Does a hospitalist really work 7 on, 7 off and make 150-170k plus bonuses?

[Saladin MD]

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I've read a few threads on this topic. It seems that if you become a hospitalist, you can make 150-170k plus bonuses, working 7 days on and 7 days off.

But when I talked to a couple residents in real life, they said that there is a lot of fine print and that in the end the hospitalists "work like dogs" and get like 140k. One of the residents I talked to said IM is "one of the worst". He is currently in IM and unhappy.

I'm pretty sure that these residents have an axe to grind, but I just wanted to get feedback on this. I understand that you would work "like a dog" in the 7 days on, but isn't that great if you get 7 days off? I'd rather have that than 8-5 every work day for the whole year. I'd just look forward to my off week all the time, and that off week would let me pursue my hobbies.

So anyways, I'm opening this up to the floor. Is it true that you can get 150-170k plus bonuses working only 7 days on and getting 7 days off? Is there something I am missing here?

 

[Tigerz_Fan]

I've read a few threads on this topic. It seems that if you become a hospitalist, you can make 150-170k plus bonuses, working 7 days on and 7 days off.

But when I talked to a couple residents in real life, they said that there is a lot of fine print and that in the end the hospitalists "work like dogs" and get like 140k. One of the residents I talked to said IM is "one of the worst". He is currently in IM and unhappy.

I'm pretty sure that these residents have an axe to grind, but I just wanted to get feedback on this. I understand that you would work "like a dog" in the 7 days on, but isn't that great if you get 7 days off? I'd rather have that than 8-5 every work day for the whole year. I'd just look forward to my off week all the time, and that off week would let me pursue my hobbies.

So anyways, I'm opening this up to the floor. Is it true that you can get 150-170k plus bonuses working only 7 days on and getting 7 days off? Is there something I am missing here?

Yup, it's true. Sometimes the schedules vary (see the other thread). Everything really depends on the group you join. Some will have unlimited bonuses, and others with a cap. +/- signing bonus, malpractice usually covered, sometimes tail coverage.

I have several friends who are hospitalists right now, and they say it is hard work. Most of the time it is no different than being a resident. The schedule is bard to beat, so that is why many keep doing it. A couple of people I know have used it as a bridge when reapplying for competitive fellowships.

If you're interested, do a job search for hospitalists. They are posted on websites like practicematch.com, even monster and yahoo hotjobs. It will give you an idea of what is out there.

 

[mercaptovizadeh]

Yup, it's true. Sometimes the schedules vary (see the other thread). Everything really depends on the group you join. Some will have unlimited bonuses, and others with a cap. +/- signing bonus, malpractice usually covered, sometimes tail coverage.

I have several friends who are hospitalists right now, and they say it is hard work. Most of the time it is no different than being a resident. The schedule is bard to beat, so that is why many keep doing it. A couple of people I know have used it as a bridge when reapplying for competitive fellowships.

If you're interested, do a job search for hospitalists. They are posted on websites like practicematch.com, even monster and yahoo hotjobs. It will give you an idea of what is out there.

So the idea is work an 80 hour week like a dog/resident one week, then don't work the next?

 

[gutonc]

Hours, workload and pay are clearly quite variable and will have a lot to do with the group you join and the setting (academic, community, large, small, etc). I have former residency classmates in 4 different groups in town.

The pay runs in the range being discussed here, some a little more, some with bonuses. The schedules vary from 5-on/5-off to 7-on/7-off to 15 shifts a month (including some swings and nights). Two of the groups hire moonlighters to cover all the nights (which can be picked up by the group members if they want) and two hire moonlighters to help on weekends but group members cover nights, one of them is looking to hire FT nocturnists to cover all nights. Patient load caps vary from 10-16 patients which includes both primary patients and consults on surgical services. Patient complexity varies according to the hospital. At the university hospital, they tend to be pretty complex while at the community hospitals you tend to get a mix of single-problem patients and some more complex patients. And one of the hospitals has an open ICU with CC attendings acting as consultants on patients in the ICU.

As far as working like a dog/resident, once you're out there doing things on your own without students/interns/attendings to slow you down, you tend to get more efficient so dealing with 10-15 patients is a little easier than it was in residency. Of course, one crashing patient can ruin your (not to mention their) whole day.

There are pluses and minuses to all jobs, including being a hospitalist. But an IM residency is great preparation for it and if you liked the work you did on your inpatient months, it could be a good gig for you.

 

[radslooking]

at least. some places you will make more

 

[radslooking]

So the idea is work an 80 hour week like a dog/resident one week, then don't work the next?

pretty much, which some people love b/c they have a week off. some hate b/c its a combination of too much and too little work.

 

[Saladin MD]

Thanks for your replies. I wouldn't mind working like a dog for a week to get a week off to sleep like a cat. Actually I just need time for my extra-curricular activities, which are very important to me.

Another thing I like about hospitalist is that there is an exit strategy if you ever need one, i.e. fellowship. It seems that EM doesn't really have one. Not that most people would need it, but it just seems like all the non-EM people keep warning against EM.

 

[elwademd]

that sounds about the average.

i've been out for less than a year, and "working like a dog" has been dependent on the hospital that i've been in. sometimes it's been really really sick patients all over the place. others, not so bad. i imagine it is like that anywhere.

so far, i'm happy and will continue to do it.

 

[radslooking]

that sounds about the average.

i've been out for less than a year, and "working like a dog" has been dependent on the hospital that i've been in. sometimes it's been really really sick patients all over the place. others, not so bad. i imagine it is like that anywhere.

so far, i'm happy and will continue to do it.

agreed

 

[dragonfly99]

120-140k and working like a dog sounds more like the hospitalist jobs I'm familiar with in my area. 170k for a hospitalist, especially one starting out, I think sounds high, but I'm not totally sure about how much they make.

 

[mig26x]

As a 2nd year IM resident all the offers I have been getting are >150K and increasing as the place of work is less desirable in terms of living conditions and this is w/o bonuses which can increase your salary 15-25K.

Im expecting to get an offer for >170K in a or near a big city.

 

[Hysty]

I am joining a hospitalist group this july. Minimum that company pays is 170k. But it has been a few months I have signed the contract and recently I have had more job posts of more than 180k than last year. Plus the locations are not bad as most of them are close to bigger cities. And if the practice is busy and job offers production bonus then it will definitely be >200k.

 

[ThinkTooMuch]

how many hours are worked on average during those 7 days?

 

[gutonc]

how many hours are worked on average during those 7 days?

It will depend on the hospital/group, the size of the service (# of patients) and your efficiency. But you can expect those to be 10-14 hour days. Some less, some more.

 

[ThinkTooMuch]

neat.

 

[Firebird]

I just visited a hospitalist program as a sort of preliminary interview and they do 8 AM to 8 PM (often being finished before 8 PM) 7 days on 7 days off. They carry 18-22 pts and minimum salary is 190K. They target 215K, but some are making 250K+. The expectation is for reimbursement to increase to a minimum of 215K with a target of 230K within the next couple of years. Some days they do see 30 pts, but it is again more like 20 on a typical day. 20 days paid vacation which are taken during the weeks you already have off.

Is there a catch?

Yes.

 

[mig26x]

for those of you that are hospitalist how did you found your current job opening? calling each hospital to see who had openings? using hospitalist society medicine webpage or one of this job search company???

 

[psychforme]

Is there a catch?

Yes.

And it is?

 

[mig26x]

And it is?

I think is the 30 pt per day part, there's no maximum of patient you can see. I have seen alot of offers and they specify how many pt you might see maximum per day, most of them cut it off at 15 or 20 patient. Put 30 is pushing it in the hospital setting.

 

[efex101]

You can look online, there are varios "head hunter" type outfits that will send you info on openings, locum, etc. Yeah, 30 is way too many, most offers are in the 15-20 patients per day range.

 

[Firebird]

The real catch for this place for most people is location--small town surrounded by relatively rural area. The town itself is not a bad place to live as it has pretty much everything you would need. But if you're looking for museums, pro-sports, or a large variety of recreation, it's a couple hours drive.

 

[elwademd]

for those of you that are hospitalist how did you found your current job opening? calling each hospital to see who had openings? using hospitalist society medicine webpage or one of this job search company???

e-mails from recruiters
word of mouth
ads in magazines (society of hospital medicine, the hospitalist, etc.)
web ads

basically keep your eyes and ears open.

though i have a job, i still get emails daily from various recruiters. so, jobs are out there, you just have to find if it's the right job for you.

 

[TulaneKid24]

I just visited a hospitalist program as a sort of preliminary interview and they do 8 AM to 8 PM (often being finished before 8 PM) 7 days on 7 days off. They carry 18-22 pts and minimum salary is 190K. They target 215K, but some are making 250K+. The expectation is for reimbursement to increase to a minimum of 215K with a target of 230K within the next couple of years. Some days they do see 30 pts, but it is again more like 20 on a typical day. 20 days paid vacation which are taken during the weeks you already have off.

Is there a catch?

Yes.

yes, there is a catch......... You will NOT be able to effectively see 22 patients a day. That census is way too high. Your work will be unsafe and sloppy at best. That will lead to burn out. You certainly can not see 30 sick hospitalized patients in a day. Reasonable census number are about 15-18 encounters per day.
And if you are seeing 20 - 30 patients a day and you are on a production/RVU system, you pay should be closer to 300k. But again, that would be impossible hard work and you would burn out in a few short months. I would stay away from this job!

 

[Firebird]

yes, there is a catch......... You will NOT be able to effectively see 22 patients a day. That census is way too high. Your work will be unsafe and sloppy at best. That will lead to burn out. You certainly can not see 30 sick hospitalized patients in a day. Reasonable census number are about 15-18 encounters per day.
And if you are seeing 20 - 30 patients a day and you are on a production/RVU system, you pay should be closer to 300k. But again, that would be impossible hard work and you would burn out in a few short months. I would stay away from this job!

I don't agree. I feel very comfortable seeing 20 patients a day without any fear of poor quality. 30 patients would be difficult, but I still think in 12 hours I would be able to provide quality care that matches the standard of care. It might entail consulting specialists more often than I would otherwise do, but still do-able. I would not be happy seeing much less than 20 a day, I don't suspect.

 

[Shah_Patel_PT]

As a 2nd year IM resident all the offers I have been getting are >150K and increasing as the place of work is less desirable in terms of living conditions and this is w/o bonuses which can increase your salary 15-25K.

Im expecting to get an offer for >170K in a or near a big city.

Similar situation for me too. I am already receiving offers.

Lowest starting salary with no prior experience--> Base pay is 150K with potential to easily go beyond 200K if you see more patients.

 

[dragonfly99]

20 patients/day would be doable. I think high teens would be better. I've certainly seen and taken care of a census in the mid to high teens while moonlighting or even on service when I was a resident (i.e. when the other intern or resident was off for the day).

30 you'd be working your tail off...and depending on how sick they are (any ICU?) I think it's too many to be seeing. It could be done, depending on the ancillary support/nursing/hospital services and the specialist support/consults available, but I wouldn't want to be doing that on a chronic basis.

 

[hipopanonymous]

Dragonfly must live in NYC, D.C, Philly, Chicago, or Boston. Or she's looking at academic center salaries. I'd say in most mid sized cities hospitalists earn between 170-200k working 7 on/7 off. In highly desirable cities like those above, or at presitigious academic centers, they cut your salary way down If you venture into the community you earn more. And if you venture into rural areas like Missouri, Arkansas, Tennessee, Kansas, etc you can make 225-250k as a hospitalist.

It's a sweet deal if you can stand working long hours for a week for a week off. I do think the burnout rate is pretty high after several years though.

And I don't know what kind of residency program you went to if you can only see 15 patients/day. Bear in mind as a hospitalist you don't spend 3 hours frittering away time on rounds and then 1-2 hours on morning report and noon conference. You just get to the hospital and start rounding, writing notes as you go. When you don't have to meet and run everything by somebody, and wait for med students and interns, and try to teach everyone, you'd be stunned how efficiently you can work. I like teaching, I like teams, I like rounds, but they bring massive amounts of wasted time into your day where you're not really doing any patient care.