Locums?

[scoopdaboop]

So, why are locum radiology rates so bad compared to just straight up private practice employment. 2400 a day is the higher end of the number that I've seen researching locum stuff. In other specialties, working locums say in ER or even neurology etc. is much more lucrative... Or are there hidden payment structures employed that they don't tell you when looking at job boards etc. I would imagine 4-6k a day to be more reasonable for a locum rate...

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[Dave1980]

5k per day would see rads making over a million a year. most rads dont make that much

 

[scoopdaboop]

5k per day would see rads making over a million a year. most rads dont make that much

Yeah I get that. But, why would any rad want to work locums when the pay rate is 2400 a day?? That's less than what most people make in private practice... and the job is in some location you don't want to work... all the negatives of locums.

 

[maxxor]

Yeah I get that. But, why would any rad want to work locums when the pay rate is 2400 a day?? That's less than what most people make in private practice... and the job is in some location you don't want to work... all the negatives of locums.

Don’t you suppose telerads cuts the upside here?

 

[Chemdude]

I've been told that $250/hr is a good locums rate.

 

[redoitall]

I agree that 2K or so a day seems not much for locum. But the truth is the rate is what radiologists are willing to take. If nobody wanted to take it, then the rate would be higher.
Bear in mind that these are often complement income. Additionally, they often come with a lot of paid stuff (travel, lodging, food, malpractice etc...). Some other places I have seen offer you a flat fee for the week between 15 to 20K and ask you to commmit x weeks per year. Depending on number of days and if you are willing to do nights, the pay varies.
But I totally agree that locum in rad are often underpaid given the lack of associated benefits. But as long as rads will take them, they will be there.

 

[5777]

How do you think radiologists get paid? For the practice paying you, you need to do enough work (i.e., RVU production) to justify your cost.

Let's say you are going to get $2500 for the "day". You need to do enough work to justify that.

Currently, Medicare pays about $36 for each professional RVU. This covers the labor cost.

$2500/$36 = 69 RVU

69 RVU is a doable day of work. What does this translate to?
-CXRs are worth 0.22 RVU for the professional component. So this is about 313 CXRs. If you are working 10 hrs for the day without breaks, it's 31 CXR/hour, or 1 every 2 minutes...for 10 hours straight. Doable.
-CT abd/pelvis is 1.82 RVU. So this is about 38 abd/pelvis CTs in the 10 hour day, or 3.8/hour. Doable.

The thing is, the place paying would only be making money on the technical stuff--basically giving you everything for the professional stuff, and you don't have to bill, collect, etc.

If practices found "cheap labor" (locums willing to "take less"), then no practice would be hiring anyone other than locums.

 

[scoopdaboop]

How do you think radiologists get paid? For the practice paying you, you need to do enough work (i.e., RVU production) to justify your cost.

Let's say you are going to get $2500 for the "day". You need to do enough work to justify that.

Currently, Medicare pays about $36 for each professional RVU. This covers the labor cost.

$2500/$36 = 69 RVU

69 RVU is a doable day of work. What does this translate to?
-CXRs are worth 0.22 RVU for the professional component. So this is about 313 CXRs. If you are working 10 hrs for the day without breaks, it's 31 CXR/hour, or 1 every 2 minutes...for 10 hours straight. Doable.
-CT abd/pelvis is 1.82 RVU. So this is about 38 abd/pelvis CTs in the 10 hour day, or 3.8/hour. Doable.

The thing is, the place paying would only be making money on the technical stuff--basically giving you everything for the professional stuff, and you don't have to bill, collect, etc.

If practices found "cheap labor" (locums willing to "take less"), then no practice would be hiring anyone other than locums.

HM. Okay all the responses make sense. I guess I was day dreaming and unrealistic.

 

[Neopolymath]

HM. Okay all the responses make sense. I guess I was day dreaming and unrealistic.

I think you also need to consider some nuances between the negotiations for locums for rads versus say anesthesia. In my opinion the dynamic is different. The hospital needs a body sitting there for weekend emergencies that might not come to the OR and the group needs to keep the contract by providing that coverage even if they might do no cases. The OR makes money and keeping surgeons happy by providing open ORs is paramount. The hospital generally gives a subsidy for coverage to the group and the anesthesia billing is a group's internal issue as well as finding coverage if needed.

In rads, a locums shift is just a guaranteed day to do a ton of studies like any other work day so the perspective is different. As far as I know, hospitals don't subsidize rads groups for this stuff because it's unnecessary compared to the financial impacts of anesthesia coverage. There isn't really any unknown to negotiate for as a locums doc. Radiologists generally know how much a person is going to read each day on a locum because they are great at analyzing this type of stuff. That means you aren't paying for an unknown. When someone takes an anesthesia locum they negotiate it based on the worst situation possible and knowing the group is almost certainly subsidized by the hospital for coverage that would otherwise lose the group money. Feel free to read threads on these subsidies.

Combine commodity work, easily tracked and predictable historical data, and radiologists already working at full capacity during their shifts and you get downward pressure because all the cards are on the table. Telerads is another downward pressure here. The efficiency and predictability of radiology workflow seem to make it difficult to negotiate higher rates as a doc.

Hopefully others with more rads business acumen can chime in. The basic market forces are high school econ though.

 

[2brads]

Locums rates may actually exceed billable work in some cases (middle of nowhere/desperate).

Also, if you are considering locums, DO NOT USE AN AGENCY when at all possible. They skim 20-30% right off the top so you could negotiate a $2500/day rate up to $3000 easy and make everyone happy (except the agencies).

 

[scoopdaboop]

Locums rates may actually exceed billable work in some cases (middle of nowhere/desperate).

Also, if you are considering locums, DO NOT USE AN AGENCY when at all possible. They skim 20-30% right off the top so you could negotiate a $2500/day rate up to $3000 easy and make everyone happy (except the agencies).

Yeah but then you need your own malpractice, you have to fund your own rental cars, airfare, housing etc. Too much garbo.

 

[2brads]

This may or may not be the case. Our group tries to negotiate directly with the locums to include per diem, travel and hotel. The only thing an agency does is skim.