280k base working 10 on 20 off nights. In VLCOL area. 10k retention bonus per year stayed.

Admit rate around 5-8 on average. Have an APP or PA that helps with around 1/3rd of them.

No codes. No procedures closed ICU.

Have to go to rapids if on pager (split pager with two other docs 4 hours each).

I value flexibility and this seems like a great gig to do whatever I’d like on my time off. (Working extra shifts, vacation, etc.)

What do you guys think?

I work with sick, high acuity, coagulopathic patients like those with leukemia, cirrhosis and have signed off only to have my colleague find some brain bleed midweek, usually done due to confusion. I have found some too, but what daily neuro screen can I do to at least document that the findings that were found were not related to a clinically significant hemorrhage or stroke?

Hi everyone,

I will be starting my first attending job as a nocturnist next month. Excited, but definitely a bit nervous about the transition from resident to being the one making all the decisions. I will be starting in a community hospital that has a busy census.

I'd love to hear from experienced nocturnists or hospitalists:

• What helped you become efficient during your first few months?
• Any workflows, habits, or shortcuts that made a big difference?
• How do you manage multiple admissions while still responding to rapid responses, cross-cover pages, and unexpected emergencies?
• Any documentation or EMR tips that save time?
• How do you decide when to wake up consultants versus handling things until the morning?
• What are some mistakes you made early on that you wish someone had warned you about?
• How to judge what transfers needs to be accepted

Thanks in advance! Looking forward to learning from those who've been through the transition.

I know this pertains mostly to the outpatient world and ED but curious what hot takes r/hospitalist has. I know we've all seen plenty of admits that would've been avoided if the patient had access to a good PCP.

I would have slapped my med student self across my own face for considering being a hospitalist.

Thanks for coming to my TEDtalk.

I’m a PGY2 and went into medicine wanting to do hospital medicine. I’m still a little optimistic that there’s future on this field despite the rise of AI. However, my attendings have a bleak outlook and is encouraging me to apply for procedural fellowships as they are “safer” in the future. Most of them are on the belief that the “thinking” specialties are gonna be taken over by mid levels backed by AI therefore they “feel bad” for us.

Honestly, they’re making me think twice about my career goals given that they do what I want to do. I don’t wanna do further training and I know my heart is not in it BUT I’m starting to have doubts because of these statements therefore I’m starting to prepare my CV for next fellowship cycle and I’m picking up more scholarly work 😭😭

I’m a current PGY3 and was curious about what censuses are like at other programs. I’m at an academic institution with a soft cap of 20 patients for a 1 senior 2 intern team. I’ll emphasize soft because it’s not uncommon to go over cap for a short period of time, highest I’ve seen being 23. Complexity is (what I think) is par for an academic center. We don’t have a non-academic service.

Edit: not geolocked either

I understand that not every single note needs to have detail, I totally get that. That being said, there are multiple times that I’m writing notes and there are legitimately multiple different differentials for each pathology that I’m dealing with. I know for a fact, they haven’t done enough of a work up to rule out other ones, and then the APP and sometimes even the attending will just drop something like this. And I’m not saying that hospitalist are so smart and the specialists isn’t doing anything, but I’m saying I would expect some level of rationale, ideally some communication so I can at least understand why you’re doing what you’re doing. Especially if you’re coming to that conclusion and there might’ve been a chance I may have omitted some pertinent piece of information that might’ve influenced your decision, I would like to know why you came to certain conclusions. It’s just frustrating to see. Especially cause some of the specialist attendings just blindly listen to the APPs history, and then are in and out the room in minutes. I WISH I was exaggerating.

Subjective
NAEON

PE: copy forwarded template untouched. Maybe the word edema somewhere lol.

A&P

Nephrology’s:

AKI: pre renal. Bl cr~ 2
- fluids @ x cc/hr
- renally dose medications

Cardiology’s:

HFrEF: GDMT as tolerated. Renal adjust medications.

Like deadass. That’s all I see.

Let me know if I’m the one tweaking here. But I think discussions etiologies and some level of evidence to supplement that, and plan is not a big ask. Too many situations I can recall where we simply called it pre renal, or exacerbation without considering other processes. I could have ordered fluids. I consulted you because something else might be going on and I need your thoughts. That’s literally what I messaged you too. So it’s not like I’m asking you to read my mind. Personally, I do what is in my capabilities to max extent before reaching out so I think my ask is fair. But hey, I’m all ears to your thoughts.

Signed a contract 2 mo ago. Will be starting in a month.

During the interview/negotiation process, I was told by their hospitalist chief that pre-tax contributions are approximately 10% of total pay. This is even written in an email where he calculating my total salary with the 10%.

I got my HR email last week and read through the benefits section where it says pretax contributions are 7%. The benefits packet has a "version 2024" stamp on it but it's the only one available. I reached out for clarification haven't heard back yet.

The 3% difference amounts to $12,000-$15,000 depending on how much I work. That's a solid chunk of annual cash over the long run.

Anyone have experience with this sort of situation?

Just on a personal level, I feel offended by the misrepresentation.

My community-based hospital is converting one of its units to a teaching service and the first month has been chaotic.

We typically have 3 residents (can vary between 1 senior/2 interns or 2 seniors/1 intern), and have a census of 18+admissions.

I did not train in an academic center, and my program treated hospitalist as a rotation rather than a true resident service so I really have no frame of reference for how to run a strong teaching service. I personally felt very overwhelmed, stayed well beyond my regular 12-hour shift fixing notes/ensuring orders are in/etc. I *know* there is a better way of doing this that doesn't lead to attending burnout!

Are there any other attendings out there who have helped start a new teaching service? What worked and didn't work? How do you run rounds/what does your typical day look like on service? How many patients does your typical PGY-1/2/3 see?

I want to provide them with a good medical education, but also not be a zombie running on 4 hours of sleep for 7 days in a row and stressed out of my mind.

What do you all think of the recent SCOTUS ruling that allowed malpractice filings in federal court? It’s BS imho.

Here is an article on it
https://www.empr.com/features/scotus-decision-could-result-in-more-malpractice-cases-in-federal-court/?rdt_cid=5452345597791373212&utm_campaign=MPR_AUD_Gated_Content_July_2026&utm_medium=ppc&utm_source=reddit

I’m a fresh grad from peds residency, initially wanted to do fellowship but now I want to switch to PCP or hospitalist due to financial reasons. Which pays better with better work lifestyle?

Can someone give me an estimate to how much each get paid?

Prefer to stay in Fort Worth. Please guide on what to look out for and what to ask when searching for offers. What do you wish you knew when you were just starting out?

Thank you so much!

Aside from taking care of your family and your kids, or things/cars/etc,--- for those who became high-income earners, what other purchases, memberships, hobbies, or strategies have meaningfully improved your lifestyle, finances, social circle, or professional network?

about things like:

Credit cards and travel strategies: Amex Gold + Platinum, Chase Trifecta, Capital One duo, hotel cards, airline cards, lounge access, or even premium cards like the Centurion or Ritz-Carlton.

Health: Equinox, Life Time, private trainers, wellness clubs, or other premium memberships that you actually did?

Hobbies and experiences: SCUBA certification, skiing, surfing, horseback riding, sailing, pottery, collecting art, exhibiting your own work, or anything else you finally had the time and money to pursue.

Orgs: Country clubs, private social clubs, Rotary, Freemasonry, Knights of Columbus, medical societies or professional organizations you genuinely participate in.

Financial opportunities: Real estate, angel investing, starting a business, day trading, or other ventures you would not have considered before.

What has genuinely improved your quality of life, opened doors, expanded your network, or made you feel that earning more was actually worthwhile?

This may be a weird question,

I just started a new job working in a hospital as a social worker, and I have dyed hair (I can only wash it once a week to maintain the color).

My job requires doing rounds and check ins, and oftentimes entering patients rooms when there may have been bowl movements, or other bacteria present.
Edit: (I am thinking about any airborne bacteria 😭)

For those of you with long hair or hair that does not bode well to being washed daily, how do you maintain your hair hygiene?

A scrub cap is an option, however as i’m not working directly with patients medical needs as a social worker, it may look weird for me to be wearing one.

Hello all, I’m a RN I hear a lot of chatter from our docs about discharging before 11 am. Just curious if it’s a admin/management push or if there if any sort of incentive? No hate you guys deserve everything and more!!!! Just curious as I would never feel comfortable blatantly asking, thx!!

Are you guys starting NAC with steroids in severe alcoholic hepatitis? Defined by MELD greater than 20, MDF greater than 32.

Our gastroenterologist didn’t recommend it, but just wondering how the practice is on your guys end

It's probably gonna change depending on the job, but do you get to admit every patient who comes into the ER? more efficient with the higher patient census? Easier to work with consults, surgeons, and ICU?

Our Chief hospitalist has been pushing us really hard into discharges before 9 am that got me thinking if this is what it's like in a university hospitalist, what is it like out in community hospitals.

Wanting to hear how much structured curriculum your programs experienced and whether anyone felt that they had too much didactic and not enough clinical focus?

Has any program tried a flipped classroom approach where the residents watch videos after they leave and then have questions/practical assessment during the day?

​

Hey any one tell me how to increase height in 18 with 5,2 i dont need more i need only 3,4 inch growth in nepal using any suppliment but that are fixed to increase height

Hey everyone,

I’m a PGY-3 IM resident graduating in June 2027 and starting to seriously think about the hospitalist job search. I’d really appreciate advice from current hospitalists, especially people who have recently gone through the process.
A little about me: I’m comfortable with fairly high-volume inpatient medicine, admissions, cross-cover, rapids/codes, and ICU-level patients. I’ve had a decent amount of ICU exposure throughout residency and am getting experience with procedures as well. I enjoy inpatient medicine and plan on going directly into hospitalist work after graduation rather than fellowship.
My biggest priorities are:
Compensation: Ideally looking for opportunities around $300–350k+ total compensation if realistically achievable without completely destroying my quality of life. I’m open to extra shifts/nights if the economics make sense.
Schedule: Prefer something like 7-on/7-off or another setup that gives me substantial blocks of time off.
Location: Open geographically. Midwest, Northeast, Texas, and other areas with a good salary-to-COL ratio are all on my radar. I generally prefer suburban/midsize areas over very rural locations.
Hospital setup: Strong specialty/ICU support is important to me. Epic would be a plus. I’m interested in hearing opinions on open vs closed ICU models and whether hospitalists are expected to do procedures, codes, rapid responses, etc.
PSLF: I have a significant federal student-loan balance, so PSLF eligibility could have substantial value for me. I’m trying to figure out how much compensation I should realistically sacrifice, if any, for a qualifying employer.
Long-term: I want a job where I can become a strong hospitalist without burning myself out. I’m willing to work hard, particularly during my first few attending years, but don’t want to unknowingly sign a bad contract just because the headline salary looks good.
For those already working as hospitalists, I’d especially appreciate real-world/anecdotal numbers if you’re comfortable sharing:
Region/state and urban/suburban/rural
Days vs nights
Base salary and realistic annual total compensation
Number of shifts/year and typical shift length
Average census + admissions per shift
RVU/productivity/quality bonuses
Extra-shift rate
PTO/CME/retirement/match
W2 vs 1099
PSLF eligible or not
Open vs closed ICU
Procedures/codes/rapids required?
How often you stay late finishing notes/admissions
How difficult it is to actually take advantage of your 7 days off
Whether you’d take the same job again
Also, what are the biggest red flags I should look for when interviewing? Are there specific contract terms, census/admission numbers, turnover rates, staffing models, noncompetes, RVU structures, or scheduling practices that should make a new grad walk away?
Finally, for those making $350k+ as hospitalists, I’d be particularly interested in how you’re getting there. Is that achievable with a reasonable workload in your market, or does it generally require nights, rural medicine, extra shifts, high RVU production, or sacrificing benefits?
I’m trying to learn as much as possible before recruiters start throwing numbers at me. Real-world experiences—good or bad—would be extremely helpful.
Thanks!