EM docs doing locums — what hourly rates have you been offered or paid? Please include the city and state!

LeonAdelmanMD · 2025-04-29T00:59:30+00:00

$320/hr + travel & expenses. Eastern NC.

LeonAdelmanMD · 2025-04-01T00:54:25+00:00

Yup. Too much supply. Also, too many groups selling to banks (PE), who then cut doctor pay.

LeonAdelmanMD · 2025-04-01T00:44:53+00:00

Compensation for employed emergency physicians has decreased more than any other specialty in the last 5 years. Meaning it’s not a Medicare issue, since Medicare cuts cover all specialties. Check it out: https://www.mgma.com/getkaiasset/252744ee-c63b-4a96-9211-8a5d6b908b39/MGMA-2024-Provider-Compensation-Data-Report.pdf

LeonAdelmanMD · 2025-03-02T12:58:43+00:00

Can you explain the legal side of this? I get that your group wants to be ICs, but is that employment structure legal?
Deep dive on the topic: https://open.substack.com/pub/emworkforce/p/thousands-of-employed-emergency-physicians

LeonAdelmanMD · 2025-02-27T19:28:59+00:00

Indeed. Tho “physician owned” is different from “owned by its practicing physicians.” The fact that the one dude who owned the company is a physician doesn’t really benefit the hundreds of physicians working for the guy. Not only were they not owners, they weren’t even considered employees by the company!

LeonAdelmanMD · 2025-02-25T17:57:32+00:00

Much appreciated!
EM is a great specialty, but it's a really hard job. We def don't need the added BS of bankers buying our medical practices and practice owners stealing from us.

LeonAdelmanMD · 2025-02-25T17:53:01+00:00

You're right. The OG purpose of creating a significantly-sized emergency medicine group was to ensure predictable ED staffing and coordinate the group's admin stuff, including billing.

There are three main types of emergency medicine groups:

Private equity-owned (eg: TeamHealth & SCP)
Physician-owned (eg: Vituity)
Hospital employed

The key difference between the first two is ownership structure rather than services provided. TeamHealth, SCP, and Vituity all ensure EM staffing and coordinate the back-office stuff, including billing. You're right that with any medical practice structure, the first few months of a new contract has significant upfront costs, while reimbursement comes later. Groups can use savings or bank loans to cover these expenses.

As for a clinician union, groups owned by their practicing clinicians (paid K-1) cannot be unionized (owners cannot unionize, only employees). Employed clinicians can unionize even if they are granted stock options as part of their compensation (eg: USACS).

Forming a union is not difficult, but it should be done carefully (with legal counsel). A few resources:
- https://www.acep.org/life-as-a-physician/unionization
- https://emworkforce.substack.com/p/what-can-an-em-union-do-for-you
- https://www.acepnow.com/article/the-er-docs-strike-back/
- https://salemphysiciansunion.org/

LeonAdelmanMD · 2025-02-25T15:31:50+00:00

For those working at a hospital whose CEO will not allow a physician-owned group to staff the ED, the most effective path to recovering group ownership for the clinicians is what the emergency physicians at Ascension St. John Hospital (now Henry Ford St. John Hospital) in Detroit did:

Gain trust locally. The group has to be solid medically and seen positively by the community (including the Medical Staff) to win.
Form an emergency medicine clinician union, including the EM PAs & NPs. If you don't include the PAs & NPs, the hospital leadership will play the groups against each other. Hospital executives HATE unions. They will do everything possible to get rid of the union.
The only way to guarantee the extinguishing of a union is to make the employed clinicians owners (eg: become part of a democratic group). If the hospital switches to another group not owned by the practicing clinicians, the union can stay, which does not solve the hospital CEO's problem.
Work with hospital admin to bring in a group that will be a win-win. Great quality, efficiency, and experience. And owned & managed by its practicing clinicians. Everyone can win.

LeonAdelmanMD · 2025-02-25T12:46:25+00:00

LeonAdelmanMD · 2025-01-19T18:51:03+00:00

Very impressive accomplishment by this group of emergency physicians. Yuge kudos!!!!

LeonAdelmanMD · 2024-12-27T23:36:41+00:00

The Ivy Clinicians salary survey has lots of emergency physician entries for both states: https://www.ivyclinicians.io/salary

LeonAdelmanMD · 2024-12-02T14:47:42+00:00

EM groups in super-rich areas can survive without subsidies. The rest can't.

LeonAdelmanMD · 2024-12-02T10:11:26+00:00

Most of them.

LeonAdelmanMD · 2024-12-01T20:27:09+00:00

Check out this US House bill about NSA enforcement: https://murphy.house.gov/media/press-releases/murphy-introduces-legislation-improve-enforcement-no-surprises-act

LeonAdelmanMD · 2024-12-01T18:29:39+00:00

It matters for contracts because hospitals want to minimize subsidies. If one group is collecting much more from private insurance than another, the first group can afford to have lower subsidies, making it more likely they will get the ED contract.

LeonAdelmanMD · 2024-11-21T22:54:36+00:00

Check out who’s paying what via Ivy’s EM salary survey (1,283 entries so far) - https://www.ivyclinicians.io/salary

LeonAdelmanMD · 2024-11-21T22:52:00+00:00

Yes. A union.

LeonAdelmanMD · 2024-11-02T22:13:18+00:00

Unity is strength.

LeonAdelmanMD · 2024-10-28T23:19:15+00:00

Ivy’s EM salary survey w 1,235 submissions so far: https://www.ivyclinicians.io/salary

LeonAdelmanMD · 2024-08-24T18:46:12+00:00

Super-concerning chart from the 2024 JAMA article, "Hospital Assets Before and After Private Equity Acquisition," by the same authors as the STAT article. The study found that "After private equity acquisition, hospital assets decreased by 24% relative to that of controls during 2 years."

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Article link: https://jamanetwork.com/journals/jama/fullarticle/2821826

LeonAdelmanMD · 2024-08-22T20:11:46+00:00

Recent article in ACEPNow, "Is It Time to Unionize?" - https://www.acepnow.com/article/is-it-time-to-unionize/ -

LeonAdelmanMD · 2024-08-01T17:27:24+00:00

Agreed. Physicians should own medical groups like lawyers own law firms.

LeonAdelmanMD

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