Locums Market Temp Check

[aneftp]

Advertisement - Members don't see this ad

is the market that flush where you can dictate what zipcode your locums live?

The real issue is just control.

Just look up the definition of irs independent contractor status

“You are not an independent contractor if you perform services that can be controlled by an employer (what will be done and how it will be done). This applies even if you are given freedom of action. What matters is that the employer has the legal right to control the details of how the services are performed.”

That’s direct from irs website

If ur locums contract dictates u get 40 hrs and mandated to work X days and give X notice. U aren’t truly a 1099 contractor.

The locums market if the irs reign in especially crnas who demand so much on the 1099 circuit.

A 1099 crna who’s been working at the same hospital for 10 years with a 40 hr gurantee is by definition NOT an independent CONTRACTOR.

 

[gunnershow]

So since Florida market is so flush with sellout boomer anesthesiologists that they can dictate mile radius stipulations for locums, how the hell is @aneftp getting 50k weeks without travel with full hourly rate for beeper and low callback?

 

[Status Sciaticus]

his stage in the profession. It’s the hospitals who are forking the cash over. The amc is just the middle man.

fair point. I honestly dont care whether I am taking it from AMCs or hospitals. I just want my money

 

[aneftp]

So since Florida market is so flush with sellout boomer anesthesiologists that they can dictate mile radius stipulations for locums, how the hell is @aneftp getting 50k weeks without travel with full hourly rate for beeper and low callback?

It’s definitely slowing down. I don’t see that many big opportunities weeks much. But I also pick and choose my spots. 1099 non employeee compensation 40k a week is more doable than 50k 1099 since middle of last year.

3-4 weeknight calls $4800 each night. Play thr game that you don’t get called in. Plus hit 20k on the weekend (hopefully) light beeper 48 hr calls. I call that mafia money.

Combine with my 28-40 hr w2 regular job during the week. I guess u can count the w2 job at 500k a year averages out to 10k a week w2. So 40k 1099 plus 10k w2 per week regular job still nets 50k overall for the week. Instead of 50k 1099 plus 10k w2 per week.

I have another big week end of march coming up.

The key to all this is to have a stable w2 job where you aren’t working hard. So u can rest and sleep before taking 1099 calls just in case you have a bad night. Which does happen 10-15% of the time.

 

[NPJR]

3-4 weeknight calls $4800 each night. Play thr game that you don’t get called in. Plus hit 20k on the weekend (hopefully) light beeper 48 hr calls. I call that mafia money.

If calls arent that busy why arent the W-2 guys doing it ?

 

[SRYSPAC]

If calls arent that busy why arent the W-2 guys doing it ?

$20K beeper on the weekend continuous, why wouldn't a W2 staffer take $10K for an easy call?

Living in FL now, I know people that are willing to work In house for an entire weekend for $10-12K.

 

[cittykat]

If calls arent that busy why arent the W-2 guys doing it ?

We get $4500 stipend + collections for 5p-7a in-house calls. Usually nothing after 11pm. We are allotted about 18/year. Nobody gives away their calls. Swap within our own group at best.

 

[aneftp]

If calls arent that busy why arent the W-2 guys doing it ?

Follow the money trail
1. Who is paying for locums coverage. The hospital or the amc. Think like a liberal democrat here. If it’s not YOUR MONEY. You won’t care. So the amc doesn’t care about spending other people’s money. The hospital is the one paying

If amc paid w2 docs extra w2. It comes out of the amc books and not the hospital.

2. If u were a w2 doc. Do you just want to not risk it at all on call especially getting taxed at 40% w2? Since the w2 money is on the amc books. AMC only wants to pay docs as low as possible. So offers to pay the traditional $2400 plus $300-hr w2 (if working). That’s not enticing enough to w2 docs to have to waste a weekend being tied to the beeper.

Do I make the rules up? Nope. These are the games I gotta play unfortunately.

 

[aneftp]

$20K beeper on the weekend continuous, why wouldn't a W2 staffer take $10K for an easy call?

Living in FL now, I know people that are willing to work In house for an entire weekend for $10-12K.

Why?? Lowest I will take is $8000/24 hr beeper 1099 and that has a circuit breaker clause if I work more than 16 hrs. I’m getting paid more up to 12k.

You guys are negotiating contracts like nfl football players (bonus plus lower base pay)

Negotiate like nba/mlb players. Guranteees.

That’s why nba/mlb players get paid more on average than nfl players.

But nfl players like Kirk cousins got smart and started demanding guarantees and less sign on bonus

 

[sbmed100]

Florida -where envision dominates - doesn’t have state taxes

We are in a state with high state taxes and many local 1099 crnas try using fake addresses from no tax states. We don't allow that BS. I have though been so, so tempted to report to govt and collect the 10-30% whisteblower redemption

 

[narcotics999]

We are in a state with high state taxes and many local 1099 crnas try using fake addresses from no tax states. We don't allow that BS. I have though been so, so tempted to report to govt and collect the 10-30% whisteblower redemption

Whisteblower redemption is for federal, am I right?

 

[Coffee PRN]

We are in a state with high state taxes and many local 1099 crnas try using fake addresses from no tax states. We don't allow that BS. I have though been so, so tempted to report to govt and collect the 10-30% whisteblower redemption

If the work is performed in your high tax state, it doesn’t matter if they reside in a 0 income tax state, their work is still taxed at your state’s rate.

 

[aneftp]

We are in a state with high state taxes and many local 1099 crnas try using fake addresses from no tax states. We don't allow that BS. I have though been so, so tempted to report to govt and collect the 10-30% whisteblower redemption

Well that’s understandable. Say if u are New York. New York wants their 8-11% state income taxes from 1099 locums

But the Florida 1099 zip code restriction isn’t the same. Since Florida has no state income taxes.

 

[SRYSPAC]

If the work is performed in your high tax state, it doesn’t matter if they reside in a 0 income tax state, their work is still taxed at your state’s rate.

If they work for locums agency not based in that state and live in FL/TN/etc, it's on them to report the state income tax. Many don't, and even with a S-Corp/LLC in a no income tax state, it's 100% illegal. I've met some locums evading thousand in taxes and their CPAs let them do it 😳

 

[aneftp]

If they work for locums agency not based in that state and live in FL/TN/etc, it's on them to report the state income tax. Many don't, and even with a S-Corp/LLC in a no income tax state, it's 100% illegal. I've met some locums evading thousand in taxes and their CPAs let them do it 😳

The docs who live in north Florida and run and do 1099 work in Georgia 2 hr away routinely do not report Georgia income taxes.

Many CPA are like defense lawyers. They will do anything their client tells them to do.

 

[SRYSPAC]

The docs who live in north Florida and run and do 1099 work in Georgia 2 hr away routinely do not report Georgia income taxes.

Many CPA are like defense lawyers. They will do anything their client tells them to do.

OK

 

[dannyboy1]

If they work for locums agency not based in that state and live in FL/TN/etc, it's on them to report the state income tax. Many don't, and even with a S-Corp/LLC in a no income tax state, it's 100% illegal. I've met some locums evading thousand in taxes and their CPAs let them do it 😳

Typically the locums agency is based in Texas or Florida. If the docs home address is listed in Florida or Texas and the is getting 1099 from those states it is almost impossible for the state that you actually worked in to find out. Similar to those who work from home in another state from where their job is located. Technically you are supposed to report to your state but in reality, wherever the companies w2 is listed is where you are going to be taxed.

 

[aneftp]

Typically the locums agency is based in Texas or Florida. If the docs home address is listed in Florida or Texas and the is getting 1099 from those states it is almost impossible for the state that you actually worked in to find out. Similar to those who work from home in another state from where their job is located. Technically you are supposed to report to your state but in reality, wherever the companies w2 is listed is where you are going to be taxed.

It’s not technically. It’s legally u gotta report taxes lol.

 

[Lab Lover]

It’s not technically. It’s legally u gotta report taxes lol.

Just like when a doc gives another doc in his practice a personal check to cover a call for them...supposed to give a 1099 and report.

 

[dannyboy1]

Just like when a doc gives another doc in his practice a personal check to cover a call for them...supposed to give a 1099 and report.

Nope. Only a business has to give a 1099. For example you don’t have to give your plumber or mechanic a 1099

 

[otis86]

Is it me or is the locums market getting very competitive now? I’m in the Northeast region and I’ve been noticing a lot more applicants for positions.

 

[sbmed100]

Is it me or is the locums market getting very competitive now? I’m in the Northeast region and I’ve been noticing a lot more applicants for positions.

If you think this is bad, well here we are in April so just wait til mid July when around four thousand eight hundred or so extra Anesthesia clinicians will start their jobs. I’m in the northeast too, and we have a waiting list. My group has made it clear to me I am not to hire any former locums as they themselves have stuck by the group through thick and thin. Literally have threatened mutiny if one is hired as full time.

 

[pgg]

If you think this is bad, well here we are in April so just wait til mid July when around four thousand eight hundred or so extra Anesthesia clinicians will start their jobs. I’m in the northeast too, and we have a waiting list. My group has made it clear to me I am not to hire any former locums as they themselves have stuck by the group through thick and thin. Literally have threatened mutiny if one is hired as full time.

Who are these 4800 new bodies looking for work?

I'd be surprised if the 2000ish residency grads don't already have jobs lined up, with their job searches done months ago. Except for the ones going straight to locums work, which is a dubious plan, even in this era.

 

[otis86]

If you think this is bad, well here we are in April so just wait til mid July when around four thousand eight hundred or so extra Anesthesia clinicians will start their jobs. I’m in the northeast too, and we have a waiting list. My group has made it clear to me I am not to hire any former locums as they themselves have stuck by the group through thick and thin. Literally have threatened mutiny if one is hired as full time.

Not everybody does locums or even can do locums. Especially as a new grad, working in different settings, that takes a while to learn.

Very few Anesthesia groups are fair/balanced, almost all have some uneven-ness in terms of work/pay. I encourage all to do Locums because Anesthesia groups are so corrupt and badly run from my experience.

 

[sbmed100]

Who are these 4800 new bodies looking for work?

I'd be surprised if the 2000ish residency grads don't already have jobs lined up, with their job searches done months ago. Except for the ones going straight to locums work, which is a dubious plan, even in this era.

2450 MDs (residents plus those finishing fellowship) hired to start JulyAugust, plus similar amount of AAs and CRNAs. Yes many are hired but the key is they haven’t started yet so lots of group bridging the gap with locums. In desirable areas the market will tighten significantly and locums will be for travel to not so desirable places and groups/departments (as it should be.)

 

[aneftp]

Who are these 4800 new bodies looking for work?

I'd be surprised if the 2000ish residency grads don't already have jobs lined up, with their job searches done months ago. Except for the ones going straight to locums work, which is a dubious plan, even in this era.

I find new grads taking sign on bonus cause they need the money. But they will leave in 1-2 years. Most bonus are pro rated. But some are sneaky like Envison and require the entire 3 years or they are forced to pay the entire non prorated bonus.

Many urban cities will not take new grad 1099. (Because they have plenty of docs and crnas who are more experienced to choose from. Some require up to 2 years of experience or board certification. Of course everything depends on the desperate nature of the situation who they will take.

 

[NPJR]

If you think this is bad, well here we are in April so just wait til mid July when around four thousand eight hundred or so extra Anesthesia clinicians will start their jobs. I’m in the northeast too, and we have a waiting list. My group has made it clear to me I am not to hire any former locums as they themselves have stuck by the group through thick and thin. Literally have threatened mutiny if one is hired as full time.

I do not understand the tactic? Who cares who you hire as long as they are competent.

 

[CopaceticOne]

I do not understand the tactic? Who cares who you hire as long as they are competent.

I can see their thinking. If things get tough, their concern could be that the former locums guy will be quick to peace out leaving the people who stuck it out in even worse shape.

Heck maybe that already happened and has left a bad taste for the docs that are there right now.

Not saying I agree/disagree, but I can see the emotional and logical components of it.

 

[NumTacos]

Is it me or is the locums market getting very competitive now? I’m in the Northeast region and I’ve been noticing a lot more applicants for positions.

Same boat, lots of new hires, residents hitting the market. At least in my area, everyone seems to be staffed up.

 

[ucladoc2b]

Same boat, lots of new hires, residents hitting the market. At least in my area, everyone seems to be staffed up.

Many hospitals and ASCs have wised up. Instead of paying $500+/hr to locums agencies, an improvement in FT compensation is more economical.

Overall, FT offers have improved substantially. It makes way more sense to pay a doc $350/hr (similar to what the locums paid for the doc) and get the vast benefits of loyal FT staff. And saves tons of money.

 

[aneftp]

Same boat, lots of new hires, residents hitting the market. At least in my area, everyone seems to be staffed up.

Hitting the locums market as brand new grads?

 

[SRYSPAC]

Hitting the locums market as brand new grads?

I think NumTacos meant hitting the job market in general.

 

[CopaceticOne]

Hitting the locums market as brand new grads?

Two years ago quite a number of our graduating residents went full time locums right away. I believe is was the strong lure of $$$ and perceived control over their schedules.

I didn’t care enough to find out how it went for them, but not something I would ever recommend for a new grad no matter how strong/rigorous their training might have been.

 

[Burned_Out]

Is it me or is the locums market getting very competitive now? I’m in the Northeast region and I’ve been noticing a lot more applicants for positions.

I am seeing the same out in the mid-west. One of my long term locums contracts is ending. They have hired up with new grads. The west coast dried up with work at least a year ago. Any new locums work I'm seeing advertised is less desirable. Some undesirable jobs that stopped advertising are now re-advertising again.

I predict this time next year, we will be in a locums job market wasteland. Of course, crappy places always have big turnovers. How many of these new grads will stick around in their new jobs? Therefore, I don't see locums dying off. Just less lucrative and/or less plentiful.

 

[aneftp]

Two years ago quite a number of our graduating residents went full time locums right away. I believe is was the strong lure of $$$ and perceived control over their schedules.

I didn’t care enough to find out how it went for them, but not something I would ever recommend for a new grad no matter how strong/rigorous their training might have been.

I agree with you. It takes some experience how to navigate just not the clinical aspects of anesthesia but also the political aspects of anesthesia.

Brand new grads have not built up enough experienced in my opinion

 

[aneftp]

I am seeing the same out in the mid-west. One of my long term locums contracts is ending. They have hired up with new grads. The west coast dried up with work at least a year ago. Any new locums work I'm seeing advertised is less desirable. Some undesirable jobs that stopped advertising are now re-advertising again.

I predict this time next year, we will be in a locums job market wasteland. Of course, crappy places always have big turnovers. How many of these new grads will stick around in their new jobs? Therefore, I don't seeing locums dying off. Just less lucrative and/or less plentiful.

New grads want the 100k or even 200k sign on bonus. That’s why they sign up w2. I can’t blame them. They want /need money.

100-200k barely moves the needle for me and others on these message boards. That’s a couple of months of work.

I’m more concern with workload and time off these days.

But u are correct new grads will get frustrated being tied down to a 5 day a week job with call responsibilities and fighting for vacation spots during peak seasonal demands like Xmas and summer break.

Locums you can choose ur own schedule
Once they get their board certification. They can and probably will fly away

 

[coffeebythelake]

Still lots of places around me looking for locum offering 400-425/hr

 

[cittykat]

New grads want the 100k or even 200k sign on bonus. That’s why they sign up w2. I can’t blame them. They want /need money.

100-200k barely moves the needle for me and others on these message boards. That’s a couple of months of work.

I’m more concern with workload and time off these days.

But u are correct new grads will get frustrated being tied down to a 5 day a week job with call responsibilities and fighting for vacation spots during peak seasonal demands like Xmas and summer break.

Locums you can choose ur own schedule
Once they get their board certification. They can and probably will fly away

Many practices around here have no problems hiring with $0 sign on. Only 1 practice (Kaiser) offers a sign on bonus.

 

[aneftp]

Many practices around here have no problems hiring with $0 sign on. Only 1 practice (Kaiser) offers a sign on bonus.

That’s great. My brothers place in LA doesn’t have any issues finding people these days. They used to. But the hospital is forking over 100% income over to the former group. So they get direct payment. Their income has jumped from 600k to 1 million and their work hours down to 55 hrs and their weeks off increased from 6 weeks to around 9 weeks off.

It’s a great time to be in the city of Angels (not in the boonies like riverside or even Orange County

The beauty of supply and demand and capital markets working. No sign on bonus needed.

 

[Status Sciaticus]

That’s great. My brothers place in LA doesn’t have any issues finding people these days. They used to. But the hospital is forking over 100% income over to the former group. So they get direct payment. Their income has jumped from 600k to 1 million and their work hours down to 55 hrs and their weeks off increased from 6 weeks to around 9 weeks off.

It’s a great time to be in the city of Angels (not in the boonies like riverside or even Orange County

The beauty of supply and demand and capital markets working. No sign on bonus needed.

where in LA are they getting 1M and 9 weeks off??

 

[aneftp]

where in LA are they getting 1M and 9 weeks off??

Downtown! Within 30-40 minutes drive of Dodger stadium. Of course it takes 30-40 minutes to go anywhere in town LA at 5pm right now

 

[SRYSPAC]

That’s great. My brothers place in LA doesn’t have any issues finding people these days. They used to. But the hospital is forking over 100% income over to the former group. So they get direct payment. Their income has jumped from 600k to 1 million and their work hours down to 55 hrs and their weeks off increased from 6 weeks to around 9 weeks off.

It’s a great time to be in the city of Angels (not in the boonies like riverside or even Orange County

The beauty of supply and demand and capital markets working. No sign on bonus needed.

So their income tax is being paid for, essentially 🤣

 

[sloh]

Downtown! Within 30-40 minutes drive of Dodger stadium. Of course it takes 30-40 minutes to go anywhere in town LA at 5pm right now

Uhh where is this?

 

[aneftp]

Uhh where is this?

Less than 20-25 min from Brentwood.

 

[aneftp]

There is money to be made anywhere. The issue is the minute people start restricting themselves to certain areas, calls, solo work etc. You start pigeon-holing yourself.

And the most important ideology is this: never fall in love with a place. Nothing lasts forever. Even long time w2 employees who have survived multiple staffing shortages and done extra work for the company or hospital get the pink slip. Long time doc has been with amc for 15 years. AMC just terminated contract and I don’t think the new amc will retain him as chief. Just politics. Hospital doesn’t like him but the amc he worked with stood by him through turmoil down to just him as the lone w2 doc 3 years ago. He rebuilt it up to 5 w2 docs. And his reward was/is to be pushed aside when new management company comes in 3 months.

 

[NPJR]

There is money to be made anywhere. The issue is the minute people start restricting themselves to certain areas, calls, solo work etc. You start pigeon-holing yourself.

And the most important ideology is this: never fall in love with a place. Nothing lasts forever. Even long time w2 employees who have survived multiple staffing shortages and done extra work for the company or hospital get the pink slip. Long time doc has been with amc for 15 years. AMC just terminated contract and I don’t think the new amc will retain him as chief. Just politics. Hospital doesn’t like him but the amc he worked with stood by him through turmoil down to just him as the lone w2 doc 3 years ago. He rebuilt it up to 5 w2 docs. And his reward was/is to be pushed aside when new management company comes in 3 months.

BEst advice ever. You start looking for your next job once you start current one.

 

[gasdoc2025]

where in LA are they getting 1M and 9 weeks off??

I doubt these numbers are accurate.

 

[aneftp]

I doubt these numbers are accurate.

My numbers are always accurate.
The key is being paid hourly plus stipends for calls etc. It’s not easy work 55 plus hours a week. Maybe 60. It all adds up.

Anyways 1 million in California is meh especially with cost of living and state income taxes.

Florida the regular guys are routinely over 1.3 million and “supposedly” it’s a “low paying state”. Few guys are hitting 150-160k a month (those guys do bill a lot of hours) and 2 weekends a month. Easy math. Around 2 million a year and those guys aren’t working hard to be honest. They just bill a lot of hours not working and sleeping from home. I dip in from time to to time to make the cash. Just not very motivated these days.

But believe what you want to believe. The money is out there to be made.

My advice is to find a job that pays you full hourly. The production model is a thing of the past. Just like blockbuster video. Sitting around and not getting paid for cases is old fashion. It’s an outdated model just like beeper call paid at $100/hr. Your time is valuable.

 

[ucladoc2b]

Anyways 1 million in California is meh especially with cost of living and state income taxes.

A million in CA buys a very nice life. Even in high cost cities.

 

[livinlavidalocums]

Any decent locums gigs in cali these days?