My Pay as an Intensivist - Then, now and to the future

[chocomorsel]

I do both. One is a locum other is a group that only does 1099. The group negotiates straight with the hospitals we help at, about 6 of them. Some are ICU only, others include pulm consults, others include night call from home or hotel with APN coverage.

Is that group in Houston by chance? Asking for a friend.

---

Members don't see this ad.

 

[DO class of 2018]

I'll be entering the Intensivist job market. Critical care only (was EM). Have a clean slate, so I don't have to be anywhere in particular. Leaning towards community, not academic. I have young children. We don't have to live in a top metro area, but being within 2 hours of one is preferable. Seeking the balance of high pay, decent COL I look frequently on the top up and coming cities, and wonder which one would be a good fit. I can say we would prefer not the most north or most south. Anyone from Chattanooga?

 

[Dred Pirate]

The key point is that they don't want control over them.

They want someone who will be a "black box" so that they don't have to deal with physician recruiting, management, staffing, etc.

It is essentially the same reason why they hire contractors to do the laundry, or security, or food services, or whatever else.

I will use my lawn as an example. I used to enjoy the riding lawnmower but age, arthritis, and prostate cancer mean that is no longer an (enjoyable) option. Now I could hire someone to do fertilizing, weed control, etc., and a kid to mow, and someone to do landscaping, and someone to do the weeding .... or I could pay the one local guy who said he would handle all of that. I pay about $100 a month premium, but it is worth it not to have to deal with 4 or 5 different people and all the conflicts.

That is basically how the CEO/COO/CMO view this stuff. They would rather sacrifice some income so that they don't have to think about staffing.

our hospital is going the exact opposite way.
Neurology, general surgery, Intensivists, and pychiatry all have been brought back from private groups to hospital employees in the past 3 years. EM is about the only major group left that isn't hospital employees.

For us - I think it is all about control and cutting pennies.

 

[Dred Pirate]

Prime Healthcare came into one of the Level II trauma centers in Los Angeles. There was a functional independent group there when they took over, a true intensivist program with anesthesia, ER, and pulmonary providers. They had already gone through the transition from old pulmonary guard to putting in a real ICU program.

Prime immediately fired the group, put NPs as the primary providers in the unit, and hired a series of locum/part-time ICU folk to come in and 'run the list' with the NPs every day for $200/hr. The NPs call anesthesia for their airways, over utilize IR for line placement, and call the ER to come and help out on codes. The "ICU docs" are there from 11am-2pm, get paid for 8hours, and simply walk through the unit. No real rounding; To me, that's ****ty care for patients, an erosion of the standard of ICU, and highly risky for those docs who are taking the $1600 for 3 hours of work (and phone consult during the other 5 hours).

wow - that is amazing ****ty care. Are anesthesia and EM separate private groups or hospital employees? Would be interesting to see what would happen if they refused to come in this situations , or at least threw a big enough stink to effect change. The thing is any physician with half a heart would never do something intentionally that negatively affects a patient's care, and that just allows the hospital to take advantage of them more and more.