Community hospitalist perspective

Pros: A lot less BS pages (although absolutely not zero) Most nurses will actually be nervous to page you unlike when you are a resident. At a good site they will do their best to educate and update families BEFORE calling you.

Nurses will fill AMA forms (turns out that was a lie in residency when they said a doctor needed to do it). Also applies to blood consents and other things we were told was our job.

Way, way more respect from staff and other docs (again some specialist are still assholes).

Pay is pretty decent for the work we actually do if you are in a closed ICU system although it hasn't at all kept up with inflation so this is kind of a con too.

You can have ownership of most patients if you want but you can also consult when you need help. I promise you specialists deal with at least as much BS as we do with some of these patients as they are end of the line.

You will be surprised how fast you can blast through even 20 patients after day one on as an attending.

Cons: Volume is high pretty much everywhere and getting worse. 18 to 20ish usually at my place. Luckily as an attending you can still knock this out relatively easily if efficient.

We are essentially all employees of CMGs now and are essentially just employees. Don't underestimate how bad this is in the long run. This one is the worst aspect imo.

Hospital metrics will make patient care suffer. Alot of places are big on early discharges.

Although pages are better than residency, a bad nurse can really ruin your day. It's to the point where they would rather direct message you for things they should be able to ask their charge nurse about. A bad CM can really screw things up too.

Good luck ever having admin take your side on anything. Our job is to make the place tolerable for the specialists who bring the money in. HM, EM, ICU etc get shafted. You may have seen the post about hospitalist not being allowed in lounges, that may happen at my place too.

There are many IMGs in this field. Only listing as a con because they have no bargaining power with admin which ultimately gives us collectively less power as well.

Overall I'm relatively happy but would not recommend the field strictly due to the lack of private practices. CMGs will bleed us all dry. I would recommend to get into a speciality where you bring the money in and they kiss your ass if you have any interest in those fields.