New Type of Inpatient EM?

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Porfirio

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I am getting more and more of these emails about job opportunities: EM physician at critical access hospital (6-10 bed ER) and requirement to see the 10-15 inpatient census with an inpatient APP (in the morning). Is this a growing trend?

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the last gig i heard of like that was offering a whopping $90/hr for 48 hour shifts. Yes, you heard that right folks. Get trapped in a hospital for TWO FRIGGIN DAYS, round like an IM attending, and work in the ED for $90/hr.
 
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the last gig i heard of like that was offering a whopping $90/hr for 48 hour shifts. Yes, you heard that right folks. Get trapped in a hospital for TWO FRIGGIN DAYS, round like an IM attending, and work in the ED for $90/hr.

That's midlevel pay. No thanks.
Plumbers get >$150/hour.
 
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the last gig i heard of like that was offering a whopping $90/hr for 48 hour shifts. Yes, you heard that right folks. Get trapped in a hospital for TWO FRIGGIN DAYS, round like an IM attending, and work in the ED for $90/hr.
Admin: “that’s fair market value, nothing we can do.”
 
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Do they pay me EM pay + Hospitalist pay?

Why would anyone take a job like that unless they are a resident?

I remember being a mac daddy as a resident making $50/hr seeing 6-7pts/24hrs AND Did not have any inpatient duties.

$50/hr 20 yrs ago would be similar to $90/hr today as a resident sleeping most of the time.
 
That's midlevel pay. No thanks.
Plumbers get >$150/hour.

There is no plumber that is earning $150/hour.

They may bill $150/hour, but keep in mind this hypothetical position is also likely billing > $500/hour.

Apples and oranges.

Plumbers in the United States earn about $20/hour.
 
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There is no plumber that is earning $150/hour.

They may bill $150/hour, but keep in mind this hypothetical position is also likely billing > $500/hour.

Apples and oranges.

Plumbers in the United States earn about $20/hour.

Wait, you don't pay your plumber bill in full?
 
But SDN says plumbers all make six figs!
 
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the last gig i heard of like that was offering a whopping $90/hr for 48 hour shifts. Yes, you heard that right folks. Get trapped in a hospital for TWO FRIGGIN DAYS, round like an IM attending, and work in the ED for $90/hr.

I could see the draw of this if you were, say, an IM or FM person who was more looking to do some ED work.

Let’s say you live in a saturated major metro market where no ones hiring a non-ABEM doc. You could commute in-commute out for one 48 hr run per week and take home about as much as the PCPs and Urgent Care docs take home working full time in some of the major cities.

$90x48h =$4320/shift

$4320 x 4 shifts/month x 12 months = $207,000/year
 
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I could see the draw of this if you were, say, an IM or FM person who was more looking to do some ED work.

Let’s say you live in a saturated major metro market where no ones hiring a non-ABEM doc. You could commute in-commute out for one 48 hr run per week and take home about as much as the PCPs and Urgent Care docs take home working full time in some of the major cities.

$90x48h =$4320/shift

$4320 x 4 shifts/month x 12 months = $207,000/year
I know you're trying to look on the bright side, but even for an IM/FM doc in the circumstances you're describing, I would imagine that this sounds exceptionally unpalatable.
 
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Wait, you don't pay your plumber bill in full?

I don't. See, as the payer, I'm automatically the expert on how much things should cost. So, after my plumber is done with everything, I will determine how much it should have actually cost. I put all the plumbing problems into certain groups such as "sinks", "toilets". It does not matter how complex my toilet problem is, I will give them my toilet payment. If they have a problem with it, they can go through my mediator.
 
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I could see the draw of this if you were, say, an IM or FM person who was more looking to do some ED work.

Let’s say you live in a saturated major metro market where no ones hiring a non-ABEM doc. You could commute in-commute out for one 48 hr run per week and take home about as much as the PCPs and Urgent Care docs take home working full time in some of the major cities.

$90x48h =$4320/shift

$4320 x 4 shifts/month x 12 months = $207,000/year

200k for 40h/wk is a terrible deal
 
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200k for 40h/wk is a terrible deal
That's median-ish starting for FM/IM/Peds.

Plus this has the advantage of only working 2 days. Now admittedly its a literal 2 days, but if its not always that busy and allows for some sleep its not a bad deal for us PCP types.
 
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I don't. See, as the payer, I'm automatically the expert on how much things should cost. So, after my plumber is done with everything, I will determine how much it should have actually cost. I put all the plumbing problems into certain groups such as "sinks", "toilets". It does not matter how complex my toilet problem is, I will give them my toilet payment. If they have a problem with it, they can go through my mediator.

That is a remarkably accurate summary of the way subcontractors are paid on building projects. Not to inject politics, but take a look at how Trump has historically paid his building subcontractors. (Or not paid.)
 
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That's median-ish starting for FM/IM/Peds.

Plus this has the advantage of only working 2 days. Now admittedly its a literal 2 days, but if its not always that busy and allows for some sleep its not a bad deal for us PCP types.
It’s a bad deal when you consider that you’re covering both an inpatient ward and an ED - that’s a lot of potential for **** to go left
 
It’s a bad deal when you consider that you’re covering both an inpatient ward and an ED - that’s a lot of potential for **** to go left
I guess. I figure this is going to be a super-rural place. Not too dissimilar to some of the folks here who have complained about being the only doctor in house overnight. And at $90-100/hour the volume has to be very low.
 
I moonlit at a place like this for a while. Maybe 10 pts a day in the ED and typical inpatient census was 0-2. I honestly didn't mind it, and it was nice to knock off 48 hrs in a row. Of course I was getting 250/hr for it (I think full timer rate was something like 160). The inpatient side really wasn't bad at all, since I just transferred anything more complicated than a minor copd or chf exacerbation.
 
IMG_20201027_193117.jpg
 
I know you're trying to look on the bright side, but even for an IM/FM doc in the circumstances you're describing, I would imagine that this sounds exceptionally unpalatable.

I run a little less crispy than the seasoned docs on here. I’m sure it’ll come with time.

For now I’m still stoked to be “raking it in” at $60k/year.
 
I run a little less crispy than the seasoned docs on here. I’m sure it’ll come with time.

For now I’m still stoked to be “raking it in” at $60k/year.

Understand how behind you are. You could have easily made $60k out of undergrad and had that compounding in IRAs/housing for the past half decade with raises to boot.

Now factor in student loans. Now factor in the fact that you should get compensated for highly skilled positions. Now factor in the fact that you should get compensated for all the risk this path entailed.

You aren’t raking it in. You are making $15/hr and you are behind.
 
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Understand how behind you are. You could have easily made $60k out of undergrad and had that compounding in IRAs/housing for the past half decade with raises to boot.

Now factor in student loans. Now factor in the fact that you should get compensated for highly skilled positions. Now factor in the fact that you should get compensated for all the risk this path entailed.

You aren’t raking it in. You are making $15/hr and you are behind.

Oh I’m well aware.

But hey, reality is relative, and this is pretty darn cool.
 
yeah, there's some problems with that article. For instance, UPS drivers have had to drive non air conditioned trucks in record heat. Not worth it. They also don't get the disposable income/capital we do as physicians, which can be used for investments.
 
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Also you can’t just work as much as you want UPS drivers can’t just decide to work 80 hour weeks
 
Do it all! EM, Hospitalist, OBGYN - the future of Emergency Medicine

Granted it is Indian Health.



I hope this message finds you well!

NES Healthcare is currently pursuing the contract for Crownpoint Healthcare Facility in Crownpoint, NM and is seeking Emergency Medicine Physicians to join us in the process.


Crownpoint Medical Facility is located in Crownpoint New Mexico which is 2 hours from Albuquerque New Mexico. The Crownpoint Health Care Facility serves a population of 20,000 Navajo people. The staff consists of primary care physicians, physician assistants, and nurse practitioners, at a 32 bed hospital. The daily inpatient load is nine; daily outpatient visits are 151; annual OB cases are 275.



DEADLINE TO APPLY: 11/11/2020

Facility Details:


    • 9 ED beds - 20 bed hospital
    • Annual ER volume of 8K-10K
    • First responders to codes
    • 12 hour Shifts (7am-7pm and 7pm to 7am)
    • Responsible for admissions between 7pm-7am
    • ED may be responsible for labor/delivery in emergent cases - ED has a dedicated room with Midwives on call
    • EMR System – RPMS
    • Imaging on site: x-ray, US, Mammography (imaging on call 24/7)
    • Transfers to Gallup Indian Medical Center, San Juan Regional Medical Center, University of New Mexico, Cibola General Hospital, Tsehootsooi Medical Center and Northern Navajo Medical Center
    • Rate: 250/hour all-inclusive
    • Housing near facility


Requirements:

  • BC or BE EM or FM, IM with at least 2 years EM experience
  • Able to work independently
  • Current unrestricted license in any state in the U.S.
  • BLS, ACLS, ATLS, PALS, (ALSO and NRP a plus)
Required Documents for submittal:

  • CV, License, DEA, Board Cert, BLS, ACLS, ATLS, PALS
 
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Do it all! EM, Hospitalist, OBGYN - the future of Emergency Medicine

Granted it is Indian Health.



I hope this message finds you well!

NES Healthcare is currently pursuing the contract for Crownpoint Healthcare Facility in Crownpoint, NM and is seeking Emergency Medicine Physicians to join us in the process.


Crownpoint Medical Facility is located in Crownpoint New Mexico which is 2 hours from Albuquerque New Mexico. The Crownpoint Health Care Facility serves a population of 20,000 Navajo people. The staff consists of primary care physicians, physician assistants, and nurse practitioners, at a 32 bed hospital. The daily inpatient load is nine; daily outpatient visits are 151; annual OB cases are 275.



DEADLINE TO APPLY: 11/11/2020

Facility Details:


    • 9 ED beds - 20 bed hospital
    • Annual ER volume of 8K-10K
    • First responders to codes
    • 12 hour Shifts (7am-7pm and 7pm to 7am)
    • Responsible for admissions between 7pm-7am
    • ED may be responsible for labor/delivery in emergent cases - ED has a dedicated room with Midwives on call
    • EMR System – RPMS
    • Imaging on site: x-ray, US, Mammography (imaging on call 24/7)
    • Transfers to Gallup Indian Medical Center, San Juan Regional Medical Center, University of New Mexico, Cibola General Hospital, Tsehootsooi Medical Center and Northern Navajo Medical Center
    • Rate: 250/hour all-inclusive
    • Housing near facility


Requirements:

  • BC or BE EM or FM, IM with at least 2 years EM experience
  • Able to work independently
  • Current unrestricted license in any state in the U.S.
  • BLS, ACLS, ATLS, PALS, (ALSO and NRP a plus)
Required Documents for submittal:

  • CV, License, DEA, Board Cert, BLS, ACLS, ATLS, PALS

I enjoy the fact that they have a "submission deadline" to create an artificial atmosphere of scarcity.
I also enjoy the fact that they are asking for BC EM docs and requiring them to have BLS, ACLS, ATLS, PALS.

Regarding the latter: it has always confused me that you are required to have BLS if you have ACLS. It also confuses me that there are still places which require BC EM docs to have any of these "credentials." It's literally akin to making a math professor take an annual test proving that they know long division and their times tables in order to be allowed to continue teaching linear algebra.
 
Do it all! EM, Hospitalist, OBGYN - the future of Emergency Medicine

Granted it is Indian Health.



I hope this message finds you well!

NES Healthcare is currently pursuing the contract for Crownpoint Healthcare Facility in Crownpoint, NM and is seeking Emergency Medicine Physicians to join us in the process.


Crownpoint Medical Facility is located in Crownpoint New Mexico which is 2 hours from Albuquerque New Mexico. The Crownpoint Health Care Facility serves a population of 20,000 Navajo people. The staff consists of primary care physicians, physician assistants, and nurse practitioners, at a 32 bed hospital. The daily inpatient load is nine; daily outpatient visits are 151; annual OB cases are 275.



DEADLINE TO APPLY: 11/11/2020

Facility Details:


    • 9 ED beds - 20 bed hospital
    • Annual ER volume of 8K-10K
    • First responders to codes
    • 12 hour Shifts (7am-7pm and 7pm to 7am)
    • Responsible for admissions between 7pm-7am
    • ED may be responsible for labor/delivery in emergent cases - ED has a dedicated room with Midwives on call
    • EMR System – RPMS
    • Imaging on site: x-ray, US, Mammography (imaging on call 24/7)
    • Transfers to Gallup Indian Medical Center, San Juan Regional Medical Center, University of New Mexico, Cibola General Hospital, Tsehootsooi Medical Center and Northern Navajo Medical Center
    • Rate: 250/hour all-inclusive
    • Housing near facility


Requirements:

  • BC or BE EM or FM, IM with at least 2 years EM experience
  • Able to work independently
  • Current unrestricted license in any state in the U.S.
  • BLS, ACLS, ATLS, PALS, (ALSO and NRP a plus)
Required Documents for submittal:

  • CV, License, DEA, Board Cert, BLS, ACLS, ATLS, PALS

noticed CT wasn’t mentioned...
 
I enjoy the fact that they have a "submission deadline" to create an artificial atmosphere of scarcity.
I also enjoy the fact that they are asking for BC EM docs and requiring them to have BLS, ACLS, ATLS, PALS.

Regarding the latter: it has always confused me that you are required to have BLS if you have ACLS. It also confuses me that there are still places which require BC EM docs to have any of these "credentials." It's literally akin to making a math professor take an annual test proving that they know long division and their times tables in order to be allowed to continue teaching linear algebra.

I don't think I've ever had a hospital not require ACLS etc.
noticed CT wasn’t mentioned...
But they have mammography :laugh:
Jesus christ, what a terrible place. You average nearly 1 delivery per day. In a state w/ ****ty malpractice. Good luck keeping your license after a couple of months.
 
I don't think I've ever had a hospital not require ACLS etc.

But they have mammography :laugh:
Jesus christ, what a terrible place. You average nearly 1 delivery per day. In a state w/ ****ty malpractice. Good luck keeping your license after a couple of months.
If it's on the res, they're covered under the FTCA. Any case is a federal case.
 
If it's on the res, they're covered under the FTCA. Any case is a federal case.

Correct. That is confirmed by the fact that you do not need to be licensed in NM.
 
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I saw that offer too. Hourly rate was 225/hour 'all inclusive' I emailed the recruiter asking what that means, received no response.
 
I don't think I've ever had a hospital not require ACLS etc.
Really? My main site as well as all of the moonlighting sites I've worked in the same general area all realize that requiring BC EM docs to have ACLS is pointless and haven't required it in years. They still obviously require it for IM/FM/whatever.
 
Really? My main site as well as all of the moonlighting sites I've worked in the same general area all realize that requiring BC EM docs to have ACLS is pointless and haven't required it in years. They still obviously require it for IM/FM/whatever.
Nice, that's encouraging. What area?

I saw that offer too. Hourly rate was 225/hour 'all inclusive' I emailed the recruiter asking what that means, received no response.

Means they don't pay extra for travel/lodging.
 
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There's still a ton of hospitals that require BLS, ACLS, PALS, ATLS merit badges, because it's written into their bylaws, and they're too stupid/lazy/arrogant to change it. On top of that, CMGs like Schumacher force you to have all of these if you want to work with them.
 
ATLS is my only problem. The other stuff you can pay for online.
 
I moonlit at a place like this for a while. Maybe 10 pts a day in the ED and typical inpatient census was 0-2. I honestly didn't mind it, and it was nice to knock off 48 hrs in a row. Of course I was getting 250/hr for it (I think full timer rate was something like 160). The inpatient side really wasn't bad at all, since I just transferred anything more complicated than a minor copd or chf exacerbation.

you were making 12k per 2 days of work?
 
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