Hospitalist, salary question

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APACHE3

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Ok, so I haven't even started internship yet, but I do get emails from headhunters looking for Hospitalist. I got one the other day, practice in the Savannah, hilton head area where they would pay the PGY-3 a 2,000 mo. stipend (during 3rd year) if he/she signs on to start after graduation. Thats like a 24,000 signing bonus. And if I remember the base salary was 170,000 with work incentives to boot. Is this atypical of hospitalist pay packages and specifcally, that PGY-3 stipend is sweet deal. Will this become the norm? 🙂
 
LOL
Over here where I be at, starting salary is 160K....I already thought that was a sweet deal 🙂
 
It's around 150 at university.
 
APACHE3 said:
Ok, so I haven't even started internship yet, but I do get emails from headhunters looking for Hospitalist. I got one the other day, practice in the Savannah, hilton head area where they would pay the PGY-3 a 2,000 mo. stipend (during 3rd year) if he/she signs on to start after graduation. Thats like a 24,000 signing bonus. And if I remember the base salary was 170,000 with work incentives to boot. Is this atypical of hospitalist pay packages and specifcally, that PGY-3 stipend is sweet deal. Will this become the norm? 🙂

You will get many similar mailings from headhunters during your residency -- this package is pretty much on par with the stuff that I've seen. A general rule is that the further away from a major city you get, the more attractive the package. The "Savannah, hilton head area" probably means that the hospital is about an hour from each of those areas - they don't tell you the exact city for a reason. 😉 Or maybe I'm just too skeptical -- I've never bothered to actually contact any of these headhunters.

I haven't seen the PGY-3 stipend offer before, but over the last couple of years I've mostly been throwing out these mailings without even looking at them.... But keep in mind that you can easily make 2,000 extra per month as a PGY-3 by moonlighting 2-3 shifts each month.
 
How much do you think the teaching hospitalists make at university based residency programs? Their job seems pretty sweet...residents do all the leg work, and they just sit back, give advice, teach a little, and come in and shake the patient's hand like as if they were the president or something.
 
Well I get a lot of those mailings..and yes, it seems minimum is 160K + incentives, but occasionally I see a 150K + incentives. however, its WHERE the job is that ,matters. Ive seen some nice pay packages. Anyway, it was the PGY-3 stipend that caught my eye because I never saw that before and I would be curious if this trend catches on...I hope so!! Let the bidding begin..!!! I can make 2 grand a month moonlighting in PGY-3??/sweeeeet. 😀
 
i've been seeing 150K guaranteed base salary in midwestern states. but of course, these are at community/private hospitals. i highly doubt you could make that at a university...you'd have more responsibilities and less pay.
 
AJM said:
But keep in mind that you can easily make 2,000 extra per month as a PGY-3 by moonlighting 2-3 shifts each month.

Many programs don't allow moonlighting (the one I'm going to doesn't), and I suspect that it will become even more rarely allowed as programs try to make sure they are within the 80 hour rules.
 
DRDARIA said:
Many programs don't allow moonlighting (the one I'm going to doesn't), and I suspect that it will become even more rarely allowed as programs try to make sure they are within the 80 hour rules.

I'm not sure moonlighting counts towards the 80 hours.
 
BMore said:
I'm not sure moonlighting counts towards the 80 hours.

I believe it's supposed to, if it's at the same institution. Regardless, many institutions no longer allow it.
 
BMore said:
I'm not sure moonlighting counts towards the 80 hours.


I sure it does not count towards 80hr rule, since it is not part of residency program. Night float counts towards 80 hrs, but not moonlight. At least this is what i have seen.

As long as you have step 3 you are ok. You will have a eval. of your before and after, and if they see moonlighing is hurting your residency you will be booted from moonligting.
 
Like I said, I heard 145-150 for starters for academic hospitalists.
 
My program allows in-house moonlighting only and (at VA). and it does count toward 80 hr work week which is why you do most of this during a easy elective month. I'm IMG so I have to wait an extra year, while my US grad colleagues will be driving their new 'benz a year earlier!! 😀
 
Straight from the horses mouth (The ACGME FAQ): http://www.acgme.org/acWebsite/dutyHours/dh_Lang703.pdf

Duty Hour Limits and Resident Moonlighting and other Clinical Activities

Question: Why does the ACGME distinguish between “in-house moonlighting,” which is counted under the weekly duty hour limit, and external moonlighting, which is not included?

Answer: The ACGME has two reasons for counting in-house moonlighting toward the weekly duty hours. First, it applies the same standard to all hours residents spend in teaching institutions, whether they are part of the required educational program or are spent moonlighting in-house. The second reason is to prevent institutions from inappropriately using in-house moonlighting to replace clinical service activities residents covered previously as part of the educational program. Second, the ACGME's purview extends to teaching programs and sponsoring institutions, but not resident activities outside of their educational program. Many perceive the ACGME does not have the right to curtail moonlighting or place all moonlighting hours under a weekly duty hour limit. In contrast, individual programs and institutions may prohibit or limit resident moonlight, and may do so formally via the resident contract.

Question: Our residents engage in “in-house moonlighting.” We are not clear which of the ACGME duty hour standards apply.

Answer: For internal moonlighting the only numeric standard that applies is the 80-hour weekly limit, e.g., the combined hours of residency education and internal moonlighting must comply be at 80 or fewer hours, averaged over four weeks. None of the other numeric standards (e.g., 10 hours rest period, 1 in 7 free of all programs responsibilities) apply. However, the expectation is that the residents’ total hours spent in-house will not exceed what is advisable from a patient safety and resident learning perspective.

Just FYI and all.

BE
 
If they are willing to pay that much just to get you to commit,
1. the job probably blows
2. I would carefully examine whatever you are asked to sign.

Remember the old adage about things that look too good to be true.
 
If they are willing to pay that much just to get you to commit,
1. the job probably blows
2. I would carefully examine whatever you are asked to sign.

Remember the old adage about things that look too good to be true.


Maybe, but I dont think living 30 minutes from Savannah nor 30 minutes from Hilton Head "blows". What I have found, is that US grads, like mirgatory animals, have the basic instinct that if they are not within the city limits of a place 850,00+, they have not made it, so they spurn these smaller town job offers leaving them for the non academics or the IMG's (like me). And since we both know there exist a doc shortage which wont be corrected in the next decade, I was hoping that this might be a growing trend. But, you may be right...
 
What you say about location is true. But there is a lot more to a job than location.

Would you think 160k + 24k signing bonus is good if you had to do q3 in house call? Or you had 5 days paid vacation a year? Or no health insurance?

Just read the fine print before committing.
 
What you say about location is true. But there is a lot more to a job than location.

Would you think 160k + 24k signing bonus is good if you had to do q3 in house call? Or you had 5 days paid vacation a year? Or no health insurance?

Just read the fine print before committing.


Absolutley...of course q3 would suck...And I will read the fine print and have my lawyer do it too. I am hoping that there will be a growing trend either from hospitals or private practices to offer more to us hospitalist. Actually I would encourage you to just cruise through the want ads, you would be amazed at the diversity of salaries and benefits offered. It would have to be a learning experience for your future negotiations, ..ok..see ya! Just to add..another job pays 150K yr, 26 weeks off!! thats what I said, 26 weeks off..maybe its a night hawk postion, I cant remember, but for some that would be a job from heaven, and personally night shift staff are cooler anyway!! 😀
 
Actually it is not that unusual as a hospitalist. You work 7 days 12 hours a day and then take 7 days off. 52 weeks a year comes to 26 weeks off!

Sounds like a tough schedule to me though.
 
does anyone have a good idea of what other responsibilities hospitalists at univ programs have other than teaching? i assume there may be some committee work - depending on how involved they are in the program. is there generally and expectation / demand for research / publication? i would also guess that they probably have to work more than 24 months a year if they have residents to take call / admit / write notes / orders, etc.
 
I wanna know how to get on those mailing lists. I've been in residency now for nearly a year and no such letters. Guess I missed that class or something.
 
I hope I never have to work 24 months a year... 😛

Hospitalsts do a lot of systems and QI stuff, patient flow, etc. It's actually pretty interesting.
 
Sounds like a decent package but find out how much you have to take call. Private internists make much more. In Houston, for example, there are several private internists who make 300k per year but the risk is higher and they work hard.
 
Start at Hospitalistjobs.com from there you can link another 100 sites. Also Check out Society for Hospital Medicine which is the organization representing our new profession. PM Mumpu, he seems to be on top of things in the hospitalist world...
 
Not really but thanks for the compliment. 🙂
 
About headhunters and hospitalistjobs.com, etc. Don't they (the recruiters) get some % of your salary if you get a job through them? I heard sometimes this is the case, other times you have to pay upwards of 30k for thier services...is this accurate? Or how does it work??
 
the fee would usually be paid by the firm looking to hire..not you. Hopefully you can find a job WITHOUT the headhunters and negotiate a better signing bonus for yourself as part of the savings the practice will get from not paying $30,000 to find you!!
 
Hello Guys,

Do you think it's fair salary to work for 120K at Unversity Hospital?. Decent schedule, no niight call and 14 weeks off. any suggestion is much appreciated

thanks
sg
 
Salaries vary a lot by region. I've heard 140s for starting academic hospitalists in my neck of the woods.
 
hmmm....$120K sounds kinda low. I'm assuming it's in a highly desirable part of the country or that the schedule is pretty cush. I just got an offer at a University program in the Midwest/East Coast for ~$158K (plus an additional $10K in bonuses if certain goals are met). 15 wks off but it's a pretty demanding schedule otherwise. I also know of another University program that offers $140K + $10K in bonuses and $10K in loan forgiveness. Hospitalists are the work-horses of University-based residencies in an attempt to off-load the 80hr work week...therefore we get worked HARD.

Sadly, we make more than Full Professors in Cardiology or ERCP-trained GI attendings at my home institution.
 
thanks...need to research more on this
 
Hey, those guys over there at the pharmacy forum are saying they will be making 160k a year by 2010. What do hospitalists expect to make in 2010? Will there be more growth of hospitalist pay? Also, I have read on some job ads that in addition to the base of say 175k/yr, you also get paid for each patient you admit for like $70 per admission when you are on duty. Those of you who are already hospitalists, is that true? What are some of the incentives pakages besides the base salary?
 
I dont know about other places, but I do have a friend who is a hospitalist at Hopkins and you'd be shocked at how little he makes.

The base rate for Hopkins IM hospitalist service is only $50 an hour. That comes out to only about 100k for 40 hour work week average.

Apparently you take a huge pay cut for "serving at hte pleasure" of Hopkins. I imagine Harvard and other elite hospitals use a similar reasoning.

P.S. A nearby community hospital in Baltimore pays $80 an hour for hospitalists.
 
Base pay doesn't tell the whole picture. There is usually a significant clinical/performance component to the salary (which is an odd thing to do at a teaching institution but I suppose the Top 10 schools are not into the whole edumacation thing anymore, it's all about research money).
 
It's hard to tell where the field of pharmacy (and medicine) will be going by 2010. Some say that retail pharmacy will go the way of computers more being relied upon. But who knows...

PharmD's are paid by a for profit corporation like Walgreens. They make sure the pharm tech counted the right number of pills and didn't put the wrong pills in the bottle. Big f-ing deal. It's a great job and if you work solely to make money, it's probably one of the best jobs. But there's more to that in life than sitting at a counter and dealing with angry customers.
 
i second ndestrukt

however i wud go even farther and say i feel the same about cosmetic medicine and boob jobs and botox 🙂
 
I am with a hospitalist group in southern california and we currently offer a starting package in excess of 200K excluding benefits. Full partners make in excess of 300K and have a week on/week off schedule with a nt call on the seventh day.
 
A local group in Akron is offering $150,000 base, full benefits, plus a production bonus that can "realistically" bring your first year annual income to $200-225K.

Has anyone had any experience with the compensation package of community hospitalists in Cleveland or InCompass Physicians?

Thanks.
 
1st year- $144,000 for 151 hours a month, 4 weeks (140 hours) for vacation/CME. Middle of nowhere community midwest. Plenty of overtime available. Not an "ideal" group, but not bad either. Work load ok.
 
Just curious, any word on whether there are plans to make a fellowship mandatory for hospitalists? I know people have thrown that idea around with no specific source, but just wondering if anyone has something concrete.
 
Speaking from personal experience here, 140's is very accurate starting base for academics. There are incentives that will vary by program - ours are based on RVU's (the numerical measure of how much you bill).

For comparison, the private group across town starts at 160K and keep themselves understaffed so that the gunners can make over 200K by working extra. Both places are 7 on/7 off (work 26 weeks a year).

Other differences, we carry 12-15 patients, which is likely the max feasible in an academic center with lower quality nursing and the red tape of academics (your consults are seen by the student, then the fellow, then the attending - and none of them have financial incentive to work quickly). In the private world, that would probably be closer to 20 patients daily. If you have midlevels this number can be higher.

So the trade-off for me is: don't work as hard, have an academic appointment, interact with students/residents vs. make ~30 less.

Also remember that $140K in NYC or southern Cal is NOT the same as in west Texas or rural Georgia or what have you. Also remember that annual salary is not always a great measure of total income. For me, I have virtually no other overhead or expenses and get a 403B with match. If you start having to pay for health insurance or malpractice your numbers will start to not look so hot.


As to the question of a hospitalist fellowship - I don't really see the point. Coming out of residency I felt much better prepared to keep working in the hospital that I was was to go into my own office. Proponents of the fellowship, please rebut -- maybe it's something we should consider.
 
As to the question of a hospitalist fellowship - I don't really see the point. Coming out of residency I felt much better prepared to keep working in the hospital that I was was to go into my own office. Proponents of the fellowship, please rebut -- maybe it's something we should consider.

Having just finished a 2 month outpt rotation at the start of my R2 year I would go so far as to say that perhaps a primary care fellowship is in order, rather than a hospitalist fellowship. My training as an intern was 85% inpatient (ward/unit/NF/ED/consult) w/ 6 wks of outpt stuff (1 month Onc, 1 month mixed, of which half was Derm). I started this year w/ outpt gen med and was in way over my head. I don't know what the hell to do w/ that ingrown toenail/chronic cough/stuff dripping out of your wang. I can manage your CHF exacerbation by seeing you every other day for the next 2 weeks (which I did) but had no idea how to handle the basics. I do now but it was a rocky couple of weeks at the beginning. Obviously people in PC tracks will have more experience w/ this than I did but they will still spend 50+% of their time on inpt rotations. IM residency is a hospitalist fellowship.

Of course, if you make people who want to do primary care do an extra year of training, the number of people going into primary care (already at a dangerously low level) will fall through the floor.
 
I doubt it will decrease hospitalist salaries in the least. If anything, I can see a small argument for it increasing hospitalist salaries. There are not enough physicians graduating from IM residency to fill all the hospitalist positions available as well as for primary care.

The diagnosis that medicare won't pay for anymore are mainly preventable. My hospital has begun screening people on admission for MRSA colonization so that they can be isolated (and if an infection occures with it, reimbursed for care.) About the falls, I'm not so certain. Demented patients don't remember to ring for the nurse before getting out of the chair, and staff can only move so fast when the bed alarm goes off. Thank goodness, most of the patients move slowly to begin with.

The hospitalist fellowships are for people considering doing research. If you have had research training, it won't add much. It may put you directly into a directorship role, but I wouldn't count on that.
 
I find this all rather encouraging.
I'm a PA who is finally fed up enough as a PA to go back to med school, applying for 08. I worked six years in family medicine, did a year of outpatient urgent care part-time while working in FP full-time, and have now worked in ED the past year. I think I have a pretty good handle on primary care problems. I also think I would LIKE hospital medicine. What I DON'T like is EM, but for now it's a good job that pays well and is flexible and would allow me to go to med school without amassing even huger debt than I already have from PA school.
Our hospitalists seem to be 50:50 internists and FPs. Do you all think one is a better preparation than another? Or should the ideal Medicine service include a smattering of both?
I've considered doing a hospitalist fellowship too, but that adds more time to an already long and protracted path to practice...not to mention I want to do an MPH which draws out my time another year.
I welcome your thoughts...thanks in advance.
Lisa
 
After recently completing a residency in IM and after working as a Hospitalist now for 3 weeks, I would have to say that an IM residency better prepares you for this career than an FP one.

Having said that, it depends on what your end goals are. Do you want to be a Hospitalist forever (high burnout/turnover rate) or do you want a smattering of outpt medicine? Do you prefer academic or private hospitals? Do you like kids or are you ok w/ only taking care of adults?

Having trained at a large academic center and now working at another large academic center, you're exposed to a lot of complicated pts that come in through the ED, specialty clinics, and outside hospitals because your facility is the regional "mecca." Without a strong subspecialty background (something that you would find in many strong IM programs), you might get overwhelmed with the liver failure pt w/ HIV/hep C who's failed 2 transplants and is back for his 4 admission in as many weeks for abd pain/distention/diarrhea/ and skin rashes.

FP's deserve a lot of credit because they're breadth of knowledge is SO VAST. I think it's actually much harder to be a good FP than Internist, but they're better suited to outpt medicine. If you like kids and want to practice in a private setting, FP might be the right choice for you. If you prefer academics and sicker pts, then IM would be good to consider.
 
I have to agree with Annette. An IM doc told me that for every hospitalist that comes out there are five jobs that need to be filled. When demand is high and supply is low salaries don't go down..... With the baby boomers coming into the mix there will be huge demand for hospitalists but a lot of people like the 9-5 outpatient lifestyle. Expect salaries to go up not down.

Plus the logic is faulty. Its like saying that interventional radiologists salaries will go down because medicare won't pay for adverse reactions to dye....
Silly logic in my humble opinion..

B-



🙁

Enjoy that while it lasts...

I can only see this decreasing hospitalist incomes:

http://www.washingtonpost.com/wp-dyn/content/article/2007/08/18/AR2007081800760_pf.html
 
I appreciate your insight MidwestMD.
I DO like kids (something I was utterly shocked to discover in my peds rotations in PA school). I've thought about Med-Peds residency because I think it would give me flexibility, but I'm not sure what those slots are going to evolve into.
I just don't like EM, or at least not long-term.
Hmmm....
thanks
 
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