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For EM what pay difference per hour for nights and holidays vs regular shifts?

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  • For EM what pay difference per hour for nights and holidays vs regular shifts?

    If normal daytime shifts pay $200 per hour, what would you consider adequate for night shifts and major holidays? Was thinking around $220-225 would be OK. Is this on par with other hospitals? 12 room 15k volume with double coverage during the day. All EM board certified.

  • #2
    If you had the choice of working 8 nights or holidays, or 9 day shifts, which would you choose? Do you think there are many candidates that really want the first option?
    Not EM but that seems like a ridiculously low differential. Though it is better than my last employer which granted no differential at all.

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    • #3
      This is usually determined by the market within your group. If you're just trying to put a number on it without letting the market within the group decide then 15-25% is probably in a reasonable range to start.

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      • #4
        There has been no differential. Forming new group, so wanted to offer something. Rural area without many comperables. Just wanted to get some ideas of what others might offer. I guess $240-250 isn't out of line. Definitly would be of more incentive to take those unwanted shifts. Thanks for the input.

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        • #5
          $250-275 should do it. Depends on the productivity and RVU numbers if that if factored into compensation overall at the end of the year. And the age of the group members and family situations.

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          • #6
            If you form a partnership, you have to consider tax ramifications of how you compensate yourselves especially with regards to 199a

            guaranteed payments from a partnership is not QBI, analogous to salary in an S Corp

            distribution of income is QBI

            so you want a partnership agreement with language that minimizes guaranteed payments and maximizes distribution of income, so that you maximize QBI and QBI deduction

            have you discussed this with CPA and lawyer?
            my radiology group is hiring, pm if you can do msk and are interested

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            • #7
              Originally posted by jacoavlu View Post
              If you form a partnership, you have to consider tax ramifications of how you compensate yourselves especially with regards to 199a

              guaranteed payments from a partnership is not QBI, analogous to salary in an S Corp

              distribution of income is QBI

              so you want a partnership agreement with language that minimizes guaranteed payments and maximizes distribution of income, so that you maximize QBI and QBI deduction

              have you discussed this with CPA and lawyer?
              We have a group meeting coming up with the lawyer that is putting the agreement together. She is in contact with CPA to make sure it is the most tax efficient. I have the accounting books from the current group in had as well. That group will dissolve at the beginning of 2020.

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              • #8
                In the group I am familiar with, the doc who chooses to work all weekend nights, as in Saturday, Sunday and Monday overnight shifts every single week, gets paid an extra 80k per year. But she does fine "hiding" on nights. I don't think she would do all that well on days as she tends to get in trouble when there are administrative folks wandering around in the ED. She likes the nights because it keeps her out of trouble, and she likes the nights because it allows her to more easily pay tuition for her kids.

                Nocturnists are a special breed, and often they like/need to be on that graveyard shift because of their particular personalities. The ED group that I am most familiar with has 4 dedicated nocturnists, and they make life good for the rest of the group. As a result of the nocturninsts covering almost the entire schedule, the day docs have very few night shifts to work, maybe an average of one per month.

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                • #9
                  Shred, have you contacted the Democratic Group chapter at ACEP yet?

                  In our much bigger shop, the differential varies based upon supply/demand, but it is usually vicinity of $100/hr for overnights. Everybody pulls their share of holidays/weekends, I think primarily because nobody has the stomach to know, let alone pay, the differential required to work on Christmas.

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                  • #10
                    We get $30/hr extra for late shifts (4p-2a, 5p-3a) and $50/hr extra for overnights (9p-7a).

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                    • #11
                      Originally posted by G View Post
                      Everybody pulls their share of holidays/weekends, I think primarily because nobody has the stomach to know, let alone pay, the differential required to work on Christmas.
                      We have refined our holiday coverage policies over the years and have arrived at a system that works very well. For holidays among our various hospital based teams, we do both fair distribution along with generous extra pay. The extra pay comes in 3 grades.

                      If you work on Thanksgiving or Christmas in the ED, you get an extra $100/hr above the regular off hours rate. It ends up being around $300/hr in the ED, and a bit less for the hospitalists. You may be surprised, but at those rates we actually do get some people who request to work those holidays for various reasons, such as living far from family. After any volunteers, the remaining shifts are fairly and evenly distributed among the others.

                      We divide the holidays for fair distribution into 3 summer holidays and 3 end of year winter holidays. We further characterize holidays into three categories based on the desirability of being off to spend time with family. If I have to work on the holiday, the generous extra pay may take away some of the sting. For me personally, I do feel psychologically more accepting and happier on my holidays in the hospital knowing that the compensation is very generous.

                      Tier 1 holidays are paid like a regular weekend day:
                      Presidents Day
                      MLK Day

                      Tier 2 holidays: (single holiday differential)
                      Memorial Day
                      July 4
                      Labor Day
                      New Years Eve overnight and New Years Day day shift

                      Tier 3 holidays: (double holiday differential)
                      Thanksgiving day and night
                      Christmas eve and Christmas day, both day and night on both days

                      In any case, I thought I would share what we have found to work well for our various hospital based teams, and this has been applied with similar success across multiple specialties. Having happy docs who feel things are fair and equitable clearly makes for a more positive culture and helps fight against burnout.

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                      • #12
                        Looking into ACEP Dem group. We had a guy that only did nights. Unfortunately, admin wanted him to go after years of working there. There has been no differential for nights or holidays for 25 yrs. we want to change that. Appreciate all the input. Gives us some good ideas.

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