so lets talk locums

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Igor4sugry

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For those about to graduate this academic year job search is under way. I am engaged in trying to find 4mo locums position prior to moving to another part of the country. Locums seems convenient in that it can be short term. But then there is less flexibility in terms of not getting paid for days off/holidays/sick time (at least this is my understanding). I don't need to get my own health insurance. And I will by my own disability insurance.

Would appreciate input form those members who did locum jobs.
1. How to assess appropriateness of hourly payment?
--I'm currently converting this to yearly salary ( [$/hr x 40 hr/week x 52 work weeks in a year]) to see what that hourly amount ends up truly being.

2. What calculation to use to account for 1099 status and needing to pay your own taxes?

3. Any input on community mental health clinics?
--there is a position that offers $125/hr. But its for face-to-face time with patient. So if patient no-shows you don't get paid. And the clinic does have 1 in 5 no-show rate, although I was told you can pick up patients of other providers.
--is this arrangement typical (apparently they get paid by the state for face-to-face time).
--btw this clinic does not go through a locums company and hires directly.

4. Locums percs?
--do they cover cost of state license, DEA #? Cost of boards?
--which things are arrangeable?
 
1. People overestimate their salary when they do this. How many weeks vacation will you have? How many three day weekends? How many sick days? You are only paid the hours you work.

2. 1099 just means that you need to pay all your own taxes. They client will not withhold. It's handy because you can write off expenses very aggressively (board cert, DEA, etc). There are calculators online that suggest how much you will likely have to set aside for your taxes. I set aside about 35%, but have a lot of right-offs.

3. That is... Less than desirable. For locum gigs, you typically set a weekly or hourly rate (go for hourly). You provide the negotiated time and they pay you for that time. How they utilize your services is up to you.


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I haven't done locums, but I would be bothered by not getting paid for the no shows because that happens all too frequently in community MH, and you have no control over that. If you're putting aside your time to be there, I think it's reasonable to be paid for it -- no shows are the clinics inefficiency problem, not yours. $125/hour also seems a little low, especially with that stipulation about the no shows. Here, you can get $100/hour with benefits in community MH without negotiating. $125/hour accounting for not getting paid for holidays (including when the clinic is closed) or getting any vacation or other benefits seems a bit low.
 
$125 /hr wouldn't be bad for CMHC if you DID get paid for no shows (ie: Billing for 8 hours each day whether they fill them with patients or not). It still wouldn't be what I would consider "good," but it wouldn't be bad.

If you do the math (taxes/health insurance), and got paid for every hour (with or without patients) this would seem to equate to a $200k /yr job with no retirement benefits. Is this the going rate in the area that you're looking?

In your salary calculations, don't multiply by 52 (unless you plan to take no vacation). Most psychiatrists I know take about 4 weeks, so you may want to multiply by 48.
 
$125 is low, I've seen gigs for coverage for as much as $180/hr. There are desperate places which need help. Never short yourself and put yourself into a position where you won't be paid.
 
Igor4sugry said:
3. Any input on community mental health clinics?
--there is a position that offers $125/hr. But its for face-to-face time with patient. So if patient no-shows you don't get paid. And the clinic does have 1 in 5 no-show rate, although I was told you can pick up patients of other providers.
--is this arrangement typical (apparently they get paid by the state for face-to-face time).
--btw this clinic does not go through a locums company and hires directly.
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This sounds like a crap deal. One of our local clinics gets paid per patient visit, regardless of time or complexity. I heard it's more than $100 from the state per encounter and they push the NPs to see 4 per hour. If this clinic is anything like that you are getting taken advantage of.
 
nexus73 said:
This sounds like a crap deal. One of our local clinics gets paid per patient visit, regardless of time or complexity. I heard it's more than $100 from the state per encounter and they push the NPs to see 4 per hour. If this clinic is anything like that you are getting taken advantage of.
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Thanks. Looks more and more like being taken advantage of. There is plenty of clinical work when not seeing patients directly. Why not take this into account and appropriately compensate.
 
Hi
I think the going rate is 140 to 160 plus travel and lodging per hour through Locums.
I think calling the psychiatric service providers in your area is a good idea as the organization pays 200 per hour at least to the Locums company. They try to keep 20 to 25 percent cut.
 
Shikima said:
$125 is low, I've seen gigs for coverage for as much as $180/hr. There are desperate places which need help. Never short yourself and put yourself into a position where you won't be paid.
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and I've seen jobs for 215 an hour. But those are often terrible terrible jobs. 125/hr is actually not that low for locums if it is a reasonable job. Especially if it pays for travel. I agree about not putting yourself in a position where you won't get paid- That(and not the 125 an hour) is what makes that cmcc job so terrible. That cmhc and locums company is smoking dope if they think they can hire someone per hour and get out of paying them the full rate per hour if there are no shows.....craziest thing I've ever heard of. That's just absurd. What isn't absurd is a locums/contract job offering the provider a certain % of outpt collections(so obviously then no shows would hurt you)....but under NO CIRCUMSTANCES can a job try to pay you per hr, not give you any cut of the collections *AND* then dock you on that hrly rate for no shows. No way jose.
 
doctorpilgrim said:
Hi
I think the going rate is 140 to 160 plus travel and lodging per hour through Locums.
I think calling the psychiatric service providers in your area is a good idea as the organization pays 200 per hour at least to the Locums company. They try to keep 20 to 25 percent cut.
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depends on the setting. The going rate for locums is 140 to 160 hr f0r some settings...typically high volume inpatient or a job where you aren't guaranteed 8 hrs per day. I'm seeing a lot of inpatient and iop locums work offers where they are trying to pay per hour and say 'expect 4-5 hrs'.....those tend to pay pretty well per hr. But then of course the issue is who the hell wants to only bill the locums co for 4-5 hrs? Even if it pays 175 an hour if you only get 4 hrs to put on your sheet you only made 700 bucks that day.
There aren't a lot of reasonable outpt locums gigs that are going to guarantee 8 hrs and pay 150+.

One of the huge advantages of medicine locums work is that hospitalists are getting paid for 12 hrs...even if they don't work it. 12 hrs at 150 an hour is 1800 dollars......it's very hard to find psych locums work in any setting which will pay you for 12 hrs. I haven't been able to consistently at least.
 
Vistaril, I agree. But it is important that we help each other with correct perspective as job applicants without lack of information are taken advantage of. I am talking locum jobs that are not in metro area. Median salary for psychiatry is 250 k plus benefits. 250k/1800 hours is 138/hour.
 
doctorpilgrim said:
Vistaril, I agree. But it is important that we help each other with correct perspective as job applicants without lack of information are taken advantage of. I am talking locum jobs that are not in metro area. Median salary for psychiatry is 250 k plus benefits. 250k/1800 hours is 138/hour.
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no, thats not the median salary. The median salary according to the numbers is about 215 for full time work including all types.
 
vistaril said:
and I've seen jobs for 215 an hour. But those are often terrible terrible jobs. 125/hr is actually not that low for locums if it is a reasonable job.
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Oi. I'd caution folks reading this to realize that any information about salary is very location and locale dependent. I work part-time at a place that pays $218/hour and is a pretty sweet gig. This $218/hour is also paid to locums for full-time work.

When you're looking at pay for jobs, you need to compare like with like and look at what similar gigs are paying in that area.
vistaril said:
but under NO CIRCUMSTANCES can a job try to pay you per hr, not give you any cut of the collections *AND* then dock you on that hrly rate for no shows. No way jose.
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Amen to this.
 
notdeadyet said:
Oi. I'd caution folks reading this to realize that any information about salary is very location and locale dependent. I work part-time at a place that pays $218/hour and is a pretty sweet gig. This $218/hour is also paid to locums for full-time work.
.
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of course....some jobs pay much more than average and median salaries and some jobs pay less. Thats why they are called average and median salaries.
 
vistaril said:
of course....some jobs pay much more than average and median salaries and some jobs pay less. Thats why they are called average and median salaries.
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Yes, but you tend to make definitive statements about salaries being good or bad without recognizing that it's very dependent on locale. What is good pay in your neck of the woods may be lousy pay in mine.

Quoting average and median salaries nationally makes very little sense. When you switch locations from A to B you may take a 30% pay cut and still be earning average/median in both locations.
 
notdeadyet said:
Yes, but you tend to make definitive statements about salaries being good or bad without recognizing that it's very dependent on locale. What is good pay in your neck of the woods may be lousy pay in mine.

Quoting average and median salaries nationally makes very little sense. When you switch locations from A to B you may take a 30% pay cut and still be earning average/median in both locations.
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I've been speaking about just how important location is very frequently the last month, so not sure where you get that from. I'll also add that it often isn't so much a national/region thing but simply your earning opportunities being so heavily dependent on how the local hospital systems work(like who owns the contracts and how they work). One practice area can have quite poor opportunities for new grads and then an area just 100 miles away can have great opportunities....obviously they are both in the same region.
 
There was another thread about locum relatively recently. I found this article and it seemed useful.

As for dipping into the calculation side:

1099 income means you're paying the full 15.3% on FICA plus state/federal income tax.

You need to figure out how much benefits are worth at most places. Between direct benefits and income-matching, let's go for 45k, although that may be high (basing it off of benefits listed for school of med professors in my home state.)

Then compare to salaried jobs that you would consider. If they tend to pay 200k, for example, then you want your locum rate to work out to at least 200k + (~7% FICA) + (45k Benefits) = 260k / (48 wk x 40 hr) = at least $135/hr.

OTOH, (according to the article I linked), a lot of locum jobs will cover travel and lodging, if you work things out properly. Keep in mind that locum can involve a lot of turnover, state license fees, potential financial downtime between jobs, etc. Those things should also factor into your costs / benefits.
 
vistaril said:
no, thats not the median salary. The median salary according to the numbers is about 215 for full time work including all types.
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I'm not sure where vistaril is getting the numbers, but here are some numbers from MGMA 2105 for the 2014 year.

All areas Mean: 264K
Eastern Mean: 230K
Midwest Mean:271K
Southwest Mean: 267K
West mean: 285K

Psych is very valuable, and I would definitely make sure you are aware of this. Obviously for many academic centers, its much lower, but generally, you can really squeeze out pretty good income. If I were you, I would buy the MGMA book($700), and calculate if you are getting paid below a certain percentile, say below 50th, and then request an increase in your salary using that book as one of your sources. Happens all the time.
 
I've been noticing that many places seem to be offering locums rates that actually pay less than the agency actually will pay its own employees. I don't quite get that, but it is what it is.
 
Igor4sugry said:
For those about to graduate this academic year job search is under way. I am engaged in trying to find 4mo locums position prior to moving to another part of the country. Locums seems convenient in that it can be short term. But then there is less flexibility in terms of not getting paid for days off/holidays/sick time (at least this is my understanding). I don't need to get my own health insurance. And I will by my own disability insurance.
Click to expand...
I'm currently doing locums. I'm on my 3rd assignment since August. It would be a great way to just make some money for 4 months while you're waiting for a permanent job to start, if that's what you're getting at.

Would appreciate input form those members who did locum jobs.
1. How to assess appropriateness of hourly payment?
--I'm currently converting this to yearly salary ( [$/hr x 40 hr/week x 52 work weeks in a year]) to see what that hourly amount ends up truly being.
Click to expand...
I would call multiple agencies and bounce hourly rates off each other for the same region.

2. What calculation to use to account for 1099 status and needing to pay your own taxes?
Click to expand...
Unfortunately, and this isn't specific to locums or to medicine, there's no way to know what your taxes are going to be like until you actually start working and have an accountant do them (or do them yourself.)

4. Locums percs?
--do they cover cost of state license, DEA #? Cost of boards?
--which things are arrangeable?
Click to expand...
Yes to licenses. The agency I currently work with said they don't usually cover DEA because most docs already have it, but in my case they were willing to. I didn't ask them to cover boards and I doubt they would, but that expense is tax-deductible if you're doing locums. Not sure what you mean by "arrangeable."

Shikima said:
$125 is low, I've seen gigs for coverage for as much as $180/hr. There are desperate places which need help. Never short yourself and put yourself into a position where you won't be paid.
Click to expand...

doctorpilgrim said:
Hi
I think the going rate is 140 to 160 plus travel and lodging per hour through Locums.
Click to expand...
The lowest hourly rate I've received so far was $130/hr, and that was in the "saturated" Boston-Washington corridor. I was making $140/hr in the Midwest, and $160/hr in California. I wonder if some of that was that I was fresh out of residency, because as I continue to talk to locums recruiters, they're starting to quote me more like $175-$185. The highest I've heard was $200.

vistaril said:
and I've seen jobs for 215 an hour. But those are often terrible terrible jobs. 125/hr is actually not that low for locums if it is a reasonable job. Especially if it pays for travel.
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Yes, it is, and they always pay for travel.

FlowRate said:
OTOH, (according to the article I linked), a lot of locum jobs will cover travel and lodging, if you work things out properly. Keep in mind that locum can involve a lot of turnover, state license fees, potential financial downtime between jobs, etc. Those things should also factor into your costs / benefits.
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They will all cover travel and lodging, as well as state license fees.

The turnover is the biggest downside for me. Things might be different if I were mid-career, with my own condo to go back to every other weekend. But coming straight out of residency, it would have made no sense to keep paying rent on an empty apartment, so I put all my stuff in storage. Now I'm effectively homeless. I've received a contract for a permanent job starting later this summer, and will have no problem filling the time until then with locums assignments, but still, it's stressful. I think I may even have some important tax documents in my filing cabinet, which is packed away inaccessibly in the moving company's storage warehouse.
 
So, if you can find a perm job that pays, say $180/hr equivalent (when you calculate out the taxes and monetize the benefits, vacation, etc) vs a $180 locums, what is the advantage of locum, other than getting to sleep in a hotel and not have to pay rent every month?


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keifernny2 said:
So, if you can find a perm job that pays, say $180/hr equivalent (when you calculate out the taxes and monetize the benefits, vacation, etc) vs a $180 locums, what is the advantage of locum, other than getting to sleep in a hotel and not have to pay rent every month?


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-Partially retired doctors only want to work a few months a year. If over 65 don't need health insurance benefits.
-If your spouse can get you benefits through their job, locums might be more valuable because no employed position gives you extra money for not using provided benefits (at least not that I've seen)
-Some people want to travel to new places. If you wanted to visit Hawaii for a few months, have housing, and can find locums with a reasonable schedule it's sort of a money saver.
 
keifernny2 said:
So, if you can find a perm job that pays, say $180/hr equivalent (when you calculate out the taxes and monetize the benefits, vacation, etc) vs a $180 locums, what is the advantage of locum, other than getting to sleep in a hotel and not have to pay rent every month?
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Also, in a perm job, you're probably under a contract which places all kinds of restrictions on you and penalizes you if you leave early. I'm currently having a lawyer look over the contract for a perm position I got offered and, with my having worked in the corporate world before, it's an uncomfortable prospect, signing my life away to some big, bureaucratic organization. There's peace of mind in being an independent contractor.
 
Shikima said:
$125 is low, I've seen gigs for coverage for as much as $180/hr. There are desperate places which need help. Never short yourself and put yourself into a position where you won't be paid.
Click to expand...

Why do people (largely med students, admittedly) complain about how low psych salaries are?

At a little lower than the rate you quoted, (I'll use 160/hr) a psychiatrist could work a 50 hour week x 44 weeks and gross 350k/year.

Seems like 50hr/week is pretty normal in a lot of higher paying specialties PLUS you're giving yourself 2 months of vacation.

What am I missing here? Is securing locums gigs hard to do full-time, for 44 weeks a year? More demand than supply of locum jobs?
 
People complain because they look on medscape salary surveys and see that psych is on the lower end of average salaries (usually its around 200k), bottom 3-5 annually. And they see Cards/Rads with averages of around 320-350k on medscape.

What they don't see is that 3/4 of psychiatrists work <40 hours/week. Or that the average cardiologist cranks 50-60 hours/week.

But you're right.
 
Blitz2006 said:
People complain because they look on medscape salary surveys and see that psych is on the lower end of average salaries (usually its around 200k), bottom 3-5 annually. And they see Cards/Rads with averages of around 320-350k on medscape.

What they don't see is that 3/4 of psychiatrists work <40 hours/week. Or that the average cardiologist cranks 50-60 hours/week.

But you're right.
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Gotcha. so let me pose this hypothetical..

Living in a large city, working strictly locums, is it possible to work 40-50 hours week x 44 weeks a year? Is there enough work to be found to accommodate that?

I realize you may have to drive a little outside a major city for higher rates (and potentially extra hours?)...but is it feasible generally?
 
yanks26dmb said:
Gotcha. so let me pose this hypothetical..

Living in a large city, working strictly locums, is it possible to work 40-50 hours week x 44 weeks a year? Is there enough work to be found to accommodate that?

I realize you may have to drive a little outside a major city for higher rates (and potentially extra hours?)...but is it feasible generally?
Click to expand...
The only part of that that's not feasible is the "large city" part. It's hard to find work in large cities in general, because that's where all the SWPL/bobo recent residency grads want to live. I've never had a locums agent offer me, nor be able to find for me, a job in a large city.
 
Trismegistus4 said:
The only part of that that's not feasible is the "large city" part. It's hard to find work in large cities in general, because that's where all the SWPL/bobo recent residency grads want to live. I've never had a locums agent offer me, nor be able to find for me, a job in a large city.
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Agreed.

But psych is still the best for job market compared to other specialties. But yes, getting a nice gig in LA/SF/NYC is relatively tougher.

But the good thing about psych, unlike other specialties, is that these larger markets have a big cash only population. So while hospitals pay lower in these cities for inpatient work, you can actually earn a crap load doing cash only.

Take a walk down park avenue in the upper east side and you'll see what I mean.

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yanks26dmb said:
Gotcha. so let me pose this hypothetical..

Living in a large city, working strictly locums, is it possible to work 40-50 hours week x 44 weeks a year? Is there enough work to be found to accommodate that?

I realize you may have to drive a little outside a major city for higher rates (and potentially extra hours?)...but is it feasible generally?
Click to expand...
Well I'm just a resident so by no means an expert on locum, but I know in the NYC area I have heard attendings getting inpatient locum jobs in long island, queens. Maybe not in sexy Manhattan or Williamsburg, but not bad. And I think rates are OK (but obviously not what you will pull in Midwest or south)

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Don't want to derail the thread, but can anyone speak to this: since you are paid hourly by CMHC jobs, does this mean you have a whole hour to spend with a patient and can use that hour how you please (do psychotherapy and med management if necessary)? Just wondering about the flexibility in your practice at these CMHC's, finances aside.

FYI I'm just a medical student so if this question seems stupid it's because I'm just trying to learn.
 
Hopium said:
Don't want to derail the thread, but can anyone speak to this: since you are paid hourly by CMHC jobs, does this mean you have a whole hour to spend with a patient and can use that hour how you please (do psychotherapy and med management if necessary)? Just wondering about the flexibility in your practice at these CMHC's, finances aside.

FYI I'm just a medical student so if this question seems stupid it's because I'm just trying to learn.
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They pay you hourly and they set the schedule. You'll be seeing multiple people per hour and they want you to prescribe and not do therapy. Of course, you could do whatever you wanted during that time, if you wish. You'll just have 10 minutes to do it.
 
Trismegistus4 said:
The only part of that that's not feasible is the "large city" part. It's hard to find work in large cities in general, because that's where all the SWPL/bobo recent residency grads want to live. I've never had a locums agent offer me, nor be able to find for me, a job in a large city.
Click to expand...

Are these jobs available 1-2 hours outside cities like LA/SD/SF/NY?

Or are we talking.....middle of texas, dakotas, etc..
 
Hopium said:
Don't want to derail the thread, but can anyone speak to this: since you are paid hourly by CMHC jobs, does this mean you have a whole hour to spend with a patient and can use that hour how you please (do psychotherapy and med management if necessary)? Just wondering about the flexibility in your practice at these CMHC's, finances aside.

FYI I'm just a medical student so if this question seems stupid it's because I'm just trying to learn.
Click to expand...

Hour long follow ups would probably never happen in community mental health. I had what was in retrospect a fairly forgiving schedule in my community job with 90 minute intakes and 30 minute follow ups (with likely some 20 minute ones once I was there longer). You could potentially do some brief therapy interventions, but I don't think you could have a therapy patient.
 
locum jobs by their nature are for hard to staff positions.

It might be the fact that a gig is time-delineated (an employer may only want someone for a few months). It might be that a gig is in a place that is hard to get psychiatrists to move to. It might be that the gig is a horrible job and word has gotten around locally so a net needs to be cast out farther to lure in unsuspecting psychiatrists.

Keep that an locum makes sense. They often pay more because they have to. They are not typically for good jobs in desirable places to live, because folks don't need to go the locum route to staff that job.
 
notdeadyet said:
locum jobs by their nature are for hard to staff positions.

It might be the fact that a gig is time-delineated (an employer may only want someone for a few months). It might be that a gig is in a place that is hard to get psychiatrists to move to. It might be that the gig is a horrible job and word has gotten around locally so a net needs to be cast out farther to lure in unsuspecting psychiatrists.

Keep that an locum makes sense. They often pay more because they have to. They are not typically for good jobs in desirable places to live, because folks don't need to go the locum route to staff that job.
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Indeed, I'm currently 90 minutes outside of a big city, and this place would love for me to sign on permanently, but there's no way I'd even consider it. They have a hard time retaining people because of the combination of the crappiness of the job and the crappiness of the area. Also, I'm the only AMG at the place right now, and that tells you something.
 
Some of my friends prefer lcoums, and after a while the autonomy may become very attractive. Is it like someone permanently dating? The benefit package now days is 10 percent of salary and the new hire with recruitment bonus actually makes more than a long term employee. Add to it that loyalty or hard work has no place in the organizational memory and it makes for short term employees.

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what is the highest hourly locums rate you've seen for telepsych?
 
sweetlenovo88 said:
what is the highest hourly locums rate you've seen for telepsych?
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I haven't seen much in terms of telepsych, I have been offered around 110 to 150 and, but haven't heard of more than that anywhere.
 
F0nzie said:
That's what I have seen too
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Is telepsych work from home hard to get? (I've heard that some telepsych jobs require you to report to an office, which kinda defeats the purpose.)
 
A basic question about locums liability insurance: when you do a locums gig (say 3 months) and the insurance is provided, and then you move on, do you need to have your own separate tail coverage? In other words, what are the limitations of the coverages that are provided by the locums company? Is there some basic level of coverage that you should have and pay for yourself when you do a series of locums gigs?

More broadly: is there a post or thread, or a weblink, that fully explains liability coverage? I feel very uninformed (I am a 2nd year resident). For example, when I finish residency, is there something I need to do, or something that happens, that protects me from claims made during residency? What about medical school?
 
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Psychotic said:
A basic question about locums liability insurance: when you do a locums gig (say 3 months) and the insurance is provided, and then you move on, do you need to have your own separate tail coverage? In other words, what are the limitations of the coverages that are provided by the locums company? Is there some basic level of coverage that you should have and pay for yourself when you do a series of locums gigs?

More broadly: is there a post or thread, or a weblink, that fully explains liability coverage? I feel very uninformed (I am a 2nd year resident). For example, when I finish residency, is there something I need to do, or something that happens, that protects me from claims made during residency? What about medical school?
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You will have to look at the insurance policy. A reputable locums company will usually have a policy for its docs that doesn't require a tail
 
Psychotic said:
A basic question about locums liability insurance: when you do a locums gig (say 3 months) and the insurance is provided, and then you move on, do you need to have your own separate tail coverage? In other words, what are the limitations of the coverages that are provided by the locums company? Is there some basic level of coverage that you should have and pay for yourself when you do a series of locums gigs?

More broadly: is there a post or thread, or a weblink, that fully explains liability coverage? I feel very uninformed (I am a 2nd year resident). For example, when I finish residency, is there something I need to do, or something that happens, that protects me from claims made during residency? What about medical school?
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Your residency will give you information about your insurance policy when you graduate. It is likely an occurrence based policy that does not require a tail. I don't think you need anything from medical school.
 
I haven't done locums in maybe 1.5 years but did occasional week-long vacation coverage, and made what seemed like a ton of money to me. I have to add the disclaimer that the place I was working was so busy & understaffed that I'd usually put in 90-100 hours over the course of 7 days. Frankly that was not at all healthy, and as I have my own outpatient practice, afterwards it would take 2-3 weeks to get rested up and caught up on my work backlog created by my absence. Certainly would not have been sustainable for any extended period or with more frequency. I don't remember the hourly rate but I got overtime (1.5 x base rate) after 40 hours per week and also an additional flat fee ($500?) for each weekend day (above what I earned based on hours worked.) I think I usually made something like 12K - 14K over 7 days & once I worked 9 days in a row (two weekends + intervening week) and made either 20K or 21K (I kind of forget..,)
 
Still Kickin said:
I haven't done locums in maybe 1.5 years but did occasional week-long vacation coverage, and made what seemed like a ton of money to me. I have to add the disclaimer that the place I was working was so busy & understaffed that I'd usually put in 90-100 hours over the course of 7 days. Frankly that was not at all healthy, and as I have my own outpatient practice, afterwards it would take 2-3 weeks to get rested up and caught up on my work backlog created by my absence. Certainly would not have been sustainable for any extended period or with more frequency. I don't remember the hourly rate but I got overtime (1.5 x base rate) after 40 hours per week and also an additional flat fee ($500?) for each weekend day (above what I earned based on hours worked.) I think I usually made something like 12K - 14K over 7 days & once I worked 9 days in a row (two weekends + intervening week) and made either 20K or 21K (I kind of forget..,)
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How hard is it to find jobs like that, where you can bust your hump for a week once or twice a month?

I'd love to try setting up my own practice in a major coastal city while traveling elsewhere for a job like you described (I'm assuming the higher paying jobs are outside major cities).
 
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