What's going on in the world of locums?

[thegenius]

a "douchecanoe"
that is a new one.

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[RustedFox]

Meh, I think they're similar. The average person who smokes weed isn't going out reeking of weed and acting like an idiot. They're the random person zenning out on their pinball machine next to you, they just happen to have eaten a gummy or hit their vape pen before they came in. The blazed ***** who reeks of weed is no different to me than the utterly s***faced guy who's trying to start a fight while barely standing up straight. They're just different flavors of a**hole.

This isn't so much a defense of smoking weed as it is an endorsement of moderation and not being a douchecanoe.

Yeah, I don't encounter ****faced drinks at my pinball arcade. I do encounter gapmouthed stoners who reek and are caught in a terminal stare, too blazed to launch the ball for 5+ minutes every damn time.

 

[DocEspana]

This is some high quality pinball conversation.

 

[RustedFox]

This is some high quality pinball conversation.

I take it seriously.
The movie is coming out next month.

But for real, my favorite places on a weekend? Invariably, some dumb stoner in a trance, smelling of skunkweed and B.O. will hog "Theatre of Magic" while he neglects his kids. Guaranteed.

 

[miacomet]

I don't really want to go back to work, but I quoted a locums job in a not undesirable place 20% above ask, and they were delighted and also offered a further 20% night differential and a 30% holiday differential. No weekend differential, but still a pretty good deal, and they only require 4 shifts a month.

 

[alphaholic06]

I don't really want to go back to work, but I quoted a locums job in a not undesirable place 20% above ask, and they were delighted and also offered a further 20% night differential and a 30% holiday differential. No weekend differential, but still a pretty good deal, and they only require 4 shifts a month.

Sounds like a good deal.

 

[emergentmd]

I don't really want to go back to work, but I quoted a locums job in a not undesirable place 20% above ask, and they were delighted and also offered a further 20% night differential and a 30% holiday differential. No weekend differential, but still a pretty good deal, and they only require 4 shifts a month.

And the guy who asked for 100% above ask got 50% above

 

[miacomet]

And the guy who asked for 100% above ask got 50% above

Maybe...I've asked for that, and not gotten it, repeatedly. But maybe that's just me???

 

[TooMuchResearch]

This is a bit off topic, but a new locum position I applied for just sprung it on me that I have to do a hair drug test. This is after I've interviewed and already been given the position. This is ridiculous. I'm skeptical of whether I can pass it. Any way of getting around it, or do I just refuse and forfeit the position? Feels a bit awkward too.

Hard pass.

 

[Brigade4Radiant]

This is a bit off topic, but a new locum position I applied for just sprung it on me that I have to do a hair drug test. This is after I've interviewed and already been given the position. This is ridiculous. I'm skeptical of whether I can pass it. Any way of getting around it, or do I just refuse and forfeit the position? Feels a bit awkward too.

Nope a hair test is just to much and if you are locums then you are 1099 so what are they even doing this for?

I could understand if it was VA or academic since W2 and usually if you have issues once hired they can’t fire you but springing that onto you is just bad behavior

They probably couldn’t fill the job if it was listed

 

[miacomet]

Is anyone getting above $400 an hour doing locums? $500?

 

[Kryptocoin]

Is anyone getting above $400 an hour doing locums? $500?

Regularly or last minute crunch?

Regularly: No.

LMC: Yes.

 

[alphaholic06]

Is anyone getting above $400 an hour doing locums? $500?

Seems top dollar is about $350 regularly. I’ve definitely gotten $500 for some last minute shifts.

 

[miacomet]

Seems top dollar is about $350 regularly. I’ve definitely gotten $500 for some last minute shifts.

Agreed, seems like locums jobs are offering a paltry $250-$275, will negotiate easily to $300, possibly $350 for less desirable locales, and then $500 for last minute needs.
I'm just no longer sure this is enough money to merit all the risks and all the credentialing headaches.

 

[alphaholic06]

Agreed, seems like locums jobs are offering a paltry $250-$275, will negotiate easily to $300, possibly $350 for less desirable locales, and then $500 for last minute needs.
I'm just no longer sure this is enough money to merit all the risks and all the credentialing headaches.

Not for 250-275. I don’t have to leave home for that. I’ll take the 350. It allows me to work less shifts and make more money. Oh but the credentialing headaches, even with dedicated credentialers to handle most of the paperwork, is still a pain in the ass.

 

[miacomet]

Not for 250-275. I don’t have to leave home for that. I’ll take the 350. It allows me to work less shifts and make more money. Oh but the credentialing headaches, even with dedicated credentialers to handle most of the paperwork, is still a pain in the ass.

And it's worse and worse, the credentialing. I've never been asked for my case logs before (the CMS ones0 while I've practiced EM full time for years, what is the point of this? If I haven't done enough I dunno, crics or LMAs will they not credential me?

 

[TooMuchResearch]

And it's worse and worse, the credentialing. I've never been asked for my case logs before (the CMS ones0 while I've practiced EM full time for years, what is the point of this? If I haven't done enough I dunno, crics or LMAs will they not credential me?

Case logs? Where TF would I even find such a thing?

 

[BoardingDoc]

Case logs? Where TF would I even find such a thing?

From residency? I know we had to keep track as a resident, though even then I stopped logging them once I hit my required numbers.

 

[Mount Asclepius]

Case logs? Where TF would I even find such a thing?

Billers can pull list of procedures billed.

 

[alphaholic06]

And it's worse and worse, the credentialing. I've never been asked for my case logs before (the CMS ones0 while I've practiced EM full time for years, what is the point of this? If I haven't done enough I dunno, crics or LMAs will they not credential me?

That’s not the worst of it. I’ve had a couple of places ask for Hep B titters. Like WTF? I have been vaccinated. You have my vaccination records.

 

[miacomet]

Billers can pull list of procedures billed.

Yes, I understand that- but what if I don't make their minimums? I haven't done a cric in recent history, nor an LMA, and my most recent facility has moved away from central lines, meanwhile I've literally done seven sedations in a day. I mean, are they not going to credential me because I haven't done enough crics? What exactly do they want?

 

[Mount Asclepius]

Yes, I understand that- but what if I don't make their minimums? I haven't done a cric in recent history, nor an LMA, and my most recent facility has moved away from central lines, meanwhile I've literally done seven sedations in a day. I mean, are they not going to credential me because I haven't done enough crics? What exactly do they want?

Valid. I agree ridiculous.

 

[miacomet]

Valid. I agree ridiculous.

Yeah, I mean, I'm thinking of pulling my credentialing/application because this is so crazy and I'm worried that I won't meet their requirements for something- I don't know what to do.

 

[alphaholic06]

Yeah, I mean, I'm thinking of pulling my credentialing/application because this is so crazy and I'm worried that I won't meet their requirements for something- I don't know what to do.

Let it play out. The billing companies provide such a jumbled messed, that I don’t think they actually look at they closely,.

 

[miacomet]

Let it play out. The billing companies provide such a jumbled messed, that I don’t think they actually look at they closely,.

Thanks. It's super stressful- I don't want any issues with credentialing to sully my future- it would be great if hospitals would only ask for what they want/need.

 

[hoot504]

Thanks. It's super stressful- I don't want any issues with credentialing to sully my future- it would be great if hospitals would only ask for what they want/need.

I think you just need someone to tell you it will all be ok. Let me be that person. I'm sure most docs would have the same issue. You'll be fine.

 

[miacomet]

I think you just need someone to tell you it will all be ok. Let me be that person. I'm sure most docs would have the same issue. You'll be fine.

Thanks. That's exactly what I needed! I worked for 12 years in a small state with minimal paperwork, this is like next level, I've never faced this before. Thank you.

 

[bky3c]

Let it play out. The billing companies provide such a jumbled messed, that I don’t think they actually look at they closely,.

I'm sure you're right. I once spotted "appendectomy" on my list of procedures from some billing company. (I'm EM. I've never come close to doing anything remotely resembling an appendectomy unless you count holding a retractor for an attending when I was a med student.) I doubt any of the pencil-pushers do any more with these logs than just check the box that they received them.

 

[alphaholic06]

I'm sure you're right. I once spotted "appendectomy" on my list of procedures from some billing company. (I'm EM. I've never come close to doing anything remotely resembling an appendectomy unless you count holding a retractor for an attending when I was a med student.) I doubt any of the pencil-pushers do any more with these logs than just check the box that they received them.

Once place I worked for just sent a list of every diagnosis they billed for over the preceding 2 years. It was acceptable to several hospitals. It’s just another box to check off for them.

 

[miacomet]

Once place I worked for just sent a list of every diagnosis they billed for over the preceding 2 years. It was acceptable to several hospitals. It’s just another box to check off for them.

I guess I don't understand box checking. Why can't we just delete the box?

 

[hoot504]

I guess I don't understand box checking. Why can't we just delete the box?

Cause then there won't be a job for box checkers.

 

[miacomet]

Cause then there won't be a job for box checkers.

I want to be a box checker. Seems a way better deal.

 

[alphaholic06]

Cause then there won't be a job for box checkers.

Ding, ding, ding… We have a winner.

 

[JacobMcCandles]

You don’t have anything to worry about. It’s just their process. A dumb process but a process, nonetheless.

 

[Boatswain2PA]

Let it play out. The billing companies provide such a jumbled messed, that I don’t think they actually look at they closely,.

I have started generalizing my response to some of their demands while ignoring some, and have not had any problems.

Example- I don't send case logs, when listing hospitals I have had privileges at I list the last several, then put "and others", and answer "as per CV" when I can.

 

[dchristismi]

The last time I looked at a list of procedures, "MAST Suit Application" was still on there. I was like "um, didn't we stop doing that decades ago?"
So I crossed it off. I think I crossed off some other stuff that I clearly wouldn't be doing including vitreous injection (really, WTF?) and shrugged my shoulders and handed the stack back to the credentialler. Granted, that was a LONG time ago but I don't think they really look at that stuff very closely. Hence "and others." I like the "as per CV." I'll have to remember that one.

Alas, paper lists are also going by the wayside, so I suppose there will be more boxes and box-checkers justifying their existence.

 

[miacomet]

The last time I looked at a list of procedures, "MAST Suit Application" was still on there. I was like "um, didn't we stop doing that decades ago?"
So I crossed it off. I think I crossed off some other stuff that I clearly wouldn't be doing including vitreous injection (really, WTF?) and shrugged my shoulders and handed the stack back to the credentialler. Granted, that was a LONG time ago but I don't think they really look at that stuff very closely. Hence "and others." I like the "as per CV." I'll have to remember that one.

Alas, paper lists are also going by the wayside, so I suppose there will be more boxes and box-checkers justifying their existence.

OMG that was on there and I was like, I do not have this skill.
It's electronic, no crossing out. So annoying.

 

[GonnaBeADoc2222]

Current locums market is trash.

Recently got an offer for less money than I make in my main gig (which is not a top paid EM gig).

Volumes way higher than should be for single coverage.

Requiring all the ACLS, etc bull****.

lol gtfo

 

[alphaholic06]

Current locums market is trash.

Recently got an offer for less money than I make in my main gig (which is not a top paid EM gig).

Volumes way higher than should be for single coverage.

Requiring all the ACLS, etc bull****.

lol gtfo

Just like with permanent positions there are trash jobs and there a better jobs. You have to be judicious in the ones you select. I have received offers for much less than I can receive at home. I tell the what my locums rate is. They either accept it or reject. I’ve had quite a few that are willing to pay.

 

[TooMuchResearch]

I've never done locums but am considering a few offers within 2 hours drive from my house.

Questions for the pros:
1. How terrible is the learning curve for Cerner for someone who's spent most of their medical career in Epic (limited Cerner exposure in school and one off site residency rotation)?
2. A couple of offers that are basically on par with my primary job, but they offer travel/lodging, which I don't need. How much over offer can I reasonably ask without getting shut out and how much over ask is a reasonable expectation/final number?

 

[PianoMedic]

I've never done locums but am considering a few offers within 2 hours drive from my house.

Questions for the pros:
1. How terrible is the learning curve for Cerner for someone who's spent most of their medical career in Epic (limited Cerner exposure in school and one off site residency rotation)?
2. A couple of offers that are basically on par with my primary job, but they offer travel/lodging, which I don't need. How much over offer can I reasonably ask without getting shut out and how much over ask is a reasonable expectation/final number?

Depends on the type of cerner. If you’re using Firstnet, which is the old version of Cerner in the ER still in use in various places like my sites, it can be a bit steep. The charting isn’t hard, I can actually finish charts faster in firstnet than in Epic. If you use the ED Course part of Epic extensively like I do, then Cerner will be much slower for re-evaluations. You can do most things from the tracking board, and can also have notes open with the tracking board also open.

 

[Fox800]

There are so many locums ads out there right now, no one should be traveling for under $300/hr. I'm getting cold texted, called, and e-mailed multiple times a day.

Hospitals and CMGs need to pay for decimating the job market during the pandemic and being too short-sighted to plan for recovery and inevitable volumes rebounding through the roof.

 

[thegenius]

There are so many locums ads out there right now, no one should be traveling for under $300/hr. I'm getting cold texted, called, and e-mailed multiple times a day.

Hospitals and CMGs need to pay for decimating the job market during the pandemic and being too short-sighted to plan for recovery and inevitable volumes rebounding through the roof.

I'm getting them too. not paying too well either.

 

[PB2464]

Has anyone ever been asked what rate they are receiving by the ED director that also doe the scheduling? Doesn't seem appropriate to me.

 

[emergentmd]

Locum rate Update in Tx with 2 recent offers

#1 - 375/hr West Tx. I believe it was 325 before. I am sure if you do 375/hr, then prob could get 1-2k shift bonuses regularly
#2 - 350/hr (forgot the area) with a +50/hr if you meet hourly threshold.

I will tell you these locums sites never learn. They pay locums more than the full timers who eventually gets pissed and leave creating a bigger need. Just pay the full timers the extra 50-100/hr and get the place staffed.

 

[s/p epilepticus]

Locum rate Update in Tx with 2 recent offers

#1 - 375/hr West Tx. I believe it was 325 before. I am sure if you do 375/hr, then prob could get 1-2k shift bonuses regularly
#2 - 350/hr (forgot the area) with a +50/hr if you meet hourly threshold.

I will tell you these locums sites never learn. They pay locums more than the full timers who eventually gets pissed and leave creating a bigger need. Just pay the full timers the extra 50-100/hr and get the place staffed.

Which locums company?

 

[emergentmd]

TH has west Tx for $350 +20/hr for min 8 shifts. I misread the $50/hr when it was a daily stipend.

EMcare sent a $325/hr for multiple sites.

These base rates are higher than when I used to do locums. Jump on a site you can deal with, pick up a few shifts a month, then after you have "proven" yourself competent/easy to work with then ask for $2K bonus.

 

[The Knife & Gun Club]

I would like to shout out my best friend from residency who scored $845/hr over thanksgiving weekend. Obviously not a day to day rate but got it for a couple shifts in a pinch when they were short.

But there’s cash to be made, couple hours from a major airport, in a hospital seeing 2hr with low acuity.

 

[emergentmd]

$2k bonus per shift? What’s the pph like for these places? Are they absolutely terrible to work at?

I have no idea but I’m sure they are dumpster fires. When I did locums 4-5 yrs ago they were desperate but I sense they are more desperate so a lot of bonus to be had.

 

[RustedFox]

If I pick up a shift at one of my home sites (I'm credentialed at 4 and will generally work at 3 of those 4... there is one site that I refuse to work because the drive is stupid), I'm asking for minimum 2k shift bonus. They can say no.