EM hourly pay/salary??

This forum made possible through the generous support of SDN members, donors, and sponsors. Thank you.
NRAI2001

NRAI2001

3K Member
15+ Year Member
20+ Year Member
Joined
Nov 6, 2001
Messages
4,653
Reaction score
65
What are average/common hourly pay for most EM jobs out there? What would be considered a reasonable hourly amount for most starting vs established EM physicians?
Members don't see this ad.
 
Hard to say. I think it depends primarily on market. I saw some jobs posted in Texas recently with a starting salary of 400k with benefits. And another on the east coast for 250k


Sent from my iPhone using SDN mobile
 
sonofva said:
Hard to say. I think it depends primarily on market. I saw some jobs posted in Texas recently with a starting salary of 400k with benefits. And another on the east coast for 250k


Sent from my iPhone using SDN mobile
Click to expand...


It's so counter intuitive that areas with lower costs of living seem to pay more for EM jobs.
 
Members don't see this ad :)
sb247 said:
It's not cost of living, it's supply and demand
Click to expand...

Yea I know but with a field as portable as EM seems to be to an outsider it is strange that people aren't migrating to areas that command a higher salary with a lower cost of living. I know the general argument is that the "Tri state area is such a great place to live and has a little bit of everything" but I live there now and cannot wait to get out west. The Tri state area is a joke for the most part but then again maybe the grass is greener on the other side.
 
People want to be close to their families. So they can raise their kids close to grandma. Tri-state NYC area is so densely populated that it's no surprise people are willing to take a pay cut to live there (close to their family). Not my thing but I get it.
 
  • Like
Reactions: 1 user
Strider_91 said:
Yea I know but with a field as portable as EM seems to be to an outsider it is strange that people aren't migrating to areas that command a higher salary with a lower cost of living. I know the general argument is that the "Tri state area is such a great place to live and has a little bit of everything" but I live there now and cannot wait to get out west. The Tri state area is a joke for the most part but then again maybe the grass is greener on the other side.
Click to expand...

Much of the West also has very high costs of living and relatively lower pay. You are making a bizarre assumption that cost of living determines how desirable a place is to live. As @sb247 pointed out above, it's all about supply and demand. The cost of living is low because the demand to live there is low, so pay has to be higher to draw in workers.
 
racerwad said:
Much of the West also has very high costs of living and relatively lower pay. You are making a bizarre assumption that cost of living determines how desirable a place is to live. As @sb247 pointed out above, it's all about supply and demand. The cost of living is low because the demand to live there is low, so pay has to be higher to draw in workers.
Click to expand...


Yea the "west" was a broad term as LA counts as the west and obviously many of the bigger cities have a high cost of living. Where someone wants to live is obviously a personal choice and there are plenty of areas in the Midwest or south that I would never want to live that have a low cost of living but in my life so far I have seen nothing in my area that makes the high cost of living worth it for me (to be fair I've never lived somewhere else only ever travelled through). But this is all just my opinion, some people love the city. I am more of an outdoor and mountain enthusiast and I know there are areas I can live that are way cheaper where I would genuinely be happier and probably command a similar salary if not a higher one.

Sorry for derailing the thread OP
 
Like many have stated above it depends on what are of the country you are working and what type of job you want to work (CMG, academics, SDG, etc.)

In my city (midwest, pop 700k-1 mil) it is mostly an SDG town. Pre-partners range in the 220-280k/yr range or about 150-160/hr, while most partners are pulling in 350-600k or 225-350/hr. The local CMG job pays in the 300-350k range or 200/hr as an IC. The local academic job starts out at 220k and depending on how much you take on and how fast you can move up pays in the 300s if you make PD, chair, vice-dean, etc.

In Chicago I was seeing 130-150/hr or high 200sK a year for most jobs. It was overrun by CMGs and hospital employee jobs. One SDG in the burbs was paying mid to high 300k a yr as partner. Rural IL, IN, WI will pay well. 300-400k depending on how much you want to work.

Diamond in the rough jobs in UT (WCI), ID, AZ, WA pay partners 300-600k a year depending on the group and how much you want to work. These groups almost never advertise and have plenty of competition. Most coast jobs I have heard about and have seen pay 100-170/hr or 200-270k/yr depending on where you want to work.

TX seems to be the gold mine due to FSED and lack of ED docs. People on this forum have quoted rates in the 300-500/hr for locums gigs. I am assuming most of this jobs are in busy EDs with a lack of resources.

So, again, it depends where you want to work and what type of group you want to work for.
 
  • Like
Reactions: 4 users
dav86 said:
Like many have stated above it depends on what are of the country you are working and what type of job you want to work (CMG, academics, SDG, etc.)

In my city (midwest, pop 700k-1 mil) it is mostly an SDG town. Pre-partners range in the 220-280k/yr range or about 150-160/hr, while most partners are pulling in 350-600k or 225-350/hr. The local CMG job pays in the 300-350k range or 200/hr as an IC. The local academic job starts out at 220k and depending on how much you take on and how fast you can move up pays in the 300s if you make PD, chair, vice-dean, etc.

In Chicago I was seeing 130-150/hr or high 200sK a year for most jobs. It was overrun by CMGs and hospital employee jobs. One SDG in the burbs was paying mid to high 300k a yr as partner. Rural IL, IN, WI will pay well. 300-400k depending on how much you want to work.

Diamond in the rough jobs in UT (WCI), ID, AZ, WA pay partners 300-600k a year depending on the group and how much you want to work. These groups almost never advertise and have plenty of competition. Most coast jobs I have heard about and have seen pay 100-170/hr or 200-270k/yr depending on where you want to work.

TX seems to be the gold mine due to FSED and lack of ED docs. People on this forum have quoted rates in the 300-500/hr for locums gigs. I am assuming most of this jobs are in busy EDs with a lack of resources.

So, again, it depends where you want to work and what type of group you want to work for.
Click to expand...

Thanks for the great reply!!

Back when I was in med school i remember the EM residents talking about offers they were getting. They were saying most were getting offers for over $200/hour and I remember one resident saying she really wasn't even too excited by an offer if it wasn't above $220/hour. I do believe that she was looking for jobs in Northern Ca outside of the Bay Area (like Humboldt, Contra Costa and Marin counties..etc)..it was a few years ago and I didn't think much about this back in Med School but was just curious about peoples experiences?? Was this exaggeration/unusual or is this the norm range nowadays?
 
NRAI2001 said:
Thanks for the great reply!!

Back when I was in med school i remember the EM residents talking about offers they were getting. They were saying most were getting offers for over $200/hour and I remember one resident saying she really wasn't even too excited by an offer if it wasn't above $220/hour. I do believe that she was looking for jobs in Northern Ca outside of the Bay Area (like Humboldt, Contra Costa and Marin counties..etc)..it was a few years ago and I didn't think much about this back in Med School but was just curious about peoples experiences?? Was this exaggeration/unusual or is this the norm range nowadays?
Click to expand...

If you're not getting above 200 an hour, you're getting robbed. They're still taking a large chunk of your billings though
 
  • Like
Reactions: 1 user
Members don't see this ad :)
Psai said:
If you're not getting above 200 an hour, you're getting robbed. They're still taking a large chunk of your billings though
Click to expand...

Agreed. Most companies can afford to pay you North of $300 and not lose money. Unless you absolutely have to be in a specific, very desirable city or location, there is no reason to accept less than $200/hour.
 
  • Like
Reactions: 2 users
$225/hr min for me to get out of bed to work in my well run ED.
To drive 1 hr for locums, I won't go unless I am getting $450/hr knowing I will get punished in a poorly run ED. I see less an hr in these poorly run EDs than my well run ED gig b/c it is so hard to move the meat. Just banked $4500 working 9 hrs, and saw 12 pts.
 
  • Like
Reactions: 7 users
emergentmd said:
$225/hr min for me to get out of bed to work in my well run ED.
To drive 1 hr for locums, I won't go unless I am getting $450/hr knowing I will get punished in a poorly run ED. I see less an hr in these poorly run EDs than my well run ED gig b/c it is so hard to move the meat. Just banked $4500 working 9 hrs, and saw 12 pts.
Click to expand...
I wish I learned about EM sooner.
 
DaTruMD said:
I wish I learned about EM sooner.
Click to expand...

EM is not the only specialty that pays well for locums. I think everyone gets worked up about some >300$/hr number being thrown around, but this is typically at sites that are hard to staff and painful to work at, and usually offered for emergency/call/last minute coverage. I moonlit at a place like that and I won't do it again. As med students you need to stop looking at the numbers/pay. EM can be a decent gig or painfully miserable. You can burn out very easily, and earlier this year I was sure feeling some of it. My friend who is a general surgeon with no fellowships gets paid $5k to cover a 24hr trauma call shift. He has residents that do all the work, and this isn't locums. Another buddy gets paid $2500/shift for critical care at a slower paced shop, 12 hr shifts, with residents, no locums. Another buddy is a non-invasive cardiologist, worked a 3 month locums gig, got paid 55k/month to do it.

let me repeat it. you can make money doing locums in all kinds of specialties. look beyond the forest for the trees.
 
  • Like
Reactions: 12 users
To me my time is worth something. If I have to spend an entire day of my life working, then I want to maximize the profit. It makes more sense to work at a tough site making $4000/day, than at an easy one making $2000. Either way I'm away from home, living in a hotel. My goal is to minimize the number of shifts I work, while maximizing the profit.
 
  • Like
Reactions: 8 users
bump.... so do more rural EDs tend to pay more hourly??
 
NRAI2001 said:
bump.... so do more rural EDs tend to pay more hourly??
Click to expand...

It's according to how rural. I have ran into two EDs that told me they prefer midlevels to run their ERs. Small less than 4K visit per year sites. Pay is crap there as well.


Sent from my iPhone using SDN mobile app
 
Makati2008 said:
It's according to how rural. I have ran into two EDs that told me they prefer midlevels to run their ERs. Small less than 4K visit per year sites. Pay is crap there as well.


Sent from my iPhone using SDN mobile app
Click to expand...
Not legal in TX. If you've got a red cross, you've got a doctor. It's a standard that we have to defend yearly to the ortho specialty hospitals, etc.
 
  • Like
Reactions: 3 users
Dr.McNinja said:
Not legal in TX. If you've got a red cross, you've got a doctor. It's a standard that we have to defend yearly to the ortho specialty hospitals, etc.
Click to expand...

I do know they use a physician on call that is off site to act as the "Dr". These sites are in Texas. So is that legal?


Sent from my iPhone using SDN mobile app
 
NRAI2001 said:
bump.... so do more rural EDs tend to pay more hourly??
Click to expand...

Out of curiosity I have looked in to some rural sites (usually <10,000 visits per year). I've noticed pay tends to be lower (some as low as 99/hr). Many allow 24 hr shifts. Admission rates tend to be low <10%. A lot of these lower paying sites have no requirement for BCEM. Rural sites close to national parks or places where folks like to recreate seasonally seem to pay more and may require BCEM.
 
carbonizedeyesockets said:
Out of curiosity I have looked in to some rural sites (usually <10,000 visits per year). I've noticed pay tends to be lower (some as low as 99/hr). Many allow 24 hr shifts. Admission rates tend to be low <10%. A lot of these lower paying sites have no requirement for BCEM. Rural sites close to national parks or places where folks like to recreate seasonally seem to pay more and may require BCEM.
Click to expand...

From my experience, this is usually the case. However, I think you can find some rural ER's with low volumes that pay $150/hr, which is a pretty sweet gig, especially if you get sleep at night. Sleeping for dollars.
 
carbonizedeyesockets said:
Out of curiosity I have looked in to some rural sites (usually <10,000 visits per year). I've noticed pay tends to be lower (some as low as 99/hr). Many allow 24 hr shifts. Admission rates tend to be low <10%. A lot of these lower paying sites have no requirement for BCEM. Rural sites close to national parks or places where folks like to recreate seasonally seem to pay more and may require BCEM.
Click to expand...

Rural sites = low population = low ED volume = Doesn't require BCEM = FP can staff it. 100/hr for an FP doc is more money than what they can make without the hassels of opening up a business. No BCEM doc would staff this place.
 
  • Like
Reactions: 1 user
Makati2008 said:
I do know they use a physician on call that is off site to act as the "Dr". These sites are in Texas. So is that legal?


Sent from my iPhone using SDN mobile app
Click to expand...
Not AFAIK. I don't think it changed this year. We've always fought the on call 30 minute rule as it's not safe.
 
EM_Rebuilder said:
Its always been fine in counties less than 100,000 in Texas. What we fought was someone staffing a small hospital in Houston, TX without a doctor on site...
Click to expand...

This facility is 50 miles away from Houston, town less than 10k


Sent from my iPhone using SDN mobile app
 
throckmortonDO said:
EM is not the only specialty that pays well for locums. I think everyone gets worked up about some >300$/hr number being thrown around, but this is typically at sites that are hard to staff and painful to work at, and usually offered for emergency/call/last minute coverage. I moonlit at a place like that and I won't do it again. As med students you need to stop looking at the numbers/pay. EM can be a decent gig or painfully miserable. You can burn out very easily, and earlier this year I was sure feeling some of it. My friend who is a general surgeon with no fellowships gets paid $5k to cover a 24hr trauma call shift. He has residents that do all the work, and this isn't locums. Another buddy gets paid $2500/shift for critical care at a slower paced shop, 12 hr shifts, with residents, no locums. Another buddy is a non-invasive cardiologist, worked a 3 month locums gig, got paid 55k/month to do it.

let me repeat it. you can make money doing locums in all kinds of specialties. look beyond the forest for the trees.
Click to expand...

Agree. I look at $/hr and benefits more than an annual salary. I had several advertisements offering 500k a year only to find it was 18 x 12hr shifts in the middle of nowhere, taking into account travel time and it just isn't worth it. People work different hours and it's hard to compare on an anual basis. Also quality of the shift in terms of how busy, how well run the ED makes a huge difference. Another job offer I got was $300-$400 an hour with a high acuity partner average of 3.1-3.2 patients per hour. Another was $240/hr for 1.6 pts/hr and seemed more appealing all things considered.

Current look on the west coast is $150-180/hr in highly desirable cities to start with a partnership track and about $200-250/hr full partner around 2 years later. Easy to get $200/hr in CA in the mid $200s as partner and hard to get above high 200s to 300 except in bad places to work (and even those places have standard hourly wages but extra "shift bonuses" as they offload shifts in desperation with an extra $1000-2000 plus hourly. I've heard rumors of higher paying full partner jobs but they usually have a bigger catch like a lower starting rate, only a few at the top of the pyramid and those are closely guarded where the senior partners don't even let the junior partners in their own group know what they are making.

Also consider tax sheltering opportunities as this is important, and also spending control/savings rate for building wealth, in addition to career longevity at a place you can enjoy. I got excited to chase the $ for a few weeks at most then realized that a fair salary while working in a place close to home that I love and can stay for the long term is more important. I do believe in fair compensation though. Know what your group is getting in terms of net revenue per patient and that you are getting an apporpriate amount of that on a patient/hr basis. As a rule of thumb I think a general average would be revenue of $150 per patient. So if you see 2 patients per hour then you are looking at $300/hr compensation - admin costs like billing (6-9%), malpractice (highly variable), administrator stipends etc which should be less than 20% and about $260/hr. If the group sees fewer per hour then the hourly will be lower, if there is more medicaid or lower acuity then a bit lower, higher for more private insurance etc. Don't be fooled by the high paying job seeing 3 per hour and taking responsibility for 2 midlevels and their charts. You are generating $450/hr plus way more with midlevels so your $300/hr salary offer suddenly isn't all that competitive anymore.
 
Last edited:
  • Like
Reactions: 1 user
ACEP newsletter is out with their annual EM salary report by region. Make sure you take a look at it. Never thought Alaska would be at the bottom for compensation. Who wants to work there? If I had a locums guy asking me to go out there I'd demand $2000 / hr to even think about it...


Sent from my iPhone using Tapatalk
 
  • Like
Reactions: 1 user
bravotwozero said:
ACEP newsletter is out with their annual EM salary report by region. Make sure you take a look at it. Never thought Alaska would be at the bottom for compensation. Who wants to work there? If I had a locums guy asking me to go out there I'd demand $2000 / hr to even think about it...


Sent from my iPhone using Tapatalk
Click to expand...

Because Alaska is like the PNW without hipsters.

In all honesty though, it's probably pretty sweet if you're into the outdoors.
 
link, plz?


bravotwozero said:
ACEP newsletter is out with their annual EM salary report by region. Make sure you take a look at it. Never thought Alaska would be at the bottom for compensation. Who wants to work there? If I had a locums guy asking me to go out there I'd demand $2000 / hr to even think about it...


Sent from my iPhone using Tapatalk
Click to expand...
 
Decent salaries in modesto or Fresno are likely skewing the averages. Bay Area and socal probably pay like $100/hr


Sent from my iPhone using Tapatalk
 
bravotwozero said:
Decent salaries in modesto or Fresno are likely skewing the averages. Bay Area and socal probably pay like $100/hr


Sent from my iPhone using Tapatalk
Click to expand...

Plus don't forget they take about 10% of your income for state tax. Tax policies should be included on salary surveys as well to give an accurate picture.
 
zero0 said:
What stuck out to me was the 45% hiring non-ABEM docs and apparently this number is growing. I always heard things were trending in the opposite direction up until now.
Click to expand...

There are just not enough ABEM docs. They have to staff it somehow. Most high paying hospitals that are decent in good areas are boarded ABEM.
 
bravotwozero said:
Decent salaries in modesto or Fresno are likely skewing the averages. Bay Area and socal probably pay like $100/hr


Sent from my iPhone using Tapatalk
Click to expand...
Man.... Someone is abusing these poor docs? 100/hr? I know PAs making more than 100/hr. Why would any doc want to make 100/hr and barely afford a shack in SF?
 
GeneralVeers said:
Plus don't forget they take about 10% of your income for state tax. Tax policies should be included on salary surveys as well to give an accurate picture.
Click to expand...

Your statement is incorrect or misleading.

https://www.tax-brackets.org/californiataxtable

OTOH, I agree with your general point: state taxes -- especially those in CA -- should not be ignored when considering salary.

HH
 
emergentmd said:
Man.... Someone is abusing these poor docs? 100/hr? I know PAs making more than 100/hr. Why would any doc want to make 100/hr and barely afford a shack in SF?
Click to expand...

There was a little hyperbole in my statement, so don't take my figure too literally. I don't think I'm that far off though...


Sent from my iPhone using Tapatalk
 
Strider_91 said:
Yea I know but with a field as portable as EM seems to be to an outsider it is strange that people aren't migrating to areas that command a higher salary with a lower cost of living. I know the general argument is that the "Tri state area is such a great place to live and has a little bit of everything" but I live there now and cannot wait to get out west. The Tri state area is a joke for the most part but then again maybe the grass is greener on the other side.
Click to expand...
Areas with a higher cost of living have such because people actually want to live there. All the money in the world can't force most people to move to Sticksville, ND.
 
Mbekweni said:
Agree. I look at $/hr and benefits more than an annual salary. I had several advertisements offering 500k a year only to find it was 18 x 12hr shifts in the middle of nowhere, taking into account travel time and it just isn't worth it. People work different hours and it's hard to compare on an anual basis. Also quality of the shift in terms of how busy, how well run the ED makes a huge difference. Another job offer I got was $300-$400 an hour with a high acuity partner average of 3.1-3.2 patients per hour. Another was $240/hr for 1.6 pts/hr and seemed more appealing all things considered.

Current look on the west coast in $150-180/hr in highly desirable cities to start with a partnership track and about $200-250/hr full partner. Easy to get $200/hr in CA in the mid $200s as partner and hard to get above high 200s to 300 except in bad places to work (and even those places have standard hourly wages but extra "shift bonuses" as they offload shifts in desperation with an extra $1000-2000 plus hourly. I've heard rumors of higher paying full partner jobs but they usually have a bigger catch like a lower starting rate, only a few at the top of the pyramid etc.

Also consider tax sheltering opportunities as this is important, and also spending control/savings rate for building wealth, in addition to career longevity at a place you can enjoy. I got excited to chase the $ for a few weeks at most then realized that a fair salary while working in a place close to home that I love and can stay for the long term is more important.
Click to expand...
Can you expand on tax sheltering opportunities? Do you mean using a backdoor Roth IRA?
 
I don't know what he meant, but tax shelter to me is any deductible item you can put your money in. HSA account, retirement plan, health insurance premium if you're a 1099, mortgage interest deduction, childcare expenses all qualify as above the line deductions


Sent from my iPhone using Tapatalk
 
You must log in or register to reply here.
Next unread thread

Similar threads

R
EM to palliative/hospice?
Replies
16
Views
1K
Frazier
Frazier
R
How to deal with EM anxiety
Replies
30
Views
2K
EmergentMagician
E
petomed
EM part time
2
Replies
57
Views
4K
Arcan57
Arcan57
Jball43
Help the lady leave EM
Replies
35
Views
3K
cyanide12345678
cyanide12345678
T
Would you recommend EM?
2 3
Replies
133
Views
8K
BoardingDoc
BoardingDoc
Top