Locums Anesthesia market in Texas

[livinlavidalocums]

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Any insight would be appreciated as to rates and experiences please pm me. I don’t do cardiac, neonates or transplants. Only interested in doing my own cases not supervising within 1 hr drive of airports in Dallas, Houston, Austin, San Antonio, El Paso.

 

[AKMD_1984]

if you really locums full time consider a full time job

yeah the pay may be 85% of locums but there will be consistency in schedule

i really don’t think that there is that much difference anymore between long term locums and a good long term gig that one can negotiate

by long term i mean 1-2 years

 

[livinlavidalocums]

I like the flexibility too much. Had trouble getting summer, Christmas, thanksgiving vacation as part of groups. Financially I agree there isn’t much difference unless you do tons of call

 

[Status Sciaticus]

if you really locums full time consider a full time job

yeah the pay may be 85% of locums but there will be consistency in schedule

i really don’t think that there is that much difference anymore between long term locums and a good long term gig that one can negotiate

by long term i mean 1-2 years

its usually not 85%, its usually 50-60%. I was working 50 hours/week with 1-2 weekend calls per month on a locums assignment and clearing 100-120k/month with 1099 benefits.

I doubt its easy to find metro jobs that are paying 800k with 12 weeks off.

 

[livinlavidalocums]

100-120k/a month is awesome. That is higher than most make doing locums. Just like senior partners in groups working less yet are making 7 figures. My situation is mainly for scheduling/flexibility. Being the locums I work longer hours than partners and although I make slightly more than the average partner, top partners make more and work less than me. Additionally per/hr worked most partners make more. I work 55-60 hrs a week on average 18 days/month. I have ~12 weeks off. I have not worked a single weekend or taken a single call in years. Every group/situation is different. The group I do locums with is financially compensated well relative to others. If I were to compare my annual income to others groups then yes, I make 30-40% more.
In my humble opinion money is one of the factors but there are many other factors like vibe of place I work, time off, not doing call, weekends, holidays. Etc.
for me the other factors are more important than the money.

 

[AKMD_1984]

its usually not 85%, its usually 50-60%. I was working 50 hours/week with 1-2 weekend calls per month on a locums assignment and clearing 100-120k/month with 1099 benefits.

I doubt its easy to find metro jobs that are paying 800k with 12 weeks off.

family?
kids?
stability?

did you factor that into this?

 

[amyl]

its usually not 85%, its usually 50-60%. I was working 50 hours/week with 1-2 weekend calls per month on a locums assignment and clearing 100-120k/month with 1099 benefits.

I doubt its easy to find metro jobs that are paying 800k with 12 weeks off.

Where was 100-120k a month?

 

[Status Sciaticus]

family?
kids?
stability?

did you factor that into this?

None of this factors into the claim you made that a permanent job is 85% of locums. I'm simply stating that the math is incorrect.

Where was 100-120k a month?

Mt St Elsewhere. LOL. I'll PM you.

 

[AKMD_1984]

None of this factors into the claim you made that a permanent job is 85% of locums. I'm simply stating that the math is incorrect.



Mt St Elsewhere. LOL. I'll PM you.

Perhaps the problem is your ability to negotiate then...
people arent stupid. no one is going to pay locums rates forever at a certain place. especially true for big metro areas with competitiion.

there is value in longevity and reliability of work as well. rather than worry about cancellation of high rate gigs with a 30 day notice...there is no stability in locums and locums companies are also taking a cut.

i can understand independent contracting as a long term stable way to work with a few select work, but travel, hotel lifestyle etc is not stable and ROI is not there. locums is not possible if you want a stable family life. groups do advertise low ball salaries. but like everything in life, all is negotiable.

again, we have a whole group of independent docs from our city on a whatsapp chat - major metro area - only a handful do locums long term. and even then it seems like a lot of work. in the beginning there is excitement but after 2-3 years, naturally they cut down or staff their preferred sites with a paycut for ease of scheduling, proximity to home base etc. they arent looking for $500/hr rates.

 

[BLADEMDA]

Let's say a "good" locums rate is $400 per hour. That would be a consistent rate at a desirable location. 80% of that rate is $320 per hour. So if you can find a local gig you like working at paying $320-$350 per hour then it's a win-win situation for everyone. Aneftp and I look for W-2 gigs paying $300 per hour with a $20 per hour benefit package (PTO, Retirement, etc) as those are acceptable as well. He does a lot more side gigs at $350 per hour "filling in" as a 1099 at area hospitals. I take much more time off than he does but still do some side work at $350 per hour locally.

The key is finding steady work and filling up your weeks to the level you prefer. For some that is 40 hours per week while for others it is 50+ hours per week. Aneftp still takes a lot of extra call with continuous billable hours at night.

 

[AKMD_1984]

Yes, I agree with you Blade.

The increased locums rate reflects their treatment of you. You have a target on your back and higher the rate, the faster they're looking to replace you or give preference to cheaper option. As I said, groups/admin arent stupid. You may get away with it for a little while but all locums contracts have an expiration.

And regarding vacations and holiday coverage:
That is a very touchy subject and many groups, esp. when short staffed fight a lot over that. Most groups look at locums to actually cover those times and in their mind they think that their higher cost is justified. The W2 employee is almost expecting the locums guy to cover not only holiday weeks but also stay later etc. Its all justified in their minds which is foolish. Most locums are best during day time. I personally think that locums in a busy 1 trauma center call right off the bat is dangerous where they may not know the system, personalities and how to get things done.

This justification to expect more from locums for more pay may be sometime right, may be no. It depends on the individual locums. In OP’s case - they do not want to work holidays. A good way to deal with this is to say no more than 2/6 holiday calls if you are taking call. Or no more than 1 major call per 6 and no more than 1 minor call per 6.

Again, everything is negotiable. There are plenty of arrangements and taylor made contracts depending on work, call, availability needed. A fair 80-85% reduction compared to locums is probably better than long term locums for most people.

Travel, lack of consistency and haphazard scheduling probably costs money too.

The problem with most groups isnt just the money. Its maldistribution of labor and senior members playing politics and also refusal of some to do certain cases. That's the real reason no one talks about. Or "this dr has known the urologist for 10 years and they are tight and only he can do 5 lma urology cases with 30 minute turnovers at an ASC close to them and go home". Its picking and choosing and how schedule is made.

Its human nature to work less and expect more.

Locums avoids all that and the relationship becomes transactional. Most people who have done locums (including me) really find that aspect to be the most valuable part of practice. At least you get compensated appropriately for your labor and have leverage.

With that said, if there is a good group and the pay is decent - just take it. There is more to life than calculating locums rate and working and worrying about next gig.

 

[AKMD_1984]

San Angelo is a good offer/gig

Thats 80-85% of locums rates with stability...

 

[amyl]

Yea the problem is most of the stability high paying jobs are in less desirable locations - like San Angelo or my job in SC. If I had a dime for every time a friend has said man I wish I could find a job like yours in dallas or Chicago or (insert desirable place here.). But the fact is they can’t because places don’t have to pay that there - they can get someone for less.
The fault is with us…. Demand more and don’t sell out.
Like the crna problem… we are to blame. There’s a ****ty anesthesiologist on a female anesthesiologist facebook group who is advertising that she pays for regional training for all her full time crnas in her Locums company. **** her.

 

[aneftp]

San Angelo is a good offer/gig

Thats 80-85% of locums rates with stability...

If it fits ur lifestyle and location. Than by all means go for it.

Probably 10%-15% of the anesthesia population would consider it. (Single no kids) or grown kids etc 3 plus hours away from any major international airport. So connecting flights makes it a pain to travel for work (increase risk of delays). My favorite year was 2007. I literally felt like a rock star. Worked in Memphis , San Francisco and Ft. Lauderdale. All within a 12 day period. I loved it. But what I loved was the direct non stop flight. I was in and out. Like a hired hit man. I would not recommend that to anyone who can needs them to adjust to work conditions. And I certainly could not do that with connecting flights to work in small towns.

There is a job for everyone. But like life. Lots of compromises.

 

[AKMD_1984]

If it fits ur lifestyle and location. Than by all means go for it.

Probably 10%-15% of the anesthesia population would consider it. (Single no kids) or grown kids etc 3 plus hours away from any major international airport. So connecting flights makes it a pain to travel for work (increase risk of delays). My favorite year was 2007. I literally felt like a rock star. Worked in Memphis , San Francisco and Ft. Lauderdale. All within a 12 day period. I loved it. But what I loved was the direct non stop flight. I was in and out. Like a hired hit man. I would not recommend that to anyone who can needs them to adjust to work conditions. And I certainly could not do that with connecting flights to work in small towns.

There is a job for everyone. But like life. Lots of compromises.

the original poster asked for texas
idk what he desires about texas
san angelo isn’t that different than brownsville or even san antonio for that matter
if you have a full time job you’re not traveling every week like locums
i was mentioning that it’s good comp and schedule and md only

 

[amyl]

I think San Antonio can’t be compared equally to San Angelo but you have a point with brownsville

 

[Status Sciaticus]

San Angelo is a good offer/gig

Thats 80-85% of locums rates with stability...

for people in their 50s/60s.
Its a BFE town.

the original poster asked for texas
idk what he desires about texas
san angelo isn’t that different than brownsville or even san antonio for that matter
if you have a full time job you’re not traveling every week like locums
i was mentioning that it’s good comp and schedule and md only

We can derive that based on the fact that he/she wants to be within 1 hour of a major international airport.

I think San Antonio can’t be compared equally to San Angelo but you have a point with brownsville

Agreed.
San Angelo population is 100k
San Antonio population is 1.5M. (7th largest city in the US).

Maybe McAllen or Odessa will be a mor eapt comparison.

 

[AKMD_1984]

yeah 1h drive to airport

then wait 4 hrs for flight delays and domestic air BS 👌

i personally live 15 minutes from a large international airport - would not have made a difference if i lived 4 hrs away - domestic air travel sucks and it’s not like it cannot be planned

 

[amyl]

15 minutes at the right time…. Southlake to DFW has taken me 45 minutes before- just saying…. You can never plan 15 minutes to DFW from anywhere unless it’s 0500

 

[aneftp]

for people in their 50s/60s.
Its a BFE town.



We can derive that based on the fact that he/she wants to be within 1 hour of a major international airport.


Agreed.
San Angelo population is 100k
San Antonio population is 1.5M. (7th largest city in the US).

Maybe McAllen or Odessa will be a mor eapt comparison.

Jacksonvile is the largest “city” in the state of Florida.

San Antonio’s is the 2nd largest “city” in Texas

It’s hard to find non stop flights to San Antonio and Jacksonvile from many parts of the country.

I’d rather work in a smaller “city” ranked 42 in the USA with non stop flights to South America, almost all of Europe, Dubai etc called the city of Miami. Plus another airport 30 min away that serves tons of city in FLL

No one will confuse the true metro size of San Antonio to Houston or Dallas.

OP is

 

[aneftp]

yeah 1h drive to airport

then wait 4 hrs for flight delays and domestic air BS 👌

i personally live 15 minutes from a large international airport - would not have made a difference if i lived 4 hrs away - domestic air travel sucks and it’s not like it cannot be planned

Connecting flights sucks.

Even a bigger city like sacromento sucks compared to flying out of Oakland or sfo.

Imagine working in Redding California or even Chico. And living in say phoenix and trying to do locums. A 1 week assignment. U will lose 2 days of work traveling there. One day each way. Ain’t no non stop lights there. Fly it into sfo and drive 3 plus hrs. That’s a ton of lost time.

 

[Status Sciaticus]

Jacksonvile is the largest “city” in the state of Florida.

San Antonio’s is the 2nd largest “city” in Texas

It’s hard to find non stop flights to San Antonio and Jacksonvile from many parts of the country.

I’d rather work in a smaller “city” ranked 42 in the USA with non stop flights to South America, almost all of Europe, Dubai etc called the city of Miami. Plus another airport 30 min away that serves tons of city in FLL

No one will confuse the true metro size of San Antonio to Houston or Dallas.

OP is

Most international routes are out of the major hubs though, like DFW, JFK, LAX, IAH.
Hard to get non-stop internationals on Emirates, JAL, ANA, etc from those BFE towns.

 

[aneftp]

Most international routes are out of the major hubs though, like DFW, JFK, LAX, IAH.
Hard to get non-stop internationals on Emirates, JAL, ANA, etc from those BFE towns.

Correct. I’m talking about trying to work in Redding California and living in the second largest city in Texas

There is no direct way to get to Redding. Best u can do it fly San Antonio to sfo than a tiny airplane to Redding airport. Or drive 3.5 hr from sfo. That’s a pain to travel back and forth when doing locums unless u like it.

 

[livinlavidalocums]

the original poster asked for texas
idk what he desires about texas
san angelo isn’t that different than brownsville or even san antonio for that matter
if you have a full time job you’re not traveling every week like locums
i was mentioning that it’s good comp and schedule and md only

So I have had a “stable” locums gig 30 minutes from my house in California for ~3 years. 55-60 hrs a week avg 18 shifts/month. Off 12 weeks a year which includes 6-8 weeks during summer months. 2-3 weeks for Christmas and New years. They hired a bunch of new grads and I will not have a full time schedule any more.
The reason I asked about Texas is to make use of my active TX license doing locums in one of the big 5 cities in Texas that have direct flights from Cali. Once I start my assignment, then I can apply for IMLC which will give me access to ~40 states. I plan to concentrate on west coast. Meanwhile looking for other locums gigs in California. Given the shortage and need for anesthesiologists I can get away with doing 100% locums. Connecting flights suck. It kills your whole day hence big 5 Texas only. I don’t plan on moving to Texas, just doing locums temporarily to get my imlc. Other option is to apply for say AZ license wait 3-4 months then do locums there then get IMLC.
I don’t know the locums rates for big 5 so wanted to ask you guys for help on getting paid fairly.
This forum especially Aneftp has been very helpful.

 

[amyl]

Big 5? Dallas Houston Austin and ?
San Antonio? El Paso?

Status may be helpful to you too…. Of these markets I think San Antonio is the best

I agree about connecting flights - we have an airport in town 7 minutes away…. But we end up driving 2h to Charlotte instead…. Wish we were closer but then I wouldn’t have the job I have if we were.

 

[livinlavidalocums]

Redding, Eureka and other boonies with low rates will always be there.
I would Rather do Texas to get my IMLC. Redding/Eureka would be a total waste of time.

 

[livinlavidalocums]

Most international routes are out of the major hubs though, like DFW, JFK, LAX, IAH.
Hard to get non-stop internationals on Emirates, JAL, ANA, etc from those BFE towns.

Yes. Lax is much better than Sfo.
LAX, JFK, ORD, MIA, BOS, ATL, DFW, IAH are the main International hubs that come to mind. For domestic travel more nonstop options at those airports also.

 

[livinlavidalocums]

Jacksonvile is the largest “city” in the state of Florida.

San Antonio’s is the 2nd largest “city” in Texas

It’s hard to find non stop flights to San Antonio and Jacksonvile from many parts of the country.

I’d rather work in a smaller “city” ranked 42 in the USA with non stop flights to South America, almost all of Europe, Dubai etc called the city of Miami. Plus another airport 30 min away that serves tons of city in FLL

No one will confuse the true metro size of San Antonio to Houston or Dallas.

OP is

San Antonio has some direct flights to me but not many. It has some nice parts by Riverwalk and Six flags l/la cantera but it has lots of parts that are not so nice.
Dallas is the best city in Texas in my opinion. Any of the big 5 will do but obviously Dallas and Houston will be the easiest to get in and out of flightswise. Traffic wise is another issue. San Antonio will have traffic rush hour too but not nearly as bad as Houston or Dallas.

 

[aneftp]

I do have a question. How do u prove residency in the state? Are u changing ur drivers license? Renting a house?

“
In addition, at least ONE of the requirements below must apply:

• Your primary residence is in the SPL (State of Principal License)
• At least 25% of your practice of medicine occurs in the SPL
• Your employer is located in the SPL
• You use the SPL as your state of residence for U.S. Federal Income Tax purposes”

How do they even audit this?

 

[livinlavidalocums]

I do have a question. How do u prove residency in the state? Are u changing ur drivers license? Renting a house?

“
In addition, at least ONE of the requirements below must apply:

• Your primary residence is in the SPL (State of Principal License)
• At least 25% of your practice of medicine occurs in the SPL
• Your employer is located in the SPL
• You use the SPL as your state of residence for U.S. Federal Income Tax purposes”

How do they even audit this?

25% practice rule. You don’t need all 4. Just 1/4. I am licensed in TX. If I do 1week/month =25%.

You can switch primary states so lets say I start a gig in TX get IMLC then get another gig in AZ. I will make AZ my primary state and use 25% rule for IMLC eligibility again.

 

[aneftp]

25% practice rule. You don’t need all 4. Just 1/4. I am licensed in TX. If I do 1week/month =25%.

You can switch primary states so lets say I start a gig in TX get IMLC then get another gig in AZ. I will make AZ my primary state and use 25% rule for IMLC eligibility again.

How do they actually audit it? Seems like it’s very loose regulations.

 

[livinlavidalocums]

I have never had imlc but you have to send a qualification letter. I would basically say I am licensed in Texas and more than 25% of my clinical practice is in Texas. There may be fingerprints and other steps too. Most locums companies have a credentialing department that has experience and can assist with process.

 

[livinlavidalocums]

I do have a question. How do u prove residency in the state? Are u changing ur drivers license? Renting a house?

“
In addition, at least ONE of the requirements below must apply:

• Your primary residence is in the SPL (State of Principal License)
• At least 25% of your practice of medicine occurs in the SPL
• Your employer is located in the SPL
• You use the SPL as your state of residence for U.S. Federal Income Tax purposes”

How do they even audit this?

In order to receive licensure through the Compact, you must:

• Hold a full, unrestricted medical license in a state that is a member of the Compact – this is called your State of Principal License (SPL). See our map of states currently participating in the Compact.

In addition, at least ONE of the requirements below must apply:

• Your primary residence is in the SPL (State of Principal License)
• At least 25% of your practice of medicine occurs in the SPL
• Your employer is located in the SPL
• You use the SPL as your state of residence for U.S. Federal Income Tax purposes

Above text copied directly from IMLC.
Once I start at least1 week/month in TX then I will be eligible as I have an unrestricted TX license and I will qualify based on bold item above.

 

[aneftp]

In order to receive licensure through the Compact, you must:

• Hold a full, unrestricted medical license in a state that is a member of the Compact – this is called your State of Principal License (SPL). See our map of states currently participating in the Compact.

In addition, at least ONE of the requirements below must apply:

• Your primary residence is in the SPL (State of Principal License)
• At least 25% of your practice of medicine occurs in the SPL
• Your employer is located in the SPL
• You use the SPL as your state of residence for U.S. Federal Income Tax purposes

Above text copied directly from IMLC.
Once I start at least1 week/month in TX then I will be eligible as I have an unrestricted TX license and I will qualify based on bold item above.

Seems like the rules are super loose. And pretty much anyone can attest they work 25%.

Not enough manpower to audit everyone.

And Envison wants drivers license from Florida residents to try to not pay them 1099 for being local. lol.

 

[narcotics999]

Yes. Lax is much better than Sfo.
LAX, JFK, ORD, MIA, BOS, ATL, DFW, IAH are the main International hubs that come to mind. For domestic travel more nonstop options at those airports also.

Anyone concerned with travel safety due to government shutdown and ATC shortage?

 

[narcotics999]

I do have a question. How do u prove residency in the state? Are u changing ur drivers license? Renting a house?

“
In addition, at least ONE of the requirements below must apply:

• Your primary residence is in the SPL (State of Principal License)
• At least 25% of your practice of medicine occurs in the SPL
• Your employer is located in the SPL
• You use the SPL as your state of residence for U.S. Federal Income Tax purposes”

How do they even audit this?

Proof of residency is similar to driver license application. In the state of Illinois, a valid driver license with a personal statement affirming your residency is enough. Others includes property tax statement, rental agreement, home insurance, utilities, bank statements, kids' school letters with your name, etc. Super easy.

 

[aneftp]

Proof of residency is similar to driver license application. In the state of Illinois, a valid driver license with a personal statement affirming your residency is enough. Others includes property tax statement, rental agreement, home insurance, utilities, bank statements, kids' school letters with your name, etc. Super easy.

U don’t really have that with the op. Who’s likely renting an air b n b or hotel and flying and forth between California and Texas with a 1099 contract

 

[livinlavidalocums]

According to imlc website, residency is one of the 4 ways of qualifying but not a requirement. There are 3 other ways. Mine will be 25% practice in TX.

 

[livinlavidalocums]

Anyone concerned with travel safety due to government shutdown and ATC shortage?

Thats a good point. For really long distances what other option do we have though.

 

[zaitoun]

any place other than San Angelo, Tx that offers good rates for W2 or locums positions?

 

[livinlavidalocums]

Mr. Olive. Any experience with san Angelo?

 

[zaitoun]

No sorry, I'm just scoping out areas further out of DFW to compare salaries

 

[AKMD_1984]

locums markets and need changes weeks to months. i highly doubt that current scoping out is going to be accurate or relevant when you’re actually looking.

 

[aneftp]

locums markets and need changes weeks to months. i highly doubt that current scoping out is going to be accurate or relevant when you’re actually looking.

Yup. It’s just trial and error. Even long term contracts are at most 60 days.

I don’t think people understand the game of locums. Or think they understand it but over play their worth.

We see all pawns in the 1099 game. I think people over estimate their worth. I’m as good as 30 days at my 1099 gig. I don’t have a lot of work in January 2026. Only 20k if side gig work compared to Jan 2025 where I had like 70k of 1099 work for the month of Jan 2025 in addition to my 40k of w2 work for that month.

It’s comes and goes. So I will have to struggle off 60k of income for next month. It’s not the same as 100k a month.

 

[AKMD_1984]

“struggle off 60k of income” for the month…
lol

similar to “my lobster is too buttery”

 

[livinlavidalocums]

I will struggle off 40-50k a month working half time till I find something better

 

[cchoukal]

Redding, Eureka and other boonies with low rates will always be there.
I would Rather do Texas to get my IMLC. Redding/Eureka would be a total waste of time.

I've been getting the same Eureka emails for 15 years...

 

[sevoflurane]

I've been getting the same Eureka emails for 15 years...

I considered interviewing there almost 20 years ago. Wasn’t stable then, probably not stable now. Water is cold as well.

 

[livinlavidalocums]

Those remote dumps will always be looking. Only incentive they can offer is $$$ but they dont.

 

[aneftp]

Those remote dumps will always be looking. Only incentive they can offer is $$$ but they dont.

Anyplace is tolerable as locums if the workload to money ratio is good. Meaning 30-40k a week and barely breaking a sweat. Sure. I will out in true Northern California next week if you ask me to.

But if it’s a hard 30-40k a week even at $500/hr. Sorry. I’m staying at home in Florida and will settle for 20k a week in comfort of my own home barely working for the week at $350-400/hr.