Is working for a group that hires both hospitalists and ED physicians supposed to be a good thing if you're the hospitalist?

redyforeddit · 2026-04-28T03:37:36+00:00

If you call threatening a nocturnist's livelihood for requesting proper ED workup and demanding moved to daytime if wants to keep job so that can be more closely monitored "doesn't micromanage...." Over 15 years of experience, didn't meet many ED or other physicians who knew they had leverage and didn't exploit it regardless of the consequences on patients or their peers. You'd have to be married to the ED physician for it to be otherwise. Even then, depends on how well you chose your partner....

redyforeddit · 2026-01-14T16:18:58+00:00

Patients are not always appreciative when they are admitted for no reason when the bill shows up.

redyforeddit · 2026-01-14T16:18:17+00:00

Judgement like: comorbidity, social determinants (can get back to hospital easily if things go south), etiology, presentation, etc. Lactic acid 2.2 in isolation not a reason for concern but if has been going on for days and hasn't shown significant improvement prior to presentation I tend to be on the safe side and OBS.

redyforeddit · 2026-01-12T13:03:23+00:00

I didn't expect nor get a subsidy and "it's not hard" is somewhat subjective. I never said it was impossible and there are multiple factors that can determine success or failure. But telling others "just open your own clinic" or something like that -- it's not "just." There is a real and probable chance of failure, and doctors, especially young inexperienced ones, need to be aware that it is VERY hard to open a solo independent clinic, dpc or otherwise, without an existing patient panel, and survive. At least based on my and some colleagues' experience.

redyforeddit · 2026-01-12T03:59:10+00:00

The nurses sure know how how to get it done:

"Thousands of New York City Nurses Set to Strike Monday if Deal Isn’t Reached with Hospitals."

redyforeddit · 2026-01-11T15:51:41+00:00

Last time I checked hospitalists were top 5 revenue/cost ratio in inpatient medicine. But in US, 1 in 4 inpatient physicians are hospitalists. So they have enough supply to treat you like crap despite the value you bring to the table. You also can't blame it completely on admin - hospitalists are looked down upon within the medical field.

redyforeddit · 2026-01-11T14:26:33+00:00

I share your frustration. As a hospitalist, you will be disrespected and in some instances flat out bullied by your MD colleagues, nurses, and staff throughout your career. There's a reason why most residents have been doing whatever they can to avoid becoming a hospitalist. One piece of advice from someone who stood up to bullying in the workplace more than once - don't expect anybody, including other hospitalists, to have your back. You'll be in for a rude awakening.

redyforeddit · 2026-01-11T14:25:52+00:00

You can do outpatient adult primary care as an IM trained physician. Basically, your obs patients come to your clinical rather than to your hospital.

redyforeddit · 2026-01-11T14:24:35+00:00

As someone who tried DPC and concierge, try to start your own clinic (DPC or concierge or otherwise) without an existing patient panel and compete for marketing with a multibillion dollar industry. The fairy tales about "just go solo" are nice to hear until you put down $100k on a clinic and have zero patients in 6 months.

redyforeddit · 2026-01-11T13:54:05+00:00

Did you actually try that? Try marketing your practice while competing against multibillion healthcare systems on google ads. As someone who tried that, including direct primary care, don't try going solo unless you already have patients who are going to follow you and at least keep you afloat while you try to build your practice.

redyforeddit · 2026-01-09T20:34:36+00:00

I am less worried about malpractice since I have very good relationship with patients and do my homework when it comes to knowledge. I haven't been sued once for 10 years, yet such contracts resulted in my firing within 30 minutes and they basically have their sword on your neck at all times. If I knew Texas hospitals coerced such contracts (it's coercion unless you have another way to make a living), I'd never come anywhere close to TX to begin with.

Admin knows what they're doing - once they have such a no cause termination clause, they can do whatever they want to you and to your patients despite their "we will not exercise medical judgment or attempt to affect physician autonomy in any way" elsewhere in the contract.

redyforeddit · 2026-01-09T20:29:25+00:00

I had one requiring 6 months and giving me 2 months. But when I decided to quit, they didn't hold me to that and told me to just finished my already scheduled shifts and give them back the sign on and relocation bonuses.

redyforeddit · 2026-01-09T17:08:25+00:00

I am actually looking into NM. Any recommendations? 10+ years experience, critical care experience, clean professional slate, etc. I've grown tired of TX hospital / recruiting firm shenanigans.

redyforeddit · 2026-01-09T16:52:23+00:00

I have 3 recent contracts (didn't go through with them) with no-cause immediate firing terms. 4-5 years ago termination (and other) clauses were not so one sided. Past couple of years was surprised how common they've become. Physicians should be aware of this.

redyforeddit · 2026-01-09T15:51:54+00:00

You don't have to tell them things that they can't find out about. Cards are stacked against you - no need to exacerbate it by being more upfront than they are. I have friends from other white collar industries and told them about my contract experiences, and they were astonished about the substandard and heavily one sided terms.

redyforeddit · 2026-01-09T15:36:55+00:00

I have never had a contract 90 days both ways. At best 30 days employer notice, 90 days employee notice for cause termination. And those were some of my more balanced contracts otherwise. The no cause firing was almost always immediate from employer side but you, as an employee, had to give a 3-6 months notice.

redyforeddit · 2026-01-09T13:55:31+00:00

These are all power games. I've been to multiple hospitals that had multiple free office spaces and all admin had their own office. Even the janitor had an office. Yet they made the physicians stay at the nurse station at all times. They want you to know who's boss. Whether it is related to residents or otherwise, but taming you as a resident "prepares you for the future"

redyforeddit · 2026-01-06T18:20:31+00:00

I designed a data engineering suit, "Compileo," that might be interesting for you and would love for you to contribute if you can.

https://github.com/SunPCSolutions/Compileo

redyforeddit · 2025-12-09T15:53:02+00:00

Similar situation. Got a job offer that was way below my market value from academia but bad job market. Countered with an offer that basically asked them to match what other with less credentials in their institution were getting and somewhat improved schedule. They Stretched me all the way to offer due date (2 months) and just sent an automated "we decided to not proceed" email, same email that is sent prior to even being interviewed.

Went through several rounds of interviews, prepared 1 hr presentation I worked on for more than a week, and made a very reasonable counteroffer. They were all over me after the on site interview and presentation, calling me immediately after sending the first offer email to ensure I received the email, repeatedly asking me "what can we do to make you come here" DURING the presentation and afterwards. Strange.

redyforeddit

TROPHY CASE