Part time outpatient practice with part time hospitalist work

[panamerica]

In the area I've been looking at for post residency practice, my job search has been coming up somewhat lacking in traditional style IP/OP practices. Generally, I don't want to give up hospital medicine right after residency, but the area I would like to be in seems to have very well established hospitalist programs at even small critical access hospitals. This leads me to wonder if it would be feasible to look for work on a part time basis (either 0.5-0.75) in an outpatient setting, and then work one week a month as a hospitalist. For instance, working 3 weeks in clinic, then working 7 days in the hospital. Anyone doing this currently, or know people that are? Are there barriers to this type of work other than the typical barriers to part time outpatient work?

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[PlutoBoy]

In the area I've been looking at for post residency practice, my job search has been coming up somewhat lacking in traditional style IP/OP practices. Generally, I don't want to give up hospital medicine right after residency, but the area I would like to be in seems to have very well established hospitalist programs at even small critical access hospitals. This leads me to wonder if it would be feasible to look for work on a part time basis (either 0.5-0.75) in an outpatient setting, and then work one week a month as a hospitalist. For instance, working 3 weeks in clinic, then working 7 days in the hospital. Anyone doing this currently, or know people that are? Are there barriers to this type of work other than the typical barriers to part time outpatient work?

It can be done. I suspect that once you get into practice you will find that doing both is rather hard. What I would do is settle for prn locums opportunities in your area. Do a few hospital shifts a month and be done with it.

 

[brianmartin]

I'm doing exactly this right now.
I do 0.75 clinic time and cover a 10 bed critical access inpatient unit for 1 week every 1-2 months.

 

[septoplasty]

It can be done, lots to be found via locums though.

Unless you know of systems that allow for this, than its harder to find.

 

[teacherman84]

Or teach at a residency and you can probably work something like this out.

 

[WantToBeFamMed]

Yes many places are run exactly like what you and brianmartin are describing, they can definitely be found. It will depend mostly on where you're willing to live, from a populated standpoint and probably a regional standpoint. I think you would have the most luck looking at small towns less than about 10,000-15,000 people, and I'm guessing probably will find more of these types of practice styles in regions such as the Midwest or West, but I doubt you'll have luck with something like this in this age in urban cities or on the coasts. You'll have to search for it because one small town system you talk to or interview with might tell you "Each day we have each physician in the practice round on any admitted patient that they're PCP for", the next might say "We have whatever doc admitted them from the ER shift that day doing the rest of the rounding throughout their stay", but then the next might say "We have our FP's or IM docs rotate as the hospitalist of the week". When I interviewed I found the various small town sites I went to were pretty equally divided amongst those 3 scenarios. I found in my personal search that towns under about 5,000 people with lower censuses tended to lean towards one of the first two scenarios, but towns in about the 5,000-10,000 population range leaned more towards the 3rd scenario which sounds like what you're looking for. I didn't look at communities larger than that, but my impression is most systems in communities larger than that have gone for several years now more towards the all Internal Medicine or FP's who have gone full-time hospitalist route for covering the system's inpatient needs.

 

[brianmartin]

The place I'm at is in a town of 5000, but serves a larger catchment area and thus the 10 bed inpatient unit is fairly regularly full, or at least busy. Thus, before I arrived they had hospitalists from nearby larger cities covering 1 week at a time. When I got there, I said I wanted to cover the hospital and they let me into the rotation. Of course, we're also starting an NP hospitalist model at the same time. What was said above is accurate--it really depends on the size of the service area. Below a certain size, and, especially if you are a good distance away from anything larger, you'll have a pretty easy time finding what you are looking for. Just realize you'll more than likely be living in a small town (which is what I wanted).