PRN Critical care compensation

[IMGASMD]

Does anyone know if the hospital gets charged an increased amount if you tell the locums company you want a higher rate? Or do locums companies get a set rate and then its on you to negotiate up? I got one offer up from $225 to $250 but now I am wondering if I shouldn't push for more seeing that range.

Usually the locum company charge at least 30% more of whatever you’re getting.

So they’re probably getting at least 300/hr. That’s probably the minimum. But then you’d have to factor in your travel and malpractice.

After doing it for a while, the only thing I really care about is getting compensated correctly. Recruiters have to eat too, locum companies have to make a profit. So, if you really care about saving hospital any money, the only way is to negotiate with them directly....

BUT, here’s the big ass capped BUT, sometimes they don’t care. The money may come from different departments, or another funding “bucket.” They sometimes rather just deal directly with the locum company rather than you. So they may not even appreciate you “can” save them ~1G per shift.....

Just my two cents.

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[Airway]

Yes, I discovered this on my academic job w locums. My department didn't care about locums wasting money because it came from a different pool even though all the same... healthcare

 

[IMGASMD]

Yes, I discovered this on my academic job w locums. My department didn't care about locums wasting money because it came from a different pool even though all the same... healthcare

A lot of wasted money floating around. And sometimes it’s just sheer laziness. Or just “not my money”.

That money isnt coming to me anyway, and that attitude can be coming from AMC, health care system, or like @Airway said academic department.

That’s why I wholeheartedly believe that PP is/should be the most efficient way to run practices.

I cannot imagine any of my senior partners just throwing “their” money at a locum company, especially when they know every dollar saved, they can get 10-25c....

 

[zizzer]

I am not CC-fellowship trained, but I recently signed up for one that was $225/hr for an overnight weekend shift. It turns out they only needed to use me to do their procedures while they handled admits and nursing pages and all. This was in my own hospital (a tertiary academic center in a large city).

 

[psychbender]

I am not CC-fellowship trained, but I recently signed up for one that was $225/hr for an overnight weekend shift. It turns out they only needed to use me to do their procedures while they handled admits and nursing pages and all. This was in my own hospital (a tertiary academic center in a large city).

Now that is a sweet arrangement.

 

[ToKingdomCome]

Is it reasonable to manage a life of PP anesthesia and then locum ICU?

 

[MirrorTodd]

I am not CC-fellowship trained, but I recently signed up for one that was $225/hr for an overnight weekend shift. It turns out they only needed to use me to do their procedures while they handled admits and nursing pages and all. This was in my own hospital (a tertiary academic center in a large city).

What procedures were you doing? Intubations, central lines, art lines? Anything else?

 

[GassYous]

I am not CC-fellowship trained, but I recently signed up for one that was $225/hr for an overnight weekend shift. It turns out they only needed to use me to do their procedures while they handled admits and nursing pages and all. This was in my own hospital (a tertiary academic center in a large city).

That's what we were doing in nyc. Most of the procedures, none of the floor work.

 

[Airway]

That sounds fun. Except for Covid annoyance

 

[pgg]

I am not CC-fellowship trained, but I recently signed up for one that was $225/hr for an overnight weekend shift. It turns out they only needed to use me to do their procedures while they handled admits and nursing pages and all. This was in my own hospital (a tertiary academic center in a large city).

Now that is a sweet arrangement.

I don't know if I'd call spending a weekend night shift running from one COVID intubation or procedure to another, constantly donning & doffing PPE, to be "sweet" at $225/hr.

Sweeter than a furlough or layoff because the ORs aren't doing elective surgery, I guess. And sweeter than being forced into doing the job of an intensivist, and accepting the responsibility and liability of an intensivist, if one isn't actually an intensivist.

 

[IMGASMD]

I don't know if I'd call spending a weekend night shift running from one COVID intubation or procedure to another, constantly donning & doffing PPE, to be "sweet" at $225/hr.

Sweeter than a furlough or layoff because the ORs aren't doing elective surgery, I guess. And sweeter than being forced into doing the job of an intensivist, and accepting the responsibility and liability of an intensivist, if one isn't actually an intensivist.

Everyone’s definition of easy money is probably different.

I’ve been wearing n95, pretty much every time I step onto the hospital campus, some hospitals that I work at actually “let” people wearing the n100 (it’s a discussion for another day), in places other than OR. We also have all these “kits” made up. So donning and doffing isn’t that big of a deal.

Certainly it all depends on how many we do.... 2-5 per shift probably isn’t a big deal. But if you tell me every half hour like during the first wave in nyc, then fk no.

 

[pgg]

Everyone’s definition of easy money is probably different.

I’ve been wearing n95, pretty much every time I step onto the hospital campus, some hospitals that I work at actually “let” people wearing the n100 (it’s a discussion for another day), in places other than OR. We also have all these “kits” made up. So donning and doffing isn’t that big of a deal.

Certainly it all depends on how many we do.... 2-5 per shift probably isn’t a big deal. But if you tell me every half hour like during the first wave in nyc, then fk no.

Yeah that's the impression I got - that if they're hiring these procedure monkey positions it's probably because there are nonstop procedures to be done. Constant movement in a high risk environment.

 

[psychbender]

I don't know if I'd call spending a weekend night shift running from one COVID intubation or procedure to another, constantly donning & doffing PPE, to be "sweet" at $225/hr.

Sweeter than a furlough or layoff because the ORs aren't doing elective surgery, I guess. And sweeter than being forced into doing the job of an intensivist, and accepting the responsibility and liability of an intensivist, if one isn't actually an intensivist.

Part of the nature of this disease process is that patients tend to hang around for a long time, occupying space. This provides a limit, then, to how many procedures need doing, particularly at night. Even back in the high turnover, full unit days of fellowship, not a ton of procedures needed to be done by the various overnight ICU teams.

As it stands, I make less than $225/hr when I do my normal ICU shifts (rate negotiated when I joined the practice almost two years ago). Extra shifts I pick up are paid at my normal rate, so the above quoted gig is more money with less responsibility, thus a comparatively sweet deal. I actually tried to sell my ICU director on something like that, to decompress the current unit docs, and provide some work and income to my group, but we just don't have the need (only 90ish total Covid, 20-30 in the unit) to pay someone to be a tube/line monkey.

 

[pgg]

All in the details I guess. If looking for extra work (locums 1099 no benefits) I'd hesitate to take a higher risk constant-movement job like that, especially pre-vaccine. If it was doing that vs finding myself in a no-work/no-pay situation I'd probably take it and be grateful. If I was part of a group showing value to the hospital that we were contracted with, a different attitude.

 

[chocomorsel]

Is it reasonable to manage a life of PP anesthesia and then locum ICU?

Yeah. But you would need > 12 weeks off IMO because otherwise you would never have vacation.
And you would end up real rusty in the ICU if you are doing <1 week a month average.