Internist doing out patient locums

[beachesWA]

why do internist get paid 115 per hour doing locums. Hospitalist, Psy, endo , ect get around 160 to 180.
We area all board certified and do as much or more critical work. A clinic cannot survive without and internist.?? . Need input

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[DrMetal]

why do internist get paid 115 per hour doing locums. Hospitalist, Psy, endo , ect get around 160 to 180.
We area all board certified and do as much or more critical work. A clinic cannot survive without and internist.?? . Need input

Well, in the hospital world, the acuity is usually much higher (thus so too is the liability), the volume can be higher, and hours are more difficult (nights, weekends, holidays), and you get to deal with lovely situations (RRTs, codes, dispo-ing a 89-yo without medicare to a SNF)....and so you get paid more.

Having said all that, I would love to see outpatient clinicians get paid more....the good ones are worth their weight in gold.

 

[rokshana]

Well, in the hospital world, the acuity is usually much higher (thus so too is the liability), the volume can be higher, and hours are more difficult (nights, weekends, holidays), and you get to deal with lovely situations (RRTs, codes, dispo-ing a 89-yo without medicare to a SNF)....and so you get paid more.

Having said all that, I would love to see outpatient clinicians get paid more....the good ones are worth their weight in gold.

Plus you can bill more and medicare/medicaid will pay more of the bill.
Plus the role of the hospitalist isn’t just about what they bill but that they allow those big renvenue generating specialties (interventional cards, ortho, surgeons in general, etc) see more pt and do more procedures...demand is high and people won’t take 110/hr.

Get the 89 yo Medicaid and you’re good! At least for 28days...

 

[DrMetal]

Plus you can bill more and medicare/medicaid will pay more of the bill.
Plus the role of the hospitalist isn’t just about what they bill but that they allow those big renvenue generating specialties (interventional cards, ortho, surgeons in general, etc) see more pt and do more procedures...demand is high and people won’t take 110/hr.

Amen!

 

[wamcp]

why do internist get paid 115 per hour doing locums. Hospitalist, Psy, endo , ect get around 160 to 180.
We area all board certified and do as much or more critical work. A clinic cannot survive without and internist.?? . Need input

hospitalist locums pay only 160-180?
Why am I getting 180/hr for VA moonlighting, 225/hr at another hospital for nights, and 250-300/hr for moonlighting at another hospital...and it’s not doing it as locums.
Is it because these are admitter/night shifts I’m doing? Or locums companies take that much of the cut as a greedy middleman?

 

[rokshana]

hospitalist locums pay only 160-180?
Why am I getting 180/hr for VA moonlighting, 225/hr at another hospital for nights, and 250-300/hr for moonlighting at another hospital...and it’s not doing it as locums.
Is it because these are admitter/night shifts I’m doing? Or locums companies take that much of the cut as a greedy middleman?

sorry, find it unbelievable that the VA is paying you 180...You work per diem, yeah, they can pay you more since they don't have to pay the locums company, so could get to the 200-220/hr rate at a private/for profit place (or a desperate place) but other than emergency/holiday pay in the middle of BFE, 300/hr is not the norm. Where in the country are you getting these rates? And how busy are you? Can't imagine you have less than 10 admissions a night...

and of course the locums companies take a cut... they are not a non profit company of doing it for altruistic reasons...they are a business after all. But they do take care of a lot of things like travel, malpractice, credentialing, etc.

 

[CCM-MD]

Don't think anyone is doubting 175/h for nights.

300/h is definitely unicorn status - even in middle of nowhere type situations.

 

[rokshana]

Why is this unbelievable? See a scan of the VA pay contract when I signed on.

I'm obviously not going to disclose my location if it seems the moonlighting gigs I have in this area are very 'unicorn'...I do live downtown city of >1 million metro area and commute to these hospitals in the burbs.

And for the 225/hr hospital, I sometimes do get fewer than 10 admits a night. Usually though it is 8-12. The most I have done is 16 in a shift so far. Closed ICU.

The other 250-300/hr hospital is open ICU but intensivist still in-house, and their admitter shift can be quite busy. (you hit 300/hr if you go above a certain admit count for the shift).

you may want to black out the location of the VA in the contract.

but you are not simply admitting...you are either MOD as well and ED coverage...ED work for 180/hr is low from what i hear.

makes sense that the 300/hour is more of a boost with higher admissions and ICU responsibilities.

 

[wamcp]

you may want to black out the location of the VA in the contract.

but you are not simply admitting...you are either MOD as well and ED coverage...ED work for 180/hr is low from what i hear.

makes sense that the 300/hour is more of a boost with higher admissions and ICU responsibilities.

Thanks I just deleted it entirely.

Actually as night MOD we don’t personally admit, only crosscover nonteaching patients and back up the residents who are doing the admits. Easiest gig ever.

NOC role is pure admitter shift and pays the same as MOD at 175/hr

I choose not to do any ED shifts though, 180/hr not enough for me to put up with that at the VA

 

[kaycee18]

do they cover housing, car rental and transport with this rate? a company is offering me 165/hr for 12h (includes icu coverage) but no flight/car rental - offering housing in hospital call room. I initially thought i could claim these expenses in my taxes but with the new tax laws, it is impossible. what would be a fare rate? the location is in a rural area.

 

[michaelrack]

Unless u are being paid as a w2 employee, you should be able to deduct flight and car etc as business expenses

 

[rokshana]

do they cover housing, car rental and transport with this rate? a company is offering me 165/hr for 12h (includes icu coverage) but no flight/car rental - offering housing in hospital call room. I initially thought i could claim these expenses in my taxes but with the new tax laws, it is impossible. what would be a fare rate? the location is in a rural area.

It is standard to cover travel and hotel...165 that requires icu coverage...uh...just say no.