Docs Outside The Box
Hosts Dr. Nii (Ghanaian) and Dr. Renee (Haitian) are first-generation physicians who paid off $662,000 in student loans in 3 years - while figuring out contracts, career moves, and money management that their colleagues learned at home.
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Docs Outside The Box
REPLAY: Starting a Locums Company, Navigating Insurance & Why Consider Locums. #432
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What if you could reshape your career and lifestyle with the freedom and flexibility you’ve always dreamed of? In this episode, we explore the exciting world of locum tenens work, sharing insights on how to start your own locums company, medical malpractice insurance and why every doctor should consider doing locums.
Timeline
0:00 Introduction
2:47 What y'all say Friday! Ask us anything y'all.
3:29 Working 24 hour shifts as a doctor.
7:44 Billing & Getting paid as a locums doctor
10:47 How to Start a Locums Agency.
14:08 Not working on important days of your life.
16:24 Medical malpractice for locums doctors
21:53 Rates vs travel expenses as locums doctors
28:12 Why consider doing locums?
35:44 Is there a Diddy in medicine y'all?
FREE DOWNLOAD - 7 Considerations Before Starting Locum Tenens - https://darkos.lpages.co/7-considerations-before-locums
LINKS MENTIONED
App for sending out receipts - https://www.waveapps.com/
To learn Ins and Outs of locums - https://locumstory.com/
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Starting a Locums Company and Q&A
Speaker 1We're interested in starting our own locums company. Are the rates negotiated in addition to travel expenses or is it inclusive? Phillip, I love you and that's why I'm doing this for you.
Speaker 2I don't know you like that yo.
Speaker 1Don't go and mess this up for everybody else. All right, Phil, how much you get paid is separate than how much it costs you to get to the site. Do not mess this up for everybody else and be like my rate. Also is going to pay for my hotel.
Speaker 2Why are you yelling at Phil, though, because people like Phil. What did he do to you? Phil was like first of all, you just told me you love me.
Speaker 1Now you're yelling at me, Phil, listen Phil. Poor Phil, Stop playing Folks. Your exciting new medical career. It's just been hit with a serious illness or injury that stops you from earning a paycheck just when you need it most. Check out what Jamie Fleissner of Set for Life Insurance said back on episode 176 about having disability insurance early in your career.
Speaker 3The real reason to get it early on is really twofold. One is to protect your insurability. So if you are healthy and you can obtain the coverage, you also pre-approve yourself to be able to buy more in the future. So down the road, as your income does increase, you don't have to answer additional medical questions. All you have to do is show that your income is increased and you can buy more benefits at that time. No medical questions asked.
Speaker 1Protect your income, secure your future. Check out setforlifeinsurancecom. All right y'all. Welcome to episode 430 of Docs Outside the Box. I am your host, dr Nii. I'm joined by Dr.
Speaker 2Renee, everybody, everybody.
Speaker 1Well, I'm glad you got the energy, because I don't have the energy and if anybody who's listening right now, if you listen on the audio version, you're messing out, because you are missing out how my face looks right now. I'm tired, exhausted, and the reason why is I just came off a slew of five straight night shifts, and the night shifts were what night shifts are?
Speaker 114 hours, so 5 pm until 7 am in the morning and, um, yeah, I'm giving to you, I'm giving people what they want and we're recording and this is gonna be a q a segment, a q a section, um, where we are at what I don't know what's going on. I guess I tired, I don't know why I can't get it right. It's a Q&A episode where we are answering the questions of you all. Remember, you guys can submit questions to us in various formats. You know how to do it. The easiest way is to send us through text message, or you can send us something through fan mail. It's the first line in the show notes.
Speaker 2That's how we look at it and that's how we're going to respond, and yeah, that's what we at. So this is what y'all say Friday, y'all what y'all say Friday. So, whatever y'all say, we're either going to answer it or commentate on it or whatever.
Speaker 1Is there a limit on what people can say? No, they can ask us anything, anything what y'all say, anything on what people could say no, they can ask us anything.
Speaker 2Anything. Anything what y'all say, anything. It could be a question, right, what y'all say. Or it could be a question what y'all say, right, like so you could you know there's different intonations on it and stuff. Yes, that's right. Okay, that's right, so what?
Speaker 1y'all listen, guys, let's keep this to the topic of locums, because that's what someone asked us about. Before we get into that, though, people, alfred, if you could run some B-roll of like the video that I recorded while I was at my this is my second gig, right? My main gig is far away. My second gig is the spot that I just did, where I just primarily do night shift, and you know, you guys get to see a little bit of what it's like to pack for the job, what it's like for me to drive out there, and what my call room looks like, and, depending on what we're doing, how busy the service is, I can sometimes even sneak in and work out. So, alfred, run that tape where you can show me working out. But that's just the way how I like to work. I like to do, at this specific job, night shift only mainly because it's busy, and just so y'all know I don't like doing 24 hour shifts anymore.
Speaker 2I don't like busy.
Speaker 1I haven't done a 24 hour shift in like close to five years now.
Speaker 2Yep, seven years Same yeah.
Speaker 1I don't like it.
Speaker 2Um, there's a whole host of reasons why I don't like it, but the biggest one yeah, the biggest one for me is it's abnormal and the it's never really a 24-hour shift yeah, it's abnormal to be in-house for 24 hours and not able to leave the hospital like it's abnormal, although people would argue that I work 62-hour shifts but?
Speaker 1but, even if you do a 24-hour shift and you like, well, let's just talk about what I do, Like what I used to do. I used to do 24 hour shifts.
Speaker 1I would stay in the hospital, get there at seven o'clock my shift is done by 7 am the next day.
Speaker 1But the question always comes in what happens to certain cases that come in at certain times?
Speaker 1So if an appendectomy comes in at like four o'clock in the morning, obviously I'm going to go see the patient, I'm going to go counsel the patient, I'm going to start the patient on antibiotics and, you know, depending on how the OR is, I might take them to the operating room at that time, or I may do it later on, or I may give it to my partner. But then if my partner's starting up a 24 hour shift and they got a whole host of things that they got to take care of, from rounding to the surgical emergencies that may happen on their own shift, you know, throwing on a very quick case you know may be like a source of anxiety, just like you're just not going to be able to get it done. So what you do is or what I do is, a lot of times, times I'll just do that case. That's what I'm saying. A 24-hour shift is never a 24-hour shift. When I sign out, then it's all right, or let's go.
Speaker 2Let's do this or you're in the OR at the time that you're supposed to be signing out. Yeah man.
Speaker 1After a while I was like look, I don't want to work like this anymore.
Speaker 2If, but so you're uh comparing yourself to someone who flies a plane. Yeah right, okay, how many patients do you take at a time?
Speaker 1to the or I'm not. Well, not at 200. Let's do it based off a list. Let's do it based off of the list. Right, my list may not be 200 long, but my list is hella long though so you think your list is as long as the.
Speaker 2What do you call it? It the manifest on a flight. Do you think your list?
Speaker 1is that long? I mean, technically, I'm the trauma depending on a night, though, if you really think about it, I'm the trauma surgeon for an entire city. So yeah, like we're talking about thousands and hundreds of thousands of people, yes, Okay, but all of them are not getting into accidents, neil.
Speaker 2All of them don't have traumas, but if they, do I do, I'm there Right.
Speaker 1So technically I'm providing a service for the entire community. Ok, so, yeah, guys, listen, let me tell you something right now. I win every debate, every argument on this show.
Speaker 2Have you noticed that this needs? To be the next what y'all say, because I need to know what y'all say about what he just said because, basically, what he just said is akin to a pilot saying well, if everybody was going to fly everybody.
Speaker 1There's only a certain amount of seats on a plane.
Speaker 2There's only a certain amount of people on your service.
Speaker 1No, no, there's no cap on my service. There's a cap on how many people could be on the. What do y'all say?
Speaker 2What y'all say I'm right. Tell me, so I could talk about this another time.
Speaker 1No, you're not right, so there's a cap what? But no, you're not right, so there's a cap. What's the cap on how many people I can see? Is there a cap?
Speaker 2I just want to know if the manifest on a plane is the same as the number of people on your service. That's all I'm asking.
Speaker 1To Alfred, our video editor. What do you say? No, no, no, no, no, no, no, wait, wait, wait, wait. Thank you, put it right here in the middle Thumbs up, thumbs down. But you know, right now I'm actually getting ready to do another night shift, don't?
Speaker 1get me started, but far away. But before I do that and this is how I end a stint, an assignment, this is how I get paid In order to do that, let me take a look at my notes, because sometimes I got to keep a note. So you know I stay in a hotel, so for five days I'm at a hotel. I got to keep a note, so you know I stay in a hotel, so for five days I'm at a hotel. I got a timesheet that kind of I create, I use timesheetscom, keep track of my timesheets. And then I got a rental car and all of those receipts I keep track of.
Speaker 1I get all that stuff and then I send that out using an app called Wave. I think it's like wave, that app. I'll put it in the show notes and stuff. And I create an invoice that you know denotes like, if I work a certain amount of time, this is how much I charge. If I do backup, where you know I'm not in the hospital but you know I'm covering, just in case something emergently happens to the other person, I charge for that. Then obviously I expect reimbursement for my car, like for the rental car, I expect reimbursement for the hotel all those different things I submit to the hospital and I do net 30 days.
Speaker 1In 30 days I either get a check, or we get a check, or it comes directly into our bank account and we rinse, wash and repeat and that's how we do it.
Speaker 2Yep.
Speaker 1So that's it, and we rinse, wash and repeat, and that's how we do it. Yep, that's it. I should have changed it down here to what I do to Bill. See, I'm trying to be more like you know, changing the banners and all that stuff.
Speaker 2Alfred could have done that.
Speaker 1But I mean, you know, alfred can't do everything right, yes, he can.
Speaker 2Alfred, can you do everything?
Speaker 1No. Well, that leads to the next Q&A. No matter where you are in your career, you've seen patients your age or younger get seriously injured, have a long-term illness or even have a mental health issue that affects their ability to work. Now, what if that was you? No, for real. What if that was you Without disability insurance? How are you going to replace your paycheck? In episode 176, jamie Fleissner of Cephalife Insurance explains why the best time to buy disability insurance is during your residency.
Speaker 3Most people, most physicians, acquire their disability policies during residency, and there's several reasons. First of all, when you're younger, you're able to obtain the insurance because they ask you a whole host of medical history and so you usually don't get healthier over time. Usually you get less healthy over time, so when you're healthy, it's easier to acquire the coverage. Number two it's also less expensive because it's based on your age and your health. You're not getting younger or healthier over time, so you're at the ideal time. The earlier you get it and the younger you are, the less expensive it's going to be.
Speaker 1So, whether you're a resident or you're an attending, it's never too late to protect your income. Renee and I, we use Set for Life Insurance to find a disability policy that fit our needs and budget. So what are you waiting for? Check out setforlifeinsurancecom Once again. That's setforlifeinsurancecom. This is a question that we've gotten from Phillip. Phillip says my wife and I love your podcast. We're interested in starting our own locums company. Everybody wants to start a locums company.
Speaker 2Yeah, man, and everybody should.
Speaker 1Competing with us. How do you negotiate rates with the hospital, ie, what's a typical rate charged by an agency versus what you'd be paid as an individual? How do you approach getting medical malpractice coverage? Is it on the individual or on the agency? Are the rates negotiated in addition to travel expenses or is it inclusive? Thanks for putting this info out there. More physicians need to be empowered with this kind of knowledge.
Speaker 2Philip.
Speaker 1Damn Philip, you want to know everything.
Speaker 2Thanks, Dr Phil.
Speaker 3Okay, that's Dr Zizmore.
Speaker 1Dr Phil from the TV.
Speaker 3Okay, got you, got you, got you.
Speaker 1All right. So look, phil, these are great questions. We're not going to be able to answer all of that today. So I think what we'll do is we'll keep it to two things and then we'll talk about the others later. So let's talk about are the rates negotiated, the pre-meds, med students out there. You want to describe what locums is real quick.
Locum Tenens Medical Malpractice Coverage
Speaker 2So locums, locum tenens, which is the official term, technically means placeholder, and so what that means is that you have a doctor who comes in and does coverage for various reasons for a facility. So let's say the facility has a doctor who went out on maternity leave, or the facility has someone who's on vacation, on an extended vacation, or the facility just wants someone who is in the rotation right, maybe their doctors are kind of tired of taking call every single weekend and they want someone in their rotation. Or the facility actually has a need where they need to hire another doctor, but they just haven't gotten to the point of being able to hire someone. So there's like a space, right, a vacancy. So that's where a locum tenens doc or an independently contracted doc who is not employed this person is not employed by the hospital. They make a contract, just like a plumber would with you at your house. The doctor makes a contract with the hospital to essentially fill whatever void that the hospital has. Well, how I do? You did good. That's a really good definite.
Speaker 1That's the reason why I asked you to do it, because I know that you will break it down, so it'll forever be broke. Cue to Love Jones.
Speaker 2Let me break it down so it can forever and consistently be broke, if you know.
Speaker 1You know right. So, yes, locum tenens, that's how we've been practicing for almost 12 years now and we've been fully locums for now seven years. Right, and this is the way how we like to practice. I still get paid just as much, possibly even more, than doctors who are salaried or employed. I just feel like I'm in that much more control of my schedule you know I can make, I can work around like really big events in my life, as opposed to hoping that you know I have time off or hoping that you know my. The time that I need off is taken into consideration by who's doing the schedule.
Speaker 2Except this year. You are working on your anniversary. Boom Called you out, yeah but it's our 11th anniversary.
Speaker 1What does that?
Speaker 2mean so it don't count.
Speaker 1It counts, but it's not the same.
Speaker 2Same as what.
Speaker 1It's not the same as the 10th anniversary.
Speaker 2What did we do for the 10th anniversary?
Speaker 1We was together, and that's all that matters, and if y'all listen to our show and I know you guys listened to our previous episodes we trying to get a house. We need to get a down payment and stop tripping. Stop tripping. Yo, we try. This is a season, folks. Before we get it, philip phil is like man. Would y'all just answer the goddamn question. If you just answer the question, you can answer all my damn questions. Right, that's what he's saying. Sorry, phil, that's just come on you don't have to self-howl.
Speaker 1But listen, like anybody who is concerned about, like you know, for locums, like If you don't work, then you don't get paid.
Speaker 3Right, right, that's, just that's just how it works Right.
Speaker 1If you don't work, then you don't get paid, whereas if you're salaried, you know you get time off you're still getting paid. There's some advantages to it and there's some disadvantages to it, but one of the biggest things that people think about with locums is look, I eat what I kill. When I work, I get paid. If I don't work, I don't get paid. Right, and you have to be really like, you have to put a checks and balances on that, because you know you can go really overboard and I think most people who switch to locums that's the biggest issue that they have is they actually find themselves working too much.
Speaker 2Right.
Speaker 1Because nobody's keeping track of how many hours you're working and they're just like look like I'm just going to keep working and you know I'll take several weeks off afterwards. But yeah, I'll do like three weeks in a row or four weeks in a row, and it's like well, that's not even how you work full time Right.
Speaker 3Full time, full-time right full-time.
Speaker 1You usually work like three weeks in a row or maybe two weeks in a row, and then you have some time off if you're a trauma surgeon.
Speaker 2If you're not, most people not normal people and trauma surgeons are not normal people. We're not all right, let's answer the question so that uh phil can go about his day yeah, so, um, let's do the first one, which is um medical malpractice.
Speaker 1So there's two ways that you can get medical malpractice right. You can either get it yourself or you can get it through the hospital. Yep, okay, I'm gonna tell you straight up right now. We think the easiest way is to let the hospital get medical malpractice for you. And Dr, yes, I say why I like to have the hospital do it One.
Speaker 2it's a little bit of a cleaner. You know a cleaner way to do it right. First of all, if the hospital gets to malpractice, that's less work on your end to be able to basically have malpractice coverage. We've tried that before in the past in the past and it's a little bit I don't want to say it's convoluted but it's also not a very seamless process to be able to get malpractice coverage as an individual. You can do it and we have done it.
Speaker 1Successfully.
Speaker 2Successfully, but it's not a very smooth process. The other thing is it's more expensive for the hospital to have us get the medical malpractice as individuals, because then what happens is and which is what happened to us is that the price as an individual is going to be way higher. Now, as individuals, as the person who's coming in and you know doing the locums business for you know covering for the hospital, that hospital is going to be the one to foot the bill anyway, so we're going to get billed by the malpractice insurance agency. Then we're going to hand that bill over to the hospital and the hospital is going to balk at it, which is exactly what happened. The hospital is going to balk at it and be like oh, we can get this cheaper, which is what we told them to do in the first place.
Speaker 1Well, what if someone comes back to you? What if Phil comes back to you and says but Dr Renee, isn't that the cost of doing business?
Speaker 2That is the cost of doing business for the hospital. See, I don't need medical malpractice as an individual physician who doesn't have my own practice. The only reason I need malpractice insurance if I'm working for a facility is because I'm working at that facility. So that's the cost of them doing business, not me, because I don't have patients on the side that I'm doing. You know that I'm practicing on, so that's why it is their job to actually cover the malpractice, regardless of who gets it.
Speaker 1So basically, if you're saying okay, let's say, for example, a family med doc is going to get paid a hundred bucks an hour.
Speaker 2Please don't take those rates.
Speaker 1I'm just dumbing it down right. But let's just say, for example, a family medicine doc wants to do locums and is going to charge a hundred dollars an hour. Well if you have to provide your own medical malpractice, so you have to go to a company get medical malpractice to do this locum stint, then my opinion is you should be actually increasing your rate to take into account that you're purchasing your own medical malpractice. So instead of it being 100, it should be, maybe you know, 120 an hour or 130 an hour.
Speaker 2You really are like dumbing this down, huh.
Speaker 1It should be. But the other thing too is you want to keep it realistic for folks also, right? Right right, because if you just say, yeah, now, it's $300 an hour.
Speaker 2Right right.
Speaker 1Then it's like well, you also?
Speaker 1have to consider that it takes time to pay this off, right? So you have to be really you have to be really specific about I just want to give a really good example of what we're talking about here, guys. So if you want to charge $100, but it's actually costing you like 30 bucks an hour to get medical malpractice, well, now you're only making $70, right? So you're actually going into red to get your own medical malpractice. So what ends up happening is a lot of excuse me, all hospitals have medical malpractice that they have for all their employed doctors and in order for them to add you on as an independent contractor onto their insurance, it's usually a very nominal cost that they don't even have to pay much for at all. So it always just makes sense, in our our opinion, to just tell the hospital listen, if you really want us to work here, you want me or whoever else to work here, cover us under your medical malpractice. We'll stay as locums. You won't have to pay any other benefits.
Speaker 2You don't have to pay 401k.
Speaker 1You don't have to pay disability insurance.
Speaker 1You don't have to pay health insurance, any, any of those things, and it ends up being an easy situation for us. I think most hospitals that have common sense will ultimately say yes, and it'll be easier for you, so, um, but there are scenarios where the hospital will be like, listen, we want to keep things, everything separate, and one of the hospitals that I worked at that's what they said we'll keep everything separate. You get your own medical malpractice, you let us know what the rate is and then we'll go from there, and I was like bet and um, I charged them appropriately and you know it was, it was a good situation and I got occurrence-based insurance, um, but we could talk about that which is way more expensive, but I didn't have to pay tail and that's the reason why.
Speaker 2And that's the reason, yeah, that's why I wanted to do that, so yeah, um phil.
Speaker 1I hope that answers that one part of your of Anything else you want to add on that at all.
Speaker 2For malpractice.
Speaker 1No.
Speaker 2I mean, you know, just know, I would say, if you do end up getting your own malpractice, just know what your state requires in terms of coverage and make sure that the medical malpractice insurance company presents you with those types of plan options and real quick if you need a place to start about what's the rates and all that.
Speaker 1It all depends, right, how much you should be charging, right? Basically, that's the question how much should I charge a hospital so I can get paid? That's tough, right. There's a school of hard knocks where you try and you just go out there and see what happens and you might end up you get burned, you might end up undercutting yourself, right. But I think a really good place to start is actually locumstorycom. If you go to locumstorycom Alfred, if you could put it below locumstorycom they do a really good job of teaching you like the ins and outs of locums, giving you stories of people who do locums I'm talking about like physician assistants, nurse practitioners, physicians, different specialties you know different specialties, from orthopedic surgeons all the way to OB, to you know allergy and immunology, and one thing that I think is extremely powerful about this site is that it actually gives you rate ranges, so it lets you know like what's the rate?
Speaker 1What's the going rate for a trauma surgeon in the Midwest as a compare to? You know, the East coast and I like that. So, um, that's a good starting place, you know. So that's that's, that's a place that I think you should, you should, check out.
Speaker 2Um, I'll tell you one more thing about the rates. One of the things that I took into consideration was, at one point I took what was my salary as a W-2 and then I broke it down until I got to you know per hour, increased that by about between 30 and 50 percent and then made that my rate. So that's another way that you can decide, like what your rate is going to be. So you, you switched up how your chair is now.
Speaker 1Yeah, I'm tired. This is gives me more active, like I feel more active like this, cause I'm I'm real, real tired. But, phillip, I love you and that's why I'm doing this for you. I'm doing this for you. All right, so your second question that we're going to answer.
Speaker 2I don't know you like that yo.
Speaker 1The rates negotiated? In addition to travel expenses or is it inclusive? So no, so rates are separate than your travel expenses. Yeah Right, this is the cost of business. This is very what's the word I want to say. This is par for the course. Don't go and mess this up for everybody else.
Speaker 3All right, phil, so listen how much you get paid is separate than how much it costs you to get to the site.
Speaker 2Remember that.
Speaker 1And to stay there, and to stay there. Yes, do not mess this up for everybody else and be like my rate also is going to pay for my hotel, why are you yelling at Phil, though? No, because people like Phil be messing things up and stuff what?
Speaker 2do you mean? He just asked a question. What do you mean? People like Phil? You don't know Phil.
Speaker 1Phil, don't mess it up. Y'all Listen. Phil was like.
Speaker 2First of all, you just told me you love me. Now you're yelling at me. What is this? Don't mess it up, y'all. I'm looking at you right in the camera.
Speaker 1Phil, I hope you're not just listening to this on the audio version, because I know you're a good fan, you're a good subscriber and you're watching this. You get your rate of how much it costs to do whatever medical work that you got to do and that's your rate. And then you know whatever is the normal. So the way how they pay for transportation is whatever it costs for a rental car. If you need to use a rental car, that's how much it's going to cost you to rent a car, plus gas. If you're going to use your own car, then it's the IRS mileage times. You know the mileage that you've done.
Speaker 1Right the mileage rate times the miles that you've done. Or if you need to fly, then it's coach, all right, whatever the coach ticket is, from wherever you want to go to wherever you need to get to, and then also the hotel Right and that's it. And those are separate. What if you do locums?
Speaker 2close to home. Let's say we live here and the hospital is reimbursable, right?
Speaker 1so you would just take the irs mileage rate, which is like 67 cents, yeah, 67 cents per mile. Multiply that you said 15 miles, yeah times 15 and that's do the math and that's your, I don't, alfred. Alfred, put it down below, please 67 cents times 15 miles, right, and that will be what your reimbursement rate is a whole lot of dollars and that's how it works you know.
Speaker 1So that's why rates negotiated in addition to travel expenses or is it inclusive? It is not the latter, it is rates and then separate as travel expenses, and that's it all right and even like um, that's it, wait. What else can we talk about that? That's it, right, yeah.
Speaker 2I think that's it. So wait, one more thing actually I did think about, because I was thinking about Dr Trevor, who we did a podcast episode with him a couple years ago. And if you, for example, do locums, let's say, in Phoenix, but then you have your next locums assignment somewhere else where you don't live, right, you have your next locums assignment, let's say, in Seattle. You can actually have them pay to fly from Phoenix to Seattle, right?
Speaker 1The next job. The next job, the next assignment can fly you from where you are in your locums assignment Right.
Speaker 2So you don't have to go back to home base and then have them fly you out there. You can just have whatever your starting point is have them start you from there.
Speaker 1So Phil, I'd like you to write in back to us on text or send us by text, or however way you want to get in contact with us. Let us know why you want to get your own locums company. I'm really interested in that. Like are you? Do you really like, want to have your own company, slash agency, where you are working with other docs and you're you know you're sending them out, or is it just for you?
Speaker 2Yeah, because that makes a difference that makes a difference.
Speaker 1So I'm super interested as to why. So for us, we started off just as me and Renee, as our company, and then we got a great opportunity to bring on other OB docs and we became an agency and it was great yeah, it was amazing. Three years Great Also. But folks, I just want folks to kind of understand that there's a difference.
Speaker 2Yeah.
Speaker 1And you know I, you know one of the locums positions that I'm at like, I found out that a PA is actually leaving and is going to go locums also. So, guys, even within the physician assistant realm, like you can do locums, and what I'm finding out, without giving too much details, is that folks just want their freedom.
Speaker 3Yeah.
Speaker 1Like folks want to be able to work when they want to work. You've got three, you know and and because you know you're working in a temporary fashion, because usually whatever facility that you're working at really really needs someone. Like now, they pay more for you than they would pay for a regular salary doc and I think we the calculation is like 30% more than what they would pay you, 30% more than what they would pay for a salary doctor.
Speaker 2I mean, if you think about it, the advantage is still with the hospital. Right, because they don't have to pay payroll taxes, for example. Right, you're not going through payroll, so they don't have to pay payroll taxes. They don't have to pay any sort of benefits, so health benefits, disability benefits, they don't have to pay CME.
Speaker 3They don't have to pay for, yeah, 401k.
Speaker 2They don't have to pay PTO, right? Because, remember, hospitals, when you're employed, they have to pay you, even when you're not working, right? So if I decide I'm going to take a two week vacation, I have to get paid for that, so they're even paying you. You know they're even. They're paying you only when you work, so you know this is not a disadvantage. Oftentimes I just had a discussion with the doc explaining that actually, this not paying benefits is actually beneficial to the hospital and it does work out to your benefit as well. So it's a win-win, which I don't know. Why more hospitals?
Speaker 1don't do that. I'll tell you why they don't consider it. Because there's two things. So with locums, it's unpredictable for them. So because you can be like, yeah, no, I'm not ready, I'm not available for next month, but I'm available the month after that, right?
Speaker 1So they want predictability in their schedule in their scheduling and it is a little bit expensive for them. Right, I'm not saying it's it's. It's not as expensive as having us. Cause, think about it. If you're a salaried doctor, if you make $450,000 a year, you actually are costing the hospital more than $450,000.
Speaker 2Oh absolutely.
Speaker 1What's it coming out to like?
Speaker 2It's got to be, but also actually between like 30 and 50 percent more. Yeah, because because of all the benefits, the $450,000 is just the salary that they write you.
Speaker 1But they still have to pay for disability insurance for you. They still have to pay for medical malpractice health insurance, your 401k, the match that goes into it. See me, all of those different things make it way more than 450. It's in the 500, 600 range. So just just so you know. But I do think that a portion of that, a large portion of that, has to do with they can't predict what the schedule is going to be, and there's a lack of control.
Speaker 2There's a lack of control. This is a fight over control.
Speaker 1I think economics plays a big role also.
Speaker 1But I think if any CMO or if any CFO, this is a fight over control. I look at it. So. That's why I think a lot of people including what I'm hearing from physician assistants they're just kind of like look like I can go anywhere and work and I can work two weeks, or I can work one week and then travel for three weeks and then you know, kind of have a lifestyle where, like you know, I go and live in Europe and then come and work for a week in the United States and then be out for another three weeks. Like you can make this work anyway, like this is something that you can make work anyway any fashion you want to.
Speaker 2So yeah, yeah, I've been.
Speaker 1I've been. You know I was listening, cause I got in my notes here like why someone would do it, and I was listening to a podcast on music. I'm not going to name which one, but I really liked this podcast and I'm listening to the complaints of this person who's in the music industry or who has left the music industry and you know, some of the things that they talk about is like their inability to collectively bargain right the artist from an artist perspective right?
Speaker 1right, because if they can collectively bargain, if they had a union between, like the, the artists, whatever genre they are, they just have more ability to go to an eight, a label like universal and what have you, and say we want to get paid more, right? Um, you know, they have these 360 deals now where you sign with a record company and, let's say, you end up becoming a huge star. Well, the 360 deal means that they own every piece of revenue that you have.
Exploring Paradigms in Medical Industry
Speaker 1So, let's say, for example, you make a big hit, making an album Well, they're going to get a whole bunch of money from that. But let's say, for example, you want to go on tour Well, to get a whole bunch of money from that. But let's say, for example, you want to go on tour Well, they get a piece of that. Let's say, for example, you get put on TV right, they want you on TV for some reason. They're going to get a piece of that. They have that in medicine also, like my first contract actually said that if so, I would work for two weeks and then I'll have two weeks off.
Speaker 1And you remember like this the it said in there if I did anything else, if I got income doing anything else working as a physician.
Speaker 2No, it said working outside of the hospital, didn't it say that? So working outside of the hospital? The reason I remember that was because our attorney went back to them and said so, if he opens up a flower shop, does he owe you revenue from the flower shop, and that's when that clause got taken out.
Speaker 1Yeah, so you know there's a lot of well, that's a parallel right there, you know, and the question is are you necessarily getting your fair share of the sweat equity that you put into this as a doctor, because the hospital, you know they. As a doctor, because the hospital, you know they, they have to put up the building, they have to put up and hire people and so forth but there's a lot of sweat equity that you put in right we're talking about.
Speaker 1You know, close to over a decade of education, schooling not to mention the you know a hundred thousand dollars of student loan debt. They can't operate without you. As a matter of fact, you, you know me already, I, you know me. I tend to be more um revolutionary about this, and I feel like everybody should be locums in some form or fashion. You ain't gotta be a hundred percent, but I feel like they should be locums in some form or fashion, but that's the way I look at it.
Speaker 2Like I.
Speaker 1I look at it almost like the music industry where, right, you're making a lot of people, you're making a lot of money for people. You may not necessarily be making that money for yourself. Or I mean, there's artists who are just like look like, I want to make this type of music, but the music label is saying no, you have to make this type of music that's going to play to the masses.
Speaker 1So that kind of goes into, like the autonomy of doctors also, right, yeah you have to practice this way or you can't have this day off, and so forth. So it's just interesting when you look at the parallels and I think in general, just corporate, anything that's corporate doesn't like taken to uh, doesn't think about the individual.
Speaker 2Yeah, and that's why, for me.
Speaker 1I like locums because that gives me that barrier right there to be like, listen, I'm not available that day, or I can't do this and I'm out and I know that you guys need coverage, but I'm not available that day. My son has Halloween, can't do it.
Speaker 2Yeah, yeah, you think that's what people experience with Diddy Oof. We did not talk about Diddy, but we will have to do that on another day, because that's the end of this podcast episode.
Speaker 1Who would have thought the Diddy that we grew up with?
Speaker 2I think people would have thought that me. Are you serious? Were you thinking that? Well, maybe not in the 90s, but Bad behavior, yo Maybe about starting. About 10 years ago, people started being hip to game.
Speaker 1Have you ever thought about what it would be like if medicine was like we talk about the music industry? But what if?
Speaker 2Is there a Diddy in medicine? Is there a Diddy in medicine? Yeah, I think so. Who's a Diddy in medicine?
Speaker 3I don't know, but I mean.
Speaker 2Not who, but what scenario? Is there a Diddy in medicine?
Speaker 1So, in order for there to be something like it in essence, is there someone who takes like severe advantage of people At their lowest point, right? Well, that's the entire medical education, but that's why I'm just like medical education is Diddy.
Speaker 1So you got to look, you got to look, but no, not like that, right, but and but. You have people who are in certain positions and they, like you, have people who are at a certain position. In order to get to here, they have to put in a huge like investment to play the game right, and you owe them with either, you know, paying those loans back or with your time as an academic or what have you I don't know man, I don't know if there's someone specifically like like diddy and medicine I don't know.
Speaker 2Let me tell you, I would hope what. I would hope not.
Speaker 1What do y'all think? What do y'all think Y'all think there is? I would hope not. I would hope not. Should we?
Speaker 2encourage people to write in. If you do write in about that, we will make sure to keep you anonymous, okay. So, yeah, we will make sure to keep you anonymous, um, if you have experienced something like that, and if you have experienced something like that one, um, seek action to definitely go to therapy, um, but yeah, I don't know that our podcast is the only platform that you would want to cover, that hold on before we we get on out of here, though, I do need to say, philip, thank you very much for writing in.
Speaker 1Yay, those who want to know more about, like, why we considered going into locums or why you may want to consider going into locum tenants, we got something that you want to check out. It's a nice little sheet, nice little gift that we want to give to you. It's called the seven considerations before starting locums. Once again, it's the seven considerations before starting locums. We just want you to click on that so you can learn more about it. But also, at the same time, we want to let y'all know we got a course coming out, all right. So, phil, all those questions that you have about, like, what rates you should charge and you know, like medical malpractice and all that stuff, man, listen, we got a course that talks about all of that, all of that, so you can make $2,000 an hour, yo, I'm telling you, yo, what you got to sign up for our course.
Enrolling in Locums Course
Speaker 2I'm telling you, okay, you know, don't make, but sign up for seven considerations before starting. You're not going to make that, phil. You're not going to make that, yes, phil. So anyway, yeah, so we do have a course and it will be coming out starting in the early months of next month, but if you want, to be on the waiting list for that course, because seating is going to be limited, very limited.
Speaker 2If you want to be on the waiting list for that, go ahead and click that link put in your information and you'll also get the seven considerations before starting locums and we'll essentially, you know, hopefully, if you get into the course, we'll handhold you through either getting your first locums gig and we'll essentially, you know, hopefully, if you get into the course, we'll handhold you through either getting your first locums gig or optimizing the gigs that you currently have already. And yeah, we really look forward to hearing from you guys and hope to work with you in the course soon.
Speaker 1All right, y'all. That's the end of this episode. Please once again let us know what you think by sending us text messages, or you know how to get in touch with us. You know the vibes. All right, Phillip, thanks again for writing us and letting us know which questions you got, and don't forget to check out Seven Considerations Before Starting Locums Y'all, we're going to catch you on.
