Actual Starting Salaries

[Groove]

Sounds like thinly veiled age discrimination more than anything else.

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[GeneralVeers]

More for years post residency. Not necessarily for years worked there. I don't mind it I'm happy.

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I've never heard of a setup like this. Is there a maximum, and how does that play with RVUs? It would be hard to justify paying the 70 yo slow doctor more than the 40 you fast doctor.

 

[EctopicFetus]

I see your point but standard of care is often defined by local standards. A lot of these jobs in the sticks are low volume and far from anywhere decent. They barely generate any revenue even taking into account federal $ for critical access hospitals (almost no private insurance etc). Bottom line is someone needs to staff these places as long as the hospital is open (whether it should be or not is another question). The hospitals and CMGs are not getting rich of these places.

THE CMGS ARE getting rich. they arent staffing those places out of the goodness of their hearts lol. The CMGs take the subsidies and enjoy. I know of a CMG that risked giving up a contract cause the $1m profit on a slew of rural EDs wasnt enough.

Listen recently in the news was TH and the $2.4M subsidy to staff a 35k volume ED in nashville. Assuming no one has insurance that works out to close to $275/hr 24/7/365.

So lets not BS each other. they are making plenty. There is ZERO ZERO ZERO goodwill extended by the CMGs.

 

[TheSingularity]

No RVUs. Labor is pretty well split between the olds and the youngins. We are staffed out the a**. It's nice.

I've never heard of a setup like this. Is there a maximum, and how does that play with RVUs? It would be hard to justify paying the 70 yo slow doctor more than the 40 you fast doctor.

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[Dr Mantis Toboggan]

I assume these tiny places are loss leaders for CMGs, who frequently don’t get a subsidy instead relying on higher volume shops with armies of midlevels for their profit.

THE CMGS ARE getting rich. they arent staffing those places out of the goodness of their hearts lol. The CMGs take the subsidies and enjoy. I know of a CMG that risked giving up a contract cause the $1m profit on a slew of rural EDs wasnt enough.

Listen recently in the news was TH and the $2.4M subsidy to staff a 35k volume ED in nashville. Assuming no one has insurance that works out to close to $275/hr 24/7/365.

So lets not BS each other. they are making plenty. There is ZERO ZERO ZERO goodwill extended by the CMGs.

 

[EctopicFetus]

I assume these tiny places are loss leaders for CMGs, who frequently don’t get a subsidy instead relying on higher volume shops with armies of midlevels for their profit.

So why would a cmg staff it? They don’t lose money long term on any contract (note contract not hospital) If they did they would drop them.

 

[deleted109597]

So why would a cmg staff it? They don’t lose money long term on any contract (note contract not hospital) If they did they would drop them.

Because they have the contract for the money maker in the system.
IE "Big Health" has inner city terrible places, and suburb high insured patients. And they have tiny rural places.
CMG gets the contract for "Big Health", not for each hospital. They bid knowing they make money overall, just not at each site.

 

[turkeyjerky]

Because they have the contract for the money maker in the system.
IE "Big Health" has inner city terrible places, and suburb high insured patients. And they have tiny rural places.
CMG gets the contract for "Big Health", not for each hospital. They bid knowing they make money overall, just not at each site.

I think you guys are saying the same thing...

 

[GeneralVeers]

So why would a cmg staff it? They don’t lose money long term on any contract (note contract not hospital) If they did they would drop them.

I worked at an HCA facility and for sure they were losing money due to doctor's salary and bonuses for last minute coverage. Envision made up that money by staffing lucrative bigger city and suburban hospitals. The hospital systems force the CMGs to staff the poo-hole hospitals in exchange for the profitable ones.

 

[Hercules]

I can only think of a small handful in our group that are over 50.

When I started 10 years ago in my 8 doc SDG, there were 2 in their 60s (one of whom was female), 2 in their 50s, 1 in his 40s, and 3 of us in our 30s.

 

[EctopicFetus]

I think you guys are saying the same thing...

Yes. The contract though is profitable. That’s the key. No goodwill. Just business. As a whole they are making millions. That’s the key.

 

[EctopicFetus]

I worked at an HCA facility and for sure they were losing money due to doctor's salary and bonuses for last minute coverage. Envision made up that money by staffing lucrative bigger city and suburban hospitals. The hospital systems force the CMGs to staff the poo-hole hospitals in exchange for the profitable ones.

Right. Well keep in mind with hca envision has a big joint venture. So it’s like a contract on steroids. Hca also lets them do all sort of shenanigans with contracting. Here in Tennessee we have 2 commercial bcbs plans. Envision is only contracted with 1 of the 2 plans.

 

[911Doc]

I am still at $315/hr because that's been my travel rate for years, but the work continues to get harder to find. I work about 22 twelves for the time being to sock away money while I still can. Usually over Christmas/New Years I can get a decent bonus ($2500/shift) but it takes work.

 

[GatorCHOMPions]

I am still at $315/hr because that's been my travel rate for years, but the work continues to get harder to find. I work about 22 twelves for the time being to sock away money while I still can. Usually over Christmas/New Years I can get a decent bonus ($2500/shift) but it takes work.

22-12’s travel gig: are you the AI from the future sent to replace us?

 

[Dr Mantis Toboggan]

998 a year. Dang.

22-12’s travel gig: are you the AI from the future sent to replace us?

 

[TheSingularity]

Different stroke for different folks.

I chased the money for a bit but now I'm happy with my 200/hr gig in a functional shop with great staffing seeing less than 2 pph.

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[KeikoTanaka]

I assumed that post was mostly sarcasm.

As of now EM continues to get more competitive for applicants despite the increase in residencies. I interviewed on mostly established programs this season and don't remember seeing any Caribbean or FMG applicants at all. Very few DO students either. This may be different at some of the new programs cropping up. Based on what senior residents quoted me at some of my interview stops, nobody is having difficulty finding a job they are satisfied with and the offers have been pretty impressive compared to the doom and gloom on this thread.

Looking at my DO schools match rates last year, it was like 25% EM, 25% IM, 25% FM and 25% mix of everything else, all being like 2 into path, 1 into rads, 1 ortho, 1 ophtho, 1 neuro, etc etc. They always stress EM being very DO friendly.

 

[Listen2Savage]

Looking at my DO schools match rates last year, it was like 25% EM, 25% IM, 25% FM and 25% mix of everything else, all being like 2 into path, 1 into rads, 1 ortho, 1 ophtho, 1 neuro, etc etc. They always stress EM being very DO friendly.

as a statistical bro-scientist I'd say EM lends its self more towards the more down to earth less cerebral DO applicant

 

[KeikoTanaka]

as a statistical bro-scientist I'd say EM lends its self more towards the more down to earth less cerebral DO applicant

Well that's offensive. I consider myself a very cerebral person (Although that's why I'm leaning more towards IM than EM). I also didn't even apply MD because DO was what struck my interest in medicine in the first place. I scored in the ninety first percentile on the MCAT, and yes that was against my MD-applicant peers that cycle. There are many intelligent people in my class, and those who are going into EM generally have a very intrinsic interest in it as many are actually coming from EMS backgrounds. Lets not forget the best DO applicants every cycle take TWO Board exams. Many of the competitive DOs crush your precious little USMLE and still have to go on to take a whole other board exam which includes not only the same hard sciences, but hundreds of various manipulative techniques and physiologic biomechanical and viscerosomatic neural principles.

I will agree with you that there are some people in my class (only like 5-10 out of the 130) that I would, from only superficially observing them, say they don't belong in medical school. But, I don't even know their grades, so I am the first to admit that it is unfair of me to judge so - But.... oh God, some of them scare me, but that is a very, very, very small percentage of my class. Someone has to do Family Medicine in North Dakota....right? But so again to my point - those people are not matching EM.

 

[TheSingularity]

Oh gosh this again.

Well that's offensive. I consider myself a very cerebral person (Although that's why I'm leaning more towards IM than EM). I also didn't even apply MD because DO was what struck my interest in medicine in the first place. I scored in the ninety first percentile on the MCAT, and yes that was against my MD-applicant peers that cycle. There are many intelligent people in my class, and those who are going into EM generally have a very intrinsic interest in it as many are actually coming from EMS backgrounds. Lets not forget the best DO applicants every cycle take TWO Board exams. Many of the competitive DOs crush your precious little USMLE and still have to go on to take a whole other board exam which includes not only the same hard sciences, but hundreds of various manipulative techniques and physiologic biomechanical and viscerosomatic neural principles.

I will agree with you that there are some people in my class (only like 5-10 out of the 130) that I would, from only superficially observing them, say they don't belong in medical school. But, I don't even know their grades, so I am the first to admit that it is unfair of me to judge so - But.... oh God, some of them scare me, but that is a very, very, very small percentage of my class. Someone has to do Family Medicine in North Dakota....right? But so again to my point - those people are not matching EM.

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[Listen2Savage]

Well that's offensive. I consider myself a very cerebral person (Although that's why I'm leaning more towards IM than EM). I also didn't even apply MD because DO was what struck my interest in medicine in the first place. I scored in the ninety first percentile on the MCAT, and yes that was against my MD-applicant peers that cycle. There are many intelligent people in my class, and those who are going into EM generally have a very intrinsic interest in it as many are actually coming from EMS backgrounds. Lets not forget the best DO applicants every cycle take TWO Board exams. Many of the competitive DOs crush your precious little USMLE and still have to go on to take a whole other board exam which includes not only the same hard sciences, but hundreds of various manipulative techniques and physiologic biomechanical and viscerosomatic neural principles.

I will agree with you that there are some people in my class (only like 5-10 out of the 130) that I would, from only superficially observing them, say they don't belong in medical school. But, I don't even know their grades, so I am the first to admit that it is unfair of me to judge so - But.... oh God, some of them scare me, but that is a very, very, very small percentage of my class. Someone has to do Family Medicine in North Dakota....right? But so again to my point - those people are not matching EM.

dude how is that offensive

the majority of people that go to DO schools didnt get accepted into MD schools

saying the MDs are overall more cerebral/smarter/socially awkward (god doesnt give with both hands my friend) isnt that far of a stretch and has been my experience so far

not trying to start ****, i just thought this was widely accepted

 

[Splenda88]

I will agree with you that there are some people in my class (only like 5-10 out of the 130) that I would, from only superficially observing them, say they don't belong in medical school. But, I don't even know their grades, so I am the first to admit that it is unfair of me to judge so - But.... oh God, some of them scare me, but that is a very, very, very small percentage of my class. Someone has to do Family Medicine in North Dakota....right? But so again to my point - those people are not matching EM.

That is a very immature thing to say...

Don't turn this thread into another MD vs. DO thread. This is not the premed forum.

 

[Listen2Savage]

That is a very immature thing to say...

Don't turn this thread into another MD vs. DO thread. This is not the premed forum.

civil disagreement is still allowed, this part of the internet is still America dammit

 

[sylvanthus]

Well that's offensive. I consider myself a very cerebral person (Although that's why I'm leaning more towards IM than EM). I also didn't even apply MD because DO was what struck my interest in medicine in the first place. I scored in the ninety first percentile on the MCAT, and yes that was against my MD-applicant peers that cycle. There are many intelligent people in my class, and those who are going into EM generally have a very intrinsic interest in it as many are actually coming from EMS backgrounds. Lets not forget the best DO applicants every cycle take TWO Board exams. Many of the competitive DOs crush your precious little USMLE and still have to go on to take a whole other board exam which includes not only the same hard sciences, but hundreds of various manipulative techniques and physiologic biomechanical and viscerosomatic neural principles.

I will agree with you that there are some people in my class (only like 5-10 out of the 130) that I would, from only superficially observing them, say they don't belong in medical school. But, I don't even know their grades, so I am the first to admit that it is unfair of me to judge so - But.... oh God, some of them scare me, but that is a very, very, very small percentage of my class. Someone has to do Family Medicine in North Dakota....right? But so again to my point - those people are not matching EM.

Dude im a DO and can say at least half of this is hogwash and the COMLEX is a joke of an exam.

 

[Listen2Savage]

Dude im a DO and can say at least half of this is hogwash and the COMLEX is a joke of an exam.

lol

 

[911Doc]

998 a year. Dang.

I'm actually closer to 800. There are usually months where I don't do that many if I plan a trip. In October I worked at a new startup FSED and worked 28 shifts, but several were 36 hrs shifts. I see this all coming to an end in the next couple of years. And when that time comes I will have no choice but to settle for whatever is out there. I don't have a "side gig."

 

[Dr Mantis Toboggan]

Respek.

Admire the hustle.

I'm actually closer to 800. There are usually months where I don't do that many if I plan a trip. In October I worked at a new startup FSED and worked 28 shifts, but several were 36 hrs shifts. I see this all coming to an end in the next couple of years. And when that time comes I will have no choice but to settle for whatever is out there. I don't have a "side gig."

 

[KeikoTanaka]

Dude im a DO and can say at least half of this is hogwash and the COMLEX is a joke of an exam.

Regardless of whether you think its a joke or hogwash, it is still a tremendous amount of information (whether you believe in it or not) that you must take time out of your studies to prepare for and memorize, all the while preparing for the USMLE. My only point was that for many DOs to do as well on the USMLE as MDs and match in EM shows a lot of commitment and intelligence.

dude how is that offensive

the majority of people that go to DO schools didnt get accepted into MD schools

saying the MDs are overall more cerebral/smarter/socially awkward (god doesnt give with both hands my friend) isnt that far of a stretch and has been my experience so far

not trying to start ****, i just thought this was widely accepted

That is a very immature thing to say...

Don't turn this thread into another MD vs. DO thread. This is not the premed forum.

Seriously Splenda? I was simply defending DOs from Listen2Savage's claim that DOs aren't as cerebral as MDs, which was a pretty unwarranted response from the get-go, and yet I'm the immature one? I didn't want to make it a MD vs DO argument, I just was defending the point that there are many high performing DOs (and btw not all of us wanted to go to MD schools). Also, many DOs getting accepted into Emergency Medicine doesn't make it any less of an intelligent-demanding field, which is what Listen2Savage implied, but I'm the immature one... Okay Anyways, I don't want to de-rail the thread, so if you'd like to see me reply, you can PM me.

 

[Listen2Savage]

saying that DOs weren't as cerebral was a compliment, this is the EM forum

not saying that EM docs are dumb just more regard for getting **** done rather than pontificating

 

[GeneralVeers]

saying that DOs weren't as cerebral was a compliment, this is the EM forum

not saying that EM docs are dumb just more regard for getting **** done rather than pontificating

If cerebral means sitting down as a group and spending 3 hours contemplating the various mechanisms whereby a sodium level has decreased by 2 points in the last 24 hours, then count me as NOT cerebral.

 

[Splenda88]

If cerebral means sitting down as a group and spending 3 hours contemplating the various mechanisms whereby a sodium level has decreased by 2 points in the last 24 hours, then count me as NOT cerebral.

That is what we do in IM.

 

[GeneralVeers]

That is what we do in IM.

Right. It literally made me want to slit my own wrists in medical school having to sit an listen to it. Anything to escape the torture of irrelevancy.

 

[bronx43]

Right. It literally made me want to slit my own wrists in medical school having to sit an listen to it. Anything to escape the torture of irrelevancy.

Irrelevant to you doesn’t mean irrelevant to all.

 

[KGflyboy]

Well that's offensive. I consider myself a very cerebral person (Although that's why I'm leaning more towards IM than EM). I also didn't even apply MD because DO was what struck my interest in medicine in the first place. I scored in the ninety first percentile on the MCAT, and yes that was against my MD-applicant peers that cycle. There are many intelligent people in my class, and those who are going into EM generally have a very intrinsic interest in it as many are actually coming from EMS backgrounds. Lets not forget the best DO applicants every cycle take TWO Board exams. Many of the competitive DOs crush your precious little USMLE and still have to go on to take a whole other board exam which includes not only the same hard sciences, but hundreds of various manipulative techniques and physiologic biomechanical and viscerosomatic neural principles.

I will agree with you that there are some people in my class (only like 5-10 out of the 130) that I would, from only superficially observing them, say they don't belong in medical school. But, I don't even know their grades, so I am the first to admit that it is unfair of me to judge so - But.... oh God, some of them scare me, but that is a very, very, very small percentage of my class. Someone has to do Family Medicine in North Dakota....right? But so again to my point - those people are not matching EM.

I wasn't offended at all. The statement didn't imply DOs are dumb. You proved the point you are taking offense to. The point was that EM attracts and retains chill docs. They don't typically show up to work in ties and white coats talking about how to calculate a free water deficit. They show up in scrubs ready to get dirty. They want to stabilize patients and save the more "cerebral" work for the inpatient docs. Then they go drink a beer with their coworkers after shifts. Sometimes they curse at work. Some of us have lots of tattoos without making any effort to cover them at work.

The personalities and type of work are drastically different.

This is obviously a big generalization, and there are some IM docs I fit in with very well. But as a general rule, certain stereotypes do apply. If someone wants to say EM is less cerebral and down to earth, I'm ok with it. I don't think that generalization applies to DO applicants any more than it does MD applicants. It accurately describes the typical EM doc.

 

[2cool4stool]

To answer the question I currently moonlight as a PGY3 at a rural hospital in the Midwest for $180/hr and average <1pph. I recently signed my first contract with a SDG in the mid atlantic region. 2 year partnership track. $200/hr for the first 2 years plus full benefits/ retirement/ match. Full time is 1600 hours/year. No nights. With bonus after making partner I'm looking at $275+/hr. I'm worried the old farts will sell before I make partner because this job was almost too good to be true as far as work environment, location and total package. Good payer mix makes me even more concerned. I feel like the writing is on the wall for this group as it's mainly made up of older docs.

I spent a lot of time job researching the current market over the past year. I spoke with locums and CMGs offering $300+/hr in undesirable, poorly staffed locations. I spoke with folks in Denver offering $145/hr. I will not do this job for less than I'm worth.

At the end of the day I don't plan on doing this job my whole life. The stress and wear/tear on my body and mind isn't worth it. I'm willing to work hard and at the end of the day if I work this hard at anything I'll be successful financially and professionally. I think I can do it for 10 or maybe 15 years.

 

[Listen2Savage]

To answer the question I currently moonlight as a PGY3 at a rural hospital in the Midwest for $180/hr and average <1pph. I recently signed my first contract with a SDG in the mid atlantic region. 2 year partnership track. $200/hr for the first 2 years plus full benefits/ retirement/ match. Full time is 1600 hours/year. No nights. With bonus after making partner I'm looking at $275+/hr. I'm worried the old farts will sell before I make partner because this job was almost too good to be true as far as work environment, location and total package. Good payer mix makes me even more concerned. I feel like the writing is on the wall for this group as it's mainly made up of older docs.

I spent a lot of time job researching the current market over the past year. I spoke with locums and CMGs offering $300+/hr in undesirable, poorly staffed locations. I spoke with folks in Denver offering $145/hr. I will not do this job for less than I'm worth.

At the end of the day I don't plan on doing this job my whole life. The stress and wear/tear on my body and mind isn't worth it. I'm willing to work hard and at the end of the day if I work this hard at anything I'll be successful financially and professionally. I think I can do it for 10 or maybe 15 years.

what parts of the country are 300/hr

you mind dropping some cities?

 

[2cool4stool]

what parts of the country are 300/hr

you mind dropping some cities?

Mississippi had the highest paying gig I found per hour. It was a poorly staffed, high acuity hospital that saw a ton of patients and not in a desirable town. I spoke with a few recruiters about jobs for >$300/hr in Texas but didn't explore these much.

 

[Listen2Savage]

Mississippi had the highest paying gig I found per hour. It was a poorly staffed, high acuity hospital that saw a ton of patients and not in a desirable town. I spoke with a few recruiters about jobs for >$300/hr in Texas but didn't explore these much.

you used a recruiter or did the leg work yourself?

when you become a pgy3 is there a list job that become available to you?

 

[Fox800]

what parts of the country are 300/hr

you mind dropping some cities?

Midwest and the Deep South.

 

[homebaseddad112818]

To answer the question I currently moonlight as a PGY3 at a rural hospital in the Midwest for $180/hr and average <1pph. I recently signed my first contract with a SDG in the mid atlantic region. 2 year partnership track. $200/hr for the first 2 years plus full benefits/ retirement/ match. Full time is 1600 hours/year. No nights. With bonus after making partner I'm looking at $275+/hr. I'm worried the old farts will sell before I make partner because this job was almost too good to be true as far as work environment, location and total package. Good payer mix makes me even more concerned. I feel like the writing is on the wall for this group as it's mainly made up of older docs.

I spent a lot of time job researching the current market over the past year. I spoke with locums and CMGs offering $300+/hr in undesirable, poorly staffed locations. I spoke with folks in Denver offering $145/hr. I will not do this job for less than I'm worth.

At the end of the day I don't plan on doing this job my whole life. The stress and wear/tear on my body and mind isn't worth it. I'm willing to work hard and at the end of the day if I work this hard at anything I'll be successful financially and professionally. I think I can do it for 10 or maybe 15 years.

You don’t have to do nights? Did you negotiate that in or did it affect your pay/hours/something like that? Congrats on the job!

 

[2cool4stool]

you used a recruiter or did the leg work yourself?

when you become a pgy3 is there a list job that become available to you?

Both. I did lot of digging on the internet. I cold called and sent emails to groups that weren't even advertising open jobs. Talked with local guys. Networked at ACEP. It's difficult to find a good job if you are only willing to work for a SDG.

I don't know of any "job list".

 

[AlmostAnMD]

You don’t have to do nights? Did you negotiate that in or did it affect your pay/hours/something like that? Congrats on the job!

Might just be a setup like my SDG. I don't work any nights. We have a dedicated core of nocturnists that do all the night shifts for a pay diff. Occasionally there is a gap in scheduling and one of us has to work a night or two but in the 6 months I've been with my SDG I haven't worked a single night.

 

[EctopicFetus]

This is an ideal setup. I work very few nights as we have a group of people who want them. We have financial and non financial incentives to work nights. It works well. I do maybe 6-8 nights a year and if I wanted to pony up some cash I could work even less.

I dont mind nights but given the option ill not work them but at this point its not worth giving someone else money to do that. Luckily the nights on an rvu basis are better so i dont need to come up with money out of pocket. It just allows someone else to "earn" more by working my nights.

 

[RustedFox]

Might just be a setup like my SDG. I don't work any nights. We have a dedicated core of nocturnists that do all the night shifts for a pay diff. Occasionally there is a gap in scheduling and one of us has to work a night or two but in the 6 months I've been with my SDG I haven't worked a single night.

We are one hire away from this same arrangement. I haven't worked a night in 4-5 weeks now, and the benefits are huge.

 

[Groove]

Lucky bastards. I just worked 4 in a row. I was extra crispy with the nurses. I’m pretty sure night crew was glad to see me back on days.

 

[cyanide12345678]

I get calls daily to cover Locum shifts in a Major Texas city. Base is $325/hr and turn down bonuses on a daily bases for $4K to cover these shifts. Too bad my wife didn't want me to travel much or I could make 100K some months.

Some shifts I was pulling over 800/hr when they were really desperate and paying 2.5x rate. I remember a holiday shift when they asked me to name my price but My wife would not have it.

Just did a shift yesterday and shift was super slow. Saw 14 pts in a 12 hr shift and pulled in 8K. Had time to watch the news and saw Trump just win the republican nomination. New England won another superbowl and Royals won the World series. Pretty good year.

The good old days, but good memories. No way I do locums at the current rate I am getting. Still shifts out there but young docs snatch shifts up quicker than I can delete them and 4 yrs ago there were 30 open shifts that was never picked up without a bonus.

Oh well, I am too far into my career to work my butt off at a dysfunctional site for the $275 being offered. Newly minted docs are jumping at them but no way am I getting crushed at that rate. Good luck to all the new grads. Lower rates at crappy hospitals are not too bad when you have no frame of reference.

You can forward the 325/hr locum gigs my way

The locum calls i get are usually around 200-220 per hour.

 

[TheSingularity]

The locums market is garbage these days. Mostly seeing offers for less than I make in the Northeast.

You can forward the 325/hr locum gigs my way

The locum calls i get are usually around 200-220 per hour.

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[Brigade4Radiant]

it depends on what you mean by locums many of Envision and Team health Firefighters make 280 so they have been taking most of the locums positions

 

[TheSingularity]

I mean emails from recruiters

it depends on what you mean by locums many of Envision and Team health Firefighters make 280 so they have been taking most of the locums positions

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[TooMuchResearch]

I don't think I've done more than 1-2/month in at least 6 months and they're almost all at our slower sites now. It's awesome. The evening shifts past midnight still suck.

Lucky bastards. I just worked 4 in a row. I was extra crispy with the nurses. I’m pretty sure night crew was glad to see me back on days.