City population needed to sustain a psychiatrist

[DO_or_Die]

This is surprisingly something that I haven't found much information on when I've searched.

What do you think would be the average population of a city required to sustain a FT clinic based psychiatrist opening up a private practice? I ideally plan to live in the rural western states (idaho, montana, oregon, washington). By rural I mean towns with less than 100,000 population. Do you think this would be feasible to do without having to do a mix of clinic + telepsych? Thank you.

---

Members don't see this ad.

 

[singasongofjoy]

I've got no real experience to base this on, but my guess would be that it might depend a whole lot on how much of the population has insurance and if so, what type. How much of your client load can you float as Medicaid? And how much of a network of local therapists do you deem needed to support your presumed patient population? (in part grew up in a poor rural county that, last time I checked, had zero psychologists, a couple social workers in the entire county. I can't imagine being a PP psychologist would be very tenable with current medicaid reimbursement rates and factoring in standard rates of no-shows/cancellations).

 

[Stagg737]

Lol, less 100,000 people is not "rural". I do telehealth and treat patients from towns with less than 500 people. If you're the only psychiatrist in town, 100k should be plenty of people to support a clinic. It could take a while to build up, but it's easily doable if they're in the same town/city.

For reference, I have a telehealth consult clinic that serves an population less than that and could easily fill a full clinic for this population if I wanted to. However, there's also only a handful of psychiatrists in these areas, so competition is basically non-existent. Would completely depend on who is already there.

 

[alina_s]

HPSA scores can tell you something about # of providers in areas you’re looking at, although data may not be 100% accurate. My first job was a NHSC position in a town of 12,000, but it was the county seat and the only MH clinic in the county, and several neighboring counties had 0. We were busy and people drove far, but it wasn’t a population I would’ve wanted to work with solo.

 

[Sushirolls]

25,000
I've looked into this before.
Go lower than that you'll need to start taking medicaid and medicare with higher certainty, depending on payer mix of the community.
But 25K will have for sure enough private insurance to make it work.

The town doesn't need to be 25K, but the relative area that people will drawn in from should have at least 25K.

If you know the payer mix and the relative reimbursement for insurance in that state or that region of the state, you'll better be able to decide if you can go lower in population.

This is for general adult psychiatry "med check style." About ~400 patients will be in full range.

If you do cash and own hour long therapy you'll only need ~100 patients.

Others, please feel free to chime in and tweak those number declarations.

I've come to that number conclusion form extrapolating with my residency metro and counting out the number of psych providers there, then the various other metros I've worked and currently the rural place I'm in now.

*if you add CAP, that can make it much, much, much lower community. But medicaid is a question/variable for CAP...

 

[clozareal]

There are too many variables involved that we don't know about. Are you planning on doing cash practice, insurance, medicaid, medicare? Are you opening up a brand new outpatient practice or taking over from someone else? Do you know the area at all or would you have to network with psychiatrists, therapists, pediatricians, etc? What does the competition look like for psychiatrists in the area? Are there a bunch of psychiatrists hunkering for patients or is everyone full and starving for a good psychiatrist to refer to? What are your expenses and your revenue/profit goals? Are you planning on doing therapy, med management, or both? What does full time mean to you? You can have a panel of 400 med management patients on your panel or 20 weekly therapy±med mgmt and be considered "full."

 

[milesed]

I live in a town of about 23,000 and we are terribly underserved with 4 full time general psychiatrists and many ARNP's. It may be an exception as we're 2 hours from major cities and are somewhat of a medical hub with 2 mid-sized hospitals.

 

[Sushirolls]

Town is 23K, but what's the catchment area? I.e. how far are people driving in from to go there, and what's that total population?