Hospitalist offer advice

[aquafresh11]

I am needing some insight from others please on this offer. I am currently overly ready to change fields from primary care where I have been for 8+ years to hospitalist. Changing fields has proven to be ridiculously challenging and I wonder if I should just take anything to get a few years of experience which will lead to more opportunities down the road, or if I am just discouraged and ready to be done with job hunting. 

Offer is in central IL, 400+ bed academic medical center. Rather reasonable cost of living. It is doing only OBS patients, 8 patients assigned each day plus 3 admissions. 12 hour shifts, 8a-8p, 36 hours a week. There are no procedures and little autonomy. You have to present to an attending for every patient. 

Salary is 126,000 a year, 5% bonus at end of the year if health system meets all their goals. 14 days PTO + 3 days CME with 2,500 in CME funds. Malpractice with tail, typical health, vision, dental, short term disability, 403B with 5% match and 1 week paid parental leave. 5,000 sign on bonus and 10,000 relocation. 

I am currently in administration and full time patient care in family medicine in WA with complete and total autonomy. I am very well compensated and know I have painted myself in a corner in regards to salary as I will take a sizeable pay cut with any job. This job will be close to 40 grand less than my current salary. My current job is 4, 8's on paper, but in reality with admin time and work at the end of the day I am probably low 40 hours per week.

I am mostly worried I will be bitter about having to present every patient and bored dealing with low acuity obs patients where the goal is churn and burn and get them discharged as quick as possible.  Am I off base?

Edited January 15, 2022 by aquafresh11

[ohiovolffemtp]

If your key concerns are the need to present every patient and seeing only low acuity patients, talk to the PA's and NP's that currently work there and see if there is a progression in their autonomy based on the working relationships with the docs.  There is the policy and there is the actual practice.  I had a relationship with my primary supervising doc at my prior FT job where my "presentations" was the answer to "Do I need to see any of your patients?"

[EMEDPA]

10 minutes ago, ohiovolffemtp said:

If your key concerns are the need to present every patient and seeing only low acuity patients, talk to the PA's and NP's that currently work there and see if there is a progression in their autonomy based on the working relationships with the docs.  There is the policy and there is the actual practice.  I had a relationship with my primary supervising doc at my prior FT job where my "presentations" was the answer to "Do I need to see any of your patients?"

Yup. As a statewide requirement at one of double coverage jobs a doc must be "involved" in the care of every trauma alert patient. Same deal:

Me: Hey, I am transferring the guy from that rollover by lifeflight. He has b/l femur fxs"

Doc: Sounds appropriate. Nice job

Me documenting: " Dr Jones is aware of this patient and agrees with the assessment and plan" 

[aquafresh11]

7 hours ago, ohiovolffemtp said:

If your key concerns are the need to present every patient and seeing only low acuity patients, talk to the PA's and NP's that currently work there and see if there is a progression in their autonomy based on the working relationships with the docs.  There is the policy and there is the actual practice.  I had a relationship with my primary supervising doc at my prior FT job where my "presentations" was the answer to "Do I need to see any of your patients?"

I got to shadow a PA and watch them do an admission and a formal presentation. After the PA has examined them, wrote the orders and the admission note, the attending physician goes back and examines them all over, and then has them change any orders they don't agree with. They admit it is a silly system and slows them down more than anything, but you just learn to deal with it and bite your tongue sometimes. 

[greenmood]

If you just want hospitalist work and don't care where you go, come to Minnesota. I have great autonomy where I work. Message me, we're hiring.