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Hospitalist Jobs: The Good, Bad, and Ugly

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  •  SValleyMD 
    Participant
    Status: Physician
    Posts: 327
    Joined: 05/12/2016

    I don’t know CM but I would take my chances with him over the mid levels that make up 50% of our Hospitalist service —

    Not knocking Hospitalist work at all as I’ve done it and I understand it has its own challenges, but I also know from personal experience that I could find some gigs (not all) that would cut my work stress levels by 90%.. but as I pointed out still ways of doing that within cardiology as well too..

    Point is lots of places to practice in this country with a lot of different setups with still some pretty good jobs if u can find them.

    #171215 Reply
    Liked by Anne, q-school, Zaphod, CM
    CM CM 
    Participant
    Status: Physician
    Posts: 883
    Joined: 01/14/2017

    Very odd to the fatlittlepig. must not have managed their money well to have to or want to work 12 hour days 7 days in a row as a retired cardiologist. Very odd indeed.

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    I’ll be 60 next year with a portfolio that PhysicianOnFire considers fat, especially so given my relatively advanced age. However, I disagree with that assessment. Moreover, I enjoy my work on the occasional slow day (usually during a winter storm). I’m only thinking about retirement because I don’t like spending every day with a red hot poker up my a**.

    I work 12 hour days fairly often now, but my average day is probably closer to 11 hours, and pell mell. A more relaxed 12 hour day would be an upgrade, and having the next seven days off would be a giant upgrade; enough time to pursue outside interests.

    The off week would not make up for an 84 hour week of hell. The job would have to be low volume.

    Erstwhile Dance Theatre of Dayton performer cum bellhop. Carried bags for Cyd Charisse (gracious). Hosted epic company parties after Friday night rehearsals.

    #171217 Reply
    fatlittlepig fatlittlepig 
    Participant
    Status: Physician
    Posts: 294
    Joined: 01/26/2017

    I say this with the utmost respect and not in any way disrespectfully but that’s absolutely makes no sense to me. A 60 yr old who has been doing cardiology as a career and has enough money wants to go to 12 hr hospitalist days. You want to learn a whole new field, workflow, how to handle GI bleeders, bacteremic patients, delirious patients, SNf placements? You want to get calls form ED to admit the 5th bounce back demented patient. lOL. I’ve been doing it for a while, I can do those admits in 30 minutes, I can round on 10 patients in 2 hrs. But you won’t be able to.

    #171221 Reply
    q-school q-school 
    Participant
    Status: Physician
    Posts: 2003
    Joined: 05/07/2017

    I say this with the utmost respect and not in any way disrespectfully but that’s absolutely makes no sense to me. A 60 yr old who has been doing cardiology as a career and has enough money wants to go to 12 hr hospitalist days. You want to learn a whole new field, workflow, how to handle GI bleeders, bacteremic patients, delirious patients, SNf placements? You want to get calls form ED to admit the 5th bounce back demented patient. lOL. I’ve been doing it for a while, I can do those admits in 30 minutes, I can round on 10 patients in 2 hrs. But you won’t be able to.

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    That’s the beauty of fire, it doesn’t have to make sense to you.  It just has to make sense to the (sort of) retiree.

    🙂

     

    #171222 Reply
    Liked by Anne, llessac15
    hatton1 hatton1 
    Participant
    Status: Physician
    Posts: 2650
    Joined: 01/11/2016

    Tough stuff CM.  I do think it would be hard to learn how to manage so much non-cardiology stuff.  The knowledge that you and I had from residency days has expired basically.  Not to be Debbie Downer.  It might be doable if someone would mentor you for a month or so.  A less stressful Cards job would seem ideal.

    #171225 Reply
    Liked by q-school
    hatton1 hatton1 
    Participant
    Status: Physician
    Posts: 2650
    Joined: 01/11/2016

    I say this with the utmost respect and not in any way disrespectfully but that’s absolutely makes no sense to me. A 60 yr old who has been doing cardiology as a career and has enough money wants to go to 12 hr hospitalist days. You want to learn a whole new field, workflow, how to handle GI bleeders, bacteremic patients, delirious patients, SNf placements? You want to get calls form ED to admit the 5th bounce back demented patient. lOL. I’ve been doing it for a while, I can do those admits in 30 minutes, I can round on 10 patients in 2 hrs. But you won’t be able to.

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    FLP CM took several years off from medicine to work in investment banking.

    #171226 Reply
    CM CM 
    Participant
    Status: Physician
    Posts: 883
    Joined: 01/14/2017

    I say this with the utmost respect and not in any way disrespectfully but that’s absolutely makes no sense to me. A 60 yr old who has been doing cardiology as a career and has enough money wants to go to 12 hr hospitalist days. You want to learn a whole new field, workflow, how to handle GI bleeders, bacteremic patients, delirious patients, SNf placements? You want to get calls form ED to admit the 5th bounce back demented patient. lOL. I’ve been doing it for a while, I can do those admits in 30 minutes, I can round on 10 patients in 2 hrs. But you won’t be able to.

    Click to expand…

    FLP CM took several years off from medicine to work in investment banking.

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    Close enough.  😀   (Thirteen years doing a variety of things, including equity research, but no investment banking.)

    Erstwhile Dance Theatre of Dayton performer cum bellhop. Carried bags for Cyd Charisse (gracious). Hosted epic company parties after Friday night rehearsals.

    #171233 Reply
    CM CM 
    Participant
    Status: Physician
    Posts: 883
    Joined: 01/14/2017

    A less stressful Cards job would seem ideal.

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    That would be better.

    Erstwhile Dance Theatre of Dayton performer cum bellhop. Carried bags for Cyd Charisse (gracious). Hosted epic company parties after Friday night rehearsals.

    #171234 Reply
     hightower 
    Participant
    Status: Physician
    Posts: 1208
    Joined: 12/07/2016

    I am a hospital-employed medical sub-specialist under contract through the end of next year. I could retire at that point, but I don’t want to retire; I just want a less stressful job.

    The shift work aspect of a hospitalist position appeals to me (assuming no nights), but seven consecutive 12-hour shifts under an avalanche of work at a high-volume center would not be an improvement on my current job.

    Do low-volume jobs exist? (Rural location is ok.) If so, how can you confidently assess the volume prior to starting the job. (I would not trust the assessment of a recruiter or employer.)

    Also, what do you consider low volume?

    Years ago, I worked as an intensivist before that was a well-recognized specialty. During my first year we covered two hospitals. One was a small facility 30 minutes beyond the outer edge of the suburbs. It was so quiet that admissions were a welcome sight. There were long periods with nothing to do. That was low volume.

    I don’t want a job so slow that it’s boring. I just want one where I don’t feel rushed and pushed throughout the day. I’d just like to start every day with the idea that it’s likely to be a good day.

     

    I realize that hospitalists frequently burn out, but that would probably be uncommon if all jobs were low volume and no one took extra shifts. Do you disagree?

    Putting compensation aside, am I crazy to think that low-volume hospitalist work would be more enjoyable than (non-invasive) medical sub-specialty work?

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    Switching to hospitalist work would certainly get you more time off, especially if you did it part time.  But, the work itself wouldn’t necessarily be less stressful.  Depending on the job, you might be really, really swamped.  There are hospitals within our system that are just nuts when it comes to volume and patient complexity.  However, a rural location might fit the bill.  I work at a rural location about 45 minutes from our city.  During the slow months (most of the year except the winter) we have a pretty chill census most weeks.  There have routinely been weeks where I’m only seeing 10-12 patients per day, I’ve even had many days with single digits.  However, if the flu hits in the fall/winter, our census could jump to 25+ each in no time.  So, it’s hit or miss and it’s beyond anyone’s control.  In general though, low volume hospitalist jobs are becoming a thing of the past very quickly.  We’re expected to see large volumes of patients most of the time.  You get quick with it, but the quality of care goes down in my opinion and the risk of a mistake goes sky high.

    It also depends on how the shifts are scheduled.  I have mostly worked for a group that allows a random length of days on and off with the ability to leave when you’re done rounding (if you’re not on call), however at this current position we’re now required to stay 7-7 (due to a change of ownership), which I’m really dreading.  Mostly because of boredom.  I’ll be done seeing patients pretty early in the day, then you have to sit around and wait for admissions until 7pm.  Not cool.  But, I’m only doing 5 days a month there right now, so it’s tolerable.

    My advice…if you’re financially independent, retire from clinical medicine.  Not worth the legal risk IMO. Maybe look into doing some teaching at a local med school?  Or pursue a whole new career?  Or just travel, blog, build stuff, etc.  Life is short, enjoy it.  You’ve won the game;)

    #171247 Reply
     Allixi 
    Participant
    Status: Physician
    Posts: 29
    Joined: 03/16/2016

    How big is the group you’d be looking to join?  Rural areas might have less volume, but if you’re the only rounder/admitter for that day, it’d still be quite busy.

    Flexible scheduling exists. I work at a place that schedules 15-19 shifts per month, proportional to FTE. I might work stretches ranging from 4-14 days in a row.

    I agree with fatlittlepig that it’s unusual for a specialist to transition into being a general hospitalist. What I have seen, is cardiologists becoming the “hospitalist” for their group, and seeing their partners’ pts in the hospital. Then you don’t have to deal with outpt/office stuff, but can still practice cardiology. Could be a nice arrangement, if there are enough pts or demand for this service.

     

    Edit: Did not mean to like my own post. I thought you could see who else liked it by pressing the button on a mobile device.

    #171298 Reply
    Liked by Allixi, q-school
     SLC OB 
    Participant
    Status: Physician
    Posts: 127
    Joined: 06/23/2018

    Where are you interested? I have contacts up and down the Eastern side of the Sierras. I might be able to get you some people to speak to about some part-time cardiology work. I know the CMO in Bishop (I’m in Truckee but we are good right now for Cardiology) and have connections north of here too.  Just a thought… if you like the Sierra Mountain range.

     

    #171300 Reply
    fatlittlepig fatlittlepig 
    Participant
    Status: Physician
    Posts: 294
    Joined: 01/26/2017

     

    It also depends on how the shifts are scheduled.  I have mostly worked for a group that allows a random length of days on and off with the ability to leave when you’re done rounding (if you’re not on call), however at this current position we’re now required to stay 7-7 (due to a change of ownership), which I’m really dreading.  Mostly because of boredom.  I’ll be done seeing patients pretty early in the day, then you have to sit around and wait for admissions until 7pm.  Not cool.  But, I’m only doing 5 days a month there right now, so it’s tolerable.

     

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    Fatlittlepig finds it hard to imagine a 12 hour work day. If that was imposed on me, it would be time for me to pack up and most to greener pastures. That’s basically your whole day, and also if you are done with your work and still confined until 7, that’s even worse. i don’t know how people who do 7 days in a row 12 hours days, honestly i don’t know how you could do that. no thanks!

    #171416 Reply
    Liked by hatton1, Zaphod
    Drop it into MD Drop it into MD 
    Participant
    Status: Physician
    Posts: 232
    Joined: 09/20/2018

     

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    Fatlittlepig finds it hard to imagine a 12 hour work day. If that was imposed on me, it would be time for me to pack up and most to greener pastures. That’s basically your whole day, and also if you are done with your work and still confined until 7, that’s even worse. i don’t know how people who do 7 days in a row 12 hours days, honestly i don’t know how you could do that. no thanks!

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    I find that those jobs are taken mostly by new residency grads.  To them it is working half as much.  However I have seen several burn out after a few years if they do not make a change.  At least with residency there is a definite end in sight.

    #171419 Reply
    Zaphod Zaphod 
    Participant
    Status: Physician, Small Business Owner
    Posts: 4739
    Joined: 01/12/2016

     

    It also depends on how the shifts are scheduled.  I have mostly worked for a group that allows a random length of days on and off with the ability to leave when you’re done rounding (if you’re not on call), however at this current position we’re now required to stay 7-7 (due to a change of ownership), which I’m really dreading.  Mostly because of boredom.  I’ll be done seeing patients pretty early in the day, then you have to sit around and wait for admissions until 7pm.  Not cool.  But, I’m only doing 5 days a month there right now, so it’s tolerable.

     

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    Fatlittlepig finds it hard to imagine a 12 hour work day. If that was imposed on me, it would be time for me to pack up and most to greener pastures. That’s basically your whole day, and also if you are done with your work and still confined until 7, that’s even worse. i don’t know how people who do 7 days in a row 12 hours days, honestly i don’t know how you could do that. no thanks!

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    100%

    12h a day guarantees no quality at either end.

    #171427 Reply
     hightower 
    Participant
    Status: Physician
    Posts: 1208
    Joined: 12/07/2016

     

    It also depends on how the shifts are scheduled.  I have mostly worked for a group that allows a random length of days on and off with the ability to leave when you’re done rounding (if you’re not on call), however at this current position we’re now required to stay 7-7 (due to a change of ownership), which I’m really dreading.  Mostly because of boredom.  I’ll be done seeing patients pretty early in the day, then you have to sit around and wait for admissions until 7pm.  Not cool.  But, I’m only doing 5 days a month there right now, so it’s tolerable.

     

    Click to expand…

    Fatlittlepig finds it hard to imagine a 12 hour work day. If that was imposed on me, it would be time for me to pack up and most to greener pastures. That’s basically your whole day, and also if you are done with your work and still confined until 7, that’s even worse. i don’t know how people who do 7 days in a row 12 hours days, honestly i don’t know how you could do that. no thanks!

    Click to expand…

    I fully agree and I don’t know how long I’ll be continuing here.  I basically reluctantly agreed to do it for the first few months since the new company took over.  My hope was and still is to get them to change it quickly.  If not, I’ll be moving on as well.  I like working at this hospital for the reasons I detailed about it being pretty chill most of the year, but if I have to sit here and stare at a clock for 12 straight hours, not to mention not seeing my wife and baby for 5 days in a row, I won’t keep doing it.

    #171429 Reply

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