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.



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