Finding a Good Locums Gig

Started by alphaholic06
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alphaholic06 said:
So Locums seem to be all the rage on the forum these days. What constitutes a good locum gig? What's the best way to find one? Once I find one, how do I evaluate it? Thanks

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What constitutes a good gig:
- You dictate your schedule
- Local to short range travel
- High hourly rate
- Hospital isn't a dumpster fire

Best way to find one
- Cold call hospitals in areas you are interested in working
- Word of mouth (that means in person word of mouth, I don't see emergentmd giving up where he works or else he won't get paid as much. $ > random internet stranger)
- If the above doesn't work, use a locums agency knowing that they will take some of your money
- Once you have a place interested, negotiate a rate for yourself. They aren't just going to offer you 300/hr

How to evaluate it?
- See the first question.
- Literally the same way you would evaluate any job.
 
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emergentmd said:
Sorry. I don't mind sharing but My friends already flood sites I find.
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Wouldn't it be in the best interest of the field as a whole to know what the highest possible locums rate is for a certain region? If a comparable but uninformed locums doctor offers to work your site for $275 while you are requesting $350, guess who the locums agency will pick?

We don't have to reveal the exact hospital, but the certain geographical region and approximate rate is sufficient, maybe also some non-identifying hospital info. For example, here's mine: Eastern PA, approx 50-70k visits/yr, lots of specialty support, accepted at $295/hr. For anyone pondering locums in this are, don't screw me and yourself by offering to work for less than that amount.
 
plick said:
Wouldn't it be in the best interest of the field as a whole to know what the highest possible locums rate is for a certain region? If a comparable but uninformed locums doctor offers to work your site for $275 while you are requesting $350, guess who the locums agency will pick?

We don't have to reveal the exact hospital, but the certain geographical region and approximate rate is sufficient, maybe also some non-identifying hospital info. For example, here's mine: Eastern PA, approx 50-70k visits/yr, lots of specialty support, accepted at $295/hr. For anyone pondering locums in this are, don't screw me and yourself by offering to work for less than that amount.
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This is useful. As I have frequently noted, we lose nothing and gain everything as a specialty with salary transparency. I think it would also be helpful to note what folks were initially offered and what they ultimately accepted.
 
I know a site in Vegas (Vegas is tough to work in) was offering $300 for Nevada-licensed docs a few months back.
 
miacomet said:
I know a site in Vegas (Vegas is tough to work in) was offering $300 for Nevada-licensed docs a few months back.
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I was talking to a staffing company about Vegas recently, and for an employed doc, the pay was RVU based, 325/hr guaranteed minimum, BUT they expected you to move 3-3.5 pph average. I'll pass on that, but it should mean locums could/should get more....
 
theseeker4 said:
I was talking to a staffing company about Vegas recently, and for an employed doc, the pay was RVU based, 325/hr guaranteed minimum, BUT they expected you to move 3-3.5 pph average. I'll pass on that, but it should mean locums could/should get more....
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Yeah, good luck with that, Vegas.
 
So I've been applying to Locums for about 4-6months now and thought I'd just quickly share my experience.

The "Good" Locums job is the place that is not a Dumpster Fire as previously mentioned, has some decent coverage and/or PAs, and has good some decent sites to transfer to as the vast majority of Locums are smaller community hospitals who found additional need and haven't been able to meet it yet for whatever variety of reasons.

The good Locums gig will also get you working faster (1-2months?) Credentialing is kind of the big hurdle as always and the more places you end up working, ultimately the more places have to be that have to be reffered to for an and referenced etc. And then of course if it's in another state another medical liscence etc. Unless you don't care and are looking for way into the future, the process can take a decent amount of time, over several months.

There are good Locums Agencies, Comph Health, Weatherby, who can help with this and there are also many BAD Locums agencies which from the moment you send them a resume, will essentially turf you off from a given hospital or system and prohibit you from working there without working through them for a year or so.

The larger question is why and how you're looking to do locums. If you have a specific geographic area in mind, it may be better just to cold call hospitals and apply to do Per-Diem work, if you want to travel it may be better to do internal locums through some supper large national group (called varying names such as firefighters, strike teams, internal travel work, etc). Alternatively you can use Nomad which is a newer online service to search for locums but I'd hesitate to apply to jobs through them rather than just calling the site directly. The big advantage of Locums agents is that they know where jobs are and are good at trying to expedite the process. Hope that helps.
 
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+ 1 for Comphealth being a good locums company.

I find that locums is not really as good as it once sounded when I was a resident. Probably best to invest in a good full time job and do “internal locums” as mentioned above- seems less tedious than going through an outside locums company.
 
Ugh. See the thread on internal locums. Sounds like hell. Worst parts of a regular job and locums combined.
 
The best way to find a good site is word of mouth from friends. Second is cold calling places you want to work.

Problem with cold calling is you have no clue if these places gives bonuses. You could easily sign on at $300/hr expecting to get 450/hr with bonuses and never get it. It becomes a trial and error.

But once you are established, they like you, and have a relationship with the medical director/scheduler you will get offers to work constantly. Emails all the time about new places, new openings, open shifts.

I am not going to give everyone where I work or my rate b/c its not hard to pin down where I work. Market forces will quickly dry my places up and there will be a flood of docs willing to work for $350/hr and soon enough it will be $300/hr.
 
I think it's totally acceptable to not disclose where one is working locums out of self preservation of their hard fought rate.

What I don't think is productive is the often observed on this forum "Just move to x,y,z location" or "Just don't work for less then $X / hr", while throwing out your own rate, which is likely much higher than most of the people here trying to get advice, and not offering and legitimate counsel.

In other words, people here probably feel bad about themselves if they are making $150/hr and you say you're making $400/hr and don't offer any real help.
 
GonnaBeADoc2222 said:
I think it's totally acceptable to not disclose where one is working locums out of self preservation of their hard fought rate.

What I don't think is productive is the often observed on this forum "Just move to x,y,z location" or "Just don't work for less then $X / hr", while throwing out your own rate, which is likely much higher than most of the people here trying to get advice, and not offering and legitimate counsel.

In other words, people here probably feel bad about themselves if they are making $150/hr and you say you're making $400/hr and don't offer any real help.
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Nurses can make $150. I would feel bad. Agreed that help rather than bragging would be preferred.
 
Another way to evaluate is by calculating $$$ reimbursement per patient that YOU see. for the above example $300/hr seeing 3.5 pt/hr = $85/patient. (eh, I'll pass.)

On the other hand, $200/hr seeing 1.4 per hour gives a respectable $143 per patient. Not as much total, but easy money!

This may be more applicable for finding a "regular" job and not locums. Especially if your goal is just to roll in the cash. But if you plan on working for more than 5-10 years, it becomes important.
 
GonnaBeADoc2222 said:
I think it's totally acceptable to not disclose where one is working locums out of self preservation of their hard fought rate.

What I don't think is productive is the often observed on this forum "Just move to x,y,z location" or "Just don't work for less then $X / hr", while throwing out your own rate, which is likely much higher than most of the people here trying to get advice, and not offering and legitimate counsel.

In other words, people here probably feel bad about themselves if they are making $150/hr and you say you're making $400/hr and don't offer any real help.
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These forums are to spread information and ideas. You have to be smart enough to filter out what is helpful and what is not. You have to be able to take whatever information you get and make educated decisions for your particular life. If anyone sees high rates, lives in SF, and feels depressed that they are making $175/hr, then its their burden in choosing to live in a low paying/tight market. The thoughtful/wise person would accept their place in life b/c they don't want to leave SF or pack up and leave for higher paying places. I think most everyone knows which regions are the highest paying, and I will begin with Texas.

I believe I am helping more than most. I atleast give you my actual rates, my actual number of hours worked, and the environment I work in. I have had people PM me not to give such details b/c they don't want to keep their "turf".

I atleast am truthful about what is actually out there. I worked 12 yrs at a full time job where other "partners" were doing locums on the side making 400+/hr. I sure wish they shared it with me 5 yrs ago.
I believe I am more helpful than keeping quiet, let the young docs flounder only to find out in Year 12 that they are sitting next to locums doctor making $200/hr more than they are who doesn't have to follow the metrics/attend meetings.
I feel truly bad for the new grads who signed on for a 2 yr contract making $225/hr thinking that this is a huge amount, only to find out 2 months into it that another guy is making $450/hr for that shift.
 
miacomet said:
Nurses can make $150. I would feel bad. Agreed that help rather than bragging would be preferred.
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I have no reason to Brag. No one knows me, I don't know anyone on here, and I get absolutely nothing from telling you how much I make.

I do it to educate the newbies that they are short changing themselves. I could easily be the other 100 docs on here making $400/hr and not saying a peep and let all of you guys flounder for years before you realize that you are getting paid 1/2 of what the guy next to you is making.

Just realize that whatever the CMG is offering you and there are lack of full timers, you should ask for more.
 
BAM! said:
which nurses make $150/hr?
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I know an NNP (two online degrees) who makes about $100 an hour and $150 for evening call shifts in the NW. The RNs I know in NoCal make $95 an hour base plus bonus, differential etc. And they have benefits physicians can only dream of. Fully paid pension, time and a half if they work more than 8 hours straight, free medical with no copays or premiums.
 
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miacomet said:
I know an NNP (two online degrees) who makes about $100 an hour and $150 for evening call shifts in the NW. The RNs I know in NoCal make $95 an hour base plus bonus, differential etc. And they have benefits physicians can only dream of. Fully paid pension, time and a half if they work more than 8 hours straight, free medical with no copays or premiums.
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It is not hard to find NP making $90+/hr base.
 
Question: How much do the locums companies make off of physicians?? I heard that they charge a crazy high % of our hourly rate? So does that mean that as long as you do locums they are charging the hospital a % of your hourly rate? That seems so unfair and obviously a huge way of cutting into physician profit.
 
BelaMedicine said:
Question: How much do the locums companies make off of physicians?? I heard that they charge a crazy high % of our hourly rate? So does that mean that as long as you do locums they are charging the hospital a % of your hourly rate? That seems so unfair and obviously a huge way of cutting into physician profit.
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You're hiring them for a service. If the service isn't worth the cost, don't use it.
 
TooMuchResearch said:
You're hiring them for a service. If the service isn't worth the cost, don't use it.
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Agreed. I have fired several locums companies that used to be good because they started lowballing docs. Here is the response I received from one of them when they were offering way less than other companies. An absurd and condescending response. Happy to name names if that is allowed on this forum:

"Good morning, thank you for the reply. I understand your concerns. I appreciate that you would like to work with CrappyLocums again. I hesitate to speak for others as I am not sure if they offer all the same level of service and malpractice coverage as CrappyLocums; also we have found that many locums companies advertise high rates and are not always able to deliver or the job only lasts for few shifts after all the work of credentialing. I will always let you know the highest rate the client is suggesting, but in the end I can present you over at any rate you feel is fair. Feel free to give me a call to discuss. Thanks again for the feedback!"
 
miacomet said:
Agreed. I have fired several locums companies that used to be good because they started lowballing docs. Here is the response I received from one of them when they were offering way less than other companies. An absurd and condescending response. Happy to name names if that is allowed on this forum:

"Good morning, thank you for the reply. I understand your concerns. I appreciate that you would like to work with CrappyLocums again. I hesitate to speak for others as I am not sure if they offer all the same level of service and malpractice coverage as CrappyLocums; also we have found that many locums companies advertise high rates and are not always able to deliver or the job only lasts for few shifts after all the work of credentialing. I will always let you know the highest rate the client is suggesting, but in the end I can present you over at any rate you feel is fair. Feel free to give me a call to discuss. Thanks again for the feedback!"
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Why would naming names not be allowed. I'll chip in:

Vista typically offers a good 20-40 less per hour than other companies. Weatherby also aggressively negotiates and tries to lowball you. I've also had a a hell of a time getting them to put anything in writing
 
turkeyjerky said:
Why would naming names not be allowed. I'll chip in:

Vista typically offers a good 20-40 less per hour than other companies. Weatherby also aggressively negotiates and tries to lowball you. I've also had a a hell of a time getting them to put anything in writing
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The quoted email was from Weatherby. Shame, I had a really good experience with them a decade ago, but they were acquired by CHG, which also owns CompHealth and Global Medical. CompHealth also used to be OK, and now they are also insanely bad. Vista has always been bad.

The email kills me- I don't care if they don't deliver, I care that I get a high salary or that I can enjoy my time off.

I wish docs were better with finances. I feel hamstrung by everyone else's poor planning and debt bringing down the market.
 
BelaMedicine said:
Question: How much do the locums companies make off of physicians?? I heard that they charge a crazy high % of our hourly rate? So does that mean that as long as you do locums they are charging the hospital a % of your hourly rate? That seems so unfair and obviously a huge way of cutting into physician profit.
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I spoke to a recruiter from Team Health about this recently and he said they pay their internal locums company, D&Y, on average $25/hr on top of whatever the physician making and external locums companies quite a bit more.
 
jiffywerk said:
I spoke to a recruiter from Team Health about this recently and he said they pay their internal locums company, D&Y, on average $25/hr on top of whatever the physician making and external locums companies quite a bit more.
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Wait, so if you are being paid $150/hr as a physician the locums company is making $175/hr off of you???!! And they profit everytime you work (per hour)?? This is INSANE.

How much does malpractice insurance cost them on average? Do they take out one malpractice plan per physician with a set cost regardless of the different hospitals/jobs they work?
 
So another locums question- I was chatting with Delta about a position, and they have a CRAZY prescreening form which they claim is for medmal. Asks all sorts of insane questions, like have you ever seen a counselor, do you drink alcohol etc. WTF? I have NEVER run into this with before, but I haven't done locums in years.

Any thoughts on this?
 
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BelaMedicine said:
Wait, so if you are being paid $150/hr as a physician the locums company is making $175/hr off of you???!! And they profit everytime you work (per hour)?? This is INSANE.

How much does malpractice insurance cost them on average? Do they take out one malpractice plan per physician with a set cost regardless of the different hospitals/jobs they work?
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No they are making at least $25/hr, with most companies making more. I agree the recurrent profit is ridiculous and what bothers me the most. I'm pretty sure malpractice insurance is fairly cheap, yet all companies upcharge slightly for the "convenience" of providing it for you. I have seen groups charge about $5-7/hr for this.
 
Anyone else know how much malpractice insurance costs? Do they have special rates? What if one wanted to purchase it on their own?
 
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BelaMedicine said:
Anyone else know how much malpractice insurance costs? Do they have special rates? What if one wanted to purchase it on their own?
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Its going to depend on your state and malpractice history.

States like Texas can be real cheap. I had my own policy last year and it was ~$15K/year. I'd imagine states like NY and PA could be double or triple that at least.
 
In everyone's experience is locums getting more popular or less popular?

Also do hospitals have a preference for working with locums companies? Are they bound to working with certain ones? Or is it a situation where all they care about is getting staffed and don't care about who they are working with
 
BelaMedicine said:
In everyone's experience is locums getting more popular or less popular?

Also do hospitals have a preference for working with locums companies? Are they bound to working with certain ones? Or is it a situation where all they care about is getting staffed and don't care about who they are working with
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How many times, and in how many different places, are you going to ask this same question?
 
I asked in the IM forum and the EM forum - two forums with totally different populations of physicians. Is that a problem???
 
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