Job Search hospitalist position.

[bananas85]

Hi Guys,

I am looking for positions, and have a good position with a recruiting firm. Being pretty new to this, I dont have a strong Idea about what kind of pitfalls to watch out for. I am open to moving anywhere even if it means the boondocks as I have no family or kids. And I figured the 7 days off (7on 7off), I can come back to my "hometown."

One of the things I am scared about, is I have heard recruiting firms often low ball the census. They tell you that your average census is 15 and you end up seeing 22 patients a day? Is this true? and if so is there a way to verify this?

Also how can you verify the acuity of patients. 15 REALLY sick multiple issue patients are not nearly as difficult as 22 straight forwayd CHF, COPD exacerbations. What kind of things can I look at or ask the director to get a feel for this.

I plan on "shadowing" one of the physicians for half day when I am there.


In residency as a seinor we take care of 15 patients/ team + or - 1 or 2 admission on a non call day and more on a call day. Hospital is a large community hospital in the area, with transfers from many outlying small hospitals so we do end up seeing some sick and rare cases.

What number would I be comfortable with in the "real world."

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[jdh71]

Hi Guys,

I am looking for positions, and have a good position with a recruiting firm. Being pretty new to this, I dont have a strong Idea about what kind of pitfalls to watch out for. I am open to moving anywhere even if it means the boondocks as I have no family or kids. And I figured the 7 days off (7on 7off), I can come back to my "hometown."

One of the things I am scared about, is I have heard recruiting firms often low ball the census. They tell you that your average census is 15 and you end up seeing 22 patients a day? Is this true? and if so is there a way to verify this?

Also how can you verify the acuity of patients. 15 REALLY sick multiple issue patients are not nearly as difficult as 22 straight forwayd CHF, COPD exacerbations. What kind of things can I look at or ask the director to get a feel for this.

I plan on "shadowing" one of the physicians for half day when I am there.


In residency as a seinor we take care of 15 patients/ team + or - 1 or 2 admission on a non call day and more on a call day. Hospital is a large community hospital in the area, with transfers from many outlying small hospitals so we do end up seeing some sick and rare cases.

What number would I be comfortable with in the "real world."

It's kind of hard to know what you'll like until you're doing it. I think just about the best way to know how things *really* are is doing exactly what you are doing going and spending time. Or asking outright. If you think you can believe your future partners and if you don't think you can believe them then maybe not the best job (real talk).

Recruiters are brought in usually for hard to fill positions which means they will polish the turd as much as possible. So they probably will low ball average daily census (or downplay it). Acuity will probably be directly proportional to the referral area of the hospital and/or surrounding population number (and demographics - expect lots of chronic patients in high retirement area for instance).

Bottom line ask lots of questions. If anything seems hinky perk your eyes and ears.

 

[FutureInternist]

Hi Guys,

I am looking for positions, and have a good position with a recruiting firm. Being pretty new to this, I dont have a strong Idea about what kind of pitfalls to watch out for. I am open to moving anywhere even if it means the boondocks as I have no family or kids. And I figured the 7 days off (7on 7off), I can come back to my "hometown."

One of the things I am scared about, is I have heard recruiting firms often low ball the census. They tell you that your average census is 15 and you end up seeing 22 patients a day? Is this true? and if so is there a way to verify this?

Also how can you verify the acuity of patients. 15 REALLY sick multiple issue patients are not nearly as difficult as 22 straight forwayd CHF, COPD exacerbations. What kind of things can I look at or ask the director to get a feel for this.

I plan on "shadowing" one of the physicians for half day when I am there.


In residency as a seinor we take care of 15 patients/ team + or - 1 or 2 admission on a non call day and more on a call day. Hospital is a large community hospital in the area, with transfers from many outlying small hospitals so we do end up seeing some sick and rare cases.

What number would I be comfortable with in the "real world."

Do you have any colleagues/friends that are working at the places where you are going to be interviewing? It is natural for the admin to low-ball the census since they are looking to hire & likely once you've made the investment to move, you are unlikely to quit over 3-4 extra patients per shift.

When I was interviewing, I tried to find friends or friends of friends who were working there to get a more accurate picture. One place told me that sick patients could be transferred to ICU any time, but I found out that the in-house ICU docs only take new patients during the am shift (unless intubation, CVL etc) so you would still have to manage the patient during the night

Another place was gung-ho about not taking any cross cover call in the last 1.5-2 hours of our shift (to finish up notes, f/u on consult recs etc) & that the NP/PA would cover in that time - but turns out they would take their sweet time getting in to work & getting their coffee, make-up & facebook updates figured out before turning on their pagers

Things to ask
a) Census
b) How are transfers to ICU handled
c) Cross cover call timings
d) Any procedures required of you
e) Social support staff - since they can really delay your patient's discharge
f) How many new patients per day can you take
g) How may patients from the previous night go to your team (new for you but not for the group)

Good Luck