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Not All Doctors Have Offices: Hospitalists

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This article provides an overview of a career as a hospitalist. It discusses the primary duties of a hospitalist, where such a professional is employed, the required training to earn a position as a hospitalist, and the average annual salary. It also details the various specialties hospitalists may pursue and discusses the outlook for the profession in the next decade.

Not all doctors have their own practice or work in an office. There is a large group of doctors that you will only find working in the hospital. Doctors, nurse practitioners and physician assistants that solely work and practice in a hospital are called hospitalists. There are currently about 12,000 practicing hospitalists in the United States right now. This number is expected to double in the next 10 years. If you are considering going into medicine and prefer to not go into a practice, take a closer look at becoming a hospitalists.

What is a Hospitalist?



Physicians that primarily practice in a hospital setting are called hospitalists. This means that they do not have an office where they see patients on a regular basis. Typically, a hospitalist is trained in internal medicine and they are employed by a hospital. It is important to understand that a hospitalist is schooled differently then a family practice doctor. Hospital medicine is a specialty, much like cardiology or oncology. Hospitalists are taught in a hospital setting this is called the site of care. The difference between a specialist in the E.R. or critical care unit is that the hospitalists will follow the patient the entire time they are in the hospital. This helps improve continuity of care.

Primary Duties

Typically, a hospitalist's will work a shift-based schedule. This is called a block schedule, which has become the preference of hospitalists. Their shift will last anywhere from 10 to 12 hours a day. Block scheduling means that the hospitalists will work 5, 7 or 10 days in a row working 10 or 12 hours each day, then they will have 5 or 7 days off.

Where can a Hospitalist work?

Like the name implies, they work in the hospital and only in the hospital. With the number of hospitals in the United States, a hospitalist has their pick of jobs. Anywhere that a patient can be admitted overnight is where a hospitalist can work. The smaller the hospital, the less likely they will hire a hospitalists, so mid to large size hospitals are the best employers.

Educational and Training Requirements

A doctor is a doctor is a doctor. What does this mean? It means that a hospitalist has to follow the same guidelines as any other doctor, which means a bachelor's degree and four years of medical school. Each and every hospitalist must have received their degree from an accredited medical school. It doesn't stop there. In order to be considered a hospitalist, you must also go through and successfully complete years of training, including a one year internship and three years of residency. You must also complete all three steps of the USMLE as well as your state's licensing exams.

This isn't to say that hospitalists are not trained in specific areas of medicine as well. A small percentage of hospitalists take their education further and specialize in an specific area of internal medicine such as critical care or pulmonary medicine. There is also a small percentage that focus on family medicine; typically 8% of hospitalists are pediatricians. Many also work as academic hospitalists.

Salary

Typically pay depends on where you live and what hospital you are going to work at. The range of annual hospitalist salary goes from $175,000 to about $260,000, which, if you think about it, is a killer of a salary for only working an average of 20 weeks a year. If you calculate that out that gives you almost $9000 per week of work. Hospitalists generally make about 15% more than primary care physicians.

You may also find it interesting to know that there is more then one way for a hospitalist to get paid. The vast majority of physicians are paid under just about every possible financial arrangement that can be made, which means that some are paid with salary and productivity incentives. There is a very small group of hospitalists that are paid only by productivity.

Career Outlook for the Hospitalists

Hospitalists are generally very happy with their positions and they feel that their jobs are rewarding. As a matter of fact, for the 12,000 hospitalists that are currently working, the expectations are to see that number double in the next decade. They also have the options of taking on more responsibilities and getting promoted to director of their hospital group.

Directors and group managers are responsible for coordinating the schedules of the group to make sure that there is always adequate coverage at the hospital. Directors are also responsible for addressing and taking care of any professional issues and quality issues that have to deal with the group.

Hospitalists that take on those additional responsibilities receive an extra $15,000 to $25,000 in their salary. The amount will actually depend on location and the size of the institution being managed.

Conclusion

In the world of physicians, there are a number of specialties: usually a doctor trained in a specialty means that they focus on one disease process such as cardiology or oncology. Hospitalists are specialists as well, but instead of being trained on a certain disease, they are trained in a particular site of care: the hospital. Hospitalists only work in hospitals where patients are admitted for overnight care. They help improve continuity of care and generally make more than the average primary care physician. Hospitalists are not just doctors; they are also nurse practitioners and physician assistants.

The medical field is a solid, safe, and secure field to go into. Regardless of the economic status in the United States, there will always be a need for doctors because there will always be patients with health issues that need to be treated.
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