Is $200 a night fair for this on-call offer?

[deathville]

---

Members don't see this ad.

I'm about to be a PGY-3 in July and excited to start moonlighting! A local psych hospital (Midwest region) has given us an offer to cover call at home on an inpatient unit. This includes:

• 108 inpatient beds (adult, geriatric, adolescent)
• On pager call 5 pm - 8 am on a weekday or weekend night. They tell us we get approximately 10 pages / night.
• No H&P's required, only admission orders and medication questions
• It seems they are short-staffed with attendings for years who are getting burnt-out with call.

So, in regards to compensation. They are offering $200 a night. I live about 1 hr from the hospital, so they say they will have their medical director cover any seclusion + restraints.

I asked one of my friends who is an attending in private practice, and he says that $200 seems low-balling, and feels $300-350 is more reasonable for the number of beds covered. I understand that as a resident we probably aren't "entitled" to attending-level pay yet, but I would like to be compensated appropriately too (these student loans ain't paying themselves)!

Is this a fair compensation or should I negotiate higher?

 

[robellis]

I'm about to be a PGY-3 in July and excited to start moonlighting! A local psych hospital (Midwest region) has given us an offer to cover call at home on an inpatient unit. This includes:

• 108 inpatient beds (adult, geriatric, adolescent)
• On pager call 5 pm - 8 am on a weekday or weekend night. They tell us we get approximately 10 pages / night.
• No H&P's required, only admission orders and medication questions
• It seems they are short-staffed with attendings for years who are getting burnt-out with call.

So, in regards to compensation. They are offering $200 a night. I live about 1 hr from the hospital, so they say they will have their medical director cover any seclusion + restraints.

I asked one of my friends who is an attending in private practice, and he says that $200 seems low-balling, and feels $300-350 is more reasonable for the number of beds covered. I understand that as a resident we probably aren't "entitled" to attending-level pay yet, but I would like to be compensated appropriately too (these student loans ain't paying themselves)!

My question r/psychiatry: is this a fair compensation or should I negotiate higher?

200 dollars to disrupt your sleep? Does that seem fair? Of course not..it should be at least 600 dollars per night and I personally would still not do it..sleep is extremely important

 

[TexasPhysician]

I wouldn’t do it at all. If you are going to, it should be $500+/night. If I get 3+ calls between 10pm-5am, I just don’t feel like myself. I once worked at a facility that had up to 140 beds. They had someone on call in-house 24/7 on weekends with no rounding. Rounding was someone else. It paid $100-120 per hour, and it was terrible. I would sign up for the rounding shifts. The call person always looked terrible by Sunday.

 

[robellis]

I wouldn’t do it at all. If you are going to, it should be $500+/night. If I get 3+ calls between 10pm-5am, I just don’t feel like myself. I once worked at a facility that had up to 140 beds. They had someone on call in-house 24/7 on weekends with no rounding. Rounding was someone else. It paid $100-120 per hour, and it was terrible. I would sign up for the rounding shifts. The call person always looked terrible by Sunday.

Exactly the science is clear about the importance of sleep, you are literally trading your life and health for money which is fine but it better be good money so consider your choices carefully

 

[SourceOfDenial]

Did you leave off a zero? 200$...maybe try Uber’ing?

 

[Slowpoke]

that's approx $15 an hour -- minimum wage in some parts of the U.S.

 

[Celexa]

$200/NIGHT? lol no.

 

[calvnandhobbs68]

Yeah this is a terrible offer. 200 bucks a night no matter how many pages/calls you get about *****ic order questions. 1-2 pages a night? Sure, then you’re basically just fulfilling whatever requirement they probably have to have a physician available 24hrs/day. But 20 bucks a page, which means you get woken up, have to call back, put in whatever orders and then try to go back to sleep. 10x a night. Yeah I bet the attendings are getting burnt out.

Dude you can go moonlight as a resident seeing outpatients for 100+ bucks an hour , make that money in 2 hours and get quality sleep every night. No way.

 

[doctalaughs]

Dude I pay 200 dollars to a plumber for 30 min to to unclog my toilet....

What is medicine coming to???

 

[Celexa]

I'm about to be a PGY-3 in July and excited to start moonlighting! A local psych hospital (Midwest region) has given us an offer to cover call at home on an inpatient unit. This includes:

• 108 inpatient beds (adult, geriatric, adolescent)
• On pager call 5 pm - 8 am on a weekday or weekend night. They tell us we get approximately 10 pages / night.
• No H&P's required, only admission orders and medication questions
• It seems they are short-staffed with attendings for years who are getting burnt-out with call.

So, in regards to compensation. They are offering $200 a night. I live about 1 hr from the hospital, so they say they will have their medical director cover any seclusion + restraints.

I asked one of my friends who is an attending in private practice, and he says that $200 seems low-balling, and feels $300-350 is more reasonable for the number of beds covered. I understand that as a resident we probably aren't "entitled" to attending-level pay yet, but I would like to be compensated appropriately too (these student loans ain't paying themselves)!

Is this a fair compensation or should I negotiate higher?

Didn't address this part in my initial response but if they want you for a job they haven't been able to retain an attending to do their owe you attending pay. You don't deserve less just because you're still a resident when you're doing attending work.

 

[SmallBird]

I'm about to be a PGY-3 in July and excited to start moonlighting! A local psych hospital (Midwest region) has given us an offer to cover call at home on an inpatient unit. This includes:

• 108 inpatient beds (adult, geriatric, adolescent)
• On pager call 5 pm - 8 am on a weekday or weekend night. They tell us we get approximately 10 pages / night.
• No H&P's required, only admission orders and medication questions
• It seems they are short-staffed with attendings for years who are getting burnt-out with call.

So, in regards to compensation. They are offering $200 a night. I live about 1 hr from the hospital, so they say they will have their medical director cover any seclusion + restraints.

I asked one of my friends who is an attending in private practice, and he says that $200 seems low-balling, and feels $300-350 is more reasonable for the number of beds covered. I understand that as a resident we probably aren't "entitled" to attending-level pay yet, but I would like to be compensated appropriately too (these student loans ain't paying themselves)!

Is this a fair compensation or should I negotiate higher?

I've seen $200 a night to cover one unit (like 20 beds).

 

[Monocles]

OP I got as far as your title. Unless they are paying you to sleep all night, $200 for the night is an insult and nowhere close to your time's worth.

 

[Bartelby]

That offer is truly horrific. You are earning about $15 per hour, and if you wake multiple times (which is likely if 10 calls is normal) you will probably feel destroyed for a day or two. Not only that, when you enter orders and handle issues by phone you take on liability. Imagine if one of your admissions completes suicide (for example) and the suit alleges your phoned-in admission missed the need for CO, or if you blow off a brewing medical emergency based on a nursing description by phone.

This offer is so bad that I would not even try to negotiate a better one, and I would make a mental note to avoid working for that system in general.

 

[robellis]

That offer is truly horrific. You are earning about $15 per hour, and if you wake multiple times (which is likely if 10 calls is normal) you will probably feel destroyed for a day or two. Not only that, when you enter orders and handle issues by phone you take on liability. Imagine if one of your admissions completes suicide (for example) and the suit alleges your phoned-in admission missed the need for CO, or if you blow off a brewing medical emergency based on a nursing description by phone.

This offer is so bad that I would not even try to negotiate a better one, and I would make a mental not to avoid working for that system in general.

Agreed

 

[Mad Jack]

200 dollars to disrupt your sleep? Does that seem fair? Of course not..it should be at least 600 dollars per night and I personally would still not do it..sleep is extremely important

Yeah, $200 is the kind of money you could make in a couple of hours on an evening. Not worth it at all. If it was lighter call, I would take $600, but if the call is heavy I wouldn't do it at all ever

 

[robellis]

Yeah, $200 is the kind of money you could make in a couple of hours on an evening. Not worth it at all. If it was lighter call, I would take $600, but if the call is heavy I wouldn't do it at all ever

200 dollars is literally one hour of work in an afternoon, so to disrupt ones sleep for that is asinine

 

[Mad Jack]

200 dollars is literally one hour of work in an afternoon, so to disrupt ones sleep for that is asinine

Around here going rate for residents is a bit lower, but yeah, I can pull 125/hr-150/hr in the region I'm headed to. Overnight phone call is $50-60/hr for psych units that have mid-20 beds plus emergency consults for the community hospital they're inside of (150-200 beds, often way below capacity). $200 is beyond a joke

 

[Psychresy]

Around here going rate for residents is a bit lower, but yeah, I can pull 125/hr-150/hr in the region I'm headed to. Overnight phone call is $50-60/hr for psych units that have mid-20 beds plus emergency consults for the community hospital they're inside of (150-200 beds, often way below capacity). $200 is beyond a joke

As an attending if I wanted to do a couple nights a week of overnight call coverage, how would I go about finding these opportunities?

 

[Mad Jack]

As an attending if I wanted to do a couple nights a week of overnight call coverage, how would I go about finding these opportunities?

This is resident moonlighting work, but the attendings get slightly more pay for the same stuff. I found the jobs by cold-calling local hospital physician recruiters. Best part is they're all W2 and include malpractice with tail

 

[Psychresy]

This is resident moonlighting work, but the attendings get slightly more pay for the same stuff. I found the jobs by cold-calling local hospital physician recruiters. Best part is they're all W2 and include malpractice with tail

W2 for just a couple of nights a week? That's surprising.

So sounds pretty easy to find a job doing this on top of a day job paying 5-600 a night as an attending. That's good to know.

 

[Mad Jack]

W2 for just a couple of nights a week? That's surprising.

So sounds pretty easy to find a job doing this on top of a day job paying 5-600 a night as an attending. That's good to know.

I was surprised, but big networks tend to be better at setting up employed arrangements than independent contracts, so it's their default. Most places aren't this way.

 

[deleted1100659]

remember you're getting taxed on that so its not even $200 a night in actuality lol.

so no. not worth it at all.

 

[TexasPhysician]

Around here going rate for residents is a bit lower, but yeah, I can pull 125/hr-150/hr in the region I'm headed to. Overnight phone call is $50-60/hr for psych units that have mid-20 beds plus emergency consults for the community hospital they're inside of (150-200 beds, often way below capacity). $200 is beyond a joke

As a PGY-2, I took a job on-call for seclusions at a residential treatment center. It was fairly large. I got $50 to be available all night. Most nights there were 0 calls. If I was called, I’d drive 7 minutes to complete seclusion paperwork/visualize patient safety. I got $150 per seclusion bonus. Best night was a brawl resulting in 4 seclusions. That’s 1 phone call disturbing my sleep for about 1 hour to earn $650.

As a PGY-2, I loved it. Now, I wouldn’t bother and I’d do that again over multiple calls for max $200.

 

[Merovinge]

Just to echo the above, I took this type of call as my first job out of training and it's absolutely worse than you are giving it credit for (I was around Q8 for reference). You are deciding PRN orders in the middle of the night on limited sleep as well as admission orders based on limited history. Not only is there significant opportunity for malpractice to occur but just the loss of sleep alone will limited your ability to be truly present for your patient's the following day (or loved ones). This was actually by far the worse part of inpatient work for me, I would go back to it in a heartbeat if we had suckers willing to do it for $200/night.

 

[Stagg737]

I'm about to be a PGY-3 in July and excited to start moonlighting! A local psych hospital (Midwest region) has given us an offer to cover call at home on an inpatient unit. This includes:

• 108 inpatient beds (adult, geriatric, adolescent)
• On pager call 5 pm - 8 am on a weekday or weekend night. They tell us we get approximately 10 pages / night.
• No H&P's required, only admission orders and medication questions
• It seems they are short-staffed with attendings for years who are getting burnt-out with call.

So, in regards to compensation. They are offering $200 a night. I live about 1 hr from the hospital, so they say they will have their medical director cover any seclusion + restraints.

I asked one of my friends who is an attending in private practice, and he says that $200 seems low-balling, and feels $300-350 is more reasonable for the number of beds covered. I understand that as a resident we probably aren't "entitled" to attending-level pay yet, but I would like to be compensated appropriately too (these student loans ain't paying themselves)!

Is this a fair compensation or should I negotiate higher?

I've seen $200 a night to cover one unit (like 20 beds).

So our program has in-house "moonlighting" that covers one of two units and is also $200/night. To give an idea of what ours looks like:

• Academic unit is 17 beds, private is ~30. 108 beds is ridiculous for home call imo.
• Call is also 5pm-8am. Average maybe 3-4 pages per night with almost all coming before 11pm. Usually just PRNs for anxiety or sleep which I can enter in 30 seconds from my phone.
• Same
• We get an additional $200 if we physically get called in (AMA d/c, acute medical concern, etc) which has only happened to me twice and once was. Once in the evening to make sure a guy didn't need to go to the ER for NMS (he *very obviously* did not have NMS). The other was an AMA d/c at ~6pm and I just dropped by on my way home from normal work to check for safety which in all truth was probably unnecessary, but an extra $200 for a quick safety check and 10 minutes of documentation was worth it.

I call staff at the start of my shift and tell them straight up to let patients know I will NOT prescribe benzos for anxiety and I will not write a PRN for sleep after midnight unless a patient is manic. On a bad night, I'll be woken up ~4 times overnight. Most of the time I'll get 1-2 calls overnight if that. Even with that, I typically only pick up these shifts on Fridays or Saturdays when I know I can sleep in.

Even for the situation I described above, it's not great pay and OP is getting completely shafted. Our advantage is it's all covered under our training license, so we can basically pick up extra pay without getting a full license as there's also an on-call attending backing us up. I'd never do either of the above as a true moonlighting gig unless the pay was much higher.

 

[sloh]

Just going to sleep with the anticipation you might get woken up is not worth $200/night

 

[Stagg737]

Just going to sleep with the anticipation you might get woken up is not worth $200/night

True, but that's why I do it on nights when I can sleep in the following day. I just anticipate that it's going to be a crappy night and say I can sleep in and it alleviates a lot of that anxiety. Most of the time it's an easy night, but I'm not annoyed when it does end up rough. Just another reason I'd never take one of these shifts during the week.

 

[FlowRate]

We get paid $500/night or so and most nights it's 0-2 phone calls. Can't imagine taking on something like this for less, as I already trade away the call I just mentioned (some people do like the low effort extra money.)

 

[Marasmus1]

Make a counter offer. I would do it for 1000 bucks Nothing less

 

[twospadz]

I live on the East coast. I'm a PGY 4 resident but started moonlighting as a PGY 3. We get paid 150 per hour at a external moonlighting gig. So A Friday night shift from 5:30-7PM. Is 2000 dollars. Even on week days, we work 5:30-11:30 and then do phone call for the rest of the night which we get an extra 300 dollars including the hours we work. At the end of the day, I will say you are being completely shafted. You should look for out of state gigs as a resident that you can work the whole weekend at a facility and make 4-5k.

 

[Psychresy]

I live on the East coast. I'm a PGY 4 resident but started moonlighting as a PGY 3. We get paid 150 per hour at a external moonlighting gig. So A Friday night shift from 5:30-7PM. Is 2000 dollars. Even on week days, we work 5:30-11:30 and then do phone call for the rest of the night which we get an extra 300 dollars including the hours we work. At the end of the day, I will say you are being completely shafted. You should look for out of state gigs as a resident that you can work the whole weekend at a facility and make 4-5k.

What's the best way to find moonlighting opportunities outside of the immediate area as a resident?

 

[twospadz]

What's the best way to find moonlighting opportunities outside of the immediate area as a resident?

Google or talk to recruiters. I got one text message from a recruiter in the north east asking for ER coverage and stating residents and fellows are welcome. Go through recruiters by applying online to ads and then when they text or email you, ask them if they know opportunities.

 

[Jules A]

I've seen $200 a night to cover one unit (like 20 beds).

That would be a hard no.

 

[Sushirolls]

Google or talk to recruiters. I got one text message from a recruiter in the north east asking for ER coverage and stating residents and fellows are welcome. Go through recruiters by applying online to ads and then when they text or email you, ask them if they know opportunities.

*Use a google voice number.

 

[samac]

We have a moonlighting opportunity at a 12 bed unit for call. $350 from 5pm-8am and the vast majority of nights there are 0 calls.
No way I'd take 10 pages a night for $200.

 

[robellis]

It’s ridiculous how low we are paid, my optho buddy makes 1400 per night on call and he tells me he very rarely has to come in and gets max 3 calls a night

 

[Jules A]

It’s ridiculous how low we are paid, my optho buddy makes 1400 per night on call and he tells me he very rarely has to come in and gets max 3 calls a night

It is ridiculous how low psychiatrists will accept. Not saying it is worth $1,400 but $200-$300 is unbelievable and if no one accepted it employers would either have to pay more or staff call with mid-levels which leads to other issues. I suspect they would rather pay a reasonable $400-$500 a night for the security of a physician covering.

 

[FatherPsychiatry]

$200 for THAT! Not even as a hungry intern.