does a hospitalist or gastroenterologist get payed better?

[wrkndply]

Obviously the love of medicine and helping people are the motives but having said that and family, loans, work and all the other complexities life throws at you....does hospitalist or GI pay best? (private practice, not academic medicine)

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[aafisahar]

GI

 

[robellis]

Is this a joke? It’s not even close GI by a mile

 

[sevo00]

How are you a ten year member on sdn and still not know GI pays significantly better than hospitalist? I’ve known this since I was a premed in college

 

[DrMetal]

GI. But they have to deal with a lot sht!

 

[DrMetal]

How are you a ten year member on sdn and still not know GI pays significantly better than hospitality?

Actually, hospitality can pay well, especially if you know the right local services.

 

[obiwan]

Actually, hospitality can pay well, especially if you know the right local services.

A hospitalist practices hospitality medicine ...... trying to make everyone happy (patients, nurses, consultants, administration, billing/insurance)

 

[PrimaryCareDOToBe]

GI Makes more, however, it has a much longer fellowship to complete after IM Residency, and you work long hours.

I think if you do 7 on 12 hour shifts in a week as a hospitalist, that would be 168 hours a month.

GI Doctors probably work 9-5 In their office, but then are on call many nights, and then do procedures whether it colonoscopies, endoscopies, or emergent GI-related procedures (ERCP, Hepatic abscess drainages, etc. etc. etc.) - Let's assume they work 50-70 hours a week. That would be anywhere from 200-280 hours a month.

So, if let's say Hospitalist makes 265k, and Gastroenterologists make ~420k, this would mean that, and I know my math is probably very wrong here because im not including tax, vacations, or countless other factors, but:

Let's pretend all GIs work 240 hours a month - That's 2880 hours a year

Let's pretend all hospitalists work 168 hours a month - That's 2016 hours a year.

That would roughly mean GIs make about 145$/hr
That would roughly mean Hospitalists make about 131$/hr

So, while GIs do make more money per year, the hourly pay rates are not extremely extremely far off.

Furthermore, while the GI Fellow makes 70k-80k for 3 years after IM Residency, the Hospitalist is making the 240-260k for 3 years during that time.

So, hospitalist is not a bad gig, but, while the GI doc can slow down their practice as they get older while continuing to still rake it in because of a large patient pool, and you become more "Automatic" with your procedures and midlevels helping manage your acute things, your life becomes easier as you get older whereas a Hospitalist will always be expected to work at 100% capacity regardless because you have less autonomy being only hospital-based.

Plus, if you want to switch over to doing outpatient primary-care, you'll expect a pretty significant pay reduction until you work many years to get your patient roster up to where all the other docs are who have been doing it for years. In the long run, PCPs can make equivalent or more to a hospitalist due to upward mobility, but the $$/hr will be way less because PCPs work probably more like the GI doc's hours, but only make 93$/hr probably, if you consider many PCPs make 225k @ about 50 hours a week.

 

[Splenda88]

Obviously the love of medicine and helping people are the motives but having said that and family, loans, work and all the other complexities life throws at you....does hospitalist or GI pay best? (private practice, not academic medicine)

You can help people by becoming a social worker. I don't get why docs need to preface with the 'helping people' *** when asking about compensation. It's ok to make a good living after spending more than a decade of your life to learn your "craft".

Realistically, hospitalist/nocturnist can make 230k-350k, while GI docs can make 400-600k. However, we all know hospitalists who make 500k, but these people work their *** off.

 

[DrMetal]

And if you do do GI, please learn advanced (therapeutic) scopes. Why this is a sub-fellowship and not somehow built into the already long 3 year fellowship is beyond me (I know some places do have it built in). It's a PITA when your local GI doc can't do an ERCP and you have to transfer the patient out.

 

[end stage fibro]

GI Doctors probably work 9-5 In their office, but then are on call many nights, and then do procedures whether it colonoscopies, endoscopies, or emergent GI-related procedures (ERCP, Hepatic abscess drainages, etc. etc. etc.)

outside residency, i can count on maybe 1 or 2 fingers ive seen a GI come in overnight for a scope. Pt is either too sick and needs to be optimized with blood or not sick enough and can wait til morning. consider cta or nm scan.

abscess drainage is more like consult id/consult ir/pain per hospitalist. no scope indicated. kthxbye

 

[nolayup]

I see several GI job postings on NEJM for upwards of $700 K per year. Is that fairly attainable?

 

[rokshana]

My brother is GI and the bonus he lost last year due to covid was more than I made last year...GI

 

[robellis]

My brother is GI and the bonus he lost last year due to covid was more than I made last year...GI

So he makes 1M+?

 

[ShuperNewbie]

do do GI

nice

 

[GastriqueGraffin]

I see several GI job postings on NEJM for upwards of $700 K per year. Is that fairly attainable?

These are “potentials” usually. Meaning they’ll give you the opportunity to work for it by taking more call and having unattainable rvu for a sane person.

 

[rokshana]

So he makes 1M+?

No...about half that

lol...I’m an endocrinologist...not hard for a higher paying specialty to make my salary in a bonus!

 

[Nespresso]

To make GI level salary as a hospitalist, you pretty much have to work residency hours +. By residency hours I’m talking 80 hour work weeks clocked in with all things considered and about 4-6 weeks of vacation. The problem is most hospitalist gigs include the weekends so each stretch of work is pretty rough. It may be doable if you find gigs that are 40 weeks a year (not 7 on 7 off) that exclude weekends, just because we all know what burnout is going to feel like if we try to grind for that long.

 

[CCM-MD]

Most SDN hospitalists seem to make GI level income and are Warren Buffet type investors.

 

[Splenda88]

To make GI level salary as a hospitalist, you pretty much have to work residency hours +. By residency hours I’m talking 80 hour work weeks clocked in with all things considered and about 4-6 weeks of vacation. The problem is most hospitalist gigs include the weekends so each stretch of work is pretty rough. It may be doable if you find gigs that are 40 weeks a year (not 7 on 7 off) that exclude weekends, just because we all know what burnout is going to feel like if we try to grind for that long.

There is an SDN nocturnist (@tantacles) that makes GI salary (450k+/yr) working somewhat GI hours (19 12hrs -shift per month. ~55 hrs/wk).

MOD can delete my post if I violate the TOS by linking 'tantacles' to this thread...

 

[VA Hopeful Dr]

There is an SDN nocturnist (@tantacles) that makes GI salary (450k+/yr) working somewhat GI hours (19 12hrs -shift per month. ~55 hrs/wk).

MOD can delete my post if I violate the TOS by linking 'tantacles' to this thread...

Sure, but that's a combination of nocturnist and 5 more shifts than is the average. Heck, I'm only working 21 days this month and I'm full time outpatient.

 

[Splenda88]

Sure, but that's a combination of nocturnist and 5 more shifts than is the average. Heck, I'm only working 21 days this month and I'm full time outpatient.

It's actually 4 more shifts because FT hospitalist jobs are 15 days/month...

By the way, I wish I was ok with outpatient... Man, outpatient gigs with good schedule (M-Th) and benefits are easier to find...

 

[VA Hopeful Dr]

It's actually 4 more shifts because FT hospitalist jobs are 15 days/month...

By the way, I wish I was ok with outpatient... Man, outpatient gigs with good schedule (M-Th) and benefits are easier to find...

That's not always true, my wife was full time at 13.

 

[Splenda88]

That's not always true, my wife was full time at 13.

She probably was getting paid commensurately to her schedule like many places do right now. They pay a rate per day.

 

[PrimaryCareDOToBe]

Basically OP, to sum it up: GI pays more. But, as cheesy as this sounds, do what you love. If you really only love money and spending it but having less time to do anything with it, work your ass off and do something that'll make insane money. If you like medicine for medicine and save your money and are not a crazy bad spender, you'll be just fine with any salary 220k+ in most states, but not in most cities. The more expensive the city, the more money you'll need, but there are also ways to make things work.

Like, at the end of the day, there are primary care physicians living in apartments in San Fran and NYC. Sure, they probably dont make as much as someone in a rural area and their CoL is higher, but it all depends on what you want out of life. If you're okay with a 1200 sq. ft. apartment cuz you plan on being at the beach all day, thats your prerogative. I think before you even decide about how much money you want to make, you should really consider how much your lifestyle actually costs and what you realistically want out of life.

For me, I grew up with parents who, combined, made 105k. We were constantly paycheck to paycheck cuz they were paying off 3 student loans: My moms, my brothers, and mine, on top of supporting my older sister monthly. Sooo.... making 220k alone as a Generalist (my SO is also going to be a physician) so combined we'll make 350k+, sooo.... like, I know for a fact I will be 100% fine and happy with that. On the other hand, if your dad was Warren Buffet and your mom was Kim Kardashian, yeah, you may frown down on a measly 350k a year.

 

[DrMetal]

Basically OP, to sum it up: GI pays more. But, as cheesy as this sounds, do what you love.

So I should play golf and play guitar?

 

[nolayup]

So I should play golf and play guitar?

I certainly hope GI allows for more golf

 

[gutonc]

I certainly hope GI allows for more golf

You don't have the time to play as often. But you can afford to play Pebble Beach.

 

[DrMetal]

You don't have the time to play as often. But you can afford to play Pebble Beach.

I've never played Pebble, is a dream of mine! FWIW, hospitalists make plenty enough to play golf. I just dropped a grand on the new Ping G710s, they're wonderful. I also shoot in the low 70s (that's my SDN score at least).

 

[disorder]

FYI it's paid. Unless you're on a boat.

 

[Gastrapathy]

And if you do do GI, please learn advanced (therapeutic) scopes. Why this is a sub-fellowship and not somehow built into the already long 3 year fellowship is beyond me (I know some places do have it built in). It's a PITA when your local GI doc can't do an ERCP and you have to transfer the patient out.

Its a PITA for you but better for the patient. There are nowhere near enough cases for every GI to be competent at ERCP, let alone the remainder of advanced endoscopy. Complications from advanced endoscopic procedures can be catastrophic and there is a clear relationship between complication rates and volume.

 

[Calizboosted76]

And if you do do GI, please learn advanced (therapeutic) scopes. Why this is a sub-fellowship and not somehow built into the already long 3 year fellowship is beyond me (I know some places do have it built in). It's a PITA when your local GI doc can't do an ERCP and you have to transfer the patient out.

HA you said do do... Anybody? No. Okay.

Edit: Nvm someone beat me to it.

 

[DrMetal]

Its a PITA for you but better for the patient. There are nowhere near enough cases for every GI to be competent at ERCP, let alone the remainder of advanced endoscopy. Complications from advanced endoscopic procedures can be catastrophic and there is a clear relationship between complication rates and volume.

Shouldn't/couldn't there be a way to do basic scopes say in your first year of fellowship, then maybe advanced scopes (if you have the caseload, or go somewhere that does) during the 2nd/3rd years of fellowship? I just feel bad for these PGY6+ fellows who have to reapply and go through another GME cycle. Can't we just practice at some point?

GI is not the only guilty of this. Did you know there's a heart failure fellowship after Cardiology? What the hell do you learn about during the Cards fellowship?!?

We love to keep training, we'll be PGY12+ before we can practice. Meanwhile, NPs are running a muck in our clinics.

 

[Gastrapathy]

@DrMetal So that’s a separate issue than whether everyone should do ERCP in practice. I totally agree that 6 years is more than enough time to make a Gastroenterologist with any of the sub-subspecialties. Frankly, I think 5 years would be enough (2 years of IM, 3 of GI) but I’d cut a year off med school too. Everyone shouldn’t do EUS/ERCP, etc, but the folks who are interested and capable should be able to do it within a standard fellowship.

 

[Redpancreas]

Shouldn't/couldn't there be a way to do basic scopes say in your first year of fellowship, then maybe advanced scopes (if you have the caseload, or go somewhere that does) during the 2nd/3rd years of fellowship? I just feel bad for these PGY6+ fellows who have to reapply and go through another GME cycle. Can't we just practice at some point?

GI is not the only guilty of this. Did you know there's a heart failure fellowship after Cardiology? What the hell do you learn about during the Cards fellowship?!?

We love to keep training, we'll be PGY12+ before we can practice. Meanwhile, NPs are running a muck in our clinics.

I imagine the perspective is different depending on where we all trained. Within HF, there's a ton of nuances in terms of transplant medications, assist devices, etc. The field of Cardiology is huge now with tons of options. I feel bad for that too, but at the end of the day, what matters most is patient safety and currently I guess people don't feel safe having general cardiologists do advanced HF management.

 

[DrMetal]

@DrMetal So that’s a separate issue than whether everyone should do ERCP in practice. I totally agree that 6 years is more than enough time to make a Gastroenterologist with any of the sub-subspecialties. Frankly, I think 5 years would be enough (2 years of IM, 3 of GI) but I’d cut a year off med school too. Everyone shouldn’t do EUS/ERCP, etc, but the folks who are interested and capable should be able to do it within a standard fellowship.

What do you think about the other important question posed in this silly thread: Golf, who has a better aptitude for it? The GI who makes more money but maybe has less time, or the Hospitalist who makes less money and maybe has more time?

 

[DrMetal]

but at the end of the day, what matters most is patient safety and currently I guess people don't feel safe having general cardiologists do advanced HF management.

Gosh, we're all concerned about patient safety , I guess . . . .

It's a crazy time in medicine, when/where we don't feel safe with a cardiologist managing HF (even advanced). Let's get Jesus Christ himself to come down and manage it, maybe then we'd feel better.

I know: let's make a sub-fellowship for every chamber/valve of the heart. A regular cardiologist shouldn't be managing Afib. It should only be done by a sub-sub-sub fellowship trained physician who's board certified in "Left-Atrial-mitral valvology".

This phenomena of extensive training for everything, what I like to call "hypertrainemia" (yes I came up with that myself)---is contributing to the demise of the physician. Of course it makes sense in some instances (advanced procedures), but not so much in other fields. We have to just accept some level of OJT. If we don't, we never get out to the workforce (or we're delayed), and the medical industrial complex finds another solution (like NPs rounding on HF patients in hospital!).

 

[nolayup]

What do you think about the other important question posed in this silly thread: Golf, who has a better aptitude for it? The GI who makes more money but maybe has less time, or the Hospitalist who makes less money and maybe has more time?

I'd say the hospitalist with more time. I routinely smoke my attendings on the course. Trying to get back to playing more often post fellowship. Looking in to joining a decent country club. Ideally, trying to have a golf themed man cave with a launch monitor. Those PINGS are pretty sweet!

 

[Splenda88]

@DrMetal So that’s a separate issue than whether everyone should do ERCP in practice. I totally agree that 6 years is more than enough time to make a Gastroenterologist with any of the sub-subspecialties. Frankly, I think 5 years would be enough (2 years of IM, 3 of GI) but I’d cut a year off med school too. Everyone shouldn’t do EUS/ERCP, etc, but the folks who are interested and capable should be able to do it within a standard fellowship.

While we are at it, undergrad should not be a de facto requirement.

It should be prereqs + 3 yr med school + 2-6 yrs residency

 

[DrMetal]

I'd say the hospitalist with more time. I routinely smoke my attendings on the course. Trying to get back to playing more often post fellowship. Looking in to joining a decent country club. Ideally, trying to have a golf themed man cave with a launch monitor. Those PINGS are pretty sweet!

They are pretty sweet, it's amazing the technology these days. I'm still a double digit handicap, bogey kinda guy on most holes, I need to learn how to putt! I'm lucky to be in SoCal . . . year round golf!

 

[aafisahar]

Gosh, we're all concerned about patient safety , I guess . . . .

It's a crazy time in medicine, when/where we don't feel safe with a cardiologist managing HF (even advanced). Let's get Jesus Christ himself to come down and manage it, maybe then we'd feel better.

Advanced heart failure isn't your standard patient who forgot to take his lasix for a couple weeks. It's not patients who need a touch of dobutamine or milrinone to diurese. Hospitalists/cardiologists can take care of those patients. Advanced heart failure is about taking a patient with a crap heart and putting them into a spot where they can get a transplant or LVAD. And most places, the specialists in cardiomyopathy (eg genetic, infiltrative, inflammatory) are advanced heart failure doctors.

Most of us can do most of heart failure, but none of us can sit on the transplant committee and select patients without advanced heart failure training.

 

[DrMetal]

Advanced heart failure isn't your standard patient who forgot to take his lasix for a couple weeks. It's not patients who need a touch of dobutamine or milrinone to diurese. Hospitalists/cardiologists can take care of those patients. Advanced heart failure is about taking a patient with a crap heart and putting them into a spot where they can get a transplant or LVAD. And most places, the specialists in cardiomyopathy (eg genetic, infiltrative, inflammatory) are advanced heart failure doctors.

Most of us can do most of heart failure, but none of us can sit on the transplant committee and select patients without advanced heart failure training.

Well, there's no doubt in my mind that advanced HF/transplant should require more training. What I wonder/question is, do we need a different fellowship for it? Same question can be posed for a lot of different things. Can't it be done during the 3rd year of a regular Cards fellowship? Or what about the general cardiologist who's already practicing and develops the interest; can't she find a way to get trained up in HF/transplant in the form of an apprenticeship/OJT (call it what you will)? Does she really need to leave her practice, forfeit her income, change her geography, reapply for another GME cycle for a 1-year fellowship?

If we want to save our profession, we need to stop glorifying every subject with its own fellowship/BC. We need to find a way to train on the job, and we need to enter the workforce sooner. We spend too much time in education and training. If med school were only 3 years (could totally be done), and IM residency only 2 (for the strong resident, and the one we know is going into fellowship), and Cards is 3 years (including any sup-specialty topic) = 8 years (instead of 11). That delta of 3 years = $1 million bucks in salary (nice for you), and that's 3 years sooner we can get you practicing.

We need this paradigm shift in medicine or we're dead in the water.

 

[Splenda88]

Well, there's no doubt in my mind that advanced HF/transplant should require more training. What I wonder/question is, do we need a different fellowship for it? Same question can be posed for a lot of different things. Can't it be done during the 3rd year of a regular Cards fellowship? Or what about the general cardiologist who's already practicing and develops the interest; can't she find a way to get trained up in HF/transplant in the form of an apprenticeship/OJT (call it what you will)? Does she really need to leave her practice, forfeit her income, change her geography, reapply for another GME cycle for a 1-year fellowship?

If we want to save our profession, we need to stop glorifying every subject with its own fellowship/BC. We need to find a way to train on the job, and we need to enter the workforce sooner. We spend too much time in education and training. If med school were only 3 years (could totally be done), and IM residency only 2 (for the strong resident, and the one we know is going into fellowship), and Cards is 3 years (including any sup-specialty topic) = 8 years (instead of 11). That delta of 3 years = $1 million bucks in salary (nice for you), and that's 3 years sooner we can get you practicing.

We need this paradigm shift in medicine or we're dead in the water.

Our GME president raised that question ~2 yrs ago, but he was talking mostly about primary care. He is a Med-Peds trained. He said based on his experience, over 90% of IM/FM/Peds are "safe" to practice medicine on their own after PGY2 year. He said he thinks they would learn much more in their first year of attending-hood than a PGY3 year. We were shocked when he said that. It's kind of refreshing to see a very few in academia get it.

 

[DrMetal]

Our GME president raised that question ~2 yrs ago, but he was talking mostly about primary care. He is a Med-Peds trained. He said based on his experience, over 90% of IM/FM/Peds are "safe" to practice medicine on their own after PGY2 year. He said he thinks they would learn much more in their first year of attending-hood than a PGY3 year. We were shocked when he said that. It's kind of refreshing to see a very few in academia get it.

It's an interesting idea that I think we should explore. There could be rules of course. For instance, the strong resident should be allowed to apply for fellowship as a PGY2; if he gets it, let him forgo the 3rd year of IM res, go straight to fellowship. The weak resident should complete the pgy3 year, or the resident intending to do just general IM should do the full 3 years, etc etc. We can define it and set rules, need not be one-size-fits-all.

Now, whether the mafia ABMS would agree with it (with respect to board certification), I dunno . . . that's a separate issue. But I'm also of the opinion that we should get rid of BC! (I have lots of crazy ideas).

 

[collegestud2013]

The salary difference between GI and hospitalist might be large but just looking at the absolute numbers, in reality it's a lot smaller once you factor in:
1) GI requires 3 years of additional training - a hospitalist can make nearly an additional $1 million in that time over the 3 years of being paid as a fellow, and a lot of that can be invested a bit earlier which further adds to the benefits of investing earlier.
2) taxes - once you're in the 37%+ tax bracket, even an additional $100-200k in additional income is not nearly as much as it looks post-tax. And with the current Biden administration set to raise the top tax bracket the post-income tax difference will only smaller. And even smaller if you live in a state with high state income taxes.
3) GI in PP works longer hours than your standard 7 on 7 off hospitalist (which comes out to about 2148 hrs per year), On a per hour basis GI still makes a bit more on average.
4) practice ownership vs employed - the GI docs on the higher end are usually have some time of practice ownership and are not just strictly employees. If you exclude those and only compare employed GI vs employed hospitalists, the difference will be smaller. However, one of the limitations of hospitalist job market right now is that most jobs currently are strictly as employee and there aren't many partnership jobs, which is probably a limiting factor in most hospitalist income.

 

[collegestud2013]

To make GI level salary as a hospitalist, you pretty much have to work residency hours +. By residency hours I’m talking 80 hour work weeks clocked in with all things considered and about 4-6 weeks of vacation. The problem is most hospitalist gigs include the weekends so each stretch of work is pretty rough. It may be doable if you find gigs that are 40 weeks a year (not 7 on 7 off) that exclude weekends, just because we all know what burnout is going to feel like if we try to grind for that long.

Not necessarily. The other option for a hospitalist is to see more patients per shift. For example, if one saw 30 patients per shift, at the current Medicare reimbursement rate of of approximately $54 per wRVU and a typical average of 1.8 rRVU per patient, that would equal to $530k a year doing the standard 7-on 7 off (which comes out a182 shifts a year) and assuming you're working at a place that pays you in line with the RVUs you generate. This is on the higher end for most hospitalists these days, but then again 30 patients per shift is higher than what most hospitalists are comfortable seeing and covering independently, but of course you can get a midlevel or residents (if at a teaching service) to help with coverage if one attending is covering that many patients.

 

[collegestud2013]

GI Makes more, however, it has a much longer fellowship to complete after IM Residency, and you work long hours.

I think if you do 7 on 12 hour shifts in a week as a hospitalist, that would be 168 hours a month.

GI Doctors probably work 9-5 In their office, but then are on call many nights, and then do procedures whether it colonoscopies, endoscopies, or emergent GI-related procedures (ERCP, Hepatic abscess drainages, etc. etc. etc.) - Let's assume they work 50-70 hours a week. That would be anywhere from 200-280 hours a month.

So, if let's say Hospitalist makes 265k, and Gastroenterologists make ~420k, this would mean that, and I know my math is probably very wrong here because im not including tax, vacations, or countless other factors, but:

Let's pretend all GIs work 240 hours a month - That's 2880 hours a year

Let's pretend all hospitalists work 168 hours a month - That's 2016 hours a year.

That would roughly mean GIs make about 145$/hr
That would roughly mean Hospitalists make about 131$/hr

So, while GIs do make more money per year, the hourly pay rates are not extremely extremely far off.

Furthermore, while the GI Fellow makes 70k-80k for 3 years after IM Residency, the Hospitalist is making the 240-260k for 3 years during that time.

So, hospitalist is not a bad gig, but, while the GI doc can slow down their practice as they get older while continuing to still rake it in because of a large patient pool, and you become more "Automatic" with your procedures and midlevels helping manage your acute things, your life becomes easier as you get older whereas a Hospitalist will always be expected to work at 100% capacity regardless because you have less autonomy being only hospital-based.

Plus, if you want to switch over to doing outpatient primary-care, you'll expect a pretty significant pay reduction until you work many years to get your patient roster up to where all the other docs are who have been doing it for years. In the long run, PCPs can make equivalent or more to a hospitalist due to upward mobility, but the $$/hr will be way less because PCPs work probably more like the GI doc's hours, but only make 93$/hr probably, if you consider many PCPs make 225k @ about 50 hours a week.

The PCPs that make the average or lower salaries are either those that only take insurance or those that work in academics or VA/government. Our current health system doesn't really value PCPs from a reimbursement perspective and they make less because insurance pays them relatively low for the amount of time work they do. However, those that take cash and have a good patient volume can make the true market rate of what patients are willing to pay for primary care, and often make similar to the typical specialist salary of $400-$500k per year and while seeing less patients than their colleagues that only take insurance. Taking cash is very efficient since not only can you charge the true market value of your services but often overhead billing and coding costs are much lower when taking cash than insurance.

 

[CCM-MD]

Not necessarily. The other option for a hospitalist is to see more patients per shift. For example, if one saw 30 patients per shift, at the current Medicare reimbursement rate of of approximately $54 per wRVU and a typical average of 1.8 rRVU per patient, that would equal to $530k a year doing the standard 7-on 7 off (which comes out a182 shifts a year) and assuming you're working at a place that pays you in line with the RVUs you generate. This is on the higher end for most hospitalists these days, but then again 30 patients per shift is higher than what most hospitalists are comfortable seeing and covering independently, but of course you can get a midlevel or residents (if at a teaching service) to help with coverage if one attending is covering that many patients.

Lol.

 

[sloh]

The PCPs that make the average or lower salaries are either those that only take insurance or those that work in academics or VA/government. Our current health system doesn't really value PCPs from a reimbursement perspective and they make less because insurance pays them relatively low for the amount of time work they do. However, those that take cash and have a good patient volume can make the true market rate of what patients are willing to pay for primary care, and often make similar to the typical specialist salary of $400-$500k per year and while seeing less patients than their colleagues that only take insurance. Taking cash is very efficient since not only can you charge the true market value of your services but often overhead billing and coding costs are much lower when taking cash than insurance.

Is this not similar to or what DPC is? AFAIK, most DPC docs do not make 400-500k per year

 

[WheezyBaby]

Not necessarily. The other option for a hospitalist is to see more patients per shift. For example, if one saw 30 patients per shift, at the current Medicare reimbursement rate of of approximately $54 per wRVU and a typical average of 1.8 rRVU per patient, that would equal to $530k a year doing the standard 7-on 7 off (which comes out a182 shifts a year) and assuming you're working at a place that pays you in line with the RVUs you generate. This is on the higher end for most hospitalists these days, but then again 30 patients per shift is higher than what most hospitalists are comfortable seeing and covering independently, but of course you can get a midlevel or residents (if at a teaching service) to help with coverage if one attending is covering that many patients.

Lol.

I'd rather have a monkey do cscopes all day on me with a barbed wire baseball bat than have a daily census of 30 as a hospitalist day in day out.