The Nocturnist Guide You Never Wanted But Are Getting Anyway. Also, like, AMA? I guess? If you really feel like it? Compliment compliment question?

[Splenda88]

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How much does sound physician or team health pay for nocturnist per hour?

A friend of mine made 370k last year working for sound in Louisiana. I dont know anyone who works for TH.

 

[kaycee18]

A friend of mine made 370k last year working for sound in Louisiana. I dont know anyone who works for TH.

I was paid 120/hr working nights for them. is there a way I can sue them for discrimination? I left the job in 2019. I was treated terribly during my employment and anything I can do to make them pay will help me with healing.

 

[Splenda88]

I was paid 120/hr working nights for them. is there a way I can sue them for discrimination? I left the job in 2019. I was treated terribly during my employment and anything I can do to make them pay will help me with healing.

Were you geographically restricted at that time?

 

[kaycee18]

it was

Were you geographically restricted at that time?

it was my first job out of residency. I was not able to get another position until I was one year into that job. Then licensing took about 1month and then credentialing. Did not get to leave until sept 2019.

And they wanted 6months noticed. I spend the first 6 months trying to negotiate for a raise. By January, I had become so depressed. gave my noticed at that time.

 

[Splenda88]

it was

it was my first job out of residency. I was not able to get another position until I was one year into that job. Then licensing took about 1month and then credentialing. Did not get to leave until sept 2019.

And they wanted 6months noticed. I spend the first 6 months trying to negotiate for a raise. By January, I had become so depressed. gave my noticed at that time.

260k for nocturnist was extremely low unless that was in a desirable location and you were working ~12 shifts/month

 

[kaycee18]

260k for nocturnist was extremely low unless that was in a desirable location and you were working ~12 shifts/month

columbus, ohio. Is there a chance I can sue if they were paying others more? it seems that is the case but I have not been able to gather evidence.

 

[kaycee18]

worked 16-17 shifts monthly

 

[Splenda88]

columbus, ohio. Is there a chance I can sue if they were paying others more? it seems that is the case but I have not been able to gather evidence.

Not sure you can sue. May need to talk to a lawyer.

You really got screwed.

 

[tantacles]

Ok, so another update on all this: Made enough money last year that I'm probably going to 0.8 FTE next year. Will still be saving a ton of money but will get to focus on self-actualization and other projects.

This is a job. I do it to survive, and my ultimate goal is not to work forever.

 

[daveiscool]

How common/uncommon to start a hospitalist/nocturnist job at 0.5 - 0.75 FTE? My wife works and pulls good money - I am looking to add on about 150K income and could see myself doing that as a nocturnist. We have kids and sick parents so I would like to be there to be primary caregiver.

Also any thoughts regarding transition from hospitalist to fellowship? Or is that conversation for another thread? If so, please link me?

 

[chessknt]

How common/uncommon to start a hospitalist/nocturnist job at 0.5 - 0.75 FTE? My wife works and pulls good money - I am looking to add on about 150K income and could see myself doing that as a nocturnist. We have kids and sick parents so I would like to be there to be primary caregiver.

Also any thoughts regarding transition from hospitalist to fellowship? Or is that conversation for another thread? If so, please link me?

What subspecialty?

 

[daveiscool]

What subspecialty?

Hey thanks for the response.
Considering Pulm/CC personally but was wondering in general what stories folks have heard from going from hospitalist to fellowship. Any factors to consider? Not much out there per my search.

 

[Nocturnist]

How common/uncommon to start a hospitalist/nocturnist job at 0.5 - 0.75 FTE? My wife works and pulls good money - I am looking to add on about 150K income and could see myself doing that as a nocturnist. We have kids and sick parents so I would like to be there to be primary caregiver.

Also any thoughts regarding transition from hospitalist to fellowship? Or is that conversation for another thread? If so, please link me?

Can't speak to the latter but the former is pretty common in my experience around the northeast. I've seen both day hospitalists and nocturnist be accommodated at pretty much any scenario from 0.5-1.2 FTEs. Would just recommend you be very upfront with the program re your circumstances. They're going to be much less pleased to find out a few weeks/months down the road the person they were counting on for a full FTE is now dropping down to half.

If you're just looking to supplement your wife's income and not particularly concerned with a guaranteed shift commitment or benefits (which you can presumably get through your wife), locums might be the best option for you. You never have to work a weekend or holiday and can set your exact schedule.

 

[tantacles]

How common/uncommon to start a hospitalist/nocturnist job at 0.5 - 0.75 FTE? My wife works and pulls good money - I am looking to add on about 150K income and could see myself doing that as a nocturnist. We have kids and sick parents so I would like to be there to be primary caregiver.

Also any thoughts regarding transition from hospitalist to fellowship? Or is that conversation for another thread? If so, please link me?

Pretty common to do less than 1.0 FTE. A bunch of the nocturnists at another hospital in my city are doing 0.6-0.7 FTE, and it works for them.

 

[daveiscool]

Thank you all for the helpful replies. This is making my last year in residency more bearable looking forward to the future!

 

[chessknt]

Hey thanks for the response.
Considering Pulm/CC personally but was wondering in general what stories folks have heard from going from hospitalist to fellowship. Any factors to consider? Not much out there per my search.

I think given how competitive pulm/cc has become being a stay at home parent is not going to strengthen your application and might make it difficult to get in. The further you get away from residency with nothing new on your CV besides employment the harder it will become for any subspecialty but it really matters who you are up against.

 

[daveiscool]

I think given how competitive pulm/cc has become being a stay at home parent is not going to strengthen your application and might make it difficult to get in. The further you get away from residency with nothing new on your CV besides employment the harder it will become for any subspecialty but it really matters who you are up against.

I suppose academic hospitalist probably better option if I’m still considering fellowship? Can anyone speak to that?

 

[aafisahar]

I suppose academic hospitalist probably better option if I’m still considering fellowship? Can anyone speak to that?

You need something to show for it, research, education, QI etc etc. You can't just show up and do your work without putting in the extra stuff that fellowship programs want.

 

[Splenda88]

I just started my hospitalist gig and it seems like life as an attending is a heck of a lot better than being a student/resident.

 

[rokshana]

I just started my hospitalist gig and it seems like life as an attending is a heck of a lot better than being a student/resident.

Lol…thank you captain obvious!😜

 

[Splenda88]

Lol…thank you captain obvious!😜

Lol. I thought the job was going to be harder. There is a thread in the EM forum about a hospitalist who is making 400k/yr and wants to go back to do an EM residency so he/she can work in the ED.

 

[Splenda88]

Now what? I have a whole week free, what should I do?

No money to travel yet since I am a new hospitalist.

 

[CCM-MD]

Now what? I have a whole week free, what should I do?

No money to travel yet since I am a new hospitalist.

I am a few years into practice and still ask myself this question periodically.

 

[Splenda88]

I am a few years into practice and still ask myself this question periodically.

You can use your attending $$$ to do things. I am still a broke doc.

 

[chessknt]

Now what? I have a whole week free, what should I do?

No money to travel yet since I am a new hospitalist.

If you find this distressing I recommend having children. You will not have free time for many years to come even when you’re off.

 

[Splenda88]

If you find this distressing I recommend having children. You will not have free time for many years to come even when you’re off.

Lol. I have 2 and they are school-aged children

 

[chessknt]

Lol. I have 2 and they are school-aged children

Time to join the pta and bake some covid awareness brownies and volunteer in the classroom. Or do they go to some fancy pants private school and that is why you are poor?

min all honesty I’m in the same place as you except my kids are younger and an endless time sink. I have no hobbies but have a list of some I plan to start…

 

[Splenda88]

Time to join the pta and bake some covid awareness brownies and volunteer in the classroom. Or do they go to some fancy pants private school and that is why you are poor?

min all honesty I’m in the same place as you except my kids are younger and an endless time sink. I have no hobbies but have a list of some I plan to start…

No private school for my kids. Did not go to one myself, and I am doing ok. I guess I should look into some volunteering opportunities.

 

[tantacles]

Sooooooo maybe my final update about being a nocturnist?

I got bored. Nocturnists medicine pays well and my job is relatively easy, but I felt like I wasn’t accomplishing anything. Revolving door of hospital medicine strikes again. Extra bonus: people who only work days not understanding what your job is and being completely unopen to most feedback about flow and hospital issues.

And of course, no hospital will ever want to promote a nocturnist who is doing their job well as keeping those nights staffed is a chief priority, so it ends up being a dead end job. And even though you work nights, you still get badgered about attending daytime meetings at noon when everyone knows you literally just worked the previous night. Really, people?

Scaled back to 1.0, but then subsequently gave notice.

What will I do? Well, started a fun YouTube channel and will very casually look for a job. Looking forward to taking 3 months off (at least) with no true deadlines.

 

[deleted849476]

Sooooooo maybe my final update about being a nocturnist?

I got bored. Nocturnists medicine pays well and my job is relatively easy, but I felt like I wasn’t accomplishing anything. Revolving door of hospital medicine strikes again. Extra bonus: people who only work days not understanding what your job is and being completely unopen to most feedback about flow and hospital issues.

And of course, no hospital will ever want to promote a nocturnist who is doing their job well as keeping those nights staffed is a chief priority, so it ends up being a dead end job. And even though you work nights, you still get badgered about attending daytime meetings at noon when everyone knows you literally just worked the previous night. Really, people?

Scaled back to 1.0, but then subsequently gave notice.

What will I do? Well, started a fun YouTube channel and will very casually look for a job. Looking forward to taking 3 months off (at least) with no true deadlines.

Congrats, sounds like you got what you wanted out of it.

I’d be interested in hearing a brag about how much you earned and saved if you care to share, and are you thinking of being a hospitalist again in the future or outpatient or undecided or or or ?

And as a general question, how long do you think a hospitalist can go unemployed (by choice) before they start to get worse at their job if they were hired again? Is it possible that an attending with a few years experience could ‘forget’ important stuff, or say if you always keep up on your licensure you could pretty much be right back in the game after an extended vacation (years even perhaps)? Not that this is your situation I’m just curious.

If we never hear more from you here, it was a good thread!

 

[Prehealth1011]

Sooooooo maybe my final update about being a nocturnist?

I got bored. Nocturnists medicine pays well and my job is relatively easy, but I felt like I wasn’t accomplishing anything. Revolving door of hospital medicine strikes again. Extra bonus: people who only work days not understanding what your job is and being completely unopen to most feedback about flow and hospital issues.

And of course, no hospital will ever want to promote a nocturnist who is doing their job well as keeping those nights staffed is a chief priority, so it ends up being a dead end job. And even though you work nights, you still get badgered about attending daytime meetings at noon when everyone knows you literally just worked the previous night. Really, people?

Scaled back to 1.0, but then subsequently gave notice.

What will I do? Well, started a fun YouTube channel and will very casually look for a job. Looking forward to taking 3 months off (at least) with no true deadlines.

How common is this kinda thing as a nocturnist?

I thought the whole point was to be off when you’re off, especially if you’re doing nights! That sounds horrid

 

[tantacles]

How common is this kinda thing as a nocturnist?

I thought the whole point was to be off when you’re off, especially if you’re doing nights! That sounds horrid

I mean… it IS the point. But your administrators have to leave you the f*** alone for that to work. Otherwise, well, they lose a nocturnist.

 

[tantacles]

Congrats, sounds like you got what you wanted out of it.

I’d be interested in hearing a brag about how much you earned and saved if you care to share, and are you thinking of being a hospitalist again in the future or outpatient or undecided or or or ?

And as a general question, how long do you think a hospitalist can go unemployed (by choice) before they start to get worse at their job if they were hired again? Is it possible that an attending with a few years experience could ‘forget’ important stuff, or say if you always keep up on your licensure you could pretty much be right back in the game after an extended vacation (years even perhaps)? Not that this is your situation I’m just curious.

If we never hear more from you here, it was a good thread!

Oh, I’m not going anywhere. Just wanted to give the final update to this particular saga.

Earnings brag: made about $430,000 in 2021. Worked extra shifts (to about 2.0 fte during that time period up until July 1 when I stopped. I haven’t filed taxes this year but I think it came out to about 270k post tax.

Future? Who knows? We’ll see. Open to many possibilities, but likely won’t work more than 1/2 time now that I’ve saved up so much.

And to answer the forgetting question: I feel like I’m getting far more stupid being a nocturnist at this particular hospital than I ever did with time off. The training never goes away, and you can always open uptodate. I’m not a mid level; I did a four year med-peds residency, and while things can be temporarily masked, the big lessons of patient care are never forgotten after 4 years of 80 hours per week.

 

[Splenda88]

Oh, I’m not going anywhere. Just wanted to give the final update to this particular saga.

Earnings brag: made about $430,000 in 2021. Worked extra shifts (to about 2.0 fte during that time period up until July 1 when I stopped. I haven’t filed taxes this year but I think it came out to about 270k post tax.

Future? Who knows? We’ll see. Open to many possibilities, but likely won’t work more than 1/2 time now that I’ve saved up so much.

And to answer the forgetting question: I feel like I’m getting far more stupid being a nocturnist at this particular hospital than I ever did with time off. The training never goes away, and you can always open uptodate. I’m not a mid level; I did a four year med-peds residency, and while things can be temporarily masked, the big lessons of patient care are never forgotten after 4 years of 80 hours per week.

I believe the poster was asking about net worth.

 

[tantacles]

I believe the poster was asking about net worth.

I said what I said

 

[aafisahar]

Oh, I’m not going anywhere. Just wanted to give the final update to this particular saga.

Earnings brag: made about $430,000 in 2021. Worked extra shifts (to about 2.0 fte during that time period up until July 1 when I stopped. I haven’t filed taxes this year but I think it came out to about 270k post tax.

Future? Who knows? We’ll see. Open to many possibilities, but likely won’t work more than 1/2 time now that I’ve saved up so much.

And to answer the forgetting question: I feel like I’m getting far more stupid being a nocturnist at this particular hospital than I ever did with time off. The training never goes away, and you can always open uptodate. I’m not a mid level; I did a four year med-peds residency, and while things can be temporarily masked, the big lessons of patient care are never forgotten after 4 years of 80 hours per week.

did you make a ton of money in the market? not understanding how you can go from 400k to nothing in San Francisco and saying things will be okay....

 

[tantacles]

did you make a ton of money in the market? not understanding how you can go from 400k to nothing in San Francisco and saying things will be okay....

Oh, I'm likely moving.

Also, that's only one year of earning and I saved > 6 figures.

Housing is expensive here, but I didn't have any trouble living well below my means and building a sizeable nest egg. My partner is also a physician.

 

[daveiscool]

This has been an awesome read. Thanks for sharing your journey @tantacles !

 

[sss2g2]

Oh, I'm likely moving.

Also, that's only one year of earning and I saved > 6 figures.

Housing is expensive here, but I didn't have any trouble living well below my means and building a sizeable nest egg. My partner is also a physician.

Any advice for new guys starting as a nocturnist fresh out of residency? Would you say it's possible to reach financial independence fairly quickly working hard for a couple of years in a HCOL city? My goal is to just out quickly because I dread everything about medicine and just want to pay off my debt, not work anymore and focus on my hobbies. It seems you did it in about 2 years?

 

[chessknt]

Any advice for new guys starting as a nocturnist fresh out of residency? Would you say it's possible to reach financial independence fairly quickly working hard for a couple of years in a HCOL city? My goal is to just out quickly because I dread everything about medicine and just want to pay off my debt, not work anymore and focus on my hobbies. It seems you did it in about 2 years?

Depends on your debt and living expenses but generally absolutely not possible unless you are planning on subsisting on medicaid and dumpster diving and living in a cardboard box using tire fire for warmth at night with no phone for the rest of your life. Look up FIRECALC for an idea of how much you might need but even if you somehow manage to save 600k and pay off all your debt in 2 years you are not going to live off 600k the rest of your life unless you are in your 80s.

 

[tantacles]

Any advice for new guys starting as a nocturnist fresh out of residency? Would you say it's possible to reach financial independence fairly quickly working hard for a couple of years in a HCOL city? My goal is to just out quickly because I dread everything about medicine and just want to pay off my debt, not work anymore and focus on my hobbies. It seems you did it in about 2 years?

I mean, I'm not FIRE status yet and still have plenty of debt. Just plenty comfortable working on my youtube channel for several months and stalling given the substantial amount I've saved.

But since you're asking:

Spend far less than you earn
Have a partner who makes a similar income
Find something inexpensive to spend your time on (video games?)
Cook and/or eat less
Don't get a gym membership - get an exercise bike or treadmill instead
Recognize whether nocturnist is a forever job for you or a temporary job
Recognize that you don't have to stop working altogether once you have a nest egg and if on income based repayment of loans can just go part time.

I'm sure I can think of more if you're desperate for more.

 

[Splenda88]

Depends on your debt and living expenses but generally absolutely not possible unless you are planning on subsisting on medicaid and dumpster diving and living in a cardboard box using tire fire for warmth at night with no phone for the rest of your life. Look up FIRECALC for an idea of how much you might need but even if you somehow manage to save 600k and pay off all your debt in 2 years you are not going to live off 600k the rest of your life unless you are in your 80s.

The poster might be able to if he/she has a paid off home (a small one) and move to a very low COL area. But it will be a tight one. However, 1 mil plus a paid off home can make that more realistic

 

[chessknt]

The poster might be able to if he/she has a paid off home (a small one) and move to a very low COL area. But it will be a tight one. However, 1 mil plus a paid off home can make that more realistic

No way--health insurance, food, property tax, utilities for 50 years on 1M? Safe return on that would be 40k a year max? Hope he never needs dental work or to take a plane anywhere and nothing in the house ever breaks.

Also paying off a house, debts, and saving 1M in a taxable account is ****ing impressive for 2 years of work. That is neuosurg pay.

 

[rokshana]

My question is why would you have spent 8 years of your life doing med school and residency to only work 2 years? You would have been better working in something else and left that spot to someone that actually wants to do medicine.

The only way you are going g to be FIRE in 2 years is if you win the lottery, a rich relative does and leaves you money, or are lucky in trading.

 

[chessknt]

My question is why would you have spent 8 years of your life doing med school and residency to only work 2 years? You would have been better working in something else and left that spot to someone that actually wants to do medicine.

The only way you are going g to be FIRE in 2 years is if you win the lottery, a rich relative does and leaves you money, or are lucky in trading.

To be fair Rona has ruined medicine (and many other aspects of society). People are entitled and nasty and we all get pay cuts as a reward for dealing with them. I totally get wanting to burn this bitch down and walk away.

 

[scoopdaboop]

Is 1 week on 2 week of common? Or is that say a .5 - .75 FTE equivalent?

 

[sss2g2]

My question is why would you have spent 8 years of your life doing med school and residency to only work 2 years? You would have been better working in something else and left that spot to someone that actually wants to do medicine.

The only way you are going g to be FIRE in 2 years is if you win the lottery, a rich relative does and leaves you money, or are lucky in trading.

I'm sure you will agree you've made a bad decision in your life? Unfortunately for many of us it was going down this path. I love the medicine. I just don't love everything that comes with it anymore.

 

[rokshana]

I'm sure you will agree you've made a bad decision in your life? Unfortunately for many of us it was going down this path. I love the medicine. I just don't love everything that comes with it anymore.

Then do something non clinical or another aspect on medicine… you can teach, go into informatics, research, etc and frankly resident life and attending life are different…you can have a lot more autonomy once you are out in The real world.

I work locums, choose to work 2 weeks a month and make more than enough to meet my financial needs and get plenty of free time to do what I want.

 

[rokshana]

To be fair Rona has ruined medicine (and many other aspects of society). People are entitled and nasty and we all get pay cuts as a reward for dealing with them. I totally get wanting to burn this bitch down and walk away.

There is truth in there…but then you find ways to pivot …whether that be a non clinical aspect, part time, focus on certain aspects of medicine that you do like, etc.
Making decisions for the rest of your medical career based on the experience of residency is silly… you have no real idea of what is available and doable.

 

[Splenda88]

No way--health insurance, food, property tax, utilities for 50 years on 1M? Safe return on that would be 40k a year max? Hope he never needs dental work or to take a plane anywhere and nothing in the house ever breaks.

Also paying off a house, debts, and saving 1M in a taxable account is ****ing impressive for 2 years of work. That is neuosurg pay.

Agree that you can save that much in 2 yrs unless you are a neuro/spine surgeon.

One can definitely live on 1M with a paid off home

You put half of it in AT&T stock... You will make 40k/yr in dividend. The other half in an S&P500 index and pull out 4%(20k)/yr. That is a total of ~60k/yr.

Buy health insurance in the insurance exchange website for $200-300/month