davidccs Posted July 9, 2023 Share Posted July 9, 2023 (edited) So I currently work in EM and am considering switching to UC. My current set up is W2: Hourly of $100/hr with yr end bonus (usually 4k), 401k no match, 1k CME, no PTO, license/DEA paid, malpractice with tail. We see whatever we want to see and have (mostly) very supportive docs. Avg of 2 pt/hr. Swinging shifts with minimum of 13 a month. We do get an increased rate for working OT but I rarely do. No insurance offered. Unspoken benny of free food at cafeteria without a cap (Valued at maybe $5K?) and free daily scrubs (No laundry, priceless.) The UC offers: W2: $53/hr with quarterly/yearly bonus (about 30k once you do a full fiscal year), 401k with match "average", PTO accrued based on hours worked, 2K CME, well-priced insurance and malprac w tail due to being part of big hospital system. Minimum is 3 12 hour shifts per week. Weekends and holidays are expected. Holiday and OT pay is $75/hr. Some solo coverage, avg of 30 patients per day. Both places run on Epic and have dragon (Im not sure id ever consider a job without those). Both places are in medium/low COL area. Both are 1 hour away from major Southeast city. No significant traffic. Why switch? Personally unhappy with the job. I would be more than happy to do solo coverage, and have 5 years of experience in said ED. What do yall think? Edited July 9, 2023 by davidccs adding no insurance offered 1 Quote Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted July 9, 2023 Moderator Share Posted July 9, 2023 I think you need to find another ER job. UC is everything we all hate about the ER; high volume, low acuity complaints, demanding pts..... 1 1 1 Quote Link to comment Share on other sites More sharing options...
SedRate Posted July 9, 2023 Share Posted July 9, 2023 I'm assuming 12h shifts for both: ER: 13 shifts x 12h x 12mo = 1872h x $100 = $187k No match = missing out on free money = $? Compounded value DEA and license = $1200 Insurance = how much does this cost you? $600/mo = $7k? $4k bonus $5k food Total package roughly = $189k ***No free compounding retirement money match!!!*** UC: $53 seems crazy low to me for someone with 5y ED experience. 12 shifts x 12h x 12mo = 1728h X $53 = $91.6k + $30k bonus = $121.6k 3.5% match of $91.6k = $3206 ***THIS IS FREE RETIREMENT MONEY THAT COMPOUNDS UNTIL YOU RETIRE = maths Do they also cover DEA and license? They should = $1200 Extra $1k CME Let's say 15 days PTO x 12h = 180 1727 - 180 = actual working hours of 1548 Rough total = $127k + compound value of match retirement money ($ value in 30+ years?) (working 324 less hours than you would in ER, roughly 27 shifts, so you could theoretically add $17k value. Or explained a different way, $190k - 17% = $158k at an equivalent schedule in the ED. (I just realized I could've done the easier route and just did $100/h x 1548.) When you compare them, the ER job pays more plus/minus any extra shifts, nuances, etc between the two. I'm no math expert and I'm probably missing stuff or incorrect on some figures so feel free to do your own math. But remember: not everything is about money. I recommend that you find a new ER job that you wanna do (like solo coverage) that pays 401k match and insurance. Quote Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted July 9, 2023 Moderator Share Posted July 9, 2023 Agree with all of the above. There are also still jobs out there that give a pension, which is more dependable than a 401k as it is a guaranteed income based on top salary and years of service, not dependent on the market. After years at various ERs I have a few 401Ks and am on track to get 2 pensions. 2 Quote Link to comment Share on other sites More sharing options...
SedRate Posted July 10, 2023 Share Posted July 10, 2023 6 hours ago, EMEDPA said: After years at various ERs I have a few 401Ks and am on track to get 2 pensions. Dayyyumm, nice work 1 Quote Link to comment Share on other sites More sharing options...
Sunnyn Posted July 10, 2023 Share Posted July 10, 2023 7 hours ago, EMEDPA said: Agree with all of the above. There are also still jobs out there that give a pension, which is more dependable than a 401k as it is a guaranteed income based on top salary and years of service, not dependent on the market. After years at various ERs I have a few 401Ks and am on track to get 2 pensions. How do you manage to get 2 pensions? pls elaborate? Quote Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted July 10, 2023 Moderator Share Posted July 10, 2023 11 hours ago, Sunnyn said: How do you manage to get 2 pensions? pls elaborate? 2 different jobs that offer a pension for 5 or more years of service. 8 years at job 1, shooting for 12 at job 2. 2 Quote Link to comment Share on other sites More sharing options...
Sunnyn Posted July 10, 2023 Share Posted July 10, 2023 10 minutes ago, EMEDPA said: 2 different jobs that offer a pension for 5 or more years of service. 8 years at job 1, shooting for 12 at job 2. Are these part time jobs? How many hours do you work at each? Thanks again! Quote Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted July 10, 2023 Moderator Share Posted July 10, 2023 I was full time at job 1 for 8 years. I worked a few other places that had 401k structures and am now full time at job 2. I have been an EMPA for 26 years so lots of jobs in that time. I currently work 3 clinical jobs: full time job (#2 above) 90 hrs/mo Part time job 96 hrs/mo ( 4 x 24 hr shifts) Per diem job 0-3 12 hr shifts/month Also teach an online course for one of the DMSc programs. 1 Quote Link to comment Share on other sites More sharing options...
davidccs Posted July 10, 2023 Author Share Posted July 10, 2023 27 minutes ago, EMEDPA said: I was full time at job 1 for 8 years. I worked a few other places that had 401k structures and am now full time at job 2. I have been an EMPA for 26 years so lots of jobs in that time. I currently work 3 clinical jobs: full time job (#2 above) 90 hrs/mo Part time job 96 hrs/mo ( 4 x 24 hr shifts) Per diem job 0-3 12 hr shifts/month Also teach an online course for one of the DMSc programs. Any advice on how to become proficient with advanced procedures? Central lines, chest tubes, A-lines? I work with residents so they get most of the procedures. I've done a lot of maniquins but it's never the same as a real person. I'd like to eventually do critical access but I don't think my procedural exposure is up to par Quote Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted July 10, 2023 Moderator Share Posted July 10, 2023 Find a double coverage position at a rural community hospital that is busy WITHOUT a dedicated fast track. Typically 10-20 bed facilities. This gets you seeing every other pt regardless of acuity and you can tag team the codes, traumas, etc with the doc and if they like to teach you get to do it all. Intubations, cardioversions, and chest tubes are most important. Try to get some OR time with anesthesia. Just ask. They generally like to teach. Probably paracentesis and thoracentesis next. Central lines are nice, but generally you can do everything you need with peripheral ines and IOs. Get good at critical care u/s for line placement, femoral nerve blocks, rush and fast exams, etc A-lines are almost never started in the ER as they really are more for monitoring a resuscitation than starting one. 1 Quote Link to comment Share on other sites More sharing options...
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