Child Psychiatry Compensation

[PhinyGage]

Can someone fill us in on the compensation of Child Psych? It seems like this is rarely discussed. Even MGMA has poor data. I have heard that it is not all that more impressive than General Adult, but it would be nice to get a better understanding of the actual numbers people have been offered around the country. Oh, and why are we so secretive about salaries again? We worked hard and endured the delayed gratification thing...

Thanks!

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[wolfvgang22]

Umm...we aren't all that secretive around here, if you've searched the forum. This has been discussed a lot, and recently.

 

[doctorpilgrim]

Psychiatrist compensation is based on either salary or production. Salary in some places has 5 percent difference for child. Production is same for all specialities based on e&m wrvu codes. It depends on how many patients you feel comfortable seeing per hour. In our organization child salary is same as adult.
I don't think anybody is too secretive. CMS has actually published individual data.

 

[TexasPhysician]

C&A psychiatry jobs vary so much that I've seen 40hr gigs pay between 140-400k.

 

[Shikima]

Isn't compensation increased when you're BC?

 

[TexasPhysician]

Isn't compensation increased when you're BC?

Some places provide a 5-20k raise to be BC.

 

[wolfvgang22]

C&A psychiatry jobs vary so much that I've seen 40hr gigs pay between 140-400k.

To be fair, adult psychiatry is about the same range.

 

[Information Underload]

Keep in mind that you do a lot of unbilled work in child. I get way more phone calls than my adult colleagues. Inpatient is a lot more work, as well. I am constantly speaking to therapists, schools, school therapists, parents, one parent in one state and another in another state, neuropsychologists, making referrals to OT, sleep, etc... I will make more than my adult colleagues because I can typically bill for greater complexity (on the outpatient side) and because my patients tend to show up more frequently than do adult patients. I do see a lot more Medicaid patients, but Medicaid pays decently in my state, and Medicaid patients don't gripe when you bill for psychotherapy.

 

[DD214_DOC]

Needy borderlines ain't got nothing on an anxious parent

 

[splik]

Needy borderlines ain't got nothing on an anxious parent

anxious parents ain't got nothing on a borderline parent.*



*was screamed at for 45 minutes yesterday by a histrionic/borderline mother of one of my patients. terrifying. and why i probably cannot help my poor enmeshed patient.

 

[Shikima]

C&A. Where you teach parents how to be parents.

 

[DD214_DOC]

C&A. Where you teach parents how to be parents.

And they ignore everything you say and demand a magical happy pill to fix their child

 

[Shikima]

Hammer isn't an option to fix parents?

 

[F0nzie]

anxious parents ain't got nothing on a borderline parent.*



*was screamed at for 45 minutes yesterday by a histrionic/borderline mother of one of my patients. terrifying. and why i probably cannot help my poor enmeshed patient.

We call it Histrionic/borderline but let's be real. You were abused. Sorry you went through that. It usually takes me few days to recover from those interactions.

 

[daru1]

We call it Histrionic/borderline but let's be real. You were abused. Sorry you went through that. It usually takes me few days to recover from those interactions.

This is exactly what I tell my staff now. This is verbal abuse, and if you feel the need to exit the situation (no matter how rude it may seem to the patient/family member), do it. Come knock on my door, and I will back you up.

Patients/family members either come back and apologize -- with no further sequelae in the office even years down the line -- or they leave the clinic, opening up a spot for someone potentially more deserving of our time and resources.

 

[Merovinge]

This is exactly what I tell my staff now. This is verbal abuse, and if you feel the need to exit the situation (no matter how rude it may seem to the patient/family member), do it. Come knock on my door, and I will back you up.

Patients/family members either come back and apologize -- with no further sequelae in the office even years down the line -- or they leave the clinic, opening up a spot for someone potentially more deserving of our time and resources.

God I wish that was every attending's stance. There has been no worse feeling as a CAP fellow then being berated by a borderline mother for 45 minutes to have your attending come and take their side and throw you under the bus to appease the parent.

 

[DD214_DOC]

God I wish that was every attending's stance. There has been no worse feeling as a CAP fellow then being berated by a borderline mother for 45 minutes to have your attending come and take their side and throw you under the bus to appease the parent.

Your attending was terrible at their job then. You know, the whole part about serving as a model for low-functioning parents and identifying and correcting maladaptive patterns of behavior in the parents and family system that perpetuates pathology and dysfunction. They fell right into the borderline trap!

When a parent becomes angry, disrespectful, and demanding, shut that **** down immediately. I will almost guarantee the reason their kid sees you is because the kid is angry, disrespectful, and demanding.

 

[Merovinge]

Your attending was terrible at their job then. You know, the whole part about serving as a model for low-functioning parents and identifying and correcting maladaptive patterns of behavior in the parents and family system that perpetuates pathology and dysfunction. They fell right into the borderline trap!

When a parent becomes angry, disrespectful, and demanding, shut that **** down immediately. I will almost guarantee the reason their kid sees you is because the kid is angry, disrespectful, and demanding.

100% correct about the child, who actually pointed a finger at me and laughed in the waiting room "you got in trouble, na na na na na". I set firm limits and told her that she needed to be respectful of me in my office which is when she went to get the attending and start making up tales about how disrespectful I had been. It's a huge disadvantage being a trainee in a new fellowship in this type of situation and it made me want to drop out of child after CF1 year. Thankfully got a new attending for this clinic and things are going much better now.

 

[DD214_DOC]

Attendings can suck, too.

 

[TexasPhysician]

To be fair, adult psychiatry is about the same range.

For an academic gig I saw, I would have actually earned less because all faculty start at the same rate. My general psych friend started a year before me while I finished training in child. He got a raise, so I would be paid less.

Child training is more in demand though. If you are flexible, you can find higher paying jobs to make it worth the extra year.

Adult is easier in my opinion, so if the pay is close, I'd claim to not recall my child training.

 

[psychMDhopefully]

Ive been wondering about this, seems like C&A psychiatry=general psychiatry in terms of salary, the work is just different and C&A gets more respect. I would much rather work with children than adults, I would do peds if it didn't pay so horribly.

 

[Blitz2006]

Well, this article was written 8 years ago, but I don't think much as changed:

http://www.psychiatrictimes.com/articles/child-and-adolescent-psychiatry-next-10-years

"Projections from the studies mentioned above estimate a need for 30,000 child and adolescent psychiatrists.10 Currently, there are about 7000. However, since many of these child and adolescent specialists also treat adult patients and/or engage in administrative, supervisory, or other nonclinical activities, the direct care workforce is well below that number. Will we reach the goal of 30,000 in the next decade when there has been virtually no change in our numbers over the past decade?

I predict that by 2018, resulting in part from recent efforts by the American Academy of Child & Adolescent Psychiatry (AACAP), we will see a modest 30% increase in the number of medical students and general psychiatry residents choosing child and adolescent psychiatry as a career."

So I think if you go into C&A, you're going to be dictating pay for a very long time...I wish I liked child psych more!

I know here in the NYC area, cash only child psych charge on average $500/hr, and I've heard in parts of Manhattan its $700/hr. But of course, this is outlier data.

 

[masterofmonkeys]

God I wish that was every attending's stance. There has been no worse feeling as a CAP fellow then being berated by a borderline mother for 45 minutes to have your attending come and take their side and throw you under the bus to appease the parent.

Or a hospital culture whose approach to patient satisfaction can best be described as "get your kneepads"

Or worse, both.

Ours seems to be to create clinic policies and conflict resolution policies that indulge Cluster b behavior on the part of parents. I hate my life.

 

[milesed]

When I started, I was paid $10k over what another general psyc was paid (both right out of residency with no experience). It doesn't sound like much but raises and bonuses are always a % of current pay so I slowly pulled further away from him.