How much do yall work?

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If people look at EM, you get a slanted view reading this forum. The ones who is positive gets shouted down by those who hate their jobs. Some jobs sucks, some are good, some are great, and some are unimaginable unicorns. The ones with unicorns don't post for many reasons including not wanting others to find said unicorn jobs.

I know many docs who still work in the pits making 3-400/hr with a higher ceiling if they look for bonuses.

It is not hard to find a 400K+ EM job in a good working environment.
 
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Porfirio said:
565, 723, 684, 767, 626 (out to Sept but projected ~830)

Don’t have records before this and would have to pull tax records from CPA.
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That's really impressive. If you don't mind me asking, which geographic region / state do you practice in? Is it one of those chaotic EDs with limited resources in the middle of nowhere? I feel like the crappy work environment = higher hourly rate formula never fails. Also, I'm curious if you have a goal net worth in mind that you feel is enough to slow down with the hustling or even walk away from the field completely.
 
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Porfirio said:
Leeches on you too uh? You should go PRN.
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I don’t work PE, so I’m around 130 hrs and 10+ pph. Significantly better money and a say in how to run things.

I’m happy. It’s just a different workflow that you get used to. After I was about 3-4 years in I knew most of my patients and staff, can shoot the s*** with people who want to talk and cruise most days.
 
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eyeeye_captain said:
I don’t work PE, so I’m around 130 hrs and 10+ pph. Significantly better money and a say in how to run things.

I’m happy. It’s just a different workflow that you get used to. After I was about 3-4 years in I knew most of my patients and staff, can shoot the s*** with people who want to talk and cruise most days.
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Ten retinas an hour?
Explain like I'm a dumb ER doc, because I'm a dumb ER doc .
 
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RustedFox said:
Ten retinas an hour?
Explain like I'm a dumb ER doc, because I'm a dumb ER doc .
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As a dumb retina doc, I feel you.

Imagine if it was mostly frequent flyers with a limited workup and imaging done by competent nursing with your imaging usually done by the time they’re roomed. Then a relatively limited exam, conversation, and if a procedure is needed, it’s quick and was set up by nursing in between your next visits. A good number of visits are procedure only. With an established panel you know who wants to chat and who wants out the door.

Surgical conversations and weird stuff slow you down, but it averages out. I’m the “favorite doctor” for a lot of patients despite shots in the eye since it’s a relatively fast visit and a long term relationship.
 
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retro said:
That's really impressive. If you don't mind me asking, which geographic region / state do you practice in? Is it one of those chaotic EDs with limited resources in the middle of nowhere? I feel like the crappy work environment = higher hourly rate formula never fails. Also, I'm curious if you have a goal net worth in mind that you feel is enough to slow down with the hustling or even walk away from the field completely.
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UPMC fails. Very bigly. In fact, so much, they dumped the docs and replaced them with NPs at the last place I worked.
 
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retro said:
That's really impressive. If you don't mind me asking, which geographic region / state do you practice in? Is it one of those chaotic EDs with limited resources in the middle of nowhere? I feel like the crappy work environment = higher hourly rate formula never fails. Also, I'm curious if you have a goal net worth in mind that you feel is enough to slow down with the hustling or even walk away from the field completely.
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South, location is medium sized city that is 45-50 mins from a large city, low cost of living

I see 1.8-2.0 patients per hour. No headaches at the locations. I also provide no headaches and prevent headaches for the people that offer me the shifts.

Net worth goal is $15-20 million. If I stopped right now I would theoretically hit $12 million without saving anything additional by age 65.
 
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Porfirio said:
South, location is medium sized city that is 45-50 mins from a large city, low cost of living

I see 1.8-2.0 patients per hour. No headaches at the locations. I also provide no headaches and prevent headaches for the people that offer me the shifts.

Net worth goal is $15-20 million. If I stopped right now I would theoretically hit $12 million without saving anything additional by age 65.
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So you are about 40 with a net worth of 1.5M... since net worth double every 7-8 years.
 
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emergentmd said:
If people look at EM, you get a slanted view reading this forum. The ones who is positive gets shouted down by those who hate their jobs. Some jobs sucks, some are good, some are great, and some are unimaginable unicorns. The ones with unicorns don't post for many reasons including not wanting others to find said unicorn jobs.

I know many docs who still work in the pits making 3-400/hr with a higher ceiling if they look for bonuses.

It is not hard to find a 400K+ EM job in a good working environment.
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Location dependent. Some markets dont have this. Thats what I will say. As you mentioned some of the SDGs are still making bank. Some SDGs are mediocre and imo some are crappier than a cmg.

The issue I see with SDGs is the schism between the wants of the older (nearer to retirement guys) and the younger folks. Sometimes this aligns but it seems like much of this depends on the hiring that happens and how good the job is. Some groups just hire warm bodies, some hire folks who are in line with the groups historic and future vision.
 
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Splenda88 said:
So you are about 40 with a net worth of 1.5M... since net worth double every 7-8 years.
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Note the difference in net worth and investable assets. If your net worth is 1.5M but 500k of that is in a home thats not going to double as quickly.

I have a sizeable chunk of my NW in my home, I have a high amount in investment accounts. I dont even look at the equity in my home (and expected appreciation) in my retirement planning. I just figure I will sell my home and buy my retirement home with some of that money and then the left over will be a bonus. The equity in my current home is more than I could imagine spending on a retirement home when I am an empty nester. I figure I have 10-15 years left.
 
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Splenda88 said:
So you are about 40 with a net worth of 1.5M... since net worth double every 7-8 years.
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Very close.

A few notes to make, I don’t include home value in my net worth (you have to live somewhere). This is purely - cash, investments, IRA, HSA, 401k. I have about $2.1 million and 38. I also look at it as inflationary net worth. $12 million today is not $12 million when I am 65.

Estimate doubling every 7 years, inflation between now and 2052 will be $1 million today = about $1.9 million in 2052 (at 2.5% yearly inflation).

Run your own calculation and it will make you cry. Inflation is such a bi*ch.
 
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Porfirio said:
Very close.

A few notes to make, I don’t include home value in my net worth (you have to live somewhere). This is purely - cash, investments, IRA, HSA, 401k. I have about $2.1 million and 38. I also look at it as inflationary net worth. $12 million today is not $12 million when I am 65.

Estimate doubling every 7 years, inflation between now and 2052 will be $1 million today = about $1.9 million in 2052 (at 2.5% yearly inflation).

Run your own calculation and it will make you cry. Inflation is such a bi*ch.
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The part that makes me cry is the capital gains tax being applied to inflationary gains. It's a backdoor wealth tax. 🙁
 
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Porfirio said:
Very close.

A few notes to make, I don’t include home value in my net worth (you have to live somewhere). This is purely - cash, investments, IRA, HSA, 401k. I have about $2.1 million and 38. I also look at it as inflationary net worth. $12 million today is not $12 million when I am 65.

Estimate doubling every 7 years, inflation between now and 2052 will be $1 million today = about $1.9 million in 2052 (at 2.5% yearly inflation).

Run your own calculation and it will make you cry. Inflation is such a bi*ch.
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Agree. But 12M in 2050 might be ~8M in today's money. Still a lot of money IMO. Kudos for doing so well as a young doc.
 
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EctopicFetus said:
Location dependent. Some markets dont have this. Thats what I will say. As you mentioned some of the SDGs are still making bank. Some SDGs are mediocre and imo some are crappier than a cmg.

The issue I see with SDGs is the schism between the wants of the older (nearer to retirement guys) and the younger folks. Sometimes this aligns but it seems like much of this depends on the hiring that happens and how good the job is. Some groups just hire warm bodies, some hire folks who are in line with the groups historic and future vision.
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We only hire people that want to be with us indefinitely. This usually works out. Occasionally it's a bad fit.
 
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TooMuchResearch said:
We only hire people that want to be with us indefinitely. This usually works out. Occasionally it's a bad fit.
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We do the same.. That being said my point is the wants of younger docs and older docs is different than it was. I am not judging if it is good or bad. Greed is an common problem. I did some consulting work for a group. They had multiple sites, they were RVU based and one of the sites was the most lucrative but all the old guys worked there and didnt open up room for the younger docs. The younger docs eventually had the numbers (plus the guys close to retirement) and basically forced a sale of the group. This is an extreme example but various bits of this happen in many gorups.

I was told early in my career than EM docs care about 2 things. 1) Money and 2) schedule. Mess with either and expect unhappy docs. Some groups have no nights for docs over 50 (or 55), this can lead to a lot of unhappiness for younger docs. Some are happy to provide healthy incentives to encourage younger docs to work nights. My group has not had a partner or associate leave for another clinical job in about 9 years. The issues I mentioned above make it hard.

Personally, I dont believe in the "no nights after age X". unless there is something being given up. I also think creating an incentive whereby people will vountarily work those shifts is the best approach.

I also find it funny when people on here say nights are worth $x/hr. I think it depends on so many factors like volume and base pay.

For example, when I was coming out of residency in job 1 working nights was worth 35% more money hourly. The hourly pay was trash so it forced the younger folks to do nights. If you make $500/hr $50/hr to do nights may not be worth it.
 
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EctopicFetus said:
I also find it funny when people on here say nights are worth $x/hr. I think it depends on so many factors like volume and base pay.

For example, when I was coming out of residency in job 1 working nights was worth 35% more money hourly. The hourly pay was trash so it forced the younger folks to do nights. If you make $500/hr $50/hr to do nights may not be worth it.
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I never understood why covering nights was that difficult. My 1st job (Great job before being CMGed) bonused nights a flat $250 (I think) for nights that eventually increased to $500/nt. It was the most democratic and fair way. The money pot is what it is, and just the allocation changed. No one got short changed, no one got screwed, everyone had a choice. It is such a simple process that only has positives and no negatives.

1. Doc wanting to do nights for $500 gets to pick up as many nights as they want. Big Positive.
2. Docs not wanting to do nights essentially subsidizes from the "pot" thus changing $ for nights. Big Positive.
3. Docs not wanting to do more nights but still wanting to do their share of nights essentially has zero change in income and pay doesn't change.

If $500 was not enough, we would just vote to increase it til it is covered or I would just offer an extra $250 or $500 for someone to cover my nights. TBH, I would have gladly paid someone $500 or even $1000 to cover my nights on top of the set "bonus"

I am not sure why groups do not do this as I do not see any negatives and only positives. This avoids screwing the new docs, making older docs happy to avoid nights, and it is a fair system. Only the greedy older docs would be against this and set up some unfair "age" system so they don't have to lose out on some $$.
 
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emergentmd said:
I am not sure why groups do not do this as I do not see any negatives and only positives. This avoids screwing the new docs, making older docs happy to avoid nights, and it is a fair system. Only the greedy older docs would be against this and set up some unfair "age" system so they don't have to lose out on some $$.
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A similar system was in effect at Kaiser NW while I was there – basically an auction-style where you could "give up" nights in exchange for working more monthly hours for the same salary, while other docs could "pick up" nights in exchange for working fewer hours.

The ratio of hours gained and lost was dictated by supply and demand, but was basically 1:2 while I was there.
 
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emergentmd said:
I never understood why covering nights was that difficult. My 1st job (Great job before being CMGed) bonused nights a flat $250 (I think) for nights that eventually increased to $500/nt. It was the most democratic and fair way. The money pot is what it is, and just the allocation changed. No one got short changed, no one got screwed, everyone had a choice. It is such a simple process that only has positives and no negatives.

1. Doc wanting to do nights for $500 gets to pick up as many nights as they want. Big Positive.
2. Docs not wanting to do nights essentially subsidizes from the "pot" thus changing $ for nights. Big Positive.
3. Docs not wanting to do more nights but still wanting to do their share of nights essentially has zero change in income and pay doesn't change.

If $500 was not enough, we would just vote to increase it til it is covered or I would just offer an extra $250 or $500 for someone to cover my nights. TBH, I would have gladly paid someone $500 or even $1000 to cover my nights on top of the set "bonus"

I am not sure why groups do not do this as I do not see any negatives and only positives. This avoids screwing the new docs, making older docs happy to avoid nights, and it is a fair system. Only the greedy older docs would be against this and set up some unfair "age" system so they don't have to lose out on some $$.
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Older guys may think.. hey man i did nights and no one paid me xtra. So many places have either no or a minimal delta. I tend to agree with you. I think it is simple.. but.. but.. what if there is no number. i wouldnt work an extra night for nearly any amount. I have my number, everyone does but with that comes its own set of issues. Lets say I want my 3 nights this month covered and doc A is happy to cover them for my 500. Suddenly though Doc Z also wants them covered and he will pay $1k. I can either pay the 1k or not. What if Doc Z is the scheduler. Do I want to piss them off? Etc. etc.

I get it, I do I spent a lot of time making a program that works for my group. Its worked for me. I havent done a night in 3-4 years. But its never quite as simple as you would hope. Reality is a challenge. Older guys tend to be greedy and selfish in many ways cause things (according to them) were so hard and unfair and imo many want to reap the benefits of their age now that they are there and based on their perceived slight earlier.
 
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EctopicFetus said:
Older guys may think.. hey man i did nights and no one paid me xtra. So many places have either no or a minimal delta. I tend to agree with you. I think it is simple.. but.. but.. what if there is no number. i wouldnt work an extra night for nearly any amount. I have my number, everyone does but with that comes its own set of issues. Lets say I want my 3 nights this month covered and doc A is happy to cover them for my 500. Suddenly though Doc Z also wants them covered and he will pay $1k. I can either pay the 1k or not. What if Doc Z is the scheduler. Do I want to piss them off? Etc. etc.

I get it, I do I spent a lot of time making a program that works for my group. Its worked for me. I havent done a night in 3-4 years. But its never quite as simple as you would hope. Reality is a challenge. Older guys tend to be greedy and selfish in many ways cause things (according to them) were so hard and unfair and imo many want to reap the benefits of their age now that they are there and based on their perceived slight earlier.
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I am sure I have never thought of all the permutations but I worked in the hospitals for 18 years, 4 hospital systems, and 10 ERs. I only did nights b/c I picked the shift up for a big bonus. Like everything else, its all about supply and demand. If I offered $500 to cover my nights, it was typically covered without issues. If the demand for Night $$ is not enough, then a bump in the amount will created a balance in supply and demand.

Everyone has their number to do nights, and if you really want the nights covered then you either have to offer that number or working the night was a better option than losing out of $$$.

My first SDG lasted 16 years, I believe I probably did 10 true overnight shifts mainly b/c I had to switch into it for personal reasons. But I was never scheduled for true overnights other than an ill conceived plan to do 3 months of summer nights to be present with the kids in the mornings. We had a 6p-2a shift that I eventually got covered too by offering someone $200 to do so I ended up with 6a-2p, 10a-6p, 1p-9p shifts 99% of the time..
 
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I've work 312-348 hours/month 99% nights divided in 2-3 sites (different cities,states) for the past 3-4 years. Prior to this, I was averaging 240-280/mo. It sucks. Here's my July schedule. I hope nobody else here is doing it like me. The money is great though. Planning to FIRE

1751957807860.png
 
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doitalldoc said:
I've work 312-348 hours/month 99% nights divided in 2-3 sites (different cities,states) for the past 3-4 years. Prior to this, I was averaging 240-280/mo. It sucks. Here's my July schedule. I hope nobody else here is doing it like me. The money is great though. Planning to FIRE
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Thanks. I’ll be showing this to my wife the next time I take heat for picking up a shift.
 
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doitalldoc said:
I've work 312-348 hours/month 99% nights divided in 2-3 sites (different cities,states) for the past 3-4 years. Prior to this, I was averaging 240-280/mo. It sucks. Here's my July schedule. I hope nobody else here is doing it like me. The money is great though. Planning to FIRE

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Dude - when they say "live like a resident", they do not add "work like a resident"!!
 
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doitalldoc said:
I've work 312-348 hours/month 99% nights divided in 2-3 sites (different cities,states) for the past 3-4 years. Prior to this, I was averaging 240-280/mo. It sucks. Here's my July schedule. I hope nobody else here is doing it like me. The money is great though. Planning to FIRE

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Dude, that's insane. I've never seen anything like that in my life. I did that once as a resident and worked my entire 3 week vacation moonlighting but 3-4 years?!

I remember flying home and praying that I didn't kill anyone because it was one big blur.
 
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doitalldoc said:
I've work 312-348 hours/month 99% nights divided in 2-3 sites (different cities,states) for the past 3-4 years. Prior to this, I was averaging 240-280/mo. It sucks. Here's my July schedule. I hope nobody else here is doing it like me. The money is great though. Planning to FIRE

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1: assuming you're getting paid at least 280/hr (You are getting paid 280+/hr for all this travel and for nights I assume?) that means you're making over 1M/yr.

2: This can not be worth it unless you're literally about to retire. I have to assume you are since your savings rate is probably insane if for no other reason than the fact that you literally don't have any free time in which to actually spend money.
 
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doitalldoc said:
I've work 312-348 hours/month 99% nights divided in 2-3 sites (different cities,states) for the past 3-4 years. Prior to this, I was averaging 240-280/mo. It sucks. Here's my July schedule. I hope nobody else here is doing it like me. The money is great though. Planning to FIRE
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I assume no family/kids? Also, are you the unhealthiest person on the planet?
 
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doitalldoc said:
I've work 312-348 hours/month 99% nights divided in 2-3 sites (different cities,states) for the past 3-4 years. Prior to this, I was averaging 240-280/mo. It sucks. Here's my July schedule. I hope nobody else here is doing it like me. The money is great though. Planning to FIRE

View attachment 406283
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Grind it out bro. It is worth it. FREEDOM!!!
 
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doitalldoc said:
I've work 312-348 hours/month 99% nights divided in 2-3 sites (different cities,states) for the past 3-4 years. Prior to this, I was averaging 240-280/mo. It sucks. Here's my July schedule. I hope nobody else here is doing it like me. The money is great though. Planning to FIRE

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This is the stupidest thing I've ever seen.

1 mil / yr. If you can't FIRE after 2 years, there's something severely wrong.

I also know I guy who did this exact same thing for multiple multiple years. Falls asleep on shift. Disappears on shift for hours. Falls asleep at wheel on drive home. Let's swing evening doc see everyone while he chills. Forgets to sign out patients. Has the site by the balls though because he provides so much coverage. Absolute scum bag.

4 kids, 7k sq ft home in VLCOL area, wife likes to spend money.

Never sees his family. Maybe that's how him and his wife like it?
 
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doitalldoc said:
I've work 312-348 hours/month 99% nights divided in 2-3 sites (different cities,states) for the past 3-4 years. Prior to this, I was averaging 240-280/mo. It sucks. Here's my July schedule. I hope nobody else here is doing it like me. The money is great though. Planning to FIRE

View attachment 406283
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yea im gonna need a salary breakdown here, this is insane
 
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miamidoc101 said:
yea im gonna need a salary breakdown here, this is insane
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1~ mil/yr from these jobs not including ROI from investments/rentals. I basically lucked out. My bosses are angels, the nurses like me (I think), and my locations aren’t county hospitals. Also, no kids (for now).
 
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doitalldoc said:
1~ mil/yr from these jobs not including ROI from investments/rentals. I basically lucked out. My bosses are angels, the nurses like me (I think), and my locations aren’t county hospitals. Also, no kids (for now).
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Im not gonna rain on your parade like others. You do you. There was a job posted in west Texas.. 8 24s a month and pay is 335/hr about 750k a year. Seems doable. Well under 1pph.

I assume the jobs are low volume which is what allows you to work the hours you are. Only you can decide if it is worth it. I have a buddy who does a lot of nights but his deal with himself is he works out in between each night shift. I dont know if that keeps him healthy enough but he is relatively thin and happy. Of course he isnt working as much as you do. I also imagine your shifts are ultra low stress. I work some at Rural sites just cause I want to remember what it is like to feel no pressure to move the meat. Place are all 1.5pph and under when i work rural.
 
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EctopicFetus said:
Im not gonna rain on your parade like others. You do you. There was a job posted in west Texas.. 8 24s a month and pay is 335/hr about 750k a year. Seems doable. Well under 1pph.

I assume the jobs are low volume which is what allows you to work the hours you are. Only you can decide if it is worth it. I have a buddy who does a lot of nights but his deal with himself is he works out in between each night shift. I dont know if that keeps him healthy enough but he is relatively thin and happy. Of course he isnt working as much as you do. I also imagine your shifts are ultra low stress. I work some at Rural sites just cause I want to remember what it is like to feel no pressure to move the meat. Place are all 1.5pph and under when i work rural.
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The only way this is actually possible is to work rural locums.

Not too hard to find 300/HR for 1 PPH sites to work in the middle of nowhere for 60 hrs month.

Work for 60 hrs month at 4 separate hospitals = 200K at 4 sites = 800K

Because the volume is low it's more like being on call at night so it's pretty easy to get a little sleep on shifts.

So it's not difficult from purely a work perspective but you'll be traveling all month and will quite literally be always working.

Personally if you're willing to literally work all over for locums shifts it's smarter to do the bare minimum and then do last minute shifts.

Work for 60 hrs month for 1x normal rate and for 60 hrs month for 2x last minute rate = 600K
 
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alpinism said:
The only way this is actually possible is to work rural locums.

Not too hard to find 300/HR for 1 PPH sites to work in the middle of nowhere for 60 hrs month.

Work for 60 hrs month at 4 separate hospitals = 200K at 4 sites = 800K

Because the volume is low it's more like being on call at night so it's pretty easy to get a little sleep on shifts.

So it's not difficult from purely a work perspective but you'll be traveling all month and will quite literally be always working.

Personally if you're willing to literally work all over for locums shifts it's smarter to do the bare minimum and then do last minute shifts.

Work for 60 hrs month for 1x normal rate and for 60 hrs month for 2x last minute rate = 600K
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Im not into the locums world. My main job pays more than most locums. I sleep at home, see my family etc.
 
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Everyone has different priorities. If you can work that much, focus on eating right and staying fit, no kids, no wife or supportive wife then kill it now but I hope you have an exit plan soon.

There is more to life than work and money but act like a resident for 3-5 yrs so you can FIRE is not a bad trade off.

I know docs back in the days making $1M travelling all over the place doing Locums for bonuses. I did Locums for about 2 years but typically only covered 10-12 shifts a month which was about 120-140 hrs/month. To do 300+ hrs seems almost impossible for me to even imagine.
 
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JacobMcCandles said:
I've got bad news but you're underpaid.
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I probably am for the hours worked and potential differential I could have earned at other sites. However, I work in two major metros >2.5 million population and one “global city”. Pay are competitive for the locations. Obviously, these aren’t my only income streams so I compensate through other means like stocks. I probably will only do this for 1~ more year then do limited prn work. I do feel valued at work so it’s not bad. Feels nice to be needed and my bosses like the quality of my work.
 
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