u/Intelligent-Zone-552

Our training is long, arduous, and expensive for a reason. We give up years of earning potential, miss milestones, work nights, weekends, and holidays, and take on enormous responsibility to develop the judgment that patients depend on.
You deserve to be compensated in a way that reflects that sacrifice and allows you to have a good life.

If it were up to admin, they’d reduce us to productivity metrics and pretend we’re interchangeable, as if the decade or more spent becoming a physician doesn’t matter.
Don’t buy into that mindset. Your expertise is what you’re being paid for. Volume is simply the easiest thing for admin to measure.

Our training is long, arduous, and expensive for a reason. We give up years of earning potential, miss milestones, work nights, weekends, and holidays, and take on enormous responsibility to develop the judgment that patients depend on.

You deserve to be compensated in a way that reflects that sacrifice and allows you to have a good life. It’s recognizing the value of what it took to get here.

If it were up to admin, they’d reduce us to productivity metrics and pretend we’re interchangeable, as if the decade or more spent becoming a physician doesn’t matter.
Don’t buy into that mindset. Your expertise is what you’re being paid for. Volume is simply the easiest thing for administration to measure.

Sincerely,
PGY8 Hospitalist

Our training is long, arduous, and expensive for a reason. We give up years of earning potential, miss milestones, work nights, weekends, and holidays, and take on enormous responsibility to develop the judgment that patients depend on.
You deserve to be compensated in a way that reflects that sacrifice and allows you to have a good life.

If it were up to admin, they’d reduce us to productivity metrics and pretend we’re interchangeable, as if the decade or more spent becoming a physician doesn’t matter.

Don’t buy into that mindset. Your expertise is what you’re being paid for. Volume is simply the easiest thing for admin to measure.

Sincerely,
PGY8 Hospitalist

Reminder to future attendings: Academic medicine drags down the averages

one of the biggest reasons published compensation averages often look lower.
I know most of you already know this but this is just a reminder.

Most major compensation surveys are a mix of academic physicians, employed hospital physicians, multispecialty groups, integrated delivery systems, some private practices.

If you aren’t spending too much time on research or administrative roles, your pay should reflect more than the average quoted in the surveys.

Also a lot of surveys are done in a way to benefit the employer instead of the employee.

A lot of times new grads are conned into signing a shitty job because they can finally see a big number.
Please know your worth!

Currently recruited new grads and could see that they don’t know jack about compensation. Fortunately our pay is pretty standard so they didn’t get fleeced.

PGY-8 hospitalist

been wondering whether there’s a long-term unintended consequence of the push for higher patient volumes.

it seems with so much volumes it’s harder to spend the time needed to manage complex issues. Naturally, the path of least resistance often becomes consulting.

Obviously many referrals are appropriate, and medicine has become much more specialized over time.

Personally think fix probably starts with changing incentives. As long as internists are rewarded primarily for volume, there will always be pressure to move quickly and refer more often.

Smaller panel sizes and reimbursement that better reflects patient complexity could give us the time and financial support to manage more conditions.

It’s difficult to expect physicians to provide comprehensive longitudinal care when the system rewards throughput more than actual management.

EDIT: guys it’s obvious we don’t ask for a higher census. That’s a given :)

I genuinely cannot fathom that many patients.

Someone mentioned daily MDRs and bs meetings.

My census is 13-16, occasionally can go to 18 but it’s maybe a couple times a month.

I’ve been doing it for 8 years.

Idk how you do it and do it well. The only reason I’ve done it this long and don’t hate my life is because at the end of the day I have the feeling of satisfaction because the census isn’t terrible.

I spend time with each patient. The nurses know me and know when to triage secure chat or page without all the BS “patient had a q” “family had this q”
Etc etc.

I guess I’m lucky.

bedside RNs need better pay, safer ratios, and improved work life balance.

Pay nurses like the skilled professionals they are, fix ratios, make the lifestyle livable, and more nurses stay where they matter.
Quality care at the bedside makes a world of difference. A competent RN is worth their weight in gold.

I see NP mismanagement/ lack of knowledge on the daily and while I’m glad physicians like myself can correct/prevent mistakes early enough, I think we need a better solution.

Incentivize RNs better.

De-incentivize NP -they should not be able to bill at all without supervision. 100% supervision at all times.