Fair pay?

[Timeoutofmind]

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I’m W2 pain

I have an opportunity to pick up OR Anesthesia shifts through my current pain employer…

7-1ish. Average shift of 6 hrs. (Which is actually what I want, just a chill, short day). Pays $1400 W2 (not 1099). So around $250 an hour…

Midwest – major metro area

50/50 supervision/Solo

(Supervision 1:2 with reasonable AAs)

Hospital and ASC work

Hospital has some sick patients and neurosurg/vascular etc, but it’s not the big house…

 

[aneftp]

I’m W2 pain

I have an opportunity to pick up OR Anesthesia shifts…

7-1ish. Average shift of 6 hrs. Pays $1400. So around $250 an hour…

Midwest – major metro area

50/50 supervision/Solo

(Supervision 1:2 with reasonable AAs)

Hospital and ASC work

Hospital has some sick patients and neurosurg/vascular etc, but it’s not the big house…

Are you out of your mind???$250/hr and only 6 hr guaranteed?

This is like my co worker in Florida who wants to visit his parents in Colorado and he’s trying to do some 1099 locums and they offered him $5000 flat 24 hrs for ob call (4000 deliveries a year) so it ain’t slow with only one crna

Thads horrific rate at barley $200/hr

 

[CopaceticOne]

For locums in today’s market you need better minimum $/day guarantee with clearly defined hours and a much better rate for each partial hour over the defined work time.

What they are offering right now is absolutely below market value for a major metro in the Midwest.

Edit: is this offer for ASC OR by your current W2 employer? If that is the case you’d need to look at time/stress of OR vs your pain practice.

 

[aneftp]

For locums in today’s market you need better minimum $/day guarantee with clearly defined hours and a much better rate for each partial hour over the defined work time.

What they are offering right now is absolutely below market value for a major metro in the Midwest.

Edit: is this offer for ASC OR by your current W2 employer? If that is the case you’d need to look at time/stress of OR vs your pain practice.

Add if it’s $250hr w2. Is atrocious taxed at 37%

OP said hospital and ASC work

 

[CopaceticOne]

I’m W2 pain

I have an opportunity to pick up OR Anesthesia shifts through my current pain employer…

7-1ish. Average shift of 6 hrs. (Which is actually what I want, just a chill, short day). Pays $1400 W2 (not 1099). So around $250 an hour…

Midwest – major metro area

50/50 supervision/Solo

(Supervision 1:2 with reasonable AAs)

Hospital and ASC work

Hospital has some sick patients and neurosurg/vascular etc, but it’s not the big house…

Also, I’m going to call you out for deleting the thread from last year which basically asked the same question.

 

[rick roller pump]

Extra shift through my W2 employer pays closer to $400/hr

 

[A Deep Breath]

As long as you keep the arrangement flexible and noncommittal, this has the potential to be a great opportunity.

Sure, the pay is approaching offensive, but you’re rekindling one of the most valuable skills a person can have in today’s world. They’re paying you to learn.

The world and your options may look different once anesthesiology is a viable way to earn money again.

 

[Timeoutofmind]

Extra shift through my W2 employer pays closer to $400/hr

Man
So you are saying if you worked an eight hour day there five days a week x 42 weeks you would make $670,000 as a day doc!???

 

[aneftp]

Man
So you are saying if you worked an eight hour day there five days a week x 42 weeks you would make $670,000 as a day doc!???

That’s average pay. I’ve been telling you guys on this message board.

That is the market rate for a 40 hr a week doc with 10 weeks off give or take

700k/10 weeks off /40 hrs a week

I take 500k/20 weeks off/40 hrs a week give or take
Nothing in house /plus crna with me all the time. No ob. Don’t ask me why they give me crna when I can do the case solo. But I ain’t complaining.

Work smarter guys. Don’t work hard.

I had a 30 week off job for almost 500k but ob call was annoying me. So I left that. lol. Again. I ain’t gonna to work hard for my money. You want easy work. Not hard work.

It’s not me being lazy. I do work and I do work hard at times. For you don’t want to go hard day in and day out. You will burn out quickly.

 

[rick roller pump]

Man
So you are saying if you worked an eight hour day there five days a week x 42 weeks you would make $670,000 as a day doc!???

Yes. When you factor in employer 401k contributions I made >760k and doubt I worked much more than 2000 hours.

This is high acuity 3:1-4:1 work so it demands a higher rate. I work hard when at work but find it tolerable due to high $/hour.

 

[aneftp]

Yes. When you factor in employer 401k contributions I made >760k and doubt I worked much more than 2000 hours.

This is high acuity 3:1-4:1 work so it demands a higher rate. I work hard when at work but find it tolerable due to high $/hour.

$400/hr w2 extra pay at 37% tax rate equals $252/hr

$350/hr 1099 at say 20% (some people are super aggressive and get taxed at 10%) =$270/hr at 20% 1099 tax rate after deductions

So imagine someone taking $250/hr w2 for extra pay. That’s $158/hr after taxes.

 

[UscGhost]

That’s average pay. I’ve been telling you guys on this message board.

That is the market rate for a 40 hr a week doc with 10 weeks off give or take

700k/10 weeks off /40 hrs a week

I take 500k/20 weeks off/40 hrs a week give or take
Nothing in house /plus crna with me all the time. No ob. Don’t ask me why they give me crna when I can do the case solo. But I ain’t complaining.

Work smarter guys. Don’t work hard.

I had a 30 week off job for almost 500k but ob call was annoying me. So I left that. lol. Again. I ain’t gonna to work hard for my money. You want easy work. Not hard work.

It’s not me being lazy. I do work and I do work hard at times. For you don’t want to go hard day in and day out. You will burn out quickly.

Probably depends on your area. Certainly not MARKET rate. Market rate would be the average rate.

That would be almost $60 per unit. There are no places in so cal, for example, that pay $60 per unit.

Even Newport Beach only gets 50, and that's considered the top of the market...not market rate

Locums rates rely on hospitals that can't find staff because the pay is low or locati. If they paid all the docs like that, there wouldn't be a shortage at that site

 

[kidthor]

Probably depends on your area. Certainly not MARKET rate. Market rate would be the average rate.

That would be almost $60 per unit. There are no places in so cal, for example, that pay $60 per unit.

Even Newport Beach only gets 50, and that's considered the top of the market...not market rate

Locums rates rely on hospitals that can't find staff because the pay is low or locati. If they paid all the docs like that, there wouldn't be a shortage at that site

This is entirely on point - and even in Newport Beach the rates are going down and fully depend on hospital stipend to augment the paltry collections.

 

[nimbus]

$400/hr w2 extra pay at 37% tax rate equals $252/hr

$350/hr 1099 at say 20% (some people are super aggressive and get taxed at 10%) =$270/hr at 20% 1099 tax rate after deductions

So imagine someone taking $250/hr w2 for extra pay. That’s $158/hr after taxes.

We have progressive taxes. The entire amount is not taxed at 37%.

 

[gunnershow]

We have progressive taxes. The entire amount is not taxed at 37%.

With "extra pay", you are already at that marginal rate. So every extra hour you work will get taxed at that rate.

 

[narcotics999]

Probably depends on your area. Certainly not MARKET rate. Market rate would be the average rate.

That would be almost $60 per unit. There are no places in so cal, for example, that pay $60 per unit.

Even Newport Beach only gets 50, and that's considered the top of the market...not market rate

Locums rates rely on hospitals that can't find staff because the pay is low or locati. If they paid all the docs like that, there wouldn't be a shortage at that site

You are so behind. Anesthesia fee is nothing. Hospitals need us to grab the big fat facility fee. They are willing to pay to get ORs open.

 

[aneftp]

We have progressive taxes. The entire amount is not taxed at 37%.

It is taxed at least 35% for likely 90% of full time call taking married anesthesiologists and likely 100% of single anesthesiologists (since the single anesthesiologist starts getting nailed at 250k income)

So yes. The entire amount is taxed at least at the 35% tax bracket. Since one can assume you are likely making 250k/500k single/married as a full time w2 doc.

“

• Marginal rates.For tax year 2025, the top tax rate remains 37% for individual single taxpayers with incomes greater than $626,350 ($751,600 for married couples filing jointly). The other rates are:
  • 35% for incomes over $250,525 ($501,050 for married couples filing jointly).
  • 32% for incomes over $197,300 ($394,600 for married couples filing jointly).
  • 24% for incomes over $103,350 ($206,700 for married couples filing jointly).
  • 22% for incomes over $48,475 ($96,950 for married couples filing jointly).
  • 12% for incomes over $11,925 ($23,850 for married couples filing jointly).
  • 10% for incomes $11,925 or less ($23,850 or less for married couples filing jointly).
    

 

[nimbus]

It is taxed at least 35% for likely 90% of full time call taking married anesthesiologists and likely 100% of single anesthesiologists (since the single anesthesiologist starts getting nailed at 250k income)

So yes. The entire amount is taxed at least at the 35% tax bracket. Since one can assume you are likely making 250k/500k single/married as a full time w2 doc.

“

• Marginal rates.For tax year 2025, the top tax rate remains 37% for individual single taxpayers with incomes greater than $626,350 ($751,600 for married couples filing jointly). The other rates are:
  • 35% for incomes over $250,525 ($501,050 for married couples filing jointly).
  • 32% for incomes over $197,300 ($394,600 for married couples filing jointly).
  • 24% for incomes over $103,350 ($206,700 for married couples filing jointly).
  • 22% for incomes over $48,475 ($96,950 for married couples filing jointly).
  • 12% for incomes over $11,925 ($23,850 for married couples filing jointly).
  • 10% for incomes $11,925 or less ($23,850 or less for married couples filing jointly).

That’s not how marginal tax brackets work.

 

[aneftp]

That’s not how progressive tax brackets work.

You aren’t getting in it. The way the w2 taxes work for overtime

You are already full time. And already gonna to make 250/500k w2 guranteee paid. and being asked to work overtime at $250-400/hr w2 extra

Every dollar you work overtime as w2 above ur wages (500k as full time doc) will be taxed heavily at 35%

Ironically I’ve had arguments with Roth IRA and pretax 401k/403b and the argument people use is inversely your way of thinking. People say at our tax bracket to do pretax deductions first since it’s 35/37% tax savings! And not your progressive tax argument.

 

[UscGhost]

It is taxed at least 35% for likely 90% of full time call taking married anesthesiologists and likely 100% of single anesthesiologists (since the single anesthesiologist starts getting nailed at 250k income)

So yes. The entire amount is taxed at least at the 35% tax bracket. Since one can assume you are likely making 250k/500k single/married as a full time w2 doc.

“

• Marginal rates.For tax year 2025, the top tax rate remains 37% for individual single taxpayers with incomes greater than $626,350 ($751,600 for married couples filing jointly). The other rates are:
  • 35% for incomes over $250,525 ($501,050 for married couples filing jointly).
  • 32% for incomes over $197,300 ($394,600 for married couples filing jointly).
  • 24% for incomes over $103,350 ($206,700 for married couples filing jointly).
  • 22% for incomes over $48,475 ($96,950 for married couples filing jointly).
  • 12% for incomes over $11,925 ($23,850 for married couples filing jointly).
  • 10% for incomes $11,925 or less ($23,850 or less for married couples filing jointly).

The entire amount is not taxed at that rate.

You literally explained in the bottom half of your post why you were wrong about that lol

 

[nimbus]

You aren’t getting in it. The way the w2 taxes work for overtime

You are already full time. And already gonna to make 250/500k w2 guranteee paid. and being asked to work overtime at $250-400/hr w2 extra

Every dollar you work overtime as w2 above ur wages (500k as full time doc) will be taxed heavily at 35%

Ironically I’ve had arguments with Roth IRA and pretax 401k/403b and the argument people use is inversely your way of thinking. People say at our tax bracket to do pretax deductions first since it’s 35/37% tax savings! And not your progressive tax argument.

Ahh my bad. You are talking about net from the overtime portion of the paycheck, not the entire paycheck. In that case, you are correct.

 

[aneftp]

The entire amount is not taxed at that rate.

You literally explained in the bottom half of your post why you were wrong about that lol

Overtime is taxed at the 35-37% tax bracket when you are full time w2 anesthesiologist.

Do you make more than 250k/500k as single/married anesthesiologist? As a w2?

Than anything extra on top of that w2 is taxed heavily.

I know the tax system (and I’m sure you know it well also)

That’s why I have zero interest in making 700k w2 with 10 weeks off. I’d rather make 500k with 20 weeks off. I know I can make the 200k 1099 pretty easily in 10 of those week or even more if I want to take calls. And that 1099 money is taxed much lower than the w2 extra money I can make.

 

[UscGhost]

Overtime is taxed at the 35-37% tax bracket when you are full time w2 anesthesiologist.

Do you make more than 250k/500k as single/married anesthesiologist? As a w2?

Than anything extra on top of that w2 is taxed heavily.

I know the tax system (and I’m sure you know it well also)

That’s why I have zero interest in making 700k w2 with 10 weeks off. I’d rather make 500k with 20 weeks off. I know I can make the 200k 1099 pretty easily in 10 of those week or even more if I want to take calls. And that 1099 money is taxed much lower than the w2 extra money I can make.

Yes that's correct. The extra amount you earn once you hit that threshold is taxed at that rate.

So yes, the take home portion goes down, so there is going to be a sweet spot.

1099, spouse in real estate, lots of tax advantaged ways to raise that threshold

 

[rick roller pump]

Lol I wish it was 37%. Im just shy of 50% marginal tax rate with state taxes. I do consider this when picking up extra W2 shifts. 200/hr post tax still worth it to me.

 

[Numbtastic]

Yes. When you factor in employer 401k contributions I made >760k and doubt I worked much more than 2000 hours.

This is high acuity 3:1-4:1 work so it demands a higher rate. I work hard when at work but find it tolerable due to high $/hour.

Wow, which state are you in?

 

[nimbus]

Lol I wish it was 37%. Im just shy of 50% marginal tax rate with state taxes. I do consider this when picking up extra W2 shifts. 200/hr post tax still worth it to me.

Wow. I’m in California and after 401k, catch up, and CBP deductions my effective tax rate is 21-22%. I could make it even lower by socking more away in the CBP but I have a life too.

 

[aneftp]

Wow. I’m in California and after 401k, catch up, and CBP deductions my effective tax rate is 21-22%. I could make it even lower by socking more away in the CBP but I have a life too.

The 21-22% effective tax rate is really just deferred money. Eventually you will have to pay money on that deferred money (at least some of it). So that true tax money when you finally start using it maybe much higher depending how much you want to withdraw. Or that effective tax rate could be that same number 21-22% if you die before you can spend it.

Effective tax rate doesn’t include Medicare or social security in the computer calculations as well

It’s just all a numbers game at the end of the day.

 

[NightyNight]

I’m W2 pain

I have an opportunity to pick up OR Anesthesia shifts through my current pain employer…

7-1ish. Average shift of 6 hrs. (Which is actually what I want, just a chill, short day). Pays $1400 W2 (not 1099). So around $250 an hour…

Midwest – major metro area

50/50 supervision/Solo

(Supervision 1:2 with reasonable AAs)

Hospital and ASC work

Hospital has some sick patients and neurosurg/vascular etc, but it’s not the big house…

Looks like equivalent of maybe $325/hr 1099. Others can correct me on the tax and take home equivalents.

If you’re doing sick cases, at least $400/hr 1099 so that’s somewhere around 275-300 on the W2 side. I know of one place that has started to offer W2 employees 325/hr W2 to work extra day shifts for guaranteed 8 hours.

If you were just sitting around doing preops and didn’t carry a phone at some easy place, then okay to take a lower rate IMO cuz you don’t need to go get credentialed elsewhere.