Locums

[urge]

I'm considering early retirement with some locums to supplement income. Somewhere between 3 to 6 months a year.

Few questions for those who have done locums before:

1 Do they pay for your flight? Let's say it is a 2 to 3 hr flight.

2 Do they pay for a car rental?

3 What is the going rate for cardiac? How much for call and overtime?

4 How do you deal with health insurance for the family?

5 How much money you think you can make working 6 months, taking call and overtime?

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[deleted162650]

I'm considering early retirement with some locums to supplement income. Somewhere between 3 to 6 months a year.

Few questions for those who have done locums before:

1 Do they pay for your flight? Let's say it is a 2 to 3 hr flight.

2 Do they pay for a car rental?

3 What is the going rate for cardiac? How much for call and overtime?

4 How do you deal with health insurance for the family?

5 How much money you think you can make working 6 months, taking call and overtime?

If you're currently part of a stable practice, what makes you want to go the locums route vs just cutting back to .5 or .25 FTE? Especially if you're still up for taking call and overtime? Just curious.

 

[urge]

If you're currently part of a stable practice, what makes you want to go the locums route vs just cutting back to .5 or .25 FTE? Especially if you're still up for taking call and overtime? Just curious.

Couple of reasons. I would like the time off in big blocks, not like 2 or 3 days off a week. Wouldn't it be great if you can go traveling for 2 month or 3 months at a time? I don't even think they will let me go part time. But if they do, they will likely offer 80% or 60% tops. Then the days your are working you are putting in 10 to 12 hrs easily not even on call. The fact that that is even cosidered part time is a joke. Plus cost of living is high where I'm at. I'm thinking moving into a low cost of living area, not necessarily even in the US, and doing locums from there.

 

[ashkenazi1234]

Plus the opportunity to travel and live somewhere for a slightly extended vacation isn't too bad.. I've been looking at Australia and New Zealand

 

[cockblockandrun]

I'm considering early retirement with some locums to supplement income. Somewhere between 3 to 6 months a year.

Few questions for those who have done locums before:

1 Do they pay for your flight? Let's say it is a 2 to 3 hr flight.

2 Do they pay for a car rental?

3 What is the going rate for cardiac? How much for call and overtime?

4 How do you deal with health insurance for the family?

5 How much money you think you can make working 6 months, taking call and overtime?

Everything is negotiated upfront. I work with agencies because they cover malpractice and also most have a solid risk management team so if you run into any issues or the group/hospital is violating terms of the agreement or scope of practice, you've got a team to bat for you.

Most will cover flights, rental, gas, tolls, and hotel/ apartment cost. The assignments in major metro areas ( e.g. NYC) won't want to pay for housing or travel cost and tend to give you crap rates.
Rates depend on location and a lot of agencies will try to screw you over because of their "margins". I have had some agencies call me about $1100 or $1050/8 hour job and I tell them to f-off and not waste my time. The golden egg is finding an assignment with 24 hour in house call- you get paid a regular 8 hour day rate and then after 3pm, you are on OT until 7am regardless if you do a case or not. If you find something like this you are looking at well over 50k per month. But most places will give you beeper call so you are looking at making 35-40k per month with 4-5 calls per month. Hope this info helps. I've been doing full-time locums for years now and love every second of it.

 

[deleted171991]

Everything is negotiated upfront. I work with agencies because they cover malpractice and also most have a solid risk management team so if you run into any issues or the group/hospital is violating terms of the agreement or scope of practice, you've got a team to bat for you.

Most will cover flights, rental, gas, tolls, and hotel/ apartment cost. The assignments in major metro areas ( e.g. NYC) won't want to pay for housing or travel cost and tend to give you crap rates.
Rates depend on location and a lot of agencies will try to screw you over because of their "margins". I have had some agencies call me about $1100 or $1050/8 hour job and I tell them to f-off and not waste my time. The golden egg is finding an assignment with 24 hour in house call- you get paid a regular 8 hour day rate and then after 3pm, you are on OT until 7am regardless if you do a case or not. If you find something like this you are looking at well over 50k per month. But most places will give you beeper call so you are looking at making 35-40k per month with 4-5 calls per month. Hope this info helps. I've been doing full-time locums for years now and love every second of it.

So what's the advantage then, over just being a w-2 employee who makes 25-30/month plus benefits? 5k/month?

 

[aneftp]

So what's the advantage then, over just being a w-2 employee who makes 25-30/month plus benefits? 5k/month?

It all depends on your life situation. Kids or no kids. Single (or spouse willing to travel with you or not travel with u!).

The "professional locums" I know who have done it 10 plus years love it. These guys (it's usually the guys) are usually in their 50s. Good health. Kids out of school. Some divorce. Some travel with their spouses. So lots of flexibility.

The key is to have flexibility if someone wants to take lots of time off in between assignments. Also as the poster said. The key is to find overtime/call assignments.

You point out stable income with full time job 25-30k w2 a month plus benefits. That's a good point.

But the professional locums is willing to go to the boonies work hard plus call. Make $10k plus a week (realistic money in today's tougher job market) Do it for 4-6 week blocks. Take 2-3 weeks off. That's how the game is played. Work hard. Makes lots of overtime. Take lots of time off.

Back in 2007. I was AVERAGING $55k a month as locums (plus having travel and hotel and car paid for). My starting rate was $200/hr (guaranteed 8 hours even post call) . Highest rate was $300/8 hours guarantee (they were desperate and I was already credendialed).

The big cities these days Try to cut locums cost by giving just $1200/8 hours and no overtime. That's only $24-28k a month no benefits. Again. It depends what you want. If you just want to be home in your own house and bed. It's perfectly fine. If those assignments are easy and you just want some income than they are fine as well.

 

[sevoflurane]

I'm considering early retirement with some locums to supplement income. Somewhere between 3 to 6 months a year.

Few questions for those who have done locums before:

1 Do they pay for your flight? Let's say it is a 2 to 3 hr flight.

2 Do they pay for a car rental?

3 What is the going rate for cardiac? How much for call and overtime?

4 How do you deal with health insurance for the family?

5 How much money you think you can make working 6 months, taking call and overtime?

At my old gig, we paid a cardiac anesthesiologist 2k per day and $250/hr after 3pm.
Everything was covered (plane, car, food, etc.). No general cases. Only cardiac.
It was a pretty sweet gig for the locums guy. Unfortunately for them, it only lasted about a year or so.
This was back in 2007-2008.
Best bet is to leave the agencies out of the deal and contract yourself. You'll always keep more in your pocket this way.

 

[IlDestriero]

Back in the day, 15-20 years ago, it wasn't uncommon for the really hungry guys to take locums jobs and bust ass for a few years making serious loot before scoping out a good partnership track. Somehow I suspect most locums people now are either between jobs, end of career part timers or scrubs.


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Il Destriero

 

[aneftp]

Back in the day, 15-20 years ago, it wasn't uncommon for the really hungry guys to take locums jobs and bust ass for a few years making serious loot before scoping out a good partnership track. Somehow I suspect most locums people now are either between jobs, end of career part timers or scrubs.


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Il Destriero

You pretty much hit the nail in the coffin with "between jobs, end of career part timers or scrubs" in today's market.

The professional locums ones I know are in their 50s with kids grown and in college or done with college.

 

[GravelRider]

So is locums looked down upon as a bridge to another job? I'm in a pretty toxic environment with minimal time off, which makes finding another job difficult. I was thinking locums could help me pay the bills while I look for another job.

 

[aneftp]

So is locums looked down upon as a bridge to another job? I'm in a pretty toxic environment with minimal time off, which makes finding another job difficult. I was thinking locums could help me pay the bills while I look for another job.

Do locums. It pays the bills. No one will question you.

It's more damaging to see 6 months of no work in a CV. Sure. Some people can explain it by saying they took time off to enjoy the world travel etc.

But those are often red flags than seeing locums experience on a CV.

 

[cockblockandrun]

So what's the advantage then, over just being a w-2 employee who makes 25-30/month plus benefits? 5k/month?

As a 1099, you can expense more, you can chuck more money into a SEP and lower your tax bracket. Drawback is you end up paying all of your self-employment wages (Medicare and SS) but 50% of that is expensed.

I think there are a lot more younger docs considering and joining the locum trail. Not many partnership gigs, the AMC takeover, etc are changing the demographics of locums. I would be considered a full-time or professional locum and about 75% of the places I have been to, I have been offered a perm job. So the jobs are there but I end up making more as a locum and have more time off than the perm guys.

As for health insurance, I know other locum folks who get on their spouses health plan or are self insured in a low premium state such as Florida.

 

[Ezekiel2517]

It all depends on your life situation. Kids or no kids. Single (or spouse willing to travel with you or not travel with u!).

The "professional locums" I know who have done it 10 plus years love it. These guys (it's usually the guys) are usually in their 50s. Good health. Kids out of school. Some divorce. Some travel with their spouses. So lots of flexibility.

The key is to have flexibility if someone wants to take lots of time off in between assignments. Also as the poster said. The key is to find overtime/call assignments.

You point out stable income with full time job 25-30k w2 a month plus benefits. That's a good point.

But the professional locums is willing to go to the boonies work hard plus call. Make $10k plus a week (realistic money in today's tougher job market) Do it for 4-6 week blocks. Take 2-3 weeks off. That's how the game is played. Work hard. Makes lots of overtime. Take lots of time off.

Back in 2007. I was AVERAGING $55k a month as locums (plus having travel and hotel and car paid for). My starting rate was $200/hr (guaranteed 8 hours even post call) . Highest rate was $300/8 hours guarantee (they were desperate and I was already credendialed).

The big cities these days Try to cut locums cost by giving just $1200/8 hours and no overtime. That's only $24-28k a month no benefits. Again. It depends what you want. If you just want to be home in your own house and bed. It's perfectly fine. If those assignments are easy and you just want some income than they are fine as well.

After taxes, the 55k you state is pretty much the same as the 25-30k W2 job. With benefits the w2 job is probably more .

 

[aneftp]

After taxes, the 55k you state is pretty much the same as the 25-30k W2 job. With benefits the w2 job is probably more .

Nope. Self employed income means less in taxes if you know how to play the game.

Let's just say I made close to 500k gross self employed income back in 2009 and qualified for Obama new tax "making work pay tax credit" for middle class.

You can manipulate taxes more as self employed. Bonus depreciation with range rover. Retirement accounts. Luxury cme travel etc.

W2 benefits vary. A w2 with Sheridan or AMC benefits tend to suck vs a generous benefits package with a state employed position at an academic medical center with liberal paid sick leave.

 

[deleted162650]

Nope. Self employed income means less in taxes if you know how to play the game.

Let's just say I made close to 500k gross self employed income back in 2009 and qualified for Obama new tax "making work pay tax credit" for middle class.

You can manipulate taxes more as self employed. Bonus depreciation with range rover. Retirement accounts. Luxury cme travel etc.

W2 benefits vary. A w2 with Sheridan or AMC benefits tend to suck vs a generous benefits package with a state employed position at an academic medical center with liberal paid sick leave.

You can and should have all those same tax benefits as a W2 with a good group by expensing everything through the practice. Depreciation, home office, 401k + DBP - I do all that through my group. Being 1099 confers almost no tax advantage if your group is set up correctly.

 

[sevoflurane]

For those interested: The "Protecting Americans from Tax Hikes Act of 2015" passed in December of last year. IRS 179 has changed.

http://www.section179.org

50% bonus depreciation has been reinstated and good until the end of the year. Exceptionally good for those who work in different hospital settings and ASC's.

 

[cockblockandrun]

Nope. Self employed income means less in taxes if you know how to play the game.

Let's just say I made close to 500k gross self employed income back in 2009 and qualified for Obama new tax "making work pay tax credit" for middle class.

You can manipulate taxes more as self employed. Bonus depreciation with range rover. Retirement accounts. Luxury cme travel etc.

W2 benefits vary. A w2 with Sheridan or AMC benefits tend to suck vs a generous benefits package with a state employed position at an academic medical center with liberal paid sick leave.

Agree 100%. If you find a group that gives you great W2 benefits, then I can see how it all equals out. But finding those groups with the AMCs out there is difficult. If you play the game right and have a good accountant, then your taxable income is reduced significantly.

 

[Ezekiel2517]

You can and should have all those same tax benefits as a W2 with a good group by expensing everything through the practice. Depreciation, home office, 401k + DBP - I do all that through my group. Being 1099 confers almost no tax advantage if your group is set up correctly.

Exactly , was going to note this. I have been both self employed and W2 and can do just as much to save on taxes with current group . I also get all health, malpractice, HSA, etc paid for by the group. With 1099 you are stuck with the self employment tax which eats up a good chunk of your perceived savings .

 

[Ezekiel2517]

Nope. Self employed income means less in taxes if you know how to play the game.

Let's just say I made close to 500k gross self employed income back in 2009 and qualified for Obama new tax "making work pay tax credit" for middle class.

You can manipulate taxes more as self employed. Bonus depreciation with range rover. Retirement accounts. Luxury cme travel etc.

W2 benefits vary. A w2 with Sheridan or AMC benefits tend to suck vs a generous benefits package with a state employed position at an academic medical center with liberal paid sick leave.

Nope. Not for me. I know all about the tax game. With right group, you can get same tax benefits and more as w2 , w/o being screwed by the self employment taxes.

 

[BLADEMDA]

Anyone do locums for Sheridan or Mednax? What do they pay?

 

[BLADEMDA]

For those interested: The "Protecting Americans from Tax Hikes Act of 2015" passed in December of last year. IRS 179 has changed.

http://www.section179.org

50% bonus depreciation has been reinstated and good until the end of the year. Exceptionally good for those who work in different hospital settings and ASC's.

Please keep in mind that to qualify for the Section 179 Deduction, the equipment listed below must be purchased and put into use between January 1 and December 31 of the tax year you are claiming.

• Equipment (machines, etc) purchased for business use
• Tangible personal property used in business
• Business Vehicles with a gross vehicle weight in excess of 6,000 lbs (Section 179 Vehicle Deductions)
• Computers
• Computer "Off-the-Shelf" Software
• Office Furniture
• Office Equipment
• Property attached to your building that is not a structural component of the building (i.e.: a printing press, large manufacturing tools and equipment)
• Partial Business Use (equipment that is purchased for business use and personal use: generally, your deduction will be based on the percentage of time you use the equipment for business purposes).

 

[BLADEMDA]

I'm in:
TAX DEPRECIATION COMPARISONS
The comparisons below illustrate the tax depreciation advantages for business owners who purchase a new Range Rover, Range Rover Sport or LR4 before December 31, 2015.†Please consult your tax advisor on how this information can be applied to your individual business situation.

FIND A RETAILER

 

[deleted162650]

I'm in:
TAX DEPRECIATION COMPARISONS
The comparisons below illustrate the tax depreciation advantages for business owners who purchase a new Range Rover, Range Rover Sport or LR4 before December 31, 2015.†Please consult your tax advisor on how this information can be applied to your individual business situation.

FIND A RETAILER

I'm not sure I'm following or interpreting that right. Are they saying buying a Land Rover confers a substantial tax benefit compared to an equally priced luxury car?? How is that?

 

[sevoflurane]

I'm not sure I'm following or interpreting that right. Are they saying buying a Land Rover confers a substantial tax benefit compared to an equally priced luxury car?? How is that?

Yes. It's based on weight of the vehicle. Anything over 6000lbs qualifies... ie a Range Rover or a Porsche Cayenne.

You get 50% depreciation year one and bonus depreciation of 50% for a new vehicle. So you get 100% depreciation as you drive it off the lot.

This will bring your effective marginal tax rate down considerably.

It's legit, but typically used for farmers who are buying 250k-1+mil vehicles.

 

[sevoflurane]

You have to drive the vehicle to multiple locations and have a separate office building. There are some rules to follow, so not everyone qualifies.

 

[Arch Guillotti]

You can and should have all those same tax benefits as a W2 with a good group by expensing everything through the practice. Depreciation, home office, 401k + DBP - I do all that through my group. Being 1099 confers almost no tax advantage if your group is set up correctly.

What do you use the home office for and what do you depreciate?

 

[aneftp]

You can and should have all those same tax benefits as a W2 with a good group by expensing everything through the practice. Depreciation, home office, 401k + DBP - I do all that through my group. Being 1099 confers almost no tax advantage if your group is set up correctly.

Yes. I understand that. My current group is structured that way. I am "w2" but we have our own pension plans and pretax slush fund we pay for "business expenses cell phones, liberal cme luxury trips (cough cough travel cme),

Like I said. Not all W2 are the same. If you are working for an AMC (I only know Sheridan health benefits and they suck when I was given the offer sheet years ago and my friend is working for them currently and they aren't any better in 2015).

AMC w2 isn't same as sorta of w2 with private group. Or w2 with a state job with access to 401a, 403b 457b (protected 457 and not those shady private based 457b).

 

[aneftp]

I'm not sure I'm following or interpreting that right. Are they saying buying a Land Rover confers a substantial tax benefit compared to an equally priced luxury car?? How is that?

I got a 2014 Range Rover sport for around $78k in 2013. Bonus depreciation ended up being around a $41k tax deduction). Means around a 13-14k tax savings. Not bad.

Ain't no Range Rover sport $64k. Ha ha. That's like the base model before anything. I only got a HSE with a couple of packages and it was before taxes around $74k. The full size is gonna to cost most people around $90-95k with basic options most people want.

Not as good as pre Hummer loophole that was closed in tax year year 2004 (where people wrote off the entire 6000 pound suv) but better than the 25k tax deduction that was in place after 2004.

 

[deleted162650]

What do you use the home office for and what do you depreciate?

Since our group does not have its own office, our contract "mandates" that we maintain a home office in order to handle accounting matters, check schedules, etc, etc. Essentially, we use the home office for our taxes .

We depreciate vehicles. We have the option to either take depreciation on a purchased vehicle, or write-off up to 92% of a lease payment. It seems like most guys choose to write off a lease, but I'll have to check with my accountant what makes more sense when my current lease is up.

 

[deleted162650]

Yes. It's based on weight of the vehicle. Anything over 6000lbs qualifies... ie a Range Rover or a Porsche Cayenne.

You get 50% depreciation year one and bonus depreciation of 50% for a new vehicle. So you get 100% depreciation as you drive it off the lot.

This will bring your effective marginal tax rate down considerably.

It's legit, but typically used for farmers who are buying 250k-1+mil vehicles.

Thanks. Maybe that 3/4T truck is in the cards sooner than later. I hope your wife is the one driving the Cayenne

 

[Arch Guillotti]

Since our group does not have its own office, our contract "mandates" that we maintain a home office in order to handle accounting matters, check schedules, etc, etc. Essentially, we use the home office for our taxes .

We depreciate vehicles. We have the option to either take depreciation on a purchased vehicle, or write-off up to 92% of a lease payment. It seems like most guys choose to write off a lease, but I'll have to check with my accountant what makes more sense when my current lease is up.

Don't you have a practice manager to do that stuff?

Are you writing off a vehicle that you use for your primary transportation back and forth to work?

 

[deleted162650]

Don't you have a practice manager to do that stuff?

Are you writing off a vehicle that you use for your primary transportation back and forth to work?

Yes we have a practice manager for most of that stuff, but we still "need" a place at home from which to check our schedule for the next day, call pts, etc.

The vehicle serves as transportation not only between the various sites we cover, but also from our home office to the hospital. Another benefit to maintaining the home office.

 

[aneftp]

Don't you have a practice manager to do that stuff?

Are you writing off a vehicle that you use for your primary transportation back and forth to work?

The original Supreme Court decision about home office deductions back in early 1990s had to do with anesthesiologist deducting home office from taxes. They essentially ruled it illegal.

But congress changed the laws to essentially "over turn" the Supreme Court decision.

Too bad our congress doesn't work like that these days. Quite a shame.

But I do think writing off 92% of the the lease is quite aggressive. I like it! Have dental friends who write off 100% of the lease but they register their car at the physical dental office and not the home. Dentists can play the tax game the best of the medical professions. My dental friends claim w2 incomes around 50-60k while really pocketing (in real money) 250k or more. That's after paying their staff and expenses. And they work 4 days a week with Friday or Monday's business close. They do open one Saturday a month.

https://en.m.wikipedia.org/wiki/Commissioner_v._Soliman

 

[deleted162650]

92% is the max they will let us write off if the vehicle is solely a work vehicle. I generally claim 75% of 92%.

 

[deleted171991]

http://whitecoatinvestor.com/lessons-from-locum-tenens/

Read the comments, too. There are some excellent ones about credentialing, which basically explain while locum is a much better choice before retirement than at the beginning of one's career.

 

[deleted682700]

Anyone do locums for Sheridan or Mednax? What do they pay?

Amsurg has the contract at the surgery ctr. The job is still open. It's boonyville. Their pay goes something like this
Every 10 minutes in the Or is one unit. No base units. Only straight time units. Also all the waiting time between cases, you are just wasting time or subsidizing the bonus payments of higher ranking middle men.

They get u all excited when they say 35 dollars a unit. WTH, it comes to 200 $ an hour only if u are working. Before these middle men companies we would get paid 300 $ an hour. Of course the collections would come in after 3-6 months.

I won't work for Sheridan or any other company that forcibly takes over anesthesia contracts from private practices.

 

[deleted682700]

At my old gig, we paid a cardiac anesthesiologist 2k per day and $250/hr after 3pm.
Everything was covered (plane, car, food, etc.). No general cases. Only cardiac.
It was a pretty sweet gig for the locums guy. Unfortunately for them, it only lasted about a year or so.
This was back in 2007-2008.
Best bet is to leave the agencies out of the deal and contract yourself. You'll always keep more in your pocket this way.

Sorry although it makes sense to negotiate directly, the middleman is the market and money maker

 

[sevoflurane]

Thanks. Maybe that 3/4T truck is in the cards sooner than later. I hope your wife is the one driving the Cayenne

Most likely. But, the Turbo Cayenne and Macan are very beastly on the road in the turbo form. The cabin is nice. I'm a big fan or the RRS however.

Sorry although it makes sense to negotiate directly, the middleman is the market and money maker

Market will always determine the rates. Negotiating directly is still the way to go. It is what I have done in the past and what most of our locums that we used did. You're still squeezing out the agencies to your benefit.

 

[aneftp]

Amsurg has the contract at the surgery ctr. The job is still open. It's boonyville. Their pay goes something like this
Every 10 minutes in the Or is one unit. No base units. Only straight time units. Also all the waiting time between cases, you are just wasting time or subsidizing the bonus payments of higher ranking middle men.

They get u all excited when they say 35 dollars a unit. WTH, it comes to 200 $ an hour only if u are working. Before these middle men companies we would get paid 300 $ an hour. Of course the collections would come in after 3-6 months.

I won't work for Sheridan or any other company that forcibly takes over anesthesia contracts from private practices.

Seems like the new thing these AMCs these days to pay per unit (but at a much lower rate than they are collecting).

Apollo MD is paying a guy I know $28/unit in the south. Sure he made around $425k. But he probably was generating $700k plus. Hospital isn't in he best part of town but still 35% private insurance. I reckon average billing rate is close to $50/unit once Medicare units are factors in.

 

[deleted162650]

Making 425k at 28$/unit is waaaayyy more time than I care to spend in the hospital.

 

[BLADEMDA]

Anyone care to covert 1099 to W-2?

For example, W-2 at $350K with no benefit package and no state tax equals about $380K 1099? The AMCs these days halve paltry benefit packages maybe worth $15K total.

 

[BLADEMDA]

http://whitecoatinvestor.com/lessons-from-locum-tenens/

Read the comments, too. There are some excellent ones about credentialing, which basically explain while locum is a much better choice before retirement than at the beginning of one's career.

Yes, as it is so much easier to show 2-3 decades at the same hospital/location then do locums later in your career. This is is even more significant if you are a "rockstar" type who can do everything in a busy, high acuity setting.

 

[aneftp]

Anyone care to covert 1099 to W-2?

For example, W-2 at $350K with no benefit package and no state tax equals about $380K 1099? The AMCs these days halve paltry benefit packages maybe worth $15K total.

It's hard to compare 1099 vs w2 cause w2 benefits vary all over the place

Like my last academic w2 was literally worth at min $60-80k (pension/401a plus 12 paid sick days a year that accumulate plus immunity from law suits as state employee plus free health insurance ). If I had kids in college or even grad school you could literally add another $20-30k a year in tax free benefits. So close to $100k in w2 benefits. Honestly if my kids were nearing college age I probably would have stayed.

 

[IlDestriero]

My benefits are definitely worth over $100k. However, I'd probably trade some for a fatter retirement plan that's available to the 1099 folks.


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Il Destriero

 

[BLADEMDA]

It's hard to compare 1099 vs w2 cause w2 benefits vary all over the place

Like my last academic w2 was literally worth at min $60-80k (pension/401a plus 12 paid sick days a year that accumulate plus immunity from law suits as state employee plus free health insurance ). If I had kids in college or even grad school you could literally add another $20-30k a year in tax free benefits. So close to $100k in w2 benefits. Honestly if my kids were nearing college age I probably would have stayed.

I was trying to compare an AMC job W-2 with little to no benefits (worth maybe $15K at most) with a 1099 gig. If an AMC pays $350 then an equivalent 1099 locums gig would be around $390K (malpractice paid by locums agency ior hospital or group).

 

[IlDestriero]

How much is occurrence insurance worth? Anyone have a reasonable guesstimate? I went with $25k/yr in my estimation. I'm not sure that I'd take a Peds job without occurrence, maybe if they paid the tail. I wonder if a Peds tail is much more? That's something I've been isolated from in my jobs, insurance was always provided by the practice (or the government).


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Il Destriero

 

[BLADEMDA]

How much is occurrence insurance worth? Anyone have a reasonable guesstimate? I went with $25k/yr in my estimation. I'm not sure that I'd take a Peds job without occurrence, maybe if they paid the tail. I wonder if a Peds tail is much more? That's something I've been isolated from in my jobs, insurance was always provided by the practice (or the government).


--
Il Destriero

Yes, about $20-$25K per year for $1/$2 million of coverage. A rough estimate to convert a 1099 income to an AMC W-2 is a 10% increase in the salary. This 10% rule works for AMCs because they provide paltry benefits vs academic jobs.

http://www.rate-calculators.com/

 

[aneftp]

Yes, about $20-$25K per year for $1/$2 million of coverage. A rough estimate to convert a 1099 income to an AMC W-2 is a 10% increase in the salary. This 10% rule works for AMCs because they provide paltry benefits vs academic jobs.

http://www.rate-calculators.com/

I dunno. It depends if you have a working spouse who has access to health insurance as well.

I would rather get paid $350k straight 1099 than 350k w2 by AMC. Just the way I can write off more things and have less income exposed to w2 taxes plus obamacare surtaxes now.

You are spot on about occurrence malpractice cost. Cause I paid my own occurrence for years as self employed. I know the rates with both medpro and doctors insurance. Both major players.

 

[deleted162650]

Apollo MD is paying a guy I know $28/unit in the south.

With regards to that job, is making 28$/unit counting all the units he's generating supervising multiple rooms, or are they just paying him based on his time? If it's the former and he's supervising 2-4 rooms at all times that's not bad. If it's the latter or it's MD only that's embarrassingly bad.