The locums thread

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cardiaclubdubbin

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Hey guys; I was hoping someone on the discussion board could help me out. I am new to locums work and recently took on a hospitalist locum job although I am a recent general card graduate. I wanted to know if anyone out there has done subspecialty locums and if the general pay rates are better/worse and if they are better than doing straight hospitalist medicine locums. (There doesn't seem to be any info online about what is a competitive rate; regions with better rates and rates for subspecialties vs. gen. medicine). Its kinda tough because i feel like these agencies are taking advantage of physicians (and me) in some cases. Any advice on locums in general, especially regarding negotiating a contract would be helpful.
 
Hi all; I was hoping to start a discussion regarding locums experiences. I recently accepted a job with an initial rate etc negotiated with the recruiter etc. I have been told everything is working out with an the agency and am to start with scheduled dates at the end of December. I have NOT gotten a letter or contract with the agency despite scheduling the dates including orientation. I have been told it is the holiday season and it will be done on my first day on the job??? Is it me or is this unprofessional and more importantly unethical? It is a well known agency and I thought it would save me from this kind of trouble. WHY are there not physician reviews for these agencies anywhere online so we can hold them accountable? I feel like I am being taken advantage of and want to let the hospital know I have not signed any contract during orientation and would like to directly negotiate going forward...is this unethical? If anyone can share there experiences and advice it would be great...
 
I think you are over reacting a bit. but that is jmo. It may be a bit unprofessional if everything was in place months prior and they waited till the last second to pump out the contract letter.
 
Maybe I am over reacting.... but that is why I am asking for others experiences regarding this process. Is it normal to start an assignment without a confirmation/contract letter in place? Also, a verbal agreement is in place once you are presented with your negotiated terms prior to getting credentialed which takes 8-12 weeks. It doesnt make sense to go through the entire process without anything in writing prior to starting work; Finally, I believe you should have these terms in writing prior to working, not in the middle of an assignment where your basically stuck in a situation where you look bad as a professional though the agency is at fault for putting you in that position in the first place.
 
Is this your first time working locums? I am pretty new to it as well, so I am not sure how it works. But for me it was Verbal Negotiation, And then credentialing + written contract came a month or so before.

Don't worry about looking good or bad. Most of this companies and places are desperate, and honestly you are overthinking it too much about looking bad as a professional. Just tell the hospital you did everything you can but the agency didn't complete stuff in timely manner.
 
It is my first year working locums; I agree with you..... BTW did you renegotiate your rate after your initial stint if the hospital wanted to extend you?
/
 
Hey guys, i was confused on some stuff about rvu's and since i work for companies I don't know too much about it. Just received an offer from a hospital i locum at but, i wasn't sure if it was good or not.

what's fair productivity cap for nocturnist at a busy hospital?
I know mgma says 60/wrvu, but what is considered a good number (wrvu) for nocturnist at a busy hospital?
everyone in the group makes productivity bonus


thanks again guys...
 
45-55 per RVU is what I have heard. Anything over 4500 rvu per year .. someone please correct me if i'm wrong.
 
For a day time hospitalist we get paid a base salary and must get 4000 wRVU's per year minimum. Anything over 4400 pays $26/RVU as a bonus. Kind of BS that we have that 400 dollar range where we get nothing extra. Its part of the reason I'm not renewing my contract with this group next time around.
 
jacksparrow82 said:
For a day time hospitalist we get paid a base salary and must get 4000 wRVU's per year minimum. Anything over 4400 pays $26/RVU as a bonus. Kind of BS that we have that 400 dollar range where we get nothing extra. Its part of the reason I'm not renewing my contract with this group next time around.
Click to expand...
yeah 26/rvu seems a little low. Maybe you are in a big city or one of the most desirable location.
 
jacksparrow82 said:
For a day time hospitalist we get paid a base salary and must get 4000 wRVU's per year minimum. Anything over 4400 pays $26/RVU as a bonus. Kind of BS that we have that 400 dollar range where we get nothing extra. Its part of the reason I'm not renewing my contract with this group next time around.
Click to expand...

Yeah. That's about 100 FREE admits. **** that. And 26 per is a joke.
 
I am going to start locum hospitalist work in a few months. What health insurance coverage to buy? Cobra is too expensive.
 
robertnadan said:
I am going to start locum hospitalist work in a few months. What health insurance coverage to buy? Cobra is too expensive.
Click to expand...
Feel free to hate on the ACA/Obamacare but...you can just go buy health insurance on the interwebs these days.

And if you can't afford $150-200/month for health insurance on a locums contract, you're either a terrible negotiator or you need to find a new job.
 
Note that to have coverage thru an exchange starting on the first of a month, you must apply no later than the 15th of the preceding month, so don't leave it to the last minute.
 
What is the best and most efficient way to keep a several of various expenses during locum assignment?
 
The locum agency says they would pay for my malpractice with tail coverage? Do I go by there word or ask for some kind of proof before hand. What is the normal practice out there?
 
radonc0756 said:
The locum agency says they would pay for my malpractice with tail coverage? Do I go by there word or ask for some kind of proof before hand. What is the normal practice out there?
Click to expand...
they will give you a copy of the policy if you ask them...but yeah it is standard for them to cover that.
 
Suppose my hourly locums pay is $100. And my hours are 6:45 am-7 pm shift. What is the pay for the time between 6:45 - 7. Is it $100 /hr so billed at $ 25 for 15 mins.? Or is it billed at overtime rate. Is locum payment done in increments of 1 hour or 15 mins or 5 mins.

Also normally what is the locum overtime rate?
 
radonc0756 said:
Suppose my hourly locums pay is $100. And my hours are 6:45 am-7 pm shift. What is the pay for the time between 6:45 - 7. Is it $100 /hr so billed at $ 25 for 15 mins.? Or is it billed at overtime rate. Is locum payment done in increments of 1 hour or 15 mins or 5 mins.

Also normally what is the locum overtime rate?
Click to expand...

your shift is from 645a-7p, so that 1st 15 mins would be billed as regular pay, pro-rated based on 100/hr...why would it be billed as OT? just because they have your shift as 12 hours and 15 mins? the shift is listed as regular hours being 12 hours and 15 mins so it bills as regular hours...

what are considered to be regular hours and what you are paid is decided upon between the 2 of you...I've have places pay for 12 hours even though the scheduled me for 10, and i've had programs consider 9 hours regular pay and anything beyond that as OT (scheduled for 9 hours though not 12).

typically the OT is 1.5x the hourly rate...but you need to have that spelled out in your contract.

however if the 100/hr is for IM, that's a crappy rate...
 
Last edited:
ED forum shows pretty high locum rates , sometimes as high as 400-25 / hr. Why is IM so low at just 160-170s?
 
If you haven't figured it out yet--EM is the highest paying field for # of years in training. They have high frequency of low/medium acuity encounters that essentially bill the same as more detailed complex encounters that IM admits from those that actually warrant admission. They run RVU circles around IM--a complicated CHF patient that will take you 20-40 minutes to admit after they give lasix when the CXR is read as congestion they bil lfor PLUS see/discharge 2-4 more patients with runny noses and headaches. If the CHF patient requires BiPAP they can also bill critical care time. The system values quantity over quality and EM is the god of quantity medicine.
 
I have a 10 hr., locum hospitalist shift (14 days a month). Does any one has suggestions on how to get more shifts or work another job like LTAC or any other suggestions?
 
1. When you do overtime at locums do you round off the extra time to an hour, half hour or report the extra time?
2. How frequently do you get paid by locums? every week ? every month ?
3. What are all the basic expenses I need to make sure that my locum company pays?

Thanks a million
 
Do locums usually reimburse your state license renewal fees?
 
cardiaclubdubbin said:
Hey guys; I was hoping someone on the discussion board could help me out. I am new to locums work and recently took on a hospitalist locum job although I am a recent general card graduate.
Click to expand...

I'm curious why a recent cardiology grad who spent an extra 3 years would want to hospitalist? Is due to a poor cards job market?
 
Locums expert(s) please help
1.Do locums usually reimburse your state license renewal fees?
2.Do locums usually reimburse your ABIM intial certification fees?
 
radonc0756 said:
Locums expert(s) please help
1.Do locums usually reimburse your state license renewal fees?
2.Do locums usually reimburse your ABIM intial certification fees?
Click to expand...
1. yes if you are working for them at the time of renewal (though will vary with locums companies)
2. doubt it but you can ask...
 
What is the best business account option for 1099 income ( locum physician) ? ( I mean which bank / which type of account has maximum benefits / least fees). Thanks.
 
cardiaclubdubbin said:
Hey guys; I was hoping someone on the discussion board could help me out. I am new to locums work and recently took on a hospitalist locum job although I am a recent general card graduate. I wanted to know if anyone out there has done subspecialty locums and if the general pay rates are better/worse and if they are better than doing straight hospitalist medicine locums. (There doesn't seem to be any info online about what is a competitive rate; regions with better rates and rates for subspecialties vs. gen. medicine). Its kinda tough because i feel like these agencies are taking advantage of physicians (and me) in some cases. Any advice on locums in general, especially regarding negotiating a contract would be helpful.
Click to expand...

As a "Healthcare Consultant", I would let you know that there are more "shady" firms out there. If it is not a part of NALTO, dont waste your time. Sub specialties are extremely hard to come by in the locums world as far as pay goes, as a general hospitalist if your not making $150 hr days, $175 nights.... find a new recruiter. I do everything I can to make sure anyone who works in a facility is well taken care of and paid at least 33% above market value....
 
radonc0756 said:
What is the best business account option for 1099 income ( locum physician) ? ( I mean which bank / which type of account has maximum benefits / least fees). Thanks.
Click to expand...
Get yourself an accountant. Start an LLC, Independent contractor will allow you to get better tax breaks.
 
radonc0756 said:
Highest hourly rate for locum hospitalists?
Click to expand...
Depends, do you have any "history", how comfortable are you with procedures? Will you round on an open ICU, and most importantly... how rural is it. If you want to work in FL, CA, or any other desirable state... move on. If you are about the money I can get you up in Wisconsin working 14 on 14 off making 230+ an hr. Its all relative sir. But if they go lower than $150, you are getting screwed. Hope that helps.
 
Raryn said:
http://amzn.to/1WsGmss
Click to expand...
Use a Credit card under your LLC "create a company" you can do it in like 10 minutes online. Charge everything to it and submit it to your consultant to reimburse. Simplest way possible. Plus you get the benefits of mileage and such. I tell my physicians to do this and instead of us booking airfare and such we let them do it so they can get all the additional benefits they can.
 
cardiaclubdubbin said:
Maybe I am over reacting.... but that is why I am asking for others experiences regarding this process. Is it normal to start an assignment without a confirmation/contract letter in place? Also, a verbal agreement is in place once you are presented with your negotiated terms prior to getting credentialed which takes 8-12 weeks. It doesnt make sense to go through the entire process without anything in writing prior to starting work; Finally, I believe you should have these terms in writing prior to working, not in the middle of an assignment where your basically stuck in a situation where you look bad as a professional though the agency is at fault for putting you in that position in the first place.
Click to expand...
No, that is not normal. Find a new recruiter.
 
radonc0756 said:
The locum agency says they would pay for my malpractice with tail coverage? Do I go by there word or ask for some kind of proof before hand. What is the normal practice out there?
Click to expand...

They should send you a generic template regarding what their insurance covers. Ours for example is a one million over three million - Unlimited tail coverage. Pretty standard for any agency... unless they are a mom and pops. Stay away from those, they will make you wait to get paid until they actually get paid by client, that could be months if not a year. Any member of NALTO is usually a good bet and means they uphold all the Morales that one would expect in the healthcare industry.
 
radonc0756 said:
Highest hourly rate for locum hospitalists?
Click to expand...
Country average is about $165.00 hr. Shady places will take a hit in their margin with higher pay, but you may have to wait to get that pay. The insurance may be lacking, travel department if they even have one will suck.... etc. If it sounds too good to be true, it is. In my experience we do see fluctuation between rates, for example I have a site paying $180.00 hr. That is awesome considering we cover everything including the insurance. You want a state license, done, you need a dea, csr done.... Most places will not pay for an ABIM renewal, unless you pass it and have worked with them in the past. Need an ROI obviously.
 
radonc0756 said:
I have a 10 hr., locum hospitalist shift (14 days a month). Does any one has suggestions on how to get more shifts or work another job like LTAC or any other suggestions?
Click to expand...
You should look for a new assignment. If the hospital only has 10 hr shifts... not much your agency can do. Find an agency that will pay for new licensure. If thats the only hospital in driving distance though and you are not looking to travel, you may just have to tough it out till things change. If you are flexible with travel/open to state licensure.... thats no issue. 1000's of hospitals are looking for someone just like you across the country. Believe that, there is about to be a HUGE shortage of physicians across the US and even if they allow NP's and PA's to potentially start working more independently, there still will be a shortage of around 50,000 physicians by 2024. Baby Boomer Generation is dying out and retiring. Its sad but true, if you know anything about business... Demand requires and increase in Supply, well that Supply is about to start getting PAID. I would bet hospitalist rates will continue to increase at the current trend. In 2010 the average rate was around 120-140 hr. Now we are seeing 140-180..... So at this rate in 2024 working locums full time you can pull in a cool $504,000.00 . Thats working 14 shifts per month, if you want more you can always work more. Not a bad way to stimulate income, or make a living off of it.
 
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