Income, benefits, compensation thread

[cyanide12345678]

In the spirit of salary transparency I've created this thread to create awareness and information for fellow EM docs so they can understand their fair market value and essentially negotiate an income that represents their worth as trained ER docs.

I’ll go first. Here's my current job.

Employer: University group
ER setting: rural
Region: mid west
Hourly: $200/hr
W2 or 1099 or k1: w2
Patients per hour: 1.1 average last year
Annual census: i believe 8600
Cme: 5k
Annual bonus ~ 40k (given quarterly)
Benefits: the usual - health, life, disability insurance., vision, dental. Plus 2 weeks paid paternity leave and 50 percent tuition discount to the university for kids. 401k match at 5%
Overtime rate: $220/hr

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[ScepticSkeksis]

Employer: CMG in malignant hospital system
ER Setting: Urban (large metro area)
Region: Texas
Hourly: Avg $270/hour W2
Pph: 1.5 directly, but supervise 2 midlevels
Annual Census: 100K
Bonus: ? I'm new to the site so not sure.
CME: 5K
Benefits: FT gets health insurance. PT gets nada

 

[valianteffort]

Employer: CMG in ok hospital system thats not too malignant..
ER Setting: Urban (large metro area)
Region: Texas
Hourly: 100% RVU based - low of 265/hr/month, high of 350/hr/month
Pph: 1.9-2.0 directly, supervise 1 midlevel
Annual Census: 25k
Bonus: No. barely get CME money approved.
CME: 5k
Benefits: great benefits, health/life/disability/401k match

 

[RustedFox]

Employer: HCA.
ER Setting: Methamphetamine county.
Region: Florida
Pay structure: 1099 IC. Hourly: Base + RVU. 250-300/hour, depending on the season.
Pph: 2-2.5 directly, supervise 2 midlevel
Annual Census: 30-33k.
Bonus: HaHaHaHa.
CME: Eff off.
Benefits: Pfft. They DEDUCT med.mal out of our hourly.

 

[cyanide12345678]

Employer: HCA.
ER Setting: Methamphetamine county.
Region: Florida
Hourly: Base + RVU. 250-300/hour, depending on the season.
Pph: 2-2.5 directly, supervise 2 midlevel
Annual Census: 40k
Bonus: HaHaHaHa.
CME: Eff off.
Benefits: Pfft. They DEDUCT med.mal out of our hourly.

That’s rough volume for that compensation. Are you signing mlp notes as well? Hca hasn’t hired any cmg?

 

[RustedFox]

That’s rough volume for that compensation. Are you signing mlp notes as well? Hca hasn’t hired any cmg?

1. Yes.
2. Yes.
3. Envision, now "Valesco", which is still run by Envision.

The thing is, this is two sites in one. During the summer months, you'll see one an hour, and they'll send MLPs home. From Thanksgiving to Easter, all the goddamned snowbirds come here and volume triples.

 

[watermanMD]

Employer: hospital employed
ER setting: suburban
Region: southeast
Hourly: 240 day, 270 night + RVU (but difficult to achieve)
W2 or 1099 or k1: w2
Patients per hour: 1.9 (1.4-2.5)
Annual census: 100k+
Cme: 4k
Annual bonus 150k (quality, engagement—easy to get); additional ~150k available as RVU bonus, but difficult to achieve.
Benefits: health, vision, dental. Full retirement matching. 1 month sabbatical per year if desired. All certs paid for. Local and national society associations/membership paid for.
Overtime rate: n/a
*With hourly + clinical bonuses factored in: 400/hr by my calculation for myself this year.
Also 20k sign on bonus. Up to 12k moving allowance (reimbursed).

 

[Groove]

Employer: CMG
ER setting: Multiple hospitals in greater metro area but spend most of my time at community site
Region: SE
Hourly: 250-275
1099
PPH: 2-2.5
Annual Census: 35K-90K depending on where I'm at
CME: None
Benefits: None

 

[gruemd]

Employer: SDG
ER setting: rural-ish
Region: Midwest
Hourly: ~$290 (see benefits)
W2 or 1099 or k1: w2/K1
Patients per hour: 1.7 avg this year so far
Annual census: ~25k
CME: See benefits
Annual bonus: See benefits
Benefits: Hourly rate above is base rate (lower than you'd think and most people scoff at it) plus biannual partner distributions and benefits including fully funded 401k (ex 66k this year), HSA, generous pre-tax reimbursement plan including CME but also including tech/medical expenses/disability etc., health insurance/medmal covered by company (minus tail)
Overtime rate: n/a

 

[cyanide12345678]

Employer: CMG in malignant hospital system
ER Setting: Urban (large metro area)
Region: Texas
Hourly: Avg $270/hour W2
Pph: 1.5 directly, but supervise 2 midlevels
Annual Census: 100K
Bonus: ? I'm new to the site so not sure.
CME: 5K
Benefits: FT gets health insurance. PT gets nada

What makes the hospital system malignant

 

[cyanide12345678]

Employer: SDG
ER setting: rural-ish
Region: Midwest
Hourly: ~$290 (see benefits)
W2 or 1099 or k1: w2/K1
Patients per hour: 1.7 avg this year so far
Annual census: ~25k
CME: See benefits
Annual bonus: See benefits
Benefits: Hourly rate above is base rate (lower than you'd think and most people scoff at it) plus biennial partner distributions and benefits including fully funded 401k (ex 66k this year), HSA, generous pre-tax reimbursement plan including CME but also including tech/medical expenses/disability etc., health insurance/medmal covered by company (minus tail)
Overtime rate: n/a

Did you have to do a buy in for the partnership?

 

[gruemd]

Did you have to do a buy in for the partnership?

There's a short (1 year) sweat equity buy in where some of those benefits are not available. Still averaged out to about $200/hr.

There is a monetary buy in, but it's dumb. Buy in is a decent amount, deferred from K1 bonuses for x number of years, but if you buy out (including at any point during the buy in process) you effectively get that money back, so it's really a wash altogether. I tried asking several people including the group accountant why it's done that way when it effectively means nothing when you leave the company and the best answer I got was that those distributions are split among the partners, so it incentivizes longer partnership, but that amount split amongst all the partners is a pretty paltry amount. And that that's just how it had always been done. I basically just accepted that if I stayed a long while, then great, I'd benefit a bit, and if not then oh well, I still get my initial buy-in back and basically lose the interest I'd have been able to earn on that money were it in my investment account instead (a very small sum in the grand scheme of things). Money buy-ins in an EM group make little sense since we own no real assets, but here we are.

 

[CoolDoc1729]

1. Yes.
2. Yes.
3. Envision, now "Valesco", which is still run by Envision.

The thing is, this is two sites in one. During the summer months, you'll see one an hour, and they'll send MLPs home. From Thanksgiving to Easter, all the goddamned snowbirds come here and volume triples.

I just can’t wait until our snowbirds head back down there 🤣 it’s been pretty mild in the Midwest, maybe they will come back early. You can have their RVUs.

What heart problems have you had?
“Cant you see my cardiologist note? I had something done in March”
: dig through the EMR :: I mean there’s nothing here
“ITS IN THE COMPUTER”
Is it in the computer …. In Florida?
“Well yeah, can’t you still see it?”
………..

 

[CoolDoc1729]

Employer: CMG -> now hospital employed
ER setting: urban, with a suburban FSED
Region: mid west
Hourly: $200/hr (extra ~25 for nights )
W2 or 1099 or k1: w2
Patients per hour: 1.9 solo (~2.3 at fsed) plus supervising 1 midlevel
Annual census: 40000 (FSED has another ~24000)
Cme: 3500
Annual bonus : none
Benefits: health, life, disability insurance., vision, dental, 401k match
Overtime rate: $300/hr

 

[Jabbed]

Employer: SDG (sweat equity)
ER setting: urban
Region: SE
Hourly: $220/hr (+$25/hr benefits)
W2 or 1099 or k1: w2
Patients per hour: 2.2
Annual census: 80k
Cme: 5k
Annual bonus: factored into hourly
Benefits: health, life, disability insurance, vision, dental. 401k match
Overtime rate: +$50-$75/hr

 

[EctopicFetus]

Are we posting about jobs we know or our jobs?

 

[ScepticSkeksis]

Are we posting about jobs we know or our jobs?

Our primary jobs

 

[RustedFox]

That’s rough volume for that compensation. Are you signing mlp notes as well? Hca hasn’t hired any cmg?

Just asked my director.
We're at 30-33k visits/year.
Feels like 40k.

 

[sdles]

Employer: CMG
ER setting: severely dysfunctional rural, high acuity hospital
Region: SoCal rural
Hourly: avg 250/hr over the year
W2 or 1099 or k1: 1099
Patients per hour: 2.0-2.5 plus mid-level sup
Annual census: 50k
Cme: 0
Annual bonus: factored into hourly
Benefits: no
Overtime rate: no

 

[RustedFox]

I just can’t wait until our snowbirds head back down there 🤣 it’s been pretty mild in the Midwest, maybe they will come back early. You can have their RVUs.

What heart problems have you had?
“Cant you see my cardiologist note? I had something done in March”
: dig through the EMR :: I mean there’s nothing here
“ITS IN THE COMPUTER”
Is it in the computer …. In Florida?
“Well yeah, can’t you still see it?”
………..

"That's a cybercrime, sir."

 

[cyanide12345678]

Employer: CMG
ER setting: severely dysfunctional rural, high acuity hospital
Region: SoCal rural
Hourly: avg 250/hr over the year
W2 or 1099 or k1: 1099
Patients per hour: 2.0-2.5 plus mid-level sup
Annual census: 50k
Cme: 0
Annual bonus: factored into hourly
Benefits: no
Overtime rate: no

50k volume rural????? That should be a level 2 or 3 hospital with almost all sub specialty support.

I think of rural as you’re the only doc in the hospital after 5 pm lol

 

[cyanide12345678]

Employer: CMG -> now hospital employed
ER setting: urban, with a suburban FSED
Region: mid west
Hourly: $200/hr (extra ~25 for nights )
W2 or 1099 or k1: w2
Patients per hour: 1.9 solo (~2.3 at fsed) plus supervising 1 midlevel
Annual census: 40000 (FSED has another ~24000)
Cme: 3500
Annual bonus : none
Benefits: health, life, disability insurance., vision, dental, 401k match
Overtime rate: $300/hr

The cmg and hospital are making a lot off of you. 200/hr for 2 pph isn’t fair compensation in my opinion. Any other jobs around you that are worth looking into?

 

[LChristmas]

Employer: CMG
ER setting: Suburban
Region: Texas
Hourly: Avg $335/hr straight RVU (2023)
W2 or 1099 or k1: W2
Patients per hour: 2.1 solo; 2.8 including APP
Annual census: 65k
Cme: $2,500
Annual bonus N/A
Benefits: Health, life, disability, vision, dental, 401k match, HSA contribution
Overtime rate: N/A

 

[RustedFox]

Jesus. Texas is outta sight with rates and benefits. I get a sharp stick in the eye by comparison.

 

[hoot504]

Jesus. Texas is outta sight with rates and benefits. I get a sharp stick in the eye by comparison.

This thread is gold. I thought I had it ok but just reading these posts I'm already questioning things.

My info:
Employer: CMG
ER setting: Urban (2 sites)
Region: Arizona
Hourly: Avg $220/hr base
Bonus: Additional $30 - 40/hr paid quarterly
W2 or 1099 or k1: W2
Patients per hour: 1.5 - 2.0 (not including PA patients but I do supervise them on most shifts)
Annual census: Approx 80k at both sites
Cme: $3,500
Benefits: Health, life, disability, vision, dental, 401k match, HSA contribution
Overtime rate: I think another $20/hr for every hour worked over 140hrs/month

 

[cyanide12345678]

This thread is gold. I thought I had it ok but just reading these posts I'm already questioning things.

My info:
Employer: CMG
ER setting: Urban (2 sites)
Region: Arizona
Hourly: Avg $220/hr base
Bonus: Additional $30 - 40/hr paid quarterly
W2 or 1099 or k1: W2
Patients per hour: 1.5 - 2.0 (not including PA patients but I do supervise them on most shifts)
Annual census: Approx 80k at both sites
Cme: $3,500
Benefits: Health, life, disability, vision, dental, 401k match, HSA contribution
Overtime rate: I think another $20/hr for every hour worked over 140hrs/month

Salary transparency is important so we know our worth and can negotiate appropriately.

 

[alpinism]

Employer: University Hospital
ER setting: Urban
Region: East Coast
Hourly: $200/hr rate
W2 or 1099 or k1: W2
Patients per hour: 2 with residents
Annual census: 100K
Cme: 4K
Annual bonus: None
Benefits: the usual - health, life, vision, dental, and 401k match
Overtime rate: $250/hr rate for last minute shifts

 

[Brigade4Radiant]

Employer: CMG
ER setting Suburban
Region: Southeast
Hourly 150 base about 13 rvu averages to 290 an hour
independent contractor
annual census 50k
patients per hour 2 by myself and 3 with app
Cme none
annual bonus none
benefits IC benefits so health and cme are all tax deductable so roughly 30% discount
no non compete can pick up extra shifts

 

[GonnaBeADoc2222]

Employer: Hospital System
ER setting: urban
Region: North East
Hourly: $250/hr (includes salary, matching, bonus)
W2 or 1099 or k1: w2
Patients per hour: 1.5ish
Annual census: 80 to 100k
Cme: 5k (near impossible to use)
Annual bonus: small, see above
Benefits: health, short-term disability
Overtime rate: none (but they pretend)

 

[deleted206819]

Employer	CMG
ER Setting	Suburban
Region	Texas (DFW)
Hourly	Straight RVU — $260 - 300+ / HR
W2 / 1099 / K1	1099
Patient Per Hour (PPH)	2.2 - 2.6 (No MLPs by local group choice)
Annual Census	40 - 50,000
CME	None
Annual Bonus	Unknown
Benefits	All out of pocket (401K, HSA, benefits, medmal policy)
Overtime Rate	None

 

[emergentmd]

Man, everyone who reads this will wonder why ER docs are complaining with most here making 250+/hr which is more than most fields.

Ill Play

SDG Austin Circa 2001-2017 Pre Takeover but from what I hear it is the same currently
Employer: Hospital System
ER setting: urban
Region: Austin Tx
Hourly: $250/hr (includes salary, matching, bonus)
W2 or 1099 or k1: w2/K1
Patients per hour: 2pph
Annual census: 60k
Cme: Nope
Annual bonus: 50K
Benefits: Basic health
Overtime rate: Nope

I would post FSER but it starts to sound outrageous

 

[GonnaBeADoc2222]

Man, everyone who reads this will wonder why ER docs are complaining with most here making 250+/hr which is more than most fields.

Ill Play

SDG Austin Circa 2001-2017 Pre Takeover but from what I hear it is the same currently
Employer: Hospital System
ER setting: urban
Region: Austin Tx
Hourly: $250/hr (includes salary, matching, bonus)
W2 or 1099 or k1: w2/K1
Patients per hour: 2pph
Annual census: 60k
Cme: Nope
Annual bonus: 50K
Benefits: Basic health
Overtime rate: Nope

I would post FSER but it starts to sound outrageous

My friend is making 600/hr in PP psych.

No nights, weekends, holidays.

No people threatening to kill you.

 

[slchino]

Employer: cmg
ER setting: metro southern
Region: California
Hourly: 170-$200/hr +25$ swing +50$ night differential
W2 or 1099: 1099
Patients per hour: 1.7-2.2
Annual census: 130k
Cme: 0
Annual bonus: rvu generation about extra 15-30$/hr
Benefits: 0
Overtime rate: none

 

[emergentmd]

My friend is making 600/hr in PP psych.

No nights, weekends, holidays.

No people threatening to kill you.

Working for the hospital and CMG caps all specialties but 250/hr is still better than many fields. I am not saying EM is great, far from that. But other fields looking in and med students will be ecstatic with 250+/hr.

Trust me, I got out before covid and when things really hit the fan. I know its even worse now and that is why I jumped ship before it started to sink.

 

[GonnaBeADoc2222]

Employer: cmg
ER setting: metro southern
Region: California
Hourly: 170-$200/hr +25$ swing +50$ night differential
W2 or 1099: 1099
Patients per hour: 1.7-2.2
Annual census: 130k
Cme: 0
Annual bonus: rvu generation about extra 15-30$/hr
Benefits: 0
Overtime rate: none

Ouchy.

 

[PikminOC]

My friend is making 600/hr in PP psych.

No nights, weekends, holidays.

No people threatening to kill you.

The drug seekers in psych certainly do threaten when they paid for the appt and don't get their drug or choice

 

[cyanide12345678]

Ouchy.

It's probably an academic program with residents helping out. I'd be surprised if a shop with 130k annual visits didn't have a residency.

Our attendings at the downtown mothership, the holy grail residency shop only make some $175/hr.

 

[GonnaBeADoc2222]

The drug seekers in psych certainly do threaten when they paid for the appt and don't get their drug or choice

They get a free screening call beforehand and if there's any whif of this, they are not accepted into the practice.

 

[emergentmd]

Employer: cmg
ER setting: metro southern
Region: California
Hourly: 170-$200/hr +25$ swing +50$ night differential
W2 or 1099: 1099
Patients per hour: 1.7-2.2
Annual census: 130k
Cme: 0
Annual bonus: rvu generation about extra 15-30$/hr
Benefits: 0
Overtime rate: none

Sorry man. Living in California HCOL drops that 170-200/hr to about $121-142/hr. Add the higher taxes and it gets worse.


MIT sets the living wage for an adult with one child in California as $83,917 before taxes compared to about $59,652 in Texas which is a .71 factor.

 

[cyanide12345678]

Man, everyone who reads this will wonder why ER docs are complaining with most here making 250+/hr which is more than most fields.

Ill Play

SDG Austin Circa 2001-2017 Pre Takeover but from what I hear it is the same currently
Employer: Hospital System
ER setting: urban
Region: Austin Tx
Hourly: $250/hr (includes salary, matching, bonus)
W2 or 1099 or k1: w2/K1
Patients per hour: 2pph
Annual census: 60k
Cme: Nope
Annual bonus: 50K
Benefits: Basic health
Overtime rate: Nope

I would post FSER but it starts to sound outrageous

I'm actually surprised how many of us are touching 300/hr. Makes me want to get off my a** and consider seeing more patients at a higher volume shop. But I love the relaxing pace of rural ERs.

 

[Brigade4Radiant]

It's probably an academic program with residents helping out. I'd be surprised if a shop with 130k annual visits didn't have a residency.

Our attendings at the downtown mothership, the holy grail residency shop only make some $175/hr.

but its 1099 and no cme which is unheard of for an academic program

 

[cyanide12345678]

but its 1099 and no cme which is unheard of for an academic program

Fair point. It's probably not an academic program then. Kaiser in California I hear has an excellent package. If docs start jumping ship from places that don't compensate adequately, then it will put pressure on them to increase compensation. Though 220/hr with RVUs added and 50% swings and nights is probably more like 240-250/hr which isn't bad.

 

[PikminOC]

They get a free screening call beforehand and if there's any whif of this, they are not accepted into the practice.

All types of psych patients out there

 

[watermanMD]

Man, everyone who reads this will wonder why ER docs are complaining with most here making 250+/hr which is more than most fields.

Ill Play

SDG Austin Circa 2001-2017 Pre Takeover but from what I hear it is the same currently
Employer: Hospital System
ER setting: urban
Region: Austin Tx
Hourly: $250/hr (includes salary, matching, bonus)
W2 or 1099 or k1: w2/K1
Patients per hour: 2pph
Annual census: 60k
Cme: Nope
Annual bonus: 50K
Benefits: Basic health
Overtime rate: Nope

I would post FSER but it starts to sound outrageous

Idk, I get paid a **** ton after bonuses and stuff, not even factoring in benefits, and I still don’t think my pay is commensurate with the job. To Med students reading this: I don’t think 250/hr is worth the baggage of EM. Sure, many people in this country would kill to make that much. Sure, many in EM aren’t even making that much. I get it. I’m just saying, I don’t think we get paid enough for the **** we have to deal with. Maybe I’d feel different if I saw 0.5 patients a hour at a freestanding in Alaska?? Idk. Considering everything, MAYBE my job would be worth it at like 500/hr. That, honestly, seems fair to me. I think we’re getting stiffed with our wages.

 

[thegenius]

Are we posting about jobs we know or our jobs?

Our jobs, unless you have incontrovertible evidence about other jobs too

 

[thegenius]

We need to compile this in a spreadsheet format: see below.

 

[thegenius]

Location/Region​	Academic / Community​	Pay Model (RVU, Hourly, Hybrid)​ ​	​ Pay Type (1099, W2)​ ​	​ Median Pts/Hr​ ​	Median Hourly Pay ​	Notes​
Bay Area, CA	Community	Hybrid	1099	2.5	$350/hr	High volume, low acuity, manage 1 midlevel, median hour excludes 30K yearly bonus, have most services, not a particulary high functioning hospital. are IC's of hospital foundation. poor payor mix.

 

[thegenius]

Idk, I get paid a **** ton after bonuses and stuff, not even factoring in benefits, and I still don’t think my pay is commensurate with the job. To Med students reading this: I don’t think 250/hr is worth the baggage of EM. Sure, many people in this country would kill to make that much. Sure, many in EM aren’t even making that much. I get it. I’m just saying, I don’t think we get paid enough for the **** we have to deal with. Maybe I’d feel different if I saw 0.5 patients a hour at a freestanding in Alaska?? Idk. Considering everything, MAYBE my job would be worth it at like 500/hr. That, honestly, seems fair to me. I think we’re getting stiffed with our wages.

that's cool, and it should be part of a different thread. We should just compile a list of work features of our hospital.

 

[slchino]

It's probably an academic program with residents helping out. I'd be surprised if a shop with 130k annual visits didn't have a residency.

Our attendings at the downtown mothership, the holy grail residency shop only make some $175/hr.

My bad not 130k, more like 100-110k

straight community but we do have some residents rotating through. It is a hefty price to pay to live in California

 

[trackrunner321]

Employer: CMG
ER setting: Urban
Region: Midwest
Hourly: $210/hr
W2 or 1099 or k1: K1
Patients per hour: 1.5-2.0
Annual census: 38k
Cme: None
Occasional Quarterly Bonus: Approximately $25-35k over the year
Annual bonus: Around $80k
Benefits: None