Moonlighting

[heysexylady]

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Is this a good deal....$2000 a week phone coverage of psych ER in the Northeast.

 

[dl2dp2]

What does "phone coverage" mean? It's very unusual to have this for a psych ER...

 

[heysexylady]

What does "phone coverage" mean? It's very unusual to have this for a psych ER...

Not Psych ER but regular ER. Deciding if a patient should be admitted or not.

 

[hamstergang]

Is this a good deal....$2000 a week phone coverage of psych ER in the Northeast.

What hours would you have to be available? Who in the ER do you talk to? Do you ever have to go in?

How did you think we could answer without details?

 

[heysexylady]

What hours would you have to be available? Who in the ER do you talk to? Do you ever have to go in?

How did you think we could answer without details?

What hours would you have to be available? Who in the ER do you talk to? Do you ever have to go in?

How did you think we could answer without details?

?

Phone coverage only.... Will not be going in self there will be a mid-level at hospital that will be calling me. $1000 per day for 24 hour period on the weekend and 500 per evening for the weekday 5pm to 8 am. . They say the amount of calls in a night is variable and so they can't give an average.

 

[Dharma]

Is this a good deal....$2000 a week phone coverage of psych ER in the Northeast.

Is this via staffing Only? Tele? I'm not sure i would be comfortable staffing with a non-psych provider, unless I admit everyone/most patients.

 

[Ironspy]

?

Phone coverage only.... Will not be going in self there will be a mid-level at hospital that will be calling me. $1000 per day for 24 hour period on the weekend and 500 per evening for the weekday 5pm to 8 am. . They say the amount of calls in a night is variable and so they can't give an average.

Potentially horrible. They could call you constantly day and night. Also lots of liability. I'd want concrete guidelines in writing limiting the number of patients

 

[slappy]

?

Phone coverage only.... Will not be going in self there will be a mid-level at hospital that will be calling me. $1000 per day for 24 hour period on the weekend and 500 per evening for the weekday 5pm to 8 am. . They say the amount of calls in a night is variable and so they can't give an average.

Ask for a trimean then.

As pointed out above, liability could be the other biggest downside here.

 

[clausewitz2]

?

They say the amount of calls in a night is variable and so they can't give an average.

That...that's not how averages work.

 

[michaelrack]

?

Phone coverage only.... Will not be going in self there will be a mid-level at hospital that will be calling me. $1000 per day for 24 hour period on the weekend and 500 per evening for the weekday 5pm to 8 am. . They say the amount of calls in a night is variable and so they can't give an average.

so how many nights a week would you be doing it- if you were on call every week night and every weekend, that would be 234,000 per year.

 

[Nasrudin]

It's a terrible idea. But give them Nasrudin's number--867-5309. Seeing Psych ER patients without the smells. In my PJ's. Terrible.

 

[NickNaylor]

Is this a situation where an ER doc or some kind of midlevel is essentially consulting you for your input?

I agree with the above - seems like something that could either be a pretty sweet gig (if it’s a low-volume ED and they don’t see many psychiatric patients) or totally not worth it. $1000/24 hours is just less than $50/hour... not terrible but if you’re working much of that 24-hour period, that wouldn’t be worth it in my mind.

A guy in my program has a similar gig except he has a telepsychiatry setup and sees psychiatric patients that present to a local urgent care. For what it’s worth - as a basis of comparison - he gets paid something like $50-75/hour in addition to a set fee for each patient he sees. I don’t know what that fee is.

I would try and get an idea of 1) how many patients they expect to refer to/staff with you within a 24-hour period and 2) try and work in a per-patient fee, particularly if they expect to be referring a lot of patients to you.

And I agree about the concerns with liability. Malpractice would have to be included in your compensation with a gig like that in my mind since you’re essentially relying on second-hand information with no actual ability to assess patients yourself.

 

[J ROD]

Sounds like a bad idea to me. Too many uncertains for low money per hr.

 

[Shikima]

Don't sell yourself short. Whether you're waiting or seeing a patient, your time per hour is the same. And remember the economics of supply and demand.

 

[TexasPhysician]

Too low. I'd want a shift fee plus a patient fee.

 

[heysexylady]

Too low. I'd want a shift fee plus a patient fee.

Don't sell yourself short. Whether you're waiting or seeing a patient, your time per hour is the same. And remember the economics of supply and demand.

How much of a patient fee and shift fee should I ask for if I plan to only work one Saturday a month.

 

[Shikima]

How much of a patient fee and shift fee should I ask for if I plan to only work one Saturday a month.

I haven't any clue on this. I'm sorry, perhaps other can share their experiences.
Personally, I'd just ask for a flat rate like any other clinic.

 

[NickNaylor]

How much of a patient fee and shift fee should I ask for if I plan to only work one Saturday a month.

Think about how long you reasonably expect it would take you to perform whatever task it is your expected to perform. If it's a fairly straightforward "staff this case with me" request, my guess is that would likely take no more than 15-20 minutes, likely less, though, of course, some cases may take much longer. Assume you are working constantly, so that means you would staff 3-4 patients per hour. You know your base rate - $50/hour - so base your "per-head" fee on whatever you think is a reasonable hourly rate, again assuming you're working for an entire hour. Depending on where you are geographically and whatever "the market" is in the area around you, I don't think aiming for an overall rate of $100-150/hour is unreasonable. That's what I'm getting paid at my gig, and this is in a place that doesn't have an extreme shortage of psychiatrists. Most other gigs in this area pay in a similar range.

For what it's worth, a couple of co-residents were looking at a moonlighting gig for inpatient rounding over the weekend, and they were being offered $25/patient. That seems unreasonable to me since that includes 1) reviewing the patient's chart, 2) actually seeing the patient, and 3) writing documentation, all of which would likely take at least 15-20 minutes in a best-case scenario unless the case is super straightforward and/or your documentation is extremely brief. If a patient monopolizes your time and/or some kind of complication develops that you have to manage, poof, you're now getting paid $50/hour or less, which isn't worth it in my mind.

Ultimately I think you should assume the worst and negotiate your fee based on that. The other thing is that the worst that can happen is that they will say no and you'll be in the same position you started in. I agree with the above, don't undervalue yourself. If needed, perhaps change the per-hour/per-head fee around. The hospital isn't going to want to pay you all that much to simply be on-call and sit around, so offering to reduce your hourly rate in return for a reasonable per-head fee may be more likely to move the needle.

 

[michaelrack]

I don't think aiming for an overall rate of $100-150/hour is unreasonable. That's what I'm getting paid at my gig, and this is in a place that doesn't have an extreme shortage of psychiatrists. Most other gigs in this area pay in a similar range.
.

that would be a very low rate for a BC/BE psychiatrist, especially for weekend work

 

[NickNaylor]

that would be a very low rate for a BC/BE psychiatrist, especially for weekend work

You’re right - I didn’t look closely and was assuming the OP was a resident. The same principles apply, I think, though.

 

[hamstergang]

You’re right - I didn’t look closely and was assuming the OP was a resident. The same principles apply, I think, though.

Yeah, what difference would it make if OP were a resident or not? The work being done is the same and so the pay should be.

 

[NickNaylor]

Yeah, what difference would it make if OP were a resident or not? The work being done is the same and so the pay should be.

I suppose that’s true in theory. In practice (at least in my area), non-BC/BE moonlighters are paid significantly less. I do the exact same work as the BC/BE staff at my moonlighting gig but I get paid less. Being unable to bill for services for most third-party payers decreases your value a bit.

 

[Nasrudin]

In my area the moonlighting landscape seems to have changed a lot in the last 4-5 years such that opportunities are somewhat limited. I've found some despite this. 100/hr. But for short shifts. None of the 12-24 hour one-shot money making gigs that I was hoping for. I don't know where the strings are on this marionette but I suspect billing changes are the issue.