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**Lithium** · 01-11-2020, 04:54 PM

Your question is too complicated to give a meaningful answer. It's like asking who is the greatest US president or professional athlete of all time. It's personal preference and everyone evaluates it differently.

This isn't really a "which state" question. Job markets and lifestyles don't change at state lines. Pick some cities, or find some jobs in certain regions to start narrowing your options down. This thread may be more helpful if you can name a few specific areas you're considering.

**illinoisdoc** · 01-11-2020, 05:05 PM

Hello Lithium, Thank you for taking time in reading my question and giving your inputs. While I agree that my question is quite long, I don't necessary consider it to be complicated. Job markets do change significantly depending on states. Benefits, pay, work load do change. I am a prime example who has seen this.
From my observation, Working directly for the hospital rather than a third party makes a huge difference. Offcourse if we go to less desirable states like Missisisippi, you will earn more, have better benefits. If we go to rural areas, you will make more. But then offcourse, Its a very personal decision to practice there.

I am looking at warmer states. But not California or Florida. I couldn't really find any website which advertise jobs employed directly by the hospital..
But I do like your suggestion of picking a big city and start calling the hospitals. I think that might work but I wasn't sure if there was a easier alternative.

Thank you

**Lithium** · 01-11-2020, 05:34 PM

Originally posted by illinoisdoc View Post

Hello Lithium, Thank you for taking time in reading my question and giving your inputs. While I agree that my question is quite long, I don't necessary consider it to be complicated. Job markets do change significantly depending on states. Benefits, pay, work load do change. I am a prime example who has seen this.
From my observation, Working directly for the hospital rather than a third party makes a huge difference. Offcourse if we go to less desirable states like Missisisippi, you will earn more, have better benefits. If we go to rural areas, you will make more. But then offcourse, Its a very personal decision to practice there.

I am looking at warmer states. But not California or Florida. I couldn't really find any website which advertise jobs employed directly by the hospital..
But I do like your suggestion of picking a big city and start calling the hospitals. I think that might work but I wasn't sure if there was a easier alternative.

Thank you

Well, of course if you go to Mississippi it will be easier to find good jobs than in California, and it will be easier to find jobs in rural areas compared to urban areas.

When I said job markets don't change at state lines, I meant that if you look for jobs in Kansas City, MO, and compare them to jobs in Kansas City, KS, the quality of jobs should be basically the same. If they're much different at all it's probably because of small differences in tax law and other very minor factors.

Are you just looking for physician job boards? Like practicelink, practicematch, careermd, NEJM careers, etc? There are a million of them.

**Tim** · 01-11-2020, 05:54 PM

Sounds like Texas has everything lifestyle you are looking for. Have tried any looking from El Paso to Texarkana? Lot’s of hospitals big and small and in between. Find comp, job and location.
Good luck.

**Brains428** · 01-11-2020, 09:26 PM

Have you looked at smaller towns in Texas (San Angelo, Waco, Tyler, Midland/Odessa, RGV area?)

The hospitalists where I am (not Texas) are direct employees. It's warm half the time. It did snow for 30 minutes today (but it did that in Texas, too).

**SerrateAndDominate** · 01-11-2020, 09:34 PM

Originally posted by Lithium View Post

Well, of course if you go to Mississippi it will be easier to find good jobs than in California, and it will be easier to find jobs in rural areas compared to urban areas.

When I said job markets don't change at state lines, I meant that if you look for jobs in Kansas City, MO, and compare them to jobs in Kansas City, KS, the quality of jobs should be basically the same. If they're much different at all it's probably because of small differences in tax law and other very minor factors.

Are you just looking for physician job boards? Like practicelink, practicematch, careermd, NEJM careers, etc? There are a million of them.

As someone moving to MS this summer, I can say jobs there are pretty sweet. Cost of living is low, and I can get to a serviceable airport in a fair drive. I don’t travel much now, but I’d like to eventually.

payor mix is good in the larger cities.
admittedly not the most desirable place, but there are some pretty towns and nice homes there.

**Cubicle** · 01-11-2020, 09:37 PM

OP: I think your only problem in Texas was your employer. Move back to Texas, under a different employer. Heck, move back to the same house & cover the same territory.

**SLC OB** · 01-11-2020, 09:50 PM

Warm States:
NV (no income tax!)-- I know Renown Hospital in Reno employs there hospitalists, they work a week on/off, paid well, but census is high! Maybe Vegas but no idea on their employment structure.
AZ-- Yuma is HOT and usually needs docs, no idea if they employ the docs directly. Had an ED/FP couple from Med School move there and paid off $500K of Med School loans in three years. Super low cost of living but still close to San Diego for weekend trips.
If tort reform is important to you:
As of 2016, thirty-three states have imposed caps on any damages sustained in medical malpractice lawsuits: Alaska, California, Colorado, Florida, Georgia, Hawaii, Idaho, Indiana, Kansas, Louisiana, Maine, Maryland, Massachusetts, Michigan, Mississippi, Montana, Nebraska, Nevada, New Jersey, New Mexico, North Carolina, North Dakota, Ohio, Oklahoma, Oregon, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, West Virginia, and Wisconsin.
I've highlighted some of the hotter states but lots are humid and so I would not like that... you have to decide.
Good luck!

**Lordosis** · 01-11-2020, 10:02 PM

Having only worked in 2 states I really do not have enough experience to give you a meaningful answer. However our hospitalists up here in Western NY are quite happy. However this area does not check any of your other boxes. State tax, cold , litigious.

**jfoxcpacfp** · 01-12-2020, 07:18 AM

Curious why FL is out? Have you considered TN? Relatively mild winters, no-tax state, Nashville has become somewhat of a cultural center.

**nephron** · 01-12-2020, 07:47 AM

There are tons of hospitalist jobs everywhere. If you have your eyes set upon a particular town/city, I would recommend just looking up whatever hospitals they have in the area and contact the hospitalist director directly to let them know that you are interested. The highest paid hospitalist positions are are no doubt in the midwest, I would imagine that the suburban high payer mix/insured patient hospitals with no local academic center to feed them new residents. Even the ones just outside of the city seem to be offering high salaries, new residents tend to just stay put and that tends to drive salaries down. I suspect that the difference in salary between some of these midwest hospitals would negate any difference in state and local taxes. The biggest benefit is probably the lower cost of living that will allow you to accumulate wealth faster. I don't know that I would pick a place based upon malpractice laws, they seem to be reversed by the court all the time and as a hospitalist, I suspect that any judgement over the limit will usually be covered by the hospital.

**Tim** · 01-12-2020, 08:07 AM

Compensation, job, location.
Usually get two out of three. You seem to have the first two covered now.
•Two physicians would only be an advantage in hard to fill locations.
•Anecdotally, climate is an individual decision. One doc moved to AZ and loved it. Moving back to Mo. because the family hated the summer heat. One year of experience was “get out” before next summer.

**Peds** · 01-12-2020, 08:21 AM

FL is always out....

**The White Coat Investor** · 01-12-2020, 09:26 AM

Originally posted by illinoisdoc View Post

Hello all,
I am a practicing hospitalist in Illinois who recently moved from Texas..

I am presently employed directly by the hospital which I love. Back in Texas, I was working for a third party and now I realize how shitty that was. Had horrible benefits with no paid vacation/CME.
Presently, I get 2 weeks paid vacation and salary of 300k for 1 week on and 1 week off. Good benefits and 401k match. No procedures or codes. Census around 14-15 with all specialists available. I would have stayed in IL but I prefer hot weather. The state also has no TORT reforms and its litigious state.

Me and my wife are hence looking at hospitalist opportunities in hot weather cities. My wife is also a hospitalist. We are pretty open to go anywhere but we prefer hot climate to cold, prefer to work directly for the hospital than a third party and preferably stay with an hour or two of major city. If the state has low litigation, No state tax, thats bonus.

Recently there was a medscape articles and also on wallet hub which ranked best places for the doctors. Most of them were in Midwest. NorthEast was horrible, and so was California, Florida. Texas was in the middle.

I am not updated with what the current job contracts for hospitalitists look like.

Could you please give me some suggestions.

1. Where can I find jobs employed directly by the hospitals? I know practice link has a section but I believe there are none in states like Texas.
2. What sate would be the best to practice? Considering pay, work load and benefits. I have an active Texas license but job market in Texas is competitive. And benefits are not great. I prefer to go back there but don't want to work for low pay and high patient load with bad benefits.
3. Can I negotiate better with the contract as its 2 people looking for hospitalist job?I don't mind working as a nocturnist. My wife however wants day shifts.
4. We also want to work extra shifts. How many of you actually have an option of taking extra shifts easily? My present employer does not offer extra shifts at all.

Thanks in advance

TX to IL would be the opposite of the usual recommendation!

I would guess most hospitalist jobs are employee jobs. I very much doubt there are no employee jobs in TX. I'd just call up the hospitals you are interested in and have them refer you to the person who hires the hospitalists. Everybody needs a hospitalist. I don't know any hospitals not hiring. And a nocturnist who wants extra shifts? You can pretty much go anywhere you want. Let me know if you decide Salt Lake is hot enough for you and I'll put you in touch with someone who will hire you this week.

I think you ought to take a look at Phoenix, Atlanta, Nashville, etc. They're all hot. They all need hospitalists and I'll bet there are multiple employee jobs open right now in each of those states.

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