Menu

hospitalist hours

Home The Lounge hospitalist hours

  • Avatar hospitalist md 
    Participant
    Status: Physician
    Posts: 81
    Joined: 10/31/2017

    i think part of it is inertia… other part is almost entire group is male physicians with stay at home spouses… so they have back up for home and kid care. There are only 2 female physicians in the group , one of them being me. the other physician mostly does nights.

    This is small mid west place with above avg pay for sure. very reasonable work load.. but frankly i did rather have heavy work load for less hours than sitting there doing nothing for most of the 12 hrs. I really don’t understand the mindset of the rest of the group . They are not exactly opposed to what i suggest but they don’t vocally support it either. That’s the trouble.

    #214457 Reply
    Avatar jessikaur 
    Participant
    Status: Physician
    Posts: 90
    Joined: 11/01/2017

    I would be careful. You can get burned for even trying to get your group together for a consensus (I would know, happened to me). Hospitalists are a dime a dozen nowadays. Good hospitalists are another story.

    I’ve done them all, hospital employed, private practice, working for VA, doing locums, working for a big corp. There are also plenty of job opportunities out there for you to carve out what you need, you will have to make certain sacrifices.

    I haven’t worked nights since Oct of 2014, but I work a lot of weekends (trade off). I refuse to work in an environment that requires me to stay put after I’ve completed my work, so I just won’t work these jobs. Since I am the queen of efficiency this can be upwards of 8-10 hours of just waiting around. Definitely feels like prison.

    Since January 24th, I have had approximately 4 days off, but worked about 50 days in a row, took a four day weekend, back at it for another 33 days until I can get to memorial day weekend.

    How did I do that? job 1  – can complete in 2-3 hrs (only doing post surgical medical consults). 10 minute drive from home. job 2/3/ and now 4 all within the same hospital right across the street from where I live, so go to job one, then go to job 2/3  at the same hospital (just covering patients for the groups that normally work there, so it’s moonlighting, but on a consistent basis) — the patient’s at this facility are long-term care patients, so not much going on from day to day, and have all regular consultants available, a lot of it is hand-holding with families, which I am good at. Home by 2pm latest (sometimes earlier, one time since I’ve been doing this and got five new admits at the LTACH, I stayed until 6pm). When I cover job 1/2/3 – make $4500 and it’s not even a full shift of 12 hrs.  So been practicing since 2011, and at any one time have worked at 3-4 different jobs/positions. It can be done, you just have to find these opportunities.

    I wouldn’t bother trying to change the hospital, as others have said, that rarely works, I would change yourself.

    Another strategy that *might* work is if they are understaffed and you don’t need the benefits, you can tell them you’re only going to moonlight with them (and make your own hours, whatever shifts you want, you can even tell them it’s because you’re burning out on their current schedule — which is true — and THEN. you can carve out your own moonlighting schedule. Tell them/or ask them, if they want you to see patients, you are willing to see 20 follows ups/or news that are already in the hospital, but when you’re done you can go home and answer via pages (whatever number the rest of the hospitalists are seeing, you will see more — saves them money, and allows you a better lifestyle.  All depends upon how much you need them or they need you. I’ve used this strategy before. I’ve also used, pay me more, take away the benefits since they claim benefits are 25% of your pay. It helps that my husband works for the state and gets his own excellent benefits, and we all know how to start a solo 401k from this forum.

    All the best.

     

    #214465 Reply
    Avatar GoBlueMD 
    Participant
    Status: Physician
    Posts: 64
    Joined: 05/27/2017

    There was recently a physiatrist that posted his busy schedule that made him $1 million a year. Now we have the Hospitalist blueprint. But schedules were rough, but Jessi’s seems easier since less total hours in house I believe.

    OP, 7 on 7 off with 12hr shifts is basically 1.5x fte. Almost impossible to have meaningful time with family on the on weeks. A third shift should be ideally added. But if the volumes are low as you mentioned, adding a third shift would drastically cut salary. But cutting hours to 5, aren’t you asking for additional coverage?

    #214474 Reply
    Avatar hospitalist md 
    Participant
    Status: Physician
    Posts: 81
    Joined: 10/31/2017

    @gobluemd- wen i leave at 5, i usually hand my pager to other docs and i return the favor next day… so we basically alternate going early … and i have done this only in the last 10 days since my husband was out of town and i had to pck up my kid from day care. usually i jus stay put… but i don’t think its ideal on long run.. my full time is about 23 weeks … but i have been doing way more than that for the last 4 yrs since we were not fully staffed and they could not hire easily… that was why it was very upsetting to me that they would not let me go early when i have a legitimate reason…

    and what bugs me even more is that non medical administrators get to have a call on our work hours instead of doctors…

    #214476 Reply
    Avatar LIFO 
    Participant
    Status: Physician
    Posts: 122
    Joined: 01/27/2018

    From what I’ve seen, management does not want the hospitalist team to drive change.  Attitude is generally “Be quiet. Do your work. You’re replaceable.”  Its really sad as many great doctors have been driven out.

    There is a lot of learned helplessness in internal medicine.  Plenty of people who do not value their time/expertise.  Still more who measure the quality of their care by amount of personal sacrifice.  That is your job competition.

    Take care of your finances. Take care of your health.  Be prepared to walk.

    q-school q-school 
    Participant
    Status: Physician
    Posts: 2333
    Joined: 05/07/2017

    I would be careful. You can get burned for even trying to get your group together for a consensus (I would know, happened to me). Hospitalists are a dime a dozen nowadays. Good hospitalists are another story.

    I’ve done them all, hospital employed, private practice, working for VA, doing locums, working for a big corp. There are also plenty of job opportunities out there for you to carve out what you need, you will have to make certain sacrifices.

    I haven’t worked nights since Oct of 2014, but I work a lot of weekends (trade off). I refuse to work in an environment that requires me to stay put after I’ve completed my work, so I just won’t work these jobs. Since I am the queen of efficiency this can be upwards of 8-10 hours of just waiting around. Definitely feels like prison.

    Since January 24th, I have had approximately 4 days off, but worked about 50 days in a row, took a four day weekend, back at it for another 33 days until I can get to memorial day weekend.

    How did I do that? job 1  – can complete in 2-3 hrs (only doing post surgical medical consults). 10 minute drive from home. job 2/3/ and now 4 all within the same hospital right across the street from where I live, so go to job one, then go to job 2/3  at the same hospital (just covering patients for the groups that normally work there, so it’s moonlighting, but on a consistent basis) — the patient’s at this facility are long-term care patients, so not much going on from day to day, and have all regular consultants available, a lot of it is hand-holding with families, which I am good at. Home by 2pm latest (sometimes earlier, one time since I’ve been doing this and got five new admits at the LTACH, I stayed until 6pm). When I cover job 1/2/3 – make $4500 and it’s not even a full shift of 12 hrs.  So been practicing since 2011, and at any one time have worked at 3-4 different jobs/positions. It can be done, you just have to find these opportunities.

    I wouldn’t bother trying to change the hospital, as others have said, that rarely works, I would change yourself.

    Another strategy that *might* work is if they are understaffed and you don’t need the benefits, you can tell them you’re only going to moonlight with them (and make your own hours, whatever shifts you want, you can even tell them it’s because you’re burning out on their current schedule — which is true — and THEN. you can carve out your own moonlighting schedule. Tell them/or ask them, if they want you to see patients, you are willing to see 20 follows ups/or news that are already in the hospital, but when you’re done you can go home and answer via pages (whatever number the rest of the hospitalists are seeing, you will see more — saves them money, and allows you a better lifestyle.  All depends upon how much you need them or they need you. I’ve used this strategy before. I’ve also used, pay me more, take away the benefits since they claim benefits are 25% of your pay. It helps that my husband works for the state and gets his own excellent benefits, and we all know how to start a solo 401k from this forum.

    All the best.

     

    Click to expand…

    so $4500 per day and don’t take too many days off, no kids.

    you are clearing a million a year?  husband works too with good benefits.  what are you planning on doing with the 50 million dollar fortune you are well on your way to establishing?

     

     

    #214493 Reply
    Avatar jessikaur 
    Participant
    Status: Physician
    Posts: 90
    Joined: 11/01/2017

    Ok,

    As I was going for a swim. I came up with several other creative solutions.

    Is the other female colleague in the same boat as you? If so… you can go to the management and say you and her are going to do a five on mon-fri every other week, and you will take the pay cut (or find someone that wants to)

    Lets say you get 200K a year for the 7 days, now you’re only doing 5, so that would get you down to 142K and you get every weekend off, if you can find a partner to do the other week with you. (8am – 4:30pm) will be your schedule and the others in your group can do the weekends etc (they’ll already be doing it anyway) administrators eat this mommy-doctor stuff up (no joke) and you get to keep the benefits.

     

    2) is your hospital open? you can do what I did: go to the surgeons in the hospital and offer to be their preferred hospitalist, you will manage all of their patients medical problems and they will handle the surgical side. the work is easy, and esp if it’s elective surgical consults that’s typically relatively healthy patients. course find another doctor to do your off week, and since you will be private, you don’t have to deal with this BS of staying in the hospital until all hours, surgeons don’t care as long as you are providing good care, which means answering every page, making sure patient’s leave by 11am, and making sure nursing staff is bugging YOU and not them about any medical issues diabetes/htn. pretty much anyone getting an elective surgery has insurance. you can do this on your own. OR you can find another group in the area after you get the contracts/agreements with the surgeons, and go under their umbrella, they’ll pay you for this work as a private hospitalist, they will do the billing, and they find your night coverage, in return they get a load of insured patients. and YOU get a low stress easy lifestyle. surgery is an early service, but even if you get late consults, most hospitals give you 24 hrs to respond to a consult (that being said, I respond right away, and then see/bill the patient later) meaning, I make sure all their home meds are in, plus prns, plus call the nurse to make sure there are no pressing issues even if the consult comes in late.  providing this type of service to surgeons is invaluable (they get so stressed about a blood sugar of 250) and they are so appreciative of the work that you are doing (which is your bread and butter and so easy anyway) that it ends up being rewarding…. and then when you do need a surgical consult they are much more amicable. no more is this inter-service- strife.  and hospital admin appreciate you decreasing rates of complications like dvts mi, getting patients out early (surgeons great at surgery, but the paperwork side really gets them) it’s a win win win win win… win win. =) hence why I love my job and have no issues working all the time except when I’m on vacay. wracking it up for the old retirement account!

    #214494 Reply
    Avatar jessikaur 
    Participant
    Status: Physician
    Posts: 90
    Joined: 11/01/2017

    I would be careful. You can get burned for even trying to get your group together for a consensus (I would know, happened to me). Hospitalists are a dime a dozen nowadays. Good hospitalists are another story.

    I’ve done them all, hospital employed, private practice, working for VA, doing locums, working for a big corp. There are also plenty of job opportunities out there for you to carve out what you need, you will have to make certain sacrifices.

    I haven’t worked nights since Oct of 2014, but I work a lot of weekends (trade off). I refuse to work in an environment that requires me to stay put after I’ve completed my work, so I just won’t work these jobs. Since I am the queen of efficiency this can be upwards of 8-10 hours of just waiting around. Definitely feels like prison.

    Since January 24th, I have had approximately 4 days off, but worked about 50 days in a row, took a four day weekend, back at it for another 33 days until I can get to memorial day weekend.

    How did I do that? job 1  – can complete in 2-3 hrs (only doing post surgical medical consults). 10 minute drive from home. job 2/3/ and now 4 all within the same hospital right across the street from where I live, so go to job one, then go to job 2/3  at the same hospital (just covering patients for the groups that normally work there, so it’s moonlighting, but on a consistent basis) — the patient’s at this facility are long-term care patients, so not much going on from day to day, and have all regular consultants available, a lot of it is hand-holding with families, which I am good at. Home by 2pm latest (sometimes earlier, one time since I’ve been doing this and got five new admits at the LTACH, I stayed until 6pm). When I cover job 1/2/3 – make $4500 and it’s not even a full shift of 12 hrs.  So been practicing since 2011, and at any one time have worked at 3-4 different jobs/positions. It can be done, you just have to find these opportunities.

    I wouldn’t bother trying to change the hospital, as others have said, that rarely works, I would change yourself.

    Another strategy that *might* work is if they are understaffed and you don’t need the benefits, you can tell them you’re only going to moonlight with them (and make your own hours, whatever shifts you want, you can even tell them it’s because you’re burning out on their current schedule — which is true — and THEN. you can carve out your own moonlighting schedule. Tell them/or ask them, if they want you to see patients, you are willing to see 20 follows ups/or news that are already in the hospital, but when you’re done you can go home and answer via pages (whatever number the rest of the hospitalists are seeing, you will see more — saves them money, and allows you a better lifestyle.  All depends upon how much you need them or they need you. I’ve used this strategy before. I’ve also used, pay me more, take away the benefits since they claim benefits are 25% of your pay. It helps that my husband works for the state and gets his own excellent benefits, and we all know how to start a solo 401k from this forum.

    All the best.

     

    Click to expand…

    so $4500 per day and don’t take too many days off, no kids.

    you are clearing a million a year?  husband works too with good benefits.  what are you planning on doing with the 50 million dollar fortune you are well on your way to establishing?

     

     

    Click to expand…

    Well, not all of the jobs happen on all of the same days. But when they do, I’m cashing in.. most days I probably only clear 2500 at most, but these days I’m only working the two jobs, and probably do only 4 hours of solid work. which is five days a week every other week. BUT on off week, I also end up doing two jobs again at the 2500, it’s when everyone wants a weekend off that I got the 4500, which happened all through march, so I had a very good first quarter.

    I realize this could be confusing… there was a third group that started at that LTACH that is building up their census, so hired me on full time and since their census is low, they asked me to work continuously, until it builds up and they will pay me as a full time person (this is the one job that I did 50 in a row, and now onto 33) (seeing ten patient’s a day at a full time salary with moonlighting for the off week is too good to last forever, so working as much as a I can until this ends) (did I mention the two full time jobs each offer a match one requires you to contribute the other doesn’t??? — this is the same thing that happened to me at the VA)

    anyway, to the OP. get creative!!!

    to the second point — cure type 2 diabetes and help put a dent into the obesity epidemic.

    #214498 Reply
    CordMcNally CordMcNally 
    Participant
    Status: Physician
    Posts: 2106
    Joined: 01/03/2017
    to the second point — cure type 2 diabetes and help put a dent into the obesity epidemic.

    Click to expand…

    I think the other way around would be more beneficial. Cure obesity and put a dent in type 2 diabetes.

    “But investing isn’t about beating others at their game. It’s about controlling yourself at your own game.”
    ― Benjamin Graham, The Intelligent Investor

    #214528 Reply
    Liked by Panscan, wonka31
    Avatar hightower 
    Participant
    Status: Physician
    Posts: 1377
    Joined: 12/07/2016

    My current job has 12 hour shifts.  We don’t stay the whole 12 hours.  We have to keep our pagers (doc halo) on 7-7. This is a small hospital so we only have 2 rounding docs during the day.  We split call up into a morning and an afternoon call.  First day we’re “early call” 7-1 the next day we’re “late call” 1-7.  After your early call ends at 1 you are technically free to go, although we end up sticking around until about 3pm or so to make sure everyone is tucked away.  The late call days you can come in later in the morning.  I usually get in around 9:30 or so.  I typically work 4 days in a row, sometimes 5.  I just had 9 days off in a row for no good reason and it was wonderful.  I work 16 shifts a month.  Pay is good since it’s rural and since I don’t need any benefits (wife’s employer provides our insurance).

    My old employer was a bit different.  We were paid for 10 hour shifts, but only had to keep our pagers on from 7-5.  We were at a bigger hospital so we had a variety of admitting shifts, most 8 hours long.  The rounding only days were come and go as you please but always be available by phone/pager if you’re not in the building. That job was actually worse though because the hospital was so much busier and we were constantly getting paged for things all day long.

    #214537 Reply
    Avatar GraceisOTL 
    Participant
    Status: Physician
    Posts: 12
    Joined: 04/19/2019

    12hours, 7on/7off. I’m responsible for my pager at for the full 12, but I don’t have to be present the full twelve. We take turns covering the codes.

    You should just find a new job.

    #214604 Reply
    wonka31 wonka31 
    Participant
    Status: Physician
    Posts: 548
    Joined: 03/24/2018

    I honestly had no idea that hospitalists didn’t have to be in the hospital for the duration of the shift. I’d find a job doing that as well as it seems to be pretty common.

    #214607 Reply
    Avatar Panscan 
    Participant
    Status: Resident
    Posts: 719
    Joined: 03/18/2017

    Not sure working at 3 separate hospitals at same time is safe for the patients or wise but to each their own.

    #214630 Reply
    Avatar Panscan 
    Participant
    Status: Resident
    Posts: 719
    Joined: 03/18/2017

    “can we have a family meeting for goals of care at 1 pm?”

    No sorry I gotta go round on my 2 other hospitals worth of patients

    #214631 Reply
    Liked by Tim
    Avatar hightower 
    Participant
    Status: Physician
    Posts: 1377
    Joined: 12/07/2016

    Not sure working at 3 separate hospitals at same time is safe for the patients or wise but to each their own.

    Click to expand…

    “can we have a family meeting for goals of care at 1 pm?”

    No sorry I gotta go round on my 2 other hospitals worth of patients

    Click to expand…

    How’s that any different than a specialist who rounds in the hospital in the morning then leaves to go to their clinic for the rest of the day?  Or a cardiologist that does procedures at 2 different hospitals each day?  Or a PCP who admits their own patients? (this, of course, used to be the norm).  This is a pet peeve of mine actually.  People wrongly assume that if you’re a hospitalist that it means you need to sit in the hospital all day just to be available for non-emergent things (like impromptu family meetings that could wait until the next day or to sign a form for care management, etc).  We’re not “available-ists”  That would kill the main attraction to the job which is having a decent lifestyle.  I’m sorry, but my time is more valuable than that.  I am being paid to manage a group of patients on a per shift basis.  My priorities are to make sure they are getting the care they need, not to be overly available for things that don’t actually require my immediate attention.

    Anyone that is forced to sit in the hospital for a full 12 hours every day is going to be miserable because it means they have zero life outside of work.  And they’ll probably be bored out of their minds if they are not on call because once their work is done, what can they do other than surf the web?  That’s a recipe for burn out.  ER doctors are required to be in the building the full 12 hours because their entire field revolves around being 100% available 24/7/365.  BUT, they only work 2-3 shifts in a row (typically).  Hospitalists are usually asked to work much longer stretches (7 being the most common).  Good luck surviving for very long working 12 hours a day 7 days at a time.  You can’t possibly have a happy/normal family life with that kind of work requirement.

    Regardless, I fear that this expectation of hospitalists becoming available-ists, is a trend that we can’t actually stop.  It’s something that is slowly becoming the expectation and it’s going to change the field dramatically.  The only way I would ever agree to a job in which I’m required to be in house and physically available all day would be if I were doing no more than 2 or 3 shifts at a time and then getting a few days off.  Even that wouldn’t last very long for me.  It’s one of the many things I see as being an end to my career in medicine and why I’m saving money like mad and living way below my means.

    #214639 Reply

Reply To: hospitalist hours

In case of a glitch or error, please save your text elsewhere, clear browser cache, close browser, open browser and refresh the page.

Notifications Mark all as read  |  Clear