Please Evaluate Hospitalist Opportunity

[timtebowner]

Hi everyone,

I just wanted to get some thoughts from people on a hospitalist gig I was offered. It is just outside a large NE city. Here are the highlights:

Half days, half night - 7 on/off, 12 hour shifts
Half non-teaching days (census average 14-15, 1-2 admits per day), half teaching nights (average admits 7-8)
210K base, 10K signing bonus
Up to 65K in incentives
Nights - Rotating admits between me, residents NP/PA, supervise residents running rapids/codes, I do cross cover calls on teaching/non-teaching and some cross coverage for calls on ICU patients
Days - I run codes/rapids on my own patients
10 days of "call" on off days that has a small payment, then pays 150/hr if called in
Academic hospitalist title with solid benefits - insurance, malpractice with tail, 403B
I am able to work extra shifts/moonlight if I so choose
Epic EMR

Thank you all, happy hunting!

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[IMGASMD]

Vacation?
What does “call” mean?

 

[thumbz]

Even as an academic gig (which it isn't actually) that's low pay for so many nights. Is it 183 shifts/year? If so they're offering peanuts for compensation.

How easy is it to earn the incentives? Some shops make them next to impossible, and in others it's checking boxes.

As above - what does "call" mean for a hospitalist? Would you be cross covering patients despite not being on service somehow? Or managing outpatient call?

 

[WheezyBaby]

Even as an academic gig (which it isn't actually) that's low pay for so many nights. Is it 183 shifts/year? If so they're offering peanuts for compensation.

How easy is it to earn the incentives? Some shops make them next to impossible, and in others it's checking boxes.

As above - what does "call" mean for a hospitalist? Would you be cross covering patients despite not being on service somehow? Or managing outpatient call?

I'm assuming call here is more of a jeopardy situation.

Agreed about pay. If the job checks all your other boxes I'd still consider taking it (I personally work more hours/nights for less), but the base pay is definitely low.

 

[chessknt]

Pay is too low for number of nights and RRT/code coverage. Assuming 14 shifts/mo that is about 130/hr assuming you get the entire incentive. You can find a job where you might work harder but for much better pay and less nights. If the easiness of the job is critical then it sounds fine since that is probably about par for an academic job.

The 10 days of call is too much if that is per month and definitely unacceptable if you are expected to carry a pager all day.

 

[DrMetal]

Hi everyone,

Pay looks a little low. What part of the country?

 

[CCM-MD]

Only on SDN is 250-275k low for an academic hospitalist in a large NE city. That’s how much many community hospitalists make and is the MGMA avg for all practice types. This is a lot of what is really out there and probably better than many academic jobs.

 

[timtebowner]

Vacation?
What does “call” mean?

there is no additional vacation on top of the 7 on/off
Call means that there is a 24 hour period where they could call you in. It's 10 days a year.

 

[timtebowner]

Even as an academic gig (which it isn't actually) that's low pay for so many nights. Is it 183 shifts/year? If so they're offering peanuts for compensation.

How easy is it to earn the incentives? Some shops make them next to impossible, and in others it's checking boxes.

As above - what does "call" mean for a hospitalist? Would you be cross covering patients despite not being on service somehow? Or managing outpatient call?

There's no cross coverage from home, it's just that they could possibly call you in to work.

 

[timtebowner]

Pay looks a little low. What part of the country?

NE US, 30 minutes outside a major city

 

[timtebowner]

Only on SDN is 250-275k low for an academic hospitalist in a large NE city. That’s how much many community hospitalists make and is the MGMA avg for all practice types. This is a lot of what is really out there and probably better than many academic jobs.

That's kind of how I am viewing it. I think I should get 70-80% of the bonus, and that will put me on par for about average with a lower census and less admissions I think it could be a chill job with good benefits.

 

[DrMetal]

NE US, 30 minutes outside a major city

Well, then your pay structure makes sense. Still, I think it's a bit low, 210K base should be a little higher. How hard is it to make the 65K incentive? I'd be happier with $240K base + 30K incentive.

But this is the price we pay for living close to major cities. I think hospitalist salaries (and the # of jobs available) are taking a hit all across the country.

 

[WheezyBaby]

Only on SDN is 250-275k low for an academic hospitalist in a large NE city. That’s how much many community hospitalists make and is the MGMA avg for all practice types. This is a lot of what is really out there and probably better than many academic jobs.

I missed the geographic area in my post and just saw outside a major city, I admittedly don't know the northeast market. Locally, I think it depends on how reliable the bonus pay is, but the pay if near base would be in the ballpark of 50k low for a similar job in my (generally better paid) metro area

 

[InvestingDoc]

Personally I would not take a job with 50% of my time on my weeks on were spent working nights.

They are getting a 50% nocturnist at a hospitalist salary. This would be a hard pass for me just based off that alone. However, the rest in your geographic reason looks not bad.

 

[Nocturnist]

Hi everyone,

I just wanted to get some thoughts from people on a hospitalist gig I was offered. It is just outside a large NE city. Here are the highlights:

Half days, half night - 7 on/off, 12 hour shifts
Half non-teaching days (census average 14-15, 1-2 admits per day), half teaching nights (average admits 7-8)
210K base, 10K signing bonus
Up to 65K in incentives
Nights - Rotating admits between me, residents NP/PA, supervise residents running rapids/codes, I do cross cover calls on teaching/non-teaching and some cross coverage for calls on ICU patients
Days - I run codes/rapids on my own patients
10 days of "call" on off days that has a small payment, then pays 150/hr if called in
Academic hospitalist title with solid benefits - insurance, malpractice with tail, 403B
I am able to work extra shifts/moonlight if I so choose
Epic EMR

Thank you all, happy hunting!

210k would be on the low side of average even for a strictly daytime job in academics in the northeast. A 50/50 day/night hybrid like this should pay around 250k in academics and 300-325k in the community.

And if you think they're low balling you on the salary but you're going to make a 65k incentive, I've got some ocean front property in Arizona to sell you.

Plus switching from night to day shift each week sounds miserable. If you're already considering working a week a month of nights, why not just become a full time nocturnist? I could make that base in my community hospital in the northeast working 8 nights a month, or 375-400k working 7 nights on/7 off.

 

[collegestud2013]

As others have said, pay is low for the amount of work, and I'm also not sure I would really consider this to be an academic job if you all your daytime is spent on a non-teaching service.

15 rounding patients and 2 admits is pretty average these days for a 12 hrs shift at a non-teaching service, but isn't chill when you have to do the work all by yourself (with no help of residents or midlevels). Also, remember that the census can fluctuate widely at any hospital, especially during a pandemic. Is there any back-up from other people that are off when the census gets excessively large, and how reliable is the back-up?

And the nights shifts with essentially open ICU can be brutal and they aren't really paying you extra for it (places with competitive night rates should pay at least 20% more per hr for nights). There's also a lot more liability to take on at night since you're cross-covering a very large volume of patients that you don't know well at all and patients are more likely to decompensate at night when there's less staff and resources available in house, and it's even harder to cover ICU level patients without having down a pulm/CC fellowship.

Based on typical the RVUs generated by 15 rounding patients and 2 admissions per day shift and current average Medicare reimbursement rate of about $54 per wRVU, if you only worked day shifts your total compensation should be around $340k per year (for 182 shifts). And if half your shifts are nights that pay should be even higher. Even if you count the signing bonus for your first year and assume you get all of your incentives (which is probably a very generous assumption), your total pay is only $285k so that's quite low.

However, once you consider the geography of the position it may not be as bad of a deal (the NE tends to be among the most saturated in the country), as it sounds but there are definitely many better offers out there if you look at places that are not overly saturated.