Pediatric ER Physician/Hospitalist?

[jwojcik]

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Currently a 3rd year student on the road to determining where my future is going to find itself. As someone interested in Pediatrics as well as Emergency Medicine, I find myself wanting a job that I'm not positive exists...

I find myself quite at home working in the Emergency Room with the acute care, healthy dose of procedural work, and generally faster pace, though I also really enjoy the aspect of being able to treat a patient through their entire hospital stay. That being said, are there positions where someone who completes a Residency in Peds followed by a Fellowship in Peds EM can work as both an EM attending and a hospitalists, splitting their time between the 2?

Whether there is or not, I certainly think it would be a great position to have, not only being an attending admitting patients but also taking admissions as well... Just a thought, would appreciate the feedback.

JJW

 

[deuist]

That being said, are there positions where someone who completes a Residency in Peds followed by a Fellowship in Peds EM can work as both an EM attending and a hospitalists, splitting their time between the 2?

When I was in residency there was a pediatrician who worked one night a week in the ED and the rest of the time was spent either in her outpatient clinic or rounding on her patients in the hospital. The job is certainly doable, just realize that most people who do 2 residencies (such as EM and IM) end up doing one field. I would imagine that the same is true with peds, as every other peds EM doc I know works only in the ED.

 

[deleted311769]

This currently exists, but is getting less common. Many pediatric hospitalists services originated as a subset of emergency medicine departments. In general, the people who do this split are NOT fellowship trained in emergency medicine, and see lower acuity patient in the emergency room as generalists. Since hospitalist medicine and emergency medicine are both shift work based specialties that attract generalists, and since the two departments are combined in some institutions, it was a natural fit. But, like I said, my understanding is that this is becoming less common.

 

[DeadCactus]

Possible but rare for practical reasons:

1) Generally requires either 2 academic departments or 2 private practice groups to share the burden of your salary and benefits while dealing with a partial employee and more difficult scheduling. There are some remaining hospitals where both services are covered by the same group but not enough to count on.

2) Your time as a hospitalist is worth significantly less than your time in the ED. How much are you willing to pay to get to go to work? Are you really going to spend a week on wards when you could do a few ED shifts and spend the rest of the week with your family, research, or charity activity? Especially when you have a 3 year loss in salary to make up for? Go the EM residency instead of fellowship route and the likelihood further declines as the pay gradient gets even steeper. Money's not everything, but few people want to keep doing general pediatrics or hospitalist work that bad when they liked EM enough to spend the extra time in training.