Lots of places in Southern CA are well below that 28 value so that tells you something about that market
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deleted162650
That's my market dude. My previous gig had a crap payer mix and no subsidy, and our unit still came in better than 28$. Rates are much higher in the South. I still wanna know how they are counting his units in that arrangement.
For all you padawans out there: If you are working a reasonable full time schedule MD only, you will generate 10-12K units/year. Now you can translate unit values to income.
I guess it also depends on how they count your units. Is it just the startup plus time, or do they include the add-on units for lines and blocks for post op pain, intrathecals etc? 28 is very low. So is 10-12 k units per year. I don't work too hard, and I don't remember making less that 15K units a year for the last 17 years. We count every billable unit.
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deleted162650
15k units/year MD only is working pretty hard. Let's say you average 50 units/day which I find pretty typical factoring in call, light days, etc. if you only took 2 wks vacation that would be 12.5k units/yr. either you do ALOT of hearts or you live in the hospital when you aren't on vacation. Either way, good on ya for putting in that much time for that many years.
Yes. My brother is in Los Angeles no subsidy. All MD. Blended units. Most guys generate 10-14k.
But the general guys make around $400-425k 1099 no benefits (take around 5-7 weeks off). The cardiac guys (who do Ob and General like my bother) make around $475-500k now. But revenue is decreasing. He was making close to $600k.
That's working around 60 hours a week as well and working post call for a few hours as well (post call guy takes room with least amount of units/shortest day). Or occasionally day off completely with zero units
That doesn't sound good at all.
With the exception of a few spots, southern ca is pretty crap. And even the few spots really aren't that great.
We had a thread in the private forum about this a couple of months ago.
I am in an MD only practice, averaging about 50 hours per week with 4 weeks vacation. Heavy Cardiac and Thoracic load, but certainly not overworked. Over past 12 months, I am just shy of 18000 Units. I am probably pretty average for my group and I would imagine the highest is around 20000 Units. I too think 10-12k/year is pretty low. 50 Units per day would be only working half days for me
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deleted162650
Not doubting you at all. Doing a lot of hearts and thoracic is how you're able to crank that many units in that time frame. A generalist not doing the cardiac volume would need to put in a lot of hours (more than I or my partners would find acceptable) to bill that many units.
If I was generating those units I personally would expect to be making >650k as well.
I really outta join the private forum.
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I think endo, ortho, or an ent room might be better for unit generation than cardiac or thoracic.
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I am sure that they do. It's called cheating on your taxes. Just like claiming phony deductions.
What are 1099 people doing about their health care? It seems HSAs are not allowed any longer on the exchange. How are most locums buying health insurance?
http://www.forbes.com/sites/gracema...r-attack-in-obamacare-exchanges/#7e1ae4dc1ceb
http://www.forbes.com/sites/gracema...r-attack-in-obamacare-exchanges/#7e1ae4dc1ceb
Blade they still have them in Florida. The sneaky exchanges "hide" HSA compatible plans. You have to filter them out on the left hand side of healthcare.gov website under search options.
I found one for around $1150 a month for family of 4 with $3200 individual deductible. (They are "embedded") which means one individual is capped at $6450. The "max for the family is $13100. In Florida.
But like u said its getting harder and harder to fine.
And pre ACA. My premiums for HSA was $6000 max for family of 4 (max out of pocket everything including co insurance and deductible ) in 2013. With $750 a month PPO.
So in 2016 it's $1150 with essentially a max of $13100 and more narrow network "hmo"
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deleted171991
Because now we are paying for all the high-risk and Medicaid who were uninsured before.
Just to add, older locums (age wise) probably benefit from obamacare since there are no pre existing conditions. It's not cheap. But most can afford the premiums (it's a tax write off any ways). Better than getting rejected on the individual market pre ACA.
Obviously the exchanges favor poorer people with subsidies.
But u can game the exchanges and retire early as well. My next door neighbor is retired bond trader from New York. Moved to Florida. Was paying $1200/month just for himself and another $600/month for his wife (wife 54) he is 59.
He's been retired since age 54 with pre existing condition (perforated bowel from diverticulitis at age 52). He barely found an insurer that would take him at age 55 when he went off cobra. They had a 12 month exclusion period (meaning they wouldn't cover any health expenses due to his colon or abdominal areas).
Now with obamacare he's paying $400/month for himself and his wife! Subsidies baby! Subsidies. Guess how? He's only showing income of around 55k! He's not even tapping his retirement accounts. All of that $55k is from dividends and stuff. Plus he's smart. He's got tax exempt muni bonds etc (he's a bond trader duh)
And his brought his $800k house cash.
So the major flaw of obamacare exchanges for subsidies is it doesn't take into account total assets. It's just takes into account income. Income is not assets. The 400% poverty line is $40k for one person.
So someone like my neighbor who shows a $55k Income and his MAGI is much less which is what the exchanges is based on. My neighbor is not super rich Wall Street but he's pretty comfortable. Enough to be on the golf course 3x a week. Enough to pay for everything he needs and take vacations to Europe twice a year. So obamacare helped with his early retirement.
It can help locums docs or docs who want to retire early before Medicare age.
I am a neurologist. I just converted from a $350k employed position to going full time locum. Will work about 6 months a year, at a rate of $2500 per day. Doing it to spend time with my children. I just did 35 days in a beautiful city for $75k. Taking 3 months off.
Does the 2500 daily rate include malpractice, car and living arrangements? Or do you pay for that yourself out of the 2500?
Is this a 12 hour day or an 8 hour day? Do you take your children and spouse with you?
Did you reach out to groups directly or did you through an agency?
Wow, didn't even know neurologists made 350K. Thats great.
Seems like you have an awesome gig.
IKR. Shoulda done neurology.
I'm impressed. Congratulations for taking the move.
Question:
Is the 2.5k for 8hr work, or are you taking call bringing the pay to that? Most of the anesthesia jobs pay 1.5k for 8 hrs which is ok but not that great in my opinion.
When I make my pitch I say I will be on call 24/7. However, in a month, I'll usually go in maybe twice. Last month I received 4 pages after 5pm all month and I handled it from my Rv.
First, i was working in a pseudo academic/ private practice center with $350k plus benefits working 1 week on/off. I started doing locum about 6 months ago and started testing waters off h0w things work, places that i was interested etc.
Does the 2500 daily rate include malpractice, car and living arrangements? Or do you pay for that yourself out of the 2500?
they cover malpractice and i cover everything else. I bought a kick ass 45 ft RV and live on it etc all tax deductible. hospitals usually want to pay for all this for $2000 a day- if they for an apt for 30 days @$2k and rental car for $1500 for the month, thats $3.5 of expenses for them. by charging $2500 a day, ill make and extra $15k and my expenses are around $2.5 a month (rv payment $300 mo, $500 food, $1000 month rv parking etc and pocket the rest.
Is this a 12 hour day or an 8 hour day?
i take call 24/7 call. last month, i went in maybe twice and I received 4 pages after 5pm.
Do you take your children and spouse with you?
yes. 2 kids under 4. i am trying to structured my locum business to where i only work when they are off from school i.e. summers, spring brake etc.....last month while on assignment, spent all week in watermarks, museums etc. i figure i can make about the same of what i make right now working 20 weeks a year.
Did you reach out to groups directly or did you through an agency?
agency first, then directly.
Wow, didn't even know neurologists made 350K. Thats great.
Yes, i am extremely happy with my salary, group, and the city where i am right now, but spending time with my family is more important to me (if i wanted too, i could make over 1 mil--two hospitals want me for the entire year) .i am still staying in my city--this will be my home base, but ultimately this is what the american dream is all about. I left the rat race and become responsible for my future.
Seems like you have an awesome gig.
Does the 2500 daily rate include malpractice, car and living arrangements? Or do you pay for that yourself out of the 2500?
they cover malpractice and i cover everything else. I bought a kick ass 45 ft RV and live on it etc all tax deductible. hospitals usually want to pay for all this for $2000 a day- if they for an apt for 30 days @$2k and rental car for $1500 for the month, thats $3.5 of expenses for them. by charging $2500 a day, ill make and extra $15k and my expenses are around $2.5 a month (rv payment $300 mo, $500 food, $1000 month rv parking etc and pocket the rest.
Is this a 12 hour day or an 8 hour day?
i take call 24/7 call. last month, i went in maybe twice and I received 4 pages after 5pm.
Do you take your children and spouse with you?
yes. 2 kids under 4. i am trying to structured my locum business to where i only work when they are off from school i.e. summers, spring brake etc.....last month while on assignment, spent all week in watermarks, museums etc. i figure i can make about the same of what i make right now working 20 weeks a year.
Did you reach out to groups directly or did you through an agency?
agency first, then directly.
Wow, didn't even know neurologists made 350K. Thats great.
Yes, i am extremely happy with my salary, group, and the city where i am right now, but spending time with my family is more important to me (if i wanted too, i could make over 1 mil--two hospitals want me for the entire year) .i am still staying in my city--this will be my home base, but ultimately this is what the american dream is all about. I left the rat race and become responsible for my future.
Seems like you have an awesome gig.
Wow neurochica, seems like you got it made. I can't imagine being on call 24/7 and only going back in twice in one month. Doesn't happen in the world of anesthesia. Call can suck ass!!
I may have to buy me an RV and try to be like you.
I may have to buy me an RV and try to be like you.
I should have been a neurologist.
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Il Destriero
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Il Destriero
Me three.
Honestly though, I shoulda been a shrink. Sweet lifestyle and the demand is insane with pay increasing.
I have a couple friends who are psychiatrists. Both do quite well working 8-4 M-F with some pager call that consists of "I'll work you in next week." Or, "Go to the ER immediately."
However, the patients are difficult to deal with, and I had zero interest in spending a lot of time talking to the mentally ill. I don't have the patience for that.
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Il Destriero
However, the patients are difficult to deal with, and I had zero interest in spending a lot of time talking to the mentally ill. I don't have the patience for that.
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Il Destriero
There was a time when neurology was a specialty that no one wanted to do and the salaries were in the range of family practice!
Everything in medicine is a cycle!
350 one week on one off is way more than I'm getting. How is that even possible? Where does the money come from? I doubt the clinic and consultation brings that much money, specially if only working 6 mo out of the year.
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deleted643396
There are new pharmaceuticals coming out to treat neurologic diseases. Some of these require infusions and many neurology clinics set up infusion centers. Rheumatology is another specialty seeing growth in that regard.
Neuro-ICU and stroke code teams are other ways that neurologists have expanded and diversified their practice over the past few years.
I've seen a few jobs on gaswork one week on one week off for around 350k. You're on call everyday during your week on though, and that can suck.
It's different. The OR usually runs late past 9pm every day. If you work that late every day you would go insane. I doubt Neuro is regularly seeing patients past 9pm. For all I know they close the clinic at 5pm.
I know an anesthesiologist who used to do the 1 week on call 1week off thing and he burned out within a year.
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deleted171991
Until the cycle is broken by midlevels. 😉
No it's not. Look at pathology.
It's sad how things have changed
Bump. Still enjoying enjoying la vida locum!
shoulve done neurology, except i hated the neuro exams hahha
Starting La Vida Locums in the next couple of months!!!
Looking forward to it.
I must admit though, the paperwork sucks!!
But the money is gonna be sweet for me.
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Damn... neuro is starting to look pretty good....
You say that until you've worked up your 457th octogenarian for "dizziness" and the gun barrel starts looking mighty inviting.
lmao ur bad Consigliere. Hope you're still killin' the game. Thanks for being a good role model.
Anytime, Detective.
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deleted162650
Neurology is just 40mins of guesswork until the MRI comes back.
Then it's diagnose and Adios.
"Well Mr. Smith, you have a very rare neuromuscular disorder."
"OK doc, so what are my options?"
"Oh there's nothing we can do for you, but isn't it interesting."
Then it's diagnose and Adios.
"Well Mr. Smith, you have a very rare neuromuscular disorder."
"OK doc, so what are my options?"
"Oh there's nothing we can do for you, but isn't it interesting."
LMAO. I swear that everytime we learned about some condition in neuro... it was noted that A) by the time the diagnosis is made, there's nothing you can do.... or B) we don't know what is actually going on and how whatever we DO use to treat it actually works...
I guess that shows how much room for growth there is in neurology. That is why it is one of the most exciting fields to a lot of people. It used to be just tpa for strokes, now they are actually going in there and extracting the clots
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deleted162650
The neurologists ain't the ones doing that.
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deleted126335
Neuro is what is known as a spectator sport.
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They are at some places. Here's one. Interventional Neurology Fellowship | Department of Neurology & Ophthalmology
You can search to find more.
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deleted162650
Well I'll be damned. A neurologist is the last person I want snaking catheters up into my brain.
dont worry, an anesthesiologist will be in the room
Neurologist been doing this for a long time.....if you don't know this.....
