USACS Denver pays EM docs 20 bucks an hour

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Brigade4Radiant

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Wow such a competitive wage

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21 bucks an hour plus $15 per RVU. So if you see 2 lvl 5 patients per hour, you get paid 141/hr. If both of those patients are Medicare, usacs collects 268. If either has private insurance, they collect much more. This job likely pays you less than half of what you're actually generating.
 
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The compensation plan comes out to roughly $80/HR for 1 PPH and $140/HR for 2 PPH and $200/HR for 3PPH at Lutheran Hospital.

For reference $140/HR for 1 PPH is the standard at many hospitals so they're literally seeing twice the patients for the same pay.
 
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I get angry at the fact that people actually work for this company.
Probably new grads. A few years back when I was talking to USACS RE: CO jobs I put the recruiter on the spot and made the comment "Man...I can't believe you guys are finding docs to work at these rates. You must have a lot of new grads fresh out who don't know what they are worth yet." He chuckled and said "Yeah...yeah..well, we do have a lot of new docs out of residency....thanks for your time doc."

Market forces. As long as people are willing to work for low rates, USACS can get away with it. I don't foresee that changing with the current and incoming glut of EPs.
 
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Probably new grads. A few years back when I was talking to USACS RE: CO jobs I put the recruiter on the spot and made the comment "Man...I can't believe you guys are finding docs to work at these rates. You must have a lot of new grads fresh out who don't know what they are worth yet." He chuckled and said "Yeah...yeah..well, we do have a lot of new docs out of residency....thanks for your time doc."

Market forces. As long as people are willing to work for low rates, USACS can get away with it. I don't foresee that changing with the current and incoming glut of EPs.

- and this is the canary in the coal-mine.

Everyone, hone your side-hustle game.
 
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21 bucks an hour plus $15 per RVU. So if you see 2 lvl 5 patients per hour, you get paid 141/hr. If both of those patients are Medicare, usacs collects 268. If either has private insurance, they collect much more. This job likely pays you less than half of what you're actually generating.
Medicare is actually paying more like $160-170 for a 99285.
 
Supply and demand. If someone is willing to take a 150/hr job, then that is what the job is worth.
 
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Is Denver a crazy market for all specialties, or is EM especially hard hit there?
 
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Medicare is actually paying more like $160-170 for a 99285.
I believe it's $138. The physician fee for a 99285 in 2022 is exactly 4.0 RVUs. The final RVU conversion factor is $34.6062 / RVU. --> 138.42 for a lvl 5 chart. I had the conversion factor wrong in my original post, so it's actually USACS collecting at least $276.84 while paying you $141 assuming 2 lvl 5 charts/hr.
 
The heck with Usucks and Denver.

Two of the most overrated cities in America - Denver and Austin.
 
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I think USACS has most of the Denver market, outside of what is staffed by the university group and only 1 SDG at 1 site I believe is left.

Basically it depends on how you define the Denver Market.

Most of the northern suburbs are still SDG hospitals.

They're paying much better in the $200 range.
 
There are still great jobs available in the rockies if you have the right connections.

When I was a senior resident I was offered a job with Aspen Valley Hospital.

They were offering $200 to see 1 per hour plus you got free lift tickets.
 
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I believe it's $138. The physician fee for a 99285 in 2022 is exactly 4.0 RVUs. The final RVU conversion factor is $34.6062 / RVU. --> 138.42 for a lvl 5 chart. I had the conversion factor wrong in my original post, so it's actually USACS collecting at least $276.84 while paying you $141 assuming 2 lvl 5 charts/hr.
The 4.0 rvus is wrvus. I’m talking total.
 
No way I would work for <$200/hr in emergency medicine. Doesn't matter if it's in the boonies or a big academic center. There is just way too much risk associated with it, a lot of stress, people get PTSD from the job, not to mention family stress from working shifts of all kinds of hours. Just not worth it for the same salary as a nurse, NP, or PA.
 
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DBag running quite a con and financially illiterate docs are gonna get screwed. This imo is anyone voluntarily holding their trash stock.
 
No way I would work for <$200/hr in emergency medicine. Doesn't matter if it's in the boonies or a big academic center. There is just way too much risk associated with it, a lot of stress, people get PTSD from the job, not to mention family stress from working shifts of all kinds of hours. Just not worth it for the same salary as a nurse, NP, or PA.
There is no academic job I know if that pays over 200 dollars an hour. Granted it is salary based, and I calculated it out roughly before I took my current academic job, and it wasn't even in the 200 dollar ballpark. And I'm considered to be at an academic shop that "pays well" relatively speaking.
 
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There is no academic job I know if that pays over 200 dollars an hour. Granted it is salary based, and I calculated it out roughly before I took my current academic job, and it wasn't even in the 200 dollar ballpark. And I'm considered to be at an academic shop that "pays well" relatively speaking.

Pretty sure southerndoc works at an academic level 1, so there is one that pays over $200/hr. I know of two in the Midwest that pay that or more.
 
There is no academic job I know if that pays over 200 dollars an hour. Granted it is salary based, and I calculated it out roughly before I took my current academic job, and it wasn't even in the 200 dollar ballpark. And I'm considered to be at an academic shop that "pays well" relatively speaking.

Yes, $200/hr for most academic gigs but that’s only if you’re looking at pay without benefits.
 
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There is no academic job I know if that pays over 200 dollars an hour. Granted it is salary based, and I calculated it out roughly before I took my current academic job, and it wasn't even in the 200 dollar ballpark. And I'm considered to be at an academic shop that "pays well" relatively speaking.

I think a lot of community based residency programs pay greater than this, including where I went to medical school, where I rotated, and where I am doing residency - all mid-Atlantic and SE regions.
 
There is no academic job I know if that pays over 200 dollars an hour. Granted it is salary based, and I calculated it out roughly before I took my current academic job, and it wasn't even in the 200 dollar ballpark. And I'm considered to be at an academic shop that "pays well" relatively speaking.

I worked at an academic W2 job where pretty much everyone made 300-360k in a base plus productivity model. The upper end was actually dominated by those with the most “protected” time, like 80-100 hours per month clinically, because they got higher base salaries which had more monetary value per hour than clinical productivity. It was a pretty backwards system and one reason which led to my frustration there. Has to be one of the sweetest deals in EM for the lucky ones. Even for full time clinical docs (120h/mo) it was pretty good from a purely financial perspective.
 
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I would say we have to define academic. To me that means the hospital and your employer are “university of … xxx” and I’m talking main site. Indiana Vanderbilt wake forest and others are gobbling up community sites. Simply hva8ng a residency doesn’t make you an academic center Imo.
 
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Perhaps I am not as well educated on this, but I did land an academic job in the last cycle (have been at my current job ~1 year).

When I look at the academic jobs I interviewed at, which included midwest, southeast, southwest, california, mountain west etc, I would say the average going rate was in the 240k range annually (which if you work 14 shifts per month puts you at sub-200/hr). The highest I saw was 285K, and the lowest I saw was 190K.

I didn't come across anything above 300, and definitely not even close to 360...

I think if you look at the major cities, especially (think LA, SF, Boston, Chicago, Houston, Miami, Denver, etc) there is no way you are breaking 300k in those markets with an academic job. Perhaps in smaller mid-size cities with decent academic centers it's more likely.

And yes, if you work at an "academic affiliate" which is a community site, you may make more. But I really don't see or know of a lot of academic docs at level 1 centers making over 300, especially not junior level faculty (perhaps is different if you are full professor/department chair etc)

Furthermore, when you look at the all the hours you put in with academics, it extends beyond just clinical shifts.... you are spending your days out of the ED in meetings, doing research, teaching, lecturing, etc. The hours you put in for all those endeavors drops your overall hourly wage even lower.
 
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I'll often tell people working for an SDG residency program is often the cushiest job in emergency medicine.

At my residency in Detroit most of the senior faculty were clearing 500k working about 150hrs a month.
 
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I'll often tell people working for an SDG residency program is often the cushiest job in emergency medicine.

At my residency in Detroit most of the senior faculty were clearing 500k working about 150hrs a month.
Was this St Johns pre teamhealth?
 
Was this St Johns pre teamhealth?
St John’s was not an SDG, was just a local CMG, with w-2 jobs. I trained there, and in my senior year the owner of the group sold it to TH for about $40 mil, all without telling the docs of course.
 
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And yes, if you work at an "academic affiliate" which is a community site, you may make more. But I really don't see or know of a lot of academic docs at level 1 centers making over 300, especially not junior level faculty (perhaps is different if you are full professor/department chair etc)

Both my medical school program and my residency program are both at Level 1 trauma centers in the southeast. Both are older programs founded in mid 80s and completely run by democratic groups. Faculty at both places are making way, way more than this. I encountered several similar setups during my residency interviews a few years ago. Certainly not the normal arrangement for academic hospitals but they are out there.

I'll often tell people working for an SDG residency program is often the cushiest job in emergency medicine.

At my residency in Detroit most of the senior faculty were clearing 500k working about 150hrs a month.

Concur based on what I've seen. Probably also the hardest job to land but if you can pull it off its quite nice. I've got faculty in their late 60s/early 70s who don't need the money but still greatly enjoy coming to work.
 
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Heh well this entire thread has come full circle.

Brooks Bock moved to Colorado and is the Medical Director for Vail Health.
 
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There is no academic job I know if that pays over 200 dollars an hour. Granted it is salary based, and I calculated it out roughly before I took my current academic job, and it wasn't even in the 200 dollar ballpark. And I'm considered to be at an academic shop that "pays well" relatively speaking.

Physicians are too sloppy when we talk about pay. Most academic jobs are about 1440 hours per year; to break $200/hr you need to make $288k per year. That's on the higher end if we're talking just base pay for early career academics but pretty attainable if we're accounting for bonuses and retirement matching and even more common if we're accounting for healthcare benefits and/or malpractice coverage.
 
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Physicians are too sloppy when we talk about pay. Most academic jobs are about 1440 hours per year; to break $200/hr you need to make $288k per year. That's on the higher end if we're talking just base pay for early career academics but pretty attainable if we're accounting for bonuses and retirement matching and even more common if we're accounting for healthcare benefits and/or malpractice coverage.
I have learned this over time. People don't consider benefits, Some people don't understand their W-2 income vs 1099 income etc. It speaks to why and how we get abused and USACS can push thru their lies and the gullible just sit by like slack jawed yokels.
 
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Physicians are too sloppy when we talk about pay. Most academic jobs are about 1440 hours per year; to break $200/hr you need to make $288k per year. That's on the higher end if we're talking just base pay for early career academics but pretty attainable if we're accounting for bonuses and retirement matching and even more common if we're accounting for healthcare benefits and/or malpractice coverage.
Again, very few people in academics are straight clinical. Just like you take into consideration benefits, matching etc, you have to take into account the degree of uncompensated time, which is a lot (research, administrative work, quality processes, resident/med student teaching, resident conference, faculty meeting, sepsis committee meeting, plus the side work I do in EMS, much of this is REQUIRED by your department). Unlike working in the community where hourly pay makes sense, it really does not translate well into being a salaried W2 employee of a university physician group. 1440 hours per year can be 100% clinical which it often is for most new faculty... Granted that clinical time can be bought down with outside sources of funding, but it can still be challenging to do.

288K/year in academics... while there are jobs out there, they are by no means easy to find, and furthermore, with all the extra work you do you are making quite a bit less than 200/hr. As you alluded to, for junior faculty its even harder, and from the research I've done on publicly available records on physician pay for state employees, the folks who are breaking the 300K mark are usually full professors, department chairs, deans of medical schools etc. This is a minority of folks in academics.
 
Again, very few people in academics are straight clinical. Just like you take into consideration benefits, matching etc, you have to take into account the degree of uncompensated time, which is a lot (research, administrative work, quality processes, resident/med student teaching, resident conference, faculty meeting, sepsis committee meeting, plus the side work I do in EMS, much of this is REQUIRED by your department). Unlike working in the community where hourly pay makes sense, it really does not translate well into being a salaried W2 employee of a university physician group. 1440 hours per year can be 100% clinical which it often is for most new faculty... Granted that clinical time can be bought down with outside sources of funding, but it can still be challenging to do.

288K/year in academics... while there are jobs out there, they are by no means easy to find, and furthermore, with all the extra work you do you are making quite a bit less than 200/hr. As you alluded to, for junior faculty its even harder, and from the research I've done on publicly available records on physician pay for state employees, the folks who are breaking the 300K mark are usually full professors, department chairs, deans of medical schools etc. This is a minority of folks in academics.

I agree, there are other consideration and nothing is going to be a perfect comparison. I left out the non-clinical time because it's hard to make an apple to apple comparison to community positions. Typically, purely clinical faculty working 1440 hours/year don't have the same non-clinical obligations that core faculty or those getting buy-down do. To me, the cleanest way to compare salaries is assuming full-time clinical work because ultimately the fundamental unit of currency in EM is dollars per hour in the emergency department. The decision to accept other responsibilities for buy-down then is a separate comparison within that one job; i.e. is it worth it to trade 12 clinical hours a month for 20 hours a month doing EMS administration (or conversely is it worth being a community Medical Director to make $X more a year or get out of N shifts).

I don't think $288k a year is all that rare. A 1440 clinical obligation with a salary of $220k-240k with a 10% retirement match and/or 10% bonus is $260k and seemed to be pretty common even for junior faculty in competitive cities. It doesn't take a lot to get another $18k in benefits, raises, etc. Is that really less than the compensation you were seeing?
 
Academician here (I.e. my paychecks are written by the University of Whatever):

When I moved from my community gig to my academic one, I broke everything down into a final hourly rate. Figuring that out for my community gig was easy - the only benefit they paid for me was my malpractice, everything else was going to come out of my pocket (no CME, no employer payroll taxes, etc).

When I needed to make the calculation on the academic job, it took a lot more work. After the salary, there’s the retirement match, the CME money, the vacation, a bonus structure, the payroll taxes, the health insurance subsidy, the dental insurance, the vision insurance, the disability insurance, the life insurance, and more. Now you can’t use what the university says the “value” of these things are, but since they’re all things I was paying for myself already, I looked at what I’d be saving (I.e. not purchasing for myself any more) and added that into my compensation too. The hours question was easy because I came on as fully clinical faculty (so I didn’t need to factor a bunch of hidden academic hours of work)

The end result was that even though the salaries on the surface appearing to be 80-90k per year different, I actually came out ahead on the academic job after factoring in the benefits.
 
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Academician here (I.e. my paychecks are written by the University of Whatever):

When I moved from my community gig to my academic one, I broke everything down into a final hourly rate. Figuring that out for my community gig was easy - the only benefit they paid for me was my malpractice, everything else was going to come out of my pocket (no CME, no employer payroll taxes, etc).

When I needed to make the calculation on the academic job, it took a lot more work. After the salary, there’s the retirement match, the CME money, the vacation, a bonus structure, the payroll taxes, the health insurance subsidy, the dental insurance, the vision insurance, the disability insurance, the life insurance, and more. Now you can’t use what the university says the “value” of these things are, but since they’re all things I was paying for myself already, I looked at what I’d be saving (I.e. not purchasing for myself any more) and added that into my compensation too. The hours question was easy because I came on as fully clinical faculty (so I didn’t need to factor a bunch of hidden academic hours of work)

The end result was that even though the salaries on the surface appearing to be 80-90k per year different, I actually came out ahead on the academic job after factoring in the benefits.
Not all benefits are worth the same to everyone. Kudos for breaking it down to sort out what makes sense for you. So few people do this.
 
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Not all benefits are worth the same to everyone. Kudos for breaking it down to sort out what makes sense for you. So few people do this.
Yeah it's surprising the lack of time some people spend on what is potentially one of the most important financial decisions they will make in life (second only to who one marries, and perhaps what house they purchase). I even broke down how long the commutes for the two jobs would be and factored in the time value of the drive.
 
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Yeah it's surprising the lack of time some people spend on what is potentially one of the most important financial decisions they will make in life (second only to who one marries, and perhaps what house they purchase). I even broke down how long the commutes for the two jobs would be and factored in the time value of the drive.
I would argue a high paying job is more important than a house. Lets say you buy a house and you overpay 150K for that house. Most of us on here would be like how could someone do something so dumb.. Yet we see people make idiotic decisions in their jobs and give up 50k+ per year over a 25 year or more career. Ill say similarly many SDGs are poorly run and leave an insane amount of money on the table.

When i found my current gig i got stupid lucky, with that came a significant amount more income over the course of my remaining career. Even more importantly is that I earn that money when i am relatively young so Compound interest can be my friend.

To give a quick illustration of how important it is. My kids 529 has about as much in "growth" as principal i put into that.

A house is a forgiveable financial mistake. Taking a bad job just isnt. Now jobs are about much more than money (as you alluded to commute, quality of employment etc all matter) but dont let the sparkle make you take your eye off the prize.
 
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Supply and demand. If someone is willing to take a 150/hr job, then that is what the job is worth.
Will many EM docs pack their bag if the going rate is $150-175/hr... That seems decent when you look at it from a non surgical specialty.
 
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Will many EM docs pack their bag if the going rate is $150-175/hr... That seems decent when you look at it from a non surgical specialty.
Some will, but most won't. Talk is cheap. A lot of doctors are in debt up to their eyeballs and can't afford to be out of work for even a week. So yes, they'll moan and gripe. And then, back to work.
 
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This is the greatness of the American supply/demand economy. It doesn't care who you are, your color, your race, your experience, your education. It just cares about $$$.

The lower your bring the rate, then less docs will go into EM. More docs would leave EM thus bringing down supply and increasing demand. Then rates go up.

But I do agree that many would take 125/hr coming out b/c they don't know better and feel like 200K/yr is a good living. I mean, what options do most EM docs have that will make 200k/yr?
 
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Will many EM docs pack their bag if the going rate is $150-175/hr... That seems decent when you look at it from a non surgical specialty.

The absolute hourly wage doesn't matter, it's the relevant hourly wage. The question is not whether $150/hr is decent. The question is whether $150/hr worth working in an ED compared to whatever else that labor pool can be doing. At $150/hr, your labor pool can now viably consider a wide pool of generic physician work and even opens up the possibility of non-clinical work.
 
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