1/3 of what you'd make being a locum. Plus being a locum you can live somewhere decent if you want, though the smart people live in tax free states.

 

[asdf123g]

Probably being a nomad. Even with loan forgiveness, the rural program is likely to pay about 1/3 of what you'd make being a locum. Plus being a locum you can live somewhere decent if you want, though the smart people live in tax free states.

is it possible to "not have anywhere to live/no home base" and literally just jump from locum to locum non-stop (so you dont have to pay rent on your housing while your gone)? Or is that actually more difficult to do in reality?

 

[GeneralVeers]

is it possible to "not have anywhere to live/no home base" and literally just jump from locum to locum non-stop (so you dont have to pay rent on your housing while your gone)? Or is that actually more difficult to do in reality?

It's completely possible to live out of a suitcase. If you're just starting out and don't have car or a lot of material possessions to store it would be easy. I think it would be a bit depressing though. It is nice to have a home to come back to if you have a block of days off.

 

[willow18]

I can get $450-600/hr without even trying. They're so desperate here in Texas that I can agree to their terms for those amounts. If I force the issue, I can get more than that. It's supply and demand. One day, the supply will be adequate. Once the ACA says midlevels are equivalent to doctors, or some other disaster happens (outlawing FSEDs or something), it will all go away. Until then, we make hay while the sun shines.

How do you find such gigs, working with a staffing firm?

Speaking of which, anyone have a yay/nay, good/bad experiences with these firms and willing to share?

 

[deleted109597]

All of them have recruiters. If you're already working with a CMG, they're always looking for someone to fill gaps. All you have to be is willing.

 

[asdf123g]

do locums cover or partially cover for your temporary housing and travel costs? If they house you, where do they house you? A motel/hotel? Locums are for any specialty right? Sorry, im kind of new to this

 

[willow18]

Thanks. Don't work for a CMG. I'm starting a 80% time non-profit gig and will be working 6-8 shifts/month so obviously hoping to maximize income while at it.

I've only been in academia so far, so have no experience with CMGs and recruiters. For those Texas gigs, is it some of the big name CMGs/staffing firms or local outfits?

 

[Alvarez13]

How do you find such gigs, working with a staffing firm?

Speaking of which, anyone have a yay/nay, good/bad experiences with these firms and willing to share?

Yah, would be interested in knowing which ones are the best. So many out there.

 

[deleted109597]

Yah, would be interested in knowing which ones are the best. So many out there.

You can't find them from afar. It's part of having boots on the ground, literally.
You make better rates hitting up EmCare, Schumacher, USACs, or whomever rather than using the locums groups. CMGs would rather pay you than pay a locums company. And if you're already credentialled, then all the better. It's just being available when it's needed.

 

[MSmentor018]

I definitely miss this forum a lot! I was even able to get just enough internet at at the far ends of the Earth to read this thread and post. Currently I'm sitting in Abu Dhabi on my way to London.

My lifestyle has definitely improved since doing locum tenans full time. Whereas I used to work 18-20 shifts per month before, I now work 12, and with the bump in hourly still make more money. I also make my own schedule and work when I want and how often I want.

Fellow Emergency Physicians, join me and break our shackles of CMG bondage! They've decided to commoditize us, so we should return the favor. Yes we're commodities, and the going rate is $300/hour, not the $150/hour they used to pay me after deducting "administrative fees". Make them compete for our warm bodies to fill their Sh*tty contracts! Hell, there's no reason we can't make it $500/hour if we are smart.

I agree in breaking the chains! diamonds are worth a ton b/c da beers only releases so many. residency slots are only so many. with govt regulations, CMG, locums controlling what and how we get it, why is it that we've been reduced to just being a high end techs?
i saw a quick news article in em monthly on this website that bypasses the locums and goes straight to the hospital so you can negotiate a better rate. has anyone used this? I figured generalveers and others that do locums may know

 

[MSmentor018]

Attendingland isn't as easy on the sleep schedule as resident life. Depending on your shop, you're very commonly "switching backwards" thanks to the chronic short-staffing, or working short turn-around shifts (say, off at 10pm, back at it at 6 am), or some other time-trap.

I'll start the list of small-task nonsense, and other attendings can chime in:

1.) Actually finishing all your charting (if you're a resident, you can't understand/appreciate this until you're actually responsible for the whole shebang).
2.) MLP supervision and being their "check-out guy" for all their cases: "Would you look at this film for me? What do you think about this belly pain?"
3.) MLP chart review and attestation.
4.) Radiology discrepancy resolutions (if you don't have an active rad reading all your films 24/7)
5.) Blood/Urine/GU/Wound culture follow-ups/callbacks
6.) QI projects
7.) Responding to patient complaint letters, charting queries, administration needs, etc.
8.) Responding to codes on the floor/ICU/etc.

... I gotta get going, but you get the idea. OtherAttendings, take it away.

I'll add to this:
the biggest thing is trying not to sign stuff out, waiting for that last consultant to call you, ct to be read....etc. at our place whoever signs the chart gets paid. you burned 3 hrs taking care of a guy, not to mention all the liability just to sign the pt out and now get nothing. this is the most common problem
finish charting/defensive charting.
MLP chart review is a huge time suck. I get about 25 or so per day. even at skimming 1-2 min per chart. well you get the idea. and god forbid you find something really jacked up that requires calling the pt to check up on them
that brings me to pt call back. I do a few every now and then. some shops require you to do it!!
worse is the sick bastard that arrives 505am at the tail end of your 9p-6am shift that may require a transfer. there's no starting it up and signing that out

 

[bravotwozero]

Yup. Like the neonatal meningitis I got at literally 505 am and I'm at a non peds hospital, and the nurses have to poke and prod the kid mercilessly. On top of that, the lab tech 'dropped' the blood culture vial.


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[GandalfTheWhite]

I can get $450-600/hr without even trying. They're so desperate here in Texas that I can agree to their terms for those amounts. If I force the issue, I can get more than that. It's supply and demand. One day, the supply will be adequate. Once the ACA says midlevels are equivalent to doctors, or some other disaster happens (outlawing FSEDs or something), it will all go away. Until then, we make hay while the sun shines.

Where is texas is offering 450-600 lol?

 

[RustedFox]

I'll add to this:
the biggest thing is trying not to sign stuff out, waiting for that last consultant to call you, ct to be read....etc. at our place whoever signs the chart gets paid. you burned 3 hrs taking care of a guy, not to mention all the liability just to sign the pt out and now get nothing. this is the most common problem
finish charting/defensive charting.
MLP chart review is a huge time suck. I get about 25 or so per day. even at skimming 1-2 min per chart. well you get the idea. and god forbid you find something really jacked up that requires calling the pt to check up on them
that brings me to pt call back. I do a few every now and then. some shops require you to do it!!
worse is the sick bastard that arrives 505am at the tail end of your 9p-6am shift that may require a transfer. there's no starting it up and signing that out

The underlined, all the time. It drives me nuts. 1-2 minutes per chart x 30 charts a shift = 1 hour. Damned if I'm going to do this on my "own time" and not get paid. I have close to 50 in my queue right now. I'm off for a week. Eff that noise. I'm gone.

The other half of this annoyance is the MLP end-of-shift two-step, where you're 15 minutes until leaving and all your patients are tucked away, but then MLP1 and MLP2 come to you and say "Hey, I have to ask you about this one" - and they want you to make decision based upon a workup that, frankly... sucks. Worst is the T-minus 10 minute "dizzy senior" patient.

"Are they orthostatic?"
(I didn't order that)
"Did you walk them?"
(Well, no, not yet)
"Any cerebellar signs?"
(What do you mean)
"So, why do you want to send them home?"
(Well, the BNP is only 3000, and I know thats meaningless, but...)
"Are they anticoagulated?"
(Well, they're not on Coumadin, but they have a history of a-fib)


Our director sent out an email several months ago that said in bold and underlined font... "Patients should be staffed with the supervising physician at the beginning of the encounter. MLPs should not consult physicians for the purpose of making a disposition."

You think those MLP'ers listened for a second? Nope. I even brought this up to one repeat offender (who feels the need to "check every patient 'out'"), and her reply was - "What email?"

Full disclosure: I don't want to "hate on the MLPs". I have worked with many that are top-flight. But more and more of them get "minted" every year - and they seem to be comfortable to not learn anything after they graduate. The general attitude is "okay, I did my joblolz now you make a /decisionk?" - ....

NO! Is my general response. YOU can do this. MAKE a decision. DOCUMENT your reasons why. STAND by your decision making with good evidence. THEN tell me what you want to do and why.

Don't let me catch you coming to me saying "Well, if conditions x-y-and-z are satisfied, and you think its okay, then I want to (....)".

Then, when I read the chart, X-Y-and-Z are nowhere to be found.

 

[GeneralVeers]

Update: Year 4 of locums, and I'm still at my regular "part-time" job doing 100 hours per month. The base "exhorbitant" rate has stayed the same. The shortage of physicians has worsened, and we now have > 20 open shifts in March. $2000/shift bonuses generally being offered to pick up the unfilled shifts 1 month out. Life has never been better.

 

[katmandu]

Update: Year 4 of locums, and I'm still at my regular "part-time" job doing 100 hours per month. The base "exhorbitant" rate has stayed the same. The shortage of physicians has worsened, and we now have > 20 open shifts in March. $2000/shift bonuses generally being offered to pick up the unfilled shifts 1 month out. Life has never been better.

Wow. In what part of the country are you seeing these types of incentives?

Do you end up changing sites frequently or do you stay with each hospital for awhile? Locums sounds tempting, but so much of the challenge of what we do is understanding the hospital system and politics rather than just managing the medical issues. Do you feel like this is not a significant issue?

 

[deleted109597]

Where is texas is offering 450-600 lol?

Lots of places.
But no, I'm not telling you, because then everyone else would take those slots for less pay, and it would leave me with less work than I want. Thanks but no thanks.

 

[deleted109597]

Wow. In what part of the country are you seeing these types of incentives?

Do you end up changing sites frequently or do you stay with each hospital for awhile? Locums sounds tempting, but so much of the challenge of what we do is understanding the hospital system and politics rather than just managing the medical issues. Do you feel like this is not a significant issue?

You can ignore the politics if you're there part time. They just don't expect you to follow them. It also lets you pull the "hey, can you get whoever admits this guy" instead of you having to follow whatever arcane admission procedure they usually do.

 

[GeneralVeers]

Lots of places.
But no, I'm not telling you, because then everyone else would take those slots for less pay, and it would leave me with less work than I want. Thanks but no thanks.

Agreed. I will say what state, but I won't divulge specific location. I'd rather be selfish and keep the gravy train for myself.

 

[GandalfTheWhite]

Lots of places.
But no, I'm not telling you, because then everyone else would take those slots for less pay, and it would leave me with less work than I want. Thanks but no thanks.

Well I cant take those spots anyway cuz MS3, just wanted to weigh how common those opportunities were in areas like Dallas, Houston, or SA since I plan to stay in TX.

 

[swamprat]

Agreed. I will say what state, but I won't divulge specific location. I'd rather be selfish and keep the gravy train for myself.

So what state lol


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[GeneralVeers]

So what state lol


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The great state of Statesylvania

 

[bravotwozero]

Update: Year 4 of locums, and I'm still at my regular "part-time" job doing 100 hours per month. The base "exhorbitant" rate has stayed the same. The shortage of physicians has worsened, and we now have > 20 open shifts in March. $2000/shift bonuses generally being offered to pick up the unfilled shifts 1 month out. Life has never been better.

Are you getting a bonus on every shift you work?


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[emergentmd]

Are you getting a bonus on every shift you work?


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If you are a smart locums you are.

I avg 510/hr last yr. Just went full locums and made as much in 6 shifts as I did 15 at W2.

I have never done a shift at rate and never will.

 

[GeneralVeers]

Are you getting a bonus on every shift you work?


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I get a contracted "travel bonus" but I have to give a minimum of 6 shifts. Technically a moderate "bonus" for each of those 6 shifts. For any shifts I pick up over that, I wait until they are offering an additional bonus of > $1500 per shift. Over Christmas for example, the shift bonus was $3000/shift.

 

[emergentmd]

I get a contracted "travel bonus" but I have to give a minimum of 6 shifts. Technically a moderate "bonus" for each of those 6 shifts. For any shifts I pick up over that, I wait until they are offering an additional bonus of > $1500 per shift. Over Christmas for example, the shift bonus was $3000/shift.

All of these places want you to give a minimum. At my place they started with 3, I kept saying no. Went down to 1 at rate. I said no. Now they stopped to even bother me.

 

[deleted109597]

I get a contracted "travel bonus" but I have to give a minimum of 6 shifts. Technically a moderate "bonus" for each of those 6 shifts. For any shifts I pick up over that, I wait until they are offering an additional bonus of > $1500 per shift. Over Christmas for example, the shift bonus was $3000/shift.

Holidays are easy to rake it in. I was already working, but a friend got 6K/night in compensation to cover the 4 day Thanksgiving weekend. $24K for 48 hours isn't bad.
Spring break, Christmas, New Years. You're going to work half of them, just work all of them when you're young and make bank. Your kids don't know what day of the week it is anyway.

 

[GeneralVeers]

All of these places want you to give a minimum. At my place they started with 3, I kept saying no. Went down to 1 at rate. I said no. Now they stopped to even bother me.

I like a little bit of security. With 6 shifts a month at a good rate, it ensures that I can cover my mortgage, student loans, cars, and living expenses with money to spare. Anything I work over that is gravy.