Malpractice insurance for physician

I will make it very short and sweet.

1. Malpractice insurance is must.

2. Tail coverage is must, and has to be provided by employer, if employer is not ready to provide it, search for another employer. As a physician you are in demand and you will find another job very easily.

3. Claims-Made Basis v. Occurrence Basis - go for Occurrence basis. Your employer may try to convince you for claims-made policy but please don't agree with it. More explanation can be found here. Once you click on this link scroll down to the end of page and look for claims made vs occurrence base.

Once again good luck to you all,

MD Suggests

Urgent advice to all physician who are graduating

I wish all new graduates a great new start of life. I would recommend all of them not to start working as a hospitalist. If you want to put your life as a resident behind then you should join with a group and start working on establishing your practice. If you are working as a hospitalist, 99.99% of time you will be resident again.

If you are fmg/img and working as a Hospitalist, you are in the worst situation, it is equivalent to modern day slavery.

I will post more later but this is my advice based on personal experience.

good luck to you all.


Application tips

When you apply for your first job, you will certainly get so many calls from recruiter. You will be asked to fill 10 pages pre screening forms. Lots of time they will ask for your location preferences as well.

In my application process I learnt few tricks which I am sharing here. You can make your best judgements.

1. Never open your cards fully. Do mention your preferences but let them know that preferences do change based on your situation.

2. In terms of salary, do not mention that this is your upper limit, always let recruiters know your lowest acceptable pay but your upper limit is always something you need to negotiate after your interview is over and your tour is over.

3. Lots of recruiters will ask about where your family is largely located, give some vauge answers. If you let them know that your close family is in NY and you are trying for job in MD or NC, they will not put in great amout of efforts considering the fact that you would not prefer to move away from family.

4. Lots of them will ask if you have any other interviews and where. Let them politely know that, you can not divulge this information and it is not professionally right for them to answer such questions. I actually ended up having situation with one particular recruiter that after divulging this information my interview which was already scheduled got cancelled. I don't know what he shared with that particualr hospital.

5. Most of recruiters are nice but some are in only for the shake of money. For them once you are placed and stay for atleast 6 months they get hefty recruitment commission and that is so lucrative that many times they just tell you good things about the place which they represent. Make sure that you check out place on internet including location, local weather, local school system, patient population etc.

I hope this helps to fresh doctors who are graduating this June.


Planning for your first job

When you are in your final year of residency, make sure you plan well ahead for your licensing.

Few important steps:

1. Pass USMLE step 3 if you haven't. It is must before you can even apply for your license in almost all states.

2. Initiate FCVS (Federal Credential Verification Service) atleast 6 months before you graduate.

3. Apply for license in the state where you intend to work.

Usually licensing process + FCVS together takes anywhere between 4-6 months.

Once you sign up your job contract it takes any where between 4-6 weeks for credentialing. So you should have provision for this time as well.




Few important things to consider when you go for hospitalist job

There are few important things you need to consider.

1. Duty hours: You always want to make sure that your contract explicitly mention duty hours. There is no verbal things here, it has to be written down in black and white. If you end up working extra hours, you have to make sure at what rate. If you did not specify, you loose.

2. Number of patients: On an average a Hospitalist can carry in one 12 hours shifts 18-20 patients. This is true when you have "state of the art" hospital with tremndously good support staff, latest Electronic Medical record system (EMR) and wonderful PACS system and amazing subspeciality support. To find this sort of dream hospital is still rarity. So ideally upto 15-16 patients you can carry. MAKE SURE YOU MENTION THAT PATIENT STRENGTH INCLUDES DISCHARGES, NEW ADMISSION, CONSULTS AND INPATIENTS. This is very important. People make a big mistake of signing contract which state that there will be patient limit of 18-20. Now you are in situation where you discharge 4 patients and admit 4, So in essence you are caring for more patients then quoted in your contract but you can not do anything about it. Remember admission and discharge takes most time when you work as a hospitalist.
To effectively provide better patient care the number of patients for which you are responsible has to be limited. It also prevents you from medicolegal standpoint because if you are exhausted with many patients then there is a chance that you probably would make mistake.

3. Vacation Time: Most hospitalist programs offer a "7 day on and 7day off" schedule which is good when you are immediately out of residency and want to have some quality time to spend with family, traveling, fun activities, hobbies etc. But in essence you are working 84 hours in 2 weeks. US national work week is 40 weeks so your program is not doing any favor to you by providing this "7 week off" time. It is your time. You have to ask atleast 2 wks off vacation per year. If they argue that vacation is built in, let them know that it is not vacation it is your off time after working 84 hours in 1 week. Let them know that you are already working more than average 40 hours work week.

I hope this post will be helpful to those who are entering into physician job market and willing to work as a hospitalist. Let me know your views.


1st step towards analyzing your job contract as a Hospitalist

Before you sign your contract, read following:

1. Analyze your contract and each word of it carefully, each word means every single word. Ideally, get it evaluated by qualified attorney. Just to give you one simple example, I was planning to join a private doctor to serve as a Hospitalist for his inpatient population. The contract looked very good except there was one simple line as follows.

"Hospitalist practice is expected to generate xxxx amount of dollars every year, any short fall will be adjusted at the end of year"

My attorney, who was very smart pointed this out and asked me to get it removed from the contract, the ramifications could be as follows. At the end of year when you sit down for your discussion of production bonus and other incentives, you will be told that there were xxx amount of expenses for Secretary, Medical record system, office maintenance etc. and you may actually need to pay some money back. This has happened in past to young physicians or they are forced to work without bonus or incentives, because legally they are in limbo.


3. Do not rush into signing contract fearing that a good opportunity will go away. Currently job market for Hospitalist is very good and is expected to do well atleast for next couple of years. If you miss one opportunity, you will find another one but if you end up with a wrong one, you will regret it so much and probably continue to live the life of a resident.

I hope you enjoy this first informative post. More to follow...

Keep visiting and leave your positive or negative feedback.




Hospitalist is a lucrative job for new physician entering into the job market. Often salary is high and job schedule is pretty inviting with "time on and time off. After those 3 to 4 years of residency it does offer a good solution for a balanced life which lets you enjoy good family life as well.

But there is a catch...there is a say "There is no free lunch" so, be very careful when you sign the Hospitalist job contract. You have to be very careful if you are on J1 or H1 visa. If you are not smart in negotiations and don't analyze your job contract carefully you are in for a big time trouble and exploitation.

In this blog, I will give you guidelines based on reallife experiences of people. Lots of posts here will be based on personal experiences and based on discussions with other hospitalists.

Please leave your valuable comments.