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miacomet

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Posting jobs, at RF's request, that pay horribly, and less than many midlevels.

Denver- CMGs appear to be paying $125 an hour. Why bother?
Columbia-Presbyterian, NYC- Last I checked, it paid ~$220k annually for ~1500 hours, not including admin responsibilities, for a grand total of less than $144 an hour.
 
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Posting jobs, at RF's request, that pay horribly, and less than many midlevels.

Denver- CMGs appear to be paying $125 an hour. Why bother?
Columbia-Presbyterian, NYC- Last I checked, it paid ~$220k annually for ~1500 hours, not including admin responsibilities, for a grand total of less than $144 an hour.

I think this is only useful when you take those numbers in context What's the average hourly rate in Denver? What's the average hourly rate in NYC? If a job is close to the local prevailing rate, then it's not really useful information. If a job is significantly lower than the local going rate (whether that rate is good or bad compared to the national average) then it's useful. Otherwise you are just drawing a supply/demand curve.
 

miacomet

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I think this is only useful when you take those numbers in context What's the average hourly rate in Denver? What's the average hourly rate in NYC? If a job is close to the local prevailing rate, then it's not really useful information. If a job is significantly lower than the local going rate (whether that rate is good or bad compared to the national average) then it's useful. Otherwise you are just drawing a supply/demand curve.

I guess it depends on your goals and what you are willing to put up with. Personally, I don't think the risk of EM (violence, needle sticks, medmal) is worth it for a midlevel salary- I'd do something lower risk that pays a similar hourly, such as telehealth or UC, or I'd do locums. So for me, it would be useful as the cost-benefit analysis of $125 or $144 for clinical EM falls squarely on the cost side for me. Obviously, others may have different goals and may think differently.

I would also argue it's not just supply and demand. The jobs in NY NEVER get filled because they can't hire folks for such a rate, but they won't raise salaries and prefer to be understaffed and/or make their docs work more. It's useful info beyond a supply-demand issue if a facility has 12 open positions and never raises their salaries, but instead staffs up with locums.

EM is not always an efficient market.
 
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Brigade4Radiant

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For those rates I would just live in Denver and do Chart review you would make the same and you just stay home in your pajamas. An EM boarded physician can just google chart review companies and amke 100-125 with very low risk. They typically want 5 years of experience but I plan to do that as a side hustle.
 
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miacomet

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For those rates I would just live in Denver and do Chart review you would make the same and you just stay home in your pajamas. An EM boarded physician can just google chart review companies and amke 100-125 with very low risk. They typically want 5 years of experience but I plan to do that as a side hustle.

100%, and travel a few days a month to keep a toe in clinically. UC pays comparably, as does telehealth. All have much lower risk and much better hours. I don't get it.
 

EctopicFetus

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Young docs are taught that they must work in an ED. No matter the trash pay. I think we should keep posting these in cities. Rural pay I hear can be as low as $60/hr but this is typically non boarded docs with low volumes.

Imagine trying to live in NYC or Denver on $100/hr with the loans docs have and the delayed start of funding retirement. recipe for B U R N O U T!
 
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Arcan57

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Young docs are taught that they must work in an ED. No matter the trash pay.

And that's a correct statement. At least if you're EM trained. Young docs that don't work in an actual ED have a pretty dismal failure rate when they decide to make the jump to a FT ED.
 

enalli

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For those rates I would just live in Denver and do Chart review you would make the same and you just stay home in your pajamas. An EM boarded physician can just google chart review companies and amke 100-125 with very low risk. They typically want 5 years of experience but I plan to do that as a side hustle.

What exactly is a chart reviewer? I did a quick online search and it seems like it has to do with denying insurance claims, improving billing, or determining disability.
 

miacomet

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Young docs are taught that they must work in an ED. No matter the trash pay. I think we should keep posting these in cities. Rural pay I hear can be as low as $60/hr but this is typically non boarded docs with low volumes.

Imagine trying to live in NYC or Denver on $100/hr with the loans docs have and the delayed start of funding retirement. recipe for B U R N O U T!

And $60 an hour is less than regular RNs in many parts of the country. Insane.

I get that people have put a ton of time into training for EM, and it's certainly a noble career. But doctors don't deserve to be abused or underpaid, no matter how we are beaten down in training, and more and more I find EM to be a pretty universally abusive (and dangerous) field. My hope is that medical students get a more realistic understanding of EM and what it means to go into a field with a very short average career, and that they take that knowledge into consideration when the pick a field.

I'm heartened that more and more EM docs are choosing FIRE and fellowships like Pain and HPM and leaving what's becoming an unbearably abusive and increasingly underpaid field. Things will only get better if we talk with our feet, and while I know it's disheartening to have put so much time into an often unsustainable career, facing reality gives us choices and more control and power to change things.
 

thegenius

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I think this is only useful when you take those numbers in context What's the average hourly rate in Denver? What's the average hourly rate in NYC? If a job is close to the local prevailing rate, then it's not really useful information. If a job is significantly lower than the local going rate (whether that rate is good or bad compared to the national average) then it's useful. Otherwise you are just drawing a supply/demand curve.

Yea and you have to look at the value of the total compensation package. For instance, an attending at Cornell / Columbia probably gets 40-50K year in extra benefits, maybe more.

As an aside, I just can't imagine working for $100/hr!!!! Or less? For real making $80/hr and you are making key decisions like starting people on anti-coagulation, sending home syncope, possibly discharging the weak 80 yr old with a normal workup?
 
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vm26

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And $60 an hour is less than regular RNs in many parts of the country. Insane.

I get that people have put a ton of time into training for EM, and it's certainly a noble career. But doctors don't deserve to be abused or underpaid, no matter how we are beaten down in training, and more and more I find EM to be a pretty universally abusive (and dangerous) field. My hope is that medical students get a more realistic understanding of EM and what it means to go into a field with a very short average career, and that they take that knowledge into consideration when the pick a field.

I'm heartened that more and more EM docs are choosing FIRE and fellowships like Pain and HPM and leaving what's becoming an unbearably abusive and increasingly underpaid field. Things will only get better if we talk with our feet, and while I know it's disheartening to have put so much time into an often unsustainable career, facing reality gives us choices and more control and power to change things.

What is the underlying cause of ED docs getting underpaid? Oversupply? Corporate takeover?
 

miacomet

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Yea and you have to look at the value of the total compensation package. For instance, an attending at Cornell / Columbia probably gets 40-50K year in extra benefits, maybe more.

As an aside, I just can't imagine working for $100/hr!!!! Or less? For real making $80/hr and you are making key decisions like starting people on anti-coagulation, sending home syncope, possibly discharging the weak 80 yr old with a normal workup?

Honestly, I'm torn on the value of benefits. Sure, they probably get a 401k match and health insurance, but I think the value is WAY oversold. I'd rather be able to donate 54k a year to a solo 401k than be limited to 18.5k and a paltry match, and you can really deduct a ton more as a self-employed doc. Taxes as an employed doc are ridiculously high.

The main reason for poor pay is we don't own the means of production- we are employed, for the most part, and we are dependent on hospitals to have a job, even if we are in a SDG. They control the market. Additionally, midlevels have largely (and unsafely) taken over much of field. And we don't have a union.
 
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Brigade4Radiant

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Honestly, I'm torn on the value of benefits. Sure, they probably get a 401k match and health insurance, but I think the value is WAY oversold. I'd rather be able to donate 54k a year to a solo 401k than be limited to 18.5k and a paltry match, and you can really deduct a ton more as a self-employed doc. Taxes as an employed doc are ridiculously high.

The main reason for poor pay is we don't own the means of production- we are employed, for the most part, and we are dependent on hospitals to have a job, even if we are in a SDG. They control the market. Additionally, midlevels have largely (and unsafely) taken over much of field. And we don't have a union.

Yeah plus that 401k is tax deductible so free money. Also health insurance is tax deductible and with higher hourly you can work less. CME tax deductible. Paid vacations as an employee are already built into your hourly rate so you are paying for it.
 
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Side Hustle Scrubs

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Yeah plus that 401k is tax deductible so free money. Also health insurance is tax deductible and with higher hourly you can work less. CME tax deductible. Paid vacations as an employee are already built into your hourly rate so you are paying for it.

Don't underestimate the value of tax free benefits. Here are some of my benefits that cut tens of thousands of dollars off my tax bill:

401k / Profit Sharing $55,000
Cash balance plan $50,000
Health and Dental insurance - $15,983
Malpractice Insurance - $25,750
Disability and Long Term Care insurance - $11,076
Life insurance - $1,025
Health Savings Account $6,900
CME $10,000
Computer / Technology fund - $5,000
Reimbursement for cell phone / internet ~ $2,500

Total benefits = $183,234

I worked 1803 hours last year. The value of those benefits works out to $101/hour. If I had just been paid straight cash with no benefits my hourly rate would have been higher, but I also would have paid an additional $64,131 in federal taxes and $12,826 in state taxes.

When it comes to full time jobs, don't let the dollar signs fool you. There's no prize for the person who pays the most taxes.

As far as side hustles like chart reviews, the hourly rate is all that matters. You can make $110 - $150 an hour working from home doing all sorts of things. The companies I work for are trying to justify inpatient admissions. My job is to review a 100 page chart and sum it up into 3 paragraphs about why the doctor thinks the patient needs to be in the hospital. I don't think I would enjoy a job where I was trying to deny claims and screw over patients and doctors.
 
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Brigade4Radiant

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How is profit sharing tax free money? Doesn't that money get taxed when you start taking it out at some point?

This is correct but you have compound interest on your side also HSA are tax free in retirement
 

hundreddaysoff

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How is profit sharing tax free money? Doesn't that money get taxed when you start taking it out at some point?

Yes it does get taxed, along w/ the CBP, but it's tax-free now (or technically it's tax-deferred). This means you are earning extra little dollars now, some of which you will get to keep at time of withdrawal, with that ~33% of your gross pay versus just immediately losing that 33% to the government if you paid it in tax. You will probably still come out ahead vs just taking the tax hit now even if your withdrawal tax bracket is the same as your current income bracket. A bird in the hand and all that.
 

EctopicFetus

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And $60 an hour is less than regular RNs in many parts of the country. Insane.

I get that people have put a ton of time into training for EM, and it's certainly a noble career. But doctors don't deserve to be abused or underpaid, no matter how we are beaten down in training, and more and more I find EM to be a pretty universally abusive (and dangerous) field. My hope is that medical students get a more realistic understanding of EM and what it means to go into a field with a very short average career, and that they take that knowledge into consideration when the pick a field.

I'm heartened that more and more EM docs are choosing FIRE and fellowships like Pain and HPM and leaving what's becoming an unbearably abusive and increasingly underpaid field. Things will only get better if we talk with our feet, and while I know it's disheartening to have put so much time into an often unsustainable career, facing reality gives us choices and more control and power to change things.
With the CMGs taking over you are only worth what you negotiate and are willing to show up for. If you work for a CMG thats reality. All the other crap doesnt matter. Why post residency have I never worked for a CMG for under 275? Cause I never had to. Why did I turn down 325/hr from a CMG cause I could.

Why dont i feel I am abused? Cause I own my share of my SDG and serve in a leadership position. Is it all sunshine and roses? No. But EM is great if you find a great job in a great city. I like my job, I am paid fairly and I live in a city I enjoy which is one of the fastest growing cities in the US (cause it kicks ass).

I like my colleagues. We just played poker earlier this week. I could go on... but if you work for the CMGs at their base rate you are being clowned by the regional VPs while they pet you on the head and tell you what a great job you are doing.

As you said, I love the FIRE principle. I am a fatFIRE type though. One of the advantages of a great job is getting a "cash balance" or DB plan. Allows you to put even more away in retirement. I also save post tax. Im FI now and fatFI in 5-7 years. Ill retire when the job sucks or I am 55+. I can work 2 days a week at my current job and then take vacation on top of that which would get me to 700 hours a year. Simple..
 
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EctopicFetus

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Don't underestimate the value of tax free benefits. Here are some of my benefits that cut tens of thousands of dollars off my tax bill:

401k / Profit Sharing $55,000
Cash balance plan $50,000
Health and Dental insurance - $15,983
Malpractice Insurance - $25,750
Disability and Long Term Care insurance - $11,076
Life insurance - $1,025
Health Savings Account $6,900
CME $10,000
Computer / Technology fund - $5,000
Reimbursement for cell phone / internet ~ $2,500

Total benefits = $183,234

I worked 1803 hours last year. The value of those benefits works out to $101/hour. If I had just been paid straight cash with no benefits my hourly rate would have been higher, but I also would have paid an additional $64,131 in federal taxes and $12,826 in state taxes.

When it comes to full time jobs, don't let the dollar signs fool you. There's no prize for the person who pays the most taxes.

As far as side hustles like chart reviews, the hourly rate is all that matters. You can make $110 - $150 an hour working from home doing all sorts of things. The companies I work for are trying to justify inpatient admissions. My job is to review a 100 page chart and sum it up into 3 paragraphs about why the doctor thinks the patient needs to be in the hospital. I don't think I would enjoy a job where I was trying to deny claims and screw over patients and doctors.
Everyone deducts Med mal. So throw that out. Who contributes your money? Do you work for an SDG, CMG or hospital.

I think your numbers are skewed. I assume your employer (unless you are an owner) isnt contributing all that for you. At least not in EM. Med mal/401k and PSP are all tax deductible. I agree they all throw in your earnings but your tax deductions there are overblown.
 

EctopicFetus

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This is correct but you have compound interest on your side also HSA are tax free in retirement
Not quite.

The HSA you can put the money in tax free, it can grow tax free and if you pull it out to pay health expenses it is tax free. If at retirement age you take it out and use it like a 401k then it gets taxed like a 401k. Not tax free.. tax deferred.
 

miacomet

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With the CMGs taking over you are only worth what you negotiate and are willing to show up for. If you work for a CMG thats reality. All the other crap doesnt matter. Why post residency have I never worked for a CMG for under 275? Cause I never had to. Why did I turn down 325/hr from a CMG cause I could.

Why dont i feel I am abused? Cause I own my share of my SDG and serve in a leadership position. Is it all sunshine and roses? No. But EM is great if you find a great job in a great city. I like my job, I am paid fairly and I live in a city I enjoy which is one of the fastest growing cities in the US (cause it kicks ass).

I like my colleagues. We just played poker earlier this week. I could go on... but if you work for the CMGs at their base rate you are being clowned by the regional VPs while they pet you on the head and tell you what a great job you are doing.

As you said, I love the FIRE principle. I am a fatFIRE type though. One of the advantages of a great job is getting a "cash balance" or DB plan. Allows you to put even more away in retirement. I also save post tax. Im FI now and fatFI in 5-7 years. Ill retire when the job sucks or I am 55+. I can work 2 days a week at my current job and then take vacation on top of that which would get me to 700 hours a year. Simple..

EF is giving a master class in how to make EM work for YOU!

EM is very tough if you are geographically limited- my guess is EF, while happy with where he is, doesn't live in New York or Denver, so caveat emptor.
 

EctopicFetus

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Dude. I lived in NY. No thanks.. I lived in AZ. Denver is great but not my cup of tea. I could have worked in Bend but turned that down. (great group and great people and a great job). I agree you cant have your cake and eat it too. I wish it were different. I spoke with an ACEP board member today to express my disgust with ACEP and why EM is getting ruined. I really wish people would get a group of good docs (not just your buds) and push for good contracts. You have something to offer they dont. You will be committed. You will attend meetings, you will be active on the med staff and make the hospital better, the ED better and provide better care and service than some non clinical suits who fly first class but cant take care of a patient. Thats you Jaquis you jaq-ass.
 
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miacomet

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Dude. I lived in NY. No thanks.. I lived in AZ. Denver is great but not my cup of tea. I could have worked in Bend but turned that down. (great group and great people and a great job). I agree you cant have your cake and eat it too. I wish it were different. I spoke with an ACEP board member today to express my disgust with ACEP and why EM is getting ruined. I really wish people would get a group of good docs (not just your buds) and push for good contracts. You have something to offer they dont. You will be committed. You will attend meetings, you will be active on the med staff and make the hospital better, the ED better and provide better care and service than some non clinical suits who fly first class but cant take care of a patient. Thats you Jaquis you jaq-ass.

Exactly.

EM is unforgiving geographically, insanely so. Good for you for finding a great gig (as long as it lasts) and for saying no to things that aren't worth it.
 

bravotwozero

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    Not quite.

    The HSA you can put the money in tax free, it can grow tax free and if you pull it out to pay health expenses it is tax free. If at retirement age you take it out and use it like a 401k then it gets taxed like a 401k. Not tax free.. tax deferred.


    ...unless you pay out of pocket for your medical expenses WITHOUT taking money out of the HSA, keep the receipts, and claim the money later when you're retired, which will be tax free. This is commonly known as the 'stealth IRA'.
     
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    migm

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    Don't underestimate the value of tax free benefits. Here are some of my benefits that cut tens of thousands of dollars off my tax bill:

    401k / Profit Sharing $55,000
    Cash balance plan $50,000
    Health and Dental insurance - $15,983
    Malpractice Insurance - $25,750
    Disability and Long Term Care insurance - $11,076
    Life insurance - $1,025
    Health Savings Account $6,900
    CME $10,000
    Computer / Technology fund - $5,000
    Reimbursement for cell phone / internet ~ $2,500

    Total benefits = $183,234

    I worked 1803 hours last year. The value of those benefits works out to $101/hour. If I had just been paid straight cash with no benefits my hourly rate would have been higher, but I also would have paid an additional $64,131 in federal taxes and $12,826 in state taxes.

    When it comes to full time jobs, don't let the dollar signs fool you. There's no prize for the person who pays the most taxes.

    As far as side hustles like chart reviews, the hourly rate is all that matters. You can make $110 - $150 an hour working from home doing all sorts of things. The companies I work for are trying to justify inpatient admissions. My job is to review a 100 page chart and sum it up into 3 paragraphs about why the doctor thinks the patient needs to be in the hospital. I don't think I would enjoy a job where I was trying to deny claims and screw over patients and doctors.

    I ask because I never got taught any of this stuff and I think I am underutilizing the tax-avoidant techniques (due to lack of understanding) you employ. How do I learn how to do this well?
     

    thegenius

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    Don't underestimate the value of tax free benefits. Here are some of my benefits that cut tens of thousands of dollars off my tax bill:

    401k / Profit Sharing $55,000
    Cash balance plan $50,000
    Health and Dental insurance - $15,983
    Malpractice Insurance - $25,750
    Disability and Long Term Care insurance - $11,076
    Life insurance - $1,025
    Health Savings Account $6,900
    CME $10,000
    Computer / Technology fund - $5,000
    Reimbursement for cell phone / internet ~ $2,500

    Total benefits = $183,234

    I worked 1803 hours last year. The value of those benefits works out to $101/hour. If I had just been paid straight cash with no benefits my hourly rate would have been higher, but I also would have paid an additional $64,131 in federal taxes and $12,826 in state taxes.

    When it comes to full time jobs, don't let the dollar signs fool you. There's no prize for the person who pays the most taxes.

    As far as side hustles like chart reviews, the hourly rate is all that matters. You can make $110 - $150 an hour working from home doing all sorts of things. The companies I work for are trying to justify inpatient admissions. My job is to review a 100 page chart and sum it up into 3 paragraphs about why the doctor thinks the patient needs to be in the hospital. I don't think I would enjoy a job where I was trying to deny claims and screw over patients and doctors.

    Some of this seems real dodgy. Malpractice? You (I presume you are an ER doc?) pay for it out of your own paycheck? All forms of insurance (life, disablitity and long term care) you deduct as well? You spending all of the CME you get on CME? Or pocketing some of it? Is a cash balance plan a defined benefits plan?

    I don't mean to be critical but some of that above seems dodgy.
     
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    EctopicFetus

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    ...unless you pay out of pocket for your medical expenses WITHOUT taking money out of the HSA, keep the receipts, and claim the money later when you're retired, which will be tax free. This is commonly known as the 'stealth IRA'.
    This is exactly what I do. That being said technically you are pulling it out vs your expenses. My HSA is invested in an HSA account at TD ameritrade.
     
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    EctopicFetus

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    Some of this seems real dodgy. Malpractice? You (I presume you are an ER doc?) pay for it out of your own paycheck? All forms of insurance (life, disablitity and long term care) you deduct as well? You spending all of the CME you get on CME? Or pocketing some of it? Is a cash balance plan a defined benefits plan?

    I don't mean to be critical but some of that above seems dodgy.
    I am not the person who posted above but yes you can do all that. It typically requires you be an owner in an SDG and that SDG has to have good finances and structure.

    A cash balance plan is equivalent to a defined benefit plan. Your max is based on age. It has its downsides but overall is a great tool. If you are a 1099 you can set up a DB plan as well but unless you put a lot away it can be cost prohibitive.

    CME is a legit expense though depending on your setup if you dont use it you lose it (or at a minimum have to pay tax on it).

    All of those expenses are legit but claiming you save money on taxes on Med Mal is not legit. NO one pays taxes on that.

    Also, as mentioned above writing off your disability is not without risks (aka if you get disabled your benefit is taxed). MOst people would tell you that it is not worth the risk of doing that.
     
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    I guess it depends on your goals and what you are willing to put up with. Personally, I don't think the risk of EM (violence, needle sticks, medmal) is worth it for a midlevel salary- I'd do something lower risk that pays a similar hourly, such as telehealth or UC, or I'd do locums. So for me, it would be useful as the cost-benefit analysis of $125 or $144 for clinical EM falls squarely on the cost side for me. Obviously, others may have different goals and may think differently.

    I would also argue it's not just supply and demand. The jobs in NY NEVER get filled because they can't hire folks for such a rate, but they won't raise salaries and prefer to be understaffed and/or make their docs work more. It's useful info beyond a supply-demand issue if a facility has 12 open positions and never raises their salaries, but instead staffs up with locums.

    EM is not always an efficient market.

    I agree with most of what you are saying. I absolutely get that there may be jobs that are just not worth the pay. What I was trying to get across is that it's probably not helpful to just have a thread where a specific job is mentioned as paying too low if its actually typical for that locale. Not because that makes it more acceptable, but because it means the entire locale may be unacceptable.
     
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    miacomet

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    I agree with most of what you are saying. I absolutely get that there may be jobs that are just not worth the pay. What I was trying to get across is that it's probably not helpful to just have a thread where a specific job is mentioned as paying too low if its actually typical for that locale. Not because that makes it more acceptable, but because it means the entire locale may be unacceptable.

    Agreed that there are entire locales that are unacceptable (hello there, Denver), but ED docs may still want to live in those areas, so knowing the general salaries and what the job is like is pretty useful info. Docs can then decide to do telehealth/locums/consulting and not waste their time looking for nonsense jobs.

    I was considering a move last year, and locals kept telling me "salaries have increased" and "X hospital is really looking," but it turned out that these were delusional or misinformed docs, and I wouldn't have wasted my time interviewing for ridiculous positions if I'd had a nice board like this telling me in no uncertain terms that it wasn't worth my time. Especially since job search expenses are much less deductible than in years past!
     
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    thegenius

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    Why is there even one ER doctor working in greater Denver with average pay $125/hr? Is Denver really that desirable? Just so shocking. I feel like an idiot working in Northern CA where we make double that, and I can't even buy a house and taxes are sky high.

    Maybe the finances end up working out that way, or the ER doc is single or something. Obviously those ER's are staffed.

    Job 1: $125/hr for 11 months, 120 hrs a month = $165,000
    Job 2: $250/hr for 9 months, 120 hrs a month = $270,000

    Job 1 is like Denver.
    Job 2 is like most places. You can work Job 2, rent a condo for three months in the winter in greater Denver and ski continuously!
     
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    JAFERD_MD

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    Got y'all beat. Got a locums email for $90/hr in the Virgin Islands. At least they'll pay for lodging and travel.
     
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    GeneralVeers

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    Why is there even one ER doctor working in greater Denver with average pay $125/hr? Is Denver really that desirable? Just so shocking. I feel like an idiot working in Northern CA where we make double that, and I can't even buy a house and taxes are sky high.

    There are doctors for whom location and lifestyle are more important than any other factor. They would rather go skiing every weekend and do other hipster outdoorsy things, while accepting greatly reduced pay. This also explains SFO, San Diego, and Austin, TX.
     
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    thegenius

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    There are doctors for whom location and lifestyle are more important than any other factor. They would rather go skiing every weekend and do other hipster outdoorsy things, while accepting greatly reduced pay. This also explains SFO, San Diego, and Austin, TX.

    I know....I asked a rhetorical question....obviously those ERs are staffed so people do work there. I even mentioned there are probably lots of people who think I'm an idiot for working in Northern CA.
     

    miacomet

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    Haha I got the same thing a few days ago. What a joke!

    So, I actually know someone who did locums in the USVI years ago. He thought it would be hot girls with ankle sprains. Not so much. It's a poor, medically underserved area with REALLY sick people, and he also had to be, yup, some sort of quasi medical examiner and go to crime scenes. Said it was insane, but interesting, and no liability but sick, sick people.
     

    EctopicFetus

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    So, I actually know someone who did locums in the USVI years ago. He thought it would be hot girls with ankle sprains. Not so much. It's a poor, medically underserved area with REALLY sick people, and he also had to be, yup, some sort of quasi medical examiner and go to crime scenes. Said it was insane, but interesting, and no liability but sick, sick people.
    I’m not interested in any of that for $90/hr.
     
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    AlmostAnMD

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    I’m not interested in any of that for $90/hr.

    I'm not interested in that for any $/hr. There are some things more important to me in life than being a medical examiner
     
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    fahimaz7

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    Centura signed a company-wide agreement with USACS to staff ALL of their ED's. They have come in and taken over multiple ED's across the state, with no buy out options offered to the current groups. Simply a "join us or find a different job" approach. This is how they have reduced payments by 50%-100% from these facilities and are currently getting away with the $125/hour staffing model for hundreds of thousands of patient encounters a year. They are the largest hospital group in the state and now there is no competition for the contract. Good news is that USAC's parent company has $400 billion in assets and is also taking over other fields of medicine.

    :(
     

    EctopicFetus

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    Centura signed a company-wide agreement with USACS to staff ALL of their ED's. They have come in and taken over multiple ED's across the state, with no buy out options offered to the current groups. Simply a "join us or find a different job" approach. This is how they have reduced payments by 50%-100% from these facilities and are currently getting away with the $125/hour staffing model for hundreds of thousands of patient encounters a year. They are the largest hospital group in the state and now there is no competition for the contract. Good news is that USAC's parent company has $400 billion in assets and is also taking over other fields of medicine.

    :(
    Issue is that docs will eat a poop burger to live there. Organized groups can make it very bad for the hospital and usacs. See summa health. Docs got screwed but jacked the system so bad they lost a residency and the c suite goons lost their jobs. That’s a warning sign for other c suite types. Have to plan ahead and stay united.
     
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    Dr.CCM

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    Centura signed a company-wide agreement with USACS to staff ALL of their ED's. They have come in and taken over multiple ED's across the state, with no buy out options offered to the current groups. Simply a "join us or find a different job" approach. This is how they have reduced payments by 50%-100% from these facilities and are currently getting away with the $125/hour staffing model for hundreds of thousands of patient encounters a year. They are the largest hospital group in the state and now there is no competition for the contract. Good news is that USAC's parent company has $400 billion in assets and is also taking over other fields of medicine.

    :(


    Wow. Is this in Denver? Thats terrible.
     

    shrine78

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    As far as side hustles like chart reviews, the hourly rate is all that matters. You can make $110 - $150 an hour working from home doing all sorts of things. The companies I work for are trying to justify inpatient admissions. My job is to review a 100 page chart and sum it up into 3 paragraphs about why the doctor thinks the patient needs to be in the hospital. I don't think I would enjoy a job where I was trying to deny claims and screw over patients and doctors.[/QUOTE]


    I'm looking for these type of opportunities. Could you PM me?
     
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    doctalaughs

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    That sux. It’s really not market supply and demand either. As great as colorado is, I have a friend who works in Denver in a much lower risk 9-5 M-F type specialty for $300/hr. So it must really be these mega corporations artificially deflating pay.
     
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    GTP

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    Don't underestimate the value of tax free benefits. Here are some of my benefits that cut tens of thousands of dollars off my tax bill:

    401k / Profit Sharing $55,000
    Cash balance plan $50,000
    Health and Dental insurance - $15,983
    Malpractice Insurance - $25,750
    Disability and Long Term Care insurance - $11,076
    Life insurance - $1,025
    Health Savings Account $6,900
    CME $10,000
    Computer / Technology fund - $5,000
    Reimbursement for cell phone / internet ~ $2,500

    Total benefits = $183,234

    I worked 1803 hours last year. The value of those benefits works out to $101/hour. If I had just been paid straight cash with no benefits my hourly rate would have been higher, but I also would have paid an additional $64,131 in federal taxes and $12,826 in state taxes.

    When it comes to full time jobs, don't let the dollar signs fool you. There's no prize for the person who pays the most taxes.

    As far as side hustles like chart reviews, the hourly rate is all that matters. You can make $110 - $150 an hour working from home doing all sorts of things. The companies I work for are trying to justify inpatient admissions. My job is to review a 100 page chart and sum it up into 3 paragraphs about why the doctor thinks the patient needs to be in the hospital. I don't think I would enjoy a job where I was trying to deny claims and screw over patients and doctors.
    I’m also interested in these chart review things. Can you send me a pm?
     
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