Locums

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Status Sciaticus said:
why gatekeep?
I have an hourly rate with a 10 hour guarantee which will get me $4,000 - $5,000. add in overnight home call for $2,000-$3,000.
Even doing that everyday is $8,000. Lets just say 8x7 = $56,000.
Where are you getting the extra 30k/week from?
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He’s bull****ting.
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Coffee PRN said:
He’s bull****ting.
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People have seen my numbers and can vouch for my big weeks. I don't do them all the time. Frankly not that sustainable. Once in a while is fine.

I don't BS when it comes to money.
 
aneftp said:
People have seen my numbers and can vouch for my big weeks. I don't do them all the time. Frankly not that sustainable. Once in a while is fine.

I don't BS when it comes to money.
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So your 500k w/ 30 weeks off W2 job...who do you work for? Hospital employed? PP partner?
 
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AppTrail said:
So your 500k w/ 30 weeks off W2 job...who do you work for? Hospital employed? PP partner?
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AMC. I have never worked for w2 for an AMC before. So here’s a first for me. I got one foot in. And one foot out if it doesn’t work.
 
aneftp said:
Everyone skeptical of stuff I say. I’m gonna to hit 80k for the week locums as well. I can’t feed a family on 70k anymore for the week. I blasted past 50k for the week where it’s chump change.

Open your eyes folks. Not everyone is working 8-10 hrs a day. Some days are 1-2 hrs. Some days off completely. Yes. Some days are 12-14 hrs. I said average of 40 hrs.
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So if you average 40 hours a week for 22 weeks that’s 880 hours. 500k would be 568/hour at your primary job as someone else mentioned. Plus benefits. At that rate, why do locums? Why not just work 44 weeks and make a million with no travel, time away from family, 24/7 call, etc?
 
jjm285 said:
So if you average 40 hours a week for 22 weeks that’s 880 hours. 500k would be 568/hour at your primary job as someone else mentioned. Plus benefits. At that rate, why do locums? Why not just work 44 weeks and make a million with no travel, time away from family, 24/7 call, etc?
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I do both!

W2 plus locums when I want. Best of both worlds.

Depend how motivated I am.

And it’s the agreement the 5 of us have decided how to run the w2 practice.
 
ToKingdomCome said:
lol 80K for the week? Ok buddy
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Like I said. I could have hit 80k in late August if I wanted to but decided not to work Labor Day (1.5x) so settled for 70k. A few have seen my paystub. But I’m tired of having to explain to people how to make it happen.

50k is an average week these days when I feel like it. That’s with 2 days off.

You guys are still working under the old algorithm formula. Hours worked x daily hours rate. That gets you to 30k-40k most weeks with hard work.

And I’m not even the high earner.

But it takes two to tango. You gotta find willing less hard working w2 docs who don’t want the calls to give it to you. That is where you can find these type of jobs.
 
aneftp said:
AMC. I have never worked for w2 for an AMC before. So here’s a first for me. I got one foot in. And one foot out if it doesn’t work.
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Knowing AMCs, I'm shocked they consider 30 weeks off as 1.0 FTE. I'm guessing they got a contract for 5 docs and just letting you all decide how to run it? Do you think it's sustainable long term or will they to squeeze you to 4 docs? I've never ever seen 880hours/year considered 1.0 FTE. Typically it's ~1700-2100 hours/year from what I've seen.
 
AppTrail said:
Knowing AMCs, I'm shocked they consider 30 weeks off as 1.0 FTE. I'm guessing they got a contract for 5 docs and just letting you all decide how to run it? Do you think it's sustainable long term or will they to squeeze you to 4 docs? I've never ever seen 880hours/year considered 1.0 FTE. Typically it's ~1700-2100 hours/year from what I've seen.
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No one cares anymore. There are muitple amc that allows this now. They don’t care how you run it as long as there is coverage.

There are some amc the docs are working even less 28 hrs a week with 16 weeks off. Complete joke of a job. Scam being going on for years. I know cause I have dinner with those guys and we laugh about it. They make 450k. And I have privileges there also.
 
I have seen aneftps paperwork on a 70k week - will vouch for him. He seems to work lots of hours and chances that they won’t be busy… and I think they usually aren’t but there’s a chance you get a bad night. He definitely knows how to play the game and negotiate well.
 
aneftp said:
No one cares anymore. There are muitple amc that allows this now. They don’t care how you run it as long as there is coverage.

There are some amc the docs are working even less 28 hrs a week with 16 weeks off. Complete joke of a job. Scam being going on for years. I know cause I have dinner with those guys and we laugh about it. They make 450k. And I have privileges there also.
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Your market is def different than mine...AMCs here will squeeze ever dollar out. Curious if anyone else in a different market than your's has a similar experience?
 
aneftp said:
There are some amc the docs are working even less 28 hrs a week with 16 weeks off. Complete joke of a job. Scam being going on for years. I know cause I have dinner with those guys and we laugh about it. They make 450k.
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28 hours x 36 weeks is 1008 hours. So they work 15% more hours for 50k less than your job (allegedly) yet it’s their job that’s the scam?!? This is getting less and less believable by the post, and that’s saying a lot since I haven’t believed a word of it for a long time.
 
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jjm285 said:
28 hours x 36 weeks is 1008 hours. So they work 15% more hours for 50k less than your job (allegedly) yet it’s their job that’s the scam?!? This is getting less and less believable by the post, and that’s saying a lot since I haven’t believed a word of it for a long time.
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Nah. They barely work. I want their job! It’s a race to who works less.

Workload.

You guys over analyze way too much.

Just figure out what works for you. We are in a weird work environment. I’m not loyal to anything anymore. If work conditions change. I will leave.

I was perfectly happy with my other job for a year and than left. So things can change quickly if you look back at my posts
 
AppTrail said:
Your market is def different than mine...AMCs here will squeeze ever dollar out. Curious if anyone else in a different market than your's has a similar experience?
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I think he’s talking about one off situations. Like it’s short notice and he’s the only option. I could see an admin choosing to pay $80k of someone else’s money to keep a service line going for a week. 80k is a rounding error compared to a hospital’s weekly budget. Shutting down ORs can be disastrous politically for an admin.

You can only negotiate like that if you have someone over a barrel. These aren’t standard situations. Good for him recognizing when he has max leverage and exploiting it. But it’s not a strategy that can be used widely.
 
ryanjmy said:
I think he’s talking about one off situations. Like it’s short notice and he’s the only option. I could see an admin choosing to pay $80k of someone else’s money to keep a service line going for a week. 80k is a rounding error compared to a hospital’s weekly budget. Shutting down ORs can be disastrous politically for an admin.

You can only negotiate like that if you have someone over a barrel. These aren’t standard situations. Good for him recognizing when he has max leverage and exploiting it. But it’s not a strategy that can be used widely.
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It’s not about max leverage.

You have to have willing w2 docs in on the game.
W2 docs want to maximize either their income or lessen their workload

There is another place the locums docs pull 36k for the weekend. And the w2 docs just take m-Thursdays call for 600k w2 and work no more than 40 hrs.

It becomes a symbiotic relationship between locums and full time docs. Maximizing work load for w2 docs (they work less). Maximizing 1099 income for locums docs.
 
aneftp said:
It’s not about max leverage.

You have to have willing w2 docs in on the game.
W2 docs want to maximize either their income or lessen their workload

There is another place the locums docs pull 36k for the weekend. And the w2 docs just take m-Thursdays call for 600k w2 and work no more than 40 hrs.

It becomes a symbiotic relationship between locums and full time docs. Maximizing work load for w2 docs (they work less). Maximizing 1099 income for locums docs.
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name these places or DM them
 
ToKingdomCome said:
name these places or DM them
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They are like stock tips. You are behind the 8 ball once you learn about it. And credentialing is the rate limiting factor. Can take up to 4 months at some places

I barely caught the tail end of a northern Florida place (northern for me is anything above west palm beach) and they told me they don’t need me anymore in December.

Im working on a gig is Wisconsin but its freaking cold there in winter time.

The upper midwest and East central (think Ohio) at your biggest bets. They come and go.
I can tell u one Ohio off interstate 70 place and u can call them and they may have enough locums coverage

There is no magic formula. Shop around. See what sticks and what doesn’t. You get turned down. You move on.

Upstate New York is huge money maker also. My bff is up there.
 
aneftp said:
They are like stock tips. You are behind the 8 ball once you learn about it. And credentialing is the rate limiting factor. Can take up to 4 months at some places

I barely caught the tail end of a northern Florida place (northern for me is anything above west palm beach) and they told me they don’t need me anymore in December.

Im working on a gig is Wisconsin but its freaking cold there in winter time.

The upper midwest and East central (think Ohio) at your biggest bets. They come and go.
I can tell u one Ohio off interstate 70 place and u can call them and they may have enough locums coverage

There is no magic formula. Shop around. See what sticks and what doesn’t. You get turned down. You move on.

Upstate New York is huge money maker also. My bff is up there.
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Had a fantastic offer in Rochester, but I know the area. Especially during the winter. It was an easy pass for me.
The credentialing/onboarding, dea/state license, traveling away from home plus unknown hospital system is a bit of a conundrum for me- all those aspects of locums assignment have their own price. Easier in a dense population I guess.
Definitely has that wild west feel to it.
Glad there are mercenaries out there!! 🤠
 
sevoflurane said:
Had a fantastic offer in Rochester, but I know the area. Especially during the winter. It was an easy pass for me.
The credentialing/onboarding, dea/state license, traveling away from home plus unknown hospital system is a bit of a conundrum for me- all those aspects of locums assignment have their own price. Easier in a dense population I guess.
Definitely has that wild west feel to it.
Glad there are mercenaries out there!! 🤠
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Tons of money everywhere. That’s what people just don’t understand. Maybe not 70k per week. But 50k is obtainable per week in many parts of the country.

It’s not gonna to drop in ur lap just like that but it’s a step up process in upstate in New York. I know the process up there.

One of my home boys I work with in Florida his kids in high school and college. So he’s heading up to upstate for 3 weeks in January also.

The money escalates with retention bonus built for 1099 up there

Every area is a little different in terms of what they call it. Retention, call stipend etc. the wording doesn’t matter.

People just need to do locums. Get a feel for the process. Obviously don’t get ripped off. Know the parameters of the contract. Most
Places will work with you what you are looking for.
 
The $50-80k locums weeks are believable to me. It’s the $500k, 40hr/week, 30 weeks off AMC W2 job that I don’t believe. That is just not a normal setup without some insider, “I have dirt on you” extortion thing going on.
 
GravelRider said:
The $50-80k locums weeks are believable to me. It’s the $500k, 40hr/week, 30 weeks off AMC W2 job that I don’t believe. That is just not a normal setup without some insider, “I have dirt on you” extortion thing going on.
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They are popping up

The crnas started this trend with the 7 days a month work plus 9 weeks of vacation time.

The docs are just following crnas schedule. Different variations of this model. I like this one doc 92 days a year job better to be honest. He hired 6 docs immediately with his model. He gets 500k also. That’s also with the same AMC!

People think these are unicorn jobs. But the future is here. Embrace it.

So many variations with night float model/26 weeks off. 7p-7a and half the time you don’t even have to come in since no ob, no trauma. That’s also 540k job. That’s 7p-7am Monday through Friday. No weekends. Next week off. So you could be working as little as 6 hours for the week but on beeper. Monday through Friday. Also with a huge amc.
 
aneftp said:
They are popping up

The crnas started this trend with the 7 days a month work plus 9 weeks of vacation time.

The docs are just following crnas schedule. Different variations of this model. I like this one doc 92 days a year job better to be honest. He hired 6 docs immediately with his model. He gets 500k also. That’s also with the same AMC!

People think these are unicorn jobs. But the future is here. Embrace it.

So many variations with night float model/26 weeks off. 7p-7a and half the time you don’t even have to come in since no ob, no trauma. That’s also 540k job. That’s 7p-7am Monday through Friday. No weekends. Next week off. So you could be working as little as 6 hours for the week but on beeper. Monday through Friday. Also with a huge amc.
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So a night float job? 7p-7a is not 40 hrs/week. Are you not counting home call hours? There are tons of 7 on/ 7 off jobs out there. Most are miserable and not sustainable unless you have a very specific set of personal circumstances.
 
GravelRider said:
So a night float job? 7p-7a is not 40 hrs/week. Are you not counting home call hours? There are tons of 7 on/ 7 off jobs out there. Most are miserable and not sustainable unless you have a very specific set of personal circumstances.
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U don’t understand what I’m saying. This place is done by 630pm 60-70% of the time. Done by 9pm 90% of the time. It’s not the night float you are thinking about.

There is no ob. No trauma

Look I moved from the northeast years ago to Florida and said. Damn. This is so much easier work than what I was doing up north.

I am very conscious of work load which I discuss a lot.

Yes. There are miserable 7p-7am night float. I do some of them as well. People learn quickly what is a good work environment and what’s not a good work environment.
 
sevoflurane said:
Had a fantastic offer in Rochester, but I know the area. Especially during the winter. It was an easy pass for me.
The credentialing/onboarding, dea/state license, traveling away from home plus unknown hospital system is a bit of a conundrum for me- all those aspects of locums assignment have their own price. Easier in a dense population I guess.
Definitely has that wild west feel to it.
Glad there are mercenaries out there!! 🤠
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If it’s the same Rochester place my buddy was at, it’s a toxic environment. Toxic environment and tons of snow is a non starter
 
Is anyone doing locums in Helene storm affected areas? If so, what has been your experience? Work, contract, hours, anything.
 
ToKingdomCome said:
The University of Rochester ?
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U of R has satellite places so that’s not specific enough

They do abuse the locums docs solo doing bs 7 cysto cases. No lunch breaks

While the rest of the staff chill. And do nothing
 
aneftp said:
U don’t understand what I’m saying. This place is done by 630pm 60-70% of the time. Done by 9pm 90% of the time. It’s not the night float you are thinking about.

There is no ob. No trauma

Look I moved from the northeast years ago to Florida and said. Damn. This is so much easier work than what I was doing up north.

I am very conscious of work load which I discuss a lot.

Yes. There are miserable 7p-7am night float. I do some of them as well. People learn quickly what is a good work environment and what’s not a good work environment.
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It’s hard for me to follow your non sequiturs sometimes, but basically your W2 job is a 7p-7a night float job where you actually work 40 hours or less per week because it’s home call and you negotiated a few extra weeks vacation on top? You then go and do locums on those off weeks or perhaps during the day during your “on” weeks? Am I interpreting this correctly?
 
GravelRider said:
It’s hard for me to follow your non sequiturs sometimes, but basically your W2 job is a 7p-7a night float job where you actually work 40 hours or less per week because it’s home call and you negotiated a few extra weeks vacation on top? You then go and do locums on those off weeks or perhaps during the day during your “on” weeks? Am I interpreting this correctly?
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No. That’s another gig.

There are so many gigs popping up everywhere.

Every company is experimenting with different models. To attract w2.

For the docs it’s massive vacation time without overworking them while keeping the salaries around 450-500k

For crnas. I’ve been telling these places crnas want 24 hrs x 7 /8 shifts a month

Or giving them 100k sign on bonus for 2 years

You need to stop the bleeding with locums

This is the future.
I told them 75k for crna for 2 years bonus (2 years ago). That price has gone up while they waste millions on 1099 locums

That’s how uneducated these places are.

Overpaying someone by 100k is still far cheaper than over paying locums 250k. It’s simple math.

Is this a perm fix? No. But it buys you 2 years with these models and saves millions.
 
centdoc said:
Is anyone doing locums in Helene storm affected areas? If so, what has been your experience? Work, contract, hours, anything.
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I’d stay away from Asheville. Not that anybody could get there.

IMG_2481.jpeg
 
centdoc said:
How hard was it to fight the locums company to pay?
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It’s not the locums company. It’s who’s paying the bills. I keep telling people this. Follow the money trail.

The client pays.

Locums companies are just the middle guys. If the client approves of the payment. It gets paid out

All the locums docs got paid due to contractual agreement. Including the call locums doc who didn’t even take call cause they shut off the bridges to the beach area hospital. The full time w2 staff ended up taking the call (they got paid extra also)

As Oprah said on her show. Everyone wins!
 
always.chillin said:
I should’ve taken the extra two years and done anesthesia.. I’m slaving away at 240/hr full time and 350/hr locums in er. Pretty decent gigs but 50k/week is something else
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EM is a 2 year residency now?
 
always.chillin said:
600-650. I work 180-190 hours/month. Life’s still pretty good.
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Coffee PRN said:
Don’t believe everything you see on here. You make the same or more than most anesthesiologists.
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If you like what you do, and make similar $$$, that's all that matters. People on our forum will lament on what interventional cardiologists make, or the IR guys/gals, and I'm F**% those specialities; I would be miserable doing what they do. I would say 180-190 hours is on the higher end, but I'm sure there are a good portion of anesthesiologists on here "making bank" and they are working 55 hours a week.
 
Coffee PRN said:
Don’t believe everything you see on here. You make the same or more than most anesthesiologists.
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Anesthesiologists should move to the shift work mentality just like EM docs. It would completely destabilize the entire hospital OR system

The backup/beeper calls we take. EM don’t do that.

We all know they base most of their schedules on approximately 16 shifts a month. Than they can add to that. Plus vacation time

Can you image every anesthesiologist just working 16 shifts a month plus vacation. Those er shifts vary from 8-12 hrs usually. You would have complete chaos with OR staffing

But anesthesia docs would be fairly compensated for the actual work they do in the hospital. The hourly model.
 
aneftp said:
EM is a 2 year residency now?
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I included a year of fellowship in anesthesia. But after doing some research it seems it’s not really that necessary for marketability? Then I regret it even more lol. They need to give financial talks in med school. Mine just stressed “follow your passion.”
 
always.chillin said:
I included a year of fellowship in anesthesia. But after doing some research it seems it’s not really that necessary for marketability? Then I regret it even more lol. They need to give financial talks in med school. Mine just stressed “follow your passion.”
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Same with the added "don't worry....just treat patients, the money will take care of itself."
 
always.chillin said:
I included a year of fellowship in anesthesia. But after doing some research it seems it’s not really that necessary for marketability? Then I regret it even more lol. They need to give financial talks in med school. Mine just stressed “follow your passion.”
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Anesthesia is hot field. For now.

But I see psych is the next big thing.
 
aneftp said:
Anesthesiologists should move to the shift work mentality just like EM docs. It would completely destabilize the entire hospital OR system

The backup/beeper calls we take. EM don’t do that.

We all know they base most of their schedules on approximately 16 shifts a month. Than they can add to that. Plus vacation time

Can you image every anesthesiologist just working 16 shifts a month plus vacation. Those er shifts vary from 8-12 hrs usually. You would have complete chaos with OR staffing

But anesthesia docs would be fairly compensated for the actual work they do in the hospital. The hourly model.
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It's coming, just give it another 3-5 years with a mass wave of retirements coming. The new school of thought is call-optional, 7-3 or 7-5 jobs, with huge incentives for taking calls that amount to vacation time, money, or more schedule flexibility with days off. That's what I see in academics, and the delta of pay for academics and private/hospital is shrinking when accounting for total hours worked and call hours especially.

More people flocking to academic centers too than ever to not have to deal with private group conflicts. Never have to worry about ditching CRNAs or other docs in academics. There's mechanisms and financial cushions to oust low performers for the most part in these places. In private, the driving force is get the cases done no matter what. For what they do relating to personnel decisions, academic chiefs probably don't get paid enough.
 
PainInTheAnes said:
It's coming, just give it another 3-5 years with a mass wave of retirements coming. The new school of thought is call-optional, 7-3 or 7-5 jobs, with huge incentives for taking calls that amount to vacation time, money, or more schedule flexibility with days off. That's what I see in academics, and the delta of pay for academics and private/hospital is shrinking when accounting for total hours worked and call hours especially.

More people flocking to academic centers too than ever to not have to deal with private group conflicts. Never have to worry about ditching CRNAs or other docs in academics. There's mechanisms and financial cushions to oust low performers for the most part in these places. In private, the driving force is get the cases done no matter what. For what they do relating to personnel decisions, academic chiefs probably don't get paid enough.
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Really depends how the academic places are run. You just can’t be paying the worker bee new grad attendings doing 98% of the clinical work the same as the tenured faculty have 2 non clinical days a week off. The new grad will leave
 
aneftp said:
Really depends how the academic places are run. You just can’t be paying the worker bee new grad attendings doing 98% of the clinical work the same as the tenured faculty have 2 non clinical days a week off. The new grad will leave
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I wonder how things will shake out. I do local locums in a couple of academic systems. Seems like these departments were blindsided, when I saw this Early 2020.
 
Direct Laryngoscopy said:
I wonder how things will shake out. I do local locums in a couple of academic systems. Seems like these departments were blindsided, when I saw this Early 2020.
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Time and money. Thads what it all boils down to.

Academic centers don’t give new grads time off or money. They depend new grads who are used to being abused /over worked to continue to work as attendings. So anything less than being in residency workload wise sounds good.
 
aneftp said:
Really depends how the academic places are run. You just can’t be paying the worker bee new grad attendings doing 98% of the clinical work the same as the tenured faculty have 2 non clinical days a week off. The new grad will leave
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Historically, they do fine as new grads will replace the less new grads that leave. Granted if the pay gap between academics and PP is great enough, no new grad will stay, which we are seeing more and more of recently.

For sure, some institutions are better than others, and also have "clinical tracks" and what not to distinguish those wanting to publish, and those just wanting to work clinically,. Some are woefully behind the market and that case, there might be more factors pushing people to leave, but
aneftp said:
Time and money. Thads what it all boils down to.

Academic centers don’t give new grads time off or money. They depend new grads who are used to being abused /over worked to continue to work as attendings. So anything less than being in residency workload wise sounds good.
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That same group wises up after they look around and start getting burnt out and annoyed when they realize how little some senior faculty are doing while being of higher rank and paid more, to be replaced by a new group of new grads 🤦‍♂️
 
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