Your clinical day will center on what drew most nephrologists to the specialty in the first place: longitudinal relationships with patients managing chronic kidney disease. Approximately 95% of your practice will occur in the outpatient setting, with clinic sessions averaging 15 to 20 patient encounters daily. This volume allows for meaningful visits rather than the rushed throughput that characterizes many nephrology practices. You will manage the full spectrum of outpatient nephrology, from early CKD staging and hypertension-related renal disease to dialysis coordination and transplant referral workups. The patient population here skews toward chronic disease management, giving you the continuity that makes outpatient nephrology rewarding.
The inpatient component of this role remains intentionally limited. Franklin Medical Center operates 35 licensed beds with an average daily census of 11 to 12 patients. You can expect one to two inpatient consults per day, typically for acute kidney injury, electrolyte abnormalities, or nephrology input on medically complex admissions. There is no fixed rounding schedule. You will coordinate with the hospitalist team to see consults as they arise, allowing flexibility in how you structure your day. The hospitalists manage primary inpatient coverage, so you function as a consultant rather than an attending of record for most nephrology patients.
This position carries no overnight call. Your responsibilities end when clinic ends. Daytime consults are handled during working hours, and the hospitalist team manages after-hours issues with the understanding that you will see new nephrology patients the following business day. If a patient requires urgent dialysis or develops a renal emergency overnight, the standard protocol is transfer to a higher level of care rather than after-hours callback. Weekend and holiday call do not exist in this role. Several specialists on the medical staff have established similar arrangements, setting parameters with the hospitalists about which patients warrant next-day nephrology follow-up versus immediate notification.
Current dialysis capabilities center on inpatient services using the Tablo machine. The hospital manages patients who are already established on dialysis and require hospitalization for other medical issues, such as pneumonia in a patient who cannot miss scheduled dialysis appointments. One dialysis nurse and one technician staff the service daily. A general surgeon joining the medical staff will begin placing temporary dialysis access, expanding what can be managed locally. Leadership has expressed openness to developing outpatient dialysis if the incoming nephrologist has interest in that direction. You would have meaningful input into expanding dialysis operations and developing the support staff as volumes grow.
Franklin Medical Center operates on the Cerner electronic medical record system, providing integrated documentation across inpatient and outpatient settings. Clinic staff handle prescription refills, lab result management, and patient messaging, keeping your focus on direct patient care rather than inbox management. Scheduling remains within your control. You determine appointment intervals and patient flow within reasonable parameters. The hospital's preference for satellite clinic rotation would have you seeing patients at locations nine miles north and south of the main campus, though this remains negotiable based on your preference.
During previous recruitment efforts, some nephrology candidates expressed interest in hospitalist or ICU work. While not the primary purpose of this position, leadership remains open to discussing supplemental clinical responsibilities if that appeals to you. The hospital maintains an intensive care unit and would consider creative arrangements for a nephrologist who wants variety beyond standard nephrology practice. This flexibility reflects the administration's broader philosophy: build a role that works for the physician, and retention follows naturally.
The clinical environment here offers something increasingly rare in nephrology: a practice sized for quality rather than volume, with genuine autonomy over how you deliver care and a clear path to shape the program's future.