Locus Work Sustainability & Structure

[Psychapplicant133]

I'm someone who is very interested in correctional psychiatry, but it seems like with all jobs the locum gigs pay nearly twice as much. It was brought to my attention that this could be because no vacation or benefits, but I had a few more questions:

1) Is a locum job of $690k a year less desirable than a steady gig paying around $410k?
2) How likely is it that a locum contract for 3 or 6 months can get renewed? For example would I be able to just renew my contract and keep the gig long-term or do people generally not do this?
3) Any other glaring disadvantages besides lack of a parent company at a full time gig? I guess I'm just not that sure why people wouldn't want to do locums outside of the fact that there might be potential for having to find a new job every 6 months.

Thank you for any replies!

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[splik]

Locums has a bit more uncertainty, it's 1099 (so self-employment taxes on first $168k though you also have deductions etc), there's no vacation or sick leave or CME, no health insurance, and no retirements. If it's a government correctional job there is usually a pension and other good benefits which can bring up the value of the total compensation. Employees will also get priority over contractors in terms of working conditions and they could just move you around as they need. There are certainly people who work registry jobs for years so it is possible especially if they have a hard time recruiting. The $690k a year is presumably not accounting for any leave at all and for doing inpatient.

Depending on the job the benefits could be worth upwards of $100k.

Another thing to consider is liability. Often if its a government job you may have sovereign immunity. However if you are a locums contractor you usually are agreeing to indemnify the state and they won't help you with any litigation (and frivolous lawsuits are common in this population).

Also no worker's comp as a contractor so if you get injured/assaulted that's on you.

 

[Stagg737]

Splik gave more details (and more specifically for gov/jail stuff). Other thoughts:

1) Completely depends on the jobs. $690k/yr makes me wonder what's wrong with the job that they're paying that much. That's high even for locums unless it's just very high volume/time.
2) Again, completely depends on the position. I've heard of some being renewed multiple times and some expiring immediately. Highly variable.
3) Instability is the big reason. You could have a job for 3-6 months then be unemployed for months. A company may give you a start date then back out right before signing. They could tell you yes then string you along for weeks or months before declining. Or just the credentialing/onboarding can be onerous. Rinse, repeat every X months to renew or find a new position. The other issue is that many locums positions are undesirable in one way or another. Location, volume, patient type/population, staff/resource unavailability or conflict; problems in any of those areas can make a position miserable and you may not know the truth about some those until you're doing the work. Some locums positions can be great, but unless you know someone there it can be a major crapshoot.

 

[Merovinge]

Point number 3 above is exactly it.

Bonds are expected to pay out less over time than stocks (yes yes, I know there are long stretches of times bonds have outperformed stocks). This is called the risk premium associated with equities. Taking short term contracts that may not renew and leave you out of work, or be soul sucking horrendous work, is the risk with locums and you should get paid more for taking that risk.

 

[nexus73]

Predicting the future is impossible. But there seem to be some inpatient units around me (within 2 hours drive) that are chronically using locums. I would say that child inpatient locums seems to have the most likelihood of long term placements. There was a child psych locums doing inpatient at a hospital for 6 years because they couldn't recruit an employed doc. And the 6 year placement did not end because they hired someone, it ended because he moved on to a different locums job closer to family and he was replaced by another locums. I haven't seen that with adult psychiatry positions.

If you could talk to people who know the history of locums use at a particular site, that would be advantageous in predicting whether the placement will be 3 months and out, or potentially indefinite.