flipmd

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base salary of around 250k/yr, working 14, 12 hour shifts per month . . .

I'll let you do the math
That's pretty generous for base from my experience. I've seen mostly 180K - 230K base, plus you'll get anywhere from 15K - 30K in productivity. If you go rural, might get 250K base, plus bonuses. But these are places where you're pretty much THE guy for everything.
 
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jdh71

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That's pretty generous for base from my experience. I've seen mostly 180K - 230K base, plus you'll get anywhere from 15K - 30K in productivity. If you go rural, might get 250K base, plus bonuses. But these are places where you're pretty much THE guy for everything.
define "rural" heh

PLENTY of good size places to live that most of you, for whatever reason, seem to be to good for that are paying a BASE of 250k.

Want to live in San Diego? Then do the math at 180k.
 
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14 12 hour shifts in one month is the equivalent of 168 hours worked in one month.

Lets just assume a base salary of $190,000.

That's $1130.95/hr.

Did I do something wrong, or is that how much they really make per hour?
 

jdh71

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Really? I make more than that (per shift) moonlighting and haven't had an admission or actually had to lay eyes on a patient in 5 straight shifts (but I only do it 2-3x/month, not half the month).
Yeah. If that's a 12 hour shifts someone got kind of a ****ty contract. I make 170/hr moonlighting as a hospitalist (200/hr when they are desperate).
 
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MedicineDoc

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Locums is going to be higher than permanent but you have to pay your own taxes and you pay both the employer and employee Medicare taxes as a 1099. If you make the deal with the hospital cutting out the Locums agency you can get the higher figure but you don't have the Locums agency trying to keep you steadily employed and you have to work out the malpractice with tail coverage if the hospitals not giving you either malpractice or tail.
 
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jdh71

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Locums is going to be higher than permanent but you have to pay your own taxes and you pay both the employer and employee Medicare taxes as a 1099. If you make the deal with the hospital cutting out the Locums agency you can get the higher figure but you don't have the Locums agency trying to keep you steadily employed and you have to work out the malpractice with tail coverage if the hospitals not giving you either malpractice or tail.
I'm getting that kind of money I described as an "employed moonlighter", taxes are taken out and paid, and I've got malpractice with tail.

Some of you guys aren't getting the best deals it appears.
 
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MedicineDoc

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Then they probably just figured if they had someone in house that they wouldn't mess with the expense and time of a Locums agency because that's the kind of money that comes from cutting out the Locums agency. It's going to be different at each hospital. It may also be taking into account your critical care background.
 
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Bostonredsox

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I got a lot of money up front, during residency, when I needed it. When you factor that in my 2 years average around 240k each with benefits and malpractice. Not the best but not the worst for first gig out of residency.
 

flipmd

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There's an SHM survey somewhere out there 2012. It's under a paywall now but I was able to see it awhile back. 250K is definitely not average, but on the higher end. I do have some colleagues though that moonlight in urgent care clinics 4-5 days of their week off, and pull down 100-200K more, depending on how crazy they are.

Also, moonlighting/locums doesn't have benefits (health insurance, 401k matching, etc). That's why it pays higher.

Yeah, maybe I over-emphasized rural. Midsize city would probably net you 230 base or so, but 250 base I think is still pretty rare except in the boonies, or they work you to death.
 
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obiwan

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There's an SHM survey somewhere out there 2012. It's under a paywall now but I was able to see it awhile back. 250K is definitely not average, but on the higher end. I do have some colleagues though that moonlight in urgent care clinics 4-5 days of their week off, and pull down 100-200K more, depending on how crazy they are.

Also, moonlighting/locums doesn't have benefits (health insurance, 401k matching, etc). That's why it pays higher.

Yeah, maybe I over-emphasized rural. Midsize city would probably net you 230 base or so, but 250 base I think is still pretty rare except in the boonies, or they work you to death.
you can get 250 base here in the metroplex with a reasonable schedule
 

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you can get 250 base here in the metroplex with a reasonable schedule
In the state I'm in, you can get that as well for base for a hospitalist position. In places like Tx, you can also get 250-300k starting up. In addition, if you look at surveys like Merrit Hawkins, the avg hospitalist salary listed is 250k. It came out in Dec. of last year I think. Given the huge demand, many places have increased hospitalist salaries tremendously. If you go to the boonies, you can make great $ as a hospitalist. In a large city obviously less. But 250k is certainly not very "crazy" these days.
 

MedicineDoc

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I worked close to 30 twelve hr shifts last month. Not saying I plan on doing that every month but I'm not even going to post what that would work out to per yr.
 

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I worked close to 30 twelve hr shifts last month. Not saying I plan on doing that every month but I'm not even going to post what that would work out to per yr.
ive seen hospitalists fresh out of residency pull this off for a few yrs before going into private practice:

20 shifts x 12 hourseach x 120perhour x 12 months=$345,600 gross salary
 
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donkeykong1

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makes one double think fellowship
 
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donkeykong1

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I had an attending do a 25 shift month last year, 15 at our place, moonlighting another 10 at a sister hospital about 2 hours away. He cleared 45k that month.
how does moonlighting work exactly? do docs just call up HR at these hospitals ask for shifts on days they're off
 

bronx43

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I had an attending do a 25 shift month last year, 15 at our place, moonlighting another 10 at a sister hospital about 2 hours away. He cleared 45k that month.
I can see myself doing that for 1 year max. I can pay off all loans, then I would go back to fellowship. Hospitalist is not a sustainable lifestyle, unless you're at a chill place. The high paying gigs work you to the bone.
 

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Ok, twist: let's project about 2 yr from now, as a PGY2 with an independent license moonlighting a couple shifts a month on a busy inpatient service in a semi-rural hospital where I've previously worked as a PA...(not hospitalist but EM--and they're hinting they want me back on the hospitalist team when I'm done...) ??appropriate hourly rate at this level?
 

didiee

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too many apples and oranges....

150/hr as locum right now. Most people around me 125/hr as locum.
My counter parts (full time) at the hospital. 90/hr X 1.5 for night + production.

You can do the math, for whatever hours you want.

you guys arent factoring vacation, CME, bonus, insurance.... etc.

Patient encounters and admissions #'s are also important.
Location, location and location........
 

nope80

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I'm wondering what the long term prospects are of being a hospitalist. Is there any "upward mobility"? Does ones career/salary 5 yrs in, 10yrs in vary than in the beginning? If one is an outpatient doctor, its different because you are building your practice but with hospitalist such a concept doesnt exist.

Also, if one would like to pursue one of these jobs, how far in advanced should you start looking and what is the best way to look?
 

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In my opinion the Hospitalist path can be an awesome career option, for the right person. After college, medical school and residency I decided enough was enough. I saw fellowship as an unnecessary hurdle that a lot of residents probably pursue just out of external pressure from others (peers, family, etc.)

If you are a single male in internal medicine this is probably the best career option. I don't care how hard I work for 7 days; I then have 7 CONSECUTIVE days off. You have to realize that having 1 to 2 days off every week is much different than having uninterrupted blocks of time off. This affords you the time to actually do other things. Travel, further education, etc.

To answer previous questions:

1. There are upward mobility options. Some senior hospitatlists in my group are involved in administrative work. If you are in an academic center, there are several upward mobility options.

2. My salary will be going up with the harder I work.

3. Moonlighting options are limitless.

4. Locums options are limitless.
 
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gutonc

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Is there 40 hrs wk hospitalist for Older docs ?
Not exactly, but it's easier to find (or make) a shared/PT hospitalist position than most other specialties. I have several friends who work 0.5 - 0.8 FTE as hospitalists which works out to 3-5 days/14. There are also some sweet nocturnist gigs out there. Our VA, which pays its hospitalists pretty well, considers 10 shifts/month a 1.0 FTE if you only work nights. Most of the people I know who do this work 10 straight and then have 3 weeks in a row off.
 
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Not exactly, but it's easier to find (or make) a shared/PT hospitalist position than most other specialties. I have several friends who work 0.5 - 0.8 FTE as hospitalists which works out to 3-5 days/14. There are also some sweet nocturnist gigs out there. Our VA, which pays its hospitalists pretty well, considers 10 shifts/month a 1.0 FTE if you only work nights. Most of the people I know who do this work 10 straight and then have 3 weeks in a row off.
Do you think this is a sustainable career? Do you thinka person could practice as a hospitalist for 30 yrs?
 

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base salary of around 250k/yr, working 14, 12 hour shifts per month . . .

I'll let you do the math
I ve heard of 1 or 2 docs doing this... but during your week off you could go work somewhere else (clinic, urgent care, ER if its rural, another hospitalist gig)... and come close to doubling that??

My mom's friend who works as a hospitalist does this and she pulled close to $400K last year... shes applying to nephro fellowships now after a few years working as a hospitalist and is really considering if its even worth it to her to go back to fellowship..
 

nope80

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I ve heard of 1 or 2 docs doing this... but during your week off you could go work somewhere else (clinic, urgent care, ER if its rural, another hospitalist gig)... and come close to doubling that??

My mom's friend who works as a hospitalist does this and she pulled close to $400K last year... shes applying to nephro fellowships now after a few years working as a hospitalist and is really considering if its even worth it to her to go back to fellowship..
Interesting, but why go into nephro fellowship with such a great salary and lifestyle. From what I understand nephros have a hard time finding a job now out of fellowship...
 

nope80

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This is really interesting - I was thinking about the combo of hospitalist/outpatient the other day and how it may be a great career option for some. I have never heard of it been done though - have others seen this done?

Would you work for a hospitalist group and then see patients in the outpatient on your off weeks? Or would you see patients as a hospitalist on behalf of your outpatient group, being given hospital privileges by the given hospital? Any insight on this would be helpful.
 

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Interesting, but why go into nephro fellowship with such a great salary and lifestyle. From what I understand nephros have a hard time finding a job now out of fellowship...
Exactly... thats why she was contemplating if it was even worth doing a fellowship in anything these days..

A lot of what I ve read and people I ve spoken to points towards hospitalists jobs becoming more difficult to get in the future.. in some big cities or desirable locations many of the hospitalists have actually done fellowships but chose to do hospitalist work... seems like you may need a fellowship to make yourself more competitive for a hospitalist job...
 

nope80

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Exactly... thats why she was contemplating if it was even worth doing a fellowship in anything these days..

A lot of what I ve read and people I ve spoken to points towards hospitalists jobs becoming more difficult to get in the future.. in some big cities or desirable locations many of the hospitalists have actually done fellowships but chose to do hospitalist work... seems like you may need a fellowship to make yourself more competitive for a hospitalist job...
Whaaaat?! Need a fellowship to make yourself competitive....never heard this before
 
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This is really interesting - I was thinking about the combo of hospitalist/outpatient the other day and how it may be a great career option for some. I have never heard of it been done though - have others seen this done?

Would you work for a hospitalist group and then see patients in the outpatient on your off weeks? Or would you see patients as a hospitalist on behalf of your outpatient group, being given hospital privileges by the given hospital? Any insight on this would be helpful.
Lol, why wouldn't you just work 25 shifts a month as a hospitalist? If you really want more money just work more shifts.

What would you work, 84 hrs one week, 50 hrs the next week? Sounds like a recipe for burnout.
 

nope80

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Lol, why wouldn't you just work 25 shifts a month as a hospitalist? If you really want more money just work more shifts.

What would you work, 84 hrs one week, 50 hrs the next week? Sounds like a recipe for burnout.
Maybe not quite that many hrs... But I was thinking it would mix things up and furthermore, you wouldn't loose either skill. You could use hospital base to build up an outpt practice too
 

NRAI2001

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Lol, why wouldn't you just work 25 shifts a month as a hospitalist? If you really want more money just work more shifts.

What would you work, 84 hrs one week, 50 hrs the next week? Sounds like a recipe for burnout.
Because some places are strict with their 1 week on and 1 week off... you cant just pick up shifts willy nilly.. some docs actually have 2 hospitalist jobs at separate hospitals in my area... I guess it depends on the region and hospital.. but most of the hospitalists from my town are pretty happy with their jobs and dont seem to be burning out much.. but I m from a medium sized semi-rural area.
 

NRAI2001

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Whaaaat?! Need a fellowship to make yourself competitive....never heard this before
Not required... but many hospitals in "desirable" locations or cities know there are a lot of nephro/ID/CC/pulm guys out there that have trouble finding jobs that use to pay as much as they did in the past.. a lot of these guys realize they can make more being a hospitalist... obviously a nephrologist will be able to market themselves much better than just a IM grad.. from what I hear some of the hospitals in NYC,Boston, LA....etc half of their hospitalists have done fellowship.
 

Bostonredsox

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Not required... but many hospitals in "desirable" locations or cities know there are a lot of nephro/ID/CC/pulm guys out there that have trouble finding jobs that use to pay as much as they did in the past.. a lot of these guys realize they can make more being a hospitalist... obviously a nephrologist will be able to market themselves much better than just a IM grad.. from what I hear some of the hospitals in NYC,Boston, LA....etc half of their hospitalists have done fellowship.
I have yet to meet a pulm/cc or IM/cc having any trouble finding a job.

Pulm/CC is making >2k/shift most places I have looked.

I do no some nephron people doing hospitalist work, mostly because they like shift work and frankly, there is a lot of nephrology in inpatient IM. Or they are in high profile areas where there aren't as many jobs or the available jobs work you like a dog.

ID this may be the case as the pay in ID has always been poor compared with other IM specialities.
 

flipmd

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Not required... but many hospitals in "desirable" locations or cities know there are a lot of nephro/ID/CC/pulm guys out there that have trouble finding jobs that use to pay as much as they did in the past.. a lot of these guys realize they can make more being a hospitalist... obviously a nephrologist will be able to market themselves much better than just a IM grad.. from what I hear some of the hospitals in NYC,Boston, LA....etc half of their hospitalists have done fellowship.
I don't know about this. Most hospitals I know are looking for hospitalists long term. I would imagine if you have a fellowship, that you're only being a hospitalist as a stop-gap measure, and would bolt once there's a pulmcc/renal position open. ID makes sense, don't think they ever get that much even though there's tons of positions open.
 

robin082006

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Depending on location.

My full time rate is 1100/12 hour shift (night and day has the same rate).

My locum rate: 140 / 12 hour day shift and 150 /12 night shift.

In LA or Orange County, California, the market is saturated. Many specialists are doing as hospitalists. I knew at least 2 BC Critical/Pulmonary guys are doing as hospitalista in Orange County. I met them and told them if they have pulmonary/critical cases, I am happy to be primary attending and they are consultants but they never give me any patients. They are on ER panel internal medicine almost daily.
 
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Not required... but many hospitals in "desirable" locations or cities know there are a lot of nephro/ID/CC/pulm guys out there that have trouble finding jobs that use to pay as much as they did in the past.. a lot of these guys realize they can make more being a hospitalist... obviously a nephrologist will be able to market themselves much better than just a IM grad.. from what I hear some of the hospitals in NYC,Boston, LA....etc half of their hospitalists have done fellowship.
I am not so sure about this statement. I can only speak from experience but I know exactly ONE hospitalist in NYC that has a fellowship (ID). My program has at least 30 on staff and I know many other hospitalists from adjacent hospitals. Most are either stop gap younger people applying for fellowship, people with families that need the money or IMGs that need a visa.
 
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