Urgent care

[beergoggles911]

Wondering if anyone has MGMA 2021 data for year 2020 for urgent care. I'm up for contract renewal for a fairly large health system in the south. Non academic. Have several years experience. The other docs that already had contract renewal were low balled, in my opinion, and didn't negotiate much. Less than MGMA median according to the 2019 data I found. Obviously they want cheap labor but I will be paid fair market value or I plan to jet out of there. so if anyone has some info , would really appreciate it. Going in for negotiations early December. Trying to get my ducks in row before then.

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[auburnHCP]

Bump. Was offered 130/hr in Urban California for UC (1.5 time for OT after 8 hours) as a per diem (no benefits, 1099). Does this sound fair? Would like to see MGMA too. Thanks guys.

 

[beergoggles911]

MGMA 2019 for west coast region:
25% 240k
Median 281k
75% 327k
90% 368k
Based on 2000 hrs a year, you're looking at 260k. Not sure how much OT will add for you but given cost of living in California and 1099 status, I'd ask for more. Of course new/recent grads usually below median.

If anyone has the 2020 numbers for UC southern, please share.

 

[FrustratedFamDoc]

There is NO WAY I would do urgent care for under $325k/ yr with benefits but I am in a different geographic region which I know plays a big role.

 

[auburnHCP]

That’s fair. What region are you in if if you don’t mind sharing?

 

[drcrispmd]

Missouri. advanced UC (technically we are named Advanced Ambulatory and bill like a clinic, but an advanced UC). $155/hr ($28/hr raise this year) + $15k a year for supervising 3 NP/PA (years of experience and I work directly with them) + yearly bonus (this year $14k). + $5000/year CME. I work 180 hours a month (15-12hr shifts, minimum required is 10/month). If I am charting past my shift, I get paid my hourly rate. All this plus benefits. I request what days I want off. Usually have a 5-7 days off in a row every month.

 

[Make Or Break]

Missouri. advanced UC (technically we are named Advanced Ambulatory and bill like a clinic, but an advanced UC). $155/hr ($28/hr raise this year) + $15k a year for supervising 3 NP/PA (years of experience and I work directly with them) + yearly bonus (this year $14k). + $5000/year CME. I work 180 hours a month (15-12hr shifts, minimum required is 10/month). If I am charting past my shift, I get paid my hourly rate. All this plus benefits. I request what days I want off. Usually have a 5-7 days off in a row every month.

How many patient do you on average personally see per shift?

 

[drcrispmd]

How many patient do you on average personally see per shift?

20-24 typically. As high as 30 when I do a pediatric shift. These are not typical UC patents. We really see level 3 ED patients. We have full lab, X-ray, US, and CT. We direct admit to the hospital. Sometimes send straight to OR (appendicitis). We are also same day scheduled. Since GoHealth joined our hospital group they had to change us from urgent care to this advanced Ambulatory clinic because gohealth UC could not see the level of patients we see. We are also bring in the money now. No more bundled billing like when we were UC. We have IV ABX as well (zosyn, rocephin, levaquin, flagyl, doxy, invanz). We apparently are the first of this type of clinic. I love it. UC but controlled with scheduling. As UC we would see 160-200 in our 12 hours open. Now we schedule 22 per physician/APC we have and can work in other as we see fit.

 

[robellis]

Missouri. advanced UC (technically we are named Advanced Ambulatory and bill like a clinic, but an advanced UC). $155/hr ($28/hr raise this year) + $15k a year for supervising 3 NP/PA (years of experience and I work directly with them) + yearly bonus (this year $14k). + $5000/year CME. I work 180 hours a month (15-12hr shifts, minimum required is 10/month). If I am charting past my shift, I get paid my hourly rate. All this plus benefits. I request what days I want off. Usually have a 5-7 days off in a row every month.

Wow this sounds like an actual nightmare holy **** is primary care/FM underpaid

 

[drcrispmd]

Wow this sounds like an actual nightmare holy **** is primary care/FM underpaid

Zero paperwork, zero patient messages, zero refill requests, zero prior authorizations. I work my shift and go home. I can drop down to 10 shifts a month but 15 is not hard to do for now and I’m trying to get things paid off. I also live is a low cost of living area. Pay before taxes and everything else $350,000 plus bonus. I rarely have to chart after shift. If I work over, I get paid for the time I’m working. Every shift is different. I do not get paid time off. If I did, they would make me salary and my pay would go down. I can arrange my days off as I want. I love it.

 

[Make Or Break]

Zero paperwork, zero patient messages, zero refill requests, zero prior authorizations. I work my shift and go home. I can drop down to 10 shifts a month but 15 is not hard to do for now and I’m trying to get things paid off. I also live is a low cost of living area. Pay before taxes and everything else $350,000 plus bonus. I rarely have to chart after shift. If I work over, I get paid for the time I’m working. Every shift is different. I do not get paid time off. If I did, they would make me salary and my pay would go down. I can arrange my days off as I want. I love it.

Sounds like it’s functioning as a fast track but with the possibility of seeing an actual emergent case. I do agree that you seem underpaid for that kind of work.

 

[auburnHCP]

350K + Bonus = underpaid? Sounds like a great gig to me. What am I missing?

 

[drcrispmd]

350K + Bonus = underpaid? Sounds like a great gig to me. What am I missing?

I don’t know. Not all of our patients are huge work ups. We see a lot of URI r/o covid which are quick in and out. Also have the regen-cov infusions. Little work for level 4 visit. And zero paperwork outside your notes. I was working more hours in primary care and making a lot less.

 

[tealeafexplorer]

Zero paperwork, zero patient messages, zero refill requests, zero prior authorizations. I work my shift and go home. I can drop down to 10 shifts a month but 15 is not hard to do for now and I’m trying to get things paid off. I also live is a low cost of living area. Pay before taxes and everything else $350,000 plus bonus. I rarely have to chart after shift. If I work over, I get paid for the time I’m working. Every shift is different. I do not get paid time off. If I did, they would make me salary and my pay would go down. I can arrange my days off as I want. I love it.

What are your thoughts on the future of urgent care for physicians? Do you think will be all replaced by mid levels?

 

[FrustratedFamDoc]

Replaced? Not unless independent practice for PA/NP gains more traction. Systems will continue to need physicians to sign off on their work at a nominal fee. 10 years down the road as the 'physician shortage' drum keeps getting beaten, your guess is as good as mine.

 

[d2305]

drcrispmd​

Your UC sounds like a free standing ER.

 

[MatchGod]

does UC make more than regular outpt clinic?

 

[VA Hopeful Dr]

does UC make more than regular outpt clinic?

There is huge variety in both areas, so there's not really a yes or no answer there.

 

[drcrispmd]

drcrispmd​

Your UC sounds like a free standing ER.

We pretty much are but with a schedule and set hours. We actually bill as a clinic instead of UC which means we can bill for everything we do and no bundle billing like we did as UC.

There has to be a doc on every shift. We do work very closely with NP and PA. They discuss their patients with me and ask questions. We have a good group and they know what they don’t know. We sign off in every chart (and get paid extra to do this).

 

[Leukocyte]

Replaced? Not unless independent practice for PA/NP gains more traction. Systems will continue to need physicians to sign off on their work at a nominal fee. 10 years down the road as the 'physician shortage' drum keeps getting beaten, your guess is as good as mine.

In New York State, NPs can practice independently after an x number of hours. No MD/DO needed to sign-off on their charts. There are urgent cares who "restructured" by replacing most of their physician employees with NPs. The COVID-19 pandemic caused many urgent cares to "downsize" their staff, and turn to preferentially hiring NPs instead of physicians.

 

[FrustratedFamDoc]

In New York State, NPs can practice independently after an x number of hours. No MD/DO needed to sign-off on their charts. There are urgent cares who "restructured" by replacing most of their physician employees with NPs. The COVID-19 pandemic caused many urgent cares to "downsize" their staff, and turn to preferentially hiring NPs instead of physicians.

I see x becoming a smaller number as time progresses. To much pressure and $ for it not to.

 

[cabinbuilder]

Wondering if anyone has MGMA 2021 data for year 2020 for urgent care. I'm up for contract renewal for a fairly large health system in the south. Non academic. Have several years experience. The other docs that already had contract renewal were low balled, in my opinion, and didn't negotiate much. Less than MGMA median according to the 2019 data I found. Obviously they want cheap labor but I will be paid fair market value or I plan to jet out of there. so if anyone has some info , would really appreciate it. Going in for negotiations early December. Trying to get my ducks in row before then.

I am not even sure what your question is here? What are you asking?

 

[Reboa]

Missouri. advanced UC (technically we are named Advanced Ambulatory and bill like a clinic, but an advanced UC). $155/hr ($28/hr raise this year) + $15k a year for supervising 3 NP/PA (years of experience and I work directly with them) + yearly bonus (this year $14k). + $5000/year CME. I work 180 hours a month (15-12hr shifts, minimum required is 10/month). If I am charting past my shift, I get paid my hourly rate. All this plus benefits. I request what days I want off. Usually have a 5-7 days off in a row every month.

Are you forced to supervise the three midlevels? Do you think that 15k a year is worth the increase in liability your taking on? Are you concerned that once they get independent practice rights in missouri, you've basically trained your replacements?

 

[drcrispmd]

Are you forced to supervise the three midlevels? Do you think that 15k a year is worth the increase in liability your taking on? Are you concerned that once they get independent practice rights in missouri, you've basically trained your replacements?

It was part of the contract. Like I have said, we work side by side with them. I know what is going on with patients real time. All of our clinic APCs do not think PA or NP should practice independently. We cover CT and MRI out patient across the hall for contrast reactions so there has to be a physician on every shift to cover. They don’t allow NP/PA to cover. I did not train our APC. Most have been in practice >10 years and fully aware their education and experience is not equal to physicians. I am not scared of losing my current job to them.