A hospitalist is a physician who works primarily in the hospital serving acutely ill patients.  The term was first coined in 1996 by a couple of doctors writing in the New England Journal of Medicine.  Since then, the movement has persistently grown to encompass the majority of hospitals in the United States.  Over 34,000 hospitalists are estimated to be working in the US as of 2012.

Back in the old days, a primary care physician did double duty : they saw patients in the office as well as in the hospital.  Whenever one of their 2,500 patients (the average patient panel size in the US) was very sick, the patient would be admitted to the hospital and the primary doctor would be overseeing the care there as well.  But, duty hour limitations, work/life balance, and even consideration of revenue has led most primary care doctors to leave hospital medicine behind.  And thus, it opened the door for this new kind of medicine to blossom.

What are the benefits of hospital medicine?  More money, better schedules, more immediate results and better support (via consults and labs/imaging all there at the hospital).  By better schedules, I simply mean there are more options for scheduling and balancing life with work.  Some hospitalists work 7 days on followed by 7 days off.   Some work a block of time at a time.  Others might do shift work and others might be traditional with call duties.

Salary.com

Just how much do hospitalists make?

The median expected salary is $200,579 according to Salary.com.  However, the MGMA reports the median as $233,855.  Another body called Today’s Hospitalist conducted their own limited survey and found that the salary ranges very widely with some hospitalists making over $300,000 in annual income.

There are two main kinds of hospitalists : adult medicine and pediatric medicine.  However, specialists are catching on to the idea as well and making a shift segregating their office from their hospital duties.

The majority of adult hospitalists have internal medicine residency training.  The majority of pediatric hospitalists have pediatric residency training.  Those are 3 years each.  Fellowships are not required but are available should you want one.

Now, family medicine can become hospitalists too but they are not as well qualified from the eyes of a hospitalist human resources recruitment perspective.  Why?  It has to do with the amount of in-hospital training one receives while in residency.  Without a doubt, internal medicine residents do more hospital work than office work.  Also, family medicine residency appropriately divides your time in pediatrics and obgyn further decreasing the potential for adult in-patient hospital medicine training.  With that said, you could always tailor your 2nd and 3rd yr electives to get more training in in-patient medicine.

To increase your chances of getting a hospitalist job as a family medicine physician, consider getting more experience in hospital medicine by choosing residencies which offer a hospitalist track or do a fellowship in hospital medicine for an extra year or two.

Hospital medicine is here to stay and it is growing more popular by the year.  The lure of higher salary and potentially better work schedules draws many physicians to consider this kind of position.  If you enjoy working in a hospital, the immediacy of getting a lab or image result to direct care, the challenge of very, very sick patients, then you might enjoy being a hospitalist.

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Hospitalists are said to have one of the best lifestyle jobs.  Mainly because these kinds of physicians do shift-work and don’t take call.  At my residency program, the hospitalists there would work 7 days in a row, and then be off for 7 days.  So essentially, they only worked half the year!

What is a hospitalist?  A hospitalist is a physician who cares for patients once they are admitted into a hospital.  It’s a growing trend for hospitals to have a hospitalist team and many primary care physicians are benefitting because they no longer have to admit their own patients.  It’s a win-win.

A hospitalist salary is on par with other primary care physician salaries.  But what you have to keep in mind is that the benefits are much better.  No call plus half of the year off.  That is awesome!

salary.com

The median salary for hospitalists is $178,632 with the majority making $163,358 to $200,715.  In one survey, the average salary is $215,000.  However, this number is for adult medicine.  Pediatric hospitalists report an average of $160,000 per year.

You can become an adult medicine hospitalist by doing a residency in one of two fields :

• internal medicine or
• family medicine

Both specialties require a 3 year residency.  The current market favors internal medicine for hospitalists because their training spends more time in the hospital.  For example, all internal medicine residencies have dedicated time to ICU training whereas only some family medicine residencies do.  Other family medicine residencies train in the ICU on an “as they come” circumstance.

With that said, there are 8 fellowships available to family medicine doctors where you can specialize in hospitalist medicine.  This will make you a more competitive job applicant.  Internal medicine doctors also have hospitalist fellowships for those who want more training before working as a hospitalist.

If you want to know what it’s like to be a hospitalist, I found this book on amazon that received good reviews : The Devil Who Walked The Earth: My Life as a Hospitalist

Hospitalists earn a good living while having great benefits.  It’s a job that really keeps your clinical skills up-to-date and on your toes.  Literally, because people’s lives depend on it.  If you like the intensity of hospital medicine and prefer not bringing work at home, you might like being a hospitalist.

Sources
Salary.com, Physician – Hospitalist Physician Salary
Allied Physicians – Physician Salary Survey
Society of Hospital Medicine – MGMA/SHM Survey Report…

Image Credit
Crossgates River Oaks Hospital, Hospitalist Program

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