FT vs multiple per-diems

[Homoochan]

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Hello!

I've been working FT for few years now. But, I've come to the realization that per-diem doctors are making much more (more than $30 / hr) doing the same work. I'm thinking about quitting and working as per-diem / PT doc at multiple local hospitals. Other than the obvious disadvantages of not having FT job such as lack of health/dental/vision insurance, 401k matching, HSA contribution, short/long-term disability and guaranteed hours, is there anything else that I'm missing? My current employer's benefits are dismal anyways so I don't feel like I'm losing much. e.g. No 401k matching, no HSA contributions, health insurance premium around $2,000 per month for family, etc.

I think this way, I can work less and make the same or work more and make more. I may also work less nights. I guess downside would be I could be no longer needed and out of job for months until I get a new gig.

 

[thegenius]

Yes you might be missing something.

Ask yourself what is the monetary value of

health/dental/vision insurance, 401k matching, HSA contribution, short/long-term disability and guaranteed hours

It's on the order of $20-30$/hr.

There isn't much difference between
1. FT Salary which usually includes a compensation package
2. Part-time Salary + $20-30/hr with no compensation package.

Now this says nothing about the individual jobs. Maybe the part time jobs are awesome. Who knows.


Also, there are some places with part time / per-diem that have a preponderance of those kinds of doctors because nobody wants to work there, and have problems retaining doctors. So they rely on part-timers and locums. Generally not good jobs.

 

[Mbekweni]

Also a big difference between full time partner and full time employee. In many groups I know of a full partner gets more profit sharing and $50 or more per hour increase after a few years. Push that out over a 30 year career and it's very much worth it to be a full partner. If it's just a benefits package then maybe not as important, particularly if you have a spouse that can help you access a good health plan through their job.

 

[Homoochan]

Also a big difference between full time partner and full time employee. In many groups I know of a full partner gets more profit sharing and $50 or more per hour increase after a few years. Push that out over a 30 year career and it's very much worth it to be a full partner. If it's just a benefits package then maybe not as important, particularly if you have a spouse that can help you access a good health plan through their job.

FT employee. SDG is rare around where I am.

 

[Angry Birds]

Another game changer is if you can get health insurance through a spouse. This could mean that per diem might be better for you. But yeah, I’m earning way more per diem and also, I don’t have to do anything to “earn” a bonus.

 

[Brigade4Radiant]

401k matching may not be worth it due to the years it may take to activate and independent contractor can put away more money they also get tax benefits. Also not all employees have the same benefits. I would always get your own disability insurance.

 

[EM Junkie]

Also don’t underestimate the difficulty of scheduling that many places. I have one main job and two part time gigs. Some months the schedulers unilaterally decide to “get the schedule out early”, so start asking for availability sooner and sooner. Some months there’s wide availability, other months none.

 

[thegenius]

So there you have it, pros and cons to FT vs PT.

 

[GeneralVeers]

I always have two jobs. I would never work full-time with a 120/hr month guarantee again. I love being able to take 2 week vacations every few months of the year, and not have to worry about cramping 14-16 shifts into a narrow window.

 

[88222]

How does one go about pursuing multiple, reliable locums gigs? Through a recruiter? Building network slowly over time?

Separately, I'm sure it's location-dependent but how many sites are required to consistently fill a month with, say, 12 non-overnight shifts?

 

[emergentmd]

How does one go about pursuing multiple, reliable locums gigs? Through a recruiter? Building network slowly over time?

Separately, I'm sure it's location-dependent but how many sites are required to consistently fill a month with, say, 12 non-overnight shifts?

I would recommend starting slowly. Keep you full time time, do 120hrs/mo. Search in the areas you want to do locums, pick up a few shifts for them, do a good job, be pleasant. The Docs/Nurses there will like you and will prioritize you for shifts. Do a bad job, and they will only call you when desperate.

Once your feet are wet, look for another site. Rinse and repeat. Many Locums are run by CMGs and staff multiple sites so you have multiple hospitals with one gig.

I have Freestanding Gig that gives me 4 shifts a month. I have 3 other sites and give avails to the ones I really like. They usually give me what I want b/c they like me. If I need more, I go to the 2nd and do the same. I rarely work in the 3rd unless they ask me to cover or I am looking for shifts.

There is some uncertainty but just work more certain months when they need you and in months when they don't, have a slow month. It all evens out.

Also, I usually only give requests to work weekdays/No overnights unless I get desperate.

Like in December, I am working one Sunday and no other weekend. I don't do overnights other than the 24hr FSERs. I am only working 2 shifts from Dec 19-Jan 7th b/c my kids are off/holidays.

I don't think I have done a true overnight in about a year other than FSERs.

 

[miacomet]

I have one W2 job and am thinking of doing nonclinical. Used to juggle multiple locums gigs, but it became a headache. Good on EmergentMD for figuring out how not to do nights!

 

[GeneralVeers]

I try to keep two jobs which have a reliable number of shifts. Usually one of them will have last minute shifts on a routine basis that I can take if I want to augment my hours, or negotiate for a bonus.