Would depend on specifically what you don't like the most about hospitalist work, and what may be driving burnout. Some of the common causes of burnout, especially among older hospitalists, include high patient volumes, increased administrative burden, being employed instead of running your own practice, and irregular work schedule (eg having to work nights, frequent holidays, every other weekend). If those are your main issues, maybe switching toa different hospitalist job may be the solution without quitting clinical medicine altogether (eg switching to a new job with lower patient census and dedicated full-time nocturnists, or switching to a job that works mostly Mon-Fri even if it means taking a pay cut). If you want to leave hospitalist medicine, most would not do it all at once. The transition is usually more gradual and involves switching from full-time to PRN/part-time/locums shifts while pursing a side gig part time until you build enough volume with it so that it can become your full time job. If the focus is finding a more family-friendly job, doing outpatient work or telemedicine are options. But those will time some time to build up a full practice so there will be a transition period where you work parttime/PRN as a hospitalist.
Not uncommon, but most places won't formally advertise it as such since you're technically responsible for your patients for your full shift. If not prohibited, on rounding shifts (where you don't have any admitting responsibilities and are only covering already admitted patients) it's not uncommon to be able to cover from home for part of the shift. Of course this assumes all your patients are stable, and you may have to go back if you end up with a sick patient later in the day.
That's because there are very few hospitalist programs that have been around long enough to have anyone older than 45. I helped start a Midwest hospitalist program right after my residency graduation in 2006. At that time, there were about a tenth of the number of hospitalists in the US compared to now.
Older physicians frequently have switched to full time hospitalist work (before the days of hospitalists, the same physicians used to work the old-fashioned way internists do, with both inpatient and outpatient responsibilities).
I think hospital medicine is arguably one of the best jobs in medicine.
We admit on average 1 patient per day. A few people do leave earlier and come back if they have to admit.
So you can leave.
Not officially but a few do it anyway.
I generally have seen pay for palliative care to be lower than hospitalist at the same institution. At places that they're comparable, they require palliative care physicians taking on some hospitalist shifts on top to justify the pay. Since GOC discussions with sick patients families tend to be time consuming, the amount of RVUs you end up billing aren't that high, and a lot of palliative care pay already has to be significantly subsidized by the hospital. And at many places you can do palliative care work without formally doing the 1-year fellowship either.
They do in fact exist in places that you might not consider rural, or those that as, @Sushirolls pointed out, may be in places that some people prefer for lifestyle purposes. I'm going to start an (outpatient, sub-specialty) job at one soon. It's closer to the nearby international airport than a lot of neighborhoods "in the city" are. And it's a hugely popular vacation/2nd home area.
You really don't know what you are talking about.
www.aspeninternalmedicineconsultants.com
COL anywhere near Aspen is pretty bad. If you don't mind a 20+ minute drive, you can live for not too much money. But that's 20 minutes in a place that gets a stupid amount of snow every winter.Aspen, Colorado.
Ski town? Moutains? Tiny?
Has a CCAH hospital!
Website of IM doctor, making it work. Even has PA-C, too.Aspen Internal Medicine Consultants
Doctor even has privileges at the CCAH, too.
www.johnethurstonmd.com
Well have you set up a private practice?
The poster he's responding to hasn't opened an outpatient primary care office either. Much, much easier to do PP psych than PP outpatient medicine.
Good catch and quite true. Especially given the bs psychiatrists try to pull nowadays with tele psych
You got me, I'm an armchair expert here on SDN (the land of Nobel laureates, Wolf-of-WallStreet investors, and real estate moguls).
There might better jobs out there than HM, but I don't think I am that lucky to find one of them.
AI isn't coming to medicine in a capacity that decreases physician jobs for a long time. GI/cards/oncology are kingmaker specialties, not just in IM but all of medicine. This is because of their business ownership and ancillary revenues which will not be threatened for the foreseeable future. 100% pick one of those 3 and don't look back.
The value added for most hospitalists above a typical NP is low. My prediction for the future of this field is heavy infiltration by midlevels; MDs will exist mostly to cosign their notes/be their scapegoats and to work the limited number of true academic teaching jobs. chessknt is exactly right: pick one of Cards, GI or Onc. Whatever it is that you find intriguing about being a hospitalist can be found in some version in another field that pays better, has better job security and isn't a 24/7 dumping ground. I would never advise anyone to become a hospitalist.
That's just cope (for the most part). Are there hospitalists who are thorough and conscientious and think seriously and critically about their patients' problems, and who bring to bear on those problems a deep knowledge far beyond that of any NP? Sure. In my experience (2 years as a hospitalist) I'd say it's less than a third. Probably less than 20%. Most hospitalists are completely unimpressive, the dregs of the medical profession imo.
If they have been doing for 5+ years and they downplay it, you should not dismiss them.
ED docs stay in the hospital their entire shift, do procedures, and see 1.5 to 2 patients per hour with higher billing codes than hospitalists and their field was destroyed by PE/midlevels because it was reliant on hospital subsidization to stay viable despite this.
At least we have an exit route unlike anesthesia and EM. We can transition to outpatient.
I am just waiting for the mass exodus and then I will concede.
I mean the entire ER field turned from a gravy train to spoiled milk in 6 months. It can happen very fast. The hospital admins are looking for new ways to save money as this house of cards starts to collapse hospitalists/intensivists will likely be early casualties. Sure you can run to outpatient medicine to be a PCP but depending on your local market you are looking at a year to be properly impaneled before you start to actually have positive income potential. Onc/cards/GI will never have this problem. They own the infusion/echo/ASC and are printing money whether the hospital goes out of business or builds a new tower. They also own the patients that generate hospitals money.