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Most Hospitalist Groups Don’t Offer Paid Time Off


More than two-thirds of HM groups do not offer paid time off (PTO) to their hospitalists, but lack of vacation time isn’t a career deal breaker for aspiring hospitalists, say some HM leaders.

“Lack of separate PTO in general has not affected young hospitalists from choosing hospital medicine as their career, as hospital medicine offers many other positives,” says Bhavin Patel, MD, assistant professor in the department of internal medicine at the University of Minnesota Medical School in Duluth and a member of SHM’s Practice Analysis Committee. “Given there has not be any major push to either build PTO hours into scheduling or to offer it separately for many [hospital medicine groups], it may not be a major factor for many or most hospitalists.”

SHM surveyed HM groups about their PTO benefits and included the results in its 2014 State of Hospital Medicine Report. The survey examined HM groups that serve adults only and categorized the groups by geographic region, ownership/employment model, academic status, primary hospital graduate medical education program status, and practice size.

Results showed that larger groups were more likely to offer PTO benefits and more PTO hours than smaller groups. Only 21.1% of groups with four or fewer full-time equivalent hospitalists (FTE) offered PTO, with a median of 120 hours, and 45.9% of groups with 30 or more FTE offered PTO, with a median of 194 hours, according to the survey. The median amount of PTO among all groups was 160 hours per year.

Carolyn Sites, DO, FHM, senior medical director of hospitalist programs at Providence Health & Services in Oregon and also a member of SHM’s Practice Analysis Committee, says the difference in PTO between large and small groups is not surprising.

“Larger practice size offers more flexibility because you have enough staff to cover the hospital,” says Dr. Sites. “Hospital health systems may have a higher percentage of PTO offered due to their size and the need to offer similar benefits to all their employees. A small group is more challenged in being able to provide adequate coverage when a provider is absent. It usually means somebody has to work a lot more shifts to cover for the person who is absent.”

The survey also found that HM groups in the eastern U.S. and those employed by a hospital health system and/or academic groups were more likely to offer PTO and more hours. In the East, 50% of groups offered PTO, with a median amount of 200 hours annually. Similarly, 54.9% of groups with academic status as well as 47.4% of groups at university-based teaching hospitals offered PTO, with medians of 208 hours and 200 hours annually, respectively.

According to Dr. Sites, the overall 160-hour median amount of PTO is appropriate. “Assuming average shift lengths are 10 to 12 hours in length, this would convert to between 13 to 16 shifts off per year,” she notes. “This provides for two weeks break per year or several slightly shorter breaks per year.”

In terms of what research needs to be conducted to better analyze PTO patterns, Dr. Sites expresses that more “in-depth knowledge of the operational differences between groups that offer PTO and those that don’t” is necessary.

Visit our website for more information on PTO for hospitalists.

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