USACS Denver pays EM docs 20 bucks an hour

[EctopicFetus]

The Va system is weird. It takes a lot of number crunching to understand the differences between it and community gigs. Plus one Va is not like the other.

Hours-wise, it demands 80 hours per pay period. One shop I know does 3 12s per week and a 8hr admin time shift. The other does an 8hr ER shift.

But you get 26 8hr days off per year. Plus 11 8hr federal holidays. So your 2080 hours comes down to 1784 after time off. Closer to 148 hrs/mo if they have you work those 8hr shifts. 140 if you get the admin time.

Pay I’ve seen is around 270k. Some starting at 300k. Per hour that’s much lower than community.

Yep. Good benefits with pension and health insurance. Hard to imagine any scenario where it makes sense. Like I said I haven’t looked at the numbers in a while but when I did about 7 years ago it wasn’t even in the ballpark. I think over time it will. Best bet is total comp is around 190-200/hr assuming you use their benefits.

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[Backpack234]

Oh man...I had that post written up partly on my phone and didn't realize I posted it incomplete. Let me finish it up real quick here. Starting over...

The Va system is weird. It takes a lot of number crunching to understand the differences between it and community gigs. Plus one Va is not like the other.

Hours-wise, it demands 80 hours per pay period. One shop I know does 3 12s per week and a 8hr admin time shift. The other does an 8hr ER shift. But you get 26 8hr days off per year. Plus 11 8hr federal holidays. So your 2080 hours comes down to 1784 after time off.

That's closer to 148 hrs/mo if they have you work those 8hr shifts. 140 if you get the admin time.

Pay I’ve seen is around 270k. Some starting at 300k. Per hour that’s much lower than community, but here's the math I've done.

At the VA, you get 280k/yr (split the difference and use easier numbers). Plus you get a 5% match into your TSP (401k type account) and what comes out to about a 8% contribution to your pension. Running these numbers, it comes out to about 280k/yr plus 36,400 in pre-tax benefits. Depending on your state you have to run the tax numbers yourself. But for easy comparison, add taxes back on to those pre-tax benefits to add them to salary. Say 30% tax rate. So about 52,000 in equivalent additional salary. Just including those two benefits, in total: $332,000 total comp.

Now look at another shop's offer, which after playing the RVU game pays about 220/hr. At the same hours/mo (148 assuming you don't get the admin time), that's $390,720. Even closer at $370,000k if you use 140hrs.

So pick your hours for comparison, but for me the comparison is $332,000 VA compared to $390,720 for CMG gig.

BUT then there are the other VA benefits. Malpractice coverage (you can still get sued, but the federal government backs you financially and it's a more arguous process. Tort reform and such). ZERO night shifts. And closer to 1 patient per hour.

Which leads to a different way of viewing this. Instead of dollars per hour, why not dollars per patient? Easy enough....That 390k CMG gig sees 2PPH. So $110 per patient. The VA sees closer to 1 patient per hour, or $186 per patient.

Check my math here, please. But even at a 60k difference, I don't see a huge loss in value going to the VA unless you don't care about those other benefits. And if you're lucky enough to go to a VA with admin time, it's even closer.

 

[turkeyjerky]

I think you make some good points. But you're talking about a strict requirement of 74 hrs per 2 week period, after vacation time. It definitely seems to lack the flexibility of most EM gigs. Also, not a whole lot of location options either.

I think for the right person, someone who wants a 9-5ish style job and doesn't really care about medicine anymore, it's a good option. It definitely beats getting to be an "owner" of usucks for 140/hr.

 

[Frazier]

Oh man...I had that post written up partly on my phone and didn't realize I posted it incomplete. Let me finish it up real quick here. Starting over...

The Va system is weird. It takes a lot of number crunching to understand the differences between it and community gigs. Plus one Va is not like the other.

Hours-wise, it demands 80 hours per pay period. One shop I know does 3 12s per week and a 8hr admin time shift. The other does an 8hr ER shift. But you get 26 8hr days off per year. Plus 11 8hr federal holidays. So your 2080 hours comes down to 1784 after time off.

That's closer to 148 hrs/mo if they have you work those 8hr shifts. 140 if you get the admin time.

Pay I’ve seen is around 270k. Some starting at 300k. Per hour that’s much lower than community, but here's the math I've done.

At the VA, you get 280k/yr (split the difference and use easier numbers). Plus you get a 5% match into your TSP (401k type account) and what comes out to about a 8% contribution to your pension. Running these numbers, it comes out to about 280k/yr plus 36,400 in pre-tax benefits. Depending on your state you have to run the tax numbers yourself. But for easy comparison, add taxes back on to those pre-tax benefits to add them to salary. Say 30% tax rate. So about 52,000 in equivalent additional salary. Just including those two benefits, in total: $332,000 total comp.

Now look at another shop's offer, which after playing the RVU game pays about 220/hr. At the same hours/mo (148 assuming you don't get the admin time), that's $390,720. Even closer at $370,000k if you use 140hrs.

So pick your hours for comparison, but for me the comparison is $332,000 VA compared to $390,720 for CMG gig.

BUT then there are the other VA benefits. Malpractice coverage (you can still get sued, but the federal government backs you financially and it's a more arguous process. Tort reform and such). ZERO night shifts. And closer to 1 patient per hour.

Which leads to a different way of viewing this. Instead of dollars per hour, why not dollars per patient? Easy enough....That 390k CMG gig sees 2PPH. So $110 per patient. The VA sees closer to 1 patient per hour, or $186 per patient.

Check my math here, please. But even at a 60k difference, I don't see a huge loss in value going to the VA unless you don't care about those other benefits. And if you're lucky enough to go to a VA with admin time, it's even closer.

Good points on the per patient analysis.
I agree and think it really depends on the interests, focus, and goals of the EM doc.

 

[EctopicFetus]

Good points on the per patient analysis.
I agree and think it really depends on the interests, focus, and goals of the EM doc.

I think the $/pt is a valuable number but total comp matters more. We are all different but I would rather make $390/hr for 2pph than $200/hr for 1 pph. There is obviously a top pph where I think it may matter but sitting with my thumb up my ass and making 50% of a normal volume job doesn't make me feel good. I mean I know of a site seeing 0.5pph but only pays $130/hr. that's $260/pt but man I would be miserable making that little.

Also, the VA just generally sucked bad when I was there as a student and resident.

 

[namethatsmell]

I know people who worked at the va. It’s like an end of line job. The people I know hated their patients, hated the whole setup etc. for those who claim it is not a major pay cut maybe it is different than the jobs I looked at before. The va required 36-40 clnical hours a week. You got paid vacation which helps but pay was in the upper 200s. That was 7 years ago. There are a number of reasons EM trained people avoid the va.

Most of the guys/gals I know at the VA like it. None of them are the "I expect my shop to run smooth like butter and be ultra-efficient" types--people wanting that would be miserable at the VA. But for docs who feel burned out by the fallacy of the "health care system," are not in the game to churn, or find working with generally respectful and grateful pts...it can be a good gig. And low stress which I've seen change the personality of a doc I know well very much for the better. Docs at his ED start at 300k and it's bascially guaranteed to go up over time (as with all federal jobs).

It can be a really good gig, with probably the biggest con is that many of their EDs expect 40hrs/wk for EM docs similar to their outpatient 9-5 docs who don't do nights/weekends/holiday. If they adjusted that by ~5-10 hours per week to match the normal hourly requirements of all other EM jobs, it'd be one of the best gigs out there. That said, I know a guy who wanted to work at the VA and had flexibility to move to multiple cities and none of the VAs had an EM opening, so seems they're doing ok?

 

[EctopicFetus]

Most of the guys/gals I know at the VA like it. None of them are the "I expect my shop to run smooth like butter and be ultra-efficient" types--people wanting that would be miserable at the VA. But for docs who feel burned out by the fallacy of the "health care system," are not in the game to churn, or find working with generally respectful and grateful pts...it can be a good gig. And low stress which I've seen change the personality of a doc I know well very much for the better. Docs at his ED start at 300k and it's bascially guaranteed to go up over time (as with all federal jobs).

It can be a really good gig, with probably the biggest con is that many of their EDs expect 40hrs/wk for EM docs similar to their outpatient 9-5 docs who don't do nights/weekends/holiday. If they adjusted that by ~5-10 hours per week to match the normal hourly requirements of all other EM jobs, it'd be one of the best gigs out there. That said, I know a guy who wanted to work at the VA and had flexibility to move to multiple cities and none of the VAs had an EM opening, so seems they're doing ok?

Most of their EDs aren’t really Ed’s and most are staffed by IM not EM.

 

[solitarius]

Denver Hospital Offering Emergency Physicians $21 Per Hour

Emergency physician hospital employment in Denver is competitive. Lutheran Medical Center pushes the envelope by offering doctors $21/hour!

sullivanlegal.us

Wow such a competitive wage

Sadly, the McDonald's down the street is paying more.

 

[EctopicFetus]

Sadly, the McDonald's down the street is paying more.

Soon it will be harder to fill that spot at Mickey Ds than your local ED.
#ThanksACEP

 

[emergentmd]

This $21/hr seems like alittle click bait b/c income mostly from RVUs. $15/RVU is the bigger issue. Avg RVUs around a level 4 so 2.6 RVUs x 2.25pph = about 6RVUs/hr. That is an extra $90/hr. Throw in some procedures and you may get to $100-125/hr.

So job seems to make about $125/hr.

Now if you oversee a bunch of APCs, then the rate starts to be competitive. If you manage 2 APCs during your shift (I have been on jobs like this), they can generate a bunch of Level 3 codes @1.6RVU/pp. If they see 3pph that is 6ptx1.6x$15= $144/hr.

Throw in good benefits that could equate to 25-50/hr, then you are pushing $300+/hr.

 

[namethatsmell]

Just curious if this $21/hr is real. I am sure they can post $21/hr but there is no way someone is taking anything remotely under $100/hr.

It's $21/hr + RVUs per the article.

My 2nd-hand understanding is that 1.5yrs ago they paid ~125/hr for non-partners and "partners" (from their pre-buyout group) were straight RVU and did OK. Then in the first part of the pandemic with super low volumes, USUCKS "lost" (ie made less) $$ on these non-partners...so goodbye peanuts hourly rate and hello incredibly pathetic compensation.

And for anybody who's never been there, Denver is a-ok...but it's not all that+bag of potato chips.

 

[HemeOncHopeful19]

It's $21/hr + RVUs per the article.

My 2nd-hand understanding is that 1.5yrs ago they paid ~125/hr for non-partners and "partners" (from their pre-buyout group) were straight RVU and did OK. Then in the first part of the pandemic with super low volumes, USUCKS "lost" (ie made less) $$ on these non-partners...so goodbye peanuts hourly rate and hello incredibly pathetic compensation.

And for anybody who's never been there, Denver is a-ok...but it's not all that+bag of potato chips.

Denver always struck me as a place that got ruined by the word getting out - I know that’s a cliche thing to say but in Denver’s case they really can’t widen up I-70 so the crowds actually do make things irreversibly worse.

 

[turkeyjerky]

This $21/hr seems like alittle click bait b/c income mostly from RVUs. $15/RVU is the bigger issue. Avg RVUs around a level 4 so 2.6 RVUs x 2.25pph = about 6RVUs/hr. That is an extra $90/hr. Throw in some procedures and you may get to $100-125/hr.

So job seems to make about $125/hr.

Now if you oversee a bunch of APCs, then the rate starts to be competitive. If you manage 2 APCs during your shift (I have been on jobs like this), they can generate a bunch of Level 3 codes @1.6RVU/pp. If they see 3pph that is 6ptx1.6x$15= $144/hr.

Throw in good benefits that could equate to 25-50/hr, then you are pushing $300+/hr.

I can't imagine they get the same 15/rvu for supervision. It's likely 6 bucks per, or something like that.