HCA hospitalist

[mumixam]

I've heard the horror stories, but what's the truth about working for an HCA hospital as a hospitalist these days? What if it's through a staffing agency rather than HCA itself? The contract looks good and the patient load is OK from what I have been told.

Any help would be appreciated.

---

Members don't see this ad.

 

[Calizboosted76]

Take my comment with a grain of salt (3rd year medical student).

I did my inpatient Im rotation at an HCA in a relatively big city. The hospitalists seemed to enjoy it. The salary was over $315k and schedule was round and go 7on 7 off with a closed ICU.

I was shooting for surgery and after doing this rotation I am highly considering hospitalist medicine because of how much I enjoyed it.

Now I will say the hospital seemed to really take care of their physicians (lounge was insane, food was great, etc) however getting an ERCP or likewise procedures was a pain in the ass and normally required to refer out.

The one negative I will say is during the MDR, it really felt like the hospitalist was being interrogated by the nurse who was running the meeting. Idk if this is hospital dependent or if nurses are taking over the medical field.

My rotation was only a month long but I have done 4 other rotations at this hospital and it doesnt seem as bad as all the horror stories Ive seen on reddit.

 

[dozitgetchahi]

Take my comment with a grain of salt (3rd year medical student).

I did my inpatient Im rotation at an HCA in a relatively big city. The hospitalists seemed to enjoy it. The salary was over $315k and schedule was round and go 7on 7 off with a closed ICU.

I was shooting for surgery and after doing this rotation I am highly considering hospitalist medicine because of how much I enjoyed it.

Now I will say the hospital seemed to really take care of their physicians (lounge was insane, food was great, etc) however getting an ERCP or likewise procedures was a pain in the ass and normally required to refer out.

The one negative I will say is during the MDR, it really felt like the hospitalist was being interrogated by the nurse who was running the meeting. Idk if this is hospital dependent or if nurses are taking over the medical field.

My rotation was only a month long but I have done 4 other rotations at this hospital and it doesnt seem as bad as all the horror stories Ive seen on reddit.

Much like the VA, I have heard that some HCA hospitals are relatively OK, and some are a total ****show.

 

[Splenda88]

Do it just only for the physician lounge/food. Lol

315k/yr is not that bad. Envision in Miami offered me $75/hr + RVU in 2021.

 

[Splenda88]

Take my comment with a grain of salt (3rd year medical student).

I did my inpatient Im rotation at an HCA in a relatively big city. The hospitalists seemed to enjoy it. The salary was over $315k and schedule was round and go 7on 7 off with a closed ICU.

I was shooting for surgery and after doing this rotation I am highly considering hospitalist medicine because of how much I enjoyed it.

Now I will say the hospital seemed to really take care of their physicians (lounge was insane, food was great, etc) however getting an ERCP or likewise procedures was a pain in the ass and normally required to refer out.

The one negative I will say is during the MDR, it really felt like the hospitalist was being interrogated by the nurse who was running the meeting. Idk if this is hospital dependent or if nurses are taking over the medical field.

My rotation was only a month long but I have done 4 other rotations at this hospital and it doesnt seem as bad as all the horror stories Ive seen on reddit.

What happened that made you change your mind?

I am a hospitalist and I think the job is ok while SDN thinks it's the worst physician job.

 

[Calizboosted76]

What happened that made you change your mind?

I am a hospitalist and I think the job is ok while SDN thinks it's the worst physician job.

So I was not at all interested in IM. I was a big time surgery gunner. After doing my inpatient rotation and seeing the lifestyle that could be had (round and go, 7 on 7 off), I was sold. I also feel like it is what people think of when they think of a physician. Also they are legit the captain of teh ship. I know some people will disagree however if the Hospitalist wants help they can ask. If they feel they can handle it, they can. The patient is YOUR patient. I enjoy being a generalist. It seems like a great gig. I just wish the earning potential was more.

 

[Splenda88]

So I was not at all interested in IM. I was a big time surgery gunner. After doing my inpatient rotation and seeing the lifestyle that could be had (round and go, 7 on 7 off), I was sold. I also feel like it is what people think of when they think of a physician. Also they are legit the captain of teh ship. I know some people will disagree however if the Hospitalist wants help they can ask. If they feel they can handle it, they can. The patient is YOUR patient. I enjoy being a generalist. It seems like a great gig. I just wish the earning potential was more.

Unfortunately the earning potential is 250-400k right now for hospitalists and probably 300-475k for nocturnists unless you are a workaholic.

I know hospitallst who make > 500k but these people are working machines. Working 22 days/month as a hospitalist is not for most.

 

[Calizboosted76]

Unfortunately the earning potential is 250-400k right now for hospitalists and probably 300-475k for nocturnists unless you are a workaholic.

I know hospitallst who make > 500k but these people are working machines. Working 22 days/month as a hospitalist is not for most.

Thats the goal. Honestly I think I will work more than the 7 on because my wife will be working and my daughter will be in school so I wouldnt mind picking up shifts (I love being in the hospital its calming to me). So I am wondering if maybe hospitalist is the dream for me.

 

[Splenda88]

Thats the goal. Honestly I think I will work more than the 7 on because my wife will be working and my daughter will be in school so I wouldnt mind picking up shifts (I love being in the hospital its calming to me). So I am wondering if maybe hospitalist is the dream for me.

I don't know if there are many dream jobs in medicine but If I could lay on a couch in the physician lounge watching the Kansas City Chiefs beating The Baltimore Ravens for 2 1/2 hrs while drinking free Starbucks with no interruptions, I think I am good.

 

[Calizboosted76]

I don't know if there are many dream jobs in medicine but If I could lay on couch in the physician lounge watching the Kansas City Chiefs beating The Baltimore Ravens for 2 1/2 hrs while drinking free Starbucks with no interruptions, I think I am good.

My dream since I was 5 years old was to be a neurosurgeon. However I dont think I can put my daughter or wife through that kind of residency. I also want to have a life and be able to be an active parent in my 4 year olds life.

 

[bronx43]

The one negative I will say is during the MDR, it really felt like the hospitalist was being interrogated by the nurse who was running the meeting. Idk if this is hospital dependent or if nurses are taking over the medical field.

Nurses own the hospital. We are all just tourists.

Honestly it was one of the reasons I ended up doing fellowship. In clinic, you’re the boss. I don’t even have a nurse in my practice at all.

 

[Calizboosted76]

This is something I am not looking forward to. I will probably end up having a private practice as well.

 

[NITRAS]

Nurses own the hospital. We are all just tourists.

Honestly it was one of the reasons I ended up doing fellowship. In clinic, you’re the boss. I don’t even have a nurse in my practice at all.

Some days this feels so true.
I don’t know if it was COVID, or just the same ****, but this job is way harder than it was 5 years ago. The nurses are worse, more arrogant, the patients are more complex, and the system is way more taxed than it used to be.

 

[NewYorkDoctors]

Nurses own the hospital. We are all just tourists.

Honestly it was one of the reasons I ended up doing fellowship. In clinic, you’re the boss. I don’t even have a nurse in my practice at all.

agreed

though i would say most nurses are fine.

it's the nurse managers.... who need to maintain that mother hen or father rooster mentality against the "wolves of doctors" or something...

 

[Splenda88]

This is something I am not looking forward to. I will probably end up having a private practice as well.

it's usually the ICU nurses. You don't deal with them if you work in a place with close ICU

 

[collegestud2013]

I've heard the horror stories, but what's the truth about working for an HCA hospital as a hospitalist these days? What if it's through a staffing agency rather than HCA itself? The contract looks good and the patient load is OK from what I have been told.

Any help would be appreciated.

Take my comment with a grain of salt (3rd year medical student).

I did my inpatient Im rotation at an HCA in a relatively big city. The hospitalists seemed to enjoy it. The salary was over $315k and schedule was round and go 7on 7 off with a closed ICU.

I was shooting for surgery and after doing this rotation I am highly considering hospitalist medicine because of how much I enjoyed it.

Now I will say the hospital seemed to really take care of their physicians (lounge was insane, food was great, etc) however getting an ERCP or likewise procedures was a pain in the ass and normally required to refer out.

The one negative I will say is during the MDR, it really felt like the hospitalist was being interrogated by the nurse who was running the meeting. Idk if this is hospital dependent or if nurses are taking over the medical field.

My rotation was only a month long but I have done 4 other rotations at this hospital and it doesnt seem as bad as all the horror stories Ive seen on reddit.

Working at a HCA hospital will be typical corporate medicine. Lots of metrics and doing anything to maximize revenue for the hospital, like getting patients out quickly and optimizing billing. And yes HCA hospitals nowadays usually go through a CMG like TeamHealth or Sound instead of employing their physicians directly; you'll run through even more issues in this set up since big decisions are often made at a regional level by CMG admin that is not even located in the same state as the hospital. Satisfaction surveys done by hospitalists have consistently shown the lowest satisfaction by hospitalists employed by CMGs. Things may be a bit better at some local hospitalist groups where you're employed directly by the hospital.

$315k for typical daytime job comes out to $144 per hour (assuming the typical 182 12-hr shifts per year) which is low in 2024 considering pay was similar or even a bit higher pre-pandemic (right before massive inflation hit); then again physician pay in most specialties has not kept up with inflation in the past few years. That pay would only be reasonable if the census was also below average (like 16-18 follow-ups/discharges on a rounding shift), but the combination of HCA hospital + CMGs are notorious for working you harder than average, often more like 20-24 patients average. Keep in mind many other shift-based specialties like EM, radiology, intensivist, anesthesiology average quite a bit higher at $180-220 per hour. I also don't foresee hospitalist pay increasing significantly anytime soon (except maybe in the least desirable locations) as HM is getting more saturated (more IM and FM grads going into it than primary care, and increased use of midlevels) and CMS reimbursements have not kept up with inflation.

Also note that it will be unlikely that 100% of your shifts will be round and go. Someone has to do the admitting everyday and night and stay late for that. Even in places with with full-time nocturnists, the day shift hospitalists still have to rotate in admitting and stay the full 12-hr shift on those days (unless your facility "outsources" the admitting shifts to locums); at places without full-time nocturnist everyone will typically have to rotate nights.

 

[shouldigomd]

There are horror stories with just about anything you look at when it comes to medicine. Every hospital has its own personality, politics, etc etc even if they are all under the same umbrella. That goes for corporations like HCA or academic centers. I think you should reach out to some of the hospitalists at the programs you are interested in for their experience.