How much does a hospitalist make per shift?

The employed shift, priced honestly

The survey shift rate and the salary division agree with each other, which is why both are worth trusting. The Today's Hospitalist survey, the specialty's own compensation survey, reports the average adult hospitalist shift rate at $142 an hour for 2022 compensation, up from $137 an hour the year before. Multiply by 12 and the average employed shift pays about $1,704. The salary route lands in the same place: $314,000 divided by 182 shifts is about $1,725. The average starting salary of $289,000 from the AMN Healthcare starting salary review divides to about $1,588 a shift, which is the right way to feel a starting offer: not as a salary that sounds close to the average, but as a per shift price about $140 below it.

That per shift price is the number to carry into every negotiation, because contracts hide weak pay inside strong salaries by adding shifts. An offer of $300,000 that requires 200 shifts pays $1,500 a shift. An offer of $290,000 that requires 182 shifts pays about $1,593 a shift. The second offer pays more for the work, leaves 18 more days of your year untouched, and reads worse in the headline. The internal medicine contracts page works this division in full, including what swing shifts and backup call do to the count.

Nights and extra shifts change the average

The averages conceal the two levers that move real hospitalist pay. The first is nights. In the same Today's Hospitalist survey, nocturnists who treat adults reported mean compensation of $360,372 while working about 13.3 shifts a month, which divides to roughly $2,258 a shift. On a like for like basis the night premium is about 20 percent: the overall mean of $339,438 spread over about 180 shifts runs about $1,886 a shift. Night work is the premium product in this specialty, and the premium is paid because the shifts are hard to staff and hard to live.

The second lever is extra shifts. Three out of four daytime hospitalists in the survey receive an amount above the standard rate for extra shifts, which means the extra shift rate is a real and negotiable line, not a favor. Every extra shift you sell is priced at that rate and taxed at your marginal rate, and it comes out of the off weeks that make the block schedule survivable. The extra shifts question on this site works the investing comparison, and the nocturnist question works the tax and retirement side of differential income.

The locums shift is a different product

A locums shift at $2,148 to $2,400 looks like a 25 to 40 percent raise over the employed shift until you load it with what it has to carry. No employer payroll tax share. No match. No health premium. No group disability definition. No malpractice tail in many arrangements. No pay at all for the weeks between assignments. The locums rates question on this site prices that load in full and reaches the standing rule of this hub: a contractor rate needs to clear the employed package by about 25 to 30 percent before it is the same pay. Measured per shift, that means the locums shift has to clear the fully loaded employed shift, not the bare salary division, and the fully loaded employed shift, counting the benefits layer, is worth well above $2,000. Some locums shifts clear that bar. The average one, at the average posted band, is closer than the posting makes it feel.