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Decision, please help me!!!

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  • Decision, please help me!!!

    I am in a conundrum. I am a Single Interventional Cardiologist with no string attached. I am debating taking a permanent job vs continuing with my locum job. I quit my permanent job last year, 2019. I immediately got another permanent job offer in Texas, and I signed the contract. So I applied for the License. While waiting, I have been doing locum works for about 4 months now. I found that I really enjoy the lifestyle and taking care of patients that are assigned to me. Even better, I found that I get compensated quite well for my work. I love the ability to control my schedule. I think both options (locum vs permanent) are very enticing for me. I am listing out some of the pros and cons of each option for you to assess. If you were in my shoes, which option would you consider?

    +Option 1: Go with permanent Job

    Base paid $600k guarantee for 3 years with First-year close to $675K; Knowing my work ethics, I will very likely make $50k north of the base salary starting my 2nd year and will likely north of $100k my third year.

    -If there is an economic recession then I am pretty safe with a permanent job (given the Corona Virus and economic future uncertainty)
    -Student Loan Forgiveness qualification, I have paid 8 years for it, and I need to 2 more years for it to be forgiven. I still have about $400k in Loan. I do have to cash to pay it off in one lump sum, but I am waiting it out because my debt monthly payment is not much.
    -401K offer with match
    -Health insurance

    -Less paid compared to Locum
    -Need to Hunt for my own patients
    -Have to deal with politics
    -Less autonomy with my schedule (definitely less vacation)


    +Option 2: Go with the Locum Job

    I will likely earn $700 to 800K; however, it depends on whether all the assignments are kept and not get canceled. I am afraid if there is economic uncertainty. The hospital will likely dispose of locum and canceling assignments. So far, I have assignments to September. Based on this local, there is another locum there that has been working for over a year, and it looks like the need is plenty still since one of the permanent cardiologists left the practice.

    -Good paid, but can be variable.
    -No Politics
    -Great schedule
    -A lot of rewards for hotels and flights

    -Time traveling is not compensated
    -I have to pay my own Student Loan which I am 8 years vested. I do have to cash to pay it off in one lump sum, but I am waiting it out because my debt monthly payment is not much.
    -Uncertain schedule due to cancellation, but I haven’t had many issues with this so far. However, if there is an economic recession, then I am uncertain of the earning.
    -Need New references for new facility and redo credentialing (not bad, but a pain sometimes)
    -The headache of doing LLC and mx my expenses (not bad since I am pretty financially savvy)


    What do you think? Your honest and frank comment will help me much.

  • #2
    Employed position. If you don’t like it after your forgiveness then do locums.


    • #3
      If locums is paying you 700K for the same work as the job that is offering 600K, you could probably be making 800-900K if you were in private practice. Locums takes a large cut of whatever the hospital is willing to pay you, so they are probably paying the locums company some 800-900K to have you as an employee. This day in age, I think that more cardiologist are becoming hospital employees though, the hospitals obviously have a monopoly on who gets called for their cath lab and they are going to want to continue to keep a portion of that for themselves. I agree with going with the employed route, locums is too uncertain for me. All hospitals try to get away from having to use locums because the locums companies are so expensive to use. I don't know how it is for cardiologist, but I know that for hospitalist, the locums companies were taking some 50% more per hour and keeping it all for themselves.


      • #4
        Employed now. Get your loans out. Reach financial independence early. Then locums.
        "Oh look another bajillion point declin-Ooooh!!! A coupon for pizza!!!!" <--- This is what everyone's IPS should be. ✓✓✓


        • #5
          Permanent/employed for 2 years, then locums if you want to wander.

          1) As these things tend to go, there are good odds that your personal situation will have changed.
          2) If I'm reading it right, when you factor in the benies/bonuses, you'll be making similar to locums, not even accounting for the loan kicker.


          • #6
            You are so close to PSLF. Cross that finish line and you get to keep 400K. It’s only 2 years away! Then do whatever you want. Just think of the “permanent” job as a 2 year locums gig.


            • #7
              “I immediately got another permanent job offer in Texas, and I signed the contract.”

              Think you got your answer on the money angle. Now the ethics shaming: You signed a contract!
              Just teasing. Take the job! Getting PSLF for that amount is bragging rights.