hospitalist job search

[kaycee18]

Hello Guys,

I am trying to leave my current hospitalist job to move a bigger city (or closer to desirable major city - 1-2 hours). This would be my third full time job since residency (2017 grad). Been at last job for 2.5 years. My first job out of residency, I was underpaid (20$/hr less than my peers) by a CMG and I curse them out after I left. I also do locum jobs while working my full time job. I have a clean file. I have gone to 5 interviews so far and not one single offer. What am I doing wrong? Is there a chance I have been blacklisted? I was hoping to sign a contract, then take two months off and travel before starting new job. How do I know if I was black listed? I can always do locum for now while living in a better city but I like stability.

Any tips on how to ace my upcoming interview? 2 of the places, I felt like they wanted me but then, I do not hear back from them.

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[CCM-MD]

I doubt you are black listed. Things just are a bit saturated in certain parts and there’s a lot to choose from right now. Are you looking in a major city?

 

[kaycee18]

Near chicago, Charlotte, atlanta, houston or Dallas. Not looking in the city but 1-2 hours from the city.

 

[Phantom Spike]

Any tips on how to ace my upcoming interview? 2 of the places, I felt like they wanted me but then, I do not hear back from them.

Are you getting "ghosted" (i.e., they are not responding to your calls/e-mails)? I have been experiencing a similar issue although I am in the Neurology job market. I was rather surprised that this happened in the medical field. But I agree that a general "blacklisting" is unlikely.

 

[kaycee18]

The recruiters/hospitals are so unprofessional.
I got one offer, 2 hours away from major city. Still interviewing and doing locums in the meantime. I still have my other job for 1 month as I had given my notice. Hopefully, I find something decent soon.

 

[thumbz]

This sounds like a reference or interview skills issue. In big cities the hospitalist market is tight enough that it's no longer just a pulse that will get you a job offer. Our non-teaching group just got 5 applicants for 2 spots and we are by no means close to a big city.

As a hospitalist with prior hospitalist experience you shouldn't be getting ghosted like this though. If you were a new grad I would point more to a tight market being the sole factor.

 

[kaycee18]

So this is my offer;

locations - 2 hours away from major city. Very small town but large hospital.
During my initial discussion, I was told that for my 4 years of experience, I would get 1924 per shift.
the offer; 1810 per shift, no wRVU, sign on bonus + relocation = 10k total.
Involves adding my name to some APPs chart as the attending while they go off practicing on my license.
What do you think of the compensation? I feel like I am being cheated out of a lot of money especially given that their providers see 18-22 pt daily without RVUs compensation.
Having money discussion makes me really uncomfortable but I know I have to be willing to walk away if they do not offer more.

 

[kaycee18]

Are you getting "ghosted" (i.e., they are not responding to your calls/e-mails)? I have been experiencing a similar issue although I am in the Neurology job market. I was rather surprised that this happened in the medical field. But I agree that a general "blacklisting" is unlikely.

some are completely ghosting after interview. One interview treated me like I was on trial. They did not even bother to send a rejection letter. How difficult can it be to type of a rejection letter? They could even send a generic plagiarized letter but they should at least send the letter if you went for the interview. Just venting.

 

[thumbz]

So this is my offer;

locations - 2 hours away from major city. Very small town but large hospital.
During my initial discussion, I was told that for my 4 years of experience, I would get 1924 per shift.
the offer; 1810 per shift, no wRVU, sign on bonus + relocation = 10k total.
Involves adding my name to some APPs chart as the attending while they go off practicing on my license.
What do you think of the compensation? I feel like I am being cheated out of a lot of money especially given that their providers see 18-22 pt daily without RVUs compensation.
Having money discussion makes me really uncomfortable but I know I have to be willing to walk away if they do not offer more.

How many shifts? The sign on bonus is laughable. 10's or 12's? Procedures? Open or closed ICU? Nights/days? For 18-22 patients/day is it just rounding or admits and rounding? All of this changes whether it is a decent offer or not. On the surface $1800 for a 12 is reasonable, but significantly less reasonable with a census of 18-22. If you're also doing admits and nights/swings all for the same pay it would be a hard no for me. Midlevel supervision is always a hard no for me.

I agree, interviewing has really changed since COVID. Gone are the days of a doc being treated like royalty. Now it's common to get ghosted, late canceled on, ignored, pushed off onto someone else, etc.

 

[Phantom Spike]

some are completely ghosting after interview. One interview treated me like I was on trial. They did not even bother to send a rejection letter. How difficult can it be to type of a rejection letter? They could even send a generic plagiarized letter but they should at least send the letter if you went for the interview. Just venting.

I commiserate. The same thing has happened to me. I am by no means a fresh graduate, I am mid-to-late career. I felt that most interviews went well. The way some groups acted, completely ignoring my calls and e-mails after my interviews, I was afraid there was some major malpractice case against me or something serious in my background check that I was unaware of (not that they would necessarily have access to those things at this stage). I thought that something as unprofessional as ghosting would be rare at the physician recruitment level, but things have obviously changed since I last looked for a job over a decade ago.

 

[rokshana]

That is a nope…run away from that offer.

 

[kaycee18]

How many shifts? The sign on bonus is laughable. 10's or 12's? Procedures? Open or closed ICU? Nights/days? For 18-22 patients/day is it just rounding or admits and rounding? All of this changes whether it is a decent offer or not. On the surface $1800 for a 12 is reasonable, but significantly less reasonable with a census of 18-22. If you're also doing admits and nights/swings all for the same pay it would be a hard no for me. Midlevel supervision is always a hard no for me.

I agree, interviewing has really changed since COVID. Gone are the days of a doc being treated like royalty. Now it's common to get ghosted, late canceled on, ignored, pushed off onto someone else, etc.

close ICU, 12h shifts, some nights but nights paid at 1910. I am really hoping I can get them to drop the midlevel from the contract. It is both a sign on bonus + relocation bonus for a 3 years contract.

 

[CCM-MD]

1800/shift is 327k a year plus benefits. It’s not a bad offer. From what I hear, market is tight and it’s not difficult to recruit hospitalists right now.

 

[collegestud2013]

close ICU, 12h shifts, some nights but nights paid at 1910. I am really hoping I can get them to drop the midlevel from the contract. It is both a sign on bonus + relocation bonus for a 3 years contract.

Decent offer if it were near a desirable location (eg major city or coastal area), but a bit unsatisfying if it's in a small town 2 hours away (where pay should be higher) and the sign-on bonus is only $10k . $1800 per day rounding shift is also decent if it's really 18-22 patients for a 12 hour shift and you have good ancillary support staff and subspecialty support from nearly every major specialty to round efficiently. But if this is a small hospital with limited services then 18-22 will suddenly feel like a lot more.

Having no RVU bonus is a big negative for me since you basically have no incentive to do extra work while your employer can try to dump as much work as possible; if the hospital gets busy and you may be stuck seeing 24-25 patients with no extra pay. If you're signing midlevel charts you should be getting an RVU bonus for each one. You can try negotiating but they'll only agree if they're desperate to hire and get staffing.

 

[Splenda88]

1800/shift is 327k a year plus benefits. It’s not a bad offer. From what I hear, market is tight and it’s not difficult to recruit hospitalists right now.

Where did you hear that?

That is not a great offer IMO. 18-22 patients (more likely 21-22 daily) is too many.

It would be an acceptable offer if it was in a big metro but 1-2 hours away from a big metro does not make it attractive.

10k sign on + relocation is laughable. Minimum should be 25k.

 

[CCM-MD]

Where did you year that?

That is not a great offer IMO. 18-22 patients (more likely 21-22 daily) is too many.

It would be an acceptable offer if it was in a big metro but 1-2 hours away from a big metro does not make it attractive.

10k sign on + relocation is laughable. Minimum should be 25k.

My graduating residents have not had an easy time finding hospitalist jobs. Not quite EM-esque yet but it’s not difficult to recruit hospitalists right now. Very popular choice among graduating residents not pursuing a fellowship.

 

[Splenda88]

My graduating residents have not had an easy time finding hospitalist jobs. Not quite EM-esque yet but it’s not difficult to recruit hospitalists right now. Very popular choice among graduating residents not pursuing a fellowship.

The problem is most restrict themselves geographically... It was kind of the same situation for me, but once I open myself up geographically, I had 3+ solid offers in < 2 months.

 

[collegestud2013]

Where did you hear that?

That is not a great offer IMO. 18-22 patients (more likely 21-22 daily) is too many.

It would be an acceptable offer if it was in a big metro but 1-2 hours away from a big metro does not make it attractive.

10k sign on + relocation is laughable. Minimum should be 25k.

Seems like 18-22 patients is getting to be close to the average for a 12 hour rounding shift nowadays, especially in the southeast (where averages RVUs for hospitalists are generally higher than other parts of the country from seeing higher patient volumes). And it should be doable if it's a true rounding shift and all 18-22 patients are already admitted patients (with no obligation to admit new patients during that shift), and the hospital has full subspecialty support to consult/co-manage most of the patients (so that not everything on every patient will fall on the hospitalist). But as I mentioned above there should be some type of RVU bonus in the pay structure so you have at least have some incentive to do a bit more work if the census gets busy.

And yes the hospitalist market is getting saturated in the coastal areas and big cities. It's open to any IM or FM grad and those are the 2 largest residencies across the country. In the past more grads would have done outpatient but right now with all the headaches of doing primary care there's less interest in it and hence more doing hospitalist out of residency. I've even seen a quite a few fellowship-trained IM subspecialists going back to do hospitalist (often in the lower paying fields like ID or Endo or those with poor job markets like nephro)

 

[Splenda88]

Seems like 18-22 patients is getting to be close to the average for a 12 hour rounding shift nowadays, especially in the southeast (where averages RVUs for hospitalists are generally higher than other parts of the country from seeing higher patient volumes). And it should be doable if it's a true rounding shift and all 18-22 patients are already admitted patients (with no obligation to admit new patients during that shift), and the hospital has full subspecialty support to consult/co-manage most of the patients (so that not everything on every patient will fall on the hospitalist). But as I mentioned above there should be some type of RVU bonus in the pay structure so you have at least have some incentive to do a bit more work if the census gets busy.

And yes the hospitalist market is getting saturated in the coastal areas and big cities. It's open to any IM or FM grad and those are the 2 largest residencies across the country. In the past more grads would have done outpatient but right now with all the headaches of doing primary care there's less interest in it and hence more doing hospitalist out of residency. I've even seen a quite a few fellowship-trained IM subspecialists going back to do hospitalist (often in the lower paying fields like ID or Endo or those with poor job markets like nephro)

I am in the southeast and our average patient is 16-18 (more 16-17 than 18), but we admit 1-2 patients/day (average ~ 1.3).

Maybe these recruiter emails I am getting every day are not real.

I agree there is potential for the market to be saturated based on the things you stated, but I have not seen any sign of that yet.

 

[kaycee18]

This sounds like a reference or interview skills issue. In big cities the hospitalist market is tight enough that it's no longer just a pulse that will get you a job offer. Our non-teaching group just got 5 applicants for 2 spots and we are by no means close to a big city.

As a hospitalist with prior hospitalist experience you shouldn't be getting ghosted like this though. If you were a new grad I would point more to a tight market being the sole factor.

I was finally told by my locum company that someone is giving me mediocre references. I think I figured out who it is it. Unfortunately, this may affect my privileging at a locum job which can cause problems for me in the future. Is there a way to prevent them from actually denying me privileging? I don't want to have a stain on my record because someone who promised excellent references is flaking.

 

[rokshana]

I was finally told by my locum company that someone is giving me mediocre references. I think I figured out who it is it. Unfortunately, this may affect my privileging at a locum job which can cause problems for me in the future. Is there a way to prevent them from actually denying me privileging? I don't want to have a stain on my record because someone who promised excellent references is flaking.

Then why have you picked someone that is giving you mediocre references? The ref sheet is basically a check mark list… someone has to go out of their way to give you a bad reference…pick someone else.

 

[kaycee18]

She said she put excellent on everything. But I provided a different reference. She is not the type of person to say she will do something and screw one. Unless she clicked something by mistake. Or maybe the hospital is just looking for an excuse to cancel my shifts/ postpone my start dates given that census are low now. I submitted everything to them in January. I’m supposed to start in 2 days and they’ve still not done my credentialing. They keep asking for dea eventhough it has been submitted since January. References responded in February. The whole situation is ridiculous.

 

[Trousseau]

Seems like 18-22 patients is getting to be close to the average for a 12 hour rounding shift nowadays, especially in the southeast (where averages RVUs for hospitalists are generally higher than other parts of the country from seeing higher patient volumes). And it should be doable if it's a true rounding shift and all 18-22 patients are already admitted patients (with no obligation to admit new patients during that shift), and the hospital has full subspecialty support to consult/co-manage most of the patients (so that not everything on every patient will fall on the hospitalist). But as I mentioned above there should be some type of RVU bonus in the pay structure so you have at least have some incentive to do a bit more work if the census gets busy.

And yes the hospitalist market is getting saturated in the coastal areas and big cities. It's open to any IM or FM grad and those are the 2 largest residencies across the country. In the past more grads would have done outpatient but right now with all the headaches of doing primary care there's less interest in it and hence more doing hospitalist out of residency. I've even seen a quite a few fellowship-trained IM subspecialists going back to do hospitalist (often in the lower paying fields like ID or Endo or those with poor job markets like nephro)

Agreed, honestly, I gave up on working in any major city. The job market is alright if you're willing to move and work in smaller places, but I have a feeling that by late-2020s it will be EM-like.

Bad times for all of medicine, really.

 

[kaycee18]

She said she put excellent on everything. But I provided a different reference. She is not the type of person to say she will do something and screw one. Unless she clicked something by mistake. Or maybe the hospital is just looking for an excuse to cancel my shifts/ postpone my start dates given that census are low now. I submitted everything to them in January. I’m supposed to start in 2 days and they’ve still not done my credentialing. They keep asking for dea eventhough it has been submitted since January. References responded in February. The whole situation is ridiculous.

The hospital now wants references from my previous jobs. For a locum job. This is ridiculous.