What’s the perfect job?

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aneftp

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We are all searching for the perfect job.

For me. It’s the 0.8 fte job. I prefer (2) 16 hr plus benefits plus pro rated vacation.

7p-11p Tuesday and Wednesday

350k (based on 450k ish fte) with 10 weeks off.

Or a 24/16 job. (I was offered a 500k/10 weeks job but that required Friday/sunday ) full time 16/24 1.0. Meaning 42 weekends. Way too much weekends for me.

I’d like to compress my work schedule as much as I can these days.

Opens up a world of opportunities (on my own time) to choose to work extra somewhere else. Or take time off for myself.

I think the days of working 60 plus hours plus 6 calls a month for 700-750k are over for most of us. Assuming 10 weeks off

That’s why people are choosing to to do locums more like me. To control our own schedules

So what’s your perfect job/pay/time off

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Good work environment- pleasant people, Good surgeons, medical direction or solo, no extended care team bs, no militant or rogue crnas - 650 and benefits 10 weeks off 4 calls a month with post call day off. 50h a week.
 
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I like the point about the compressed schedule. I’d rather work long days and have more days off. Kind of doing that now with a 0.8 position in a traditional PP group and taking extra call with (mostly) post call and pre-and-post-night-OB off. Solo, efficient, very pleasant colleagues up and down the chain. I’d take more money, but everything else I like.
 
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Honestly, I am young and don't mind working. But a good balance of time off when not working ie call intensity is ok but call frequency should be fair.
 
Working conditions and being at home (almost) every night trump hours and income.

Genuine question: if you wanted to be home every night why didn't you do something like pain?
 
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Genuine question: if you wanted to be home every night why didn't you do something like pain?
Not speaking for pgg. But have you seen pain patients? I was intending to do pain fellowship after my ca-3 year. I did 4 months of pain. I could not stand those patients. Not my cup of tea

So pain is not for everyone.

Plus many pain guys haven’t done regular anesthesia in such a long time. And now the regular anesthesia market is so good. They would like to jump back into doing some regular anesthesia work but they may not have enough case logs to get privileges at many places.
 
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Not speaking for pgg. But have you seen pain patients? I was intending to do pain fellowship after my ca-3 year. I did 4 months of pain. I could not stand those patients. Not my cup of tea

So pain is not for everyone.

Plus many pain guys haven’t done regular anesthesia in such a long time. And now the regular anesthesia market is so good. They would like to jump back into doing some regular anesthesia work but they may not have enough case logs to get privileges at many places.
Yep, I'm going pain right now. Almost 2 years in practice, and considering going back to the OR. I just don't know about taking call, working nights, weekends, etc. Being in the OR can be so much more stressful...
 
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We are all searching for the perfect job.

For me. It’s the 0.8 fte job. I prefer (2) 16 hr plus benefits plus pro rated vacation.

7p-11p Tuesday and Wednesday

350k (based on 450k ish fte) with 10 weeks off.

Or a 24/16 job. (I was offered a 500k/10 weeks job but that required Friday/sunday ) full time 16/24 1.0. Meaning 42 weekends. Way too much weekends for me.

I’d like to compress my work schedule as much as I can these days.

Opens up a world of opportunities (on my own time) to choose to work extra somewhere else. Or take time off for myself.

I think the days of working 60 plus hours plus 6 calls a month for 700-750k are over for most of us. Assuming 10 weeks off

That’s why people are choosing to to do locums more like me. To control our own schedules

So what’s your perfect job/pay/time off
Every other week-ish, locums work 7-3 for 5 days at 375+ per hour. No call, no weekends.

26 weeks, pulling 15-18k per week. 416k with all the tax benefits that come with 1099.

Can sandbag your weeks to make it 3 weeks a month for 2-4 months per year. Then you’re looking at 8 months with 14 weeks of work plus a week off in the other months.

Plenty of money, time, and flexibility. Still getting up early to not be a potato. Ultimate job.
 
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Every other week-ish, locums work 7-3 for 5 days at 375+ per hour. No call, no weekends.

26 weeks, pulling 15-18k per week. 416k with all the tax benefits that come with 1099.

Can sandbag your weeks to make it 3 weeks a month for 2-4 months per year. Then you’re looking at 8 months with 14 weeks of work plus a week off in the other months.

Plenty of money, time, and flexibility. Still getting up early to not be a potato. Ultimate job.
That is why it’s hard to justify any full time w2 job commitment in this current anesthesia job environment.

Almost every city is offering some type of full time job ranging from 425k-500k with required calls. Plus they dangle some type do sign on bonus and try to entice you with some extra compensation to do more work

It’s the mandatory 5 days a week plus call “availability” of full time work as a w2 (outside of paid time off) that turns off people these days when they can easily do what you are suggesting. (To make Low 400s) with the tax benefits of 1099 but you get half the year off plus not take call

Now I was messaging one of the partners at a small private practice group on the coastal side of Florida on Facebook on a physicians group (not that physician community group, avoid that lady radiologist who self promotes herself on that page) I belong to.

He was asking if i knew anyone who was interested in a nice job with low call backs beeper. They were done early by 5pm most days (call doc done) with call backs 10% of time hardly call backs past 9p. But essentially q3 calls with one doc on vacation. Working post call (usually done 11-/12p post. No ob. No peds. No trauma MD only. Sounds nice. They get 12-13 weeks off. 4 doc model.

They pay around 550k depending on revenue. They get a subsidy as well from hca. There is a reason why envision didn’t want the contract and hca likely has to pay 50-100k
More if they went employee model with hca in house.

I’m telling him that’s 2018 Compensation. I’m sure it’s a nice gig. But told him that’s not what people want and these days. He agreed. It’s the call burden. The availability.

But so many practices are stuck on this mentality of “having control” of their own practice model.
 
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Best job imo is a hospital employed job where you are making under market rate but doing far less than a usual private practice work load. The bean counters are content because they think they are paying you a low salary but don't realize you are doing far less work. You would think these admin guys would compare your ASA units per year to some regional average, but they really aren't that smart.

Rotated at a place as a resident. 2:1 direction, occasionally 3:1. Reasonable case mix. 9 weeks off. But these guys were working like 30 hours a week. Had a call guy and an afternoon shift guy every day. So none of the days guys ever stayed past 3pm, and about half were done around noon. Low salary about 500k, but on a per hour basis very good.

Money to work ratio, that's all that matters.
 
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Best job imo is a hospital employed job where you are making under market rate but doing far less than a usual private practice work load. The bean counters are content because they think they are paying you a low salary but don't realize you are doing far less work. You would think these admin guys would compare your ASA units per year to some regional average, but they really aren't that smart.

Rotated at a place as a resident. 2:1 direction, occasionally 3:1. Reasonable case mix. 9 weeks off. But these guys were working like 30 hours a week. Had a call guy and an afternoon shift guy every day. So none of the days guys ever stayed past 3pm, and about half were done around noon. Low salary about 500k, but on a per hour basis very good.

Money to work ratio, that's all that matters.
That’s 80-% of most VA hospitals ! Many are working just 7-430p (like show up actually at 7am and not 630am ). And the work 4 days a week. The pay is still low. Around 330-350k in most regions.

But the workload is super easy at 80% of VA. I say 80% of VA. Cause the other 20% you actually have to work. Those are the VA that consistently have job openings.

Plus outside of being an idiot. They can’t fire you after 2 years unless u make a lot of enemies. You can claim you aren’t comfortable doing lungs or hearts and they will reasonably accommodate you.
 
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Genuine question: if you wanted to be home every night why didn't you do something like pain?
I prefer to interact with people who are asleep.

I can imagine few fates worse than getting on an outpatient clinic treadmill seeing a dozen chronically noncompliant and unhelpable patients every day. The occasional patient you can help wouldn't be enough to offset the rest of it.
 
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Genuine question: if you wanted to be home every night why didn't you do something like pain?
Anesthesia is fun. Being woken up in the middle of the night to deal with something that is absolutely not an emergency, or a problem that someone else created, is not.

When I took call, the best part was being solo doing the actual emergencies (dead limb, dead gut) with a group of staff that actually functioned as a team. Unfortunately, that also came with a lot of "this isn't appendicitis, but the radiologist said it could possibly be, so we're going to take it out" or calls up to L&D five minutes after I laid back down, after checking with them that there was nothing else brewing. Sprinkle that with "we tried five times to tube this guy and couldn't, can you come try?" or calls from outlying facility looking for the person on call at that facility, a CRNA deciding to call off work at 0500, and surgeons trying to declare an emergency to get their call case from the previous day started an hour before they're regular cases are scheduled to begin.

I am so glad I gave up regular call, eventhough it came with a huge cut in pay.
 
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Anesthesia is fun. Being woken up in the middle of the night to deal with something that is absolutely not an emergency, or a problem that someone else created, is not.

When I took call, the best part was being solo doing the actual emergencies (dead limb, dead gut) with a group of staff that actually functioned as a team. Unfortunately, that also came with a lot of "this isn't appendicitis, but the radiologist said it could possibly be, so we're going to take it out" or calls up to L&D five minutes after I laid back down, after checking with them that there was nothing else brewing. Sprinkle that with "we tried five times to tube this guy and couldn't, can you come try?" or calls from outlying facility looking for the person on call at that facility, a CRNA deciding to call off work at 0500, and surgeons trying to declare an emergency to get their call case from the previous day started an hour before they're regular cases are scheduled to begin.

I am so glad I gave up regular call, eventhough it came with a huge cut in pay.

Do you think taking call is worth the money? I found a no-call gig. No OB. Essentially M-F 7-3 for $416k. Haven't been in the OR for almost 3 years at this point, but pain patients/clinic combined with low pay are a drag.
 
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Do you think taking call is worth the money? I found a no-call gig. No OB. Essentially M-F 7-3 for $416k. Haven't been in the OR for almost 3 years at this point, but pain patients/clinic combined with low pay are a drag.
That sounds fantastic. Do they give you vacation and benefits?
 
Do you think taking call is worth the money? I found a no-call gig. No OB. Essentially M-F 7-3 for $416k. Haven't been in the OR for almost 3 years at this point, but pain patients/clinic combined with low pay are a drag.
Depends on the money and the expected work while on call. There were several other reasons conspiring to have me give up call, and I could be talked back into it, with the right assurances and compensation in the form of time and/or money.
 
350/hr W2, 425 1099
I pick the hours, guarantee to provide 45/wk at minimum
10wks off
 
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That sounds fantastic. Do they give you vacation and benefits?
Yep. 5 weeks of vacation + "work life" days. Not that much vacation comparatively to the gigs with call. The jobs around here with call make ~$550-650k depending on pre & post-call shifts with 8 weeks.
 
Depends on the money and the expected work while on call. There were several other reasons conspiring to have me give up call, and I could be talked back into it, with the right assurances and compensation in the form of time and/or money.
I went about 11 months with “no call”. And frankly hated it. No pre or post call days off. 5 days a week can drain on you even at 40 hours.

You end up trying to sneak a Monday or Friday paid time off but that can drain my 44 days I had off for real vacation.

Working 5 days in a row daytiem is draining mentally.

For any of you in act models. How many crnas do you have working 5 days a week. Especially in acute trauma setting. It’s likely less than 10%.
 
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Do you think taking call is worth the money?
Well depends on the money and the other details. :)

We all gripe about call. We gripe about it more the older we get. God knows it takes me longer to feel great after a busy overnight call now than it did 20 years ago. But it's not all bad.

It's usually compensated better than day work. Often much better, and the total hours in the hospital may be less.

It's usually solo work, since CRNAs often don't take overnight call at many practices. For those of us who prefer solo time, this is nice.

It usually comes with pre and/or post call days off. Which is great for getting non-work tasks done on weekdays during business hours, getting the kids to or from school, sleeping in a bit, breakfast / lunch with your spouse. That's hard to do with a M-F no-call day job.
 
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We do a in house nightfloat 12 hrs at night m-f and sat sunday 14 hrs in house. Very underutilized at night. We have crnas and aas at night who are very proficient at CLE. Really should be a home call.
 
That’s a great gig at 425/hr 1099. That’s permanent, not locums?
Nothing is permanent in this market to be honest unless you are a tenured state faculty or federal employee after 2 years.

Take any job on a rolling 90 day basis.

I take my job side gigs on a 60 day rolling basis these days.
 
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Best job imo is a hospital employed job where you are making under market rate but doing far less than a usual private practice work load. The bean counters are content because they think they are paying you a low salary but don't realize you are doing far less work. You would think these admin guys would compare your ASA units per year to some regional average, but they really aren't that smart.

Rotated at a place as a resident. 2:1 direction, occasionally 3:1. Reasonable case mix. 9 weeks off. But these guys were working like 30 hours a week. Had a call guy and an afternoon shift guy every day. So none of the days guys ever stayed past 3pm, and about half were done around noon. Low salary about 500k, but on a per hour basis very good.

Money to work ratio, that's all that matters.
Aneft had such a job working 36 hours per week. No overnight call. Mid 400's. 9 weeks off. On his "late day" which was around 5:30 pm he was given off the following day as compensation. Great benefits too.
 
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I went about 11 months with “no call”. And frankly hated it. No pre or post call days off. 5 days a week can drain on you even at 40 hours.

You end up trying to sneak a Monday or Friday paid time off but that can drain my 44 days I had off for real vacation.

Working 5 days in a row daytiem is draining mentally.

For any of you in act models. How many crnas do you have working 5 days a week. Especially in acute trauma setting. It’s likely less than 10%.
We used to have nice pre and post-call off days. The last couple of years, though, even the pre-call people were staying until 3-5pm the day before call, and all of the home call people then worked a full day post-call, with only the in-house call folk actually going home at 0700. It was exhausting.

Now, I have my 40hr work week, which is M-F 7-3 (would prefer 4 10s, but this is how my former partners decided to schedule it). I work no weekends, nights, or holidays in the OR. All solo work. On top of this, I have my 84hr, 7 day ICU weeks. I'm essentially two weeks OR, one week ICU, one week off, plus additional weeks off. In total, I work 1840-1900 hours a year, with 17 full weeks off. Full benefits. Pay is lower than the numbers everyone throws around on here, but at this stage of life, with young kids at home and getting burned out with 2400 work-hour years doing **** I hate, this works for me.
 
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All depends on how much you have to make and what lifestyle you want.

I’m done with accumulation, so going for 1040 hrs a year now. Averages to be about 4 weeks on, 6 weeks off, teaching hospital 1099 no call. Has been great to be with the kids/work on my golf game.

Sometimes ASC work or OB 1099 prn shifts from old connections if price is right, because I like OB and regional. But only at my old stomping grounds where I know everyone and it’s a mini reunion.

As I enter my 50s, I’d like to cut further back. I’ve seen active 75+ yo MDs - most went part time in their 50s permitting a far more active lifestyle than the FT folks working >40 hrs week. Use it or lose it.
 
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My perfect job is one where I get to punch CRNAs in the face all day long.
 
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We are all searching for the perfect job.

For me. It’s the 0.8 fte job. I prefer (2) 16 hr plus benefits plus pro rated vacation.

7p-11p Tuesday and Wednesday

350k (based on 450k ish fte) with 10 weeks off.

Or a 24/16 job. (I was offered a 500k/10 weeks job but that required Friday/sunday ) full time 16/24 1.0. Meaning 42 weekends. Way too much weekends for me.

I’d like to compress my work schedule as much as I can these days.

Opens up a world of opportunities (on my own time) to choose to work extra somewhere else. Or take time off for myself.

I think the days of working 60 plus hours plus 6 calls a month for 700-750k are over for most of us. Assuming 10 weeks off

That’s why people are choosing to to do locums more like me. To control our own schedules

So what’s your perfect job/pay/time off

So what’s the strategy? Places don’t advertise these sorts of jobs. They would much rather give you the $550k/6 week vacation/$100k sign on bonus offer than anything with flexibility. Do you make suggestions of what you are looking for? Is it even worth engaging with employers that aren’t advertising these sorts of arrangements?
 
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So what’s the strategy? Places don’t advertise these sorts of jobs. They would much rather give you the $550k/6 week vacation/$100k sign on bonus offer than anything with flexibility. Do you make suggestions of what you are looking for? Is it even worth engaging with employers that aren’t advertising these sorts of arrangements?
Everything is negotiable at this point. W2 Employee or 1099

This one doc negotiated 3p-7am Monday call (That’s the best call as everyone knows w2)

Drives back home 2 hrs away

Comes back 3p-7am Wednesday night call and works post call Thursday 8hrs.

That’s his w2 academics state employee schedule

1.0 fte

He does take one Saturday call a month as part of his call rotation requirement. Not bad for 450k w2. Plus paid time off.
5-10 cme (10 if presenting)
22 days pto
3 free days
13 days sick

Even w2 amc employees are negotiating side stuff when short staff. $1700 extra for m-Thursday call plus $300/hr after 4pm

$2000 Friday call plus $300/he added 4p
$2500 beeper weekend/24 hr plus $300/hr
 
Everything is negotiable at this point. W2 Employee or 1099

This one doc negotiated 3p-7am Monday call (That’s the best call as everyone knows w2)

Drives back home 2 hrs away

Comes back 3p-7am Wednesday night call and works post call Thursday 8hrs.

That’s his w2 academics state employee schedule

1.0 fte

He does take one Saturday call a month as part of his call rotation requirement. Not bad for 450k w2. Plus paid time off.
5-10 cme (10 if presenting)
22 days pto
3 free days
13 days sick

Even w2 amc employees are negotiating side stuff when short staff. $1700 extra for m-Thursday call plus $300/hr after 4pm

$2000 Friday call plus $300/he added 4p
$2500 beeper weekend/24 hr plus $300/hr

I imagine some new part time guy taking every Monday call isn’t going to sit well with current employees.

I guess the more specific question is are these negotiations starting with very specific requests? Do you respond to ads that are advertising full time jobs with requests for alternative arrangements? Is it better to have a very specific arrangement request or to simply ambiguously ask for non-traditional or <1.0 FTE arrangements?

I guess I am asking because out of curiosity I have contacted some big employers that I know are in desperate need for people and they wouldn’t even entertain reasonable part time arrangements. The best I’ve gotten is a vague statement about allowing flexibility, but qualifying it with emphasizing that they are looking for full time people. There are not many jobs advertised on gasworks that have the types of arrangements you talk about. Is there a better strategy to negotiate them?
 
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It very much depends on the place - not sure which large groups you are referring to but the variability in USAP is considerable from what I’ve heard…. Some places (Colorado) seem to be flexible and others (Orlando) are not.
 
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Most places when I was looking were flexible, I would go through the interview and secure the offer first then return with what you want. That way you can have everything spelled out to decide, the difference going between 0.75 and 0.9 at different jobs this may be the same hours.
 
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Kind of a gossip-y, non-actionable post. Real value IMHO is that it shows it's an anesthesiologist's market right now, with the shortage and all the NAPA/USAP/Envision implosions. When i came out of residency, job market was tight. Now, it's figure out what YOU want, and float it by an employer. Downside is that the security is as good as your notice duration (2-3 months notice). Good for those past accumulation phase, bad if you're starting out/don't have the appetite for risk = Kaiser/academic/W2 gaswork ad for you then. Best jobs aren't advertised.

Just watch the tail, the non-compete, and the claw-back of the bonus (if any).

Flipside: of course groups won't advertise anything beyond 2080 hours, 450k, 4 wks vacation, full benefits. You have to get multiple offers and BATNA. Which new grads/non-savvy folks don't do. But the groups that are strict about these parameters...are withering on the vine as their "partners" are overworked for their 450k, and are suffering for not taking off their blinders.

Know your worth, as I tell all my residents, who I have helped negotiate 600-800k w2 academic jobs. And PRN 350-400/hr 1099 gigs (incl medmal).
 
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Kind of a gossip-y, non-actionable post. Real value IMHO is that it shows it's an anesthesiologist's market right now, with the shortage and all the NAPA/USAP/Envision implosions. When i came out of residency, job market was tight. Now, it's figure out what YOU want, and float it by an employer. Downside is that the security is as good as your notice duration (2-3 months notice). Good for those past accumulation phase, bad if you're starting out/don't have the appetite for risk = Kaiser/academic/W2 gaswork ad for you then. Best jobs aren't advertised.

Just watch the tail, the non-compete, and the claw-back of the bonus (if any).

Flipside: of course groups won't advertise anything beyond 2080 hours, 450k, 4 wks vacation, full benefits. You have to get multiple offers and BATNA. Which new grads/non-savvy folks don't do. But the groups that are strict about these parameters...are withering on the vine as their "partners" are overworked for their 450k, and are suffering for not taking off their blinders.

Know your worth, as I tell all my residents, who I have helped negotiate 600-800k w2 academic jobs. And PRN 350-400/hr 1099 gigs (incl medmal).
800k academic?!?!

Even 600 seems hard to believe...
 
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Kind of a gossip-y, non-actionable post. Real value IMHO is that it shows it's an anesthesiologist's market right now, with the shortage and all the NAPA/USAP/Envision implosions. When i came out of residency, job market was tight. Now, it's figure out what YOU want, and float it by an employer. Downside is that the security is as good as your notice duration (2-3 months notice). Good for those past accumulation phase, bad if you're starting out/don't have the appetite for risk = Kaiser/academic/W2 gaswork ad for you then. Best jobs aren't advertised.

Just watch the tail, the non-compete, and the claw-back of the bonus (if any).

Flipside: of course groups won't advertise anything beyond 2080 hours, 450k, 4 wks vacation, full benefits. You have to get multiple offers and BATNA. Which new grads/non-savvy folks don't do. But the groups that are strict about these parameters...are withering on the vine as their "partners" are overworked for their 450k, and are suffering for not taking off their blinders.

Know your worth, as I tell all my residents, who I have helped negotiate 600-800k w2 academic jobs. And PRN 350-400/hr 1099 gigs (incl medmal).
The 600-800k w2 academic jobs are not true state faculty job. State jobs are public record with salaries (and overtime pay). More likely private practice jobs in disguise as academic jobs.

But agree. 450k/8 weeks off is 2018-2020 pre covid pay.

That pay doesn’t work anymore unless there is no call.
 
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Everything is negotiable at this point. W2 Employee or 1099

This one doc negotiated 3p-7am Monday call (That’s the best call as everyone knows w2)

Drives back home 2 hrs away

Comes back 3p-7am Wednesday night call and works post call Thursday 8hrs.

That’s his w2 academics state employee schedule

1.0 fte

He does take one Saturday call a month as part of his call rotation requirement. Not bad for 450k w2. Plus paid time off.
5-10 cme (10 if presenting)
22 days pto
3 free days
13 days sick

Even w2 amc employees are negotiating side stuff when short staff. $1700 extra for m-Thursday call plus $300/hr after 4pm

$2000 Friday call plus $300/he added 4p
$2500 beeper weekend/24 hr plus $300/hr
I am 1.0 fte and routinely do 3 x 12 hour nights in a row Sun-Tues and get rest of week off. Same pay as your friend. Could do this almost every week if I wanted. Academics.
 
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Yeah the 800k was in LCOL undesirable area, and was at the Cush private hospital affiliated with the residency. So 2:1 supervision of residents or CRNAs but still with an admin day a week and minimal call.

500-600k was more the norm, lower end had 12 weeks vacation - which they would then use 5-6 to moonlight
 
550 plus benefits opportunity for extra work if wanted - 12 weeks vacation. Desirable location. Medical direction of AAs n crnas… never go over bc AAs. Opportunity to teach residents and AA students if wanted. Community suburban hospital but call in house bc of OB. No big cases or high acuity- nice suburban pt population
 
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