Is this easy lifestyle hospitalist gig sustainable or not?

[WIFEL585]

I’m a recent graduate out of residency. Have basically worked 2 jobs out of residency that were both locums tenens in rural, desperate places.

Got $270/hr for 12-hour shifts (procedures required, but I trained for them) and basically could work as little or as much as I wanted to.

So I decided to work like 5-6 shifts per month and make like $180-$230K per year. No kids or student loans either.

Can I do this for another 15-30 years or will I realistically have to settle down and do a more traditional full-time job at some point?

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[DrMetal]

I’m a recent graduate out of residency. Have basically worked 2 jobs out of residency that were both locums tenens in rural, desperate places.

Got $270/hr for 12-hour shifts (procedures required, but I trained for them) and basically could work as little or as much as I wanted to.

So I decided to work like 5-6 shifts per month and make like $180-$230K per year. No kids or student loans either.

Can I do this for another 15-30 years or will I realistically have to settle down and do a more traditional full-time job at some point?

Sure you can . . . Until the hospital system realizes how much money its losing on you, at which point it'll implement a variety of nurse-driven protocols for various admissions/diagnoses, then use AI to generate notes, and employ mid-levels to do the same job that you're doing now, at a fraction of the cost.

Enjoy the general hospitalist construct while it lasts. It's not financially sustainable.

 

[dozitgetchahi]

I’m a recent graduate out of residency. Have basically worked 2 jobs out of residency that were both locums tenens in rural, desperate places.

Got $270/hr for 12-hour shifts (procedures required, but I trained for them) and basically could work as little or as much as I wanted to.

So I decided to work like 5-6 shifts per month and make like $180-$230K per year. No kids or student loans either.

Can I do this for another 15-30 years or will I realistically have to settle down and do a more traditional full-time job at some point?

Sustainable?

From a “you” standpoint - if you’re satisfied with that $180-230k a year, working 6 days a month, sounds pretty damn sustainable to me.

From a “meta” standpoint - as stated above, who knows how long this arrangement will continue. The current hospitalist thing may not last forever.

 

[CCM-MD]

Locum by definition is temporary. I wouldn’t expect for that job or that rate to be available forever.

 

[Splenda88]

Sustainable?

From a “you” standpoint - if you’re satisfied with that $180-230k a year, working 6 days a month, sounds pretty damn sustainable to me.

From a “meta” standpoint - as stated above, who knows how long this arrangement will continue. The current hospitalist thing may not last forever.

You don't think it will last another 7-8 yrs.

 

[Splenda88]

Sure you can . . . Until the hospital system realizes how much money its losing on you, at which point it'll implement a variety of nurse-driven protocols for various admissions/diagnoses, then use AI to generate notes, and employ mid-levels to do the same job that you're doing now, at a fraction of the cost.

Enjoy the general hospitalist construct while it lasts. It's not financially sustainable.

You think they will go back having outpatient PCP admit their own patients.

 

[DrMetal]

You don't think it will last another 7-8 yrs.

I give it about 10-20 years, before we see the general hospitalist phased out.

You think they will go back having outpatient PCP admit their own patients.

No, most outpatient PCPs want nothing to do with hospitals (that's why they chose outpatient).

What your more likely to see is sub-specialists admitting: if the patient is admitted for renal failure, since Nephrology is consulted, the Nephrologist can act as the admitting physician. If it's a HF exacerbation, the Cardiologist plays also the role of admitting, the GI will do the same for a GI bleed, etc. Why not?! These are all trained and BC'd internists! [Of course, these sub-specialists wont like this at all, but they'll have no recourse and they'll have to play ball if they'd like to stay privileged]

The other scenario is using mid-levels (or even just nurses) to play the 'admission director' role. You can have one general hospitalist supervise an army these, essentially signing off on 60 charts a day.

 

[Splenda88]

I give it about 10-20 years, before we see the general hospitalist phased out.



No, most outpatient PCPs want nothing to do with hospitals (that's why they chose outpatient).

What your more likely to see is sub-specialists admitting: if the patient is admitted for renal failure, since Nephrology is consulted, the Nephrologist can act as the admitting physician. If it's a HF exacerbation, the Cardiologist plays also the role of admitting, the GI will do the same for a GI bleed, etc. Why not?! These are all trained and BC'd internists! [Of course, these sub-specialists wont like this at all, but they'll have no recourse and they'll have to play ball if they'd like to stay privileged]

The other scenario is using mid-levels (or even just nurses) to play the 'admission director' role. You can have one general hospitalist supervise an army these, essentially signing off on 60 charts a day.

I have been having an ok time working as a hospitalist thus far.

I still don't get why people keep saying working as a hospitalist for 20+ yrs is not sustainable when arguably it's one of the most flexible jobs in medicine.

 

[DrMetal]

I have been having an ok time working as a hospitalist thus far.

I still don't get why people keep saying working as a hospitalist for 20+ yrs is not sustainable when arguably it's one of the most flexible jobs in medicine.

It's not sustainable for the institution (sure, its great for you and me, as individuals). I agree it is flexible, if you do part time for Locums, you can essentially call your own shots.

Every hospital (institution) in this country is looking for ways to consolidate or re-define their hospitalist contracts (looking for cheaper groups, looking for consolidation, corporatization that might lead to cheaper contracts, etc etc).

 

[Splenda88]

It's not sustainable for the institution (sure, its great for you and me, as individuals). I agree it is flexible, if you do part time for Locums, you can essentially call your own shots.

Every hospital (institution) in this country is looking for ways to consolidate or re-define their hospitalist contracts (looking for cheaper groups, looking for consolidation, corporatization that might lead to cheaper contracts, etc etc).

You hire NP/PA and they will start demanding more and I don't think NP/PA are capable to move patients out like we do.

 

[dozitgetchahi]

I give it about 10-20 years, before we see the general hospitalist phased out.



No, most outpatient PCPs want nothing to do with hospitals (that's why they chose outpatient).

What your more likely to see is sub-specialists admitting: if the patient is admitted for renal failure, since Nephrology is consulted, the Nephrologist can act as the admitting physician. If it's a HF exacerbation, the Cardiologist plays also the role of admitting, the GI will do the same for a GI bleed, etc. Why not?! These are all trained and BC'd internists! [Of course, these sub-specialists wont like this at all, but they'll have no recourse and they'll have to play ball if they'd like to stay privileged]

The other scenario is using mid-levels (or even just nurses) to play the 'admission director' role. You can have one general hospitalist supervise an army these, essentially signing off on 60 charts a day.

Part of the reason you may not see the first scenario happening is that it would chew up time that specialists could use to make more money (for both themselves and the hospital) elsewhere. In the case of GI (for instance), the hospital isn’t going to want their cash cow scope jockeys to waste time playing general internist on a hospital floor somewhere. Hell, there’s already GI departments where virtually all the outpatient visits are conducted by midlevels and the doctors just scope.

More likely IMO is an attempt to make most/all general medicine inpatient management done by midlevels, with liberal amounts of consults being called. Even in residency, there were “non resident” inpatient services at my institution’s academic hospitals where that was going on…or where one hospitalist or intensivist was supervising 2-3 midlevels.

 

[Splenda88]

Part of the reason you may not see the first scenario happening is that it would chew up time that specialists could use to make more money (for both themselves and the hospital) elsewhere. In the case of GI (for instance), the hospital isn’t going to want their cash cow scope jockeys to waste time playing general internist on a hospital floor somewhere. Hell, there’s already GI departments where virtually all the outpatient visits are conducted by midlevels and the doctors just scope.

More likely IMO is an attempt to make most/all general medicine inpatient management done by midlevels, with liberal amounts of consults being called. Even in residency, there were “non resident” inpatient services at my institution’s academic hospitals where that was going on…or where one hospitalist or intensivist was supervising 2-3 midlevels.

Agree. These people are quick to say "admit to medicine."

The few patients they admit, they consult medicine for no reasons and dump the patient on the medicine service.

 

[hopefulraddaddypls]

Part of the reason you may not see the first scenario happening is that it would chew up time that specialists could use to make more money (for both themselves and the hospital) elsewhere. In the case of GI (for instance), the hospital isn’t going to want their cash cow scope jockeys to waste time playing general internist on a hospital floor somewhere. Hell, there’s already GI departments where virtually all the outpatient visits are conducted by midlevels and the doctors just scope.

More likely IMO is an attempt to make most/all general medicine inpatient management done by midlevels, with liberal amounts of consults being called. Even in residency, there were “non resident” inpatient services at my institution’s academic hospitals where that was going on…or where one hospitalist or intensivist was supervising 2-3 midlevels.

Liberal consults and panscans, the hospitals love this

 

[IM_to_ortho_hopeful]

Sent you a PM - would love to work a job like yours, am willing to move anywhere if you want to hook me up with your gig

 

[hotsaws]

Sent you a PM - would love to work a job like yours, am willing to move anywhere if you want to hook me up with your gig

Aren't you a GI fellow?

 

[IM_to_ortho_hopeful]

Aren't you a GI fellow?

I’m thinking of dropping out so I can focus on ortho research, 7on14off would let me spend a good amount of time pumping out ortho publications, then I can just keep applying for the rest of my life. Alternatively I could just finish GI and do a 7on7off gi hospitalist gig and do ortho research as a GI doc

 

[thumbz]

I’m thinking of dropping out so I can focus on ortho research, 7on14off would let me spend a good amount of time pumping out ortho publications, then I can just keep applying for the rest of my life. Alternatively I could just finish GI and do a 7on7off gi hospitalist gig and do ortho research as a GI doc

dude what - you could do a week of locums scope call once a month and make $40-$50k a month. Do that every other month if you want to and spend 7 weeks doing ortho research

 

[IM_to_ortho_hopeful]

dude what - you could do a week of locums scope call once a month and make $40-$50k a month. Do that every other month if you want to and spend 7 weeks doing ortho research

Where do you see offers like this? I’ve never heard of a GI doc making more than 5k/day. But this is a good idea 1 on 7 off as a GI doc could make 250k or so if we use 40k as a number if it’s real. That’s not bad.

 

[hopefulraddaddypls]

Where do you see offers like this? I’ve never heard of a GI doc making more than 5k/day. But this is a good idea 1 on 7 off as a GI doc could make 250k or so if we use 40k as a number if it’s real. That’s not bad.

5kx7 days=35k so not far off

 

[thumbz]

My shop is paying $8k/24h period for our locums GI as we are a desperate little turtle. They come in and work 7 days strait - so don't get me wrong it is an atrocious 7 days of little to no sleep but they're getting absolute bank for it. And it's $8k to the GI doc (at least the one I chatted with on the floor) - not $8k to the locums company. I suspect this somewhat varies from doc to doc and week to week - if I recall this was a week that crossed a holiday

 

[IM_to_ortho_hopeful]

My shop is paying $8k/24h period for our locums GI as we are a desperate little turtle. They come in and work 7 days strait - so don't get me wrong it is an atrocious 7 days of little to no sleep but they're getting absolute bank for it. And it's $8k to the GI doc (at least the one I chatted with on the floor) - not $8k to the locums company. I suspect this somewhat varies from doc to doc and week to week - if I recall this was a week that crossed a holiday

What state? Holiday week makes sense for 8k/day

 

[Splenda88]

Where do you see offers like this? I’ve never heard of a GI doc making more than 5k/day. But this is a good idea 1 on 7 off as a GI doc could make 250k or so if we use 40k as a number if it’s real. That’s not bad.

They do make that at myself shop. Saw it.