Hospitalist, salary question

[avendesora]

Our program only employs internists. I think that most academic places are the same. The other private group in town is also all IM trained. FP residency really isn't geared to learning hospital medicine - it's geared to being as efficient/effective as possible in the office. Not to say that there aren't awesome FP hospitalists out there - I'm sure there are. If you're going into residency with the intent to be a hospitalist, though, you would be better served in IM. If you like kids, do Med-Peds and try to find a place where you can practice both.

As to possible declining hospitalist income - There is currently a hospitalist shortage. Our program was not able to hire as many qualified people as we wanted to this year. Even the outlying "podunk" hospitals are hiring hospitalists. Among PCP's out there, most of the ones that don't already use hospitalists would like to. Things are definitely moving in that direction.

So, in this kind of buyers market, I doubt income will go down. I personally would not work for less than I make now.

In hospitals that have gone all-hospitalist, even if Medicare and pvt. insurers reimburse less, they will still have a need for house physicians. Whether this translates into hospitals running their hospitalist operation at a loss so that the subs can make money, we'll have to see. Will be interesting to see how this shakes out over the next few years.

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[copacetic]

I dont know about other places, but I do have a friend who is a hospitalist at Hopkins and you'd be shocked at how little he makes.

The base rate for Hopkins IM hospitalist service is only $50 an hour. That comes out to only about 100k for 40 hour work week average.

Apparently you take a huge pay cut for "serving at hte pleasure" of Hopkins. I imagine Harvard and other elite hospitals use a similar reasoning.

P.S. A nearby community hospital in Baltimore pays $80 an hour for hospitalists.

this is how it works in academia. the more prestigious the institution the lower your salary will be no matter the specialty.

 

[copacetic]

A local group in Akron is offering $150,000 base, full benefits, plus a production bonus that can "realistically" bring your first year annual income to $200-225K.

Has anyone had any experience with the compensation package of community hospitalists in Cleveland or InCompass Physicians?

Thanks.

try to avoid jobs were they use production bonuses as incentives. these are usually just ways for the owners of the group or partners to make money off of your hard work

 

[GassiusClay]

Actually it is not that unusual as a hospitalist. You work 7 days 12 hours a day and then take 7 days off. 52 weeks a year comes to 26 weeks off!

Sounds like a tough schedule to me though.

Right. 7 days, 12 hrs/day is rough because usually hospitals like to squeeze the use out of you. The good dollars are usually a combination of not so good location and work schedule.

The main thing for all hospitalists is looking at the days on/off schedule and call schedule = basically hours worked per month. Plus, look into the census limit per hospitalist which includes current and new admits. If it's 20 per, enjoy your hellhole. If it's 15, it seems manageable for awhile, but my family friend dropped it after 3 years to open up his own practice and chooses to make less money. If it's 10, that's like nothing for 12 hours. I'm sure most of us have faced that intern year, but now without waiting for an attending to round.

Hospitalist can be cool, but I hear for a lot, it's not. But this is based on personal anecdotes from graduated seniors from intern year and others.


For all the IMGs, making money is not easy as one thinks. Plus, keep talk of Benzs and BMWs to a minimum in public. Our image is being bashed all the time in this country and many find the money mentality to be screwing us in public relations. For example, I had a patient during my intern year who spoke lowly of doctors with bad English and horrible bedside manners talking about cars outside in the main area. This is something we can't have as doctors.

 

[andwhat]

I am reading some very disappointing stuff here. I think that Hospitalist is a great lifestyle, admixed with a few rough nights.
Weekend nights are the roughest without a doubt.
We do not have 20 admits -- that is unheard of, and is quite easily burnout if you do that over a 12 hour shift. I would quit my first day if that were the case. I work at a community based program with a residency program, and medical students, population of close to 400,000.
We admit up to 12 admits per 12 hour shift maximum. I have come close to that number, but hope that I never do.
Yes University based programs typically want you to work like a dog, and not make nearly as much as you would at a community based program.
Community based Hospitalists are generally very happy, and the work is enjoyable.
Rounding days -- round on say 20 to 25 patients from 9 am to 1 or 2 pm (after hopefully efficient morning report from 7:30 am to 9 am) based on your speed, and efficiency. Nurse Practitioners and PAs tend to take more of the social admits, and people that have been in the hospital forever.
I take phone calls until 7 pm from the floor (maybe one or two maximum per hour -- I am actually in the gym at around 6:30 every day, after my afternoon nap), and on a RARE occasion go back to the hospital.
We all make a little over $200K plus bonus incentives that are quarterly, working around 40 hours a week. I actually have time to moonlight if I truly wanted to.
The work is not that demanding or difficult, we all loathe clinic and certain aspects of Primary Care. The politics of it are insane. Who in their right mind would actually work all day and night, and then clinic all day the next day, followed by being up again the following night. Primary care is rewarding, albeit complicated at times. It is difficult to run an office, albeit not impossible.
Admitting days as a Hospitalist are unpredictable -- and crazy as well as hectic at times, but overall not bad at all. Not nearly as bad as residency.
Why not work at your own pace, and be done when you want to be done, and not be burned out?
ER is burnout if you ask me. The 12 hour shifts that those guys pull off are extremely impressive. They are busy as you can possibly be, constantly multitasking -- drug overdose, comatose, MI, CHF, seizure -- something that I am glad that I can watch on television and not be directly involved in initially. I suppose if that is your personality, then that is great.
Urgent Care sucks almost completely. It's composed of everyone that is too lazy to either find a doctor, or go to their regular doctor. Everything that I loathed seeing in clinic, is what this is composed of.
Almost everything is a viral illness, and everyone wants an antibiotic. If you see a real case, you cannot deal with it and send it to the ER. Why? Because you do not have a CT scanner, or other sophisticated technology. The most ridiculous concept of Medicine that I have ever seen or heard of truly. PAs and NPs should do this only, not physicians. Not to disrespect NPs or PAs, but a physician should not act like "McDonald's" of Medicine. It is ridiculous.
TRUE twelve hour days are the admitting days, you truly earn your money those days.
You are admitting, rounding and discharging patients all in the same day.
However, there are backup doctors on the shifts also.
You can be either
1) dedicated rounding doctor seeing 15 to 25 patients per day, including new patients, discharges, patients that have been there for a while.
2) admitting doctor -- basically feels like being on call at times, admitting, rounding and discharging patients. Fortunately there is almost always backup. Not nearly as bad as it would be going solo. You take less than ten of these shifts per month. They really are not that bad at all, if you know your system very well. New patients, being either from the ER, from a Physician's office, new consults from Psychiatry or Rehab, or Ortho -- a couple General Surgery also.
3) shift doctor -- you are the backup doctor, helping out the admitting doctor -- taking New admits, Consults. You have to be careful though, because PRN doctors that take occasional shifts will suck you into extra work.
Overall Hospitalist life is great.
You have an answer for almost everything, unlike clinic --
"doctor, you may CLAIM that my sore throat is viral, but I am NOT leaving this clinic without an antibiotic"
"doctor you BETTER sign my FMLA papers even though nothing is wrong with me -- what do you think? Are you so stupid that you think that I will actually WORK for a living, instead of taking free money --- because of the disability you BETTER claim that I have -- otherwise I will see somebody else?"
"Doctor, hurry up and fill my Vicodin" (This patient just got a refill of Vicodin from the ER the night before) Sorry but drug seeking is NOT a diagnosis that I can get PAID for -- too bad that you refuse to go to the pain clinics which you got fired from.
"doctor, why can't you hurry up and determine why I have blurry vision and nystagmus?"
"doctor, are you freakin STUPID -- why can't you figure out what is wrong with my one month old with constipation for 6 hours over the phone?"
Life couldn't be better honestly.......
at the end of my shift, I don't need to do painful sign out. I just turn my pager off.
Talk about a great lifestyle..... leave the difficult cases for the specialists -- the Critical care doc in the ICU, the chest pain to the Cardiologist, the GI bleeder to the Surgeon and GI doc...
If you are a raging workaholic, go ahead and choose a busy specialty.
On call nights are not for me.

 

[Dyssrhythmia]

I'm not sure moonlighting counts towards the 80 hours.

Moonlighting definitely counts toward the 80 hours, even if it is at a different institution. ACGME is explicit and strict about this.

 

[WSUreds]

This is 2 1/2 years late! Thanks for the update!

 

[jdh71]

I heard they are getting paid over 9000 these days

 

[Captopril]

Going super sayan is a signing bonus.

I heard they are getting paid over 9000 these days

 

[bronx43]

i heard they are getting paid over 9000 these days

What?! 9000???? There's no way that could be right!