Docmomof3 wrote: Shift work sounds nice but to me it seems like being a hospitalist is like being a resident forever...
As a person VERY interested Hospitalist medicine, I'd love to hear your and anyone else's opinion about why you feel this way. Looking at things from the outside, it seems to me that some of the "disdain" for this field stems from the fact that it's not as "sexy" as some of the other fields of medicine. In other words, really "smart" Docs specialize, pay is not as great, and all the other trite and superficial reasons I hear for why some people don't choose what appears to be a Mom perfect field of medicine
Well, the work itself is very much like being a resident: taking care of sick people in the hospital. There's nothing wrong with that, and of course hospitalists are no longer supervised by attendings, they are paid better than residents, and the hours are generally less than 80/wk. So it's kind of like residency, and kind of not.
Some hospitalists where I trained (specifically, some of the best ones - that were the most conscientious about their patients) expressed the sentiment that as resident works hours had decreased, theirs had actually increased - with no 80h, 1d off/wk limits. I suspect it's extremely job/hospital dependent. But, some places, it's a LOT of work, much of it thankless, and without the ongoing patient relationships that many find sustaining in the outpatient world - those are the ways in which I think of it being like being a resident forever, not so much because of status.
7 years 8 months ago - 7 years 8 months ago#81286by mohm
I am an academic pediatric hospitalist. From my perspective, being a hospitalist is not any more like being a resident than working in urgent care, being a neonatologist, or an intensivist. I was very concerned taking a hospitalist job out of residency that it would feel that way. For me, the two are completely different.
There is no comparison to the hours I worked inpatient as a resident and the burn out I felt as a resident compared to my experience now. When I'm on service I work very hard, but I have so much more non-clinical time per month compared to being a resident. I have learned so much doing hospitalist medicine, since completing residency. I enjoy working with residents and medical student. I also have service time on a non-teaching service and enjoy the autonomy there as well.
In pediatrics, hospitalists make more money than many subspecialists. There has definitely been more pressure with more duty hour restrictions, but there are ongoing adjustments in our institution. My work load hasn't changed significantly overall. I also have significant continuity with a broad patient population of patients with CF, chronic lung disease, CP, renal and cardiac transplant/disease, seizure disorder, etc. It just depends on how the institution and services cover patients.
I think the hardest part of being a hospitalist is the inconsistent schedule and the intensity of my work when I am on clinical service. Our group has started doing shorter stretches trading off a service with a shorter time on but with continuity by flipping the service between two providers like A-->4days, B-->5days, A-->5days, B-->4days. So much is group and practice setting dependent. I love not having much to follow up on clinically when I'm off clinical service. There is good and bad, but it works well for our family and fulfills me.
I am a FT Hospitalist and it is nothing like being a resident and I just finished residency. I take care of my patients like I see fit w/o having to discuss it with anyone. If I need a consult I order it, if not I do not and I get to use my clinical judgement daily with patients that are acutely ill. The hours are not bad and yes it is dependent on where you practice but with all the different models you should be able to find one that suits your personality. I work hard while at the hospital but it is NOTHING like residency hours wise. I work 7 on then 7 off and my days are 10 hour days and extremely doable. We carry a patient load that allows us to care well for our patients and not feel overwhelmed.
It is a great career and pays much better than outpatient medicine, so I have no clue where you all are getting the info regarding low pay bc it's high. If you like to do locums it's upward of 120/hr or more...
Career choice once in IM has less to do with "intelligence" versus personal likes/dislikes. Many super abled and top notch clinicians choose Hospitalist for the lifestyle of working one week then one off and being able to put two in a row and take extended vacations.