Income, benefits, compensation thread

[NYEMMED]

Employer: large CMG
ER setting: Community
Region: South East
Hourly: ~$240/hour (170/ hour base 190 nights, plus some RVU
W2 or 1099 or k1: 1099
Patients per hour: 2.2+
Annual census: 60k
Cme: None
Occasional Quarterly Bonus: None
Annual bonus: NO
Benefits: ROFL

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[TooMuchResearch]

This feels like when I was reading people's Step scores on SDN. I know the average of ER docs nationally, but curious where the other side of the bell curve is? No shade... seems like some good gigs out there.

I've seen some ****ty salary data published in the last year. From where I sit, it seems like manipulation and scare tactics to get people to accept low wages. Don't fall for it.

 

[Mount Asclepius]

How do you have a W2, and not a K1, If you are partner?

We do it this way too. I'm a shareholder in the business and also employed by the business. Seems to work out just fine.

But, I mean, do you get both? The K1, I believe, is common across other businesses.

I believe if the business is set up as an S corp then you can be a w2 employee while being an owner separately. Then you get an employee w2 and distribution income on the side through ownership. I could be wrong but that’s my understanding.

No, it's managed in a way that everything comes through as W2. Pretty simple.

Great question. I'll answer to the best I can and add to what others said. The tax implications are slightly beyond me though and I would need help of an accountant. Our group was set up this way long before I joined. I believe there was debate about founding company as C corp versus S corp years ago. Relates to how taxes paid. Limited as S corp to 100 shareholders and no preferred stock. As small equal group though that doesn't matter. We are both shareholders in the business with equal stock (negligible value) and also employees in that business receiving income as W-2. Taxes on income paid at personal level instead of as corporate tax.

 

[Tenk]

Employer: Hospital
ER setting: rural
Region: PNW
Hourly: $250/hr. 10 hour shifts.
W2 or 1099 or k1: w2
Patients per hour: 1.5-2
Annual census: ~22,000
Cme: 4k
Annual bonus: none
Benefits: insurance + disability + life + 403b match and 401a
Overtime rate: $312/hr

 

[emergentmd]

Reading this thread, no wonder CMGs are going bankrupt.

 

[JacobMcCandles]

Reading this thread, no wonder CMGs are going bankrupt.

I think a lot of CMGs are at a point where they’re trying to keep their docs from leaving and not being able to staff their EDs.

 

[GonnaBeADoc2222]

Employer: large CMG
ER setting: Community
Region: South East
Hourly: ~$240/hour (170/ hour base 190 nights, plus some RVU
W2 or 1099 or k1: 1099
Patients per hour: 2.2+
Annual census: 60k
Cme: None
Occasional Quarterly Bonus: None
Annual bonus: NO
Benefits: ROFL

This is a terrible job, especially for the SE.

Why are you here?

 

[cyanide12345678]

This is a terrible job, especially for the SE.

Why are you here?

This is what a normal ER job is. The rest of you making 280-300/hr dont have normal jobs.

 

[GonnaBeADoc2222]

This is what a normal ER job is. The rest of you making 280-300/hr dont have normal jobs.

240/hr as 1099 is not normal for the SE

 

[goodoldalky]

Employer: Physician owned partnership (limited number of partners, of which I am not)
ER setting: Academic/Community hybrid
Region: TX
Salary: $330,000/yr (half clinical - 7 shifts per month, 8s/9s, half admin/teaching)
W2 or 1099 or k1: W2
Patients per hour: 1.6-1.8 for non-teaching shifts
Annual census: 100k
Cme: 2500/yr
Occasional Quarterly Bonus: None
Annual bonus: No
Benefits: Health, 401k match, everything else (vision, dental etc.) is a pass-through, but available

 

[WorkNoteEmergency]

Employer: Hospital employed
ER setting: semi rural hospital - town of 6000 people 1+ hour from mother ship hospital and 2 academic tertiary care centers
Region: Mid Atlantic
Salary: 190/hr day, 220/night - bonus pay (chart completion, press Gainey, meetings, etc) maxes at $60k for full time
W2 or 1099 or k1: W2
Patients per hour: 1.5-1.8
Annual census: 35k
Cme: 5000/yr - recently changed to income and taxed/paid out monthly. Probably better as they previously made it very difficult to use.
Annual Bonus: Paid annually end of fiscal year, used to be paid monthly
Benefits: Health, 403b with a soft match, health/dental etc available for about $900/month family but the health plan is hospital owned and really sucks. I use my wife's plan. No vacation time, no sick time. full time hours bumped up to 1760 at beginning of pandemic.

My all in hourly for the past couple of years (excluding 403 match) was $236/hr. I am working prn for $235 now, no late evenings or night shifts. Just before pandemic I was making (with some productivity pay) $260-280/hr but cut pay to these numbers right as the pandemic hit hard. Thanks! I made around $240k last year at 0.6 FTE.

 

[FlaminHotER]

Employer: Catholic Hospital system PSLF eligible
Setting: Semi rural- 45 minutes from mother ship Level II trauma center
Region: Great Plains
1099/W2: W2
Salary: $198.5/ hour + $20 night shift differential
Yearly Bonus: Yes, $20,000 ( Charts done within 3 business days of Pt encounter)
Benefits: great 401K match 6%, full health, dental, vision, HSA, PSA, short and long term disability, 4 weeks paid off for paternity leave
CME: $5,000/ yr, also pay for license and DEA doesn’t take away from CME funds
Annual Census: 25K
Other benefits: $25,000 sign on bonus, $50,000 towards student loans, always two docs on shift with overlapping coverage, no mid levels.

Also, very important to me and should be to others, the group of guys you work with can make a difference. I’m taking a little less pay to work at a well staffed ED with great group of guys that get along well and supportive. I can grab beer and watch football with any of the Docs in my group and our consultants. Important in my book for long term success in EM

 

[ScepticSkeksis]

This is what a normal ER job is. The rest of you making 280-300/hr dont have normal jobs.

I see plenty of jobs advertised in the south for 250+. $250 is my red line which I would not go below.

 

[Splenda88]

You guys/gals are making banks. You work hard for it.

It would be nice if people put their annual income last year.

 

[Splenda88]

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

I think we should have a thread like this in every specialty forum.

I will use a similar format to start a thread like this in the IM forum.

 

[EM Junkie]

Employer: CMG (previous CMG bankrupt, taken over by the most hated CMG online -- these numbers likely change)
ER setting: Suburban
Region: Texas
Hourly: $180/hr floor + RVU, as a nocturnist I average $400-$415/hr
W2 or 1099 or k1: 1099
Patients per hour: 3-3.5 PPH, about 1-2 PPH additional midlevel supervision
Annual census: 60K
Cme: 3K
Bonus: Nope again
Benefits: See above

 

[doggydog]

Employer: Academics
Setting: Urban
Region: West Coast
1099/W2: W2
Salary: $350/hr
Patients per hour: 1.5-2.5 depending on shift type, if residents are on, etc.
Yearly Bonus: no
Benefits: 8% retirement gifting, full health, dental, vision, short and long term disability, 8 weeks paid off for paternity leave
CME: $3,000/ yr
Annual Census: 100k

 

[cyanide12345678]

Employer: Academics
Setting: Urban
Region: West Coast
1099/W2: W2
Salary: $350/hr
Patients per hour: 1.5-2.5 depending on shift type, if residents are on, etc.
Yearly Bonus: no
Benefits: 8% retirement gifting, full health, dental, vision, short and long term disability, 8 weeks paid off for paternity leave
CME: $3,000/ yr
Annual Census: 100k

What? Academics 350/hr???? With residents to do a lot of heavy lifting? Now that’s a unicorn gig.

Is this a typo 🤣

 

[Mount Asclepius]

This feels like when I was reading people's Step scores on SDN. I know the average of ER docs nationally, but curious where the other side of the bell curve is? No shade... seems like some good gigs out there.

Yeah like anything in life people are more likely to post their high rates.

Lot of 75th and 90th percentile jobs getting posted.

Definitely a wide spread of jobs out there, but yeah, you aren't hearing from the people in the places I listed because who wants to share that?

No one wants to post their 25th percentile pay and that’s okay. I think it’s actually more helpful for people to see the higher end of the bell curve to move the market. Just like when a player in the NFL signs a new record breaking contract for their position. Hopefully it convinces people to demand more and settle for less. Slightly pessimistic though with the flood of supply of EPs coming.

Yea I know...who is posting that they make $185/hr as an 1099? Those jobs exist. It's almost like we need to make this an anonymous thing

Funny how posting anonymously isn’t quite even anonymous. I hear what you are saying though.

 

[doggydog]

What? Academics 350/hr???? With residents to do a lot of heavy lifting? Now that’s a unicorn gig.

Is this a typo 🤣

Not a typo, I get paid really well at my shop. But you also have to take into account that I get a one to two shift buy down for a non clinical gig that I then make up for by picking up two to three in house moonlighting shifts a month at a higher moonlighting rate. I just averaged it all out for simplicity sake.

 

[xaelia]

Not a typo, I get paid really well at my shop. But you also have to take into account that I get a one to two shift buy down for a non clinical gig that I then make up for by picking up two to three in house moonlighting shifts a month at a higher moonlighting rate. I just averaged it all out for simplicity sake.

You found the marble in the oatmeal.

 

[thegenius]

You guys/gals are making banks. You work hard for it.

It would be nice if people put their annual income last year.

Well it's all how much you work. Someone might make $550K/year and another doc makes $350K/year and they make the same per hour. I think hourly rates are where it's at. There are plenty of docs who choose to work part time.

 

[Splenda88]

Well it's all how much you work. Someone might make $550K/year and another doc makes $350K/year and they make the same per hour. I think hourly rates are where it's at. There are plenty of docs who choose to work part time.

I was just curious to see if there is anyone here that makes 800k+.

 

[BoardingDoc]

I was just curious to see if there is anyone here that makes 800k+.

Outside of the FSED owners, I doubt it.

 

[GonnaBeADoc2222]

I was just curious to see if there is anyone here that makes 800k+.

I know an ER doc who works everyday (yes, everyday) who makes this much.

 

[DocEspana]

240/hr as 1099 is not normal for the SE

You're incorrect. But I suspect it has quite a bit to do with some areas of the SE being almost purely CMG at which point the prevailing pay get driven down by the fact that everyone has the same model so there isnt a need to pay more than "other areas of the country", only a need to be a better job than the hospitals near you, since they're all 1099 no benefit models. Prices can stay stagnant and tweaking can happen at lifestyle stuff (a place Im working part time at recently advertised they dont care how many people you see at all.... and they mean it. and they're pulling in applications left and right just for the lifestyle of that).

 

[DocEspana]

I know an ER doc who works everyday (yes, everyday) who makes this much.

I work (at two sites) with a dude proudly approximating or cracking a million every year. He does nocturnist work only and works at 3 sites to basically get 24-25 shifts a month done. He's been doing this for like 8 years now.... maybe more. He just had a kid and is saying hes going to cut back to 20 shifts.

guy is *definitely* on cocaine. Just sayin'

And this comes from me, doing 16-18 12-hour shifts a month for essentially my entire 6 year career so far.

 

[Splenda88]

I know an ER doc who works everyday (yes, everyday) who makes this much.

I know hospitalist who make 600k, so I figure out ER docs can make 800k+ if they work a lot.

There is an ED doc at my shop who told me he has been working 21-22 days (12-hr) per month consistently for the past 2 years. He might make that much if he is getting $275/hr. It's semi rural with an ER volume of 55-60k/yr.

 

[Birdstrike]

By far the most important portion of a job income package, is job satisfaction. If you job gives you that, it's gold.

 

[dav86]

I was just curious to see if there is anyone here that makes 800k+.

I know of at least a couple from just pure clinical and they work way less than 22 shifts a month, more like 17-19. And they make more than that total with side gigs.

 

[Splenda88]

I work (at two sites) with a dude proudly approximating or cracking a million every year. He does nocturnist work only and works at 3 sites to basically get 24-25 shifts a month done. He's been doing this for like 8 years now.... maybe more. He just had a kid and is saying hes going to cut back to 20 shifts.

guy is *definitely* on cocaine. Just sayin'

And this comes from me, doing 16-18 12-hour shifts a month for essentially my entire 6 year career so far.

So you have been making 650k+ in the past 6 yr in south FL. That is remarkable.

One hospital in Miami (HCA-Envision) offered me $75/hr + RVU as a hospitalist in 2021.

 

[emergentmd]

Employer: Academics
Setting: Urban
Region: West Coast
1099/W2: W2
Salary: $350/hr
Patients per hour: 1.5-2.5 depending on shift type, if residents are on, etc.
Yearly Bonus: no
Benefits: 8% retirement gifting, full health, dental, vision, short and long term disability, 8 weeks paid off for paternity leave
CME: $3,000/ yr
Annual Census: 100k

This is legit unicorn. Great benefits, top pay, residents, security.

With residents, 40 hrs a week is doable putting u at 700k/yr

 

[emergentmd]

I was just curious to see if there is anyone here that makes 800k+.

We have Fser non owners working 8x24 right there.

 

[DocEspana]

So you have been making 650k+ in the past 6 yr in south FL. That is remarkable.

One hospital in Miami (HCA-Envision) offered me $75/hr + RVU as a hospitalist in 2021.

Absolutely. Goal is to pump the breaks hard in a few more years once I have a few more properties down here.

 

[Splenda88]

Absolutely. Goal is to pump the breaks hard in a few more years once I have a few more properties down here.

We tend to overestimate how much we need to pump the breaks. Remember, whatever you have right now in an S&P500 with double in 7-8 even if you don't add anything to it.

Medicine is GREAT. Lol

 

[BoardingDoc]

I retract my previous statement of "outside of FSED owners, I doubt it" and replace it with "outside of FSED owners and people working a legitimately absurd number of shifts, I doubt it."

I mean, yeah, if I worked 24 shifts a month (8-9 hrs/shift), I'd break 800k / yr not including benefits. I have literally zero interest in doing that however.

 

[DocEspana]

I retract my previous statement of "outside of FSED owners, I doubt it" and replace it with "outside of FSED owners and people working a legitimately absurd number of shifts, I doubt it."

I mean, yeah, if I worked 24 shifts a month (8-9 hrs/shift), I'd break 800k / yr not including benefits. I have literally zero interest in doing that however.

I'm a weirdo who truly enjoys working 15+ 12-hour shifts and gets really bored and anxious at home without something to keep me busy at least half the month. This is *while* living in a major city with tons to do each day and while being the primary person cooking and cleaning in my household to keep me busy with chores (admittedly - no kids). If i ever run out of stuff to do, I get restless and I plow through hobbies fast too. I'm worried about how I'll handle working less than 180 hours a month, psychologically. I did not enjoy when a contract dispute at one of my hospitals left me at 132-144 hours per month. All my partners laugh at the fact that I'm legitimately happy to be at work 95% of the time. I do suspect children may change that, though.

But I may say I'm a weirdo who prefers >200 hours, but the guy who regularly works 288? thats a real weirdo. Gotta have some time to see my family eventually.

 

[Janders]

I did about 9mo of 17-19 shift / mo (13-14core, 3-5 moonlight), while also being department chief (normally a ?4-5? shift mo / workload), during the 2nd - 3rd covid waves (double the base admin work, cut the admin pay a bit). I think my peak month was 20-21 shifts, also doing like 4hr / day admin ****e.

In the end, that did make a fair amount of $. And I shan’t do it again. It was largely d/t a conglomeration of moonlighting opportunities that paid decently and didn’t suck clinically (hard to find that as much now), and significant pandemic financial uncertainty, with school aged kids doing remote school all day in the house. I’m already a make-hay-while-the-sun-shines, sir-saves-a-lot type personality, and that time period had me acting like a proverbial grandma who survived the Great Depression. Thankfully my moonlighting gigs both started tailing off naturally, letting me glide down from that before I lost my mind.

That type of thing was fine when I first got out, needed cash for a down payment, had no children, had a significant other who worked a 50hr/wk job. I could guzzle up extra shifts, even slam extra overnights and barely impact my home life. Not true now.

Now that I have some degree of a nest egg, I’m trying to be a little more balanced and not burn my candle from both ends EVERY day. That said I still work 85% FTE clinically while doing my admin stuff, and have been saying “oh I’m going to go down 1 shift a month… soon… yeah.. totally..” since well before the pandemic. *shrug*

 

[GatorCHOMPions]

I'm a weirdo who truly enjoys working 15+ 12-hour shifts and gets really bored and anxious at home without something to keep me busy at least half the month. This is *while* living in a major city with tons to do each day and while being the primary person cooking and cleaning in my household to keep me busy with chores (admittedly - no kids). If i ever run out of stuff to do, I get restless and I plow through hobbies fast too. I'm worried about how I'll handle working less than 180 hours a month, psychologically. I did not enjoy when a contract dispute at one of my hospitals left me at 132-144 hours per month. All my partners laugh at the fact that I'm legitimately happy to be at work 95% of the time. I do suspect children may change that, though.

But I may say I'm a weirdo who prefers >200 hours, but the guy who regularly works 288? thats a real weirdo. Gotta have some time to see my family eventually.

Having young kids has made me want to work MORE than before. Kidding…but not really

 

[GonnaBeADoc2222]

Having young kids has made me want to work MORE than before. Kidding…but not really

Opposite over here.

Seen too many docs come down with some awful disease at a young age - friend in 30s with two kids has ALS.

Time is your most valuable commodity folks, and I can think of 1000 better ways to spend it rather than in the ED.

 

[DocEspana]

Opposite over here.

Seen too many docs come down with some awful disease at a young age - friend in 30s with two kids has ALS.

Time is your most valuable commodity folks, and I can think of 1000 better ways to spend it rather than in the ED.

I can think of much fewer (obviously still many). Which may be why I enjoy pulling that many shifts. but again... I think kids will upend that quite a bit

 

[EctopicFetus]

Guy in California made 180k in a month.. consistently making $1M+/ yr pre NSA. SoCal for those wondering.

If you see a lot of PPH and use some MLPs making 600k isnt crazy for an SDG doc.

 

[cyanide12345678]

Guy in California made 180k in a month.. consistently making $1M+/ yr pre NSA. SoCal for those wondering.

If you see a lot of PPH and use some MLPs making 600k isnt crazy for an SDG doc.

I mean if you add my bonuses, then I’ll pull around 430k a year working 13 shifts a month and seeing 1.1 pph on average. If i add 4-5 more shifts i should hit that 600k a year too. So you don’t need to see a crazy pph, just extra days at work will do the trick.

Night shift right now and I’m in bed. Seen 2 people since 7 pm (almost 5 hours now). Too bad I’m not able to fall asleep -_-

Edit: i jinxed myself. 2 people came in at 1 am

 

[BoardingDoc]

I mean if you add my bonuses, then I’ll pull around 430k a year working 13 shifts a month and seeing 1.1 pph on average. If i add 4-5 more shifts i should hit that 600k a year too. So you don’t need to see a crazy pph, just extra days at work will do the trick.

Night shift right now and I’m in bed. Seen 2 people since 7 pm (almost 5 hours now). Too bad I’m not able to fall asleep -_-

Edit: i jinxed myself. 2 people came in at 1 am

17-18 (12.5 hr by your math) shifts a month sounds unpleasant.

 

[cyanide12345678]

17-18 (12.5 hr by your math) shifts a month sounds unpleasant.

Making 600k in EM is not going to be pleasant. Seeing 2.5 pph isn’t pleasant either.

 

[Splenda88]

Making 600k in EM is not going to be pleasant. Seeing 2.5 pph isn’t pleasant either.

Is it if they are making $275+/hr? Is 15 days/month (12 hrs) soul crushing in EM?

 

[Jabbed]

Is it if they are making $275+/hr? Is 15 days/month (12 hrs) soul crushing in EM?

Any amount of 12 hour shifts in the ED is soul-crushing.

 

[FormerNFLQB]

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

Sorry this may be incorrect math on my part but does this mean if you worked 40hr a week youd gross like $544,000?

 

[bravotwozero]

Any amount of 12 hour shifts in the ED is soul-crushing.

Wouldn't go that far. I'd rather work a 12 seeing 1.2 pph then a 8-10hr shift seeing 2+ pph. Plus I get more days off working 12s.

 

[RustedFox]

Sorry this may be incorrect math on my part but does this mean if you worked 40hr a week youd gross like $544,000?

Someone wanna tell him the mistake he's making?