Am I crazy for thinking that hospital medicine is one of the best lifestyle specialties?

[mumixam]

Any outpatient clinic - suppose you work M-F 8-5. Get home around 530 optimistically after wrapping up. Dinner with the wife, chill with the kids, then it's 7. I start my bed time routine about an hour before I want to be asleep, and I take about an hour to get ready, so that gives me, what, 2 hours of free time every evening? wtf am I going to do for 2 hours? Not really enough time to engage in many hobbies. Am I going to go to the gym, watch some TV, take care of my garden, work on my project car, learn a new skill, etc in that 2 hours after a full day of work? F--- no. I'm useless after a full day of work.
What about the weekend? well all of the above applies to Friday. Then I get Saturday off to do the above. I could spend all day on various hobbies, great. Then sunday comes around, and I can also sleep in and do whatever, but by evening I'm then constrained by preparing for the week and going to bed early for work and then it starts all over again.

Hospitalist - Monday to sunday, 7-7. Even if I have to be there for the full 12 hours, I get home at 730, I have time for a late dinner, chill with my kids for a bit, then it's 9, then I have to get ready for bed. So, what, I miss 2 hours of "free time," that I wouldn't have really used in the first place. So I go a full week without much free time. But then I get a FULL 7 DAYS of time off. Even if I spend the first day "recovering" like everyone says I will, then spend the whole last day preparing for going back to work, then I still get 5 full days. I could spend a massive amount of time working on my car, learning a skill like programming, travelling(!) to pretty much wherever I wanted, getting swole, etc.

Not to mention making a decent amount of money for only 3 years of training.

Am I missing something?

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[New_Vegas]

Its for posts like this that make me glad I didn't do medicine

 

[bronx43]

Any outpatient clinic - suppose you work M-F 8-5. Get home around 530 optimistically after wrapping up. Dinner with the wife, chill with the kids, then it's 7. I start my bed time routine about an hour before I want to be asleep, and I take about an hour to get ready, so that gives me, what, 2 hours of free time every evening? wtf am I going to do for 2 hours? Not really enough time to engage in many hobbies. Am I going to go to the gym, watch some TV, take care of my garden, work on my project car, learn a new skill, etc in that 2 hours after a full day of work? F--- no. I'm useless after a full day of work.
What about the weekend? well all of the above applies to Friday. Then I get Saturday off to do the above. I could spend all day on various hobbies, great. Then sunday comes around, and I can also sleep in and do whatever, but by evening I'm then constrained by preparing for the week and going to bed early for work and then it starts all over again.

Hospitalist - Monday to sunday, 7-7. Even if I have to be there for the full 12 hours, I get home at 730, I have time for a late dinner, chill with my kids for a bit, then it's 9, then I have to get ready for bed. So, what, I miss 2 hours of "free time," that I wouldn't have really used in the first place. So I go a full week without much free time. But then I get a FULL 7 DAYS of time off. Even if I spend the first day "recovering" like everyone says I will, then spend the whole last day preparing for going back to work, then I still get 5 full days. I could spend a massive amount of time working on my car, learning a skill like programming, travelling(!) to pretty much wherever I wanted, getting swole, etc.

Not to mention making a decent amount of money for only 3 years of training.

Am I missing something?

Most outpatient docs I know don’t do 5 FULL days of clinic like you describe. Some do, but most do 4-4.5. Even if you do 5, you’re basically working normal job hours. You think engineers and financiers go home at 2pm everyday?

Hospitalists give up half of their weekends, which some find to be untenable. For people that don’t, it’s a fine lifestyle assuming the night shift problem is solved (have nocturnists at your shop).
Ultimately, I view hospital medicine as in a precarious situation given they are completely at the mercy of hospital admin. Most places are moving to midlevel staffing model, which I suspect will only expedite in the future.

in the outpatient world, there’s only so much market share midlevels can take since a lot of patients refuse to pay full price for a lesser practitioner. I’m seeing this more and more

 

[CCM-MD]

Primary care is the hidden gem right now. I have friends making 250-300k working 4 days a week with all weekends and holidays off plus 4-6 weeks of vacation. That comes out to $160-200/h while working bankers hours after a 3 year residency.

 

[fooli_doc]

Primary care is the hidden gem right now. I have friends making 250-300k working 4 days a week with all weekends and holidays off plus 4-6 weeks of vacation. That comes out to $160-200/h while working bankers hours after a 3 year residency.

This is true. I don't expect that to change any time soon with internal medicine. The residency outpatient experience is so bad across the board and most residents are specialize or bust to begin with. 90% or more can't stomach the idea of primary care.
Also the comment above about mid level encroachment is correct. There are an over abundance of mid level PCP providers but the most common thing I hear from new patients about their prior clinic is "I could never get in to see the actual doctor."

 

[Crayola227]

Lol what I'm laughing at is the idea you could do half that stuff with kids, let alone your job allowing for it

 

[AshNiffler]

If you find the right job yes. When I’m not on call, I can round and leave the hospital as long as I answer my pager until 7pm. So technically I’m not in the hospital until 7pm every day on my 7 on which is pretty great because I leave 1-2pm, however a lot of my friends can’t leave their job till 6pm.

 

[TaroBubbleTea]

in the outpatient world, there’s only so much market share midlevels can take since a lot of patients refuse to pay full price for a lesser practitioner. I’m seeing this more and more

This makes me unreasonably happy

 

[Splenda88]

Any outpatient clinic - suppose you work M-F 8-5. Get home around 530 optimistically after wrapping up. Dinner with the wife, chill with the kids, then it's 7. I start my bed time routine about an hour before I want to be asleep, and I take about an hour to get ready, so that gives me, what, 2 hours of free time every evening? wtf am I going to do for 2 hours? Not really enough time to engage in many hobbies. Am I going to go to the gym, watch some TV, take care of my garden, work on my project car, learn a new skill, etc in that 2 hours after a full day of work? F--- no. I'm useless after a full day of work.
What about the weekend? well all of the above applies to Friday. Then I get Saturday off to do the above. I could spend all day on various hobbies, great. Then sunday comes around, and I can also sleep in and do whatever, but by evening I'm then constrained by preparing for the week and going to bed early for work and then it starts all over again.

Hospitalist - Monday to sunday, 7-7. Even if I have to be there for the full 12 hours, I get home at 730, I have time for a late dinner, chill with my kids for a bit, then it's 9, then I have to get ready for bed. So, what, I miss 2 hours of "free time," that I wouldn't have really used in the first place. So I go a full week without much free time. But then I get a FULL 7 DAYS of time off. Even if I spend the first day "recovering" like everyone says I will, then spend the whole last day preparing for going back to work, then I still get 5 full days. I could spend a massive amount of time working on my car, learning a skill like programming, travelling(!) to pretty much wherever I wanted, getting swole, etc.

Not to mention making a decent amount of money for only 3 years of training.

Am I missing something?

For people in the right setting, that's actually one of the best jobs in medicine. For instance, one person I know can leave work when she is done and have to answer calls until 7pm. She is usually out by 3-4pm on weekdays and 1-2 on sat/sun. The only downside is that she makes only 250k/yr.

The PCP working outpatient M-Thur making 250K+/yr have it good as well.

But it's not easy to find these jobs.

 

[sanfran256]

The problem is finding that 7-7 daytime job. Most people I know are doing either nocturnist or a mix of days/nights which really effs with your sleep schedule/social schedule. The HM job market is not good right now desirable areas

You can work as a PCP 4 days a week and make almost as much on a normal schedule. Outpatient is actually a good gig if you can find the right group/patient population (which I think is easier than the above)

 

[bronx43]

This makes me unreasonably happy

Your joy is reasonable. Very reasonable.

 

[InternistDO]

I’ve worked 7 on/7 off before I went to medical school (EMS). It is hands down my least favorite schedule. Yes, 7 days off is great but 7 days on is rough, and while you only “lose” two hours, those hours are the difference between being able to do something after work (grab dinner with your SO, gym, etc) and just eating dinner and getting ready for bed.

The issue with the 7 days off is that everyone else you know is still working. Kids in school—can’t see them. Spouse works a normal schedule—not there for most of your days off. And you’re still working every other weekend which means you’re missing half of most social events.

If both you and your partner are on the same 7/7 schedule then I think it has some potential, at least until you have kids.

 

[Splenda88]

The problem is finding that 7-7 daytime job. Most people I know are doing either nocturnist or a mix of days/nights which really effs with your sleep schedule/social schedule. The HM job market is not good right now desirable areas

You can work as a PCP 4 days a week and make almost as much on a normal schedule. Outpatient is actually a good gig if you can find the right group/patient population (which I think is easier than the above)

It's not easy to find a hospitalist job in major cities but it's doable if you are ok to go 1 hr outside... Being a hospitalist is not a perfect job but it's not the worst job some in SDN make it out to be.

I just started about a month ago and I found that being a hospitalist is very tolerable for the most part.

 

[Splenda88]

A few PCP (outpatient PCP) in the town that I am are happy picking some locum shifts in my group on sat/sun. I guess making the extra ~$2000 per shift is not that bad.

 

[darklabel]

A few PCP (outpatient PCP) in the town that I am are happy picking some locum shifts in my group on sat/sun. I guess making the extra ~$2000 per shift is not that bad.

Would you consider switching to outpatient?

 

[Splenda88]

Would you consider switching to outpatient?

HEEEEEEEELLLLL NO! (at least for the next 2-3 yrs)

My job is not the best, but I am making $ 330k/yr and I am on a mini vacation every other week.

Physician parking spot is literally a few yards from the hospital entrance. We have a physician lounge, a dining room, a common folks cafeteria, Starbucks and a salad/sandwich stand that we can get stuff at no charge

Nurses can write menial orders for me (tylenol, replete K+, Mg++, Phos; order EKG, CXR etc..). Census has been 14-18 with 1 admit most days.

No job is perfect. I give my job a 7/10 right now but if it were 1 hr from a major city or airport, I would have given it an 8.5/10.

I dont think there is any hospitalist/nocturnist at my job who make < 400k/yr. Some of these people are there all the time.

 

[Osteoth]

HEEEEEEEELLLLL NO! (at least for the next 2-3 yrs)

My job is not the best, but I am making $ 330k/yr and I am on a mini vacation every other week.

Physician parking spot is literally a few yards from the hospital entrance. We have a physician lounge, a dining room, a common folks cafeteria, Starbucks and a salad/sandwich stand that we can get stuff at no charge

Nurses can write menial orders for me (tylenol, replete K+, Na+, Phos; order EKG, CXR etc..). Census has been 14-18 with 1 admit most days.

No job is perfect. I give my job a 7/10 right now but if it were 1 hr from a major city or airport, I would have given it an 8.5/10.

I dont think there is any hospitalist/nocturnist at my job who make < 400k/yr. Some of these people are there all the time.

Where are you?

 

[Splenda88]

Where are you?

Can't give too much about my location, but I am in the southeast.


Surgeons are God in these small towns.

Where else can a surgeon admit a patient, perform surgery and tell a nurse transfer the patient to hospitalist service I am no longer the attending on record when stuff start to hit the fan. That happens after a few days when patient is in the ICU and look toxic. You can't make this stuff up.

 

[ortnakas]

Counterpoints:
7 days on is a long time on.
7 on 7 off means you’re on every other weekend.
PCP hours means my time off corresponds to my husbands (and my friends who work normal jobs). Hospitalist time off can mean you’re off but everyone else is working so less fun.
Those extra few hours in the evening when I leave my office at 5 vs if I left the hospital at 7 are actually quite lovely.

if 7 on 7 off is for you that’s awesome but it’s definitely not for everyone

 

[Splenda88]

Counterpoints:
7 days on is a long time on.
7 on 7 off means you’re on every other weekend.
PCP hours means my time off corresponds to my husbands (and my friends who work normal jobs). Hospitalist time off can mean you’re off but everyone else is working so less fun.
Those extra few hours in the evening when I leave my office at 5 vs if I left the hospital at 7 are actually quite lovely.

if 7 on 7 off is for you that’s awesome but it’s definitely not for everyone

I agree that it's a matter of preference. No job is perfect.

One of your points does not hold too much water. I used to work at 8-5 job when I was a RN, and by the time I got home it's almost 6pm and there was nothing to do with anybody except close family members. Many of your friends are tired and just stay home to hang out with their family.

However, I agree about not having every weekend off.

Both settings have their pluses and minuses. But hospitalist jobs have more pluses IMO. Hence, it's growing to the point it is kind of its own specialty now.

 

[ortnakas]

I agree that it's a matter of preference. No job is perfect.

One of your points does not hold too much water. I used to work at 8-5 job when I was a RN, and by the time I got home it's almost 6pm and there was nothing to do with anybody except close family members. Many of your friends are tired and just stay home to hang out with their family.

However, I agree about not having every weekend off.

Both settings have their pluses and minuses. But hospitalist jobs have more pluses IMO. Hence, it's growing to the point it is kind of its own specialty now.

Goes back to personal preference, like you said. I’ve noticed a huge difference in my quality of life with going home at 5 as an attending vs when I went home at 6 or 7 or later as a resident. Even if I just hang with my husband and pets, being at home in the evening is a win for me.

Hospitalist schedule is better for @Splenda88 and a lot of my real life friends, and PCP schedule is better for me. long story short - you do you, OP.

 

[Splenda88]

Goes back to personal preference, like you said. I’ve noticed a huge difference in my quality of life with going home at 5 as an attending vs when I went home at 6 or 7 or later as a resident. Even if I just hang with my husband and pets, being at home in the evening is a win for me.

Hospitalist schedule is better for @Splenda88 and a lot of my real life friends, and PCP schedule is better for me. long story short - you do you, OP.

But it's safe to say most like the hospitalist schedule since it's the fastest growing 'specialty' in the past 5 yrs. Glad you like your PCP outpatient job, however.

 

[bronx43]

But it's safe to say most like the hospitalist schedule since it's the fastest growing 'specialty' in the past 5 yrs. Glad you like your PCP outpatient job, however.

I wouldn't say people pick hospital medicine over primary care due to the schedule. I think the overwhelming benefit for 90% of people is the TYPE of work - no clinic, no inbasket, no longterm controlled substances, etc.

 

[Crayola227]

But it's safe to say most like the hospitalist schedule since it's the fastest growing 'specialty' in the past 5 yrs. Glad you like your PCP outpatient job, however.

Eh, this doesn't take into acct other factors like how the way most IM programs are heavily skewed to inpt and how outpt clinic is often structured in a way that on top of inpt duties basically is the best way to expose people to the worst aspects of continuity clinic and the upsides can frequently get lost.

It's been talked about for some time how IM training has contributed to the hospitalist trend, and it isn't necessarily because inpt is so superior to working outpt.

The exposures can also make new attending grads feel pretty lost when it comes to outpt management and issues.

The path of least resistance for many is to work as hospitalists because that is the type of work most similar to what they've done in training.

 

[Splenda88]

I wouldn't say people pick hospital medicine over primary care due to the schedule. I think the overwhelming benefit for 90% of people is the TYPE of work - no clinic, no inbasket, no longterm controlled substances, etc.

I guess the 7 days off in a row is the icing on the cake.

 

[Splenda88]

Eh, this doesn't take into acct other factors like how the way most IM programs are heavily skewed to inpt and how outpt clinic is often structured in a way that on top of inpt duties basically is the best way to expose people to the worst aspects of continuity clinic and the upsides can frequently get lost.

It's been talked about for some time how IM training has contributed to the hospitalist trend, and it isn't necessarily because inpt is so superior to working outpt.

The exposures can also make new attending grads feel pretty lost when it comes to outpt management and issues.

The path of least resistance for many is to work as hospitalists because that is the type of work most similar to what they've done in training

Our clinic was terrible I understand that real world might not be the same. I dont think there is any superiority in setting. But we can not discount the fact that there are more FM docs who want to do hospital medicine than IM docs who want to work outpatient coming out of residency these days. And @bronx43 illustrates in his post many of the reasons. I also think the 7 on/off is another contributing factor.

There is a reason derm is a competitive specialty and it's not because most people are fascinated with skin diseases or organic diseases with skin manifestation.

 

[DO2015CA]

I guess the 7 days off in a row is the icing on the cake.

7 on is rough though when they are 12h days. Especially a day full of 20-25 sick patients.

 

[CCM-MD]

7 on/off is a scam that tricks physicians into thinking "more time off". The reality is most of these jobs don't offer any vacation time and as a result one ends up working quite a bit more than the typical outpatient job which has: 4-6 weeks vacation/CME time, better work life balance, more weekends off, and better control of how one wants to practice. As an outpatient physician one also is bringing revenue into the hospital which is arguably a better position to be in than an inpatient physician.

 

[Splenda88]

7 on is rough though when they are 12h days. Especially a day full of 20-25 sick patients.

No one will have all sick patients in their panel. I have had anywhere from 14-18 patients since I started and ~5 them are really sick.

I trained in the biggest trauma center in my state and half of the patients in our census of 18 were really sick.

No one is saying there is a perfect job out there. But I think hospital medicine offers a good work-life balance.

 

[Splenda88]

7 on/off is a scam that tricks physicians into thinking "more time off". The reality is most of these jobs don't offer any vacation time and as a result one ends up working quite a bit more than the typical outpatient job which has: 4-6 weeks vacation/CME time, better work life balance, more weekends off, and better control of how one wants to practice. As an outpatient physician one also is bringing revenue into the hospital which is arguably a better position to be in than an inpatient physician.

Very presumptive to think physicians do not look at these things. They work more, and they also make more.

I am new to this. Maybe my opinion might change. I used to work M-F, and this setting is better for ME. My SO also thinks it's better for the family. In fact, most of the hospitalist I have talked to think it's better for theirs.

However, the people who have a M-Th job outpatient primary care and make 250k+ have it better than most hospitalists.

 

[DO2015CA]

No one will have all sick patients in their panel. I have had anywhere from 14-18 patients since I started and ~5 them are really sick.

That’s fair. Do you have a code team? Open icu?

 

[Splenda88]

That’s fair. Do you have a code team? Open icu?

There is a code team; no procedure, open ICU for patients that are not on ventilator.

 

[CCM-MD]

Very presumptive to think physicians do not look at these things. They work more, and they also make more.

I am new to this. Maybe my opinion might change. I used to work M-F, and this setting is better for ME. My SO also thinks it's better for the family. In fact, most of the hospitalist I have talked to think it's better for theirs.

I'm not being presumptive, so many of my residents seriously think 7 on/off is "more time off" until they talk to me. The reality is that it is more hours worked and less time off.

My friends who are hospitalists make very similar money to those working outpatient. The MGMA numbers are also not different for primary care versus hospitalist... 285k versus 320k. There is also significant potential for growth in the outpatient setting if one is entrepreneurial: our local mid-career outpatient internists make well over 400k working bankers hours and this is not uncommon. Its also much easier to get a well compensated job as a PCP in a major metro than it is to get a hospitalist job. As I mentioned, primary care is the hidden gem right now.

 

[Splenda88]

I'm not being presumptive, so many of my residents seriously think 7 on/off is "more time off" until they talk to me. The reality is that it is more hours worked and less time off.

My friends who are hospitalists make very similar money to those working outpatient. The MGMA numbers are also not different for primary care versus hospitalist... 285k versus 320k. There is also significant potential for growth in the outpatient setting if one is entrepreneurial: our local mid-career outpatient internists make well over 400k working bankers hours and this is not uncommon. Its also much easier to get a well compensated job as a PCP in a major metro than it is to get a hospitalist job. As I mentioned, primary care is the hidden gem right now.

We all can find a few cases where someone is doing better than the average just like my friend who got a hospitalist job and leave at 3pm on weekdays and noon on weekends and have the next week off. But the vast majority of us are not that lucky.

I am looking for an hidden gem anywhere and once I find an outpatient medicine that offers it, I will say 'F... you' hospital medicine. Trust me: I am not loyal to hospital medicine.

The things I see these hospital medicine physicians like is that it's less structured. If you are scheduled to see patients at 8am in outpatient medicine, you gotta be there to see that patient. Our schedule says 7am to 6:15pm, but people show up at 7:30 and no one gives a bleep.

I dont have a lunch break. My lunch break or snack break is anytime I want it to be. The few that live close to the hospital go home sometimes have lunch with their family. We dont have a 15-20 minutes time per patient and have to go from room to room. I can sit in the physician lounge and watch Fox News and no one gives a damn as long as I answer these pesky calls from SW and RN/LPN.

 

[osprey099]

I almost decided to not do fellowship and become a hospitalist last year before submitting ERAS. I think the draw of hospitalist is more for the younger crowd. I can't speak for PCP vs hospitalist but for any of the higher paying IM-subspecialties, the following factors would put them > hospital medicine:

1. Schedule - 7 on 7 off is great when you are young and single, but if you have kids, that means you are going to miss half the weekends, holidays, etc
2. Money - While making 300k is nice for just 3 years of training, the financial head start hospitalists have only lasts for 5-7 years, even if assuming you invest a substantial portion of income, before outpatient subspecialists catch up and surpasses exponentially
3. The work - Dealing with bread and butter medicine and dispo issues can be easy right out of residency because we are used to this, but I think 10+ years down the road, hospitalists may get bored of their work or feel like a cog in the system. Having to always answer to admin regarding why patients aren't being discharged and etc can also take a toll.
4. Personal health - This applies more-so to nocturnists or hospitalists who have to rotate with some nights mixed in. As a resident, I moonlighted many nights for that extra money but it took a big toll on my personal health. Even as a pre-30 year old, I was experiencing issues with sleep deprivation, GERD, concentration issues, etc. I can't imagine having to sustain that kind of lifestyle after training.

 

[Splenda88]

I almost decided to not do fellowship and become a hospitalist last year before submitting ERAS. I think the draw of hospitalist is more for the younger crowd. I can't speak for PCP vs hospitalist but for any of the higher paying IM-subspecialties, the following factors would put them > hospital medicine:

1. Schedule - 7 on 7 off is great when you are young and single, but if you have kids, that means you are going to miss half the weekends, holidays, etc
2. Money - While making 300k is nice for just 3 years of training, the financial head start hospitalists have only lasts for 5-7 years, even if assuming you invest a substantial portion of income, before outpatient subspecialists catch up and surpasses exponentially
3. The work - Dealing with bread and butter medicine and dispo issues can be easy right out of residency because we are used to this, but I think 10+ years down the road, hospitalists may get bored of their work or feel like a cog in the system. Having to always answer to admin regarding why patients aren't being discharged and etc can also take a toll.
4. Personal health - This applies more-so to nocturnists or hospitalists who have to rotate with some nights mixed in. As a resident, I moonlighted many nights for that extra money but it took a big toll on my personal health. Even as a pre-30 year old, I was experiencing issues with sleep deprivation, GERD, concentration issues, etc. I can't imagine having to sustain that kind of lifestyle after training.

Most people cant get into GI/Cardi/Heme... Not saying CCM because I think a CC medicine doc is a hospitalist with more ICU training (My IM program was 6 month ICU) . The draw for HM is very enticing. It is not ONLY for the younger crowd, which I think it's something that is said a lot here but it's far from the truth. For instance, 1 MD at my shop work 1 wk on and 3 wks off and has all the benefits of a FT employee.

 

[rokshana]

Very presumptive to think physicians do not look at these things. They work more, and they also make more.

I am new to this. Maybe my opinion might change. I used to work M-F, and this setting is better for ME. My SO also thinks it's better for the family. In fact, most of the hospitalist I have talked to think it's better for theirs.

However, the people who have a M-Th job outpatient primary care and make 250k+ have it better than most hospitalists.

Key here is that you are new to this…

 

[Splenda88]

Key here is that you are new to this…

FM docs train in outpatient medicine, but good chunk of them choose to do inpatient

IM docs train in inpatient medicine but have the choice to practice outpatient, but most of them don't do it.

Maybe both IM/FM docs hate their lives.

 

[Crayola227]

FM docs train in outpatient medicine, but good chunk of them choose to do inpatient

IM docs train in inpatient medicine but have the choice to practice outpatient, but most of them don't do it.

Maybe both IM/FM docs hate their lives.

Now I think you are on to something....

 

[VA Hopeful Dr]

We all can find a few cases where someone is doing better than the average just like my friend who got a hospitalist job and leave at 3pm on weekdays and noon on weekends and have the next week off. But the vast majority of us are not that lucky.

I am looking for an hidden gem anywhere and once I find an outpatient medicine that offers it, I will say 'F... you' hospital medicine. Trust me: I am not loyal to hospital medicine.

The things I see these hospital medicine physicians like is that it's less structured. If you are scheduled to see patients at 8am in outpatient medicine, you gotta be there to see that patient. Our schedule says 7am to 6:15pm, but people show up at 7:30 and no one gives a bleep.

I dont have a lunch break. My lunch break or snack break is anytime I want it to be. The few that live close to the hospital go home sometimes have lunch with their family. We dont have a 15-20 minutes time per patient and have to go from room to room. I can sit in the physician lounge and watch Fox News and no one gives a damn as long as I answer these pesky calls from SW and RN/LPN.

I can get you a hidden gem IM outpatient job right now. My wife is IM. Works 4 days/week 8-4, 1.25h lunch. Max patients/day is 22. 6 weeks vacation. Came within a rounding error of hitting 300k last year. Oh, and an actual retirement pension. Works out to about 55-60% of salary.

Speaking more generally, outpatient tends to have more flexibility and more income potential per hour. I see patients from 8-4 with a 90 minute lunch. I have a partner who skips lunch and so works 7:30-2:30. I have a friend who takes a very short lunch and so only works 4 days per week. None of us work nights or weekends ever. No holidays. If my kid is sick, I just call and cancel for the day.

If I want more money, I see more patients. Since I'm paid on production and not an hourly rate, its pretty easy to manage.

But, there's more busy work - refill requests, calls, portal messages. Not everyone likes longitudinal care. And outpatient isn't generally as interesting as hospital medicine, or so my former hospitalist wife keeps saying.

 

[CCM-MD]

We all can find a few cases where someone is doing better than the average just like my friend who got a hospitalist job and leave at 3pm on weekdays and noon on weekends and have the next week off. But the vast majority of us are not that lucky.

I am looking for an hidden gem anywhere and once I find an outpatient medicine that offers it, I will say 'F... you' hospital medicine. Trust me: I am not loyal to hospital medicine.

The things I see these hospital medicine physicians like is that it's less structured. If you are scheduled to see patients at 8am in outpatient medicine, you gotta be there to see that patient. Our schedule says 7am to 6:15pm, but people show up at 7:30 and no one gives a bleep.

I dont have a lunch break. My lunch break or snack break is anytime I want it to be. The few that live close to the hospital go home sometimes have lunch with their family. We dont have a 15-20 minutes time per patient and have to go from room to room. I can sit in the physician lounge and watch Fox News and no one gives a damn as long as I answer these pesky calls from SW and RN/LPN.

When I say primary care is the hidden gem right now, I mean the field as a whole, not specific jobs. There are numerous good opportunities out there.

 

[Splenda88]

I can get you a hidden gem IM outpatient job right now. My wife is IM. Works 4 days/week 8-4, 1.25h lunch. Max patients/day is 22. 6 weeks vacation. Came within a rounding error of hitting 300k last year. Oh, and an actual retirement pension. Works out to about 55-60% of salary.

Speaking more generally, outpatient tends to have more flexibility and more income potential per hour. I see patients from 8-4 with a 90 minute lunch. I have a partner who skips lunch and so works 7:30-2:30. I have a friend who takes a very short lunch and so only works 4 days per week. None of us work nights or weekends ever. No holidays. If my kid is sick, I just call and cancel for the day.

If I want more money, I see more patients. Since I'm paid on production and not an hourly rate, its pretty easy to manage.

But, there's more busy work - refill requests, calls, portal messages. Not everyone likes longitudinal care. And outpatient isn't generally as interesting as hospital medicine, or so my former hospitalist wife keeps saying.

You and your spouse have it good. Will shoot you a PM when I am ready to leave HM.

 

[Osteoth]

I can get you a hidden gem IM outpatient job right now. My wife is IM. Works 4 days/week 8-4, 1.25h lunch. Max patients/day is 22. 6 weeks vacation. Came within a rounding error of hitting 300k last year. Oh, and an actual retirement pension. Works out to about 55-60% of salary.

Speaking more generally, outpatient tends to have more flexibility and more income potential per hour. I see patients from 8-4 with a 90 minute lunch. I have a partner who skips lunch and so works 7:30-2:30. I have a friend who takes a very short lunch and so only works 4 days per week. None of us work nights or weekends ever. No holidays. If my kid is sick, I just call and cancel for the day.

If I want more money, I see more patients. Since I'm paid on production and not an hourly rate, its pretty easy to manage.

But, there's more busy work - refill requests, calls, portal messages. Not everyone likes longitudinal care. And outpatient isn't generally as interesting as hospital medicine, or so my former hospitalist wife keeps saying.

How’d she find her gig?

 

[VA Hopeful Dr]

How’d she find her gig?

We moved back to my home town and it's the only hospital here.

 

[Appellatelove]

I can get you a hidden gem IM outpatient job right now. My wife is IM. Works 4 days/week 8-4, 1.25h lunch. Max patients/day is 22. 6 weeks vacation. Came within a rounding error of hitting 300k last year. Oh, and an actual retirement pension. Works out to about 55-60% of salary.

Speaking more generally, outpatient tends to have more flexibility and more income potential per hour. I see patients from 8-4 with a 90 minute lunch. I have a partner who skips lunch and so works 7:30-2:30. I have a friend who takes a very short lunch and so only works 4 days per week. None of us work nights or weekends ever. No holidays. If my kid is sick, I just call and cancel for the day.

If I want more money, I see more patients. Since I'm paid on production and not an hourly rate, its pretty easy to manage.

But, there's more busy work - refill requests, calls, portal messages. Not everyone likes longitudinal care. And outpatient isn't generally as interesting as hospital medicine, or so my former hospitalist wife keeps saying.

Is 4 days a week considered full time?

 

[gutonc]

Is 4 days a week considered full time?

In some practices and some specialties, yes.

 

[VA Hopeful Dr]

Is 4 days a week considered full time?

Our contracts state 36 hours. If you do 8-5 with a shorter lunch break, you can manage it. Most of us do 4.5 days with long lunch breaks.

 

[Prehealth1011]

Our contracts state 36 hours. If you do 8-5 with a shorter lunch break, you can manage it. Most of us do 4.5 days with long lunch breaks.

Does anyone in your practice do 10 hour shifts? How many days do they work

 

[Crayola227]

Does anyone in your practice do 10 hour shifts? How many days do they work

It can be problematic for a lot of reasons for a doctor to try to see patients past the time the rest of the clinic is generally open. Having one or few doctors there, no MAs, no receptionists, the clinic not locked up, the lab if there is one closed, no chaperone available if needed, etc.

VAhopeful doctor may have a different answer, not trying to answer for him. But some people have this idea of extending clinic hours so they come in less days, and that's really going to be constrained by the practice environment.

 

[VA Hopeful Dr]

Does anyone in your practice do 10 hour shifts? How many days do they work

Nope. Part of that is for the reasons the above post goes over. Part of it is that if any doctors are gone a full day every single week the rest of us have to pick up the slack, and no one really wants to do that.