Pediatric Hospitalists: Answers to 15 Career Questions
Pediatric hospitalists provide acute, inpatient care to youngsters in community and children’s hospitals and coordinate with pediatricians. What brings career success to physicians in this specialty?
“Everyone has to decide for them what success means,” advised H. Barrett Fromme, MD, MHPE, chair of the American Academy of Pediatrics (AAP) section on hospital medicine and a professor of pediatrics at the University of Chicago, Pritzker School of Medicine.
Fromme explained that success as a pediatric hospitalist might mean achieving clinical or nonclinical goals, such as working with infants, having a schedule that offers time to pursue non-medical activities, being well-published, or being home during the day with one’s children, or many other things.
“Hospital medicine is so heterogeneous,” Fromme said. Once a pediatrician determines what success means, “It’s about doing the things and finding the mentors to get you to the definition you have targeted.”
Fromme recently talked to Locum Leaders about this rewarding field and helped address some frequently asked questions about inpatient pediatric care.
Choose your path as a locum tenens pediatric hospitalist.
Answering 15 key questions about pediatric hospitalists
1. What education and experience are needed to work in pediatric hospital medicine?
A person must complete medical school and a pediatric residency before starting to provide inpatient pediatric care. All physicians who finish residency in 2020 or later must complete a fellowship in pediatric hospital medicine (PHM) to become board certified in the specialty. Anyone who completed a residency in 2019 or earlier can take the practice route.
“There will always be a path for people who do not do the fellowship or get board-certified and work in pediatric hospital medicine,” Fromme said.
2. Do you need experience in primary care before working as a pediatric hospitalist?
No, said Fromme. Often pediatric hospitalists who started 15 or more years ago did come from primary, outpatient pediatrics. Now, most new doctors go directly into hospital medicine.
3. How important is PHM certification?
This remains to be seen, Fromme said. Some hospitals, particularly academic centers, will likely require pediatric hospital medicine (PHM) certification. However, many hospitalists will be able to practice without certification in community hospitals, particularly in rural or underserved areas.
4. Who do hospitalists work for?
“You can work for a university, you can work for a hospital, you can work for a hospitalist group that contracts with one of those, or you can be a locum,” Fromme said.
Locum tenens pediatric hospitalists are considered independent contractors, though they work under contract for a facility and are paid by their locum tenens agency.
5. What helps a candidate be more employable?
It depends on the hospital and what it needs, Fromme said. For instance, some might prioritize quality improvement records or high-risk delivery experiences.
6. What can a pediatric hospitalist expect for compensation and contracts?
The website Glassdoor reports the national average salary for a pediatric hospitalist is $220,911 annually, with variation by geographic location.
Contracts often include incentives, such as relative value units, education, or program expansion, Fromme reported.
Locum tenens contracts usually pay an hourly rate, with guaranteed hours plus provisions for overtime and bonuses.
7. What are pediatric hospital medicine schedules like?
Work schedules will depend on the hospital. Some pediatric hospitalists work 24 hours on for a set number of days per month, while others might work 12-hour shifts, seven days on and seven off.
A 2019 study in the Journal of Hospital Medicine reported that full-time pediatric hospitalists work a median of 1,882 hours annually.
8. Are there subspecialties within pediatric hospital medicine?
Yes, pediatric hospitalists might choose to work with newborns and become neonatal hospitalists. Nocturnists work the overnight shift, typically 12 to 14 hours each shift. They may receive a shift differential or might work fewer hours for the same salary as a day hospitalist.
9. Do most pediatric hospitalists work in children’s hospitals?
An AAP study found about 900 hospitals have pediatric hospitalists, and more than half of the workforce can be found in community hospitals. Most children’s hospitals also rely on physicians who provide inpatient pediatric care.
10. Do pediatric hospitalists tend to be younger than community pediatricians?
“Yes, we are a young field,” Fromme said.
11. Does this field sometimes act as a stepping-stone to other careers?
It could, but Fromme said that pediatric hospital medicine is more of a career choice.
“[Pediatric hospitalists] like the acuity, which is different from primary care medicine,” she said.
However, she added, some pediatric hospitalists may work in the inpatient setting for a couple of years, perhaps waiting for a spouse to finish residency or while deciding on a subspecialty.
Additionally, pediatric hospital medicine offers leadership and career advancement opportunities and a chance to influence better health in the community.
“It allows a strange level of flexibility, compared to someone in a clinic five days per week, to do things outside of clinical care,” Fromme said.
12. How do pediatric hospitalists coordinate with primary care pediatricians?
Fromme sends a fax to her patient’s primary pediatrician to inform that person of the admission and calls and sends discharge instructions. She finds the pediatrician helpful in providing medical history.
13. How do pediatric hospitalists collaborate with hospital staff?
This might look a little different at each facility. At the children’s hospital where Fromme practices, she rounds together with members of the care team, including the patient and family.
14. What are some key challenges in this discipline?
“We do not invest as a country in kids as much as we should,” Fromme said. This can lead to frustration at times, knowing you can only impact the child’s health while in your care.
With inpatient medicine, the hospitalist has many resources, but once the child leaves the hospital, the family may not have access to the follow-up care the child needs.
15. What is rewarding about providing inpatient pediatric care?
“Everything,” Fromme said. “The first is the patient population.”
She finds the ability to work with and serve families and patients while they go through a challenging hospital admission rewarding. Additionally, the chance to lead and provide high-value care drives some hospitalists.
“Most of us are drawn to it initially because of the great privilege to care for families and patients who are sick,” Fromme said.
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