Anyone Make the Switch from Surgery to Hospitalist?

[SedRate]

Anyone make the switch from surgical to hospitalist? Did you like it or hate it?

For the past 10 years, I have only worked in surgical subspecialties. I interviewed for a surgical job but they gave it to a local candidate they have worked with before. However, the recruiter said they received positive feedback and want to hire me at least PRN. The admin also offered two other positions, one of which is as a hospitalist. Schedule is 7-on and 7-off 11-hour days plus PTO and some holidays. Sounds like it'll be mainly admissions with RRT coverage. No codes. I would also have the opportunity to pick up PRN shifts in that surgical specialty and be a candidate should another FTE opening come up.

I'm interested in the opportunity. At this point in my career and life, I don't want a stressful job so looking to hear from others if it was a worthwhile switch. Also, I live in a small town and opportunities are limited and I'm not looking to relocate for jobs anymore. 

Appreciate any input or advice. 

 

[Reality Check 2]

I have not worked as a hospitalist. I applied a few years ago within our facility.

However, the 7 days on and 7 days off shift just turned me off. They were 12 hour days.

The lack of continuity at home was profound. I would basically be a zombie every other week with my family.

My clinical abilities also came into question for me. After 3 days of 12 hr shifts - I would not want ME making medical decisions for an inpatient or outpatient. Maybe age, maybe physical tolerance or just maybe common sense on how the human body works with continuity. 

My brain and body do not work well with those shifts and I honestly question the validity of forcing shifts like this and how they impact patient care, safety and medical error.

My kids are grown and I could sleep at will but at the complete expense of my family and household.

If you have never worked those shifts - how do you think working 77 hours in 7 days would impact your mental health, physical health, sleep patterns and ability to make accurate medical decisions and documentation?

I ask honestly and without intended malice. Some folks may thrive on this. 

I find the idea of this pattern questionable at best and likely unsafe. 

Just my thoughts.

[SedRate]

10 minutes ago, Reality Check 2 said:

I have not worked as a hospitalist. I applied a few years ago within our facility.

However, the 7 days on and 7 days off shift just turned me off. They were 12 hour days.

The lack of continuity at home was profound. I would basically be a zombie every other week with my family.

My clinical abilities also came into question for me. After 3 days of 12 hr shifts - I would not want ME making medical decisions for an inpatient or outpatient. Maybe age, maybe physical tolerance or just maybe common sense on how the human body works with continuity. 

My brain and body do not work well with those shifts and I honestly question the validity of forcing shifts like this and how they impact patient care, safety and medical error.

My kids are grown and I could sleep at will but at the complete expense of my family and household.

If you have never worked those shifts - how do you think working 77 hours in 7 days would impact your mental health, physical health, sleep patterns and ability to make accurate medical decisions and documentation?

I ask honestly and without intended malice. Some folks may thrive on this. 

I find the idea of this pattern questionable at best and likely unsafe. 

Just my thoughts.

Thanks for your input and bringing up some salient points. Three 12s seems to be a good spot for me, too, so there must be some truth to what you say. Some important things to consider, thanks!

[ohiovolffemtp]

The 7 on 7 off schedule for hospitalists is pretty common: doc or PA/NP.  I've actually seen more 7 12's (which are probably more like 13 to allow time for sign out).  The number of patients and their acuity probably drives exhaustion more than the total hours.

I'm EM, not hospitalist, but my typical month is get up early and fly/drive to a site, nap, work 5 overnight 12's, stay up and drive over the lower Rockies to my other site, have that night off, then work 5 overnight 12's, then stay up and drive/fly home where fortunately my wife picks me up at the airport.  That's my FT job.  I used to do a 2nd 5 day run in each month, but cut back to FT (10 shifts) once my wife retired and "suggested" I do so - "yes, dear".  I do get tired, but I find it very doable.  I've been eligible for Medicare for some time - for rough age calibration.

Continuity of care isn't anywhere the issue in EM that it is in hospital medicine, but I can see why hospitalists use that schedule, and it could be doable.  However, the 1st 1-2 days after a run would be largely for recovery.