How common is $310,000 for a hospitalist?

[tima]

I was talking to an IM attending and he said he makes about $310,000 by working 2 weeks (7 on/ 7 off) of 12's and 3-5 extra shifts every month at another hospital or walk in clinic.

1) Does that salary seem accurate? I guess hospitalist base is $225k and $75-100k in additional shifts?

2) How easy is it to find additional shifts like finding 3-5 shifts during the 2 weeks off?

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[Postictal Raiden]

Punching the numbers into a calculator shows an hourly pay of $108. Not too long ago, I remember reading on this sub-forum that 150/hr was the going rate.

 

[PlutoBoy]

Not hard to do if you are working extra shift. However, this is ill advised. Enjoy your days off! Enjoy life!

 

[Doc_Mcstuffins]

Need more information. Location is biggest factor. What is average hospitalist salary in that area? Procedures required?

In my area (major East coast city), full-time hospitalist hourly rate ranges from $75 (academic) to $110-115 an hour. Moonlighters/locums pay higher rates - around $125/hr on average for no procedures, no real ICU work - ICU coverage in house so you're "helping to co manage" the patient. In the very few places where there isn't ICU and you have to do lines, procedures, ICU - moonlighter/locums will pay more, maybe $150/hr but that type of hospitalist/moonlighter is almost non existent in area.

But yeah, if you work 5 extra shifts a month, an extra 90K is possible.

 

[Captain DO]

I'd imagine the salaries will go down as hospitalist continues to be a popular career choice.

They are a necessary cost center for hospitals, they dont bring in money, thus hospitals will always drive down salary as supply increases.

 

[Taurus]

Salaries will go down as supply meets demand. Unfortunately, that supply comes from the ranks of physicians as well as midlevels especially NPs. Most places probably won't let NPs work completely independently. However, you the physician more likely will be the head of a team of midlevels, residents, pharm, etc. That team model will still decrease the overall demand in the job market. The question is when will the golden age end? 5 more years?

 

[psychMDhopefully]

I'd imagine the salaries will go down as hospitalist continues to be a popular career choice.

They are a necessary cost center for hospitals, they dont bring in money, thus hospitals will always drive down salary as supply increases.

What do you mean they don't bring in money? Wtf?

 

[psychMDhopefully]

Salaries will go down as supply meets demand. Unfortunately, that supply comes from the ranks of physicians as well as midlevels especially NPs. Most places probably won't let NPs work completely independently. However, you the physician more likely will be the head of a team of midlevels, residents, pharm, etc. That team model will still decrease the overall demand in the job market. The question is when will the golden age end? 5 more years?

The last thing a nurse wants to do is hospitalist work, they aren't qualified for it, it requires to much thinking and knowing of actual medicine.

 

[Taurus]

What do you mean they don't bring in money? Wtf?

Hospitals do not make a profit on hospitalists. They are an expense like IT, janitors, etc. They NY Times article pointed that fact clearly.

http://forums.studentdoctor.net/threads/good-nytimes-article-on-hospitalists.1178207/#post-17320486

So when you are a cost center and not a money maker, the organization will constantly look for ways to minimize that cost. That's business 101.

The salaries and job opportunities for hospitalists have been so good in the last few years because every hospital in the country was moving at the same time to this new hospitalist paradigm. However, supply is starting to catch up to demand. Eventually, there will be an oversupply because you have both physicians and midlevels entering this space. As I pointed out in other threads, there is a small difference between a physician and NP hospitalist, especially in community hospitals. I would imagine in small community hospitals, you will have independent NP hospitalists. In larger or tertiary hospitals, you will be head of a team.

 

[psychMDhopefully]

Hospitals do not make a profit on hospitalists. They are an expense like IT, janitors, etc. They NY Times article pointed that fact clearly.

http://forums.studentdoctor.net/threads/good-nytimes-article-on-hospitalists.1178207/#post-17320486

So when you are a cost center and not a money maker, the organization will constantly look for ways to minimize that cost. That's business 101.

The salaries and job opportunities for hospitalists have been so good in the last few years because every hospital in the country was moving at the same time to this new hospitalist paradigm. However, supply is starting to catch up to demand. Eventually, there will be an oversupply because you have both physicians and midlevels entering this space. As I pointed out in other threads, there is a small difference between a physician and NP hospitalist, especially in community hospitals. I would imagine in small community hospitals, you will have independent NP hospitalists. In larger or tertiary hospitals, you will be head of a team.

Hospitalist here have had this argument before NPs are slow, they have trouble managing complex patients , if there were a "team" model for inpatient medicine, they would be trying it now. Its just not worth the expense. As for supply catching up with demand, hospitalist medicine seems to be a transition job between residency and eventually private practice or some other type of practice. Turnover is high.

 

[Taurus]

Hospitalist here have had this argument before NPs are slow, they have trouble managing complex patients , if there were a "team" model for inpatient medicine, they would be trying it now. Its just not worth the expense. As for supply catching up with demand, hospitalist medicine seems to be a transition job between residency and eventually private practice or some other type of practice. Turnover is high.

The decision makers are the MBAs. They are the bean counters. As that article pointed out, you will be at their mercy and whim when you are a cost center and not a money maker. The dropping hourly pay for locums is a canary in a coal mine and a hint of the future. People should not expect the pay and lifestyle of the last few years will continue for the rest of their careers. Things change rapidly and often not for the better. I would not write off midlevels so quickly. That would be foolish. They are increasing their penetration more and more into every facet of medicine. Their numbers are growing every year

 

[Elixir6]

The decision makers are the MBAs. They are the bean counters. As that article pointed out, you will be at their mercy and whim when you are a cost center and not a money maker. The dropping hourly pay for locums is a canary in a coal mine and a hint of the future. People should not expect the pay and lifestyle of the last few years will continue for the rest of their careers. Things change rapidly and often not for the better. I would not write off midlevels so quickly. That would be foolish. They are increasing their penetration more and more into every facet of medicine. Their numbers are growing every year

You really do not stop with the doom and gloom eh. Every forum on SDN the same thing.

Obviously, anyone thinking about it can see that there are many problems in US healthcare, one of which is the corporatization of healthcare leading to important decisions being made by "bean counters" as you have called them. These people obviously want to pay themselves more by squeezing cash out of the hospital (you could frame it as they want to make the hospital more efficient if you want).

However, the article you had posted earlier, though interesting does not support what you are saying that physicians will make less money. In fact it says quite the opposite:

"Outsourced hospitalists tend to make as much or more money than those that hospitals employ directly, typically in excess of $200,000 a year. But the catch is that their compensation is often tied more directly to the number of patients they see in a day — which the hospitalists at Sacred Heart worried could be as many as 18 or 20, versus the 15 that they and many other hospitalists contend should be the maximum."

They want to get physicians to see more people and pay them more. Obviously, this may not be everyone's cup of tea. But you can't claim something and reference an article that says otherwise.

Also, you have this thing that you keep alluding to with NPs and how like CNRAs they will destroy physician salaries etc... Except I did a quick look, and not only are anesthetists among the best compensated physicians there salaries have gone up each in the Medscape Physician Compensation Report over the past 5 years, moreover, I found two articles showing increases in salaries over the past decade.

http://money.usnews.com/careers/best-jobs/anesthesiologist/salary
http://drivinghp.com/consulting/how-is-md-compensation-affecting-your-anesthesia-subsidy/

Lastly, you claim that hospitalists are a money drain on hospitals. That's got to be a load of BS. Maybe they don't bring in as much money as someone coming in for a PCI, but they make money. With the logic you posted earlier, the cardiologist is also an "expense" as you claim janitors and IT people are. Sure if you can do a PCI without a cardiologist then you can think of a cardiologist as an expense instead of being part of the service rendered. And if your claims are true, wouldn't hospitals shrink away their gen med floor and try and only attract patients with diseases treated by specialists. Also, why is it then that hospitalist salaries have increased dramatically over the past decade if they are such a money drain for hospitals?

Now, I am only a medical student and not "in the know". I have no idea if physicians will be paid less in the future because of "bean counters" or NPs etc... What I do know is that you keep going around screaming that the sky is falling when I don't see any evidence of this. Maybe NPs will be really good for both physician job satisfaction and income because they will take care of crap like run of the mill diabetes out of control, or diuresis for CHF with physician oversight so we can see more patients and bill for more complex things.

 

[path or no path]

Hospitals do not make a profit on hospitalists. They are an expense like IT, janitors, etc. They NY Times article pointed that fact clearly.

http://forums.studentdoctor.net/threads/good-nytimes-article-on-hospitalists.1178207/#post-17320486

So when you are a cost center and not a money maker, the organization will constantly look for ways to minimize that cost. That's business 101.

The salaries and job opportunities for hospitalists have been so good in the last few years because every hospital in the country was moving at the same time to this new hospitalist paradigm. However, supply is starting to catch up to demand. Eventually, there will be an oversupply because you have both physicians and midlevels entering this space. As I pointed out in other threads, there is a small difference between a physician and NP hospitalist, especially in community hospitals. I would imagine in small community hospitals, you will have independent NP hospitalists. In larger or tertiary hospitals, you will be head of a team.

Not quite sure why a radiologist has an axe to grind with hospitalists...but I guess to each their own...

There are very few if any midlevels entering the profession. We have a couple and they essentially function as interns. They are not given the autonomy neither do they possess the fund of knowledge or analytical skills to make independent management decisions.

Right...there is a small difference between M.D. and NPs. That must be true because you said so. OK guy.

 

[chessknt]

Hospitals do not make a profit on hospitalists. They are an expense like IT, janitors, etc. They NY Times article pointed that fact clearly.

http://forums.studentdoctor.net/threads/good-nytimes-article-on-hospitalists.1178207/#post-17320486

So when you are a cost center and not a money maker, the organization will constantly look for ways to minimize that cost. That's business 101.

The salaries and job opportunities for hospitalists have been so good in the last few years because every hospital in the country was moving at the same time to this new hospitalist paradigm. However, supply is starting to catch up to demand. Eventually, there will be an oversupply because you have both physicians and midlevels entering this space. As I pointed out in other threads, there is a small difference between a physician and NP hospitalist, especially in community hospitals. I would imagine in small community hospitals, you will have independent NP hospitalists. In larger or tertiary hospitals, you will be head of a team.

From a wRVU ONLY perspective this is completely accurate--hospitalists (among other specialties) do not bill enough RVUs to pay their own salary in most places. Looking at only physician billing is inaccurate however because they add significant value to care, especially when a hospital system sets them up for success. Reduced <30d readmissions, less tests ordered on surgical patients who have bundled payments, improved quality measures that avoid reductions in overall medicare reimbursement to a hospital--these are just the BASIC components hospitalists bring. Once they start staffing pre-op clinics, co-management services, etc their value added skyrockets as they prevent surgical cancellations and post-operative complications.

As much as you deride the bean-counters, any one worth his/her salt knows this because they involve physicians in administration and run pilots to see these results in real life. Janitors/IT do not impact medicare reimbursement based on quality measures or have a significant impact in post-operative complications in bundled surgical payments. Depending on payer mix, this amounts to a significant portion of money. NPs cannot add this value so far so that is why they are generally only being used to the degree that they can enable hospitalists to see more patients.

 

[PlutoBoy]

As for supply catching up with demand, hospitalist medicine seems to be a transition job between residency and eventually private practice or some other type of practice. Turnover is high.

Yeap! Shortly after starting the dream schedule of 7 on/7 off most people realize they have been duped and the job sucks!

 

[rokshana]

There are very few if any midlevels entering the profession. We have a couple and they essentially function as interns. They are not given the autonomy neither do they possess the fund of knowledge or analytical skills to make independent management decisions.

Right...there is a small difference between M.D. and NPs. That must be true because you said so. OK guy.

you obviously are not keeping up with the current practice of hospital medicine (or the increasing autonomy of NPs...)in your academic world you may not see many...but in community hospitals (and these are not necessarily small places) they have a much bigger foot print and state licensing bodies are giving more and more autonomy to NPs( look for the post on legislation that is up in Ohio )and in MANY states mid levels (particularly NPs) they do not even have to be in the same places as their "collaborating" physician...unfortunately the only place they don't have autonomy is their legal responsibility...you as the physician get to keep that...

and while YOU may think that they don't possess the fund of knowledge and analytical skills...patients, insurance companies, and hospital groups beg to differ...

please wait til you actually have some experience behind you...you will see how naive these comments of yours are...do notice its the students that are pooh poohing the "doom and gloom"...those actually practicing medicine know that there is a lot of truth in the doom and gloom...

 

[Taurus]

It's not hard to be doom and gloom when most of medicine is going to ****. Every field has issues including my own. The key is to carve out a little niche for yourself. Therefore, it is important for people to recognize the pros and cons of their field and make some reasonable predictions about the future.

I suspected and the NY Times article put it in writing that hospitalists are cost centers. If I and the NY Times are wrong, I would be very interested to hear it. Current hospitalists should ask their hospital administrators how they are viewed. They should ask to see the books and accounting.

Everyone knows that there are a certain fields that generate profits for hospitals and they usually bend over backwards for them. Surgery, radiology, cards, and GI are the usual names. Lots of pediatric subspecialties do not make profits for hospitals. Using some business sense, you should always want to be a money maker. Otherwise, hospital administration will always be looking to minimize your costs. I would further argue that most hospital administrations look at hospitalists as commodities. You don't advertise how great your hospitalists are in newspaper ads. You brag about how great your cardiology, orthopedic, GI people are.

So what do you do get when you combine a commodity, cost center, and oversaturation? I think we all know the answer to that.

 

[Taurus]

From a wRVU ONLY perspective this is completely accurate--hospitalists (among other specialties) do not bill enough RVUs to pay their own salary in most places. Looking at only physician billing is inaccurate however because they add significant value to care, especially when a hospital system sets them up for success. Reduced <30d readmissions, less tests ordered on surgical patients who have bundled payments, improved quality measures that avoid reductions in overall medicare reimbursement to a hospital--these are just the BASIC components hospitalists bring. Once they start staffing pre-op clinics, co-management services, etc their value added skyrockets as they prevent surgical cancellations and post-operative complications.

As much as you deride the bean-counters, any one worth his/her salt knows this because they involve physicians in administration and run pilots to see these results in real life. Janitors/IT do not impact medicare reimbursement based on quality measures or have a significant impact in post-operative complications in bundled surgical payments. Depending on payer mix, this amounts to a significant portion of money. NPs cannot add this value so far so that is why they are generally only being used to the degree that they can enable hospitalists to see more patients.

You're absolutely correct. Hospitalists can play a very important role to save the hospital money by reducing read mission, etc. IT can argue similarly that they play a very important role in making things more efficient, etc.

But does stop hospitals and companies like Disney from outsourcing their IT? Nope. Google Disney and IT H1B lawsuit.

I think it's a lot harder to show your value when you have to prove that you save an organization money versus showing every knee replacement generates $$$ for the hospital.

Sure, some wise, savvy, and smart hospital administrators will understand the value of paying their hospitalists well and keeping them happy. But most will simply look to minimize their costs. I would not bet my career on being employed by wise hospital administrators. That's a fool's bet.

 

[chessknt]

You're absolutely correct. Hospitalists can play a very important role to save the hospital money by reducing read mission, etc. IT can argue similarly that they play a very important role in making things more efficient, etc.

But does stop hospitals and companies like Disney from outsourcing their IT? Nope. Google Disney and IT H1B lawsuit.

I think it's a lot harder to show your value when you have to prove that you save an organization money versus showing every knee replacement generates $$$ for the hospital.

Sure, some wise, savvy, and smart hospital administrators will understand the value of paying their hospitalists well and keeping them happy. But most will simply look to minimize their costs. I would not bet my career on being employed by wise hospital administrators. That's a fool's bet.

As the margins for hospitals shrink with the changing payment landscape, more facilities will be absorbed or go under if they are not run properly. Any administrator who only looks at physicians as earning money or costing money is terrible because we don't live in communist Russia and have an unbelievably more complicated system of payment that involves multiple federal and state agencies, private insurers, and uninsured people with payment reductions calculated from contrived formulas by CMS for problems ranging from CAUTIs to DVTs to HCAHPS. As a radiologist you are essentially removed from the every-day workings of floor medicine and simply don't understand the complex interplay between physicians, nurses, patients, and payers.

Hospitalist medicine has a very stable future, especially as the boomers reach geriatric age with multiple comorbidities that are potential penalty targets for Medicare. Ortho might be able to fix a knee, but their management of DM, CHF, and COPD is nonexistent. NPs that consult endocrine, cardiology, and pulm to manage this cost far more money in the bundled payment structure than a single hospitalist who manages all 3. The biggest threat right now will be the attempt by hospitals to use NPs to extend hospitalist reach to more patients in an attempt to cut costs. If this results in worse outcomes, as it eventually will at a certain ratio, this will be immediately pulled back.

 

[Mad Jack]

Hospitals do not make a profit on hospitalists. They are an expense like IT, janitors, etc. They NY Times article pointed that fact clearly.

http://forums.studentdoctor.net/threads/good-nytimes-article-on-hospitalists.1178207/#post-17320486

So when you are a cost center and not a money maker, the organization will constantly look for ways to minimize that cost. That's business 101.

The salaries and job opportunities for hospitalists have been so good in the last few years because every hospital in the country was moving at the same time to this new hospitalist paradigm. However, supply is starting to catch up to demand. Eventually, there will be an oversupply because you have both physicians and midlevels entering this space. As I pointed out in other threads, there is a small difference between a physician and NP hospitalist, especially in community hospitals. I would imagine in small community hospitals, you will have independent NP hospitalists. In larger or tertiary hospitals, you will be head of a team.

Physician hospitalists have been shown to be more effective by every hospital in the area that has tried then than midlevels. We're talking discharge rates that more than make up for their pay. The suits have done the numbers- the whole reason hospitalists exist is that they allow beds to turn over faster and the hospital to collect for the time billed to their inpatients for hospitalist visits (small though it may be). It's not about quality of care or any of that nonsense. Hospitalists move beds much, much faster than both midlevels and hospitals without a hospitalist program. More beds=more money. The idea that hospitalists don't increase hospital revenue neglects the very reason they exist in the first place.

 

[PlutoBoy]

Physician hospitalists have been shown to be more effective by every hospital in the area that has tried then than midlevels. We're talking discharge rates that more than make up for their pay. The suits have done the numbers- the whole reason hospitalists exist is that they allow beds to turn over faster and the hospital to collect for the time billed to their inpatients for hospitalist visits (small though it may be). It's not about quality of care or any of that nonsense. Hospitalists move beds much, much faster than both midlevels and hospitals without a hospitalist program. More beds=more money. The idea that hospitalists don't increase hospital revenue neglects the very reason they exist in the first place.

Not to mention that hospitalists make the surgeons and other medical sub specialists happy.

I know of orthopedic groups that have requested their hospital to hire hospitalists for them.

This is not to say that the job does not suck, though.

 

[laserbeam]

I do not understand why people say the hospitalist job sucks. It is highly doable, for most IM graduates. It does require good fund of knowledge, analytical skill and work efficiency be feel comfortable and confident. After the initial learning phase, the rest is just routine work. I am in a large hospitalist group. Most people can get their work done fast and go home early.

 

[IMreshopeful]

I do not understand why people say the hospitalist job sucks. It is highly doable, for most IM graduates. It does require good fund of knowledge, analytical skill and work efficiency be feel comfortable and confident. After the initial learning phase, the rest is just routine work. I am in a large hospitalist group. Most people can get their work done fast and go home early.

That particular poster basically only posts about how much he hates the hospitalist job. There are extreme viewpoints in every circumstance and it depends a lot on your practice model as you said.

 

[PlutoBoy]

I do not understand why people say the hospitalist job sucks. It is highly doable, for most IM graduates. It does require good fund of knowledge, analytical skill and work efficiency be feel comfortable and confident. After the initial learning phase, the rest is just routine work. I am in a large hospitalist group. Most people can get their work done fast and go home early.

Well, maybe you should look at burnout rates by specialty. Hint: IM is up there. And I would bet it is even worse for hospitalists.

 

[PlutoBoy]

I guess it is not all that bad if you can get over the fact that you:

1) Will lose half of your weekends and holidays (good luck hanging out with normal people on a wednesday afternoon).

2) Have to talk to patients and all of their family members all day long, explain why the patient still has chest pain despite a normal cath and EGD, etc.

3) Will be unable to sign off when you no longer have anything to offer to the patient but the patient is still "ill".

4) Be expected to admit whatever the ER wants you to admit.

5) Admit whatever any other doctor wants you to admit (cards will "let you" admit their MIs even after they did the cath, urology will "let you" handle nephrolothiasis, etc).

6) Be interrupted at all times. If you think being paged 50 times per shift won't hurt your soul, I am here to tell you that it definitely will.

7) Be constantly bothered by case managers and social workers.

8) Be expected to attend all sorts of meetings in the hospital. You know, since you are the hospitalist.

9) Will have to present patients to SOME dick subspecialists that treat you at best like a nuissance and at worst like an idiot child. This gets old pretty quickly and the only way around it is to subspecialize.

10) Will have no control over how many patients you see any given day. It could be 15... Or it could be 30! No ACGME to protect you in private practice, my friend.

11) You will likely have no paid vacation time.

Realize that what you will be doing is work in a week what most people work in two.

You are gullible if you think you are only working "half a year".

Internists all around the country have been duped into thinking that hospitalist work and the schedule is a great deal. Let me break it down to you. This is a good deal for the hospital and for the hospital only. That's it.

People grow out of the field pretty quickly.
FOR A REASON.

My advice: Either subspecialize or establish a private practice. Working as a hospitalist for 30+ years is not feasible.

PS: Did I mention that the social life you want to improve will actually suffer by losing half the weekends and holidays of the year? Did I? I think I did.

PS2: You will not be sailing through the Caribbean every other week. Get over that stuff. Protect your weekends and holidays.

 

[tachycore]

At an academic institution, I have watched my former IM attendings and co-residents become hospitalists, as the field began expanding in my city. They actually practice medicine and complete the diagnostic work-ups before calling in consultants. They work their butts off with the 2 week on, 2 week off deal. They also practice in a resource-limited setting.

They have my greatest respect for what a hospitalist should be.

I have watched outside physicians join them. These get laughed at and mocked by other services and IM trainees across the board. Why? They pan-consult everyone without actually seeing the patient. They clearly expected to sit back and let others run the show (and you wonder why other specialties treat them like idiot children). They also practice discharging patients far earlier than the former group, and often against the advice of the consultants. On the private side, I have watched a hospitalist discharge my family member way too early (I even advised against discharge the night beforehand, as an IM resident). Only for his follow-up clinic to ship him urgently back to the ICU nearly septic (I kept insisting he get taken back to the ED, he sounded bad).

So, I personally despise so-called sit-on-their-butts hospitalists with super-awesome discharge rates. I regard trainees aspiring to be private hospitalists as lost causes.

Yes. Some hospitalists can have great discharge rates. Numbers never tell the whole story, though. I challenge that hospitals, insurance companies, and CMS should measure consulting rates and bounce back rates as well.

 

[PlutoBoy]

Bounce back rates are already measured.

 

[James ij]

with bundle payments will the reimbursements for hospitalists go down. Assuming you are taking care high acuity patients with good RVUs but then you dont have choice but to consult more and more specialists

 

[Mad Jack]

I guess it is not all that bad if you can get over the fact that you:

1) Will lose half of your weekends and holidays (good luck hanging out with normal people on a wednesday afternoon).

2) Have to talk to patients and all of their family members all day long, explain why the patient still has chest pain despite a normal cath and EGD, etc.

3) Will be unable to sign off when you no longer have anything to offer to the patient but the patient is still "ill".

4) Be expected to admit whatever the ER wants you to admit.

5) Admit whatever any other doctor wants you to admit (cards will "let you" admit their MIs even after they did the cath, urology will "let you" handle nephrolothiasis, etc).

6) Be interrupted at all times. If you think being paged 50 times per shift won't hurt your soul, I am here to tell you that it definitely will.

7) Be constantly bothered by case managers and social workers.

8) Be expected to attend all sorts of meetings in the hospital. You know, since you are the hospitalist.

9) Will have to present patients to SOME dick subspecialists that treat you at best like a nuissance and at worst like an idiot child. This gets old pretty quickly and the only way around it is to subspecialize.

10) Will have no control over how many patients you see any given day. It could be 15... Or it could be 30! No ACGME to protect you in private practice, my friend.

11) You will likely have no paid vacation time.

Realize that what you will be doing is work in a week what most people work in two.

You are gullible if you think you are only working "half a year".

Internists all around the country have been duped into thinking that hospitalist work and the schedule is a great deal. Let me break it down to you. This is a good deal for the hospital and for the hospital only. That's it.

People grow out of the field pretty quickly.
FOR A REASON.

My advice: Either subspecialize or establish a private practice. Working as a hospitalist for 30+ years is not feasible.

PS: Did I mention that the social life you want to improve will actually suffer by losing half the weekends and holidays of the year? Did I? I think I did.

PS2: You will not be sailing through the Caribbean every other week. Get over that stuff. Protect your weekends and holidays.

Not all (or even the vast majority of) hospitalist job are 7 on/7 off. The hospitalist group at the hospital I used to work for were M-F with nocturnists, no call, and weekend hospitalists. If they finished early (which they did many days) they could go home. It didn't seem like a bad gig, 40-50 hours a week at most, weekends and holidays off, etc.

 

[67552931811]

Not all (or even the vast majority of) hospitalist job are 7 on/7 off. The hospitalist group at the hospital I used to work for were M-F with nocturnists, no call, and weekend hospitalists. If they finished early (which they did many days) they could go home. It didn't seem like a bad gig, 40-50 hours a week at most, weekends and holidays off, etc.

Similar set-up in my neck of the woods. The older I get the less I want to be in school/training. So, that 3 year path is looking mighty appealing.

 

[PlutoBoy]

Similar set-up in my neck of the woods. The older I get the less I want to be in school/training. So, that 3 year path is looking mighty appealing.

You can always do outpatient medicine. I think it is more conducive to a normal lifestyle.

 

[Postictal Raiden]

You can always do outpatient medicine. I think it is more conducive to a normal lifestyle.

To each their own, but I much prefer hospitalist's 7 on/ 7 off schedule; it allows for more freedom to travel around and do things in your time off. Also prefer nights, since I can't go to sleep before 3am.

 

[psychMDhopefully]

12 hrs is a long time, should be 7 on from 7am-3pm then just be available by phone or have some midlevel or something cover those last 4 hrs. Btw there was a hospitalist job in Mississippi paying 310k for 10 days of work a month.

 

[Postictal Raiden]

12 hrs is a long time, should be 7 on from 7am-3pm then just be available by phone or have some midlevel or something cover those last 4 hrs. Btw there was a hospitalist job in Mississippi paying 310k for 10 days of work a month.

how about 620K for 20 days?

 

[psychMDhopefully]

how about 620K for 20 days?

Maybe?

http://www.practicelink.com/jobs/46...ississippi/Merit Health Northwest Mississippi

they took it down to 305K dang it.

 

[Postictal Raiden]

Maybe?

http://www.practicelink.com/jobs/462862/physician/hospitalist/Mississippi/Merit Health Northwest Mississippi

they took it down to 305K dang it.

Maybe they saw your post

 

[Raryn]

Salaries have a lot of geographic variability. Buddy of mine last year found a hospitalist offer in Wyoming that reportedly paid $475k. But then you have to live in WY.

He brought up the possibility with his fiancee... and took a job in Northern CA paying about half that.

 

[psychMDhopefully]

Salaries have a lot of geographic variability. Buddy of mine last year found a hospitalist offer in Wyoming that reportedly paid $475k. But then you have to live in WY.

He brought up the possibility with his fiancee... and took a job in Northern CA paying about half that.

Wyoming http://cdn.yellowstoneparknet.com/images/content/2714_12740_Yellowstone_Scenic_Rafting_md.jpg

 

[Mad Jack]

I'd imagine the salaries will go down as hospitalist continues to be a popular career choice.

They are a necessary cost center for hospitals, they dont bring in money, thus hospitals will always drive down salary as supply increases.

Hospitalists actually generate additional revenue by freeing up beds. If you've looked at the economics of hospitalist medicine, they're basically worth their weight in gold, as the limiting factor for most hospitals in regard to revenue generation is bed capacity.

 

[Siggy]

Wyoming http://cdn.yellowstoneparknet.com/images/content/2714_12740_Yellowstone_Scenic_Rafting_md.jpg

Wyoming in December:
http://jeffreyfavero.com/wp-content/uploads/2013/03/JFP-WTR-108.jpg

Southern California in December:
http://blog.sandiego.org/wp-content/uploads/2013/11/Skating-by-the-Sea-Coronado-Beach.jpg

 

[MedicalDoctorV]

Definitely agree with others - geographic variation is immense. I've done academic hospitalist work in Boston, SF and NYC - and also locums work in rural Maine and upstate NY.

NYC academic jobs right now pay around $160K for a Mon-Fri schedule with 1 weekend a month, vs if you want to go an hour into the suburbs into NJ/Long Island then you can make 60K more (i.e. 220 starting). In these markets the moonlighting rate is $100-120/hr for your days off. IF you wanna work like a dog, you can make $280K in NY/NJ.

Now, want to do purely locum tenens in bumblef*ck (ie. rural maine) and you're looking at hourly rates of $150-200/hr plus all your expenses paid for (rental car, hotel etc).

This looks pretty accurate http://www1.salary.com/Physician-Hospitalist-salary.html

Salaries right now aren't sustainable. Hospitalists don't bill enough to justify their own salary. We mainly just stop the hospital from hemorrhaging money and allow high $ fields like ortho and neurosurg to admit patients to us, and do things that earn them actual big $.

Sure, it's easy to pick up 3-5 extra shifts, but like someone else said - enjoy life, you could be dead tomorrow.

Best of luck.

 

[laserbeam]

Salaries right now aren't sustainable. Hospitalists don't bill enough to justify their own salary. We mainly just stop the hospital from hemorrhaging money and allow high $ fields like ortho and neurosurg to admit patients to us, and do things that earn them actual big $.

Hospitalists worth more than we can bill. For most "CHF exacerbation", "acute hypoxic and hypercapneic respiratory failure", "severe sepsis/septic shock" we document, hospitals are making money. And there are more cases of hypertensive urgency/emergency, pneumonia, COPD exacerbation, DKA than neurosurgical cases. We are subsidized by the hospitals in addition to what we can bill. Hospital employees, like unit secretaries, medical assistants, they can not bill, but hospitals still have to pay their salaries. Likewise, we are paid to keep the hospital running. For our income, it is determined by job market, not our billing.

 

[IMICUer]

Salaries have a lot of geographic variability. Buddy of mine last year found a hospitalist offer in Wyoming that reportedly paid $475k. But then you have to live in WY.

He brought up the possibility with his fiancee... and took a job in Northern CA paying about half that.

Agree regarding regional variability with salaries. Always better pay if you leave big cities, even an hour away the difference in the southeast where I am is an extra 70k. Plus you can occasionally have slower days than in larger cities, and be done sooner and cut that 12 hr shift down to 10 or 11 hrs. We rotate who shows up early for signout from nocturnist and who leaves earlier every day in my group, its highly doable. Some days may be busy but midlevels help with a lot of the paperwork, giving us more time with patients.

Administrators outside of large cities know that if they cut too much people vanish and then they end up paying more for locums who are not invested and bring down the hospitals reputation, sending insured patients elsewhere. Specialists get upset, some leave, and a vicious cycle begins. Keeping your hospitalists happy is key, if the good ones leave and you can only replace them with uncommitted substandard locums or more midlevels, everything starts falling apart for that organization with unhappy patients and families that spread the word. Believe me, I have seen it happen, our salaries cannot be touched much without dire consequences for all.

I love being a hospitalist. If you like complex patients mixed in with straightforward ones and coordinating their care to solve problems many other doctors didnt have the time to figure out, inpatient care is the way to go.