Home 2023 Compensation & Career Survey What type of shift do hospitalists work?

What type of shift do hospitalists work?

Seven-on/seven-off shifts are still the most common

October 2023

WHEN IT COMES to hospitalist schedules, seven-on/seven-off shifts are common, at least for full-time adult hospitalists.

That’s according to data from the 2023 Today’s Hospitalist Compensation & Career Survey, which found that 55% of full-time hospitalists treating adult patients reported working seven-on/seven-off. More than one third (36.5%) work another type of day shift and 8.0% are nocturnists who work only nights

The scheduling picture is much different picture for pediatric hospitalists. While 20% work seven-on/seven-off, the majority—74.5%—reported working some other type of day shift. About 6% of pediatric hospitalists work as nocturnists.

Here’s a look at other differences in the type of shifts hospitalists reported in this year’s survey.

type-shift-hospitalistAcademic hospitalists
Less than half of academic hospitalists—47.1%—work seven-on/seven-off, which is 10% less than their non-academic colleagues. Nearly the same number (41.2%) reported working another type of daytime shift. About 12% of academic hospitalists responding to our survey work as nocturnists.

Employer type
In terms of different employers, there are fairly big differences in the types of schedules hospitalists have. Among hospitalists working for national hospitalist management companies, for example, a whopping 71.2% reported working seven-on/seven-off. The number of hospitalists pulling seven-on/seven-off shifts was lowest among hospitalists with local groups: 39.2%.

The largest percentage of hospitalists who work day shifts other than seven-on/seven-off was among those with primary care/multispecialty groups: 50.9%. It was lowest (22.0%) among hospitalists working at national hospitalist management companies.

And in our survey, the percentage of hospitalists who reported working as nocturnists was highest among those in universities and medical schools: 14.3%.

Geographic region
Look at our survey by geographic region, and seven-on/seven-off is most common in the South.

Two-thirds of hospitalists in our survey from the South said they worked seven-on/seven-off. That percentage was lowest among hospitalists in the Pacific region, where only 45.3% said they work seven-on/seven-off.

As for working daytime shifts other than seven-on/seven-off, that percentage was highest in the Pacific (48.8%) and lowest among hospitalists in the South (23.5%).

Years as a hospitalist
Our data found that in general, older hospitalists tend to work fewer seven-on/seven-off shifts. Among hospitalists who’ve worked in the specialty for three to four years, 63.5% reported working seven-on/seven-off shifts. Among those in the specialty for 20-plus years, by comparison, 45.6% work seven-on/seven-off

Group size
Finally, our survey found that fewer hospitalists working for larger groups work seven-on/seven-off. Among groups with 10-15 hospitalists, 61.9% said they worked seven-on-seven-off. Among groups with more than 50 hospitalists, however, that number dropped to 49.2%.

Looking for alternatives to seven-on/seven-off? Here’s a look at some options.


See more data on hospitalists’ shift work at our 2023 Today’s Hospitalist Compensation & Career Survey coverage

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