u/Honest_Owl_4217

I joined a job post residency about 4 years back. During that time in the job market the usual census was around 16-18 and more than 20 seemed kind of rare and undoable. Due to various concerns like increasing census and administrative burden I am exploring for the job opportunities and now it seems like census around 20 is a norm. Even in places with census around 16-17 there seems something tied to it like nights, supervising APPs. And many places have APPs tied to physicians these days. They advertise as no admissions and in reality there is some APP admitting patient under your lisence. Some places boast on round and go but they have census of 25-28 and how it is possible to round and go when you have more than 25 patients. On top of that corporate medicine has been increasing a lot of burden on health care workers and physicians with different metrics before 9, LOS, press ganey and so on. While talking with seasoned Hospitalist it looks like patients are getting more and more demanding. Might be there are some unicorn jobs but not sure what will it looks like further few years down the road. There are few good weeks but after finishing most of the weeks, it feels like coming out of war.

Have been in one hospital in north east for almost 3.5 years post residency. Place was great when I came in immediately post residency. Good hospitalist retention as well. Gradually the acuity, census and administrative burden has been increasing. More so in last 1 year. We see 20-21 patients with NP/PA support. NPs help with 10 patients but with most the help is usually with notes only. One admission almost always around 3-4 PM. There are 2 meeting with case manager and nursing one in morning 9 and another at around 2. Morning one last for half an hour and afternoon one lasts for 30-45 mins. We have to go through every patient rooms in afternoon meeting. There is atleast 1 another hour long meeting every week. With all meetings and patient census and one admission have been returning home late around 6-7 everyday these days. Some of the old hospitalist left and few are leaving. I was looking for places with census of 14-17, closed ICU and less meetings. Even ready for pay cut if needed. Was wondering are these kinds of job still available or the hospitalist market and job is same in majority of places these days?