Chronicle of Medicine - Dr. Carrie Jo Prather finished up the third year of her internal medicine residency in September at Palmetto General Hospital in Hialeah, Fla. and is starting to look for a job as a hospitalist.

Dr. Prather, who is in the residency’s hospital medicine training track, is sending out her CV sparingly and finding openings through word of mouth so that she can avoid the flood of unsolicited phone calls from potential employers and recruiters. And she’s only looking for jobs where she can work seven days on, seven days off.

"They’re long days. They’re hard days. They’re sick patients. But then you’ve got a whole week off," she said. For Dr. Prather, a schedule like that would allow her to stay in Florida, where she owns a house, and still travel to Michigan to see her family frequently.

Dr. Prather is fairly typical of young hospitalists entering the field these days. She’s enthusiastic about the pace and acuity offered in treating hospitalized patients. She’s attracted to the work/life balance of the hospitalist schedule. She wouldn’t consider an office-based practice, at least not for right now. And she’s in demand.

The latest figures show that hospitalists were the third most-requested search assignment in 2010-2011. And hospitalists have been in the top four most-requested specialties for the last five years. The figures come from the firm’s "2011 Review of Physician Recruiting Incentives" report which provides an overview of salaries, bonuses, and other incentives used in recruiting physicians.

The report also found that hospitalists can command salaries between $160,000 and $305,000, with an average salary of $217,000. That average salary has risen every year in the last five years.

Internal medicine has become one of the hardest search requests to fill, in part because so many internal medicine physicians are choosing to practice as hospitalists, according to the 2011 report.

"Everybody’s kind of choosing sides, it seems, based on what kind of lifestyle they want and what type of practice they want," one recruiter said, "But there are very few left in the middle."

For Dr. Prather, the decision to go into hospital medicine came early in her training. She seized on the idea of hospital medicine early on when she realized it would fulfill her desire to treat sick, complicated patients. The other thing that convinced her to pursue hospital medicine was observing general internists in traditional practices that combine hospital and ambulatory work.

The experience of seeing those doctors running all over town to visit their hospitalized patients, only to incur the ire of office patients who were always kept waiting, turned her off to that type of practice.

But the lifestyle offered by a career as a hospitalist was the biggest draw, she said.

"Lifestyle is huge. If I was an outpatient doctor and I was going back and forth, there’s no way it would work," Dr. Prather said. "I would like to get married someday. I would like to have children and I want to be able to have time for them."

For Dr. Joseph Sweigart, a third-year internal medicine resident at the University of Colorado in Denver, lifestyle is a perk, but he’s attracted to hospital medicine because it allows him to do primary care in a fast-paced setting.

"The thing that attracted me so much to internal medicine and continues to excite me about it is just all the energy and community that you get in the hospital," said Dr. Sweigart, who is participating in the residency’s hospital medicine training track.

Dr. Sweigart, who will graduate in June 2012, said he hopes to find a job as an academic hospitalist. Before deciding on hospital medicine, he considered pursuing a fellowship in interventional cardiology. But the decision came down to wanting to have greater involvement in the lives of patients.

A hospitalist can be a primary care physician, just in an inpatient setting, he said. "You really take control of the patient, every aspect of their care, every family discussion, coordinating the multidisciplinary teams," he said.

Dr. Nichole G. Zehnder is a recent graduate of the University of Colorado’s internal medicine residency and was also a participant in the hospital medicine training track. She is now a faculty member and director of the hospitalized adult-care clerkship there. For her, one the biggest attractions of hospital medicine has been the chance to work as part of a team.

"In hospital medicine, you’re afforded a unique opportunity to get to interact with subspecialists and other teams, whether it be through perioperative care or comanagement," Dr. Zehnder said. "It’s a real-time team-based environment that I think the office setting lacks."

Dr. Zehnder is early in her career, but she expects to stick with hospital medicine for a long time. So far her job has allowed her to achieve a work/life balance, as well as a balance between clinical and academic time. "Right now, I’m incredibly happy and satisfied with my career."

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