Is life as a Hospitalist really conducive to a lot of traveling?

[psychMDhopefully]

If a person wants to travel a lot, first around the country, then around the world, is hospitalist the way to go? I suppose working 7 days straight would be tough but eventually it wouldn't be too bad. 12 hr shifts seem exhausting though, is there any way to work from 7am-3pm and have a patient cap as a hospitalist? Id even take a pay cut for that.

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[PlutoBoy]

If a person wants to travel a lot, first around the country, then around the world, is hospitalist the way to go? I suppose working 7 days straight would be tough but eventually it wouldn't be too bad. 12 hr shifts seem exhausting though, is there any way to work from 7am-3pm and have a patient cap as a hospitalist? Id even take a pay cut for that.

Lol no to all.

7-3 and capped? 🤣

There is no cap as an attending. No ACGME to protect you.

What are you going to say if a septic patient needs admission? "Sorry i have seen 10 today?"

 

[Siggy]

Lol no to all.

7-3 and capped? 🤣

There is no cap as an attending. No ACGME to protect you.

What are you going to say if a septic patient needs admission? "Sorry i have seen 10 today?"

Hard caps? No. However don't most hospitalist groups either have enough hospitalists to keep the lists manageable and/or offer bonuses for patients over a certain number?

 

[smq123]

If a person wants to travel a lot, first around the country, then around the world, is hospitalist the way to go? I suppose working 7 days straight would be tough but eventually it wouldn't be too bad. 12 hr shifts seem exhausting though, is there any way to work from 7am-3pm and have a patient cap as a hospitalist? Id even take a pay cut for that.

I had a friend who "job-shared" a hospitalist position. She worked 7 days on, then 7 off, but she worked from 7 AM to 1PM. She would then sign out to her "job partner," who took over from 1PM to 7PM. My friend mostly rounded on the inpatients, while her partner did mostly admissions, but it seemed to work out for them. She made, I think, about $80K or so. This was about 5-6 years ago, so I don't know what the details of such a job would be now.

Keep in mind, though, that a) this type of position isn't terribly common, b) her husband worked full time and so she got health insurance benefits through his job, and c) planning a long trip for just a 7-day time frame is tough, unless you don't plan on going anywhere too exotic and you live near a major airport (Atlanta, Orlando, Miami, New York, etc.)

 

[Brahnold Bloodaxe]

Is it possible to get enough hours for a full time schedule purely from locums? I think it'd be sick to do 1 month on, 1 month off. On your 'on' month you try to work every single day, so assuming you can get enough hours at $150/hr you end up grossing 30*12*150=54k

Then have a whole month off cruising your sailboat in Southeast Asia until you come back for your next month's hustle. I know people are itching to tell me you'll never survive working 30 shifts straight, but that aside, is getting that many consecutive locums shifts even possible on a consistent basis?

 

[bananas85]

While not common, I understand where you are coming from cause I have asimilar mentality. I know of places where you can negotiate how many patients you will see a day and get paid per progress note, H and P or consults. You can tell them I will only do 12 progress notes a day or so on. They will give you a part of the collections. Usually 60% (depending on the location). This comes out to about 50 bucks per progress note, or 100 bucks per h and p.

I have heard of seasoned hospitalist who know the hospital system well, and the EMR knock out 20-25 patients without batting an eyelash. I dont know how they do it but they would come in at and leave at 3 and take calls from home.

Right now for me weekend gig, I do moonlighting for a hospitalist group. They pay me per progress note and I told them I dont want to see more than 12 for right now. Slowly I will get up to 15, and max 16 or 17. Since it is my side gig it is jsut extra cash, so I dont want to kill myself, and I like talking to patients. I hate running out of the room cause I have a lot of work left to do.

 

[bananas85]

absolutely. locums are non stop you can work as much as you want. I had a friend who did 60 days straight and made 90-100K in 2 months. BEAST MODE.. LOL.. If you go this route just keep an SSRI with you or a Psych counselor on speed dial. 🙂

 

[Brahnold Bloodaxe]

absolutely. locums are non stop you can work as much as you want. I had a friend who did 60 days straight and made 90-100K in 2 months. BEAST MODE.. LOL.. If you go this route just keep an SSRI with you or a Psych counselor on speed dial. 🙂

That is epic.

 

[Brahnold Bloodaxe]

Double

 

[rokshana]

Is it possible to get enough hours for a full time schedule purely from locums? I think it'd be sick to do 1 month on, 1 month off. On your 'on' month you try to work every single day, so assuming you can get enough hours at $150/hr you end up grossing 30*12*150=54k

Then have a whole month off cruising your sailboat in Southeast Asia until you come back for your next month's hustle. I know people are itching to tell me you'll never survive working 30 shifts straight, but that aside, is getting that many consecutive locums shifts even possible on a consistent basis?

sure, but realize those places are most likely in chaos and there is a reason they are 1 using locums and 2 are willing to have one person work 20-30 days...most of those places will have a heavy census since they are understaffed and in the long run not sustainable...

also remember as locums, you are an independent contractor and that 54K really is only 27-30k (you have to pay all of your taxes)

really if you have the traveling itch like that you should do EM... i have a friend that travels the world and works when he needs to and can work abroad as well...

 

[HelpPleaseMD]

While not common, I understand where you are coming from cause I have asimilar mentality. I know of places where you can negotiate how many patients you will see a day and get paid per progress note, H and P or consults. You can tell them I will only do 12 progress notes a day or so on. They will give you a part of the collections. Usually 60% (depending on the location). This comes out to about 50 bucks per progress note, or 100 bucks per h and p.

I have heard of seasoned hospitalist who know the hospital system well, and the EMR knock out 20-25 patients without batting an eyelash. I dont know how they do it but they would come in at and leave at 3 and take calls from home.

Right now for me weekend gig, I do moonlighting for a hospitalist group. They pay me per progress note and I told them I dont want to see more than 12 for right now. Slowly I will get up to 15, and max 16 or 17. Since it is my side gig it is jsut extra cash, so I dont want to kill myself, and I like talking to patients. I hate running out of the room cause I have a lot of work left to do.

i bet these are the hospitalist who don't know their patients at all with multiple ICU transfers for ****ty care. high white count? must be infection its start some abx. agitation? must be alcohol withdrawal. lets snow them with benzos and haldol until they cant protect their airway. respiratory distress? lets intubate and send to the ICU

 

[Brahnold Bloodaxe]

sure, but realize those places are most likely in chaos and there is a reason they are 1 using locums and 2 are willing to have one person work 20-30 days...most of those places will have a heavy census since they are understaffed and in the long run not sustainable...

also remember as locums, you are an independent contractor and that 54K really is only 27-30k (you have to pay all of your taxes)

really if you have the traveling itch like that you should do EM... i have a friend that travels the world and works when he needs to and can work abroad as well...

Absolutely, but as they say, no pain no gain. Now that you mention it, I am leaning towards EM for precisely the reason you noted. With that said, IM does offer the potential to "specialize" in case I end up getting tired of working whack schedules after a couple years. That may or may not be worth the lower hourly rates compared to EM, but that is still something I have to decide.

 

[bananas85]

Oh you haven't don't residency yet. If money and travelling is your goal Definitely go ER route. ERs have locums too except they pay lot more than IM locums. I am carribean grad so it was a little bit harder to get ER and also didn't know how to decided when I was a med student. Looking back ER would have been a better choice for my lifestyle needs

 

[PlutoBoy]

Hard caps? No. However don't most hospitalist groups either have enough hospitalists to keep the lists manageable and/or offer bonuses for patients over a certain number?

Some do. Not all. The Society of Hospital Medicine recommends a census of 14 or less IIRC. I'm just saying.

A lot of hospitals are understaffed. These are the hospitals targeted by the huge national hospitalist groups (think Apogee Physicians, IPC, Sound Physicians, etc).

Believe me, if you have to see 20 patients while playing nephrologist, neurologist, and intensivist, things get hectic pretty quickly.

No amount of money is worth my peace of mind and the safety of my patients.

Don't think for a second that when **** hits the fan the hospital or group you work for will have your back. And you won't be able to justify substandard care in court because you were overworked on any given day.

My advice: If you want to be a hospitalist, ask why they are looking for hospitalists, for how long hospitalists have stayed with them in the past 3-5 years, subspecialty support (at least two providers per specialty. A single nephrologist can't cover the hospital 24/7), ICU coverage (run away if you need to cover it), need for procedures and if you do need to do procedures ask if you are you reimbursed for it (otherwise, why would you take the liability of causing hemothoraces, puncturing the carotid, and so on and so forth? Believe me, you do enough of these and it will happen to you).

If you are not required to do procedures, what do they mean? Who will do the procedures? Is the procedure team off during the weekend? Because if they are you will end up doing them or delaying patient care until the procedure team gets back.

What is the average census and how do they calculate it? Because they may tell you "Over the past twenty eight days Dr. Pluto has seen 12 patients per day, on average." Yeah, but was Dr. Pluto working 28 days or 14 days during that month? I'm sure you can see where I am going with this.

Lastly, a backup team is always bull****. Assume that no one will come help you when you are overwhelmed. This is not residency.

Think about it. You wanna do hospital medicine to travel and relax. Do you wanna be called in when you are sailing the Caribbean because Dr. Smith can't handle one more admission? Well, if your answer is no, let me tell you that your colleagues feel the same way.

Hospital medicine is brutal. The week you are on you are on. There is little life outside of work for a week. Further, when you are off none of your friends or relatives are off unless they happen to be hospitalists or ER docs. No one is off on a Wednesday afternoon.

You will not travel every other week. Protect your weekends and holidays

My $0.02

Source: Experience

 

[IMreshopeful]

I have a friend who travels a ton locally on his weeks off with his hospitalist job but simply hasn't had enough time to go abroad on a week off. Travel alone to some place in Asia for example will usually eat up 3 days of the 7 off.

It's certainly doable but being a hospitalist is not a joke. It's a tough career which requires a lot of hard work when you're doing your week on. You also won't make as much money as you think if you're in a particularly "desirable" area and often I know people moonlight quite a bit to make ends meet. Or they just end up moving to somewhere that makes more money or do a locums gig.

 

[IMreshopeful]

absolutely. locums are non stop you can work as much as you want. I had a friend who did 60 days straight and made 90-100K in 2 months. BEAST MODE.. LOL.. If you go this route just keep an SSRI with you or a Psych counselor on speed dial. 🙂

That sounds like a great way to end up depressed, burned out, angry, and more. As a married person I'm sure if said person had a spouse they would be appalled.

 

[Brahnold Bloodaxe]

That sounds like a great way to end up depressed, burned out, angry, and more. As a married person I'm sure if said person had a spouse they would be appalled.

Not all people have a spouse, however. There is no point to malign a lifestyle based off of whether it is inappropriate for one sub section of the population.

 

[ProfMD]

One of my best friends is a hospitalist and loves it. He is a bit of a workaholic, though. He works at a critical access hospital, sees tons of sick patients, manages some of his own ICU patients, and only transfers out patients for subspeciality surgery that is not available at his place.

He also works with a good group that has a couple of people who only work nights - so he essentially never has to. He also is able to arrange his schedule to get several weeks off in a row (once in a while) for longer trips. All this, and he makes good money.

 

[IMreshopeful]

Not all people have a spouse, however. There is no point to malign a lifestyle based off of whether it is inappropriate for one sub section of the population.

I think it's a bad idea regardless of your marital status

 

[dozitgetchahi]

I think it's a bad idea regardless of your marital status

Bingo. You need to keep your sanity for the long run as a physician. I think a lot of medical students don't fully grasp this until they experience residency.

Hospitalist medicine sounds like a sweet deal ('oh boy, one week on one week OFF!!') when it actually isn't. From what I've seen/heard from practicing hospitalists and experienced as a resident, the week on is a gigantic kick in the ass and much of the next week off is spent recovering. It's a bizarre rhythm to get used to. Additionally, most of your time off occurs when nobody else is available (as stated above) - just wait till your first wards block in residency when you try to get some people together to hang out on a random Thursday. Getting everybody's schedules to line up happens about as rarely as a solar eclipse. Nobody else will be available on those weeks off when you're an attending, and meanwhile you're spending every other weekend in the hospital.

Not to mention that carrying 20+ pt censuses all while admitting 5+ pts a shift (and often covering an ICU to boot) is a recipe for piss poor patient care. If your dream as a doctor is to be a glorified chart-writing monkey all while speed-dialing every consultant around for every issue because you don't have time to breathe and/or think, then some of these jobs may be great for you. If not, look elsewhere.

This doesn't even take into the account the fact that as a fresh attending, you will likely have many other financial priorities to deal with and blowing huge amounts of cash to be a jetsetter seems unwise at best.

As stated above...'protect your weekends'. Subspecialties are where it's at, especially primarily outpatient ones where you get to dodge rounding constantly in the hospital.

 

[dozitgetchahi]

absolutely. locums are non stop you can work as much as you want. I had a friend who did 60 days straight and made 90-100K in 2 months. BEAST MODE.. LOL.. If you go this route just keep an SSRI with you or a Psych counselor on speed dial. 🙂

LOL. It sounds like some get rich quick huckster's sales pitch ('Wanna make $100k in 60 days flat? Here's how!').

There's other insane ways to do this in the medical profession too. My wife works as a nurse at a hospital where most of the night hospitalist coverage (they call them 'house officers' despite the fact that they are not, in fact, residents but actually attendings) have completely separate day jobs as PCPs/hospitalists elsewhere/nursing home docs etc. These attendings work their day job and show up to work a night shift hoping that there will be as little action as possible to allow for sleep. They do their best to avoid having to do anything during these shifts. They then roll out of bed in the AM, shower in the OR locker room and go to their day job...rinse and repeat for months on end.

All of these doctors are exhausted, miserable and objectively doing a terrible job of patient care from the sounds of it - but I guess they're living the dream of making $100k every 60 days as per what my wife overhears.

 

[Brahnold Bloodaxe]

LOL. It sounds like some get rich quick huckster's sales pitch ('Wanna make $100k in 60 days flat? Here's how!').

There's other insane ways to do this in the medical profession too. My wife works as a nurse at a hospital where most of the night hospitalist coverage (they call them 'house officers' despite the fact that they are not, in fact, residents but actually attendings) have completely separate day jobs as PCPs/hospitalists elsewhere/nursing home docs etc. These attendings work their day job and show up to work a night shift hoping that there will be as little action as possible to allow for sleep. They do their best to avoid having to do anything during these shifts. They then roll out of bed in the AM, shower in the OR locker room and go to their day job...rinse and repeat for months on end.

All of these doctors are exhausted, miserable and objectively doing a terrible job of patient care from the sounds of it - but I guess they're living the dream of making $100k every 60 days as per what my wife overhears.

That's even more epic! I'm beginning to think that hospitalist locums is even more lucrative than EM locums. EM might pay more per hour, but from what I read at their forum an EM shift really kicks your a$$ so your ability to maximize the number of hours worked in a month is not that high.

How sweet would it be to spend ~90% of your time in the USA, both awake and asleep, getting paid! Like work 12 hour shifts for 150/hr at a reasonably calm place during the day, then spend the next 12 hours at a very low volume shop at $100/hr or more. So you can make at least $3000 per 24hr period. If you can endure 25 such shifts in a month, you will make 75K and can work 1 month on 2 months off!

 

[lymphocyte]

It's hilarious to read the medical students vs the actual doctors in this thread.

The students talk about things being epic, jet-setting, and imagine money piling up.

The doctors are saying, "Dude, it's actually really hard."

I'm only a medical student, but I consulted for a large ACO, including hospitalist compensation review. Based strictly on my "top-down" perspective, hospitalists work damn hard for their money, and hospital medicine can be brutal, especially if you care about practicing responsible medicine. I have tremendous respect for quality hospitalists. @PlutoBoy's posts are so on point.

Burnout is very real. So is depression.

Just remember this: as long as you're working for somebody else, and you don't fight for yourself, you'll be worked to the ground--wherever possible, as much as possible, for as long as possible, and for as little remuneration as possible. That might sound swell when you're 28, but 38-you is not 28-you. Plan accordingly.

To answer your original question OP: the most travel-friendly specialties seem to be EM, Gas, and rural-ish FM. You could work almost anywhere in the world with those skills (and FM even has reciprocal licensing agreements with Australia, New Zealand, Canada, and Ireland--that's almost unheard of in any other speciality).

As a caveat, anything is possible with a steep enough pay cut.

 

[Brahnold Bloodaxe]

^^What is even more hilarious is that you apparently didn't notice the actual doctors in this thread describing other actual doctors not in this thread "jet setting and letting money pile up." Everyone has different priorities brah. The docs in this thread happen to place less emphasis on stacking cash than other doctors who are too busy stacking cash to participate in this thread.

And that's all right. I'm glad not everyone in medicine is as focused on making money as I am. This makes it easier for me and others like me to make money, because it means there is less competition for those exhausting but lucrative opportunities. To each his own.

 

[lymphocyte]

^^What is even more hilarious is that you apparently didn't notice the actual doctors in this thread describing other actual doctors not in this thread "jet setting and letting money pile up." Everyone has different priorities brah. The docs in this thread happen to place less emphasis on stacking cash than other doctors who are too busy stacking cash to participate in this thread.

Yeah brah. Totally. Best of luck with your vocation for stacking cash. But I promise, from being part of a team that actually set remuneration at an actual hospital, it's going to be money, lifestyle, or patient care--pick 1 and a half.

Oh, and the trend for remuneration is down, not up. Value by volume is always a losing battle. It's also the easiest way to fall into the crosshairs of reimbursement cuts. Ask any pathologist, radiologist, cardiologist, gastroenterologist etc.

 

[Brahnold Bloodaxe]

Yeah brah. Totally. Best of luck with your career stacking cash. But I promise, from being part of a team that actually set remuneration at an actual hospital, it's going to be money, lifestyle, or patient care--pick 1 and a half. Being a hospitalist is tough. The good ones have my complete respect and admiration.

And here's a quote from every self-identified doctor in this thread:

What's your point brah? As I've said, the doctors in this thread are providing one particular perspective. They're not all about the benjamins, and that's ok. They don't like to kill themselves for money, and so when describing their colleagues who do, they offer their personal perspective, which isn't supportive of that mentality. I bet if you asked those colleagues, however, you'd get quite a different perspective. There are docs working all sorts of crazy hours out there making all sorts of crazy money, and you cannot deny that any more than you can insist the world is flat. If they felt it wasn't worth it, they wouldn't do it, but they do.

I really don't understand what your 'thing' is here but whatever. If choosing between sleeping comfortably in my bed for $0 or somewhat less comfortably at the hospital for $1500 I'll choose the latter as often as practicable, and there is nothing you can do about it😛

 

[lymphocyte]

What's your point brah? I really don't understand what your 'thing' is here but whatever. If choosing between sleeping comfortably in my bed for $0 or somewhat less comfortably at the hospital for $1500 I'll choose the latter as often as practicable, and there is nothing you can do about it😛

My "thing" was to help OP by providing some insider perspective on hospitalist compensation and echoing the excellent advice he or she just received. I've accomplished that. Again, best of luck to you.

 

[dozitgetchahi]

What's your point brah? As I've said, the doctors in this thread are providing one particular perspective. They're not all about the benjamins, and that's ok. They don't like to kill themselves for money, and so when describing their colleagues who do, they offer their personal perspective, which isn't supportive of that mentality. I bet if you asked those colleagues, however, you'd get quite a different perspective. There are docs working all sorts of crazy hours out there making all sorts of crazy money, and you cannot deny that any more than you can insist the world is flat. If they felt it wasn't worth it, they wouldn't do it, but they do.

I really don't understand what your 'thing' is here but whatever. If choosing between sleeping comfortably in my bed for $0 or somewhat less comfortably at the hospital for $1500 I'll choose the latter as often as practicable, and there is nothing you can do about it😛

It isn't worth it. Getting paid huge sums of cash means essentially nothing when you have no time whatsoever outside of work to enjoy it - or when you're so tired that you can't enjoy it even when you're off.

The number of people doing this crazy stuff is minimal within the profession, and these people generally aren't well regarded by their colleagues because they're sacrificing the quality of their care for $$$. Most doctors aren't 'all about the Benjamins' despite what the liberal brain trust would have everyone believe, and most doctors care just as much (if not more) about doing the best they can for their patients as opposed to lining their pockets in the most reckless ways possible. Ruining your health for the $$$ is also an extremely unwise proposition as well (I'm 29 years old and I'm the only person in my family with HTN; I'm also the only doctor. Free associate as you like.). Work insane hours like that and sooner or later your health will take a hit.

You wanna make big cash money as a doctor? Do derm or plastic surgery if you want the easy life, or do neurosurgery if you want to live like a Navy SEAL for the rest of your life. General IM isn't the way to do it unless you're a) concierge (there are some concierge PCPs in my area that are pulling $500k from retainers all while working 40 hr/wk) or b) doing something stupid as we've been talking about in this thread or c) doing something illegal.

 

[IMreshopeful]

What's your point brah? As I've said, the doctors in this thread are providing one particular perspective. They're not all about the benjamins, and that's ok. They don't like to kill themselves for money, and so when describing their colleagues who do, they offer their personal perspective, which isn't supportive of that mentality. I bet if you asked those colleagues, however, you'd get quite a different perspective. There are docs working all sorts of crazy hours out there making all sorts of crazy money, and you cannot deny that any more than you can insist the world is flat. If they felt it wasn't worth it, they wouldn't do it, but they do.

I really don't understand what your 'thing' is here but whatever. If choosing between sleeping comfortably in my bed for $0 or somewhat less comfortably at the hospital for $1500 I'll choose the latter as often as practicable, and there is nothing you can do about it😛

My colleagues who work in this sort of position are miserable and are trying actively to find another job after two years of doing it. Or they are using it as a way to pay down student loans prior to fellowship. Sure there's some crazy doctors out there who want to make money to the exclusion of all else, but what exactly is the point of that money if you're never going to use it?

If you want to sleep at the hospital and get woken up incessantly by nurses paging to put in orders for Tylenol on a census of 150 or more cross covering patients you don't know much about then sure it's a great gig. Or if you don't have much of a life it's a great gig. I have friends and family outside of work that I like to enjoy my time with and the lifestyle you are recommending is a one way ticket to major depression, burnout, and very poor health.

 

[Brahnold Bloodaxe]

It isn't worth it. Getting paid huge sums of cash means essentially nothing when you have no time whatsoever outside of work to enjoy it - or when you're so tired that you can't enjoy it even when you're off.

The number of people doing this crazy stuff is minimal within the profession, and these people generally aren't well regarded by their colleagues because they're sacrificing the quality of their care for $$$. Most doctors aren't 'all about the Benjamins' despite what the liberal brain trust would have everyone believe, and most doctors care just as much (if not more) about doing the best they can for their patients as opposed to lining their pockets in the most reckless ways possible. Ruining your health for the $$$ is also an extremely unwise proposition as well (I'm 29 years old and I'm the only person in my family with HTN; I'm also the only doctor. Free associate as you like.). Work insane hours like that and sooner or later your health will take a hit.

You wanna make big cash money as a doctor? Do derm or plastic surgery if you want the easy life, or do neurosurgery if you want to live like a Navy SEAL for the rest of your life. General IM isn't the way to do it unless you're a) concierge (there are some concierge PCPs in my area that are pulling $500k from retainers all while working 40 hr/wk) or b) doing something stupid as we've been talking about in this thread or c) doing something illegal.

I agree. As I've noted in my previous posts in this thread, my goal is maximize the time I am not working. There are different ways to go about doing so. One way is to work the usual 5 days a week, every week, but only work part of the day. The other extreme is to work intensively for a period of time, before taking extended periods of time off. That's the route I prefer. I am not advocating ruining your health by living to work, but rather working in such a way as to concentrate both the pain (work) and the gain (time off).

 

[IMreshopeful]

And that's all right. I'm glad not everyone in medicine is as focused on making money as I am. This makes it easier for me and others like me to make money, because it means there is less competition for those exhausting but lucrative opportunities. To each his own.

What are you, twelve? That's not how the market works.

If you want to make a lot of money you are barking up the wrong tree. Might want to find the derm forum buddy.

Also lol @ the comment about EM being more likely to burn you out... yes you probably see more patients on EM but to me it's a hell of a lot less stressful than rounding on several patients a day and doing comprehensive H&Ps on several patients a day simultaneously for days on end. Oh and EM doesn't require continuity of care...you discharge or admit from the ED once you've stabilized and made a diagnosis and started treatment (if that, knowing some of the crappy care that I've seen from EM sometimes).

 

[IMreshopeful]

I agree. As I've noted in my previous posts in this thread, my goal is maximize the time I am not working. There are different ways to go about doing so. One way is to work the usual 5 days a week, every week, but only work part of the day. The other extreme is to work intensively for a period of time, before taking extended periods of time off. That's the route I prefer. I am not advocating ruining your health by living to work, but rather working in such a way as to concentrate both the pain (work) and the gain (time off).

You aren't listening to us. This is not a feasible option - we are describing outlier cases. My friends who work like dogs for weeks on end as locums hospitalists have already started developing health issues with their cholesterol and blood pressure in their early 30s. Whether or not you want to admit, this is an incredibly unhealthy lifestyle and the "pain" you are so keen on working through becomes actual physical pain when you're in your 30s and 40s.

Maybe trust that we have lived a similar existence to this as residents and that there's a reason we are saying what we are.

 

[Lee Ik-jun MD]

i bet these are the hospitalist who don't know their patients at all with multiple ICU transfers for ****ty care. high white count? must be infection its start some abx. agitation? must be alcohol withdrawal. lets snow them with benzos and haldol until they cant protect their airway. respiratory distress? lets intubate and send to the ICU

You just described 2/3 of the hospitalists here 😉 ( where i work).

 

[Brahnold Bloodaxe]

You aren't listening to us. This is not a feasible option - we are describing outlier cases. My friends who work like dogs for weeks on end as locums hospitalists have already started developing health issues with their cholesterol and blood pressure in their early 30s. Whether or not you want to admit, this is an incredibly unhealthy lifestyle and the "pain" you are so keen on working through becomes actual physical pain when you're in your 30s and 40s.

Maybe trust that we have lived a similar existence to this as residents and that there's a reason we are saying what we are.

I guess I am having trouble understanding why it's possible for neurosurgery residents (and some attendings) to work 80-90hr weeks for 7 years straight while doing the same exact thing but only every other month will ruin your health as a hospitalist. But sure, I admit I haven't experienced it myself, and until I do I have to leave open the possibility that it is in fact not feasible.

 

[IMreshopeful]

I guess I am having trouble understanding why it's possible for neurosurgery residents (and some attendings) to work 80-90hr weeks for 7 years straight while doing the same exact thing but only every other month will ruin your health as a hospitalist. But sure, I admit I haven't experienced it myself, and until I do I have to leave open the possibility that it is in fact not feasible.

The neurosurgery residents that I have met have all been a mix of screw up, alcoholic, sociopath, or psycho. Where I trained I knew residents who quickly developed medical issues due to chain smoking and poor diet combined with stress. I knew a neurosurgeon who has had two MIs prior to the age of 50. It's an extremely stressful life. Not all of them make it through and I know two residents who dropped out of their respective programs. There's also incredible marital strife - some programs are known for having > 100% divorce rates. They are all around known for being incredibly unhappy throughout their training and usually attendings elect to do something laid back like spine or they remain unhappy and angry.

Being a surgeon also has a different set of duties from a hospitalist. They typically round in a focused manner on their inpatients and spend most of their time answering consults and doing surgery. Hospitalists take care of much more medically complex patients and have a much higher turnover even without doing procedures. Both specialties have their pluses and minuses.

It also isn't actually 80-90 hour weeks for 7 years on end. Like any specialty they have slower months and as you go up the rank ladder there's less grunt work.

So sure they are able to do it for an extended period of time but they suffer like hell for it.

 

[ProfMD]

What's your point brah? As I've said, the doctors in this thread are providing one particular perspective. They're not all about the benjamins, and that's ok. They don't like to kill themselves for money, and so when describing their colleagues who do, they offer their personal perspective, which isn't supportive of that mentality. I bet if you asked those colleagues, however, you'd get quite a different perspective. There are docs working all sorts of crazy hours out there making all sorts of crazy money, and you cannot deny that any more than you can insist the world is flat. If they felt it wasn't worth it, they wouldn't do it, but they do.

I really don't understand what your 'thing' is here but whatever. If choosing between sleeping comfortably in my bed for $0 or somewhat less comfortably at the hospital for $1500 I'll choose the latter as often as practicable, and there is nothing you can do about it😛

To be fair, my buddy who is a hospitalist loves his job. Wouldn't do anything else. He is a workaholic and working like this makes him happy. He works 1-2 weeks on, then 1-2 weeks off. When he is on, he works 14-16 hour days. Another person in his group covers nights. About half the time, he covers the teaching service and has residents and med students, the other half he is on his own. He makes use of his time off working out, traveling, hanging out with non-medical friends.

He is also nearly 40, single, lives in the same apartment he had as a resident.

It is a lifestyle choice, not for everyone. Like others said, if you are in it for the money, don't do medicine.

 

[Brahnold Bloodaxe]

What are you, twelve? That's not how the market works.

That's precisely how the market works, for shift work. Wages are determined by supply of labor and demand for labor. If every hospitalist wanted to maximize earning all of a sudden and switched from 7 on 7 off to always on, effective supply would double while demand would be the same. Guess what that would mean for wages?

 

[lymphocyte]

.

 

[rokshana]

That's even more epic! I'm beginning to think that hospitalist locums is even more lucrative than EM locums. EM might pay more per hour, but from what I read at their forum an EM shift really kicks your a$$ so your ability to maximize the number of hours worked in a month is not that high.

How sweet would it be to spend ~90% of your time in the USA, both awake and asleep, getting paid! Like work 12 hour shifts for 150/hr at a reasonably calm place during the day, then spend the next 12 hours at a very low volume shop at $100/hr or more. So you can make at least $3000 per 24hr period. If you can endure 25 such shifts in a month, you will make 75K and can work 1 month on 2 months off!

you haven't gotten past basic years have you?

but then by the time you finish up residency (that is of course you get into medical school), being a hospitalist probably won't be as lucrative...

 

[rokshana]

What's your point brah? As I've said, the doctors in this thread are providing one particular perspective. They're not all about the benjamins, and that's ok. They don't like to kill themselves for money, and so when describing their colleagues who do, they offer their personal perspective, which isn't supportive of that mentality. I bet if you asked those colleagues, however, you'd get quite a different perspective. There are docs working all sorts of crazy hours out there making all sorts of crazy money, and you cannot deny that any more than you can insist the world is flat. If they felt it wasn't worth it, they wouldn't do it, but they do.

I really don't understand what your 'thing' is here but whatever. If choosing between sleeping comfortably in my bed for $0 or somewhat less comfortably at the hospital for $1500 I'll choose the latter as often as practicable, and there is nothing you can do about it😛

there are very ver few places that are going to let you sleep for 1500/night...do not expect to sleep as a nocturnist, especially at a place that is dependent on locums...place that depend on locums are in chaos...or in the middle of BFE where they can't keep permanent people...meaning that you will be working your butt off (20-25 pts per day, 10-15 admission/night)...and the choice isn't between making money or not making money...its whether you are capable of practicing good medicine...and seeing that volume on a consistent basis for more that 7 days is going to result in mistakes...ethically you should feel that you are short changing your patients...legally...puts you at greater risk of being sued...

 

[PlutoBoy]

To be fair, my buddy who is a hospitalist loves his job. Wouldn't do anything else. He is a workaholic and working like this makes him happy. He works 1-2 weeks on, then 1-2 weeks off. When he is on, he works 14-16 hour days. Another person in his group covers nights. About half the time, he covers the teaching service and has residents and med students, the other half he is on his own. He makes use of his time off working out, traveling, hanging out with non-medical friends.

He is also nearly 40, single, lives in the same apartment he had as a resident.

It is a lifestyle choice, not for everyone. Like others said, if you are in it for the money, don't do medicine.

Single, near 40, and in a college student apartment? More power to him!

 

[ProfMD]

Single, near 40, and in a college student apartment? More power to him!

Like I said - it's a lifestyle choice. Some people like it, some people don't.

 

[dozitgetchahi]

Single, near 40, and in a college student apartment? More power to him!

Yeah, jesus christ. Sounds like a bizarre, godawful life.

At least he's being frugal with his housing.

 

[bananas85]

No one is trying to sell anything. I am just saying if there is a will power to do it then I guess you can. I personally could not do it. I barely last 7 days of hospitalist shifts in a row. It sounds easy on paper until you actually do it.

 

[IMreshopeful]

No one is trying to sell anything. I am just saying if there is a will power to do it then I guess you can. I personally could not do it. I barely last 7 days of hospitalist shifts in a row. It sounds easy on paper until you actually do it.

The last sentence is I think the point we were making to our premed/med student in this thread that thinks he'd be able to do this, make bank, and live like a king.