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need recommendations for new hospitalist job

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rogerds

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Hello all,
I am a practicing hospitalist who recently moved from South..

Presently my job in IL, I have been employed directly by the hospital and things are really different. I get 2 weeks paid vacation and salary of 300k for 1 week on and 1 week off. Good benefits and 401k match. No procedures or codes. Census around 14-15 with all specialists available. I would have stayed in IL but I prefer hot weather. The state also has no TORT reforms, has state tax and my patient population is filled with opiod and drug addictions.
Me and my wife are hence looking at hospitalist opportunities outside. We are pretty open to go anywhere but we prefer hot climate to cold, prefer to work directly for the hospital than a third party and preferably stay with an hour or two of major city.

I am not updated with what the current job contracts for hospitalitists look like.

Could you please give me some suggestions.

1. Where can I find jobs employed directly by the hospitals? I know practice link has a section but I believe there are none in few states like Texas.
2. What sate would be the best to practice? Considering pay, work load and benefits. I have an active Texas license but job market in Texas is competitive. And benefits are not great. I prefer to go back there but don't want to work for low pay and high patient load with bad benefits.
3. Can I negotiate better with the contract as its 2 people looking for hospitalist job?I don't mind working as a nocturnist. My wife however wants day shifts.
4. We also want to work extra shifts. How many of you actually have an option of taking extra shifts easily? My present employer does not offer extra shifts at all.

Thanks in advance
 
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xoggyux

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A residency colleague of mine ended up hiring a company to do the search for her. The deal was for a percentage of earnings that she did for the first year, I do not remember the exact percentage but it was in the ballpark of ~5% for first-year + a 1 time payment fee. This company took care of finding multiple options, negotiating benefits and reviewed the contract for her. At the end of the day, this cost her ~ $20-30k. In my opinion, this was not a bad deal. She got rid of a lot of legwork and basically got handed a dozen or so offers, she just had to go to a few interviews and she landed a job paying 80%+ percentile in an area that was better than her expectation (she also needed visa sponsorship so the areas where she would get offers were not that great). So this was a lot of value to her and she told me she was happy with this arrangement at the end, despite the initial shock of giving up a substantial amount of money. (although keep in mind, that if the company manages to negotiate 5% higher salary, it essentially pays for itself, not to mention your time).

If I understand correctly, you and your wife will both need jobs, so your situation is more complicated than my friend's. Personally, I would feel uncomfortable if my wife worked in the same place as me in your situation. I'd be wary about employer going out of business, bankruptcy, acquired by another company and restructuring/laying off people/etc, so I would rather not put all my eggs on the same basket. Especially if that basket is both the source of financial means and the reason for your legal immigration status. If I was on your shoes, this would further narrow the search for me to places that are not very rural, where there are multiple "acceptable" hospitals where you can work at, and that each one of you grab different jobs at different employers, even if one of the two is not as good of a job as the other.

I do not know much about visas, but my understanding is that different employers require a different duration of contracts to sponsor permanent residency. My friend was very frustrated with one of the offers she got because they required a 5-year contract. Even if you fall in love with a place, and you think you might end up living there for the rest of your life, I would not feel comfortable with this kind of arrangement. I'd shoot for 3 years or less.

I think those things, if you agree with them, will severely narrow down your options to the point that going to a "warm, sunny, tax free" state such as texas, Florida might be a bit wishful thinking unless you are willing to take a decent pay cut or end up in the middle of nowhere.

If I were on your shoes, I'd take the next 3 years as Residency 2.0. Residency 1.0 was about getting your license to practice solo and unlock your attending salary. Residency 2.0 is about sorting out a permanent legal status and maybe getting a solid financial grounds. If for some reason you both end up working for the same employer, I'd make sure to save up a sizable emergency fund of at least 1 year of expenses, because if for some reason you both end up without a job, between income loss and immigration issues it would be a nightmare.

As to whether or not you hire a firm to search for your job, it is really up to you and how much you value your time. In the particular situation, you both are, it could literally take hundreds if not thousands of hours of research. If this is a kind of work you enjoy doing it, save the money and do it yourself, if not? don't be cheap, it will pay for itself in the long run.
 
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wjs010

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What are these types of companies called? The 5% thing sounds like a good deal.


Sent from my iPhone using SDN
 
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rogerds

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A residency colleague of mine ended up hiring a company to do the search for her. The deal was for a percentage of earnings that she did for the first year, I do not remember the exact percentage but it was in the ballpark of ~5% for first-year + a 1 time payment fee. This company took care of finding multiple options, negotiating benefits and reviewed the contract for her. At the end of the day, this cost her ~ $20-30k. In my opinion, this was not a bad deal. She got rid of a lot of legwork and basically got handed a dozen or so offers, she just had to go to a few interviews and she landed a job paying 80%+ percentile in an area that was better than her expectation (she also needed visa sponsorship so the areas where she would get offers were not that great). So this was a lot of value to her and she told me she was happy with this arrangement at the end, despite the initial shock of giving up a substantial amount of money. (although keep in mind, that if the company manages to negotiate 5% higher salary, it essentially pays for itself, not to mention your time).

If I understand correctly, you and your wife will both need jobs, so your situation is more complicated than my friend's. Personally, I would feel uncomfortable if my wife worked in the same place as me in your situation. I'd be wary about employer going out of business, bankruptcy, acquired by another company and restructuring/laying off people/etc, so I would rather not put all my eggs on the same basket. Especially if that basket is both the source of financial means and the reason for your legal immigration status. If I was on your shoes, this would further narrow the search for me to places that are not very rural, where there are multiple "acceptable" hospitals where you can work at, and that each one of you grab different jobs at different employers, even if one of the two is not as good of a job as the other.

I do not know much about visas, but my understanding is that different employers require a different duration of contracts to sponsor permanent residency. My friend was very frustrated with one of the offers she got because they required a 5-year contract. Even if you fall in love with a place, and you think you might end up living there for the rest of your life, I would not feel comfortable with this kind of arrangement. I'd shoot for 3 years or less.

I think those things, if you agree with them, will severely narrow down your options to the point that going to a "warm, sunny, tax free" state such as texas, Florida might be a bit wishful thinking unless you are willing to take a decent pay cut or end up in the middle of nowhere.

If I were on your shoes, I'd take the next 3 years as Residency 2.0. Residency 1.0 was about getting your license to practice solo and unlock your attending salary. Residency 2.0 is about sorting out a permanent legal status and maybe getting a solid financial grounds. If for some reason you both end up working for the same employer, I'd make sure to save up a sizable emergency fund of at least 1 year of expenses, because if for some reason you both end up without a job, between income loss and immigration issues it would be a nightmare.

As to whether or not you hire a firm to search for your job, it is really up to you and how much you value your time. In the particular situation, you both are, it could literally take hundreds if not thousands of hours of research. If this is a kind of work you enjoy doing it, save the money and do it yourself, if not? don't be cheap, it will pay for itself in the long run.


Thank you for your valuable suggestion. I am comfortable doing my own research instead of hiring a firm. But I agree that options might be limited. I have 20 months with me to find this job. I also am decided on working directly for the hospital but these options are very limited int Texas. I might just call some hospital chains randomly and ask if they have openings.
 

VA Hopeful Dr

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    I might just call some hospital chains randomly and ask if they have openings.
    That's what I'd do.

    Might consider South Carolina. Most of our hospitals employee their hospitalists. It's warm, low COL outside of Charleston, decent malpractice environment.
     

    pgy0246

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    You can also try Indiana, closed to IL, but also have bad weather.
    Some hospitals have a dedicated recruitment officer that coordinate interview, job offers

    so if you are interested in Duke, UNC; just google "Duke physician recruitment" and then you will have the email of the HR.
    even though Southeast tend to pay more for hospitalist if you are in near the metropolitan area such as charlotte, Atlanta, Charleston, I expected your starting salary to be around 220-250k range
     
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