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Still looking for a gig where I can get 70-80 24 hour shifts at locum rates.
How about that?
Seems like money is always the problem.
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Locums Market Temp Check
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Still looking for a gig where I can get 70-80 24 hour shifts at locum rates.
Seems like money is always the problem.
Seems like you are too addicted to the 1099 lifestyle. Taxes etc. That’s fine. Nothing wrong with that
The 24 hr w2 (73 calls) averages close to $350/hr w2. I don’t see a problem with that. Plus they have crnas on call with them and sleep.
The big 24 hr 1099 calls average around $400/hr-420/hr but they come and go and you won’t get it consistently. Many places will only let you do 7p-7am 1099 calls and that defeats the purpose.
I just did 4 (24h) calls for a quick 40k in 5 days but gotta pace myself.
But it’s not something that’s consistent 70-80 (24) hr 1099 shifts for the year. It’s sporadic and most people will settle for w2 that has 70-80 calls shifts.
Undersupply? So you mean ... there's a shortage? 🙂
So there's a shortage now, but not in 4-6 years?
Maybe. The population is aging, getting sicker, fatter, less healthy. Demographics aren't moving in the direction of fewer old people and more working-age people.
Old people run the government and they're not going to legislate away healthcare for old people.
The boomer generation owns more than half of the wealth in the United States - they're not going to quit spending on their health, even if the government tries to.
We may be churning out graduates but I don't believe for an instant that this problem is going to be fixed in 4-6 years. Or even mitigated.
In fact, the only "fix" I see that's likely to put any downward pressure on our job market is the AANA winning and extended supervision becoming more common - i.e., a "fix" that depresses demand for our services.
Well yes, of course.
Anyway, the point is that if Practice A raises pay and fills their needs, other groups are then short. Those doctors didn't just get promoted from the mailroom over in HR. They came from somewhere, that now no longer has their services.
The entire point is that EVERY practice can't go physician only. It's a zero sum game. There aren't enough physicians for ALL practices EVERYWHERE to go physician only.
Money can solve the problem for some practices.
The practices that people leave will then be short.
Look, this is obviously good, in a macro sense, for all of us. The shortage exists, whether you want to deny its existence or not, and it's what's driving our paychecks up. MGMA data, lagging and incomplete as it is, shows US anesthesiologists' pay going up something like 25% in the last few years. Hooray for me, hooray for you.
Take a wider view - this isn't a physician or even a medicine issue. The only reasons prices for any thing, or any service, ever go up is because demand exceeds supply. The mere fact that our incomes have dramatically outpaced inflation in the last 10 years is the only information necessary to understand that supply is insufficient to meet demand. Everything else is just noise.
Money fixes the problem ... at least for the facilities with deeper pockets than their competitors ... for a while.
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I deducted 200k off my W2 this year. will deduct 400K off my W2 next year with the STR loophole and section 178/179, paying likely under 15% income taxes. Cant beat 1099.
Holler at me if you need someone to take the other half of a lucrative gig.
RELATIVE undersupply, not an absolute one. Like the other poster said, if you increase the pay, the undersupply magically disappears. Imagine that!
To be frank, I am a big pro-physician care advocate. I turned down several jobs that diminish that perspective. I think your assumption is that people are leaving other practices. My assumption is that people are giving up locums. I know several anesthesiologists that will sign a contract for 700k/10weeks off. Why? Because I have a recruiting agency and thats that they tell me their number is... in a decent sized city.
I think we are in an excellent position here for the next 6-10 years to dictate our compensation and competitiveness. The whole CRNA nonsense is just noise. No one gives a rats a** if CRNAs are opt-out or 'independent'. Theyre already pricing themselves out of many markets. Its incredibly difficult recruitng them for $275-290/hr in the NE. We just need to stop fighting for the lowest dollar. @aneftp has mentioned on this topic on numerous occasions.
That’s ok. Keep doing what you are doing with the tax deduction. I deducted around 200k 1099 last year. Probably do similar this year with the deductions.
I deducted 200k off my W2 this year. will deduct 400K off my W2 next year with the STR loophole and section 178/179, paying likely under 15% income taxes. Cant beat 1099.
Holler at me if you need someone to take the other half of a lucrative gig.
RELATIVE undersupply, not an absolute one. Like the other poster said, if you increase the pay, the undersupply magically disappears. Imagine that!
To be frank, I am a big pro-physician care advocate. I turned down several jobs that diminish that perspective. I think your assumption is that people are leaving other practices. My assumption is that people are giving up locums. I know several anesthesiologists that will sign a contract for 700k/10weeks off. Why? Because I have a recruiting agency and thats that they tell me their number is... in a decent sized city.
I think we are in an excellent position here for the next 6-10 years to dictate our compensation and competitiveness. The whole CRNA nonsense is just noise. No one gives a rats a** if CRNAs are opt-out or 'independent'. Theyre already pricing themselves out of many markets. Its incredibly difficult recruitng them for $275-290/hr in the NE. We just need to stop fighting for the lowest dollar. @aneftp has mentioned on this topic on numerous occasions.
And yes paying around 15% total taxes off ur overall 1099 income is normal. When I was pure 1099. I paid around the same. We all know the tax games with 1099. My hybrid situation exposes me to more federal taxes. So I think I was around 27/28% last year. Some of that due to short term capital gains.
But just comes a time when home is home. The kids are only young once. I spent less than 15 total nights away from home in the last 12 months. Excluding my vacation time spent in hotels. I wouldn’t trade that for the world.
I’d done the travel locums. It’s fun. Or it was fun. But when u have children and family. It’s a little different. Even though my kids are teens now. They still like you to be around lol. Sorta.
As for decent size city 700k/10 weeks off. Means very little without factoring in work hours per week. Memphis is a decent size city and I got the heck out of there quickly paying similar many years ago. If you can get it in Nashville then that’s worth it.
700k/42 weeks work/40-45 hrs a week including all beeper hours. Find a job like that in a decent size city larger than 2- 3 million people in the metro area. You will get many takers. Well some one may not take Detroit even with those work hours and pay.
I deducted 200k off my W2 this year. will deduct 400K off my W2 next year with the STR loophole and section 178/179, paying likely under 15% income taxes. Cant beat 1099.
Holler at me if you need someone to take the other half of a lucrative gig.
RELATIVE undersupply, not an absolute one. Like the other poster said, if you increase the pay, the undersupply magically disappears. Imagine that!
To be frank, I am a big pro-physician care advocate. I turned down several jobs that diminish that perspective. I think your assumption is that people are leaving other practices. My assumption is that people are giving up locums. I know several anesthesiologists that will sign a contract for 700k/10weeks off. Why? Because I have a recruiting agency and thats that they tell me their number is... in a decent sized city.
I think we are in an excellent position here for the next 6-10 years to dictate our compensation and competitiveness. The whole CRNA nonsense is just noise. No one gives a rats a** if CRNAs are opt-out or 'independent'. Theyre already pricing themselves out of many markets. Its incredibly difficult recruitng them for $275-290/hr in the NE. We just need to stop fighting for the lowest dollar. @aneftp has mentioned on this topic on numerous occasions.
Agreed. Until physicians stop taking 250/hr w2 pay we will continue to get hosed by PE groups to line their pockets with profits
I use Italian mafia guy (kidding but not kidding). He’s Italian dude in his 60s and wears tank tops and owner of 3 strip clubs. Operates out of an office similar to a cheap lawyers office next to the beach. You would never guess he was an accountant.
As opposed to my previous accountant of 16 years who retired along with their partners from merger. Typical white corporate suit and tie in downtown fancy high rise office.
I’ve gone from white corporate suit and tie office to red neck beach attire.
But he’s aggressive. However he fired one of the clowns on these message boards for pissing him office. So I’m afraid to send him any more clients. He’s pretty much full so picks and chooses his clients.
There are so many tax schemes. Just go with someone who shares the same goals and agrees with you (within legal framework).
But Miami has such “culture”
No “culture” exists in Kansas City or Amarillo. I bet they don’t even have internet access to stream videos of broadway shows there.
Ha. I went to med school in Kansas City (Kansas side). It’s a great city. People were surprise it hosted World Cup games. It’s a very underrated town. But Kansas City is very high tech. KC was first city to get google fiber. Kansas City also one of the first cities to get full LTE cellular data in 2012
Location of airport 25 min north of downtown does suck especially in dangerous icy snowy conditions in the winter time
How many hours a week on average and call frequency? I thought southeast was the lowest paying region
I would stay away from these on-line, out of state CPA firms. They vastly overcharge and underperform.
Yes, I enjoy KC too, I think the better BBQ is there vs closer to NC. I make the joke because the cost and low pay in Miami to me is no way justified. It's simply not a pleasant place for a mid-30s or older professional to live. Can't imagine who is clamoring for that crap pay in that town.
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Likely H1B Green card holders given Miami's rich diversity.
Nope. White 52 year old balding dudes from lcme med schools and in the northeast with baby mammas who like the Miami lifestyle making $275/hr 1099 instead of $425/hr-450/hr 1099 is elsewhere.
$265/hr for north Florida (jax area) 1099 contract prn lol
This is for MD (not crna). They will give you whatever rate sticks.
Hello. Early pre Covid 2020 pay called and wanted their last half of the decade back.
Anyone who knows the address of the billing company in Tennessee knows which amc is trying to pay this low of a rate.
This is for MD (not crna). They will give you whatever rate sticks.
Hello. Early pre Covid 2020 pay called and wanted their last half of the decade back.
Anyone who knows the address of the billing company in Tennessee knows which amc is trying to pay this low of a rate.
Attachments
Duh, ENVISION. Just say the name.
Someone is accepting this?
Oh yes, sadly all the time.
Come on, we all know he just likes to play games and pretend he is smarter than everyone else
Well some people really don’t know these corporate addresses. If it’s in Tennessee. It’s a spin off of Amsurg (Amsurg history is closely tied to executives from hca rolling over to Amsurg after hca implosion)
If it’s based in sunrise Florida its originated from Sheridan
Sheridan emcare and larger Amsurg all formed to be Envison
“
Founded in Dallas in 1972, EmCare began as a private physician practice management company providing emergency department staffing to hospitals in Texas. Before its massive mergers, it expanded nationally through acquisitions in the 1990s, was bought by Laidlaw in 1997, and merged with AMR in 2005 under Emergency Medical Services Corporation. [1, 2, 3, 4]
The pre-merger history of EmCare is marked by private equity backing, rapid national consolidation, and eventual parent-company rebranding before its defining 2016 merger. Key historical milestones include: [1, 2, 3, 4]
Founded in Dallas in 1972, EmCare began as a private physician practice management company providing emergency department staffing to hospitals in Texas. Before its massive mergers, it expanded nationally through acquisitions in the 1990s, was bought by Laidlaw in 1997, and merged with AMR in 2005 under Emergency Medical Services Corporation. [1, 2, 3, 4]
The pre-merger history of EmCare is marked by private equity backing, rapid national consolidation, and eventual parent-company rebranding before its defining 2016 merger. Key historical milestones include: [1, 2, 3, 4]
- 1972: Founded in Dallas, Texas, initially operating as a privately owned medical group providing ER staffing to regional hospitals. [1, 2]
- 1990s: Transitioned into a national company by actively acquiring various emergency physician, radiology, and anesthesia groups. [1, 2, 3]
- 1997: Acquired by the transportation and healthcare company Laidlaw, which also owned American Medical Response (AMR), an ambulance provider. [1, 2]
- 2005: Onex formally merged EmCare and AMR to create Emergency Medical Services Corporation (EMSC). EMSC was subsequently taken public, generating hundreds of millions in revenue. [1, 2, 3, 4, 5]
- 2011: Acquired by the private equity firm Clayton, Dubilier & Rice (CD&R) in a \(\text{\$}3.2\) billion deal. [1, 2]
- 2013: CD&R took EMSC public via an IPO and officially changed the parent company's name to Envision Healthcare (EVHC). [1, 2]
- 2016: Envision Healthcare (including EmCare) completed its largest pre-bankruptcy merger with AmSurg—a leading ambulatory surgical center (ASC) management company. This merger created one of the largest healthcare service providers in the United States, valued at roughly \(\text{\$}15\) billion.[1]
livinlavidalocums
Full Member
Bumping this thread as it’s been dormant for weeks. Any new updates?
How do we find out the bill rate? Thats the biggest key to the puzzle. If we know the bill rate we can assume a 5% vendor management fee and ~$5/hr for malpractice insurance. Let’s assume bill rate is 500/hr thats $30/hr subtracted.
If you are local and have no other expenses and agency pays you 400/hr they are taking 70/hr. Some of that goes to overhead obviously like paying their employees their referrals insurance etc. but thats the basics of how much revenue these agencies get
How do we find out the bill rate? Thats the biggest key to the puzzle. If we know the bill rate we can assume a 5% vendor management fee and ~$5/hr for malpractice insurance. Let’s assume bill rate is 500/hr thats $30/hr subtracted.
If you are local and have no other expenses and agency pays you 400/hr they are taking 70/hr. Some of that goes to overhead obviously like paying their employees their referrals insurance etc. but thats the basics of how much revenue these agencies get
Anyone know, does the VMS (assume locumsmart) fee typically come out of the agency’s cut or the client’s? If agency quotes client 500/hr for an anesthesiologist, is that inclusive of VMS fee usually?
All locums companies are contractors or subcontractors. You won't find an appreciable difference between them except sometimes the smaller ones have people who are directly accountable to you because they don't have middle managers or recruiters to be your point of contact. Pay is all going to depend on their ability to negotiate with facilities and your ability to say yes or no.
I think bill rates for most facilities are higher than 500/hr. Expenses have gone up over the past 5 years. If a standard doctor pay rate is 375-425, then bill rate is north of 500.
Most facilities is the key word
I know the bill rate for at one Florida facility is as low as $450-hr. Simply because I know the COO who approved the rates. Dude so cheap and wants to be the CEO. Glorified bald headed former RN.
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Bezos is currently filling that role
One of the newer 2022-3 grads is leaving my area of central Florida with 500k/22 weeks off 40 hr week plus night float starting at 6pm from home with a crna and not working that hard for a south Florida gig with 475/8 weeks off and being solo 20-30% of the time.
Idiot. He just wants the s Florida Latin lifestyle (he’s Latin). To each their own. Single dude who leaves in 700 sq foot apt with his 8 pound dog.
Took about 2 seconds to fill his gig he gave up. From a doc who is making 450k/9 weeks off with 4 doc model taking 13 weeks of beeper call solo. It’s like they are moving in opposite directions. He’s going to make just a little more money to get more weeks off
The younger attending is taking less money to be where he wants to be.
Idiot. He just wants the s Florida Latin lifestyle (he’s Latin). To each their own. Single dude who leaves in 700 sq foot apt with his 8 pound dog.
Took about 2 seconds to fill his gig he gave up. From a doc who is making 450k/9 weeks off with 4 doc model taking 13 weeks of beeper call solo. It’s like they are moving in opposite directions. He’s going to make just a little more money to get more weeks off
The younger attending is taking less money to be where he wants to be.
livinlavidalocums
Full Member
Different strokes for different folks
cittykat
Full Member
After hitting a level of financial security, squeezing out additional incremental income is not worth the squeeze. I would never do 30 weeks of night float even with 22 weeks off.
Add 20-25% to your hourly and its a good guess most of the time.
VMS fees are about 5-6% of the bill rate. This doesnt include the monthly fee that they charge. Locumsmart charges 2000/month in addition to that.
Malpractice is not $5/hr. usually $25-$30/hr for supplemental and excess policies.
This also doesnt include what you have to pay the recruiter (usually 20%).
Profit margin isnt as high as people assume on a per-provider-basis.
See above. VMS fees are deducted from the agency, not the client. It is free for the client (hospital). Otherwise they would never sign up.
No Bill rates do not include VMS fees.
$500-550/hr is what most hover around.
Yes $550/hr is average. That’s the exact rate my sister company underbid by $10/hr with her mega anesthesia practice she was full partner
So the partners all got $540-hr when covering but paid the Locums docs $350-hr plus expenses
Who says it’s 30 weeks of night float.
It’s 10 weeks of beeper njght float coming in 6p-8pm most nights. It’s easy job.
He just wants the Latin location in south Florida.
cittykat
Full Member
Ha ha I’ve never spent a single night in the hospital with this night float schedule
The whole CRNA nonsense is noise.
It's not noise. I'm in a physician only practice. There are 12 of us. We have a small stipend for call coverage . EVERY year they talk about bringing in CRNAS. I was just talking to the CFO at the Y who tried to talk me into bringing in crnas. I am adamant. NO WAY. But eventually they will come.
even if they are 290 an hour. Thats not 450 an hour. 290 wins.
Thankfully I have less than 10 years to go in practice less than 5 in fulltime practice.
I'm not worried. I can always pivot to pain, or just retire and get my MBA and become the villain.
If the push continues, I'd recommend hiring a bunch of AAs, or a mix of crnas and AAs because you're unlikely to recruit any super militant crnas if there are AAs in the practice.
ya gotta get there first. L icensure for AAs its an uphill battle not impossible obviously since states like Virginia have done it
Pain is hit or miss. Either pain guys are making over 1.5 million (which asc ownership stake) and working 4 days a week. Or not making it and going to general anesthesia Locums.
One of the pain docs in the south got fired from Locums trauma one assignment due to messing up twice in a period of 2 weeks. Young pain doc.
So some Locums agencies do look closely at recent trauma experiences from a pain doc cv.
