Job opinion

[Wardles888]

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[Sushirolls]

Depends on your ability to round and see patients. For me, 12 patients for inpatient is my max census. This allow 2-4 new patients and 0-3 discharges per day.

How many patients can you truly see on a daily basis and meet your level of quality? If you can't do 18 then you can't do 18, and your decision is made for you.

 

[Bartelby]

I would go with job 2. An inpatient census of 18 sounds pretty miserable. I am presuming, of course, that this is acute inpatient (not residential or long-term stays).

 

[hebel]

Hi everyone,

would love to get opinions on two job options for new residency grad. Both are inpatient positions

1. job 1- patient load up to 18. Good pay and good commute

2. job 2- patient load of 10. Worse pay and worse commute.

I do have children so commute is important to me, but so is safe patient care. What do you think

18 is a lot.

 

[clausewitz2]

Unless this is a state hospital job (in which 18 patients per day might be doable in a few hours), I wouldn't.

 

[hamstergang]

Are you alone on the unit? I'd worry a little of 18 turning into even more if you need to help cover for someone else some of the time too.

 

[clozareal]

Hi everyone,

would love to get opinions on two job options for new residency grad. Both are inpatient positions

1. job 1- patient load up to 18. Good pay and good commute

2. job 2- patient load of 10. Worse pay and worse commute.

I do have children so commute is important to me, but so is safe patient care. What do you think

how much worse pay and how much of a worse commute?

for me, burnout from a stressful job tends to have a worse impact on those around me compared to a stressful commute.

 

[Attending1985]

2

 

[robellis]

What’re the numbers? You have to be more specific for good advice

 

[Wardles888]

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[robellis]

What is the income for a cap of 18?

 

[Wardles888]

What is the income for a cap of 18?

You don’t make more for seeing more patients. It’s salaried

 

[robellis]

You don’t make more for seeing more patients. It’s salaried

Yes what is the salary??

 

[calvnandhobbs68]

Salary is a difference of about 60k. Commute is a difference of 30 min each way. The place w 18 patients told me that generally I will rarely go over a patient load of 13-14, but my technical cap is 18 (I’m not sure I should trust that). I’m pretty efficient time wise and used to high patient load from training. My concern is as a new attending carrying a big load and also not have a senior attending around for a second opinion on the difficult cases... is that a bad idea

So say you spend an extra 2 hours of actual work a day on those 4 extra patients between talking to nurses, interviewing the patients, writing notes/discharge stuff, etc (might be more if you end up going up to 16-18 at times).

2 hours x 5 days x 48 weeks a year (assuming no weekend coverage or anything)= 480 hours

60,000/480= 125/hr

So I suppose you’d have to decide if 125/hr (in all probability may work out to less) is worth it for you.

 

[J ROD]

I would say one. I don't find 18 that much if you have help with medical issues. What I would be more concerned with is no bonus structure.

 

[robellis]

An extra 8 patient per day is worth much much more than 60k, you don’t seem to want to give specifics but that’s the bottom line

 

[Candidate2017]

I’m pretty efficient time wise and used to high patient load from training. My concern is as a new attending carrying a big load and also not have a senior attending around for a second opinion on the difficult cases... is that a bad idea

I'd take the shorter commute since you're already used to a heavy case load. Spread those wings, fly, make some mistakes. It's not residency where you have to be afraid that every little mistake will torpedo your career.

Also, won't you have former residents with whom to consult? The hive mind usually comes up with the correct answer.

 

[Merovinge]

Hi everyone,

would love to get opinions on two job options for new residency grad. Both are inpatient positions

1. job 1- patient load up to 18. Good pay and good commute

2. job 2- patient load of 10. Worse pay and worse commute.

I do have children so commute is important to me, but so is safe patient care. What do you think

There's so much more to the job then the details you are including. What is the support staff like at each location, how good are they at making your life easier? Some places nail this, other places leave it to the docs to handle a lot of the grunt from inpatient. What is the call like and how often are you getting called in the middle of the night? How much IM/FM support do you have at each location? What is the patient mix/insurance mix and how much time are you going to be spending fighting with insurance companies for approved days? Is there pressure to practice in a certain manner (most importantly, discharge when approved days runs out). How convenient is court for involuntary patients (matters more depending on the population again)? Do you have good outpatient/partial hospital referral sources at one versus the other?

 

[Sushirolls]

Is there court for involuntary and do you do testimony for detention?
Is this a for profit psych hospital?

 

[comp1]

You're approaching this wrong. You're in demand. Negotiate the first one to something reasonable, ie 8-10 patients. You simply cannot do 18 a day without either a large number of residents or NPs, which I doubt are included. Don't just take what's offered. Also, I agree with the other people who are saying there's a heck of a lot more to consider than patient numbers, salary and commute.

 

[Wardles888]

You're approaching this wrong. You're in demand. Negotiate the first one to something reasonable, ie 8-10 patients. You simply cannot do 18 a day without either a large number of residents or NPs, which I doubt are included. Don't just take what's offered. Also, I agree with the other people who are saying there's a heck of a lot more to consider than patient numbers, salary and commute.

Thanks for the info! I always thought the job is what it is. I didn’t realize you could negotiate patient caps. Wouldn’t that mean they would have to hire someone else? That sounds like a lot of work they may not want to go through

 

[comp1]

Thanks for the info! I always thought the job is what it is. I didn’t realize you could negotiate patient caps. Wouldn’t that mean they would have to hire someone else? That sounds like a lot of work they may not want to go through

Outside of the VA, you can negotiate anything and sure, they could pass, but then they will keep paying the locums a boatload.

 

[robellis]

Thanks for the info! I always thought the job is what it is. I didn’t realize you could negotiate patient caps. Wouldn’t that mean they would have to hire someone else? That sounds like a lot of work they may not want to go through

You obviously are inexperienced yet you don’t want to share any specifics which would allow us to give you better advice..I guess you want to be ripped off

 

[Mass Effect]

I agree with others that we need more specifics, but based on what we know, I wouldn't touch the first job at all, not even for 100K extra. It sounds like you're be completely alone on a unit with 18 beds, which means screw what they told you. You will likely often have 18 patients. You could walk in to 5 or 6 admissions. You may have 4 or 5 discharges. It sounds like hell. What good does it do if it's close by if you're going to be working extra hours to get your work done?

I would go with the second job and maybe moonlight one weekend a month to make up the 60K. You can easily make 3-5K per weekend.

 

[Psychresy]

I agree with others that we need more specifics, but based on what we know, I wouldn't touch the first job at all, not even for 100K extra. It sounds like you're be completely alone on a unit with 18 beds, which means screw what they told you. You will likely often have 18 patients. You could walk in to 5 or 6 admissions. You may have 4 or 5 discharges. It sounds like hell. What good does it do if it's close by if you're going to be working extra hours to get your work done?

I would go with the second job and maybe moonlight one weekend a month to make up the 60K. You can easily make 3-5K per weekend.

Based on previous posters here I was under the assumption weekend coverage is like 6-9k?

At the hospital some of our upper level residents moonlight at there is one out of towner who comes in for a 60 hours a shift paid at 120 an hour once a month.

 

[Mass Effect]

Based on previous posters here I was under the assumption weekend coverage is like 6-9k?

At the hospital some of our upper level residents moonlight at there is one out of towner who comes in for a 60 hours a shift paid at 120 an hour once a month.

I mean, it depends on what you're willing to do. Spend the night Friday night until Monday morning? 10K at many places, easy. I'm not willing to do that. I have a family and like my weekends. I occasionally round on an inpatient unit 5-6 hours on a Saturday, 5-6 hours on a Sunday and make 3-5K. I still get most of the weekend to myself and still make pretty good money.

 

[Psychresy]

I mean, it depends on what you're willing to do. Spend the night Friday night until Monday morning? 10K at many places, easy. I'm not willing to do that. I have a family and like my weekends. I occasionally round on an inpatient unit 5-6 hours on a Saturday, 5-6 hours on a Sunday and make 3-5K. I still get most of the weekend to myself and still make pretty good money.

yeah true, he's basically there the entire weekend. what's the process for finding a job like that which pays 10k - do you go through locums? how easy are these entire weekend shifts to find?

 

[Mass Effect]

yeah true, he's basically there the entire weekend. what's the process for finding a job like that which pays 10k - do you go through locums? how easy are these entire weekend shifts to find?

You have to have your full license, but yes find a good locums company in your area.

 

[michaelrack]

you're not going to find a 10k job through a locums company