Starting Locums journey

[james775]

Just starting to get into the Locums market. I have a w2 lined up but have a week off every month. Would like to make some money during some of those off weeks. Best Locums companies to use? Are you allowed to work with multiple companies? Any advice for someone starting out?

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[2buckchuck]

Sent you a DM.

 

[coffeebythelake]

Just starting to get into the Locums market. I have a w2 lined up but have a week off every month. Would like to make some money during some of those off weeks. Best Locums companies to use? Are you allowed to work with multiple companies? Any advice for someone starting out?

Avoid Weatherby, Locumtenens, comphealth and other big places if u can. They take a huge cut and low ball you.

 

[aneftp]

Avoid Weatherby, Locumtenens, comphealth and other big places if u can. They take a huge cut and low ball you.

The flip side is if u ask for too much. Facilities will cut the most expensive providers first

So if you are asking and getting $50/hr more than the others who came after you. You will get cut first.

That’s the nature of the beast.

Agree it’s all a game like the mortgage industry and fees and spread difference yields and companies taking spread difference yields off you.

 

[Simba1711]

I heard good things about aya Locums. You’re in a good spot since you have w2 from your primary job and will have 1099 from Locums. I would look into starting a llc or s corp. you can do a backdoor Roth , set up an individual 401k and a personal cash balance plan. write offs due to 1099 and benefits from w2

 

[coffeebythelake]

The flip side is if u ask for too much. Facilities will cut the most expensive providers first

So if you are asking and getting $50/hr more than the others who came after you. You will get cut first.

That’s the nature of the beast.

Agree it’s all a game like the mortgage industry and fees and spread difference yields and companies taking spread difference yields off you.

Not facilities. The locums company. The money set aside per contract hour remains the same. Difference is how it is distributed between u and the locum company. The only caveat is for travel expense reimbursement which I think is a separate expense for the facility

 

[aneftp]

Not facilities. The locums company. The money set aside per contract hour remains the same. Difference is how it is distributed between u and the locum company. The only caveat is for travel expense reimbursement which I think is a separate expense for the facility

Well we (the facility) cut the more expensive crnas first. From the same locums company. Because it’s one locums company providing all the providers crna and Docs.

And it wasn’t performance issue. They were the better crnas to be honest. Comfortable with all cases including young peds.

 

[james775]

I heard good things about aya Locums. You’re in a good spot since you have w2 from your primary job and will have 1099 from Locums. I would look into starting a llc or s corp. you can do a backdoor Roth , set up an individual 401k and a personal cash balance plan. write offs due to 1099 and benefits from w2

Yep that’s my plan. Talked to an accountant, scorp if only over 100k. Just gonna do an llc for now. Can put 20 percent profit into a 401k. And then can use my 1099 to write things off like board exams, licensing, etc

 

[Simba1711]

Sounds good. I put 69 k in my 401k this year. Way more than w2 would allow.

 

[coffeebythelake]

Well we (the facility) cut the more expensive crnas first. From the same locums company. Because it’s one locums company providing all the providers crna and Docs.

And it wasn’t performance issue. They were the better crnas to be honest. Comfortable with all cases including young peds.

That's a weird arrangement. So your facility doesn't sign a standard contract per hour, and it is negotiated with each presented crna? Not a regular or common thing for places do this.

 

[narcotics999]

I heard good things about aya Locums. You’re in a good spot since you have w2 from your primary job and will have 1099 from Locums. I would look into starting a llc or s corp. you can do a backdoor Roth , set up an individual 401k and a personal cash balance plan. write offs due to 1099 and benefits from w2

Bad idea for s-Corp if w2. You need to pay the employer portion of payroll taxes for the s-Corp. straight schedule C. In addition, if your income is below qbi threshold, more deductions.

 

[deleted1183938]

Not facilities. The locums company. The money set aside per contract hour remains the same. Difference is how it is distributed between u and the locum company. The only caveat is for travel expense reimbursement which I think is a separate expense for the facility

Not all locums companies get paid the same actually.

 

[anonanes]

Avoid Weatherby, Locumtenens, comphealth and other big places if u can. They take a huge cut and low ball you.

I cannot agree with this anymore - coming from someone who has been doing locums >8 years. Not just $ reasons - but when they say "they have your best interest" - these folks are nothing more than sleazy car salesman.

 

[IM_to_ortho_hopeful]

Not all locums companies get paid the same actually.

Can you elaborate on this?

Are smaller locums companies paid less? What determines if a locums company is paid more?

Anybody have any experience with starting their own locums company?

 

[james775]

Has anyone worked with epic staffing?

 

[Status Sciaticus]

Can you elaborate on this?

Are smaller locums companies paid less? What determines if a locums company is paid more?

Anybody have any experience with starting their own locums company?

They probably get paid the same but have less overhead and would be able to pay you more.

 

[deleted1183938]

Can you elaborate on this?

Are smaller locums companies paid less? What determines if a locums company is paid more?

Anybody have any experience with starting their own locums company?

What happens is this from what my recruiter tells me and I have worked w him for years. The locums company offers physician X. Physician Negotiates Y. Some agreement is reached and the locums company presents the doc at whatever number (between X and Y) in addition to whatever profit margin (25-50% let’s call that A) to make a total per hour of B. B is the number that gets presented to the hospital or Corporate AMC or PP.

That is why when staffing is cut the highest paid one will be the first to go. Obviously A can also be manipulated by the individual locums companies and some choose to be less greedy than others for a number of reasons.

I know people in admin and have confirmed this info. Now maybe some hospitals choose to pay a flat rate to everyone. And now there is this new thing where hospitals go through a fourth party so they don’t have to deal with so many companies themselves directly and are usually sold some lie by these parties. They are called vendors. When they go through a fourth party vendor that party also takes their cut and that fourth party then offers these locums agencies a straight hourly/daily rate and the locums companies then divvy it up to the doctors. Locums companies hate these fourth party vendors for obvious reasons and also hate the AMC because that is also another company to deal w outside of the actual hospital and AMCs usually take forever to credential for also obvious reasons.

It’s all a big game and that’s why no one should accept the first number they are offered. Always counter. What’s the worst that could happen??.

And then of course admin so stupid and never wants to improve their current long term situation because they truly believe this need is a short term need and they would rather use that specific pot of money for that short term need instead of offer better incentives to their current staff.

 

[dizzy21]

I recently started locums at one location. I was asked to schedule more days after the first round of scheduling by the locums company but they ask that I cut my rate for them.

I told them no, but I’ve never had a locum company ask me to cut my rate after I started. They said the hospital will likely find someone to work for less. If they want to get rid of me I don’t worry about it too much because i have other contracts. Anyone else experience or thoughts on this?

I’ve heard many times agents tell me I should accept a lower rate so hospitals won’t cut me first, but I always thought that was a bunch of bull—— they say to low ball you and get more margin.

Just to reiterate what others on this forum have said the locums agents are not your friend.

 

[aneftp]

I recently started locums at one location. I was asked to schedule more days after the first round of scheduling by the locums company but they ask that I cut my rate for them.

I told them no, but I’ve never had a locum company ask me to cut my rate after I started. They said the hospital will likely find someone to work for less. If they want to get rid of me I don’t worry about it too much because i have other contracts. Anyone else experience or thoughts on this?

I’ve heard many times agents tell me I should accept a lower rate so hospitals won’t cut me first, but I always thought that was a bunch of bull—— they say to low ball you and get more margin.

Just to reiterate what others on this forum have said the locums agents are not your friend.

I haven’t had the locums company directly asked me to cut the rate. I’ve had the medical director who schedules me ask me to cut my rate!! And we are on super friendly terms. As in. We go and have dinner at the country club and I hang out at his beach condo friendly terms.

So obviously he’s not being mean. I’m just expensive and I know it. The hospital is telling him what to do and he’s passing for information on to me personally. I appreciate him telling me. So they are actively shopping for other “cheaper providers”.

They rather have me go w2. At almost the same guarantee rates I am getting but obviously I prefer my 1099 money for write off.

It can be a cat and mouse game. But i will not cut my rate. I rather just move on to another assignment.

 

[Coffee PRN]

If I ever get asked to cut my rate by the locums company, I will tell them to cut their margin instead. They are making 35%+ margins on every hour that I work.

 

[IM_to_ortho_hopeful]

What happens is this from what my recruiter tells me and I have worked w him for years. The locums company offers physician X. Physician Negotiates Y. Some agreement is reached and the locums company presents the doc at whatever number (between X and Y) in addition to whatever profit margin (25-50% let’s call that A) to make a total per hour of B. B is the number that gets presented to the hospital or Corporate AMC or PP.

That is why when staffing is cut the highest paid one will be the first to go. Obviously A can also be manipulated by the individual locums companies and some choose to be less greedy than others for a number of reasons.

I know people in admin and have confirmed this info. Now maybe some hospitals choose to pay a flat rate to everyone. And now there is this new thing where hospitals go through a fourth party so they don’t have to deal with so many companies themselves directly and are usually sold some lie by these parties. They are called vendors. When they go through a fourth party vendor that party also takes their cut and that fourth party then offers these locums agencies a straight hourly/daily rate and the locums companies then divvy it up to the doctors. Locums companies hate these fourth party vendors for obvious reasons and also hate the AMC because that is also another company to deal w outside of the actual hospital and AMCs usually take forever to credential for also obvious reasons.

It’s all a big game and that’s why no one should accept the first number they are offered. Always counter. What’s the worst that could happen??.

And then of course admin so stupid and never wants to improve their current long term situation because they truly believe this need is a short term need and they would rather use that specific pot of money for that short term need instead of offer better incentives to their current staff.

Wow I had no idea that these fourth party vendors exist. Talk about admin bloat and wasted money. Can anybody provide any links for website for these fourth party vendors?

Is there an official name for what the fourth party vendor is?

Anybody have any experience with starting a fourth party vendor?

 

[deleted1183938]

Wow I had no idea that these fourth party vendors exist. Talk about admin bloat and wasted money. Can anybody provide any links for website for these fourth party vendors?

Is there an official name for what the fourth party vendor is?

Anybody have any experience with starting a fourth party vendor?

Ha ha ha that last line got me. Look at you!!! You are a hustler!!!