Where are the high paying locums?

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Short term.. Doctors need to feed their families. Ask yourselves how many of you could go 2 months without a paycheck and potentially not get a job as your other "partners" get picked off one by one as they have real needs they need to support.
 
EctopicFetus said:
Short term.. Doctors need to feed their families. Ask yourselves how many of you could go 2 months without a paycheck and potentially not get a job as your other "partners" get picked off one by one as they have real needs they need to support.
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Elaborate? I have no intention of working picking up shifts for a takeover group like the one in OH. I would however, like to find a way of subsidizing the ****ty pay I make in NYC
 
Cerberus said:
Elaborate? I have no intention of working picking up shifts for a takeover group like the one in OH. I would however, like to find a way of subsidizing the ****ty pay I make in NYC
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I mean its simple I think. Put yourself in the shoes of the 35-55 year old doc at SUMMA. (I am not one).

JOb goes to absolute trash. You live in Akron, you have a spouse and 2 kids. To make the example even simpler lets pretend said spouse isnt tied to a job in town.

My option is to suck it up and put my pride to the side and take a job with USACS, move to another city and uproot my kids and family to a place I may not know anyone, or try to get another job in town.

Option 3 is the likely what everyone will try at first. Its the most tolerable solution. There are only so many jobs and the 40 or so SEA docs may get 1-2 of these.

The other 38 docs have the option of sucking it up or moving. What do you think they will do? Be honest.. Its really that simple. I went through this myself but I wasnt overly thrilled with my location so I chose moving.
 
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South Texas will give you lots of love $350+ is the norm there. Mississippi also pays well.


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Think "Where would I really hate to live?" That's where the big money is. Unless you're a weirdo. In that case think "Where would most emergency docs really hate to live?"
 
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I'm no fan of corporate EM, but the Summa situation is being consistently presented rather one sided. I have a hard time imagining a realistic scenario that doesn't involve a ridiculous failure by both parties. Frankly, if USACS can pull off the transition, they seem to be the only people involved with their s*** together.
 
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I'm and ER scribe in rural Missouri. Locums i've worked with are getting pain $500/hr. 12 hour shifts.
 
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Not through the locums but instead by direct contact with those systems.
 
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I am a doc who does locums and goes to Missouri and can say I have not seen rates close to that. I think that might have been a one off someone had. The malpractice is bad, no caps anymore.
 
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SeekerOfTheTree said:
I am a doc who does locums and goes to Missouri and can say I have not seen rates close to that. I think that might have been a one off someone had. The malpractice is bad, no caps anymore.
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Just out of curiosity: if you were working pure locums what is the maximum rate you think you could get if you wanted to load up on a solid 20 shifts a month and didn't care about location or working weekends?
 
Brahnold Bloodaxe said:
Just out of curiosity: if you were working pure locums what is the maximum rate you think you could get if you wanted to load up on a solid 20 shifts a month and didn't care about location or working weekends?
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Apart from the fact that you'd have to work at maybe 4 shops, tops, otherwise you're eating into work days with travel?
Many of the high paying shops have more than 1 FTE, so you could probably work all 20 there.
But if you offer 20 shifts, they'll lowball you. You'd have to pick them up 1 or 2 at a time. And it wouldn't last real long likely.
So there's not an answer to this. But an estimate is "a lot".
 
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Brahnold Bloodaxe said:
Just out of curiosity: if you were working pure locums what is the maximum rate you think you could get if you wanted to load up on a solid 20 shifts a month and didn't care about location or working weekends?
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First thing I will say is I am getting away from posting the amount online. I am becoming like those physician surveys for salary, I say a low number publicly but my paycheck and I know. I noticed alot of envy in other specialties of us and how they troll these boards too so just always keep that in mind. There are great opportunities that pay a very good wage.

I would agree, don't offer anyone 20 shifts at one site. What they offer you for a site always counter with a 50 markup. They will either bite or come up. They are trying to lowball you. Missouri has and will continue to have a huge shortage of docs because of the malpractice issues. If you can sleep without worrying about getting sued you should be fine. I do have some sleepless nights I have to admit.

20 days of work = 28 days worked. So I am only willing to ever do 15 locums shifts a month because the travelling will eat away at your time, life and sanity after that.

There are people that can work 10 day straight stretches in the locums business. I cannot and I honestly think they are crazy. If you can do this then great you will only have 4 total travel days. 1 to get there and 1 to get back. But wait! What if you can fly in on the day you work and fly out the day you are done. Doesn't work well, trust me. I have tried every possible iteration of this. Also in locums they don't really care about your schedule as much as you would like. So if you sign up for 10 it would be Day, Day, Night, Night, Night, Mid, Mid, Day, Night, Night...etc. You can see how that eats up your time.

So now lets say you want to maintain sanity but still want to do 20. I can get away with doing 5 day stretches and feel good. So you work 5 on and throw in 2 days of travel. That's 7 days gone. Now do that 4 times. 28 days gone. 10-12 has been the magic number for me. I am also working a teaching gig now on the side on top of this. I was all for I am going to get out of residency and work 20 shifts and only do nights...it's hard at community shops. Some of these shops are brutal.

I tend to rant alot but always happy to answer questions since this board has helped me since before medical school so please hit me up on PM if you have more Qs.
 
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I would argue you could probably easily tell 3 different sites that you could give them 7, 7, and 6 (or 7) and they would eat it up. You would pick your shifts. Those shops generally would be 12s though, so your pick is day or night.
Of course, you would want different schedulers for those 3 sites, so it would have to be TH, SG, EmCare, or USACs (or different regions), so you'd have to travel between them. It's not that hard though.
There's good money in Amarillo right now, but that might change soon. The Valley is always hurting, but the primary care guys undercut the price there.
 
To follow up with this train of thought, my dream setup after a year or two of busting my balls full time post-residency is one month on, one month off. Is it possible to find a steady supply of shifts every other month? The assumption is, again, that I would be willing to travel anywhere and work any shift during that month I'm "on."
 
Brahnold Bloodaxe said:
To follow up with this train of thought, my dream setup after a year or two of busting my balls full time post-residency is one month on, one month off. Is it possible to find a steady supply of shifts every other month? The assumption is, again, that I would be willing to travel anywhere and work any shift during that month I'm "on."
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Yes. You can create almost any schedule as a 1099 if you're willing to travel.
 
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Brahnold Bloodaxe said:
To follow up with this train of thought, my dream setup after a year or two of busting my balls full time post-residency is one month on, one month off. Is it possible to find a steady supply of shifts every other month? The assumption is, again, that I would be willing to travel anywhere and work any shift during that month I'm "on."
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Places that are desperate for help will almost always accommodate your requests if you are willing to work shifts.
 
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When I was working only locums I would work 5 in a row usually. I would ask for time and a half for any string less than 5 if I was traveling. If they were desperate they would pay more and make it worth my time, if not then I would work locally instead for a lower rate, but sleep in my own bed.
 
Locums within the Houston metro area is all but dried up - opportunities are still there, but you won't get past $250/hr in the metro area.

One of my locums gigs used to pay bonuses when they were chronically understaffed, but they hired MLPs and their need has dwindled.




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bravotwozero said:
Locums within the Houston metro area is all but dried up - opportunities are still there, but you won't get past $250/hr in the metro area.

One of my locums gigs used to pay bonuses when they were chronically understaffed, but they hired MLPs and their need has dwindled.
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That's brutal to hear. Not because I care about the dynamics of Houston area job market in particular, but for what it portends for the entirety of the field in the coming years.
 
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bravotwozero said:
Locums within the Houston metro area is all but dried up - opportunities are still there, but you won't get past $250/hr in the metro area.

One of my locums gigs used to pay bonuses when they were chronically understaffed, but they hired MLPs and their need has dwindled.




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This is surprising to hear. I would have expected Houston to be the last to be adequately staffed. I do find places needs fluctuates, and curious to see what is driving this other than some FSEDs closing down.
 
Brahnold Bloodaxe said:
That's brutal to hear. Not because I care about the dynamics of Houston area job market in particular, but for what it portends for the entirety of the field in the coming years.
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To be fair, they also hired a whole bunch of full time physicians, so you can stop hyperventilating...

Most of the places that had a locums need in Houston were emcare sites, but looks like emcare managed to hire enough docs to meet their needs.


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bravotwozero said:
To be fair, they also hired a whole bunch of full time physicians, so you can stop hyperventilating...

Most of the places that had a locums need in Houston were emcare sites, but looks like emcare managed to hire enough docs to meet their needs.
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Ok, but you have to admit that the way you phrased your comment indicated a direct relationship between the decline in demand for your services with an increase in midlevel utilization.

Midlevels aside, one of the concerns I've had about the long term future of EM is the rapid pace in residency expansion compared to the youth of the existing workforce. When I see a datapoint indicating that a previously "hot" job market is cooling down it only serves to reinforce my concern about this trend.

I'm by no means saying the sky is falling, but I think the news you are reporting falls under the "bad news" category. Whether it will end up being small impact or large impact I don't know.
 
bravotwozero said:
To be fair, they also hired a whole bunch of full time physicians, so you can stop hyperventilating...

Most of the places that had a locums need in Houston were emcare sites, but looks like emcare managed to hire enough docs to meet their needs.


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If they found full time EM docs, then I don't know how they can pay only 250/hr when IMO that is below market. Something must have changed b/c they were paying well above 250/hr before. FSEDs are paing 200/hr, so not sure why an extra 50/hr would motivate most ED docs to jump ship.
 
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