You just can't compare jobs like this based on compensation (or possible compensation) alone. Hospitalist work and PCP work are very different. I see people sometimes comparing different specialities within IM using compensation as well. This is apples and oranges. In general, outpatient private practice in any field is always going to have a higher ceiling. Employed positions typically have higher bases. Outpatient PP is a business with opportunities for revenue streams beyond just seeing patients. Nothing is free. People who make significantly above the median in any field are working hard, at least initially. But that depends on how you like to practice, where you want to live, where you're at in life, and what kind of personal investment you want to make in your work. An outpatient PCP who employs midlevels and other physicians, has great staff, owns their own building, has an excellent payor mix, sees a high volume of patients, and maybe offers some additional services (wt loss, hormones, cosmetics, whatever) is obviously going to earn way more than a PCP who works as an employee of the local large health system and sees 18pt/day with nights/weekends/holidays off and multiple weeks of vacation per year. As a hospitalist, your ceiling is generally not as high. I've heard of some small hospitalist groups that own their own group, contract with a hospitals and local care facilities, employ their own midlevels, and have negotiated lucrative contracts. The partners in these groups make significantly more than the hospitalist who is just a w-2 employee of some large hospital system...but, again, more headache and more personal investment.
There is no such thing as a free lunch. There's some unicorns out there but there's a reason there's a median of compensation. Anything offering really high numbers should have a clear explanation for why they are an outlier or you should be suspicious.
