Purely from a financial perspective, how much more money do pulm/crit attendings roughly make than hospitalists?

[rockstar88]

You can say that since you are hemonc, but CCM docs are glorified hospitalists with more added stress.

I matched to Pulm/crit fellowship to start in 2023. Currently working as a nocturnist at a big academic center. It's not necessarily a bad thing that CCM docs are glorified hospitalists. It was very hard for me to choose a subspecialty given how much I enjoy the general pathology of IM and not being restricted to a certain system. That is exactly why I chose Pulm/crit since it's still treating the whole body. This whole thread was very entertaining to read but I don't really understand the point of it. People choose whichever specialty they like. Money is important, but not the final deciding factor. If money is so important, why doesn't everyone want to be a Gastroenterologist? Not everyone enjoys looking at poop all the time regardless of how much it pays.

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[Splenda88]

I matched to Pulm/crit fellowship to start in 2023. Currently working as a nocturnist at a big academic center. It's not necessarily a bad thing that CCM docs are glorified hospitalists. It was very hard for me to choose a subspecialty given how much I enjoy the general pathology of IM and not being restricted to a certain system. That is exactly why I chose Pulm/crit since it's still treating the whole body. This whole thread was very entertaining to read but I don't really understand the point of it. People choose whichever specialty they like. Money is important, but not the final deciding factor. If money is so important, why doesn't everyone want to be a Gastroenterologist? Not everyone enjoys looking at poop all the time regardless of how much it pays.

Read the first post of this thread. It's about 'HM making sense financially instead of CCM'. The answer is "yes" due to opportunity cost. Aside from that, no one here has any issue with CCM physicians because they are actually GREAT doctors.

 

[gutonc]

You are being extreme here. There is a happy medium in everything.

If you give some workers a few millions, 90%+ of them will stop working.

If they cut heme/onc reimbursement to the point you guys are making 200-250k, these Ivory towers will be FMG/IMG galore (nothing against IMG/FMG by the way). You really think these specialties are competitive because people LOVE them.

Look at radonc: 10+ years ago, you needed a PhD on top of your MD to get into radonc, but the moment the job market was bad, most US students deserted.

I think you're the one being extreme. All I'm pointing out is that we're all getting f****d going forward so choose something you like doing while you're getting bent over.

 

[CCM-MD]

Read the first post of this thread. It's about 'HM making sense financially instead of CCM'. The answer is "yes" due to opportunity cost. Aside from that, no one here has any issue with CCM physicians because they are actually GREAT doctors.

Not really. More like “maybe” if you make some big assumptions and do some fishy math.

 

[Splenda88]

Not really. More like “maybe” if you make some big assumptions and do some fishy math.

Or you can use the MGMA median 328k for a hospitalist vs. 418k for a CCM.

In all honesty, from talking to older hospitalists, 5+ years ago it might have been the case that CCM makes more sense financially than HM. However, since HM salary has increased a lot compared to CCM for the past 3 yrs, financially it's a better deal.

People who are going into HM should understand that they will be the least respected physician in the hospital if they care about status/prestige.

I am already making 330k/yr working ~70 hrs every other week and my company is already taking about giving 10k raise this year and retention bonus because they don't want people to leave.

My take is that I don't think that gravy train will last for more than 5 years.

 

[CCM-MD]

Or you can use the MGMA median 328k for a hospitalist vs. 418k for a CCM.

In all honesty, from talking to older hospitalists, 5+ years ago it might have been the case that CCM makes more sense financially than HM. However, since HM salary has increased a lot compared to CCM for the past 3 yrs, financially it's a better deal.

People who are going into HM should understand that they will be the least respected physician in the hospital if they care about status/prestige.

I am already making 330k/yr working ~70 hrs every other week and my company is already taking about giving 10k raise this year and retention bonus because they don't want people to leave.

My take is that I don't think that gravy train will last for more than 5 years.

Those are inaccurately quoted MGMA numbers. Here they are again MGMA 2021 mean/median: CCM 454k /440k, pulm crit 501k/465k, hospitalist 318k/307k. I would argue CCM has seen more growth in compensation that hospitalist in the last 5-10 years, and even more in the last couple of years thanks to COVID. I don't have a crystal ball so I won't predict the future, but right now there remains a big shortage for crit care docs, while hospitalists are a dime a dozen. That 410k/year hospitalist job that you're claiming to the be the best job in medicine is near 90th percentile of hospitalist pay, there are other docs in other specialties getting paid at the 90th percentile also - and at that level there is a 270k difference between hospitalist and pulm-crit.

 

[MD46]

You are being extreme here. There is a happy medium in everything.

If you give some workers a few millions, 90%+ of them will stop working.

If they cut heme/onc reimbursement to the point you guys are making 200-250k, these Ivory towers will be FMG/IMG galore (nothing against IMG/FMG by the way). You really think these specialties are competitive because people LOVE them.

Look at radonc: 10+ years ago, you needed a PhD on top of your MD to get into radonc, but the moment the job market was bad, most US students deserted.

You cant generalize these things, My mother is a Clinical Hematologist UK trained and still practices in USA as she did residency in Pathology and subspecialized in Cytopathology.

She also had her own lab/clinic when we were overseas

Point is she inspired me to become a Hematologist Oncologist. In med school I was doing research and published in Nature during 2nd year residency etc etc

I didnt do it for the money, and would do it again if money was less. But I did luck out maybe more than other specialities at this current time in terms of compensation however all specialities over past 20-30 years have their ups and down in compensation.

 

[Splenda88]

You cant generalize these things, My mother is a Clinical Hematologist UK trained and still practices in USA as she did residency in Pathology and subspecialized in Cytopathology.

She also had her own lab/clinic when we were overseas

Point is she inspired me to become a Hematologist Oncologist. In med school I was doing research and published in Nature during 2nd year residency etc etc

I didnt do it for the money, and would do it again if money was less. But I did luck out maybe more than other specialities at this current time in terms of compensation however all specialities over past 20-30 years have their ups and down in compensation.

Where did I generalize things in the post you quoted?

 

[Splenda88]

Those are inaccurately quoted MGMA numbers. Here they are again MGMA 2021 mean/median: CCM 454k /440k, pulm crit 501k/465k, hospitalist 318k/307k. I would argue CCM has seen more growth in compensation that hospitalist in the last 5-10 years, and even more in the last couple of years thanks to COVID. I don't have a crystal ball so I won't predict the future, but right now there remains a big shortage for crit care docs, while hospitalists are a dime a dozen. That 410k/year hospitalist job that you're claiming to the be the best job in medicine is near 90th percentile of hospitalist pay, there are other docs in other specialties getting paid at the 90th percentile also - and at that level there is a 270k difference between hospitalist and pulm-crit.

View attachment 368225

I used the FM-hospitalist number because I think it's more accurate. Even with your number, I would say it favors HM because of opportunity cost. I don't know all about CCM fellowship programs, but the one where I did my residency were not working 30-35 hrs/wk (60-70 hrs every other week), which are the hours most HM physician work.

 

[CCM-MD]

I used the FM-hospitalist number because I think it's more accurate. Even with your number, I would say it favors HM because of opportunity cost. I don't know all about CCM fellowship, but the one where I did my residency were not working 30-35 hrs/wk (60-70 hrs every other week), which are the hours most HM physician work.

You used the FM-hospitalist number because they more conveniently fit your narrative. Pretty sure you are IM and not FM working in a rural area. There is lots of elective time in crit care and pulm-crit fellowships. But sure, like I said before, using some twisted logic/"reasonable assumptions" like working 288 shifts a year as a hospitalist in lieu of doing a fellowship and doing some "solid math" with above avg rates/working nights only and big investment returns = you do come out ahead as a hospitalist.

 

[Splenda88]

You used the FM-hospitalist number because they more conveniently fit your narrative. Pretty sure you are IM and not FM working in a rural area. There is lots of elective time in crit care and pulm-crit fellowships. But sure, like I said before, using some twisted logic/"reasonable assumptions" like working 288 shifts a year as a hospitalist in lieu of doing a fellowship and doing some "solid math" with above avg rates/working nights only and big investment returns = you do come out ahead as a hospitalist.

60k city or town. Major international airport is 1.5 hrs away. You dont' really believe FM make more than IM as HM.

I put my numbers above. I worked 205 shifts last year and made 405k.

You like CCM and that's is great, but from a financial standpoint, it does fare better than HM if we are doing a direct comparison.

 

[CCM-MD]

60k city or town. Major international airport is 1.5 hrs away. You dont' really believe FM make more than IM as HM.

I put my numbers above. I worked 205 shifts last year and made 405k.

You like CCM and that's is great, but from a financial perspective, it does fare better than HM if we are doing a direct comparison.

Major metros tend to pay less and are dominated by IM trained hospitalists. FM are more likely to be in smaller/less desirable locations where pay tends to be higher, leading to a higher reported mean/median. Again, I don't think you're doing a direct comparison because 405k approaches the 90th percentile where the difference between hospitalist and pulm crit is 270k. The opportunity cost argument also starts to fall apart when you compare to CCM alone, where fellowships are only 2 years.

 

[Splenda88]

Major metros tend to pay less and are dominated by IM trained hospitalists. FM are more likely to be in smaller/less desirable locations where pay tends to be higher, leading to a higher reported mean/median. Again, I don't think you're doing a direct comparison because 405k approaches the 90th percentile where the difference between hospitalist and pulm crit is 270k. The opportunity cost argument also starts to fall apart when you compare to CCM alone, where fellowships are only 2 years.

I actually agree w/ you here... I think CCM only fellowship might beat HM, but that 3rd year of PCCM makes a big difference (opportunity cost and compound interest).

My friend that are 30-45 minutes away from major cities in the south east make 300k+/yr

I kind of have an idea where you work based on your prior posts (I might be wrong here). HM docs at your site just got 50k (yes 50k) raise.

 

[Nocturnist]

72 hours/week x 48 weeks = 288 shifts/year. Maybe doable for some of the hospitalists on this website but unrealistic for the rest of us mortals. You also have a very high paying pure nocturnist job. And you’re comparing that to the average rates for pulm/crit. Realize that there are jobs that pay at the 90th percentile in crit care too, and pure nights jobs in the ICU pay a ridiculous amount. Locum jobs also exist in CC and pay significantly more.

But sure, if you make the “very reasonable assumption” of above avg rates as a nocturnist and/or work like a dog, you will definitely come out ahead of a pulm crit doc working mostly days at normal hours at an average rate.

Thats 24 shifts a month. 6-7 days off a month, even enough to still fit a nice monthly vacation in there. I've worked that much many a months. I would have given my first born in residency to work that little. If any resident is expected to work 80 hours and have one day off a week, what's preventing a new hospitalist from continuing to do so for over 10 times the pay?

Again, I only need to work around 17-18 shifts a month to make that. Throw my bonus in there and its really closer to 15-16 shifts. Like I said at 24 shifts a month I'd be way, way over 700k.

$180-200 is very much the going rate, and I keep being reminded in every yearly salary report I'm in the lowest paid part of the country.

Want to keep getting hung up on the 72 hour thing? Fine, call it 60 and factor in my employer's match. Better yet, factor in the 100% ROI on the down payment on my homes in 2-3 years I've got locked at 2.5% mortgage. How's that working out for them CC docs looking to buy these days? Call it luck, but luck favors the prepared- and I was prepared and stacking bands 3 years sooner.

 

[CCM-MD]

I actually agree w/ you here... I think CCM only fellowship might beat HM, but that 3rd year of PCCM makes a big difference (opportunity cost and compound interest).

My friend that are 30-45 minutes away from major cities in the south east make 300k+/yr

I kind of have an idea where you work based on your prior posts (I might be wrong here). HM docs at your site just got 50k (yes 50k) raise.

I think you're right about knowing where I used to work. I remember that exchange we had very well. I moved last year and work in a big city in the west now. I miss my old place and the people a lot. Would go back in a heartbeat if the wife would agree.

Thats 24 shifts a month. 6-7 days off a month, even enough to still fit a nice monthly vacation in there. I've worked that much many a months. I would have given my first born in residency to work that little. If any resident is expected to work 80 hours and have one day off a week, what's preventing a new hospitalist from continuing to do so for over 10 times the pay?

Again, I only need to work around 17-18 shifts a month to make that. Throw my bonus in there and its really closer to 15-16 shifts. Like I said at 24 shifts a month I'd be way, way over 700k.

$180-200 is very much the going rate, and I keep being reminded in every yearly salary report I'm in the lowest paid part of the country.

Want to keep getting hung up on the 72 hour thing? Fine, call it 60 and factor in my employer's match. Better yet, factor in the 100% ROI on the down payment on my homes in 2-3 years I've got locked at 2.5% mortgage. How's that working out for them CC docs looking to buy these days? Call it luck, but luck favors the prepared- and I was prepared and stacking bands 3 years sooner.

Again, you are very highly paid, work nights only, and work a lot. The numbers speak for themselves, $700k is like so far beyond the 90th percentile ($422k) for hospitalists, it's like some alternate reality. Not that I don't believe you but realize that to do a fair comparison you would have to do it to one of the similarly ludicrous high paying jobs for pulm crit - they exist and the comp can be just as off the charts.

 

[Splenda88]

Thats 24 shifts a month. 6-7 days off a month, even enough to still fit a nice monthly vacation in there. I've worked that much many a months. I would have given my first born in residency to work that little. If any resident is expected to work 80 hours and have one day off a week, what's preventing a new hospitalist from continuing to do so for over 10 times the pay?

Again, I only need to work around 17-18 shifts a month to make that. Throw my bonus in there and its really closer to 15-16 shifts. Like I said at 24 shifts a month I'd be way, way over 700k.

$180-200 is very much the going rate, and I keep being reminded in every yearly salary report I'm in the lowest paid part of the country.

Want to keep getting hung up on the 72 hour thing? Fine, call it 60 and factor in my employer's match. Better yet, factor in the 100% ROI on the down payment on my homes in 2-3 years I've got locked at 2.5% mortgage. How's that working out for them CC docs looking to buy these days? Call it luck, but luck favors the prepared- and I was prepared and stacking bands 3 years sooner.

I don't think fellows in the most cushy PCCM program in the country work (30-35 hrs/wk) or 60-70 hrs every other week. For instance, I worked on average ~45 hrs/wk last year and still made 405k.

 

[CCM-MD]

I don't think fellows in the most cushy PCCM program in the country work (30-35 hrs/wk) or 60-70 hrs every other week. For instance, I worked on average ~45 hrs/wk last year and still made 405k.

You're not factoring in elective time in your hr/week calculation. There are months where fellows don't do jack ****.

 

[Splenda88]

You're not factoring in elective time in your hr/week calculation. There are months where fellows don't do jack ****.

Counting these months, would the average be 30-35 hrs/wk?

 

[Nocturnist]

I think you're right about knowing where I used to work. I remember that exchange we had very well. I moved last year and work in a big city in the west now. I miss my old place and the people a lot. Would go back in a heartbeat if the wife would agree.



Again, you are very highly paid, work nights only, and work a lot. The numbers speak for themselves, $700k is like so far beyond the 90th percentile ($422k) for hospitalists, it's like some alternate reality. Not that I don't believe you but realize that to do a fair comparison you would have to do it to one of the similarly ludicrous high paying jobs for pulm crit - they exist and the comp can be just as off the charts.

I do work nights only (I'd take that any day over some 40% night hybrid or whatever BS schedules they throw some of ya'lls way).
I do work alot for a nocturnist just because full time is typically 10-12 nights a month for full time, but not terribly much more than your average 7 on/off hospitalist. Compared to residency, my schedule is cake.
Per hour, I feel I am very reasonably paid. Would not call it very well paid by any means. There are loads of $225-250 opportunities an hour or two drive that I wouldn't touch location wise.

I've said it before- you don't have to spend too long with any hospitalist group to feel how downwardly biased the MGMA percentiles because the job specifically attracts alot of lifestyle oriented folks who couldn't care less about moonlighting. For those of us that just want to ball out, this gig is like an ATM. My salary being 90th+ percentile is just a reflection of my priorities and willingness to pick up a few extra shifts a month. I don't have the hubris to pretend there's anything special about me, I believe any hospitalist can make what I make and still enjoy life as much as I do if that became their priority.

Honestly do I think most hospitalists will come out millions ahead of CC after 30 years? Probably not. I was saying from the get go by just eyeballing the issue that I think you hard working folks will and do probably catch up to us...in 15-20 years or even more. I do think people greatly underestimate the power of compound interest and opportunity cost (social, too). I do think its much more neck and neck for average folks but for those of us willing to work a little hard for a few years- forget it, CCM is never catching up.

Anyway, I respect you and what you do alot. Agree with prior sentiment that money shouldn't be a driving factor in the decision to specialize.

 

[chessknt]

Counting these months, would the average be 30-35 hrs/wk?

I've given up on this pointless conversation but the math of this intrigued me so here is my n of 1:
18 months of research where (if I was being generous) I averaged 15 hrs per week.
12 months ICU-65-70 hrs/week
6 months pulm-probably 50ish hrs/week

So overall avg is 40 hrs/wk so not far off honestly. I am sure there are programs that have less research and more clinical that would weigh more toward 60/wk but it would be uncommon to see 80/wk regularly.

I just ran my hours worked last year against my comp and it is a little over 280/hr fwiw.

 

[rockstar88]

Read the first post of this thread. It's about 'HM making sense financially instead of CCM'. The answer is "yes" due to opportunity cost. Aside from that, no one here has any issue with CCM physicians because they are actually GREAT doctors.

The thread started off as that but turned into a pointless argument about HM vs Pulm/CCM. Again, it's entertaining and I'm learning a lot about compensation in both specialties. I don't get paid as much but that's because it's a huge academic center, but I'm glad to know that HM makes a lot more than that. I just lost interest in HM and feel like a glorified resident.

 

[collegestud2013]

I used the FM-hospitalist number because I think it's more accurate. Even with your number, I would say it favors HM because of opportunity cost. I don't know all about CCM fellowship programs, but the one where I did my residency were not working 30-35 hrs/wk (60-70 hrs every other week), which are the hours most HM physician work.

Really depends on which source you're using. For example, according here according to this article (Earning what you're worth)
median hospitalist compensation was $353k for 2022. The MGMA numbers have IM lower than FM which does seem plausible. FM is higher probably because they are probably more clinical care based in non-academic settings see higher patient volumes and hence their RVUs are also higher (the full MGMA dataset also comes with wRVUs for each specialty and IIRC the RVU numbers for FM hospitalist are indeed higher than IM), while I suspect more IM hospitalists work in academic medicine where pay and RVUs are lower.

As the article mentions, one way increase your RVUs as a hospitalist is to work in an open ICU settings where you can bill for critical care just like the intensivist does (and in many cases still have intensivist support for the true ICU level stuff like vent management, intubated/extubating patients).

Again, not saying pulm/CC isn't a good field to go into or that you won't come out financially ahead of hospitalist, but that if you do the financial difference is a lot smaller than you think based on current numbers. No one can predict the future for sure, but I do agree that hospitalist jobs are more prone to getting saturated than intensivist.

 

[collegestud2013]

The thread started off as that but turned into a pointless argument about HM vs Pulm/CCM. Again, it's entertaining and I'm learning a lot about compensation in both specialties. I don't get paid as much but that's because it's a huge academic center, but I'm glad to know that HM makes a lot more than that. I just lost interest in HM and feel like a glorified resident.

In that case, one could argue that intensivist is just like a glorified pulm/CC fellow. As mentioned above, both are similar in many ways. Both hospitalist and intensivist take care are shift-based and take care of inpatients. Intensivist just treats the sicker patients and does vent management and more procedures, but tend to have discharging responsibilities unless it's discharging the patient to heaven, under the argument that "the patient doesn't need ICU anymore but isn't ready to be discharged from the hospital yet either, so I'm passing them on to the hospitalist service to discharge."

If dealing with discharge planning stuff is at the top of the your least favorite parts about being a hospitalist, one can be a nocturnist, or at many places just volunteer to always be the daytime admitter (and probably make the rest of your colleagues very happy since most hate dealing with the stress and unpredictability of having to admit everyday from the ED).

 

[rockstar88]

In that case, one could argue that intensivist is just like a glorified pulm/CC fellow. As mentioned above, both are similar in many ways. Both hospitalist and intensivist take care are shift-based and take care of inpatients. Intensivist just treats the sicker patients and does vent management and more procedures, but tend to have discharging responsibilities unless it's discharging the patient to heaven, under the argument that "the patient doesn't need ICU anymore but isn't ready to be discharged from the hospital yet either, so I'm passing them on to the hospitalist service to discharge."

If dealing with discharge planning stuff is at the top of the your least favorite parts about being a hospitalist, one can be a nocturnist, or at many places just volunteer to always be the daytime admitter (and probably make the rest of your colleagues very happy since most hate dealing with the stress and unpredictability of having to admit everyday from the ED).

I dunno, I actually enjoyed my residency training. Not every day is a 7-7 inpatient work. There's more balance between floors, electives, and ambulatory clinics. HM is pretty much 7-7 floors all the time. As I said, I like general IM and that's why chose to be a hospitalist. But, I got really bored of being a floor resident all the time. I don't find myself doing it all my career. I can't do purely CCM either. I need some amount of outpatient life. Not saying that this is the case with everyone, it's just my preference.

 

[Gaborik10]

I'm interviewing for some jobs right now. Does anyone have the MGMA 2022 data they can share with me? Pretty please?

 

[Legend of Link]

The few (4) ICU docs that I know (all at different hospitals) work around 21 days per month.
1 week each of ICU, Pulm & clinic.

2 have an RVU clause by which they have to “pay back” if they get higher than threshold RVU first 3 quarters, but then are below by a # greater than what they were up previously.

1 has clinic pts being paid by RVU only.
Pt cancels, you don’t get paid.

I like my 7on-7off, in at 7 out by 2 (in a “12 hour” shift), and then that leaves me fresh enough to do rehab on my weeks off and get around $100K via the side-gig

Can you talk a bit about rehab side gig? How does one go about training during residency for these rehab jobs? Is it like an SNFist?

 

[FutureInternist]

Can you talk a bit about rehab side gig? How does one go about training during residency for these rehab jobs? Is it like an SNFist?

Oh F No…
A 4th year med student could do SNF work.
Mentally there is nothing to do.

Stable pts that are chronically sick with routine meds.
Usually there is a NP that handles all acute issues.
From my understanding, like HD units, they need an actual doc to round on pts once a month so they make it easy for you.

 

[end stage fibro]

Oh F No…
A 4th year med student could do SNF work.
Mentally there is nothing to do.

Stable pts that are chronically sick with routine meds.
Usually there is a NP that handles all acute issues.
From my understanding, like HD units, they need an actual doc to round on pts once a month so they make it easy for you.

While i agree snf work is closer to grunt work than the god tier hospitalist jobs i see on here, it’s nice to drive over, see a few pts, grind out some notes (from anywhere but the snf, mind you), and collect my $x,xxx. Everyone is very appreciative of your time as well, patients and staff. It’s not a bad gig if you can handle the slow pace,smell of urine, and DQ ulcers. Collect a couple med director stipends and baby you got a stew going.

N.b. I want to shoot myself while im there

 

[FutureInternist]

While i agree snf work is closer to grunt work than the god tier hospitalist jobs i see on here, it’s nice to drive over, see a few pts, grind out some notes (from anywhere but the snf, mind you), and collect my $x,xxx. Everyone is very appreciative of your time as well, patients and staff. It’s not a bad gig if you can handle the slow pace,smell of urine, and DQ ulcers. Collect a couple med director stipends and baby you got a stew going.

N.b. I want to shoot myself while im there

Oh for sure..
Easiest gig ever

My F No was to their comment about a “SNF-ist”… like what would that even entail.
How to convince family to make their 89 yo “loved one” who is CVA’ed out on TFs, with no QoL whatsoever, a DNR.. wait a minute… 😏

 

[Ubba]

60k city or town. Major international airport is 1.5 hrs away. You dont' really believe FM make more than IM as HM.

I put my numbers above. I worked 205 shifts last year and made 405k.

You like CCM and that's is great, but from a financial standpoint, it does fare better than HM if we are doing a direct comparison.

I received thousands of emails flooding me with PCP and HM job opportunities when I was a 3rd year resident. There were actually several times when I saw FM-trained offers being 15-20k higher than the same positions for IM-trained docs. Yes, mostly rural, but for the same exact positions. Not unreasonable, actually, as FM docs can handle Ob/Gyn (and certain procedures) more than IM docs can.

 

[Splenda88]

I received thousands of emails flooding me with PCP and HM job opportunities when I was a 3rd year resident. There were actually several times when I saw FM-trained offers being 15-20k higher than the same positions for IM-trained docs. Yes, mostly rural, but for the same exact positions. Not unreasonable, actually, as FM docs can handle Ob/Gyn (and certain procedures) more than IM docs can.

It's strange.

IM and FM got paid the same rate at my place.

 

[collegestud2013]

I received thousands of emails flooding me with PCP and HM job opportunities when I was a 3rd year resident. There were actually several times when I saw FM-trained offers being 15-20k higher than the same positions for IM-trained docs. Yes, mostly rural, but for the same exact positions. Not unreasonable, actually, as FM docs can handle Ob/Gyn (and certain procedures) more than IM docs can.

I've never seen a hospitalist position that pays FM (or IM) more for the same exact work, as both would do the same in an inpatient setting. I suppose FM can do peds and OB stuff but that would be extra work for the extra pay. If one is getting paid more at the same institution, they probably have more responsibilities.

FM hospitalist pay is higher than IM per MGMA, probably because FM tends to be more community-based with 100% clinical time. Their RVUs are also higher than IM if you look at the full MGMA dataset. There tends to be more IM hospitalists in big city academic positions which tend to pay less, but their RVUs are also less as they are not 100% clinical.

 

[Dagrimsta1]

While i agree snf work is closer to grunt work than the god tier hospitalist jobs i see on here, it’s nice to drive over, see a few pts, grind out some notes (from anywhere but the snf, mind you), and collect my $x,xxx. Everyone is very appreciative of your time as well, patients and staff. It’s not a bad gig if you can handle the slow pace,smell of urine, and DQ ulcers. Collect a couple med director stipends and baby you got a stew going.

N.b. I want to shoot myself while im there

So how does one go about getting a SNF side hustle

 

[end stage fibro]

So how does one go about getting a SNF side hustle

in my case, i knew a guy that knew a guy who is med director at several SNFs
you can cold call SNFs to see if they are open to new groups rounding
if you see that your hospital discharges are going to a common SNF, call that SNF and ask to round there. SNFs have metrics too- they love the continuity of care and possibility of preventing bouncebacks because you know the patient. I've heard you can guide patient's to your SNF and it is not a stark law violation because it is continuity of care but i am not certain of that and I advise you to not commit illegal activity.


keep in mind you won't finish PGY3, stroll in as an attending, and have 100s of high paying side gigs. Takes some time and elbow grease