Upcoming Locum Assignment - The Hard Numbers

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Zekchar

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Upcoming Locum Assignment: The Cliff-notes Version
Me: Late :( 30's, academic physician, clean record
Time: 2 Week assignment March 2019, Mon-Fri, No Weekends
Location: North California - 1.5 hours outside of San Francisco
Model: Doing own cases - No Supervision
Compensation: $200/hour, guaranteed exactly 12 hours/day
Cases: Level 2 Trauma center, No Cards or Peds, Locums don't do OB
Included: Roundtrip Flight, Lodging, Transportation, All meals at hospital
Malpractice: Occurence 1/3 Mil
Charting: EMR + Paper Charting

Intangibles:
1) I specifically wanted to do my own cases since my primary job is care model and I rarely do own cases
2) I shopped around 2 weeks of coverage on gaswork and doccafe 6 months in advance and this best fit what I was seeking
3) Lots of board warriors on here demanding hourly compensation that is nowhere to be found. I had both the time, patience, and 4 state medical licenses to shop around - this was the best I found.
4) Goal was to supplement my primary income and take a break from care team model - expected take home before taxes = $24,000 and plan to visit friends in San Fran during weekend in between

Happy to answer questions and would appreciate feedback.

**Updates 4/28/19** ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Assignment is over. Thoughts below:
1) 12 hours/day shifts are too long - 10 hour is more appropriate. After 5 days of 12 hours in a row, I was beat and could not find the time to work out and eat health like I would have liked.
2) Total hours worked across 2 weeks = 120 hours + 5 hours of overtime for total of ~$25,000 of 1099 income.
3) Would avoid extended stay type of hotel and opt for airbnb instead or someplace with access to a kitchen to allow for cooking
4) The flights cost the locum agency ~ $850
5) The hotel cost the locum agency ~ $2100
6) The car rental cost the locum agency ~ $750
7) I took home ~$25,000 and it cost the locum agency ~$3,000 for flight, hotel, and car rental + some amount for an occurence med mal polcy x2 weeks ... I wonder how much they took off the top before paying those expenses .... food for thought
8) There is a lot of need for locum coverage ... don't settle for crappy rates and unsafe coverage models

Happy to answer questions and would appreciate feedback.

**Updates 8/2/2020** ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Completed a 2nd assignment at the same location in July. Here's the hard data.
1) 2 Week assignment. Fly in Sunday and leave 2 Sundays later. Mon-Fri x 10 hour shifts x 2 weeks + Sat x 12 hour shift x 2 Saturdays.
2) Total Hours worked 131.5 @ $215/hr = $28,272 of 1099 income.
3) Flight, extended stay hotel, and rental car cost the agency ~ $3500.
4) Med Mal was Occurence 1/3mil policy from The Medical Protective Company
5) Meals are free for physicians in the cafeteria so out of pocket food and intangible costs were ~$300
6) Given 1 N95 mask per day. Bread and butter cases.
7) Next 2 week assignment planned for October

**Updates 4/25/2021** ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Completed a 3rd assignment at the same location in October, but forgot to post. Here's the hard data.
1) 2 Week assignment. Fly in Sunday and leave 2 Sundays later. Mon-Fri x 10-12 hour shifts x 2 weeks + Sat x 12 hour shift x 1 Saturday.
2) Total Hours worked 11 Shifts (126hrs) @ $3200/shift + 14 hrs overtime @ $300/hr = $39,400 of 1099 income.
3) Flight, extended stay hotel, and rental car cost the agency ~ $3500.
4) Med Mal was Occurence 1/3mil policy from The Medical Protective Company
5) Meals are free for physicians in the cafeteria so out of pocket food and intangible costs were ~$300
6) Given 1 N95 mask per day. Bread and butter cases.
7) Being offered to return at will to same location, but husband is nixing further trips for now.

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12 hour guarantee is nice. Any idea how much you will actually work?

"Mon-Fri work weeks with 12 hours scheduled each day" as per the locums recruiter and confirmed by the site coordinator ... will have to see what happens when I actually get there but this is all I have to go on right now.
 
If you didn’t have license in that state how quickly were they able to get you licensed?

Would love to do something similar for 2 weeks doing own cases in the future.

Was there much negotiation at all? Or were most take it/leave it?
 
Upcoming Locum Assignment: The Cliff-notes Version
Me: Late :( 30's, academic physician, clean record
Time: 2 Week assignment June 2019, Mon-Fri, No Weekends
Location: North California - 1.5 hours outside of San Francisco
Model: Doing own cases - No Supervision
Compensation: $200/hour, guaranteed exactly 12 hours/day
Cases: Level 2 Trauma center, No Cards or Peds, Locums don't do OB
Included: Roundtrip Flight, Lodging, Transportation, All meals at hospital
Malpractice: Occurence 1/3 Mil
Charting: EMR + Paper Charting

Intangibles:
1) I specifically wanted to do my own cases since my primary job is care model and I rarely do own cases
2) I shopped around 2 weeks of coverage on gaswork and doccafe 6 months in advance and this best fit what I was seeking
3) Lots of board warriors on here demanding hourly compensation that is nowhere to be found. I had both the time, patience, and 4 state medical licenses to shop around - this was the best I found.
4) Goal was to supplement my primary income and take a break from care team model - expected take home before taxes = $24,000 and plan to visit friends in San Fran during weekend in between

Happy to answer questions and would appreciate feedback.

is 1/3 mil enough malpractice? Seems low?
 
I commend you, OP. Get out there and do your own cases and make some money while at it. The deal seems fair enough to me.

I assume, no recruiter involvement?
 
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Seems ok, but I’ve definitely been emailed better offers. 14-1600 for 8 hours + 1.5x per hour after 8, etc. Though your guaranteed 12’s probably pay more overall.
They’re out there.
I’ve also seen worse.
Have you tried calling your local hospitals within an hour or so drive? They might be able to work out a regular gig for you for more since you’re leaving out the middle man, hotels, airfare, etc. Though you’d have to pick up your own MedMal policy.
 
Thank you for posting this. I will definitely be looking for these sorts of opportunities in the future to supplement my military income.
 
The guaranteed hours/day is key, other question is are the work day’s guaranteed (e.g. no chance of you getting called off before coming in)
 
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1/3 is standard. Remember if you are insured for more you are also a bigger target....
I used to believe that you are a bigger target (and maybe there is some truth to this), but being fully insured outweighs the risk of being a target, in my estimation, along with others I’ve spoken to.
 
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I used to believe that you are a bigger target (and maybe there is some truth to this), but being fully insured outweighs the risk of being a target, in my estimation, along with others I’ve spoken to.
Either way. It’s not like anything bad can happen since the OP will be doing his own cases.... (sarcasm intended)
 
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Seems pretty reasonable to me. My last locums job in CA was 180/hr. 8 hour minimum. General with no OB or cardiac, doing my own cases.

I had a 1M/3M policy for CA. Moved to VA and 2.25M/6.75M was the standard.
 
Seems pretty reasonable to me. My last locums job in CA was 180/hr. 8 hour minimum. General with no OB or cardiac, doing my own cases.

I had a 1M/3M policy for CA. Moved to VA and 2.25M/6.75M was the standard.
2.25M?! My God. Waiting for the 1B/3B cap. Or how about a 1T/3T?
 
If you didn’t have license in that state how quickly were they able to get you licensed?

Would love to do something similar for 2 weeks doing own cases in the future.

Was there much negotiation at all? Or were most take it/leave it?

California license took me 9 months and dozens of emails to get done. I applied for it back during residency and have kept it active in case the primary gig doesn't work out.

No negotiations to be had. I tried but to no real avail. Most places book 3-4 months out and there is a frenzy as needs arise and recruiters start their spamming.
 
I commend you, OP. Get out there and do your own cases and make some money while at it. The deal seems fair enough to me.

I assume, no recruiter involvement?

Dozens of recruiters and 100s of recruiter emails to sort through. I initially focused on a few select areas and had to expand my search radius as most places wanted more than the set 2 weeks of coverage I am able to provide. My recommendation is to zero in on a few good recruiters who communicate well, are punctual, can hold a conversation on the phone, and are responsive. Regretfully they are in the minority and most simply spam you with gazillions of undesirable postings in undesirable locations. Those earned quick "spam" or "block" settings.
 
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The guaranteed hours/day is key, other question is are the work day’s guaranteed (e.g. no chance of you getting called off before coming in)

Contractually either party can terminate outside of a month without direct penalty. This potentially hurts me more than them since they will have found some permanent coverage and I would be scrambling to fill my availability. I would have little real recourse. On the flip side, it takes places 6-8 weeks to process paperwork and that is a cost that is not negligible so that thinking was if they went through the trouble, the assignment should proceed.
 
1/3 is indeed standard. I also have a personal 4mil umbrella policy that I hope to never have to use.

the overwhelming majority of umbrella policies exclude anything related to malpractice. I know mine does and the broker we went through to get it said it is nearly impossible to get them to include malpractice unless you pay a lot for it.
 
My umbrella excludes professional liability too. Are there really companies that will cover it?

I haven't seen any, but if the circumstances are right (state dependent), you have a high enough med mal limit, and you pay an arm and a leg you could maybe find somebody to do it. When we shopped around for personal liability the person I talked to was quick to point out that none of the policies they had were going to have anything to do with med mal.
 
My umbrella excludes professional liability too. Are there really companies that will cover it?
I stand corrected. Umbrella does NOT cover med mal ... I suppose I'm just going to have to accept the 1/3 mil coverage on its own.
 
Bump with updates - New assignment completed in July
 
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Bump with updates - New assignment completed in July

Very nice. Thank you for the info. I wish we get more of these kind of reports to see what’s out there and what kind rates our work is worth.
 
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If this facility that you were at is located in a city that ends with odesto, Then $200/h is the low end number. I have heard of up to $250/h. I think this type of transparency is good for our profession.
 
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If this facility that you were at is located in a city that ends with odesto, Then $200/h is the low end number. I have heard of up to $250/h. I think this type of transparency is good for our profession.
I negotiate pretty ok. But when I get offered $200 an hour, I never take it. When offered $225, don’t take that either.
Negotiate. These companies are using us, so we need to use them.
 
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If you are board certified, even board eligible, you’re worth more than $200/hr.

I am in between jobs right now, been doing some homework. One of their first questions is, do you have any lawsuits against you or pending. To me that means their pool of workers have some “blemish” with their records. So, you don’t, I’d think you can do more than $200.

Lastly, they ask if you do ob. If you do it with some consistency. You should ask more than $200.

Just some things to consider.
 
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how are you getting two whole weeks off in a row like that from your primary job?? and you're using all your vacation to work?
 
how are you getting two whole weeks off in a row like that from your primary job?? and you're using all your vacation to work?

Some of us live in wonderful areas that are already vacation spots, but wish to hustle and make more money in anticipation of November's election results. I certainly don't use all, but once a year I do indulge in such activities. If you bring along the husband and kids, it becomes a work/vacation in one. Win/win in my opinion.
 
If you are board certified, even board eligible, you’re worth more than $200/hr.

I am in between jobs right now, been doing some homework. One of their first questions is, do you have any lawsuits against you or pending. To me that means their pool of workers have some “blemish” with their records. So, you don’t, I’d think you can do more than $200.

Lastly, they ask if you do ob. If you do it with some consistency. You should ask more than $200.

Just some things to consider.

Negotiation is all about leverage. Some have more than others. As someone who has 2 weeks to offer once a year for a definite amount of time and with certain stipulations, there is a limited amount of room to truly negotiate. I earned $200/hr in 2019 and was able to get $215/hr in 2020. The shifts and overall hours worked were a greater priority for myself.
 
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how are you getting two whole weeks off in a row like that from your primary job?? and you're using all your vacation to work?

Won’t most jobs allow you to structure your time off however you damn well please?? That’s how it works in all the PP’s around here.
 
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Negotiation is all about leverage. Some have more than others. As someone who has 2 weeks to offer once a year for a definite amount of time and with certain stipulations, there is a limited amount of room to truly negotiate. I earned $200/hr in 2019 and was able to get $215/hr in 2020. The shifts and overall hours worked were a greater priority for myself.

I think you did well for your specifics. Very limited time for exactly what you want to do. Even got a raise on top!
 
I love doing locums, even though on here there is this stigma. The staff at the host places is appreciative, including the docs. They are usually in places that have a hard time recruiting quality people. Go in, do your job, get paid by the hour, which is the way it should be. Not this insurance/Medicare/medicaid/stipended bull****.
 
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Some of us live in wonderful areas that are already vacation spots, but wish to hustle and make more money in anticipation of November's election results. I certainly don't use all, but once a year I do indulge in such activities. If you bring along the husband and kids, it becomes a work/vacation in one. Win/win in my opinion.
So what do you anticipate is going to happen in November that is making you hustle? Just curious.
 
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so do you guys all get paid per hour on locum? even if one place does bread and butter, and another place is cardiac /trauma/complex peds etc?

or is that the hourly rate to be on call and then you get fee for service for whatever cases come in the door?
 
so do you guys all get paid per hour on locum? even if one place does bread and butter, and another place is cardiac /trauma/complex peds etc?

or is that the hourly rate to be on call and then you get fee for service for whatever cases come in the door?

I locums at a small level 3 community hospital. Call is homecall at a beeper rate. When I get called in rate is $220/hr, they tack on an additional hour of pay for travel time (I live 10mins away though ) . I sit my own cases, no cardiac, OB, or peds <9yo. I’ve never had any complex trauma, they go to the level 1/2’s. I have never been called in at night. If I did cardiac or complex peds I would push for a higher rate for those cases but I’m not interested. I have full time benefits at my main w2 gig but if I was strictly working 1099 I would have pushed for higher rates.
 
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interesting. thank you
what is the beeper rate?
what if you get called in are really busy like do a whole bunch of epidurals in obese preeclamptics versus something simple like a 20 min appy in a healthy young person?
is it still the same rate?
like the epidurals coukd stay in for days and youre 'managing' them from home but not getting paid?
 
so do you guys all get paid per hour on locum? even if one place does bread and butter, and another place is cardiac /trauma/complex peds etc?

or is that the hourly rate to be on call and then you get fee for service for whatever cases come in the door?

Moonlighting/locums has always been hourly for me. I wouldn't do it any other way. It seems to me that taking a short term eat-what-you-kill job is a great setup for being exploited by the people doing the scheduling.
 
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Moonlighting/locums has always been hourly for me. I wouldn't do it any other way. It seems to me that taking a short term eat-what-you-kill job is a great setup for being exploited by the people doing the scheduling.

Yep. I was willing to do some locums down the street, at a neighboring hospital. Just barely over what it would cost them to pay a locums CRNA after travel/food/board. Then they wanted to know, “Would you be willing to just bill/eat what you kill, for the cases you do??”.

Hell, no. You think I’m gonna come in, do an egd at 8am, sit around for 3 hours waiting to do some I&D hand “lunch case”, and then get sent home???

I’ll give you 8 hours at a set price, and it’s YOUR job to fill it with work.
 
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Only way to do that would be a guaranteed unit minimum, and if you come up short they pay you the balance.
 
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Only way to do that would be a guaranteed unit minimum, and if you come up short they pay you the balance.

Yep. I had no reason to think they were doing it for MY benefit or so I could make MORE money, that’s for sure...
 
You had the composure to keep a straight face and not bust out laughing. The lesson here is to know our value. That offer is a hard nope all the nope home.

Yep. I was willing to do some locums down the street, at a neighboring hospital. Just barely over what it would cost them to pay a locums CRNA after travel/food/board. Then they wanted to know, “Would you be willing to just bill/eat what you kill, for the cases you do??”.

Hell, no. You think I’m gonna come in, do an egd at 8am, sit around for 3 hours waiting to do some I&D hand “lunch case”, and then get sent home???

I’ll give you 8 hours at a set price, and it’s YOUR job to fill it with work.
 
You had the composure to keep a straight face and not bust out laughing. The lesson here is to know our value. That offer is a hard nope all the nope home.
Well, the flip side is that they need bodies which is why they are offering the opportunity. They probably know that if you don’t get enough RVUs, you will not come back. So that’s their incentive to get you to work. With that being said, hourly pay structure usually pays more.
 
So what do you anticipate is going to happen in November that is making you hustle? Just curious.

If Biden wins, the markets are going to tank. Thus I want "dry powder" to either have more to invest or to have more options for a down payment in case I need to switch jobs. The market is grossly overvalued and eventually the Fed will stop printing money. Then the full brunt of COVID will be felt. Unfortunately I believe it will be drastic.

Still voting blue.
 
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