What are salaries actually looking like these days?

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BoardingDoc said:
Getting 12 12h shifts a month regularly at a site that is offering 350/hr is no longer an easy task.
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It happens I work with docs that make 500 an hour for a CMG. This is one hour from a major metropolitian area. These jobs aren’t advertised but you can negotiate.

I don’t make that but when my contract runs out...
 
Brigade4Radiant said:
It happens I work with docs that make 500 an hour for a CMG. This is one hour from a major metropolitian area. These jobs aren’t advertised but you can negotiate.

I don’t make that but when my contract runs out...
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How do I get these kinds of jobs? Do I ask my program director/faculty for help?
 
EMhopeful2 said:
How do I get these kinds of jobs? Do I ask my program director/faculty for help?
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Honestly most people wouldn't want these kind of jobs. Most people are married, have kids, or are tied to a very specific geographic area. I'm lucky enough to have a spouse who allows me to travel away from home weeks at a time for work. Not everyone can do that.
 
GeneralVeers said:
Honestly most people wouldn't want these kind of jobs. Most people are married, have kids, or are tied to a very specific geographic area. I'm lucky enough to have a spouse who allows me to travel away from home weeks at a time for work. Not everyone can do that.
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Agreed. I tried convincing my wife on taking a remote travel position for 300+/hr. That idea was shot down in seconds. Those jobs are out there.
 
4 yrs ago when there were high EM demands and every recruiter thought I was some rare unicorn, I could have made right at $1.1 Mil working 15, 12hr shifts at $500/hr.

Could have picked bonus shifts at $650/hr which had about 30 shifts a month openings each schedule.

I have worked in trauma receiving hospitals, 60K+ ERs, trained at one of the busiest county hospital in the country, Rural lonely ERs and I will say this place was the most difficult by far with the sickest population.

If I was single, I would likely have sucked it up for 3-5 yrs and retire but the rib only allowed me to pick up a few $650/hr shifts a month. But man, it was nice getting paid close to 8K for 12 hrs of work.

Concerning being overworked. I have been Above 400K for the past 10 yrs and don't feel overworked with a family and three young kids working 14-16 shifts.

If I were single, and noone to bother me after a shift doing 14-16 shifts would be a piece of cake.
 
GeneralVeers said:
Not many places. I'm seeing rates of $225 in big cities in Texas, which a few years ago were at least $250+.
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Eew. And one would have to live in Texas. I earn in that range seeing 1.3 an hour, and it's somewhere pretty desirable. Probably won't last long.

Recession-proof? Maybe, but not immune to the laws of supply and demand, and we don't control the supply.

Earn your capital, invest, leverage, and get out.
 
miacomet said:
Eew. And one would have to live in Texas. I earn in that range seeing 1.3 an hour, and it's somewhere pretty desirable. Probably won't last long.

Recession-proof? Maybe, but not immune to the laws of supply and demand, and we don't control the supply.

Earn your capital, invest, leverage, and get out.
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I agree with a lot of what you say and have my own issues with EM, but from what I can surmise through your postings, you:

-Work in a good group with good nurses, etc
-Live in a nice area of the country
-Make ~225/hr to see ~1.3 pph

So you live in a nice place and (if we assume avg collections of $150/pt) are paid more money than you bring into the group, and yet are still disillusioned? Cause you gotta do a few nights here and there? What do you want - $300/hr to see zero/pph? I don't get it.
 
GonnaBeADoc2222 said:
I agree with a lot of what you say and have my own issues with EM, but from what I can surmise through your postings, you:

-Work in a good group with good nurses, etc
-Live in a nice area of the country
-Make ~225/hr to see ~1.3 pph

So you live in a nice place and (if we assume avg collections of $150/pt) are paid more money than you bring into the group, and yet are still disillusioned? Cause you gotta do a few nights here and there? What do you want - $300/hr to see zero/pph? I don't get it.
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Sometimes I get paid well over 200/hr to sleep or watch movies. That’s the dream.
 
GonnaBeADoc2222 said:
I agree with a lot of what you say and have my own issues with EM, but from what I can surmise through your postings, you:

-Work in a good group with good nurses, etc
-Live in a nice area of the country
-Make ~225/hr to see ~1.3 pph

So you live in a nice place and (if we assume avg collections of $150/pt) are paid more money than you bring into the group, and yet are still disillusioned? Cause you gotta do a few nights here and there? What do you want - $300/hr to see zero/pph? I don't get it.
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Sure, I just picked the wrong field. I'd rather work in a field where it's easier to build a practice, and where you have ownership and some control. GI or something where I can avoid CMS. Nights, weekends, and holidays are just really bad for me. I just don't enjoy being an employed, hourly worker in an under-appreciated field like EM where one is essentially paid to do a job not based on expertise, but because no one else wants to deal with those hours and those patients.

Different strokes for different folks. It works for some. I realize I have a comparatively good deal and for that reason I'm loath to give it up, but it's just not my thing. YMMV.
 
miacomet said:
Sure, I just picked the wrong field. I'd rather work in a field where it's easier to build a practice, and where you have ownership and some control. GI or something where I can avoid CMS. Nights, weekends, and holidays are just really bad for me. I just don't enjoy being an employed, hourly worker in an under-appreciated field like EM where one is essentially paid to do a job not based on expertise, but because no one else wants to deal with those hours and those patients.

Different strokes for different folks. It works for some. I realize I have a comparatively good deal and for that reason I'm loath to give it up, but it's just not my thing. YMMV.
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I hear you
 
20s delayed gratification for medical school and residency

30s delayed gratification for retirement

40s delayed gratification for family legacy

50s half me and half retirement

60s me

Don’t live like a top 5% earner, and you will be happy and do fine.
 
GeneralVeers said:
Huh? I'd take Dallas, Houston or San Antonio over most other large cities in the US. To each their own I guess.
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Why, aside from low COL? Traffic, ugly, no outdoors nearby, not walkable, too hot, too flat. What do you find so appealing about them?
 
Porfirio said:
20s delayed gratification for medical school and residency

30s delayed gratification for retirement

40s delayed gratification for family legacy

50s half me and half retirement

60s me

Don’t live like a top 5% earner, and you will be happy and do fine.
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Of course, that's where the catch is -- remembering to live and enjoy life while still somewhat delaying gratification during peak earning years. It's okay to spend some. Just "pay yourself first."
 
Or pick a field where everyone isn't looking for an exit strategy....
 
I used to make $25/hr prior to med school. I worked 180 hrs a month and 2340 hours a year for about 60K annual compensation with end of year bonus. I worked in an office with a window and was really pumped about the window office because that meant you were "special" in corporate. The weekly M-F, "regular hours", "lower stress" corporate grind was utterly and completely soul crushing to me. I hated life and medical school was my ticket to really "do something", be successful and "make a difference". I wanted to make myself and my family proud.

Even on my worst days in EM, I thank my lucky stars I don't have to do corporate work anymore. I make $250+/hr and work...however much or as little I want within reason. (100-150 hours....hey, literally whatever I feel like that month) I live in a 4000 sqft house and drive a 100K+ SUV. I take 5-6 vacations a year and ski 21 days a year. I spend a week in a caribbean villa every year and bum around on the beach. I've got 100K just sitting in one of my bank accounts right now because I've been too lazy to figure out which retirement/investment vehicle to put it in. If I lost my job today, I could easily live a decade or more with my current lifestyle on what I have saved. Never in my wildest dreams would I have ever thought I'd get paid as much as I do today or have as much financial independence. I've been tremendously blessed.

Sure, I just finished 3 nights in a row, and dealt with everything from codes to angioedema to unstable fracture reductions to lac repairs to annoying psychiatric patients to annoying parents bringing in their toddlers to everything in between. Now I'm off for 4 days. I just finished throwing ball with my dog in a field nearby with a sunny, warm breeze and birds chirping in trees and might hit the gym and take him for a trail run later this afternoon. Maybe check out Avenger's later. I might even crack open my bottle of Lagavulin or Macallan later this evening and play PS4 if the gf will let me. For all the medical students reading this forum and all the doom and gloom disgruntled doc naysayers in here, trust me when I say...life in the EM world is really NOT all that bad despite what you might hear in these forums to indicate otherwise.
 
miacomet said:
Why, aside from low COL? Traffic, ugly, no outdoors nearby, not walkable, too hot, too flat. What do you find so appealing about them?
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What are we comparing them to? LA, NYC, Chicago and PHL?

LA - Not particularly walkable, ugly, horrendous traffic and COL is astronomical. The only good point is weather
NYC - Walkable, but who can afford to live in Manhattan? Long Island and New Jersey have high COL and are ugly. Not to mention terrible weather
Chicago - Walkable, but again high COL and terrible weather
PHL - Never been so can't comment
SFO - High cost of living, homeless and feces everywhere. Don't care for the weather as its too cold
Seattle - Becoming rapidly like SFO
San Diego - Great city. I'd move there except jobs pay nothing, and taxes are a deal killer
Austin TX - Also a great city but jobs pay nothing as well

Not saying my own city is for everyone, but at least every it's 24 hours, we almost never get snow, the cost of living is low, and traffic is tolerable. I live in Henderson, which is a suburb that is easily walkable for you hippie-dippies who want to walk everywhere for some reason.
 
So, it seems that one of the main issues is high COL. Well, I guess you get what you pay for. LA is actually surprisingly walkable. The reason they cost a lot is because they don't suck. Places that are cheap...tend to be crappy.

Fields that pay more in HCOL, pleasurable areas are a better choice than EM, I guess, which only pays if you live somewhere no one else wants to.

Basically, Texas is cheap and doesn't have snow. And is hot. These to me are not the markings of a high QOL city. Obviously, YMMV.
 
Fairly desirable metro area, low to middle of the road cost of living. Community hospital. Appx 2pph, $235-$250/hr.
 
Porfirio said:
20s delayed gratification for medical school and residency

30s delayed gratification for retirement

40s delayed gratification for family legacy

50s half me and half retirement

60s me

Don’t live like a top 5% earner, and you will be happy and do fine.
Click to expand...

I don't feel any delayed gratification really. In my 20s (residency) we took 3 trips to Europe, sailed around the Caribbean, couple ski trips, saved what we could, moonlighted here and there. In our 30s (attending/fellow; wife and I are 32) we have taken three more trips to Europe, multiple trips to Hawaii, more skiing, live in a nice place, buy whatever I want, save very aggressively. I'm sometimes surprised how easily we are able to do this.
 
GonnaBeADoc2222 said:
I don't feel any delayed gratification really. In my 20s (residency) we took 3 trips to Europe, sailed around the Caribbean, couple ski trips, saved what we could, moonlighted here and there. In our 30s (attending/fellow; wife and I are 32) we have taken three more trips to Europe, multiple trips to Hawaii, more skiing, live in a nice place, buy whatever I want, save very aggressively. I'm sometimes surprised how easily we are able to do this.
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Do you have kids?
 
miacomet said:
Basically, Texas is cheap and doesn't have snow. And is hot. These to me are not the markings of a high QOL city. Obviously, YMMV.
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I hate snow. I hate driving in it and don't do winter sports. Any place with no snow is a plus to me. I would never even consider a city like Chicago that gets a ton of snow.

As far as COL it's major. Want to live in LA? great, that 13% income tax means you work one month out of the year for the government. It's equivalent to at least $30K which is huge. That means I could live in a "crappy city" and afford to rent a malibu beach house for one month out of the year, or go to Asia/Europe on a 5-star vacation 3-4 times a year and still come out ahead.
 
Yes, but unfortunately for the rest of the year you are in...Texas. Texas is great for making money (although less so recently), but I personally hope to never live in a place that's all LCOL and minimal QOL just so I can escape for a few weeks a year to stay at fancy hotel in Paris.

There's not a great answer to this in EM, and it's one of the major flaws of the field- you don't get paid more to live in more expensive places. Unless you like Texas (or MS, maybe), it makes for a dissatisfying career/ life.
 
GeneralVeers said:
I hate snow. I hate driving in it and don't do winter sports. Any place with no snow is a plus to me. I would never even consider a city like Chicago that gets a ton of snow.

As far as COL it's major. Want to live in LA? great, that 13% income tax means you work one month out of the year for the government. It's equivalent to at least $30K which is huge. That means I could live in a "crappy city" and afford to rent a malibu beach house for one month out of the year, or go to Asia/Europe on a 5-star vacation 3-4 times a year and still come out ahead.
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That's one of the things I love about the SE. I think I paid about $540K for my house (4000sqft). Affluent neighborhood. We have no state income tax. If I had tried to buy something similar on the West coast or in some of the NE states, it probably would have been well over 1 million. Probably 1.1-1.4 million. As long as you don't mind living in some not so glamorous locations, you can live like a King or Queen. I can't imagine wanting to live in CA. That state income tax and cost of living is a hard stop deal breaker. Plus, the state is broke and it's being overrun by immigrants with the wealthy starting to wise up and move out. I guess if you're a homeless heroin addict it might seem like Utopia. Where else can you poop in city streets and not get arrested? All while benefiting from working class taxpayers to get free housing, free needles and better poop cans?
 
GeneralVeers said:
What are we comparing them to? LA, NYC, Chicago and PHL?

LA - Not particularly walkable, ugly, horrendous traffic and COL is astronomical. The only good point is weather
NYC - Walkable, but who can afford to live in Manhattan? Long Island and New Jersey have high COL and are ugly. Not to mention terrible weather
Chicago - Walkable, but again high COL and terrible weather
PHL - Never been so can't comment
SFO - High cost of living, homeless and feces everywhere. Don't care for the weather as its too cold
Seattle - Becoming rapidly like SFO
San Diego - Great city. I'd move there except jobs pay nothing, and taxes are a deal killer
Austin TX - Also a great city but jobs pay nothing as well

Not saying my own city is for everyone, but at least every it's 24 hours, we almost never get snow, the cost of living is low, and traffic is tolerable. I live in Henderson, which is a suburb that is easily walkable for you hippie-dippies who want to walk everywhere for some reason.
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Yah, I just don't get CA. You want me to pay 12% of my income to the state so that I can step over human feces, choke on smog, and now I'm reading articles about how you can't discharge a homeless patient from the ED unless you find them shelter. To each his own I suppose.
 
But mosquitoes and humidity, no?
California has high taxes, but it's far from broke. Agree the cost of living is high. Actually, the wealthy aren't leaving:Who’s leaving California? Not who you think: Thomas Elias

Some of us don't want to live with people who hate immigrants, who make up a huge proportion of the workforce in medicine. 5% of doctors are from India alone. What exactly are you implying? Do you dislike your immigrant colleagues/patients?
 
miacomet said:
But mosquitoes and humidity, no?
California has high taxes, but it's far from broke. Agree the cost of living is high. Actually, the wealthy aren't leaving:Who’s leaving California? Not who you think: Thomas Elias

Some of us don't want to live with people who hate immigrants, who make up a huge proportion of the workforce in medicine. 5% of doctors are from India alone. What exactly are you implying? Do you dislike your immigrant colleagues/patients?
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Nevada, no mosquitos and no humidity.

I'm okay with legal immigration.....I'm a legal immigrant. I'm utterly opposed to California's sanctuary policy and I don't like paying taxes that go to support non-citizens. It's bad enough I have to pay to support actual citizens who are too lazy/high/disabled to work.
 
GeneralVeers said:
Nevada, no mosquitos and no humidity.

I'm okay with legal immigration.....I'm a legal immigrant. I'm utterly opposed to California's sanctuary policy and I don't like paying taxes that go to support non-citizens. It's bad enough I have to pay to support actual citizens who are too lazy/high/disabled to work.
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My response wasn't directed at you, but I guess I don't understand your answer- I can understand that people are against certain kinds of immigration, but I don't understand your logic. Undocumented workers are basically what keeps SS afloat, and being younger, healthier, and ineligible for many benefits, they pay more in taxes than they receive, so I don't understand how they are being "supported". It's actually better for citizens than legal immigration since legal immigrants can become citizens and are then eligible for a wide variety of benefits, and they can also compete with native-born citizens for desirable jobs, which the undocumented can't.

Nevada is nice. I agree.
 
miacomet said:
But mosquitoes and humidity, no?
California has high taxes, but it's far from broke. Agree the cost of living is high. Actually, the wealthy aren't leaving:Who’s leaving California? Not who you think: Thomas Elias

Some of us don't want to live with people who hate immigrants, who make up a huge proportion of the workforce in medicine. 5% of doctors are from India alone. What exactly are you implying? Do you dislike your immigrant colleagues/patients?
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I'm referring to illegal immigrants. California leads the nation with about 3 million alone living there. That's about 25% of illegal immigrants for the entire nation. Most live in 3-4 metro areas. The state is spending 50 million on legal representation for them alone. Let's not get into the health care expenditures. All of the benefits are a tremendous burden to not only the state but on all the hard working legal working state residents. Not to mention the families who suffer from rape or murder at the hands of criminals sneaking into the state/country. I don't have anything against ethnicities, I love all people but I abhor illegal immigration. We have enough of our own problems in this country with the impoverished and the sick in need of health care than to care for people that force illegal entry in order to live as parasites on our resources and society. Sorry, that's just how I feel about it.

Yes, we have "skeeters" down here in the South. And it's damn hot but hey...you can't have everything.
 
Groove said:
I'm referring to illegal immigrants. California leads the nation with about 3 million alone living there. That's about 25% of illegal immigrants for the entire nation. Most live in 3-4 metro areas. The state is spending 50 million on legal representation for them alone. Let's not get into the health care expenditures. All of the benefits are a tremendous burden to not only the state but on all the hard working legal working state residents. Not to mention the families who suffer from rape or murder at the hands of criminals sneaking into the state/country. I don't have anything against ethnicities, I love all people but I abhor illegal immigration. We have enough of our own problems in this country with the impoverished and the sick in need of health care than to care for people that force illegal entry in order to live as parasites on our resources and society. Sorry, that's just how I feel about it.

Yes, we have "skeeters" down here in the South. And it's damn hot but hey...you can't have everything.
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But this isn't based in facts- I understand some people are vehemently opposed to illegal immigration, but your financial facts are not in order. It has been shown repeatedly that undocumented workers pay far more into the system than they receive. Also, undocumented immigrants commit crimes at a lower rate than native-born Americans.
 
Groove said:
I'm referring to illegal immigrants. California leads the nation with about 3 million alone living there. That's about 25% of illegal immigrants for the entire nation. Most live in 3-4 metro areas. The state is spending 50 million on legal representation for them alone. Let's not get into the health care expenditures. All of the benefits are a tremendous burden to not only the state but on all the hard working legal working state residents. Not to mention the families who suffer from rape or murder at the hands of criminals sneaking into the state/country. I don't have anything against ethnicities, I love all people but I abhor illegal immigration. We have enough of our own problems in this country with the impoverished and the sick in need of health care than to care for people that force illegal entry in order to live as parasites on our resources and society. Sorry, that's just how I feel about it.

Yes, we have "skeeters" down here in the South. And it's damn hot but hey...you can't have everything.
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What bugs me are people who have lived in this country for 20+ years and still don't speak English. Doesn't even matter if they are legal or illegal or here on a lifetime visa. how can you live in a country for decades and not know the language, or not try hard to speak the language when in an ER? I really appreciate those who try to speak English, even if it's very broken. I will try to speak my limited Spanish, which is broken. Usually goes quite well.

The other thing too is we are in Emergency Medicine....so technically we should be around for anyone whether you are legal or illegal, if you have a real medical emergency. Imagine you are in Austria or Bolivia and you are in a bad car accident. I would want to be taken care of in that county for my emergency injuries (regardless if I spoke Austrian or Spanish).
 
Oh, agreed. Look at all the American retirees in Mexico and Costa Rica who never learn Spanish!



Criminals, all of them, obviously. And they clearly don't speak English!
 
miacomet said:
But this isn't based in facts- I understand some people are vehemently opposed to illegal immigration, but your financial facts are not in order. It has been shown repeatedly that undocumented workers pay far more into the system than they receive. Also, undocumented immigrants commit crimes at a lower rate than native-born Americans.
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Oh boy....this might erupt into something dangerous. I can feel the temperature increasing. If we keep it civil we can talk more about it.

This paper, from 2013, suggests illegal immigrants cost the US tax-payer $54 billion. They are a net drain. The Fiscal Cost of Unlawful Immigrants and Amnesty to the U.S. Taxpayer
 
More complicated than it appears.The National Academy of Sciences is nonpartisan on this- I have included a link. I am trying to quote from a nonpartisan source- the Heritage Foundation is certainly partisan.

How much does immigration cost taxpayers?

Agriculture would shut down without undocumented labor and shift entirely to Mexico. I'm not sure if that's a great thing for national security.
 
CajunMedic said:
A CMG is already offering me 220/hr for day 230/hr for night plus 10$ per RVU. 12hr shifts, 10 shifts/month at a community facility with 44,000 visits a year. With a stipend and student loan repayment if I sign now for a 2yr contract.
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How did you get this? Did you reach out to a CMG and offer your earning-futures to them like that chick who needed money for college offered 8% of her post-college earnings to some angel investor?
 
Can I ask how a CMG requires a certain number of shifts? Is this W 2, not 1099?

Also, stipend and loan repayment are meaningless until you complete the two years. I would not want to work twelves with 44k volume. How many pts per hour? How many midlevel charts are you signing?
 
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