Your thoughts on this contract for Hospitalist

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JamaicanHerb

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Job is in southeast US, no state income tax with private physician group contracted with large chain hospital. People I would work with are chill and consultants are nice and I know them already (same city as my residency). Avg. patient census per someone that works there is 23 pts daily avg'd out, usually 20-25 pts., Person that works there usually out in 8 hours of a 12 hour shift 7 on/7 off, no codes except if its your patient you should do it otherwise ICU answers codes/met calls, open ICU but very hands off as ICU physicians are protective of patients. Don't have to get there at 7am and if admitter is there you get out in 6-8 hours. City is smallish with good housing prices but 4 hours from major cities but city has its own airport serviced by major airlines, but city is more of a college town. Friend states she has never worked more than 12 hours a day.

-35k$ sign on bonus paid monthly during residency last year (whatever is left is given day 1 of work) with 2 year commitment
-105$ an hour with 5$ rvu. Avg. 60 RVUs a day
-40$ per patient after patient 18
-$480 bonus for every shift above 15 (I plan on working like a resident taking 18-20 shifts a month if not here or in more rural cities an hour away that have paid anywhere between 2000$ to $5000 (only when they get really desperate obviously)
-$5k/yr. CME thats pretty constricted to like books, conferences, subscriptions to journals, subs to societies (cant use on cars, phones, computers)
-malpractice with tail/medical/dental/vision
-401k with essentially 2% match vested for 4 years (25% per year)
-No non-compete clause

The hourly rate looks low but when factoring in bonuses improves to my understanding running the numbers. Easy to pick up tons of shifts as its very busy. City is kinda boring (I'm single with no kids) but i did my residency there so i know most of the consultants already and there is an airport with delta, AA, jetblue etc. Not 501c3 but im not doing PSFL. What do you guys think?

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It doesn’t sound horrible. If you’ve done the residency there, u Should have firsthand knowledge. Do your attendings seem happy? Do they actually stay for a while? Or do they just stay for a year or two until they get burned out.

23/day sounds a lot to me, but I haven’t really done that kind of work for a while. I also think 7/7 can be pretty draining too. However, as a first job and you think you can make good money then I consider to stick it out for a while?
 
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For the amount of work your doing in a small town 4 hours away from a major city you should average a lot more per hour. From what I calculate you’ll be getting about 146/hr.. I think a fair starting rate should be in the range of 175 (with everything factored in) for location and amount of patients. I would try to get your base rate increased, I’m sure there’s wiggle room. If they don’t increase your base rate I would decrease amount of required shifts in a month to 12 and do locums for rest of your shifts. If your just graduating just remember they need you more than u need them, there’s always room to negotiate.
 
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It doesn’t sound horrible. If you’ve done the residency there, u Should have firsthand knowledge. Do your attendings seem happy? Do they actually stay for a while? Or do they just stay for a year or two until they get burned out.

23/day sounds a lot to me, but I haven’t really done that kind of work for a while. I also think 7/7 can be pretty draining too. However, as a first job and you think you can make good money then I consider to stick it out for a while?

I did residency in the same city not same hospital. The attending i know that works there tells me its a great starting job which she has done for 2 years now and pretty easy but people either stay because they have family in the city or move to bigger metros for a pay cut.
 
I wouldn't take a job that expects you to round on 25 patients per day. Also, I dislike the structure where it would seem you have to keep track of your patient censuses each day, how many RVU's you're billing, etc to make sure that your pay check is accurate. This job would be a hard pass for me but everyone is different with priorities of hospitalist jobs.
 
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Ya i think im going to hold out and see my options in a bigger city
 
Job is in southeast US, no state income tax with private physician group contracted with large chain hospital. People I would work with are chill and consultants are nice and I know them already (same city as my residency). Avg. patient census per someone that works there is 23 pts daily avg'd out, usually 20-25 pts., Person that works there usually out in 8 hours of a 12 hour shift 7 on/7 off, no codes except if its your patient you should do it otherwise ICU answers codes/met calls, open ICU but very hands off as ICU physicians are protective of patients. Don't have to get there at 7am and if admitter is there you get out in 6-8 hours. City is smallish with good housing prices but 4 hours from major cities but city has its own airport serviced by major airlines, but city is more of a college town. Friend states she has never worked more than 12 hours a day.

-35k$ sign on bonus paid monthly during residency last year (whatever is left is given day 1 of work) with 2 year commitment
-105$ an hour with 5$ rvu. Avg. 60 RVUs a day
-40$ per patient after patient 18
-$480 bonus for every shift above 15 (I plan on working like a resident taking 18-20 shifts a month if not here or in more rural cities an hour away that have paid anywhere between 2000$ to $5000 (only when they get really desperate obviously)
-$5k/yr. CME thats pretty constricted to like books, conferences, subscriptions to journals, subs to societies (cant use on cars, phones, computers)
-malpractice with tail/medical/dental/vision
-401k with essentially 2% match vested for 4 years (25% per year)
-No non-compete clause

The hourly rate looks low but when factoring in bonuses improves to my understanding running the numbers. Easy to pick up tons of shifts as its very busy. City is kinda boring (I'm single with no kids) but i did my residency there so i know most of the consultants already and there is an airport with delta, AA, jetblue etc. Not 501c3 but im not doing PSFL. What do you guys think?

Seems like a high individual census for only “6-8 hours” out of a 12 hour shift but maybe. Especially if acuity isn’t too high. So I’m skeptical there but . . .

My math has that job paying ~330k per year BEFORE extra shifts. And at an average ~1800/shift (assuming the 23 patients per day)

Seems like a nice 401k too. Just remember you need those four years in to keep any match. So plan to to hang in for four years.

No income tax will be super nice. But most states without one will get you in property taxes so live simply for now and you should make a relative killing.

Nice pick up. If I’d have had the chance for a job like that out of residency would have been hard to go to fellowship.
 
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Sounds like a round and go gig? high census, but if truly round and go you should have all your work done in 4hrs with 25 pts, hang around for any tests/dispo stuff, then scadadle out of there
Having a higher census on admitting days would suck

The problem becomes what to do with your time, if able to cut out early...early for what? Workout, after that then what? With a family that sounds ideal, but in a “boring” college town, im not sure what what/who you’ll be doing to fill all that time
 
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Sounds like a round and go gig? high census, but if truly round and go you should have all your work done in 4hrs with 25 pts, hang around for any tests/dispo stuff, then scadadle out of there
Having a higher census on admitting days would suck

The problem becomes what to do with your time, if able to cut out early...early for what? Workout, after that then what? With a family that sounds ideal, but in a “boring” college town, im not sure what what/who you’ll be doing to fill all that time

Drink whiskey?
 
pick a city with a lot of singles in their 20s/30s; you won't be young forever.
 
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