Firefighter Position

[EMgig]

So i'm resurrecting an old topic in a new thread.

Does anyone have experience as a "firefigher" with any of the CMGs?- I don't know anyone who has personally done it but it sounds as though everyone who has done locums loves the position temporarily because of the freedom it provides in scheduling/no meetings/etc.. The "firefigher position" sounds stressful, but i'm wondering what are the absolute worst cons/negatives about the position? The appeal is of course more control over schedule at the expense of travel and of course not a long term career. I'd be thankful for any input for those who have experience in this position.

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[deleted547339]

The biggest con is that you are supplying the CMGs with someone who is willing and able to help them round out the schedule of newly consumed ERs.

 

[deleted109597]

The biggest con is that you are supplying the CMGs with someone who is willing and able to help them round out the schedule of newly consumed ERs.

Or the utter ****holes they can't staff.

 

[WalkingCorpse]

I work with one guy who is a firefighter with Team Health. He loves it. N of 1. But he doesn't feel used and abused. At least not yet.


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[link2swim06]

Maybe it changed but the pay wasn't as great as you would expect.

 

[RustedFox]

Maybe it changed but the pay wasn't as great as you would expect.

This is my understanding, as well. I know a MeCare firefighter. Its meh.

 

[EMgig]

The pay is actually quite good and competitive for the short term, it pays more than an employed contracted position but being employed is obviously better for the long haul. I'm wondering if the pay is worth the stress of being placed in new hospitals for a few months at a time and the travel involved. I'm drawn to the freedom and flexibility as I try to figure out where I ultimately want to live, but I was also hoping to hear from someone who has actually gone through it and could share their personal experience. Anyone?

 

[Groove]

It's absolutely f'ing great when you are single and fresh out of residency with no ties AND/OR when you are married and want to escape your terrible home life. Either way, people seem to burn out relatively quickly. The travel gets old, living out of a hotel gets old, the continental breakfast gets old, the movies on your iPad gets old, sitting next to crying, snotty kids on the airplane gets old....it just all starts to monumentally suck after awhile. I hated that life. All the "firefighters" I meet these days seem to be young, new grads who are drinking some serious koolaid and brainwashed with the typical corporate "JOIN OUR CMG SEAL TEAM 6 FIREFIGHTER STRIKE TEAM ALPHA BRAVO TEAM LEADER BRIGADE AND BE THE BEST OF THE BEST!" spiel. I haven't found the extra money to be really worth it when you factor in the inconvenience and the time spent traveling. Credentialing at new places every few months and meeting new nurses and consultants and new EMRs and new hospital/dept politics just when you finally got used to the old place is just such a major suck.

I'm glad somebody is willing to do it though because it sure helps me fill the gaps in our schedule!

 

[deleted109597]

The pay is actually quite good and competitive for the short term, it pays more than an employed contracted position but being employed is obviously better for the long haul. I'm wondering if the pay is worth the stress of being placed in new hospitals for a few months at a time and the travel involved. I'm drawn to the freedom and flexibility as I try to figure out where I ultimately want to live, but I was also hoping to hear from someone who has actually gone through it and could share their personal experience. Anyone?

I would argue it isn't. EmCare is offering $300 right now, plus travel, AFAIK. That isn't much more than the base rate in many areas.

 

[GeneralVeers]

I don't think there is a need to sign on as a "fire-fighter" anywhere. I usually just agree to work part-time at specific facilities. That way I can control how many shifts I am doing, and where I work.

Generally I refuse to work anywhere that is > 45 minutes from a commercial airport.

 

[emergentmd]

Unless they are paying atleast $450/hr, what is the point? You get stuck with the worse EDs, Working the worse shifts after the full timers get all the early shifts, do all the holidays, get sent to different places on monthly basis to have to learn new systems, terrible consults, difficult to admit, poor nursing support.

To top this off, you are making $300/hr and after a month, figure out a locums guy is getting $450/hr.

Just do locums. You will make more, choose your shifts, stick to a few hospitals, avoid weekends, avoid holidays.

 

[thorg12]

Being "employed" is the exact reason there is less freedom.
Schedule is nice for a couple months then more nights, more shifts at unorganized er's, what happens when you don't like those er's they're scheduling you at.
I called around and found several "part time" gigs and locums gig that I can work as many or as few shifts as I want and pays more than firefighter jobs.

The posters above advice above is spot on. Only if they are in the 300/400$/hr would I consider

 

[deleted109597]

To top this off, you are making $300/hr and after a month, figure out a locums guy is getting $450/hr.

The locums companies are trying to shortchange us lately. They balked at $225 for me. So I told them thanks but no thanks.

 

[Alvarez13]

The locums companies are trying to shortchange us lately. They balked at $225 for me. So I told them thanks but no thanks.

We should all be doing this.

 

[Alvarez13]

The firefighter position is pretty awful.

One of the big groups (EMCare, TH, USACS, etc), won't say which, runs at $200/hr up until you break 140 hr/mo and then it's like $280/hr. You get benefits, ~$50k/yr which at 140 hrs is $30/hr, and they pay for travel which is nice. So you're running at ~$230/hr w/ a few airline miles. If you work 160s hrs/mo (ugh), those bonus shifts get you $210/hr averaged out and then $240/hr with your benefits. You also go where they tell you to.

Or...you can do locums. I see a lot of $250+/hr out there. In the midwest I've found multiple $270+/hr positions. Guess what, they also pay for all the travel/lodging. If I don't like it, I can leave. If I don't want to work nights/weekends, I don't have to. If I want to work 80 hrs 1 month and then 160 hrs the next, I can. Better pay and better flexibility is tough to beat.

The only possible reason I can to do the fire fighter thing is you want to start buying into these groups because there's a permanent site you want to be at or you don't like the buying insurance and extra tax work that comes with the IC role.

 

[RustedFox]

The firefighter position is pretty awful.

One of the big groups (EMCare, TH, USACS, etc), won't say which, runs at $200/hr up until you break 140 hr/mo and then it's like $280/hr. You get benefits, ~$50k/yr which at 140 hrs is $30/hr, and they pay for travel which is nice. So you're running at ~$230/hr w/ a few airline miles. If you work 160s hrs/mo (ugh), those bonus shifts get you $210/hr averaged out and then $240/hr with your benefits. You also go where they tell you to.

Or...you can do locums. I see a lot of $250+/hr out there. In the midwest I've found multiple $270+/hr positions. Guess what, they also pay for all the travel/lodging. If I don't like it, I can leave. If I don't want to work nights/weekends, I don't have to. If I want to work 80 hrs 1 month and then 160 hrs the next, I can. Better pay and better flexibility is tough to beat.

The only possible reason I can to do the fire fighter thing is you want to start buying into these groups because there's a permanent site you want to be at or you don't like the buying insurance and extra tax work that comes with the IC role.

They tried to roll this "escalating pay bracket" nonsense out to us about two years back to get us to pick up more shifts/month, at about the same time that they wanted to withhold about 1/4 of our monthly pay to be given to us in "bonus" format at the end of each quarter if we met goals and out"worked" our peers.

That $hit went over like a fart in church. Nobody signed up. Shifts went unfilled. Bonuses were given to fill shifts in last-minute format.

 

[EMgig]

Wow, this has turned into an incredible thread with AMAZING insights from seasoned physicians who can provide more depth on this topic based on experience (i'm completely limited in my own scope/perspective so this was exactly what I was looking for- brutal honesty)- so THANK YOU SO MUCH for all those who contributed to the above posts.

The figures are also spot on for the "firefighter" positions, in the end, i'm finding those positions do pay more than employed positions (at least the region I was looking at- i haven't come across an employed position that would offer a base-rate of $300/hr but I don't doubt it's out there if you don't care about region) but maybe less than locums (which is spotty work and rates along with need are variable).

"Firefighter" positions are good in that you have the ability to make your own schedule, you can do a week on and a week off which provides a more predictable and more controlled schedule, the pay rate is higher, you can find positions that offer benefits- but it sounds as though the downsides are: inconvenience of travel which is understood from the beginning, higher potential burn out rate because of possibly being sent to dysfunctional sites or high volume sites with higher medical-legal liability, you don't know who you're working with in terms of staff/consultants/etc., constant credentialing every few months, anything else i'm missing?

I'm finding employed positions (at least where I was looking) simply pays much less and requires more hours (which makes the firefigher position much more attractive), a rotating erratic schedule, more corporate oversight such as meetings/quality measures/etc. but the benefits would be no travelling (local) so work is more integrated with life, generally better benefits, and a more stable predictable environment.

I hope this thread helps others in the future when they are making this same decision- thanks everyone again!

 

[deleted109597]

No, that's pretty much it. They handle most of the credentialling, and you can limit where you work by telling them you only have or will only get licenses in certain states. So you can reduce the malpractice that way.
Is it a decent way to pay down debt if you're single? Sure. You're rarely home, so you can get a tiny apartment and they cover your hotels when travelling. You might not even need a car if you live in certain cities. All of that money goes towards your loans.
It's tough to do for more than a couple years though.

 

[The White Coat Investor]

"Firefighter" sounds a lot more noble than "scab" doesn't it?

When docs refuse to be firefighters, CMGs can no longer poach contracts from SDGs. So realize if you sign up to do this that you are directly contributing to making our specialty suck to practice. I mean, it's one thing if the only way to work in your desired locale is for a CMG, but to actively volunteer to help screw over other docs? For $225 an hour? You sold your soul pretty cheaply IMHO.

It's certainly nothing to be glorified. Maybe if you had a rule that you weren't willing to do it for any contract the CMG had held for less than a year or something, I dunno.

 

[GeneralVeers]

"Firefighter" sounds a lot more noble than "scab" doesn't it?

When docs refuse to be firefighters, CMGs can no longer poach contracts from SDGs. So realize if you sign up to do this that you are directly contributing to making our specialty suck to practice. I mean, it's one thing if the only way to work in your desired locale is for a CMG, but to actively volunteer to help screw over other docs? For $225 an hour? You sold your soul pretty cheaply IMHO.

It's certainly nothing to be glorified. Maybe if you had a rule that you weren't willing to do it for any contract the CMG had held for less than a year or something, I dunno.

I think the salary is more of an issue. Every time we refuse to work at a site for <$300/hour it is a finger in the eye of the CMG. I want to cost them a lot of money. I want to make them bleed a bit. Between travel, regular pay, and bonuses they aren't making much money off of my services. Once you are a firefighter you are essentially a full-time employee, as TeamHealth and USACS usually sets minimum hours for their employees, but they do get benefits. That means loss of flexibility, which means it is easier for them to carry out their plan of world domination