What's up, EM?

[Birdstrike]

Advertisement - Members don't see this ad

It seems like forever since I peaked into this place. What's new in EM-land?

 

[JacobMcCandles]

Same as it has ever been. Too many subpar residencies opening up. The usual suspects who hate their job yet continue to do it. The usual suspects who have a good job and don't mine EM. New program directors gleefully popping in eager to answer questions and then never returning. Americans still have no self-discipline and continue to take no blame in their medical problems that they helped create. There are still some patients that you really do help. As I said, same as it has ever been.

 

[WhatJobDoIPick]

What's up? Chilling and waiting for urine to be collected 2+ hours.

 

[WhatJobDoIPick]

What's up? Chilling and waiting for urine to be collected 2+ hours.

Up to 5 hours now

 

[valianteffort]

Whats up? Hourly rates in the 100s, 3PPH , NP charts you have to sign that will lead to legal action, night shifts and your medical director shows up 5 mins late to every shift because he can and theres not a thing you can say about it...

Also Karen in room 5 wants to talk to you about why you didn't order a stat extremity MRI for her 12 year old daughter who tweaked her knee and is on her way to becoming a star WNBA player....

 

[WhatJobDoIPick]

Whats up? Hourly rates in the 100s, 3PPH , NP charts you have to sign that will lead to legal action, night shifts and your medical director shows up 5 mins late to every shift because he can and theres not a thing you can say about it...

Also Karen in room 5 wants to talk to you about why you didn't order a stat extremity MRI for her 12 year old daughter who tweaked her knee and is on her way to becoming a star WNBA player....

Are people actually working for rates in the 100s outside of like NYC and Denver

 

[thegenius]

It seems like forever since I peaked into this place. What's new in EM-land?

Our dear friend Bob Weir died. He isn't associated with EM at all but it was still sad to read.

 

[alpinism]

Are people actually working for rates in the 100s outside of like NYC and Denver

I mean that is standard at most CAHs under 10K visits.

 

[DocEspana]

Are people actually working for rates in the 100s outside of like NYC and Denver

as far as I know the last "in the 100s" job in NYC was HHC jobs in the 2010s. They were paying around 185ish but had extremely good benefits (like. you had a pension). My understanding is in the late 2010s they decided to give everyone a pay raise bringing them to the low 200s, idk the exact number, but cut half the benefits including the pension.

given the size of that employer/the union that represents them I'm sure a poster here either does work for hhc or knows someone well enough that does that they can confirm what the current situation is.

I just cant stand here and let NYC slander continue 😉

 

[TooMuchResearch]

I mean that is standard at most CAHs under 10K visits.

Not if you have good agreements in place.

 

[Emapp20177]

I mean that is standard at most CAHs under 10K visits.

This is absolutely false. Saw a recent job posting 8k volume, 1pph $300/hr. Was tempted. Can't remember where it was though, probably bfe.

 

[Birdstrike]

Our dear friend Bob Weir died. He isn't associated with EM at all but it was still sad to read.

Yes. A sad day. R.I.P. Bobby Weir

 

[alpinism]

This is absolutely false. Saw a recent job posting 8k volume, 1pph $300/hr. Was tempted. Can't remember where it was though, probably bfe.

I didn’t say you couldn’t get higher rates but the vast majority of shops with that volume certainly aren’t paying 200/hr+ rates.

 

[cyanide12345678]

I mean that is standard at most CAHs under 10K visits.

Nope. That’s not standard. That’s just people choosing crappy options.

My prn job pays 295/hr for 7k annual volume ER.

A 3500 annual volume ER 20 minutes away from me with vituity pays $190/hr.

When i was job hunting i got offers for $325/hr from dystaffing (internal locums arm of team health) for 2 sites with 7k and 9k volume. This was about 1 month ago.

 

[DocEspana]

Nope. That’s not standard. That’s just people choosing crappy options.

My prn job pays 295/hr for 7k annual volume ER.

A 3500 annual volume ER 20 minutes away from me with vituity pays $190/hr.

When i was job hunting i got offers for $325/hr from dystaffing (internal locums arm of team health) for 2 sites with 7k and 9k volume. This was about 1 month ago.

yeah and to add to that, vituity's internal locums pays 325/hr across the country regardless of the volume (nice decision by them to just set one rate)

 

[WhatJobDoIPick]

yeah and to add to that, vituity's internal locums pays 325/hr across the country regardless of the volume (nice decision by them to just set one rate)

After becoming partner and seeing what we pay for certain shifts, I don't know why anyone would do locums.

 

[Mount Asclepius]

AI ambient listening for assisted documentation has been one of the most recent and greatest positive changes to the practice of EM for me. Significantly reduces documentation burden. By far from perfect, but it will only keep getting better. I’m curious though how the medicolegal environment will handle this early on. Inaccurate and unedited recordings have contributed to some patient complaints and CDI issues I’ve reviewed, which leads me to believe it will come up medicolegally.

Insurers increasingly low balling contracted rates essentially forcing you to rely on being OON and utilize IDR probably one of the most recent impactful negative aspects to EM. I worry about insurers trying to force hospitals and systems to require their physicians to accept terrible in-network rates.

Luckily patients high on meth no longer come to the ED. I guess that’s a win. Ha, if only.

 

[alpinism]

Nope. That’s not standard. That’s just people choosing crappy options.

My prn job pays 295/hr for 7k annual volume ER.

A 3500 annual volume ER 20 minutes away from me with vituity pays $190/hr.

When i was job hunting i got offers for $325/hr from dystaffing (internal locums arm of team health) for 2 sites with 7k and 9k volume. This was about 1 month ago.

I wish that were the case but those rates
are few and far between in western states.

Sadly even in the heyday of EM most sites
with that volume had under 200/hr rates.

 

[WhatJobDoIPick]

AI ambient listening for assisted documentation has been one of the most recent and greatest positive changes to the practice of EM for me. Significantly reduces documentation burden. By far from perfect, but it will only keep getting better. I’m curious though how the medicolegal environment will handle this early on. Inaccurate and unedited recordings have contributed to some patient complaints and CDI issues I’ve reviewed, which leads me to believe it will come up medicolegally.

Insurers increasingly low balling contracted rates essentially forcing you to rely on being OON and utilize IDR probably one of the most recent impactful negative aspects to EM. I worry about insurers trying to force hospitals and systems to require their physicians to accept terrible in-network rates.

Luckily patients high on meth no longer come to the ED. I guess that’s a win. Ha, if only.

OON and IDR is destroying EM. We're winning most of the IDRs but there's no mechanism to force the insurers to pay.

The govt hates private physician groups, and them not enforcing their own process is yet another way they're forcing everyone down the employment pipeline.

 

[cyanide12345678]

I wish that were the case but those rates
are few and far between in western states.

Sadly even in the heyday of EM most sites
with that volume had under 200/hr rates.

Maybe because I’m in the Midwest.

My current w2 job is also critical access but 13k annual volume and not under 10k, though staffed with a MLP with a 10 hr midshift from 10 to 8 in addition to 24 hr physician staffing. Even the w2 gig pays $255/hr with benefits worth some $35-40/hr (health, dental, vision, half of social security and SS taxes, and 4% 401k match and access to 457 in addition to 401k).

Yesterday i saw 18 patients in 12 hrs and felt it was a very busy day 😆 but im so well aware how most ER jobs are way worse.

 

[HemorrhagicShock]

Are people actually working for rates in the 100s outside of like NYC and Denver

Not uncommon in many desirable parts of CA

 

[HemorrhagicShock]

I wish that were the case but those rates
are few and far between in western states.

Sadly even in the heyday of EM most sites
with that volume had under 200/hr rates.

Exactly.

Anytime I see rates like what cyanide posted, I immediately know they're in states I have zero desire to every travel to, even for a brief amount of time.

 

[cyanide12345678]

Exactly.

Anytime I see rates like what cyanide posted, I immediately know they're in states I have zero desire to every travel to, even for a brief amount of time.

Some of these mid west cities get a bad reputation.

I think there’s plenty of great places to live in places like Nashville, Indianapolis, Cincinnati, Columbus.

You get more space, more bang for your buck, most amenities of any major city, excellent job opportunities, and some of the more expensive suburbs of these towns are repeatedly ranked as one of the best cities in the entire country as far as quality of life - for example Carmel, fishers, zionsville, blue ash, mason, Dublin…there’s a reason Carmel is ranked a top 5 city in the US by a dozen or so magazines.

I’ve lived in lahore, Houston, Dallas, Chicago and spent some months in New York, London, LA. I wouldn’t pick any of those places over my current spot in the mid west, Dallas or i guess specifically plano would be a close second.

Though maybe if i had unlimited money i might pick San Diego…. But today i don’t have unlimited funds and definitely don’t want California taxes