What is the lifestyle of a IM hospitalist like?

[rokshana]

Do either of you work in the US? Because I have never seen a medicine resident,fellow, or attending ever write emergent HD or chemo orders...that’s why Nephrologists are on call...they come in for HD even in the middle of the night ...

And sorry, no amount of money would make me feel comfortable doing things outside of what is expected of a hospitalist when I’m a hospitalist...I don’t think I’ve ever seen HD as part of credentialing as a hospitalist.

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[rokshana]

Yep. Especially to initiate. Time is short, because you don’t want to do a lot right off the bat. Then you just adjust based on electrolytes.....

I am not saying anyone should do anything they aren’t comfortable. But maybe at some point with enough education, it’s also a skill someone who wants to learn can learn.

Yeah...those that did fellowship in the specialty...that’s how you get “enough “ education

 

[rokshana]

I was on renal for a month and you can very easily figure out how to write dialysis orders. It's all formulaic. There's no magic going into them. Nephrology seemed happy they didn't have to spend several hours writing dialysis orders instead of seeing consults that required much more thought.

That’s just the dunning-Kruger in you

 

[IMGASMD]

Yeah...those that did fellowship in the specialty...that’s how you get “enough “ education

Yep. The last time I check I did everything in the US.
You know your have a unrestricted license to practice medicine right? As long as the hospital credentials you to do certain procedure, in this case initiating hemodialysis; you say you can do it. In this case, after you received “adequate” training, you can do whatever you want with your license and knowledge.....

Whether you should/would is a different conversation than “could”.

 

[DrSnips]

Yep. The last time I check I did everything in the US.
You know your have a unrestricted license to practice medicine right? As long as the hospital credentials you to do certain procedure, in this case initiating hemodialysis; you say you can do it. In this case, after you received “adequate” training, you can do whatever you want with your license and knowledge.....

Whether you should/would is a different conversation than “could”.

Would you perform general surgeries like an appendectomy if a hospital would pay you enough?

 

[IMGASMD]

Would you perform general surgeries like an appendectomy if a hospital would pay you enough?

If I get “enough” training. Also initiating dialysis and surgery are two different skills.

You have FM who deliver and/or doing c-sections. How about that? If that’s okay, I am certainly okay doing an appy.

When I was training a-line, para, thoracentesis even TLC were just at the time point, no longer needed to be certified to graduate. You have half of the class, very excited; the other half, just want to do them. If you’re not comfortable, no one is forcing you to do anything you aren’t happy to do.

PS. If you’re still in training and if your attendings let you do some of those procedures, do them.

 

[TraderDoc]

Relatively new hospitalist here, 31 years old, single. top 10 most populated city in midwest (2nd most fun outside of Chicago in my opinion) live downtown. Work 268 shifts year when including sick days and PTO. Make about 500K. We have excellent social workers (which is key), relatively low-moderate stress overall (average 13-16 patients, most shifts 8-5pm, some swings and some overnights, no procedures/line/vents, we have team for RR and CODE BLUES). Travel plenty, not a problem to see friends and family. Overall very excellent lifestyle, I'm very happy. GI/Cardiology friends make more $$$ but def more stressful job IMO. Hospitalist like everything else, have to find good group.

 

[DrSnips]

If I get “enough” training. Also initiating dialysis and surgery are two different skills.

Yeah, but according to you anything a physician is licensed to do falls under your purview if you are game for it. That should include surgery too then.

You have FM who deliver and/or doing c-sections. How about that? If that’s okay, I am certainly okay doing an appy.

FM at least has some training in these areas during residency. We in IM have no formal training in performing surgery. Also, since when does another person's questionable practice make it ok for us to perform substandardly?

When I was training a-line, para, thoracentesis even TLC were just at the time point, no longer needed to be certified to graduate. You have half of the class, very excited; the other half, just want to do them. If you’re not comfortable, no one is forcing you to do anything you aren’t happy to do.

PS. If you’re still in training and if your attendings let you do some of those procedures, do them.

I know no one is forcing me to do these things. I'm more worried about other people who aren't qualified jumping at the chance to do them when they see $$$ being thrown at them.

 

[IMGASMD]

Yeah, but according to you anything a physician is licensed to do falls under your purview if you are game for it. That should include surgery too then.

I still stand by my statement. If the hospital let you and you are comfortable, then you absolutely can perform surgeries.

 

[KnuxNole]

I would personally run far, far, far away if a hospitalist says he/she wants to do an appy on me...

 

[VA Hopeful Dr]

I still stand by my statement. If the hospital let you and you are comfortable, then you absolutely can perform surgeries.

Ah, so you're just being pedantic about "can"

 

[IMGASMD]

Ah, so you're just being pedantic about "can"

This discussion started with dialysis initiation by a hospitalist after adequate training(for big bucks).

If a highly trained (cc if IIRC) physician such as you cannot stomach that thought, then I guess I should just surrender my license to practice......

 

[ortnakas]

This discussion started with dialysis initiation by a hospitalist after adequate training(for big bucks).

Only an IM intern, but I think most people would think anything less than nephrology fellowship as less than adequate.

 

[IMGASMD]

Only an IM intern, but I think most people would think anything less than nephrology fellowship as less than adequate.

At one of my training hospital for IM, didn’t have surgical residency. If we “need” a central line, we’d have to call surgical attendings in. I’d venture to guess, less than 50% of patients who were on Levo had a central line.

If “you” had “enough” training, would you feel comfortable to stick the patient to start a central line?

“Initiating dialysis” is also a “skill” that “anyone” can training for. If someone who is proficient who taught you AND the hospital let you AND you feel comfortable. Why can’t you do it?

Just asking.

Edit: before we get too far.
My point is that we, as physicians, have a license to practice “medicine.”

I have faith in “medicine” as an institution. So if I have a legal medical license and hospital credential then I can practice.

I have faith in my training. My teachers have taught me to the best of their abilities. I’ve learned as much as I can.

Lastly I have faith in myself. If I cannot handle the task at hand, I know when to ask for help. I know when to stop. If I am not comfortable at performing the task, then I don’t ask permission to do it. Hopefully I am smart enough to not put myself in that position.

Can all these things fail? Sure. But as you go on, these are decisions you make every day. I hope you will make the best decision for your patients and yourself. At end of the day, you’re the one who will live with your decisions for the rest of your life.

 

[Sandovalsel]

Relatively new hospitalist here, 31 years old, single. top 10 most populated city in midwest (2nd most fun outside of Chicago in my opinion) live downtown. Work 268 shifts year when including sick days and PTO. Make about 500K. We have excellent social workers (which is key), relatively low-moderate stress overall (average 13-16 patients, most shifts 8-5pm, some swings and some overnights, no procedures/line/vents, we have team for RR and CODE BLUES). Travel plenty, not a problem to see friends and family. Overall very excellent lifestyle, I'm very happy. GI/Cardiology friends make more $$$ but def more stressful job IMO. Hospitalist like everything else, have to find good group.

How do you find these good group?? Recruiter?

 

[aafisahar]

How do you find these good group?? Recruiter?

Recruiter is the last person you should ask to find such a group.

 

[sanfran256]

How is the job market for hospitalists now ? Particularly in SoCal
Whenever I do a job search online there are always tons of outpatient positions but not many hospitalist ones?

 

[yellowdonkey]

How is the job market for hospitalists now ? Particularly in SoCal
Whenever I do a job search online there are always tons of outpatient positions but not many hospitalist ones?

what websites have you been using? practice match is a good place to start