Do I take an inpatient job after 11 years in outpatient ortho?
Short version: My family is moving to a rural area, and I have the opportunity to take an inpatient position with better pay, benefits, flexibility and autonomy than the outpatient options I have, but I have enjoyed working in outpatient ortho for the last 11 years, am good at it, and know very little about inpatient and whether I would like it.
Questions:
- What should I expect my day-to-day will be like an inpatient position in a small rural hospital (a mix of ER patients, post op, and acute care)?
- What should I do to prepare?
- For those of you who have made the switch to inpatient after many years enjoying outpatient orthopedic care, have you regretted it or has it been a good move?
Thank you!
The long version:
My family (me, husband, and young son) is relocating from a large western US city to a smaller, more rural area in the northeast to be closer to our extended family. I currently have verbal offers from two outpatient clinics and one hospital (inpatient role). To my surprise, the inpatient role has merged as my favorite for the following reasons:
- Good pay. I would earn my current annual salary for fewer hours (32 vs 36) plus $10,000 signing bonus
- Good benefits. Despite being a small community based hospital, it is under the umbrella of a larger non profit hospital system which means all the perks (health care, 403b match, dependant savings account) at the lowest overall cost to me vs. the others
- Stability. My husband works in a notoriously unpredictable field (biotech), so working for a larger organization with a high need for PT (they have a shortage right now) would give us some piece of mind
- Flexibility and autonomy. The current rehab team is very independent and supportive of each other. I could mostly set my schedule as long as patient needs are met, which means I could spend more time with my son and be there when he needs me (school pick up, drop off, etc)
- Possibility for splitting my time with the hospital's outpatient clinic in a year or two, which would allow me to retain my skills in both settings
The only cons I see (which is where I need advice or reassurance)
- I haven't worked inpatient since I was a student, which means I'd have a lot to learn and am not sure if I would enjoy the patient care as much (it would be a mix of same-day post op ortho eval/discharge, ER patients, and inpatient beds)
- I might lose some of my outpatient skills (manual, dry needling, etc) and fall behind on the latest evidence
In comparison, the two outpatient clinics (both PT owned) are polar opposite of each other, and neither are great. One could offer good pay and benefits, excellent mentorship, high quality practitioners, evidence based care, but would demand a lot (90% productivity standard and a reputation of being "a factory"). The other is more laid back, but couldn't pay me as much and doesn't provide healthcare (!) which is kind of a non starter for me.
About me: Since I graduated PT school 11 years ago, I have worked for a large non profit healthcare organization in a hospital-based outpatient orthopedic clinic. I have my OCS and am dry needling certified. I've been lucky to work under reasonable productivity standards, one-on-one treatments, no aides, hour evals, and I've always really enjoyed ortho. However, I've also really enjoyed my neuro, geriatric, and post op patients, so I think there's a lot of inpatient I would enjoy.