I would suggest that if, in your community, the docs are using the term "hospitalist" to mean "anyone who has privileges at and practices in a hospital", they are using the term outside of the widely accepted norm for the balance of medicine. If you use the term hospitalist in a conversation with a co-MD the assumed definition will be one of a physician whose sole practice is inpatient medicine. It implies employment, either by a private group contracted with a hospital or directly by the hospital itself. That would be the accepted definition of "hospitalist". A "laborist" is the relatively newly minted counterpart for employed shift work inpatient OB workforce. .
Didn't I say that a hospitalist is someone who only practices hospital medicine?... Anyways.
Disagree (again) that a hospitalist "implies" employment. It's a matter of what you practice vs. how it's practiced. There are some hospitals that pay physicians to take call while others do not, simply requiring call as part of the bylaws to maintain privileges. In the latter, it behooves the hospitalist to have a contract. But for some hospitals I've worked in where you get paid to take call, you can make money just by being in the call pool. In that instance, the only contract that's cut is that rate. Call it employment, call it whatever. The guys I know who get paid to take call to do hospital medicine are independent contractors.
Whatever the "traditional" term of Hospitalist or Laborist is irrelevant, at least to OP; because the question posed was along the lines of "is it possible" to which my answer was, yes it is possible. Your response was closer to that it is unlikely due to real world medicine or whatever, but my counter response is that you can't generalize because different communities have different needs. And, these opportunities exist. You can't tell me they don't exist, because there are people who are doing it.
You don't have to be employed to be a hospitalist/laborist. The only prereq you need is privileges. From there, you take call and admit. And, if the hospital you're looking at insist that you be employed by 1 group and won't hire you, then find another hospital. Simple as that, not rocket science.
This is another matter entirely -- and is not as clear cut a case as suggested. Yes, restriction of trade has been a problem with legal precedent; this does not mean, however, that you can expect -- much less demand -- that a hospital grant you privilege to provide any service you desire within their walls. Those with training and credentials prefer to refer to it as "scope of practice"; those with a smattering of each decry it as "turf wars". In truth, it's a little of both, but that's the way the world works. I would have extreme difficulty gaining OR privileges although it would be safe to bet that I have more experience with flaps and grafts than that of the sum of the balance of OR privileged providers at the hospital (thousands of cases performed).....
Absolutely and a different discussion altogether. From my understanding, case law goes both ways where groups have won/lost cases of collusion and have had to play treble damages.
Given today's market, there is little hope of going the FP route and subsequently landing a job as a full time
laborist. I agree with the second statement, however; if you feel comfortable and can find patients who trust in you, by all means -- go for it. The only concerned parties should be the patient and the doc. The final statement, while very true at face value, unfortunately has little application in this highly cartelized world of modern day medicine.
Sorry, but I'm not impressed with your google search in the laborist want ads as evidence. There are multiple ways of finding a job when a resident graduates. One, is to look for a job in the want ads. Another, is word of mouth. Yet another, is to create your own opportunities to fill the needs of a community.
It all starts with the hospital in which you desire to practice out of. If the hospital has it's own FM section, has a history of FP's delivering, and has reasonable privileging criteria, you're chances are better. If your hospital is dominated by OB's who refuse to let FP's into L&D, well, you're screwed.
All a hospitalist/laborist deal is is a change in practice arrangement. It's not a new field of study or whatever. Your analogy that a Moh surgeon is qualified but unlikely able to get hospital OR privileges doesn't apply because at most hospitals there's likely no precedence of dermatologists getting privileges because dermatologists usually don't have a section within the hospital and you're not general surgeons.
Family medicine's different. We have our own section, in most hospitals, and we traditionally have had privileges in L&D. *IF* your hospital grants FP's privileges in C-sections, chances are you need to be fellowship-trained and even then it's hard. If that's what you're referring to, I agree with you.
The wrinkle in this topic is that NOBODY wants to do OB anymore. Not even OB's. And, there's not enough OB's for all the pregnant ladies out there. And, as the laborist movement picks up, you'll find hospitals advertising and looking for laborists to change how they do business. But!, you'll also find places/hospitals where that movement has not picked up. This is where the OP can find opportunity and make it their own.
