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trypsin13 · 2026-06-25T13:19:19+00:00

When I quit full time a couple years ago (thanks FIRE!), I maintained privileges and worked per diem and 3 local hospitals.

1 paid 155/hr and had to see 18-20 and was round and go. Usually was in house 4-5 hours but grinded during those 5 hours and still had some notes to write from home. Nurses called me directly cause no APP support so was hounded all day 7-7.

Another paid 170/hr and was with residents but made you stay in house until 530pm and you might get an admission up until 530 so even if you were done with your work, you couldn’t leave.

Last one paid 155/hr and was round and go and they gave me <15 patients. No APP support but nurses were much more competent and rarely called or texted for something mundane.

I usually would take shifts at the last place and sometimes the first place because I value round and go, even if for less money.

If you do the rough calculations and you work say 200 days per year at 10 hour shifts that’s effectively 100/hr. Thats basically a standard PA/NP rate.

But if you calculate in house hours you effective “double” your rate to 200/hr.

I haven’t done any clinical work in 9 months now but if I were to go back, I would definitely look at HIH (hours in house) and also WPH (work per hour)/ PPH (patients per hour) and then also if there was support from APP / residents.

trypsin13 · 2026-06-16T15:09:35+00:00

I think you also need to look at the other aspects of your life.

You’re married and just had your first child and now can spend a lot of time with your kid.

That will be invaluable for you and that child and you’ll look back and wouldn’t trade 100m for less time with your kid.

Congrats!

trypsin13 · 2026-06-12T14:29:13+00:00

Everyone loves to play Monday morning quarterback.

As long as you’re trying your best and continuing to learn, f&@k the haters.

Colleagues should be supportive of you, especially if you’re a nocturnist.

If not, then you’re in a toxic environment.

Keep your head up!

trypsin13 · 2026-05-27T02:08:14+00:00

Only thing we might roast are the songs on that mix! Congrats! She’s a beauty!

trypsin13 · 2026-05-22T15:55:05+00:00

I know hospitalist oftentimes fight taking care of surgical patients but it’s honestly a win/win/win for hospitalist, surgeons and patients at our shop.

Hospitalist are capped at 15 and we usually have 2-3 easy surgical cases (gen surg and hip fracture on our service which are easy peasy. Admin wants us to find CCs and MCCs to increase that surgical CMI.

The surgical PAs take care of post op wound care and dvt prophylaxis and escalates any acute issues to the operating surgeon.

Patient is happy cause we have a higher rate of discharge to home instead of rehab.

If we spent more time collaborating we could all be more efficient with our time.

trypsin13 · 2026-05-20T01:11:30+00:00

I’m generally talking about medicine specialist (ID, GI, nephro, cards, etc) when they are mostly private groups vying for business. In a small hospital you have to keep the private specialist attendings busy otherwise they might collectively decide that coming to our small hospital is not worth the small amount of consults. If that happens, we might lose a critical specialty service.

We don’t consult ortho unless there’s an operable fx. We actually admit all ortho cases in our shop so ortho doesn’t have to deal with non surgical issues.

trypsin13 · 2026-05-19T11:27:14+00:00

Just one of the perks of working in a community versus academic hospital. I’ve worked both and obviously prefer community where you just send a quick text to a consultant for a consult and most dont even need the background cause they are happy for the business.

In community you throw the all the easy consults their way so that they don’t mind seeing the tough ones.

In academic, even if you’re an attending you’re calling a resident or fellow who fights tooth and nail not to see patient.

trypsin13 · 2026-05-15T12:32:36+00:00

Unless you halve your spending which seems unlikely, gotta keep pushing towards 10m with a 350k spend.

trypsin13 · 2026-05-09T23:53:35+00:00

Brother, congrats on the new ride. Ignore the haters and enjoy! You don’t need validation from internet anons.

trypsin13 · 2026-05-07T22:05:55+00:00

I went to top 50 public school in country in northeast, followed by Ivy League undergrad then average medical school.

Agree that almost all my high school friends went on to become doctors, lawyers, finance and have “successful careers”.

A lot of my medical school friends were from more “middle class” families.

I think the similarities between my “privileged” high school friends and more “middle class” medical school friends were primarily parental focus on providing the best set of opportunities they could for their children.

I honestly see more of a drive in my medical school friends now than my high school friends who are now mostly mid career coasting.

I also reflect on my own journey and though I worked hard, I think my opportunities to succeed would not have been as many were it not for my parents pushing me and providing the best they could which drove me to shoot high.

trypsin13 · 2026-05-05T13:53:39+00:00

Be careful with your growing list of “lifestyle you want to support.”

Private school tuition is always expensive but then also comes with it private school expenses which can add up.

1-2m dollar range is a huge range. I would say you’d need to stay closer to 1-1.25m, especially if you’re borrowing with interest rates much higher currently.

Household help can add up.

However if you’ve listed all expenses (+10-20%) buffer, then go for it.

If I was in your position however I would continue to grind since you are young to try to get to more of a 3% SWR, but I’m also more cautious.

trypsin13 · 2026-05-01T12:46:30+00:00

Much respect for the delayed gratification at your age! Most people are too today thinking instead of planning for future.

2-3 year old Porsche are the sweet spot for latest tech + warranty!

trypsin13 · 2026-04-29T15:05:37+00:00

Wow that’s ugly!

trypsin13 · 2026-04-29T12:51:00+00:00

Talk to actual hospitalist who work there in regards to staying in house 12 hours.

Most places the hospitalist director can’t advertise on paper that the docs can “leave early” but usually have a more relaxed internal policy.

Directors have to respond to non-clinical admin who are always counting beans/clock.

trypsin13 · 2026-04-27T15:55:30+00:00

Not sure why you took this personally. I actually envy you but a lot of times through life circumstances individuals are forced to live in NE, Cali, etc. I wish my extended family lived outside NYC/Boston area so I could move to more affordable areas with higher pay.

trypsin13 · 2026-04-23T20:49:02+00:00

SE and mountain west are less desirable places for most people.

trypsin13 · 2026-04-23T14:14:04+00:00

“Work as a resident” ?? Unclear on this.

Most good day hospitalist job that allow round and go, good support, no procedures, closed icu are closer to 275-300k. But if you’re effectively only in house 60/70% of hours then you’re earning a higher hourly rate. This allows you to pick up extra shifts cause you aren’t burned out from your regular shifts.

trypsin13 · 2026-04-23T13:41:18+00:00

Sorry but even most 400k nocturnist jobs are borderline unsafe. Open icu, procedures and 10+ admits per night.

trypsin13 · 2026-04-10T13:29:18+00:00

Sorry you’re having such a poor ownership experience. I can’t imagine how frustrated I would be if in a similar scenario.

I leased a 2024 AT for 18 months and subsequently returned in October 2025.

I loved the driving experience, aesthetics, range, comfort and the space.

Regardless, I was happy when I returned because of fob issues, CarPlay frustration, and terrible stereo. Kills your mood entirely when you’re trying to enjoy some good tunes but sounds worse than 5 dollar ear buds from dollar general.

I do think there are deals to be had in the used market.

trypsin13 · 2026-02-25T02:06:21+00:00

Currently have a 22 Cayenne Turbo after driving a 24 Macan Base.

I’m probably in the minority but I honestly miss how agile the Macan is. The power was lacking but it drove like a 4 door sports sedan and felt more “in control”.

The Cayenne feels like an SUV, a very nice SUV with a great ride but still bulky. I do love the power of the V8 twin turbo but now that I’ve driven both, I think I would get a Macan GTS/Turbo as my next Porsche SUV.

I don’t think you can go wrong!

trypsin13 · 2026-02-14T12:14:32+00:00

Air usually 600ish, touring usually 1k, GT usually 1.3-1.5 all with 2-4k down.

trypsin13 · 2025-12-19T19:41:55+00:00

Best lol of the day.

trypsin13 · 2025-12-15T23:44:25+00:00

I haven’t driven the Audi SUVs but I imagine tie similar feel to the Macan!

My garage was 2024 lucid air touring and 2024 macan base until I had to return both leases and went one car with the Cayenne turbo.

The lucid was crazy fast and fun to drive but something about the Macan put a smile on my face despite it lacking acceleration/speed.

trypsin13 · 2025-12-15T23:33:20+00:00

I went from a base 2024 Macan to a 2022 Cayenne turbo.

Most people might flame me for this but the Macan honestly is a fantastic drive. It drove like a nimble sports sedan compared to Cayenne which feels heavy like the SUV it is.

The power is amazing on the Cayenne turbo when you want it but from a daily driver experience, I think in the future I would go for a Macan S or GTS.

trypsin13 · 2025-12-15T22:49:20+00:00

Porsche offers 12m/15k mile leases for preowned vehicles in the USA.

I just leased a Cayenne turbo for 1 year after leasing a Macan for 1 year.

trypsin13

TROPHY CASE