Know your number before you call back.

What's Inside

A complete assignment toolkit:

1. Rate Benchmark Database

   Outpatient internal medicine rates by state and setting — urban clinic and rural/FQHC — at the 25th, 50th, 75th, and 90th percentile. Fifty states. The number you need before you call the recruiter back.

2. Recruiter Call Scripts

   Word-for-word. The exact sentences:

   • The opening anchor when you've received a below-market offer
   • The patient volume cap script — define the daily ceiling before finalizing the rate
   • The subspecialty premium script — how to state that cardiology or nephrology training changes the rate tier
   • The APP supervision scope script — clarify co-signature expectations and liability before committing
   • The counter when they say "this is our standard clinic rate"
3. Outpatient IM Leverage Points

   The specific credentials and contract terms that determine your real compensation:

   • Daily patient volume cap is the most important clause in any outpatient IM contract — a $155/hr rate covering 30 patients per day is a fundamentally different arrangement than $155/hr covering 18 patients
   • Subspecialty training (cardiology, nephrology, endocrinology) commands a 10-20% premium at sites where your background reduces downstream referral costs
   • Procedure capability (joint injections, skin biopsies, stress tests) expands your eligible assignment pool and justifies a higher rate at sites that currently refer out
   • APP supervision scope is the most commonly undisclosed workload obligation — clarify how many NPs/PAs you co-sign for and whether supervision time is on top of your patient load
4. Contract Red Flag Checklist

   Daily patient volume not capped, APP supervision scope not disclosed, RVU productivity penalties embedded, procedure expectations undefined, charting and EMR template requirements not specified. One page, annotated. Open it while reviewing any contract.

5. Agency Markup Framework

   The math behind what the clinic actually pays for your coverage. Outpatient IM generates revenue through visit billing, chronic care management codes, and downstream referrals. When you know the approximate bill rate, "that's our maximum" means something different.

6. Locum Tax Framework

   The 1099 math: S-corp threshold, Solo 401(k) gap, and the minimum premium required to break even against a W-2 employed outpatient IM position — accounting for benefits, malpractice, and CME.

7. Licensing & Credentialing Roadmap

   The licenses, registrations, facility privileges, documents, start gates, and timelines required for the assignment.

8. From Signed Contract to Final Shift

   A specialty-specific first-shift gate, assignment escalation scripts, a stay/pause/leave framework, and a final-shift checklist.

What It Looks Like on the Call

When a recruiter quotes $140/hr for an outpatient IM clinic covering 25+ patients per day, this is the sentence from Section 2:

"The market median for outpatient internal medicine in this region is $152/hr. Before we discuss rate, I need to confirm the daily patient volume — I work to a cap of 20 patients per day, and I'd want that in writing. With my nephrology background and procedure capability, I'd expect to be in the $160-170 range. Can we structure it that way?"

You change the numbers to match your state. You say it. That is the product.

Who Built This

For years I took every rate I was offered without pushing back. Not because I was naive. I did not have the data to know whether I should. Neither did anyone I trained with.

I built the same rate model and negotiation framework across 22 physician specialties, then added the contract, credentialing, first-shift, and assignment protections I would want before accepting the work myself.

The agency has this organized. Now you do too.

— General Surgery MD

Built on Evidence, Written for the Call

The toolkit combines 50-state benchmark data, specialty-specific assignment research, current licensing and tax guidance, and 17 peer-reviewed negotiation sources. The research establishes the framework; the product gives you the number, language, and checklists to act on it.

What $99 Has to Do

One $10/hr improvement on one 10-hour shift covers the full price. One avoided unpaid hour can do the same. Every protected shift, corrected contract term, or future renewal comes after that.

One Honest Limitation

This will not help you if you are already negotiating above the 75th percentile for your specialty and state. If you don't know what percentile your current rate is, that is the problem this solves.

About the Data

Based on BLS OEWS public data and CMS geographic adjustment factors, processed through a locum-adjusted model, calibrated and validated against publicly posted rates and observations.