Hospitalists: Off Call
The hospitalist life may provide an appealing alternative to being available 24/7.
For many physicians who choose to work as hospitalists, a chief attraction is the chance to have a relatively normal life outside of medicine. Lakshmi Halasyamani is part of a 50-hospitalist team at Saint Joseph Mercy Health System in southeast Michigan, and like most hospitalists, she works 10- to 12-hour block shifts with seven days on and seven off. A mother of two who has worked in the field for more than a decade, Halasyamani likes that she can deliver high-quality clinical care and also be fully present for her family. “This kind of schedule can give you a work/life separation,” she says. Moreover, she and her colleagues don’t mind adjusting schedules to accommodate one another. “We schedule things so that we can all attend to what’s important to us, like going on our children’s school field trips,” she says.
Still, working a week of 12-hour shifts brings its own pressures, and scheduling may be one reason why, in a recent survey of hospitalists, one in four expected to move out of the field within five years. “Heavy clinical schedules are tough and can lead to dead-end jobs, with no time for professional development,” says David Meltzer, chief of the University of Chicago’s division of hospital medicine. To encourage hospitalists to stay, the University of Chicago, Saint Joseph Mercy Health System and other academic medical centers have begun funding hospitalist positions that allow time for research, teaching and quality improvement duties. Last year, Halasyamani, became St. Joseph Mercy’s chief medical officer, and she now spends the bulk of her time off the hospital units, but when she is on the units, she continues to work the same block schedule that her colleagues do. “This is what makes the field of hospital medicine wonderful,” Halasyamani says. “There’s not just one career path that you have to take.”