Telehospitalist rates

[WIFEL585]

Hospitalist looking to do some telemedicine. Have some experience during training as well with virtual/tele-inpatient medicine. Obviously it's mostly CHF, pneumonia, UTI, COPD, SSTI stuff and within reason, anything too exciting has to go to brick and mortar hospitalization for safety reasons.

Been looking around and not sure what a good rate is. Or if there are any sites that list good tele-hospitalist rates.

Thanks.

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[DrMetal]

Hospitalist looking to do some telemedicine. Have some experience during training as well with virtual/tele-inpatient medicine. Obviously it's mostly CHF, pneumonia, UTI, COPD, SSTI stuff and within reason, anything too exciting has to go to brick and mortar hospitalization for safety reasons.

Been looking around and not sure what a good rate is. Or if there are any sites that list good tele-hospitalist rates.

Thanks.

I don't know about rates (I would think if a live hospitalist gets paid roughly $100 per patient encounter per day, the tele-hospitalist rate would be a fraction of that, maybe $75 or $50 per encounter?)

Just curious though: what company(ies) are you looking at?

 

[WIFEL585]

I don't know about rates (I would think if a live hospitalist gets paid roughly $100 per patient encounter per day, the tele-hospitalist rate would be a fraction of that, maybe $75 or $50 per encounter?)

Just curious though: what company(ies) are you looking at?

Haven’t looked at any particular company yet.

Was going off a rough estimate of like $180-$210 / hour for an in person hospitalist hourly rate (the rough average of what PRN people get at my place) and assumed a virtual hospitalist might get something a little less than that, but not sure what is considered acceptable.

 

[DrMetal]

Haven’t looked at any particular company yet.

Was going off a rough estimate of like $180-$210 / hour for an in person hospitalist hourly rate (the rough average of what PRN people get at my place) and assumed a virtual hospitalist might get something a little less than that, but not sure what is considered acceptable.

I would hope for at least 75% (of what a live hospitalist makes). But I wouldn't be surprised by as low as 50% (given much of the quackery going on in corporate medicine right now, including midlevel encroachment).

If you wouldn't mind providing an update (what companies, what rates), would appreciate it. I've thought about the tele-hospitalist route. In the end, I've always concluded that it's probably just easier to do it live at a local community hospital.

"We'll Do it Live!"
--Bill O' Reilly

 

[Ubba]

I would hope for at least 75% (of what a live hospitalist makes). But I wouldn't be surprised by as low as 50% (given much of the quackery going on in corporate medicine right now, including midlevel encroachment).

If you wouldn't mind providing an update (what companies, what rates), would appreciate it. I've thought about the tele-hospitalist route. In the end, I've always concluded that it's probably just easier to do it live at a local community hospital.

"We'll Do it Live!"
--Bill O' Reilly

Telemedicine makes sense if someone wants to live somewhere very specific, usually rural or urban, and not have to commute either long distances or through agonizing traffic. But for the vast majority of doctors who live more or less "down the block" from the hospital or clinic (say, within 20 minutes), the ability to work in shorts just isn't worth the substantial pay cut.

 

[DrMetal]

Telemedicine makes sense if someone wants to live somewhere very specific, usually rural or urban, and not have to commute either long distances or through agonizing traffic. But for the vast majority of doctors who live more or less "down the block" from the hospital or clinic (say, within 20 minutes), the ability to work in shorts just isn't worth the substantial pay cut.

Quite true. And physical rounding isn't that hard. You can spend an hour rounding, then go home and get into shorts.

Not only that, but in some tele-medicine constructs (I see this with the Neurologist), you have to 'round' with a live nurse who takes you virtually to every room. You're dependent on said nursing schedule, and sometimes you have to round multiple times, you have to always be available video on demand, etc.

It's not worth the hassle right now (I may entertain it some day)

 

[end stage fibro]

Quite true. And physical rounding isn't that hard. You can spend an hour rounding, then go home and get into shorts.

Not only that, but in some tele-medicine constructs (I see this with the Neurologist), you have to 'round' with a live nurse who takes you virtually to every room. You're dependent on said nursing schedule, and sometimes you have to round multiple times, you have to always be available video on demand, etc.

It's not worth the hassle right now (I may entertain it some day)

disclaimer: i didn't actually start doing tele-hospitalist, only because of the tons of BS. i tried going through with it about 2.5 years ago

I agree, yet again, with drmetal. i thought teleshifts would be a cluster of patients that i could easily round on. turns out i would be rounding all over the country on a given shift. So i needed roughly 15 state licenses (not an issue with IMLC) and I needed to be credentialed at over 30 podunk hospitals (the company did a good job filling out the paperwork but it was still annoying. and that is 30 EHR related HAs to manage as well.)

some hospitals, the nurse would load up a tablet and i would virtually round with him/her. Sometimes i was on the tablet waiting like 10 mins as the nurse was walking around. Some hospitals had a high-res camera in the room that I could turn on. this setup was awesome- I could literally assess pupil size with the high quality. you usually get low acuity patients, but sometimes there is an emergency and it becomes a cluster- you dont know anyone you can message directly, you may or may not run the rapid/code, you are at the mercy of some usually garbage hospital and it's garbage resources.

i thought i would be able to round then go hang out and field calls somewhere. nope...needed to be available by video all the time. Was more annoying than in person. back then, none of the companies had phone apps, just PC login.

my comp was 50/encounter. there was more to it than that but i didn't get far enough into the prcoess to see what that entailed

 

[DrMetal]

disclaimer: i didn't actually start doing tele-hospitalist, only because of the tons of BS. i tried going through with it about 2.5 years ago

I agree, yet again, with drmetal. i thought teleshifts would be a cluster of patients that i could easily round on. turns out i would be rounding all over the country on a given shift. So i needed roughly 15 state licenses (not an issue with IMLC) and I needed to be credentialed at over 30 podunk hospitals (the company did a good job filling out the paperwork but it was still annoying. and that is 30 EHR related HAs to manage as well.)

some hospitals, the nurse would load up a tablet and i would virtually round with him/her. Sometimes i was on the tablet waiting like 10 mins as the nurse was walking around. Some hospitals had a high-res camera in the room that I could turn on. this setup was awesome- I could literally assess pupil size with the high quality. you usually get low acuity patients, but sometimes there is an emergency and it becomes a cluster- you dont know anyone you can message directly, you may or may not run the rapid/code, you are at the mercy of some usually garbage hospital and it's garbage resources.

i thought i would be able to round then go hang out and field calls somewhere. nope...needed to be available by video all the time. Was more annoying than in person. back then, none of the companies had phone apps, just PC login.

my comp was 50/encounter. there was more to it than that but i didn't get far enough into the prcoess to see what that entailed

Yeah, this sounds horrible, and I bet its the norm. Paradoxically, in the tele-hospitalist world, you probably spend more of your time (albeit virtual) in the hospital doing more mundane tasks (like overly-detailed physical exams).

Assessing pupil size? We hardly make eye contact with some of our patients. And any whiff of something neuro-ophtho related gets a stat head MRI (+/- contrast of course).

 

[tantacles]

Yeah, this sounds horrible, and I bet its the norm. Paradoxically, in the tele-hospitalist world, you probably spend more of your time (albeit virtual) in the hospital doing more mundane tasks (like overly-detailed physical exams).

Assessing pupil size? We hardly make eye contact with some of our patients. And any whiff of something neuro-ophtho related gets a stat head MRI (+/- contrast of course).

Yeah if I had to do this I would just end up ordering more imaging.

 

[dozitgetchahi]

disclaimer: i didn't actually start doing tele-hospitalist, only because of the tons of BS. i tried going through with it about 2.5 years ago

I agree, yet again, with drmetal. i thought teleshifts would be a cluster of patients that i could easily round on. turns out i would be rounding all over the country on a given shift. So i needed roughly 15 state licenses (not an issue with IMLC) and I needed to be credentialed at over 30 podunk hospitals (the company did a good job filling out the paperwork but it was still annoying. and that is 30 EHR related HAs to manage as well.)

some hospitals, the nurse would load up a tablet and i would virtually round with him/her. Sometimes i was on the tablet waiting like 10 mins as the nurse was walking around. Some hospitals had a high-res camera in the room that I could turn on. this setup was awesome- I could literally assess pupil size with the high quality. you usually get low acuity patients, but sometimes there is an emergency and it becomes a cluster- you dont know anyone you can message directly, you may or may not run the rapid/code, you are at the mercy of some usually garbage hospital and it's garbage resources.

i thought i would be able to round then go hang out and field calls somewhere. nope...needed to be available by video all the time. Was more annoying than in person. back then, none of the companies had phone apps, just PC login.

my comp was 50/encounter. there was more to it than that but i didn't get far enough into the prcoess to see what that entailed

Jesus, this sounds absolutely horrific. Especially the part about running codes and emergencies. That was one of the first questions I had about this sort of thing - what do you do when **** hits the fan? I figured they would have EM or some midlevel or something to do that, but at least some of these places have a telehospitalist running the code? Holy god.

When you say $50/encounter, I’m assuming that’s per patient per day? The pay would have to be way better than this to put up with that much BS and liability.

 

[timpview]

Haha it’s amazing docs sign up for stuff like that.

 

[end stage fibro]

Yeah, this sounds horrible, and I bet its the norm. Paradoxically, in the tele-hospitalist world, you probably spend more of your time (albeit virtual) in the hospital doing more mundane tasks (like overly-detailed physical exams).

Assessing pupil size? We hardly make eye contact with some of our patients. And any whiff of something neuro-ophtho related gets a stat head MRI (+/- contrast of course).

I've said it multiple times - If i am touching the patient, something has gone horribly wrong. to me, assessing pupils is an "ocular touch" (that was a good one gimme some credit). the other guy was doing the encounter and I was shadowing remotely

Jesus, this sounds absolutely horrific. Especially the part about running codes and emergencies. That was one of the first questions I had about this sort of thing - what do you do when **** hits the fan? I figured they would have EM or some midlevel or something to do that, but at least some of these places have a telehospitalist running the code? Holy god.

When you say $50/encounter, I’m assuming that’s per patient per day? The pay would have to be way better than this to put up with that much BS and liability.

yeah, apparently you call ED or call an onsite person if possible. I didn't see any codes run...noped out too fast. yes 50 bucks per pt per day. theres bonuses and some shift incentives but I don't know the details. the guy I was working with said you could make pretty decent money once you had an efficient setup. He actually seemed like a decent doc- up to date on literature and reviewed labs at a good speed and had note done before encounter was finished. understood the system too- did his admin BS like queries, nurses liked him, notes were good. not sure why he is doing it*

*spoiler i have a strong suspicion- $$$. he mentioned teleSNF as well (i think through sound)

edit: now that i think of it, i read articles of overemployed tech people working 2-3 jobs at once. I could see a doc doing round at 2-3 jobs at once lol.

 

[Laradd]

disclaimer: i didn't actually start doing tele-hospitalist, only because of the tons of BS. i tried going through with it about 2.5 years ago

I agree, yet again, with drmetal. i thought teleshifts would be a cluster of patients that i could easily round on. turns out i would be rounding all over the country on a given shift. So i needed roughly 15 state licenses (not an issue with IMLC) and I needed to be credentialed at over 30 podunk hospitals (the company did a good job filling out the paperwork but it was still annoying. and that is 30 EHR related HAs to manage as well.)

some hospitals, the nurse would load up a tablet and i would virtually round with him/her. Sometimes i was on the tablet waiting like 10 mins as the nurse was walking around. Some hospitals had a high-res camera in the room that I could turn on. this setup was awesome- I could literally assess pupil size with the high quality. you usually get low acuity patients, but sometimes there is an emergency and it becomes a cluster- you dont know anyone you can message directly, you may or may not run the rapid/code, you are at the mercy of some usually garbage hospital and it's garbage resources.

i thought i would be able to round then go hang out and field calls somewhere. nope...needed to be available by video all the time. Was more annoying than in person. back then, none of the companies had phone apps, just PC login.

my comp was 50/encounter. there was more to it than that but i didn't get far enough into the prcoess to see what that entailed

50$ per patient is kinda ridiculous for the liability and headache

 

[Kach]

Hospitalist looking to do some telemedicine. Have some experience during training as well with virtual/tele-inpatient medicine. Obviously it's mostly CHF, pneumonia, UTI, COPD, SSTI stuff and within reason, anything too exciting has to go to brick and mortar hospitalization for safety reasons.

Been looking around and not sure what a good rate is. Or if there are any sites that list good tele-hospitalist rates.

Thanks.

I'm a full time telehospitalist. A good rate is 120 an hour or greater.

 

[CDI]

I work in this space as well.

Agree with above. Shoot for $120/hr+

Though I can confirm that I have seen a few climb to $150-175/hr. Those gigs have extremely low turnover.

 

[end stage fibro]

I'm a full time telehospitalist. A good rate is 120 an hour or greater.

I work in this space as well.

Agree with above. Shoot for $120/hr+

Though I can confirm that I have seen a few climb to $150-175/hr. Those gigs have extremely low turnover.

can you 2 elaborate on this? i dont see much discussion on hospitalization work anywhere.can you see patients on your phone? are you rounding at 1 facility? are codes still FUBAR? how many patients?

 

[WIFEL585]

Cool stuff, appreciate the responses. It appears however harder than negotiating a rate for telehospitalist is simply finding telehospitalist work. The demand simply isn’t there like it is for in person, so I caved and went for in person. Much better pay obviously but without the convenience of working home in your PJ’s.