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To All of you hospitalists or soon to be, please share with us why you love your job! (and also what you may not like)
Happy Hospitalists: Share your stories!
- Thread starter TopsyKrett
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I love this post.... I hope people add on to it. I'll tell you why I can't wait to be a hospitalist. First, I want to work in a rural area..... $$$. Second, I can't wait to have 7 days off in a row ever other week! My son is going to know his dad... unlike others I go to school with. 🙁
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My son will know me as well...because I'm going to work in the office, 8-5 M-F...pretty much when he"ll be in school.
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Hospitalist medicine can be a fantastic journey for those who loved the potential held by the inpatient months of residency. It functions as a direct extension of residency - along with a great deal of potential autonomy and self/ family time (unlike during residency). It's empowering to know that you have the knowledge and ability to help heal the sickest members of society... all the while continuing to learn more and more as the days, months, and years pass. Choice is abundant within the field - in terms of solo v. group practice models - as well as scheduling.
Being surrounded by other hospitalists, specialists, outpatient physicians, as well as ancillary service personnel allows for an ability to maintain sharply incorporated into the acute care world. Very nice.
Being surrounded by other hospitalists, specialists, outpatient physicians, as well as ancillary service personnel allows for an ability to maintain sharply incorporated into the acute care world. Very nice.
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I think being a hospitalist is great and has gotten better in recent years. For starters, the salaries have increased- you can now find guys making > 200K for working 6mths out of the year and one can double one's income by moonlighting during your time off or of course, spend time with loved ones. I disagree with the popularized notion: of easy burnout and nonsustainability on the long term. The 7 on/7 off afford me sufficient time for personal endeavors- case in point, I just arrived from a week vacation from The Dominican Republic. I also get time to catch up on my NEJM, JAMA, THE HOSPITALIST and TODAY's HOSPITALIST journals during my week off. BTW, I also visited England and Canada in recent months.
I personally feel that hospitalists have the BEST Salary/work ratio in medicine now and its only gonna get better given the rate hospitals are scrambling to increase the reimbursements and reduce costs, esp LOS( length of stay) in the hospital and lets not forget the quality-improvement and patient safety initiatives that more and more hospitalists are championing at their respective hospitals. Studies have even shown that hospitalists achieve a much lower mortality score than Pulm/CC, even when adjusted for severity of illness. Interesting, huh?
Needlless to add, I am happy. I initially wanted to do Cards. I ended up not applying and just wanted to work and catch up with my $$, pay down the debt and simply enjoy life a little. RIght now, given the climate of healthcare and medicine now, I would not advise even my worst enemy to continue further schooling. Common hospitalists( some) are making > 300k easily!!
I personally feel that hospitalists have the BEST Salary/work ratio in medicine now and its only gonna get better given the rate hospitals are scrambling to increase the reimbursements and reduce costs, esp LOS( length of stay) in the hospital and lets not forget the quality-improvement and patient safety initiatives that more and more hospitalists are championing at their respective hospitals. Studies have even shown that hospitalists achieve a much lower mortality score than Pulm/CC, even when adjusted for severity of illness. Interesting, huh?
Needlless to add, I am happy. I initially wanted to do Cards. I ended up not applying and just wanted to work and catch up with my $$, pay down the debt and simply enjoy life a little. RIght now, given the climate of healthcare and medicine now, I would not advise even my worst enemy to continue further schooling. Common hospitalists( some) are making > 300k easily!!
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Unfortunately it probably won't be that way. My father is an internist and worked those hours in the office. The problem is that you have other responsibilities. Typical day is more like get to hospital at 5:30am and round and/or do nursing home rounds...make it to the office by 8/8:30...see patients till 5/6 depending on the day. Maybe have to go back to hospital afterwards some days. Get home anywhere from 5:30 on a good day to 7 or 8 on a bad day. Go to bed around 9 to 10. So yeah. I pretty much never saw my dad unless he was off on the weekend.
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No inpatient...no nursing homes.
Seriously, office 8-5...it's not that uncommon nowdays.
that's why they created the hospitalist track, less and less primary care doctors wanted to spend their time running from clinic to hospital and back. Instead now they can be at the office 8-5 or 6 and someone else gets paid to see the PCP patients at the hospital.
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I am going to give you guys an idea of what I am dreaming of when I start to practice (7 on and 7 off schedule)...
I am hoping to live in a more rural area near a mountain (skiiing purposes) that is also 2 hours outside of the city where I grew up. So, I plan on having a house in both places so when I have a week off I can go back to the city and enjoy my life there. And during the winters I am going to ski and enjoy the winter games in the more rural area. This way I can have city life and rural life at the same time. What do you all think?
I am hoping to live in a more rural area near a mountain (skiiing purposes) that is also 2 hours outside of the city where I grew up. So, I plan on having a house in both places so when I have a week off I can go back to the city and enjoy my life there. And during the winters I am going to ski and enjoy the winter games in the more rural area. This way I can have city life and rural life at the same time. What do you all think?
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Not necessarily. The "old" model where internists do both inpatient and outpatient is much less common these days (thanks to hospitalists).
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I asked this in another thread and got a few responses but I figured this thread may get more focused attention from current hospitalists....
Any predictions on long term view of the hospitalist profession? I've heard from a school administrator that the field will get full fairly soon.
I figure that I really liked IM, had a kick-ass attending who is a hospitalist and really dig rounding on patients. To me, it's a no brainer......especially if the 7/7 is the real deal. I can handle busting it for a week and then kickin' it with the fam for a week.....and they'll pay me also? Baby, where do I sign?
Any predictions on long term view of the hospitalist profession? I've heard from a school administrator that the field will get full fairly soon.
I figure that I really liked IM, had a kick-ass attending who is a hospitalist and really dig rounding on patients. To me, it's a no brainer......especially if the 7/7 is the real deal. I can handle busting it for a week and then kickin' it with the fam for a week.....and they'll pay me also? Baby, where do I sign?
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I am not currently a hospitalist but i do doubt that any hospitalist (or anybody else) will be able to answer your question about the future of hospitalists. but, I would like to give my opinion if nobody minds....
1. it seems unlikely that any field of medicine becomes completely saturated. City positions may become more competitive, however, there will always be positions in the midwest and more rural areas that need a hospitalist to treat their inpatients.
2. It is widely agreed upon that the current system will change in the near future. And any changes may move IM docs towards primary care again which should open up more positions in hospitals. I could see myself becoming a primary care doc if the system is fixed.
3. Finally, a hospitalist has been described as a "burn out" position. I don't believe this to be all encompassing but if it is somewhat true then positions will always open up
Would love feedback if anyone has an opinion....
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My opinion is that the hospitalist field will not be saturated any time in the near future. There is continued pressure on outpatient docs to do more stuff in less and less time, and for some it just isn't worth it to schlepp over to the hospital daily, especially given that many patients don't appreciate their primary care doc nor have the personal relationship they had with him/her that they did years ago. There is also hospital politics and credentialing to deal with, which some private practice docs don't want to deal with.
Also, as mentioned above there is a fair degree of burnout among hospitalists, as many of the hospitalist jobs involve you being a hospital employee, and some hospitals have an incentive to just work you as hard as they can (and just get a new person in 2-3 years if/when you burn out and leave). This isn't true of all hospitalist programs, but I think there will continue to be a fair number like this.
I also agree with the above post...if the field gets more saturated, it will be the nice urban and suburban hospitals that fill up first, but there still will be positions in smaller towns and rural areas.
I think the hospitalist field would saturate before oupatient primary care or traditional primary care would get saturated, but both will continue to be in demand for the forseeable future.
Also, as mentioned above there is a fair degree of burnout among hospitalists, as many of the hospitalist jobs involve you being a hospital employee, and some hospitals have an incentive to just work you as hard as they can (and just get a new person in 2-3 years if/when you burn out and leave). This isn't true of all hospitalist programs, but I think there will continue to be a fair number like this.
I also agree with the above post...if the field gets more saturated, it will be the nice urban and suburban hospitals that fill up first, but there still will be positions in smaller towns and rural areas.
I think the hospitalist field would saturate before oupatient primary care or traditional primary care would get saturated, but both will continue to be in demand for the forseeable future.
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hey guys, quick question...i know a lot of discussion in this thread has been centered around the rural hospitalist...what about the city? (ie: phili, NYC, jersey)...is there still the potential to make 200K like the rural areas working 6/8am-5/6pm?
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obviously i'm not even a medical student yet, but becoming a hospitalist gas become a very appealing prospect to me
the whole reason i want to get into medicine is to be able to help people and see the effects i have directly on different people
while being a hospitalist may not let me do that, i do get to get to work with a lot of different patients and help the process of making countless people better from an infinite number of sicknesses and injuries
i like the idea of a 7 on, 7 off schedule, and while i will never be able to afford my Aston Martin Vanquish like an anesthesiologist might (what i originally though about being), i dont care
in the end i will get to do what i got interested in medicine for, making people better
and being able to pursue my personal interests and spend time with my loved ones on my days off to avoid burnout
i also like the idea of filling a current need in the national health care sector, as i hear there is a shortage of primary care doctors
no, im not in medical school yet, and yes, i might change what i want to do, and by the time i become a doctor we might not even need any more hospitalists
i just wanted to put in what i thought would be cool about being a hospitalist
my knowledge is limited, being only a high school senior, and i am currently researching the profession, but it is definitely something that has caught my eye
the whole reason i want to get into medicine is to be able to help people and see the effects i have directly on different people
while being a hospitalist may not let me do that, i do get to get to work with a lot of different patients and help the process of making countless people better from an infinite number of sicknesses and injuries
i like the idea of a 7 on, 7 off schedule, and while i will never be able to afford my Aston Martin Vanquish like an anesthesiologist might (what i originally though about being), i dont care
in the end i will get to do what i got interested in medicine for, making people better
and being able to pursue my personal interests and spend time with my loved ones on my days off to avoid burnout
i also like the idea of filling a current need in the national health care sector, as i hear there is a shortage of primary care doctors
no, im not in medical school yet, and yes, i might change what i want to do, and by the time i become a doctor we might not even need any more hospitalists
i just wanted to put in what i thought would be cool about being a hospitalist
my knowledge is limited, being only a high school senior, and i am currently researching the profession, but it is definitely something that has caught my eye
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A little background...I've been a hospitalist at a major academic center in a large city for the past 2 yrs. I do not plan on doing this for a career and have plans to subspecialize in the near future. I do not work the traditional 7 on/7 off model but have essentially 9 days off a month and make ~$150K/yr.
The Good...
-Residency teaches you to be a great hospitalist from the start
-you're working anywhere from half to two-thirds as much as you did in residency but making 3 times as much (which is significantly more than your colleagues in outpt IM at academic centers)
-You don't have to worry about seeing enough pts, what type of insurance they have, or paying overhead (at least in my practice)
-you have immediate access to specialists and studies 24/7 (on a side note, I feel that outpt medicine is actually more clinically challenging than inpt as you have a limited amt of time and resources at your disposal and must trust in your clinical judgment and physical exams skills to determine how quickly you must act on your DDx).
-it's one of the few areas of IM that allow you to see/make a difference in a short period of time (ie- treating acute illnesses like PNA and PE's are more satisfying than the more chronic illnesses like hypertension and diabetes)
-I can spend as much time as I like w/ each of my pts on rounds...no-one's knocking on my door for the next appt.
The Bad...
-the hospital has an incentive to keep you understaffed and overworked (some practices do not have pt caps or PAs/NP's to assist you w/ your workload)
-you become the dumping ground as the non-teaching service
-there is the constant sense of urgency w/ seeing new admits in a timely manner and getting pts discharged ASAP
The Ugly...
-I have nightmares about my job daily...even when I'm on vacation in another country
-I detest our ED
-there appears to be less respect from other specialities as they realize that most hospitalists just finished residency and are wet behind the ears (therefore, I'd recommend working at a different institution than where you trained)
If I had to do it over again, I would still be a hospitalists as opposed to an outpt physician. Just be careful when signing your contract 😳
The Good...
-Residency teaches you to be a great hospitalist from the start
-you're working anywhere from half to two-thirds as much as you did in residency but making 3 times as much (which is significantly more than your colleagues in outpt IM at academic centers)
-You don't have to worry about seeing enough pts, what type of insurance they have, or paying overhead (at least in my practice)
-you have immediate access to specialists and studies 24/7 (on a side note, I feel that outpt medicine is actually more clinically challenging than inpt as you have a limited amt of time and resources at your disposal and must trust in your clinical judgment and physical exams skills to determine how quickly you must act on your DDx).
-it's one of the few areas of IM that allow you to see/make a difference in a short period of time (ie- treating acute illnesses like PNA and PE's are more satisfying than the more chronic illnesses like hypertension and diabetes)
-I can spend as much time as I like w/ each of my pts on rounds...no-one's knocking on my door for the next appt.
The Bad...
-the hospital has an incentive to keep you understaffed and overworked (some practices do not have pt caps or PAs/NP's to assist you w/ your workload)
-you become the dumping ground as the non-teaching service
-there is the constant sense of urgency w/ seeing new admits in a timely manner and getting pts discharged ASAP
The Ugly...
-I have nightmares about my job daily...even when I'm on vacation in another country
-I detest our ED
-there appears to be less respect from other specialities as they realize that most hospitalists just finished residency and are wet behind the ears (therefore, I'd recommend working at a different institution than where you trained)
If I had to do it over again, I would still be a hospitalists as opposed to an outpt physician. Just be careful when signing your contract 😳
A little background...I've been a hospitalist at a major academic center in a large city for the past 2 yrs. I do not plan on doing this for a career and have plans to subspecialize in the near future. I do not work the traditional 7 on/7 off model but have essentially 9 days off a month and make ~$150K/yr.
The Good...
-Residency teaches you to be a great hospitalist from the start
-you're working anywhere from half to two-thirds as much as you did in residency but making 3 times as much (which is significantly more than your colleagues in outpt IM at academic centers)
-You don't have to worry about seeing enough pts, what type of insurance they have, or paying overhead (at least in my practice)
-you have immediate access to specialists and studies 24/7 (on a side note, I feel that outpt medicine is actually more clinically challenging than inpt as you have a limited amt of time and resources at your disposal and must trust in your clinical judgment and physical exams skills to determine how quickly you must act on your DDx).
-it's one of the few areas of IM that allow you to see/make a difference in a short period of time (ie- treating acute illnesses like PNA and PE's are more satisfying than the more chronic illnesses like hypertension and diabetes)
-I can spend as much time as I like w/ each of my pts on rounds...no-one's knocking on my door for the next appt.
The Bad...
-the hospital has an incentive to keep you understaffed and overworked (some practices do not have pt caps or PAs/NP's to assist you w/ your workload)
-you become the dumping ground as the non-teaching service
-there is the constant sense of urgency w/ seeing new admits in a timely manner and getting pts discharged ASAP
The Ugly...
-I have nightmares about my job daily...even when I'm on vacation in another country
-I detest our ED
-there appears to be less respect from other specialities as they realize that most hospitalists just finished residency and are wet behind the ears (therefore, I'd recommend working at a different institution than where you trained)
If I had to do it over again, I would still be a hospitalists as opposed to an outpt physician. Just be careful when signing your contract 😳
I am a little confused. What area of the country are you in? If you only get 9 days a month off, how many hours are you working in a month/week? All the offers I have seen in the midwest/south are paying more than this for the 7 on and 7 off shifts. We just had a guy come to our school and talk about this set up and the "proceduralist" jobs. He claimed way bigger numbers and less hours. Was he full of it?
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I'm in the midwest, work 2100 hrs per yr = 175 hrs/month, shifts alternate between day shifts (carrying a team), doing straight admissions, consults, and nights. No ICU coverage. I have friends at other large academic programs in the midwest who work less, make more, and have better benefits. I think academic hospitalists probably cap out at ~$160K (not including benefits, bonuses, student loan forgiveness). I would actually prefer the 7 on/7 off schedule better and our practice is trying to move towards that now. Private practice offers I've received from headhunters range anywhere from $175-300K (but the locations leave much to be desired). Hope that helps!
Hey thanks for the info! Those numbers are essentially the same.
The guy that came and spoke with us was claiming more along the 175-300 range. He said that at an academic hospital you could expect starting salary to be between 150 and 200 for 7 on and 7 off, but that most hospitals had a bonus system setup that made 200 pretty common. Also, that private practice could go up past 300. His claim was that most hospitalists will do 7 on 7 off, and then do locums etc' for around 125 an hour and that was where the real money was. He had a chart that showed that if you worked the same hours as a general surgeon you could make much more money. This was the crux of his talk, that a career in IM could still be just as financially stable as any other specialties because of the extra earning potential due to the lower hours worked.
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I think $200K for an academic position is a lot, but I guess that depends where in the country we're talking about. Bonuses vary at different places as well. I know of one program that offers up to $50K in student loan forgiveness (great deal) while others may provide $10K-20K if you meet certain quality standards (billing accuracy, PCP notification, etc). My job offers an additional $2K in moving expenses and $1500 in education funds. Others focus on productivity as well... You just have to pick your poison.
I occasionally moonlight at my own facility (didn't have to learn a new system) but only make ~$80-90/hr and it's a tough shift. Locums sounds like a good deal as well, but all the emails I get are for other states (making licensing an issue). In principle, moonlighting sounds like a great idea and is always a nice way to supplement your income, but the high burnout rate among hospitalists makes your downtime more precious 😳
