Hospitalist Compensation Southern California

[NewDocInTown123]

Hello all,

First time poster here. I currently received a job opportunity in a community hospital in San Fernando Valley California which is in Los Angeles County. This is a nocturnist position. They are paying 280k base salary guarentee for 3 years and offer your standard stuff. However, there is no potential for share holding or partnership. I am just trying to get a feel whether this is the normal pay that folks are offered. I am torn by what many people have told me. Have a friend who stated that he was getting 280k as a day time hospitalist just in pasadena. Anyone share any knowledge about this area and what in general is fair for a recent IM graduate. Thanks for your help.

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[DrMetal]

LA (and SoCal in general) is a very crowded market. I've been told $200-250K and $250-$300K for days and nights, respectively. So you're offer sounds about right. I can't speak of other perks (share holding or partnership, it's probably variable).

 

[wamcp]

Hello all,

First time poster here. I currently received a job opportunity in a community hospital in San Fernando Valley California which is in Los Angeles County. This is a nocturnist position. They are paying 280k base salary guarentee for 3 years and offer your standard stuff. However, there is no potential for share holding or partnership. I am just trying to get a feel whether this is the normal pay that folks are offered. I am torn by what many people have told me. Have a friend who stated that he was getting 280k as a day time hospitalist just in pasadena. Anyone share any knowledge about this area and what in general is fair for a recent IM graduate. Thanks for your help.

How many shifts per month?

After taking into account California taxes, what is the net take home pay reduced to? Then after subtracting the high cost of property and cost of living there...is this really worth it?

 

[NewDocInTown123]

How many shifts per month?

After taking into account California taxes, what is the net take home pay reduced to? Then after subtracting the high cost of property and cost of living there...is this really worth it?

14 shifts/month

I'm well aware of the tax and high cost of property. I am from there. Family is there. When you live in areas that are very unappealing, no amount of extra money to work in those areas will convince me to stay. I've lived all over the midwest for rotations, as well as NY, Connecticut. Im done with midwest or east coast. People fail to see California as a place of opportunity. All anyone thinks about is the cost or expense.

 

[wamcp]

14 shifts/month

I'm well aware of the tax and high cost of property. I am from there. Family is there. When you live in areas that are very unappealing, no amount of extra money to work in those areas will convince me to stay. I've lived all over the midwest for rotations, as well as NY, Connecticut. Im done with midwest or east coast. People fail to see California as a place of opportunity. All anyone thinks about is the cost or expense.

Closed icu? Average admits a night? Average number of patients you xcover?

 

[NewDocInTown123]

Closed icu? Average admits a night? Average number of patients you xcover?

Co management with ICU. They have on staff attending there at all times. admits are 6-12. I have another nocturnist with me. In total we cover 80-100 patients divided between us.

 

[chessknt]

14 shifts/month

I'm well aware of the tax and high cost of property. I am from there. Family is there. When you live in areas that are very unappealing, no amount of extra money to work in those areas will convince me to stay. I've lived all over the midwest for rotations, as well as NY, Connecticut. Im done with midwest or east coast. People fail to see California as a place of opportunity. All anyone thinks about is the cost or expense.

The opportunity to have to work an extra 5-10 years? No thanks.

 

[DrMetal]

Co management with ICU. They have on staff attending there at all times. admits are 6-12. I have another nocturnist with me. In total we cover 80-100 patients divided between us.

Doesn't sound bad. Can I ask, what hospital system?

 

[wamcp]

Doesn't sound bad. Can I ask, what hospital system?

Really? 138/hr for that setup is low to me. What rates you get in your area?

 

[NewDocInTown123]

Really? 138/hr for that setup is low to me. What rates you get in your area?

So I did some intense investigation and applied to many places. In general in the Los Angeles area, this is about what is paid. For your day time hospitalist, its around 225-250. For your nocturnist its from 260 - 280. If you go further away from LA, the pay is higher, upwards to about 300k for nocturnist. Outside the Bay Area in Northern Cali, Found a gig that paid 315k for 7on/7off 8 hour shifts and chance for partnership.

Other benefits to live in LA area or suburbs of LA area are also the schooling system if you have a family. Great Schooling system. LA is a livable place and is not as bad as people from the outside who dont live there make it seem. I will admit, in order to live comfortably, it would be best to have a 2 income household rather than one. If you are like me and don't care about needing a nice 5000-6000 square fee house, then its fine. The other thing is, most people view the housing there as outrageously high, which it is, but its also an investment. Housing will continue to rise and it may hit a plateau or even fall at some point. I would bet though, if you bought a house now, ultimately, you will gain profit on it 15 years down the road.

 

[NewDocInTown123]

The opportunity to have to work an extra 5-10 years? No thanks.

Im not sure what you mean by opportunity to work extra 5-10 years? When i mean opportunity, I mean that I have the ability to things that I want to do in the future, i.e. (Concierge medicine, botox, telemedicine, health spa, etc.) I do have a plan in getting involved in a small niche business, medically related, that will do well in los angeles area.

 

[chessknt]

Im not sure what you mean by opportunity to work extra 5-10 years? When i mean opportunity, I mean that I have the ability to things that I want to do in the future, i.e. (Concierge medicine, botox, telemedicine, health spa, etc.) I do have a plan in getting involved in a small niche business, medically related, that will do well in los angeles area.

You think you are the only person who thought of botox, telemedicine, and a health spa in LA? You think LA is the only place that business works?

Heres an example: Cost of Living Calculator | Los Angeles-Long Beach, CA vs. Raleigh, NC | NerdWallet

Raleigh has somewhat similar weather, access to excellent higher education and an overall fairly educated population. You pop in your 280k nocturnist salary on there and see you only need to make 178k to live the same on that. Except youll be making 300+ there as a nocturnist. That means functionally every year you will be seeing at least 100k more x10 years=1M. I dont know what your FI number is (or if you have one) but that is probably at least 25% of it, if not more--hence why you will be working 5-10 years longer.

If you want to live in LA for family reasons thats fine, but dont pretend it is a good financial decision. Your logic on housing was also what everybody thought in 2007 too. How much do you think it can keep going up? Will a single family home start at 2 million in 30 years there? 10 million?

 

[wamcp]

You think you are the only person who thought of botox, telemedicine, and a health spa in LA? You think LA is the only place that business works?

Heres an example: Cost of Living Calculator | Los Angeles-Long Beach, CA vs. Raleigh, NC | NerdWallet

Raleigh has somewhat similar weather, access to excellent higher education and an overall fairly educated population. You pop in your 280k nocturnist salary on there and see you only need to make 178k to live the same on that. Except youll be making 300+ there as a nocturnist. That means functionally every year you will be seeing at least 100k more x10 years=1M. I dont know what your FI number is (or if you have one) but that is probably at least 25% of it, if not more--hence why you will be working 5-10 years longer.

If you want to live in LA for family reasons thats fine, but dont pretend it is a good financial decision. Your logic on housing was also what everybody thought in 2007 too. How much do you think it can keep going up? Will a single family home start at 2 million in 30 years there? 10 million?

Pretty much this 100%. The opportunity cost of literally an extra 100k+ aftertax dollars each year to spend or invest with compound interest is massive

 

[calvnandhobbs68]

Im not sure what you mean by opportunity to work extra 5-10 years? When i mean opportunity, I mean that I have the ability to things that I want to do in the future, i.e. (Concierge medicine, botox, telemedicine, health spa, etc.) I do have a plan in getting involved in a small niche business, medically related, that will do well in los angeles area.

You’re a real businessman definitely no dermatologists or plastic surgeons have thought of doing Botox or medi spas in LA yet.

 

[NewDocInTown123]

You think you are the only person who thought of botox, telemedicine, and a health spa in LA? You think LA is the only place that business works?

Heres an example: Cost of Living Calculator | Los Angeles-Long Beach, CA vs. Raleigh, NC | NerdWallet

Raleigh has somewhat similar weather, access to excellent higher education and an overall fairly educated population. You pop in your 280k nocturnist salary on there and see you only need to make 178k to live the same on that. Except youll be making 300+ there as a nocturnist. That means functionally every year you will be seeing at least 100k more x10 years=1M. I dont know what your FI number is (or if you have one) but that is probably at least 25% of it, if not more--hence why you will be working 5-10 years longer.

If you want to live in LA for family reasons thats fine, but dont pretend it is a good financial decision. Your logic on housing was also what everybody thought in 2007 too. How much do you think it can keep going up? Will a single family home start at 2 million in 30 years there? 10 million?

Those were just examples I was giving. I am well aware of the saturation in business such as botox, telemedicine, etc. Like I said there is a certain niche business, that i plan on getting into nothing to do with the above that you described. I was simply providing examples. As far as housing goes, again read what I said. If i were to buy NOW, ultimately the value will increase and will plateau at a point, but overall the value will increase.

I understand that it seems money is everything to you. While California is expensive, I think on a two income salary, we will be stable, but most importantly happy rather than working in a place like Kansas where I can prob make a ton of money, but would be miserable.

 

[gutonc]

Those were just examples I was giving. I am well aware of the saturation in business such as botox, telemedicine, etc. Like I said there is a certain niche business, that i plan on getting into nothing to do with the above that you described. I was simply providing examples. As far as housing goes, again read what I said. If i were to buy NOW, ultimately the value will increase and will plateau at a point, but overall the value will increase.

I understand that it seems money is everything to you. While California is expensive, I think on a two income salary, we will be stable, but most importantly happy rather than working in a place like Kansas where I can prob make a ton of money, but would be miserable.

So, if you've already decided what to do, and nothing anybody says is going to change your opinion or plan, why come here and ask?

And if you've already got a billion dollar side hustle planned, who cares what your day job pays?

 

[rokshana]

You think you are the only person who thought of botox, telemedicine, and a health spa in LA? You think LA is the only place that business works?

Lol, my first thought was marijuana dispensary....

 

[NewDocInTown123]

So, if you've already decided what to do, and nothing anybody says is going to change your opinion or plan, why come here and ask?

And if you've already got a billion dollar side hustle planned, who cares what your day job pays?

Seems to be a lot of hate or pew pew about picking a job in Cali. Thanks to the first persons response who helped to clarify that the current offer I have is within the norm.

 

[chessknt]

I understand that it seems money is everything to you. While California is expensive, I think on a two income salary, we will be stable, but most importantly happy rather than working in a place like Kansas where I can prob make a ton of money, but would be miserable.

3 million people live in that state, somehow they manage despite not being in such an incredible place like LA. A lot of us hate California for the reasons described above--you are paying a 100k annual opportunity tax for the pleasure of living in half the house and 4x the traffic I have. But you can get Marijuana delivered to your door and eat chinese food at 4AM or go to a crowded beach so I guess it's an even trade.

 

[NewDocInTown123]

3 million people live in that state, somehow they manage despite not being in such an incredible place like LA. A lot of us hate California for the reasons described above--you are paying a 100k annual opportunity tax for the pleasure of living in half the house and 4x the traffic I have. But you can get Marijuana delivered to your door and eat chinese food at 4AM or go to a crowded beach so I guess it's an even trade.

I should change the topic title to, "People who have never lived in California, Why do you hate California?"


I guarentee the majority of the folks who have commented on this, have never lived in California and are likely hearing all the negative things about based on other sources instead of personal experience.

To those that complain about the traffic, you do realize you are in a profession where you are not dictated to have to work in the downtown area. Hospitals are everywhere. Clinics are everywhere. You actually have the option of living in the suburbs and working the suburbs. This is what I chose to negate having to deal with LA traffic on the week days.

 

[rokshana]

I should change the topic title to, "People who have never lived in California, Why do you hate California?"


I guarentee the majority of the folks who have commented on this, have never lived in California and are likely hearing all the negative things about based on other sources instead of personal experience.

To those that complain about the traffic, you do realize you are in a profession where you are not dictated to have to work in the downtown area. Hospitals are everywhere. Clinics are everywhere. You actually have the option of living in the suburbs and working the suburbs. This is what I chose to negate having to deal with LA traffic on the week days.

Then why bother? You can live in the ‘burbs anywhere.

 

[chessknt]

I should change the topic title to, "People who have never lived in California, Why do you hate California?"


I guarentee the majority of the folks who have commented on this, have never lived in California and are likely hearing all the negative things about based on other sources instead of personal experience.

To those that complain about the traffic, you do realize you are in a profession where you are not dictated to have to work in the downtown area. Hospitals are everywhere. Clinics are everywhere. You actually have the option of living in the suburbs and working the suburbs. This is what I chose to negate having to deal with LA traffic on the week days.

I lived in Southern California (orange county, LA county, inland empire, and san Diego) for over 25 years dude. The whole point of living in LA is having access to all this stuff but the traffic is so bad you functionally don't have all the stuff you think you do. I have 2 friends who live in LA that haven't seen each other in years because they are on opposite sides of town and act like they live in different states.

Sorry you couldn't handle open space and a bit of weather and had to move back to that madness instead. I have seen the light and am all too glad to leave California behind.

 

[dggopal]

k.... so moving beyond the LA sucks and we should all move elsewhere theme of this thread and getting back to what the thread owner asked.... my wife just joined with loma linda for 250. 7 on 7 off with only about 11 nights of cross coverage requirement (no admissions) which can be farmed out to fellows/residents for a 11k pay cut. faculty position with plan to work with residents. I dunno about partnership but doubt that is part of the structure. I will say thought that LLU pays great benefits. 5% retirement regardless of your contribution which vests 100% after 5 years. But LLU is slightly inland of LA proper so go figure.

 

[Grace upon grace]

A group at redlands comm hosp pay 280k for days for night you should be asking for 300-320k min.

 

[Trogghunter]

Raleigh has somewhat similar weather, access to excellent higher education and an overall fairly educated population.

Similar weather to Socal? Raleigh is unbearable 90% of the summer, with humidity so high that your skin will prune while the skin burns you. It doesn't evaporate! It's similar to Socal for about 1 month from mid september to mid october. The only saving grace is that Wrightsville Beach is an hour and a half away.

 

[Splenda88]

Really? 138/hr for that setup is low to me. What rates you get in your area?

I agree with you that $138/hr seems low when ED docs are making $225-275/hr. What would be a good hourly rate? I am not sure why IM docs accept such low rate for hospital medicine...

 

[NewDocInTown123]

k.... so moving beyond the LA sucks and we should all move elsewhere theme of this thread and getting back to what the thread owner asked.... my wife just joined with loma linda for 250. 7 on 7 off with only about 11 nights of cross coverage requirement (no admissions) which can be farmed out to fellows/residents for a 11k pay cut. faculty position with plan to work with residents. I dunno about partnership but doubt that is part of the structure. I will say thought that LLU pays great benefits. 5% retirement regardless of your contribution which vests 100% after 5 years. But LLU is slightly inland of LA proper so go figure.

Thank you for your reply and answering what the thread originally asked. So many people got so mad lol

 

[NewDocInTown123]

A group at redlands comm hosp pay 280k for days for night you should be asking for 300-320k min.

I did get an offer in redlands area, frankly I want to be in LA county and near the city and near my family.

 

[wamcp]

k.... so moving beyond the LA sucks and we should all move elsewhere theme of this thread and getting back to what the thread owner asked.... my wife just joined with loma linda for 250. 7 on 7 off with only about 11 nights of cross coverage requirement (no admissions) which can be farmed out to fellows/residents for a 11k pay cut. faculty position with plan to work with residents. I dunno about partnership but doubt that is part of the structure. I will say thought that LLU pays great benefits. 5% retirement regardless of your contribution which vests 100% after 5 years. But LLU is slightly inland of LA proper so go figure.

Comes out to 112/hr for day hospitalist work, and 83/hr for night coverage. In a HCOL area. How does one agree to that...pathetic...

 

[wamcp]

I agree with you that $138/hr seems low when ED docs are making $225-275/hr. What would be a good hourly rate? I am not sure why IM docs accept such low rate for hospital medicine...

In my suburban area in a >1 million metro. Rates are typically $175/hr for full time night or admitter shift work. Moonlighting rates often spike much higher here, up to $250 at times. Highest I have picked up is $300/hr.

I will concede that these moonlighting rates are probably unicorn rates and for that reason I will (selfishly) not disclose where I am

 

[Hippocrates II]

Seems to be a lot of hate or pew pew about picking a job in Cali. Thanks to the first persons response who helped to clarify that the current offer I have is within the norm.

You invite that criticism when you describe the Midwest and East coast as the "undesirable" places to live, and the people living there are too unenlightened to understand the appeal of California.

 

[Splenda88]

In my suburban area in a >1 million metro. Rates are typically $175/hr for full time night or admitter shift work. Moonlighting rates often spike much higher here, up to $250 at times. Highest I have picked up is $300/hr.

I will concede that these moonlighting rates are probably unicorn rates and for that reason I will (selfishly) not disclose where I am

Is that in the midwest? In the south, these are offers one can get in rural areas. However, I know two individuals at my program who got 380k for 7 days on/off (morning shifts) at a semi-rural place (population 60k).

 

[FattySlug]

Is there a another reliable source to do this research on salary other than sdn and word of mouth? People kept telling me I should know the standard rate in my area but where does one even begin the research? lol

 

[Skindoc83]

Is there a another reliable source to do this research on salary other than sdn and word of mouth? People kept telling me I should know the standard rate in my area but where does one even begin the research? lol

The only way to know standard rate is to apply to all of the practices in that area and compare the offers you are given. That will let you figure out what/how much you can negotiate

 

[deleted547631]

Is that in the midwest? In the south, these are offers one can get in rural areas. However, I know two individuals at my program who got 380k for 7 days on/off (morning shifts) at a semi-rural place (population 60k).

Wow!! Is this 380K base salary? That's very strong!

 

[Splenda88]

Wow!! Is this 380K base salary? That's very strong!

Yes, it is... But this place is hours from a major city

 

[TraderDoc]

Have many friends in California, especially LA, most live in west Hollywood/Santa Monica. I spend about 4-8 weekends (Friday to Monday) there every year visiting friends and partying. Incredibly high cost of living in my opinion, although the nightlife and food scene is absolutely amazing. Traffic is a nightmare and one primary reason I never considered living in LA even it is one of my favorite cities to visit.

And opening a Botox clinic/healthspa/concierge practice is not easy by any means. Have IM friends who have opened health spas. They're making money, but definitely is not "raking in the cash" like people think it does, and actually takes 1-2 years before making real profit. And opening a business comes with own headaches and stress.

You should live in California purely because you love the weather/lifestyle and being with family should be of utmost priority. It is an absolute horrible decision to live in California, especially in SoCal and ultra populated cities like LA, from a financial standpoint.