Reasonable rate for inpatient weekend?

[psyduck1990]

I'm considering a part-time position covering weekends at an academic inpatient unit. Responsibilities include rounding on 20-24 patients with a resident on Saturday and Sunday and taking phone call Saturday night to staff ED and floor consults. Discharges typically don't occur unless planned by the weekday teams. You can leave after rounding - you just need to be available by phone. Malpractice is provided. This is in a high cost of living area. What would be a reasonable rate for this in this market in your opinion?

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[michaelrack]

Assuming a 12 hour call period, 2500 dollars

 

[jbomba]

I'm considering a part-time position covering weekends at an academic inpatient unit. Responsibilities include rounding on 20-24 patients with a resident on Saturday and Sunday and taking phone call Saturday night to staff ED and floor consults. Discharges typically don't occur unless planned by the weekday teams. You can leave after rounding - you just need to be available by phone. Malpractice is provided. This is in a high cost of living area. What would be a reasonable rate for this in this market in your opinion?

Do you have to handle new intakes in addition to your 24 follow ups?

 

[nexus73]

10 years ago I’d get $3000 per weekend. I hope it’s more than this today.

 

[Ironspy]

I’ve seen rates from $200-330/hour depending on their desperation. The fact that it’s a high cost of living area means that rates are probably on the lower end. I wouldn’t do that for <220/hour

 

[Stagg737]

I'm considering a part-time position covering weekends at an academic inpatient unit. Responsibilities include rounding on 20-24 patients with a resident on Saturday and Sunday and taking phone call Saturday night to staff ED and floor consults. Discharges typically don't occur unless planned by the weekday teams. You can leave after rounding - you just need to be available by phone. Malpractice is provided. This is in a high cost of living area. What would be a reasonable rate for this in this market in your opinion?

Not enough info really, the bolded can make a huge difference. In the city from my residency, $2000 ($1k daily) for just the day portion of the weekend would be typical or for day and overnight but only covering the inpatient unit without ED or floor consults. If the bolded is busy I'd ask for a lot more than $2k. Where I was the inpt call and ED/med floor consults were covered by 2 separate teams.

With what you're describing I don't think I'd do it for less than $4k for the weekend.

 

[psych_0]

$2000/day is reasonable. I would imagine $2500/day if the ceiling of what you could reasonably expect to get unless you have some sort of leverage you haven't disclosed. Other people mention asking about the call portion, but it's going to vary widely. When I'm on call there are days when I get 0-2 calls all day, and other days when I get called every 20-30 minutes. It would be tough for me to describe an "average" day of call because it varies widely and I don't track it. What I can tell you is that taking call via phone feels more like a minor annoyance than a major inconvenience most days. Now, if that phone-call doesn't allow you to give phone orders to nurses and you have to log in to a computer and manually input every Tylenol, melatonin or hydroxyzine etc then yea call is going to be really annoying. Where I'm at the only time I have to physically log on to the computer and do something is if I have to put in admit orders or document someone going into restraints. Makes call a breeze (most days).

 

[clozareal]

I'm in a high cost of living area and I get $4,000 for rounding on an academic inpatient unit without that overnight call.

 

[psyduck1990]

Thanks for the feedback everyone. To answer some questions, yes you would see intakes. The number would mainly depend on how many open beds there were going into the weekend. Two intakes is probably average. And regarding phone call, how busy it is can vary greatly. Maybe you get 2 calls per night, maybe 5 or 10. The residents are pretty sharp, so most calls involve little more than signing off on the resident's plan. 4k for the weekend sounds fair enough.

 

[Stagg737]

$2000/day is reasonable. I would imagine $2500/day if the ceiling of what you could reasonably expect to get unless you have some sort of leverage you haven't disclosed. Other people mention asking about the call portion, but it's going to vary widely. When I'm on call there are days when I get 0-2 calls all day, and other days when I get called every 20-30 minutes. It would be tough for me to describe an "average" day of call because it varies widely and I don't track it. What I can tell you is that taking call via phone feels more like a minor annoyance than a major inconvenience most days. Now, if that phone-call doesn't allow you to give phone orders to nurses and you have to log in to a computer and manually input every Tylenol, melatonin or hydroxyzine etc then yea call is going to be really annoying. Where I'm at the only time I have to physically log on to the computer and do something is if I have to put in admit orders or document someone going into restraints. Makes call a breeze (most days).

Sure, call can vary a ton. The reason I asked is that it's an academic program where OP would be covering Inpt, ED, and floor consult calls. If residents are only seeing stat consults overnight it might not be too bad. If the residents have a night float system where they see everything that comes in overnight that could mean regularly waking up 4-5x per night for residents to check patients out. In which case no thanks unless they're willing to pay premium rates for coverage.

 

[comp1]

It's going to be $3-4k per weekend.

 

[Jules A]

Thanks for the feedback everyone. To answer some questions, yes you would see intakes. The number would mainly depend on how many open beds there were going into the weekend. Two intakes is probably average. And regarding phone call, how busy it is can vary greatly. Maybe you get 2 calls per night, maybe 5 or 10. The residents are pretty sharp, so most calls involve little more than signing off on the resident's plan. 4k for the weekend sounds fair enough.

In my experience at a large urban hospital with a unit that size it isn't unusual to have 3-6 new admits on Saturday. They can also vary depending on the attending you are following. I work behind one who purges the unit on Fridays and another who prefers to see how they do over the weekend and DC Monday.

 

[psych_0]

I'm in a high cost of living area and I get $4,000 for rounding on an academic inpatient unit without that overnight call.

Per day?! Or for the whole weekend?

 

[psych_0]

Sure, call can vary a ton. The reason I asked is that it's an academic program where OP would be covering Inpt, ED, and floor consult calls. If residents are only seeing stat consults overnight it might not be too bad. If the residents have a night float system where they see everything that comes in overnight that could mean regularly waking up 4-5x per night for residents to check patients out. In which case no thanks unless they're willing to pay premium rates for coverage.

I guess I missed the part where we were talking overnight coverage. Would agree that having residents check out to you all night in the ER at a busy hospital overnight would be miserable and not worth most amounts of money, imo.

 

[J ROD]

4-5 K for the weekend. Don't be a cheap hoe!

 

[clozareal]

Per day?! Or for the whole weekend?

The whole weekend

 

[Stagg737]

Thanks for the feedback everyone. To answer some questions, yes you would see intakes. The number would mainly depend on how many open beds there were going into the weekend. Two intakes is probably average. And regarding phone call, how busy it is can vary greatly. Maybe you get 2 calls per night, maybe 5 or 10. The residents are pretty sharp, so most calls involve little more than signing off on the resident's plan. 4k for the weekend sounds fair enough.

Okay, but are the residents going to be calling you for all of those 5-10 calls to sign off on the plan? As in, are they going to be calling everytime they give someone trazodone or hydroxyzine at 1 am, or are they mainly calling for major things like agitated patients still being agitated an hour after a B-52?

To provide some context, I'll be making $1k per day of call covering ED and floor consults with 2 residents working under me and another attending coming on around 2-3pm. RVUs earned also go towards my total. So $1k+RVUs for somewhere between 4-7 patients for ~7 hours of coverage at an academic hospital.

 

[dl2dp2]

Thanks for the feedback everyone. To answer some questions, yes you would see intakes. The number would mainly depend on how many open beds there were going into the weekend. Two intakes is probably average. And regarding phone call, how busy it is can vary greatly. Maybe you get 2 calls per night, maybe 5 or 10. The residents are pretty sharp, so most calls involve little more than signing off on the resident's plan. 4k for the weekend sounds fair enough.

This sounds REALLY low to me. Do you have to be on-site overnight or just phone calls? Still, being interrupted at night by the ED is not pleasant.

 

[Monocles]

4-5 K for the weekend. Don't be a cheap hoe!

Or even per day. My record for negotiating for a 24h coverage has been about $225 per hour...

 

[Monocles]

4k for the weekend sounds fair enough.

Ffs mate absolutely not

My strategy has been leveraging two different locums companies against each other. I let them both know my minimum is $200/h, and give them the opportunity to bid against each other. I also let them know that I am reliable for last minute coverage (meaning they can literally call me the night before) but it'll charge them a very pretty penny (the most I've gotten was close to 275/h). Then I show up and do the work safely and efficiently so all the ancillary staff can vouch that they want me back, which allows me to push up my rates more.

After a while you get a sense of which hospitals in the region are the chillest ones and can maximise your money to work ratio.

 

[comp1]

This is not locums and there is resident support. It's going to be about $3500.

 

[jbomba]

Ffs mate absolutely not

My strategy has been leveraging two different locums companies against each other. I let them both know my minimum is $200/h, and give them the opportunity to bid against each other. I also let them know that I am reliable for last minute coverage (meaning they can literally call me the night before) but it'll charge them a very pretty penny (the most I've gotten was close to 275/h). Then I show up and do the work safely and efficiently so all the ancillary staff can vouch that they want me back, which allows me to push up my rates more.

After a while you get a sense of which hospitals in the region are the chillest ones and can maximise your money to work ratio.

Amazing. This is exactly what I want to do to supplement my private practice build up when I graduate next summer. Any particular locums companies you recommend looking for/working with?

 

[Monocles]

Amazing. This is exactly what I want to do to supplement my private practice build up when I graduate next summer. Any particular locums companies you recommend looking for/working with?

PM me. I have a sh*tlist and don't want to get sued for libel lmao

 

[clozareal]

Okay, but are the residents going to be calling you for all of those 5-10 calls to sign off on the plan? As in, are they going to be calling everytime they give someone trazodone or hydroxyzine at 1 am, or are they mainly calling for major things like agitated patients still being agitated an hour after a B-52?

To provide some context, I'll be making $1k per day of call covering ED and floor consults with 2 residents working under me and another attending coming on around 2-3pm. RVUs earned also go towards my total. So $1k+RVUs for somewhere between 4-7 patients for ~7 hours of coverage at an academic hospital.

This is important to know when you are deciding on a weekend gig like this. In my residency, we only called the attending when we wanted to discharge a patient from the ER, unplanned discharges overnight from the inpatient unit, dropping involuntary holds, if a patient needs to be transferred to another service, if there are major changes in clinical status (acute delirium, seclusion/restraints), or if a patient dies. Most of the calls are decisions where the faculty has the most liability. These were all pretty uncommon except for wanting to discharge a patient from the ER, but even then it's a ~5 minute phone call usually. Any other decision can be discussed with the faculty but doesn't need to be and residents tend to call less later in the academic year than earlier. Trazodone or hydroxyzine at 1am is most likely not going to get called in.

In my community hospital overnight, the nurses can page for any medication decision for any of the patients in the inpatient unit, but they typically put verbal orders in. This is more annoying because you don't have a resident to buffer these concerns. Typically there are about 2-3 pages a night but sometimes more.

 

[dl2dp2]

This is not locums and there is resident support. It's going to be about $3500.

It seems like it's not as much work with resident support, but having a regular gig each month where you MUST be on-site for BOTH Sat AND Sun for rounding is VERY annoying.

I can see having a weekend gig with the option of telemedicine, etc. if I need to be away for a weekend, but making a commitment like that is really really annoying.

 

[forchinet121]

It seems like it's not as much work with resident support, but having a regular gig each month where you MUST be on-site for BOTH Sat AND Sun for rounding is VERY annoying.

I can see having a weekend gig with the option of telemedicine, etc. if I need to be away for a weekend, but making a commitment like that is really really annoying.

It’s definitely not worth it but to each his own

 

[Stagg737]

Ffs mate absolutely not

My strategy has been leveraging two different locums companies against each other. I let them both know my minimum is $200/h, and give them the opportunity to bid against each other. I also let them know that I am reliable for last minute coverage (meaning they can literally call me the night before) but it'll charge them a very pretty penny (the most I've gotten was close to 275/h). Then I show up and do the work safely and efficiently so all the ancillary staff can vouch that they want me back, which allows me to push up my rates more.

After a while you get a sense of which hospitals in the region are the chillest ones and can maximise your money to work ratio.

$4k for a weekend isn't uncommon in my area or really unreasonable depending on what the setup and duties are. If seeing 10-12 inpts per day with minimal/no overnight call it doesn't sound terrible. You can be done by noon and take the rest of call from home. For the op who is also covering the ED and floor consults and taking calls overnight, I agree it doesn't seem like a good deal. I mean, this is also an academic place though which won't pay nearly as much as a locums position desperate to get coverage for a ton of patients...

Idk how many hours you're being paid for on those weekends, but for 24 hrs that's a range of 4,800-6,600 and double that for 48 hours. I've never heard of anyone seeing a reasonable number of patients making $9k+ for a weekend.

It seems like it's not as much work with resident support, but having a regular gig each month where you MUST be on-site for BOTH Sat AND Sun for rounding is VERY annoying.

I can see having a weekend gig with the option of telemedicine, etc. if I need to be away for a weekend, but making a commitment like that is really really annoying.

It's an academic program, meaning residents should be receiving some kind of education while on duty. I think it would be kind of crappy for an attending NOT to physically come in at some point when they're overseeing PGY-1s and 2s.

 

[jbomba]

Whats the best way to find weekend coverage gigs? I keep hearing people talk about going through locums companies Ive never heard of...but these smaller ones don't show up on google readily.

 

[Nudexta]

Whats the best way to find weekend coverage gigs? I keep hearing people talk about going through locums companies Ive never heard of...but these smaller ones don't show up on google readily.

Indeed had good opportunities

 

[Dr. ADT]

I think 4-5 K is reasonable

 

[Zyprexa100]

I'm considering a part-time position covering weekends at an academic inpatient unit. Responsibilities include rounding on 20-24 patients with a resident on Saturday and Sunday and taking phone call Saturday night to staff ED and floor consults. Discharges typically don't occur unless planned by the weekday teams. You can leave after rounding - you just need to be available by phone. Malpractice is provided. This is in a high cost of living area. What would be a reasonable rate for this in this market in your opinion?

Should be 2 k per day. Minimum is $1500-$1800 depending on location.

 

[BiscoDisco]

I think 4-5 K is reasonable

How many patients to cover would this entail?

 

[jbomba]

So I was proposed a weekend moonlighting job but would entail something like 40 follow ups (total, not per day) and 10 new intakes spread across a weekend. What should a job like this generate?

 

[ObsequiousAplomb]

So I was proposed a weekend moonlighting job but would entail something like 40 follow ups (total, not per day) and 10 new intakes spread across a weekend. What should a job like this generate?

So 5 intakes and 25 follow-ups per day for two days? Given that it's double what the OP is asking, I'd say multiply the values in this thread by 3. I wouldn't consider it for less than $10k for the weekend. Even then I would only consider it, I wouldn't actually do it until a much higher number was offered, if I would do it at all.

 

[jbomba]

So 5 intakes and 25 follow-ups per day for two days? Given that it's double what the OP is asking, I'd say multiply the values in this thread by 3. I wouldn't consider it for less than $10k for the weekend. Even then I would only consider it, I wouldn't actually do it until a much higher number was offered, if I would do it at all.

Close - 20 follow ups per day, 5 news per day.

The offer was significantly less than 10k. Any idea how much the hospital is actually making off my billings with this work load?

 

[ObsequiousAplomb]

Close - 20 follow ups per day, 5 news per day.

The offer was significantly less than 10k. Any idea how much the hospital is actually making off my billings with this work load?

If you want an estimate for Medicare, then plug the cpt codes into a calculator with your local area's reimbursement for that code. It will at least tell you the professional fees. But professional fees make up a small portion of what hospitals make per patient.

If you code them all as level 2, a 99222 pays around $140. 99232 pays around $75. So 5*140 = $700 for the intakes and 20*75 = $1500 for follow-ups. That would be $2200 per day.

If you code them all as level 3 a 99223 pays around $200. 99233 pays around $110. So 5*200 = $1000 and $2,200 for the follow-ups, around $3200.

That's all assuming CMS rates only, no add-on codes, etc. A mix of higher and lower payers is to be expected. And then there's the non-professional fees associated with the day of hospitalization. Most hospitals say it's at least $1,000 a day to hospitalize someone. Usually a lot more. Have you seen an EOB for a hospitalization there?

Then there's non-billings costs to not having rounding on the weekends. They would probably lose out on a lot of other things, since hospitals are required to offer "the same" services/level of care on the weekend as on the week. So they often overpay people for the weekend so they can keep claiming they offer the same level of care on the weekends.

 

[michaelrack]

So I was proposed a weekend moonlighting job but would entail something like 40 follow ups (total, not per day) and 10 new intakes spread across a weekend. What should a job like this generate?

$5000 for rounding plus call pay ( 500 per full day)

 

[Geraltofrivia]

How does one find these positions?