Internal locums rates

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cowbydoc

cowbydoc

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I will write the eulogy later but our long term PP group is being “transitioned” into hospital employees. We feel like we made the correct business decision and have a good salary for the area.
One thing I’m curious about for other employed people out there is what are the rates you are paid for “extra” work . We have a $300/hr after 5pm OT rate but otherwise our previous PP rates for extra weekends, selling back vacation, etc have been suppressed because the partners did it more out of service and obligation than for maximum cash value. This attitude is definitely changing.
We are a level one trauma center in a challenging place to recruit to. It’s very busy on the weekends, 4-5 rooms running twelve hours a day Saturday and Sunday. Up most of the night. What I don’t want is opinions on this “should” be or crazy locums rates. I’m looking for what people are actually being compensated for extra work effort. Thanks SDN crew.
Here is our previous rates:
$300/hr after 5pm or after 2pm post late shift
$6k for a weekend shift that is usually around 24 hours of total work between Fri-Sun. Usually a night shift in that 24 hours of work.
$3k for a vacation buy back day for 7-5 work M-F.
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cowbydoc said:
I will write the eulogy later but our long term PP group is being “transitioned” into hospital employees. We feel like we made the correct business decision and have a good salary for the area.
One thing I’m curious about for other employed people out there is what are the rates you are paid for “extra” work . We have a $300/hr after 5pm OT rate but otherwise our previous PP rates for extra weekends, selling back vacation, etc have been suppressed because the partners did it more out of service and obligation than for maximum cash value. This attitude is definitely changing.
We are a level one trauma center in a challenging place to recruit to. It’s very busy on the weekends, 4-5 rooms running twelve hours a day Saturday and Sunday. Up most of the night. What I don’t want is opinions on this “should” be or crazy locums rates. I’m looking for what people are actually being compensated for extra work effort. Thanks SDN crew.
Here is our previous rates:
$300/hr after 5pm or after 2pm post late shift
$6k for a weekend shift that is usually around 24 hours of total work between Fri-Sun. Usually a night shift in that 24 hours of work.
$3k for a vacation buy back day for 7-5 work M-F.
Click to expand...
$300/hr extra w2 is what hospital employed (not AMC) pays on weekends and in excess of 40 hours (per week). Make that very clear. Not average of 40 hours every 2 weeks. But 40 hour per week before overtime kicks in

A true university base pay pays its docs $230/hr w2 but the same university base pays its other place $300/hr. Makes no sense

And AMC pays its w2 docs pays its docs $300/hr w2 extra. But the same exact AMC pays pays its docs $225/hr in the same exact freaking city. It’s ridiculous.
 
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What part of the country? My academic level 1 trauma is ~250/hr for clinical track with call around 300/hr. Nights covered by night float so different comp. Weekends vary in price, usually average ~400/hr. All W2. All before benefits.
 
lolnotacop said:
What part of the country? My academic level 1 trauma is ~250/hr for clinical track with call around 300/hr. Nights covered by night float so different comp. Weekends vary in price, usually average ~400/hr. All W2. All before benefits.
Click to expand...
State academics are cheap they don’t like to pay
 
Interesting, I was previously with a group that went from PP eat what you kill to hospital employed bc the board of the larger group made a lot of mistakes and the unit value was low. I think it is crucial if your group is doing this to put everything in hourly terms, that is what the hospital is used to for employees, and right now the hourly rate is high. Aneftp is correct, make it very clear that it's hourly per week, 40/45 hr at 275-300/hr for W2, and 1.3-1.5x this for anything over, this has to be spelled out in your contract and you have to have a way to clock hours (Qgenda can clock in/out).

Don't start talking about call from home/in house, everything should be hourly and your schedule maker should distribute the call evenly. What will happen is the easier shifts in your group will now be the most desirable, the important part about this is you need clear and transparent scheduling, if it's done by someone in the group everyone will think that there's sides being taken. You also need some feedback mechanism for your people that went from foxes to turtles.

If it has good benefits be open to taking less (which is a major advantage I've seen from PP vs. academics/employed from what I've seen and I've friends who have had kids with health issues who left their group bc of it)
 
This isn’t crazy locum rate but actually what many private groups make. Weekends at a place like that should not be under $350/hr or at least 8k a 24 hour shift. Locums would be 4-450 and 10k+ so I think that’s a fair weekend rate
 
cowbydoc said:
I will write the eulogy later but our long term PP group is being “transitioned” into hospital employees. We feel like we made the correct business decision and have a good salary for the area.
One thing I’m curious about for other employed people out there is what are the rates you are paid for “extra” work . We have a $300/hr after 5pm OT rate but otherwise our previous PP rates for extra weekends, selling back vacation, etc have been suppressed because the partners did it more out of service and obligation than for maximum cash value. This attitude is definitely changing.
We are a level one trauma center in a challenging place to recruit to. It’s very busy on the weekends, 4-5 rooms running twelve hours a day Saturday and Sunday. Up most of the night. What I don’t want is opinions on this “should” be or crazy locums rates. I’m looking for what people are actually being compensated for extra work effort. Thanks SDN crew.
Here is our previous rates:
$300/hr after 5pm or after 2pm post late shift
$6k for a weekend shift that is usually around 24 hours of total work between Fri-Sun. Usually a night shift in that 24 hours of work.
$3k for a vacation buy back day for 7-5 work M-F.
Click to expand...
You need to shift your thinking into an Employee based compensation model. This means what is your contracted hourly obligation? If you were smart it should be "good salary" for 40 hours per week with "extra" compensation at $300 per hour over that work. So, 24 hours would be $7200 if the shift wasn't part of the base 40 hours. Staying late should be past 300 PM if the person is expected to work 5 days per week.

As an EMPLOYEE you are no different that the CRNAs who would demand even MORE $$ for this compensation model than what I have posted. They would expect 1.5 X base pay, plus additional weekend/nights stipend pay on top of the 1.5 X base pay. Again, you need to rethink your approach towards compensation and realize the paradigm has changed from PARTNER to EMPLOYEE.
 
cowbydoc said:
I’m looking for what people are actually being compensated for extra work effort. Thanks SDN crew.
Click to expand...
W2. Compensated pretty much spot on what you have quoted there for extra. But my shop is not NEARLY as busy as yours.

Agree with Blade about how to calculate what is fair under the employed model. It's all calculator work.
 
BLADEMDA said:
You need to shift your thinking into an Employee based compensation model. This means what is your contracted hourly obligation? If you were smart it should be "good salary" for 40 hours per week with "extra" compensation at $300 per hour over that work. So, 24 hours would be $7200 if the shift wasn't part of the base 40 hours. Staying late should be past 300 PM if the person is expected to work 5 days per week.

As an EMPLOYEE you are no different that the CRNAs who would demand even MORE $$ for this compensation model than what I have posted. They would expect 1.5 X base pay, plus additional weekend/nights stipend pay on top of the 1.5 X base pay. Again, you need to rethink your approach towards compensation and realize the paradigm has changed from PARTNER to EMPLOYEE.
Click to expand...
The beeper call/backup is a huge issue.
We have discussed a few times. It’s worth at least 0.5 the full hourly rate plus time called in

I’m on on beeper pass 5pm (already a 10 hr day)

That’s 14 hrs beeper so every beeper call must be guaranteed the next day. There are places who will say you should work post beeper or be available. If I’m working post beeper. It has to be a guarantee 8 hrs of overtime regardless if I’m working 2-3 hrs or not.
 
aneftp said:
The beeper call/backup is a huge issue.
We have discussed a few times. It’s worth at least 0.5 the full hourly rate plus time called in

I’m on on beeper pass 5pm (already a 10 hr day)

That’s 14 hrs beeper so every beeper call must be guaranteed the next day. There are places who will say you should work post beeper or be available. If I’m working post beeper. It has to be a guarantee 8 hrs of overtime regardless if I’m working 2-3 hrs or not.
Click to expand...
Fully agree with this. MDs are way behind on pay for beeper call. CRNAs will often ask for same as in house. 0.5 in house rate minimum correct. So $150-175/hr of beeper call. Don’t take less. I promise you CRNAs are not
 
lolnotacop said:
What part of the country? My academic level 1 trauma is ~250/hr for clinical track with call around 300/hr. Nights covered by night float so different comp. Weekends vary in price, usually average ~400/hr. All W2. All before benefits.
Click to expand...
I meant to mention this. New England area. Not a major metro. Just 3-4 years ago New England was the lowest anesthesia salaries in the country. As of the most recent mgma numbers in June this region is now above the national average. Quite a jump.
 
cowbydoc said:
I meant to mention this. New England area. Not a major metro. Just 3-4 years ago New England was the lowest anesthesia salaries in the country. As of the most recent mgma numbers in June this region is now above the national average. Quite a jump.
Click to expand...
The reality is many hospitals based w2 jobs were in the mid 300s-low 400s plus benefits in the early 2000

That’s 20 plus years ago

Salaries decreased between 2010-2020 relative to workload and hours worked and inflation data.

550-600k is rate adjusted for 2000 pay.

Partnership tracks are a little different because involves taking 20-40% off new grads partnership for 2-5 years and partners dividing off the revenue from over working the young grads. You know those partners. Telling the new grad to take an extra weekend call. So the new grad is generating money and partners sit at home and get 40% of what they are generating
 
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cowbydoc said:
I will write the eulogy later but our long term PP group is being “transitioned” into hospital employees. We feel like we made the correct business decision and have a good salary for the area.
One thing I’m curious about for other employed people out there is what are the rates you are paid for “extra” work . We have a $300/hr after 5pm OT rate but otherwise our previous PP rates for extra weekends, selling back vacation, etc have been suppressed because the partners did it more out of service and obligation than for maximum cash value. This attitude is definitely changing.
We are a level one trauma center in a challenging place to recruit to. It’s very busy on the weekends, 4-5 rooms running twelve hours a day Saturday and Sunday. Up most of the night. What I don’t want is opinions on this “should” be or crazy locums rates. I’m looking for what people are actually being compensated for extra work effort. Thanks SDN crew.
Here is our previous rates:
$300/hr after 5pm or after 2pm post late shift
$6k for a weekend shift that is usually around 24 hours of total work between Fri-Sun. Usually a night shift in that 24 hours of work.
$3k for a vacation buy back day for 7-5 work M-F.
Click to expand...
These numbers seem low. $6k for 24 hrs of total work is very low, should be atleast $350/hr worked. We get 5k for Fri-Sun, but avg less than 5 hrs of weekend work.
 
mostwanted said:
These numbers seem low. $6k for 24 hrs of total work is very low, should be atleast $350/hr worked. We get 5k for Fri-Sun, but avg less than 5 hrs of weekend work.
Click to expand...
U get 5k x 3 days equals 15k?

Or 5k beeper for 64-72 hrs of beeper?
 
cowbydoc said:
I will write the eulogy later but our long term PP group is being “transitioned” into hospital employees. We feel like we made the correct business decision and have a good salary for the area.
One thing I’m curious about for other employed people out there is what are the rates you are paid for “extra” work . We have a $300/hr after 5pm OT rate but otherwise our previous PP rates for extra weekends, selling back vacation, etc have been suppressed because the partners did it more out of service and obligation than for maximum cash value. This attitude is definitely changing.
We are a level one trauma center in a challenging place to recruit to. It’s very busy on the weekends, 4-5 rooms running twelve hours a day Saturday and Sunday. Up most of the night. What I don’t want is opinions on this “should” be or crazy locums rates. I’m looking for what people are actually being compensated for extra work effort. Thanks SDN crew.
Here is our previous rates:
$300/hr after 5pm or after 2pm post late shift
$6k for a weekend shift that is usually around 24 hours of total work between Fri-Sun. Usually a night shift in that 24 hours of work.
$3k for a vacation buy back day for 7-5 work M-F.
Click to expand...
We get $2000 for extra day shift (8 hours). Any other shifts like nights/weekends, working on PTO day is $250/hr.
 
AppTrail said:
We get $2000 for extra day shift (8 hours). Any other shifts like nights/weekends, working on PTO day is $250/hr.
Click to expand...
So exactly the same rate. 2000/8= 250. 250/hr is very inadequate especially for nights and weekends. Maybe adequate if it’s a very light overnight where you can generally expect significant sleep.
 
I think they’re saying that’s on top of their salary.

I’m not paid anything for weekends, just baked into my W2 pay.
 
Shimmy8 said:
I think they’re saying that’s on top of their salary.

I’m not paid anything for weekends, just baked into my W2 pay.
Click to expand...
And you are buying into the koolaid if ur w2 salary is “baked” into your salary.

I hope u get 2 days off in weekday if you are doing the weekends
 
is $350 per hour flat rate for 24 hours in house on a Saturday for Locums a bad deal?

My W2 place offers $3500 for 24 hours chill in house and like $1500 for at home beeper call (lowish call back) on weekends + hourly call back which I think is like $160 per hour. I assume my group is making a ton off us ?
 
ToKingdomCome said:
is $350 per hour flat rate for 24 hours in house on a Saturday for Locums a bad deal?

My W2 place offers $3500 for 24 hours chill in house and like $1500 for at home beeper call (lowish call back) on weekends + hourly call back which I think is like $160 per hour. I assume my group is making a ton off us ?
Click to expand...
Straight $350/hr ($8400) is good if it's your home shop and it's not crazy busy. Even a busy OR without OB for that rate and at a job where I don't have to credential elsewhere, I would accept that.
 
SRYSPAC said:
Straight $350/hr ($8400) is good if it's your home shop and it's not crazy busy. Even a busy OR without OB for that rate and at a job where I don't have to credential elsewhere, I would accept that.
Click to expand...
I’d take the home rate w2 at $8k than chase a 10-11k 1099 rate 1 hr away almost any day of the week.

Just for convenience.
 
was
SRYSPAC said:
Straight $350/hr ($8400) is good if it's your home shop and it's not crazy busy. Even a busy OR without OB for that rate and at a job where I don't have to credential elsewhere, I would accept that.
Click to expand...
its a Locums job busy-ish. Has OB. I asked the Locums gig if they would give me more and they said no
 
aneftp said:
I’d take the home rate w2 at $8k than chase a 10-11k 1099 rate 1 hr away almost any day of the week.

Just for convenience.
Click to expand...
The $8K is not the W2 home rate though. That’s a 1099 rate I’m already credentialed at
 
ToKingdomCome said:
The $8K is not the W2 home rate though. That’s a 1099 rate I’m already credentialed at
Click to expand...
It’s fair rate as long as not taxing on you. 1-2 epidurals a weekend day is good if u get that. Use the hospital state of the art gym and keep urself entertained
 
dannyboy1 said:
So exactly the same rate. 2000/8= 250. 250/hr is very inadequate especially for nights and weekends. Maybe adequate if it’s a very light overnight where you can generally expect significant sleep.
Click to expand...
Yes, but a guaranteed rate if you get out early, so if you work 5 hours still get paid for the full 8. Problem is that people in my group keep picking up extra shifts and are satisfied with the rate after I've asked multiple times for us to request an increase. Other problem is that no other places in town pay well for 1099 PRN (highest I've seen is 300/hr). Not worth it to go to a new place further away for slightly extra pay.
 
cowbydoc said:
I will write the eulogy later but our long term PP group is being “transitioned” into hospital employees. We feel like we made the correct business decision and have a good salary for the area.
One thing I’m curious about for other employed people out there is what are the rates you are paid for “extra” work . We have a $300/hr after 5pm OT rate but otherwise our previous PP rates for extra weekends, selling back vacation, etc have been suppressed because the partners did it more out of service and obligation than for maximum cash value. This attitude is definitely changing.
We are a level one trauma center in a challenging place to recruit to. It’s very busy on the weekends, 4-5 rooms running twelve hours a day Saturday and Sunday. Up most of the night. What I don’t want is opinions on this “should” be or crazy locums rates. I’m looking for what people are actually being compensated for extra work effort. Thanks SDN crew.
Here is our previous rates:
$300/hr after 5pm or after 2pm post late shift
$6k for a weekend shift that is usually around 24 hours of total work between Fri-Sun. Usually a night shift in that 24 hours of work.
$3k for a vacation buy back day for 7-5 work M-F.
Click to expand...
What are y’all doing with call trading? If you want to get rid of a call do you pay cash to the partner that takes it?
 
This has been such a quick change that we haven’t established that yet. Most likely that is exactly what we will settle on. Brief case full of cash or a sack full of nickels.
 
cowbydoc said:
This has been such a quick change that we haven’t established that yet. Most likely that is exactly what we will settle on. Brief case full of cash or a sack full of nickels.
Click to expand...
Hopefully, you can find a system that lets the money trade hands pretax so the person that does the work and earns the money also pays the tax. That would require the employer being willing to handle that.
 
caligas said:
What are y’all doing with call trading? If you want to get rid of a call do you pay cash to the partner that takes it?
Click to expand...
That’s the one downfall of working as a w2 employee of a state/govt/hospital
Vs private practice setup

Private we could pretax every call shift change

As w2 it’s some cash rate tax adjusted

Like I could pay someone $2000 cash for 8 hrs for a Saturday as w2.
 
aneftp said:
That’s the one downfall of working as a w2 employee of a state/govt/hospital
Vs private practice setup

Private we could pretax every call shift change

As w2 it’s some cash rate tax adjusted

Like I could pay someone $2000 cash for 8 hrs for a Saturday as w2.
Click to expand...
At my previous (academic) shop, the department would take care of the pretax issue, but the rate was usually so low, you had to pay cash to your colleague on top of that to take a Saturday call, for example 😆
 
cchoukal said:
I’m w2 and we handle all this pre-tax with scheduling software. We use EZCall.
Click to expand...
Easier when its private entity

When dealing with mega corp or govt entity. It gets messy even with uneven bonus
 
mostwanted said:
Not really, for avg 35 hrs/wk with 12 wks off, will be clearing 620-650k+, with any extra work at $350-400/hr with 8 hr guarantee
Click to expand...
Congrats

You are making market pay I’ve been telling everyone about. The market is 700k/40 hrs a week/10 weeks off.

This is the current market rates. If you aren’t getting close to these numbers you are getting underpaid
 
aneftp said:
Congrats

You are making market pay I’ve been telling everyone about. The market is 700k/40 hrs a week/10 weeks off.

This is the current market rates. If you aren’t getting close to these numbers you are getting underpaid
Click to expand...
Do you do cardiac?
 
Shimmy8 said:
I think they’re saying that’s on top of their salary.

I’m not paid anything for weekends, just baked into my W2 pay.
Click to expand...


Same. Weekend work=weekday work for us. Same unit compensation and same stipends. The only advantage on weekends is that we can flip flop rooms on weekends which yields better turnover times and efficiency and we do a lot of ortho trauma on weekends which means a lot of blocks.
 
nimbus said:
40hrsx42weeks=1680hrs.


The market is $417/hr for permanent full time jobs?
Click to expand...
Full time equivalent calculations are always based on 2087 hours
“
  • Hourly rates of basic pay are computed by dividing an employee's annual rate of basic pay by 2,087 hours. Rates must be rounded to the nearest cent, counting one-half cent and over as the next higher cent (e.g., round $18.845 to $18.85).”
www.opm.gov

Computing Hourly Rates of Pay Using the 2,087-Hour Divisor

Welcome to opm.gov
www.opm.gov www.opm.gov
 
aneftp said:
Full time equivalent calculations are always based on 2087 hours
“
  • Hourly rates of basic pay are computed by dividing an employee's annual rate of basic pay by 2,087 hours. Rates must be rounded to the nearest cent, counting one-half cent and over as the next higher cent (e.g., round $18.845 to $18.85).”
www.opm.gov

Computing Hourly Rates of Pay Using the 2,087-Hour Divisor

Welcome to opm.gov
www.opm.gov www.opm.gov
Click to expand...

2087 is 40hrs/week x52 weeks.


Most workers don’t get 10 weeks vacation/yr.
 
nimbus said:
2087 is 40hrs/week x52 weeks.


Most workers don’t get 10 weeks vacation/yr.
Click to expand...
Don’t overthink things.

I’m just Showing you how wages are calculated

And if you are with the federal govt. the docs get 44 weeks off if u include cme annual leave and sick leave

In addition to 12 federal holidays (2.5 weeks). So federal employees get equivalent of 11 plus weeks off a year

It a complicated equation when comparing w2 vs 1099

Regular workers at federal level after 10 years also get similar time off
 
aneftp said:
Congrats

You are making market pay I’ve been telling everyone about. The market is 700k/40 hrs a week/10 weeks off.

This is the current market rates. If you aren’t getting close to these numbers you are getting underpaid
Click to expand...

How many calls a month are expected to be included in that 700k salary on avg per month?
 
finalpsychyear said:
How many calls a month are expected to be included in that 700k rate per month?
Click to expand...
You guys overthink. As long as it averages 40 plus hours give or take 40/45 hrs a week. Thats
What everyone should shoot for.

Say u have 5 docs.
2 docs cover 8 locations 7-5 (7-1) one doc leaves at 12-1pm. So both docs for the week average less than 40 hours

Night float doc comes in at 5pm (finishes up) on beeper to 7-9pm and goes home

All 3 docs really only Average 40 hrs
The night float doc works 5p-7am beeper (98 hrs on beeper). But gets extra week off. So really averages 49 hours max beeper hour inclusive. And really only works physically in the hospital as little as 25 hrs-40 hrs) but gets the bonus week off

There are so many different staffing models. People need to do what is best for the practice
 
aneftp said:
Full time equivalent calculations are always based on 2087 hours
“
  • Hourly rates of basic pay are computed by dividing an employee's annual rate of basic pay by 2,087 hours. Rates must be rounded to the nearest cent, counting one-half cent and over as the next higher cent (e.g., round $18.845 to $18.85).”
www.opm.gov

Computing Hourly Rates of Pay Using the 2,087-Hour Divisor

Welcome to opm.gov
www.opm.gov www.opm.gov
Click to expand...
That doesn't make sense. How can you base the rate on 2067 hrs and say you should only be working 1680 hrs?
 
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