Advice - Hospitalist Position with a Private Medical Group

[NewGrad88]

Hi there,

 

I was offered a Hospitalist position with a private medical group where I would work 5 days a week with rounding starting at 7 am and "leaving whenever I am finished with seeing my patients". I may leave early and finish charting at home as long as I am done seeing my patients. If I work weekends (average of 1-2 weekends per month), then I get two days off during the weekday. The hospital is a level 2 trauma teaching hospital. Compensation is 102k/year.

 

The expected goal is to see an average of 20-25 patients per working day. Is that too much of a work load for an ~ 8 hour shift, M-F?

 

PAs at the hospital (level 1 trauma) where I rotated as a student saw approximately 12-15 patients per 12 hours shift so I am worried that I will be burnt out with 20-25 patients in an 8 hour shift.  Does the fact that it is a level 2 trauma hospital make a significant difference? Is the compensation fair? 

 

If 20-25 is too much, how do I bring this up to the physicians without sounding as if I am trying to take short cuts and be perceived as "not motivated to work hard". 

 

Those who are practicing as a PA hospitalist, please help! 

 

 

[LT_Oneal_PAC]

I'm not a hospitalist, but they are asking you to see too many patients in 8 hours, too little money, asking you to chart for free. I'd walk. Are you doing admits as well? If so then that's really going to suck.

[ventana]

20-25 to many

 

pay is too low - if you worked a weekend a month in the ER you would get 1000+ per month 12,000per year

so your 102 is really 90 with far to many patients

 

 

where is this offer?

 

 

it really comes down to figuring out an HOURLY rate

 

I have NEVER been happy with salary - I was always taken advantage of

 

9-5 is 10 hours, 50 hours per week

 

about 2500 hours per year

then the 12 weekends - another 200

 

2700 hours per year

 

102,000/2700 is UNDER $28/hour......  about the same as an experienced LPN

 

If you think you are only worth $28/hour we have to talk.....

[IDCtoPA]

Slight math error there.

9-5 is 8 hours so 40/week x 52 weeks

Also states that weekends are compensated by week days off so no extra hours for weekends.

So 2080 hours per year at 102K is $49.03/hour.

 

The 2015 salary report for puts 50th percentile at $52.40 / hr for Hospital Medicine.

So salary may be on target depending on region, experience etc..

 

Work load and charting at home are an entirely different story.

[anewconvert]

I doubt a new grad is going to see 20-25 hospital inpatients in an 8 hour day, and since it is salary your day is as long as it takes to see your patients, chart on them and handle any other work they are not telling you about.  Seems that 50 hour weeks are reasonable to assume here.  So that is more like 2500 hours a year (50 weeks a year of work because of holidays), so call it $40/hr.

 

I would be looking at keeping the pay and negotiating a lower patient load for the first year you are working and then bring the patient load up as your experience grows

[Houstonian]

Also, may depend on whether that 20-25 patients per day is:

 

1)  you personally rounding on all of them

 

2)  the PA-MD team responsible for rounding on all of them

 

3)  how many of these patients will be "new to you" (even if not new to hospital)

 

4)  how many new admissions/consults will be included. 

 

If you can see 3 patients per hour and work 8 hours per day, that adds up to 24 patients in an 8-hour shift.  But these are not going to be patients with minor problems.  Many will be very sick and complex (and old) with lots of test results and consultations to order and followup on.  Plus, some of the patients will be acutely deteriorating and require extra time, code situations, and transfers to critical care.  New admissions require lots of (electronic medical record) orders to be entered, including DVT prophylaxis orders and sliding-scale insulin orders;  also every invasive procedure ordered will require a signed informed consent form not to mention actually informing the patient about the benefits and risks of the proposed procedure. 

 

Also, there is going to be unproductive time.  Like waiting for an elevator.  Or having to put on gown, gloves, and mask in order to examine MRSA patients.  Or calling/waiting for a foreign language interpreter.  Going to the bathroom.  Looking for an available computer terminal to document your visit.  Waiting for a specialist physician to return a phone call about an urgently needed consult.  You get the picture. 

[NewGrad88]

Thanks all for the advice thus far. To answer some questions, it would be 20-25 patient load for myself alone. These patients will include both new and follow-up throughout the week.

 

Also, how can I negotiate a lower patient load without sounding as if I am trying to take short cuts and be perceived as "not motivated to work hard"?