Compensation Options

[postbacpremed87]

I am curious if it is a likely scenario to take a salaried position at $220,000 a week for 45 hours a week, but then either take extra call/obtain a productivity bonus to get an extra few thousand a year or if it is possible to work part-time for another psych practice to make a few extra thousand a year. I guess what I am asking ...what are the various ways to make above your guaranteed base salary of 215-220k. Thanks.

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[wolfvgang22]

Yes, very possible. You can easily do part time contract work on weekends or evenings if you have the desire/energy/financial need. Lots of people ask this question all the time here. There is a shortage of psychiatrists in most areas.

 

[F0nzie]

You can work as many hours as you want. Plenty of part-time work out there. You just need to make sure there isn't a non-compete contract at your full time job.

 

[TexasPhysician]

Sure - the sky is the limit. 220k for 45 hours is low in my area unless we are talking academia.

 

[Baller MD]

Sure - the sky is the limit. 220k for 45 hours is low in my area unless we are talking academia.

Are you in the Austin area?

 

[TexasPhysician]

Are you in the Austin area?

No. Austin is the most saturated area of TX, so I would expect it to be a little lower for an employed gig.

 

[notdeadyet]

Sure - the sky is the limit. 220k for 45 hours is low in my area unless we are talking academia.

Yeah, Texas seems to have about as high an average salary as I've seen in the field. Nice thing when combined with a low cost of living in most spots, I'd imagine.

 

[Baller MD]

Yeah, Texas seems to have about as high an average salary as I've seen in the field. Nice thing when combined with a low cost of living in most spots, I'd imagine.

Funny. I remember reading somewhere here that the South doesn't value mental health and low pay is a result of it.

 

[Shikima]

I came across an ad for $275ish as employed based on a 40 hr work week plus extra for taking call. The numbers are steadily increasing. Now I couldn't comment what the work environment will be like and how much pushing from administration there would be.

 

[Baller MD]

I came across an ad for $275ish as employed based on a 40 hr work week plus extra for taking call. The numbers are steadily increasing. Now I couldn't comment what the work environment will be like and how much pushing from administration there would be.

Is the increase due to a shortage of psychiatrist or the actual value in what psychiatrists do?

 

[Shikima]

Is the increase due to a shortage of psychiatrist or the actual value in what psychiatrists do?

Both?

 

[Baller MD]

Both?

Ok.

 

[shan564]

Sure - the sky is the limit. 220k for 45 hours is low in my area unless we are talking academia.

This is also true in my area... low for private practice, high for academia.

 

[demayette]

Base on what I read in this thread, it's not impossible for a psych physician to make 300k/year working 50 hrs/week average... Am I correct?

 

[whopper]

IMHO a private psychiatrist working 40 hours a week could realistically make $400K provided that you are good, efficient, and your practice has a good business model.

Academia doesn't pay as much. You should be in academia only if you give a damn about the field, are willing to make less money, and want to be intellectually stimulated.

I make less in academia but I'm considering supplementing my academic position with private practice. I used to make a lot in the stock market to the degree where it didn't make me mind at all making less, but I'm considering a possible plummet in the next several months and the older I get and with kids, each time I make money off the market I envision losing a lot too and I don't want to put their futures on the line.

Each field has it's pros and cons.
While PP makes money you aren't exposed to top people in the field. You are not in a learning environment, and you don't get benefits though your pay is to the degree where so long as you put some money into a 401K and other options you'll be fine.

The state: awesome benefits, but lower pay and you likely will be working with colleagues that aren't good practitioners. Some will be but the bad outnumbers the good.

Academia: It could make money if you play it right but that could take quite some time. I know, for example, a professor that already owns a nursing home and makes a fortune off of it. He loves research and teaching and is very good at it. He doesn't need the money of his academic salary. Successful research could also make good money but in general expect to make less.

U of Cincinnati, while I was there, did pay a lot more vs other academic places I've seen. They payed around $180-200K plus if you did good work they gave bonuses. I made about an extra $1200 a month due to the bonuses, and I've known people to rake in a heck of a lot more. You also get a state retirement option where you make half your salary the rest of your life if you put in 25 years. That said, they were an exception. No private institution provides anything like this and most pay very low salaries.

With the above, plus they covered malpractice, had a separate 403B (the same thing as a 401K but with a state or charity employer), health benefits, etc, my salary with them was really the equivalent of about $275K a year.

 

[hamstergang]

Does anyone know how to compare different options of different salaries and benefits? If we're just comparing salaries, that's easy for a first grader. But I don't know how to fit various benefits into the equation.

 

[vistaril]

Funny. I remember reading somewhere here that the South doesn't value mental health and low pay is a result of it.

if you heard this is it bull****.....most psychiatry jobs in the south are very similar to the same type of psychiatry jobs in other areas of the country.

oh and texas isn't really the south though.

 

[Shikima]

Does anyone know how to compare different options of different salaries and benefits? If we're just comparing salaries, that's easy for a first grader. But I don't know how to fit various benefits into the equation.

Would be easier to give you advice if you have some specific senarios to review...

 

[whopper]

if you heard this is it bull****.....most psychiatry jobs in the south are very similar to the same type of psychiatry jobs in other areas of the country.

I'm in Missouri now. It's not the South but it's far worse vs the East coast states that nicely fund mental health. I got patients in jail that are schizophrenic, refusing services and I can't do anything about it despite that they are dangerous. In NJ or Ohio they would've been brought to a forensic unit. Here they will only be brought to such a facility if the crime is of the most seriousness such as murder. The usual acute-care hospitals units refuse to take them despite that it is likely an EMTALA violation. The outpatient community programs don't hold a candle to what I saw in NJ, NY, and Ohio.

The flip-side is psychiatry can pay a lot more.

 

[hamstergang]

Would be easier to give you advice if you have some specific senarios to review...

I'm not even there yet. Just planning ahead.

 

[TexasPhysician]

Does anyone know how to compare different options of different salaries and benefits? If we're just comparing salaries, that's easy for a first grader. But I don't know how to fit various benefits into the equation.

Sure. Assign a dollar value to the benefits. You can research health insurance to find an equivalent plan's cost. Do the same for all benefits.

 

[vistaril]

I'm in Missouri now. It's not the South but it's far worse vs the East coast states that nicely fund mental health. I got patients in jail that are schizophrenic, refusing services and I can't do anything about it despite that they are dangerous. In NJ or Ohio they would've been brought to a forensic unit. Here they will only be brought to such a facility if the crime is of the most seriousness such as murder. The usual acute-care hospitals units refuse to take them despite that it is likely an EMTALA violation. The outpatient community programs don't hold a candle to what I saw in NJ, NY, and Ohio.

The flip-side is psychiatry can pay a lot more.

I read horror stories all the time in the media about mistreated mental health patients in the northeast(and the problem is always blamed on lack of funding/resources)......the vast majority of high profile cases of late involving mental illness and tragedy(much of them blamed on lack of resources and access) have been outside the south for example.

 

[shan564]

I read horror stories all the time in the media about mistreated mental health patients in the northeast(and the problem is always blamed on lack of funding/resources)......the vast majority of high profile cases of late involving mental illness and tragedy(much of them blamed on lack of resources and access) have been outside the south for example.

I agree, but I think part of that is probably due to the fact that the Northeast gets more media attention in general.

 

[vistaril]

I agree, but I think part of that is probably due to the fact that the Northeast gets more media attention in general.

maybe for some things(entertainment, cultural, etc), but when when mass murders or high profile murders happen, it gets covered regardless of where it is. Death and mayhem knows no geographic bounds......from susan smith to Kaycee Anthony.

 

[shan564]

maybe for some things(entertainment, cultural, etc), but when when mass murders or high profile murders happen, it gets covered regardless of where it is. Death and mayhem knows no geographic bounds......from susan smith to Kaycee Anthony.

Yeah, but I think it's more likely to be "high profile" if it's in certain parts of the country.

 

[vistaril]

Yeah, but I think it's more likely to be "high profile" if it's in certain parts of the country.

If a kid/guy walks into school and kills 20 or so 1st graders, that's going to be a HUGE national story for awhile whether it happens in a distant suburb of NY or in Amarillo, Tx.

Another point to remember is that celebrities are more likely to live in LA and NY, and when celebrities are involved in murder cases that's always going to be a bigger deal. Had OJ killed ron and Nicole in Chicago rather than socal, for example, I think that's still a huge story.

And then I think about cases that got FAR MORE attention than they would seemingly merit which occurred in other places.....I heard far more about the casey Anthony case, for example, in magazines and national tv shows than I wanted to or felt it deserved......and she lived in central florida.

I think the media will pick up on a good story and run with it if they can market it and market the stories and people behind it....and Im not sure geography matters all that much(name rec does to some degree)

 

[smalltownpsych]

I read horror stories all the time in the media about mistreated mental health patients in the northeast(and the problem is always blamed on lack of funding/resources)......the vast majority of high profile cases of late involving mental illness and tragedy(much of them blamed on lack of resources and access) have been outside the south for example.

Probably because that is where the vast majority of people live. Also if you are looking at a low base rate occurrence such as mass murders, it is not a good idea to draw any conclusions without statistical analysis.

Oh and people always blame lack of resources and funding although in our state we rank 7th in spending on mental health and 47th in access to mental health. We are also in top 5 suicide rate. This would point to a system that might not work no matter how much funding is increased.

Obviously we're off topic but the original posted question has been discussed a lot already and isn't as interesting as mass murder.

 

[st2205]

Oh and people always blame lack of resources and funding although in our state we rank 7th in spending on mental health and 47th in access to mental health. We are also in top 5 suicide rate. This would point to a system that might not work no matter how much funding is increased.

I don't know that it's an issue of a system not working in as much as it is realizing there's no "system," we just happen to be assigned the default. Every time some sociopath murders a bunch of people, we hear about needing more access to mental health treatment. Granted, that's in many ways a good thing. But the underlying assumption is that if these sociopaths simply "had access" to mental health treatment that these events wouldn't happen. I think this is a rather faulty view. Sure, if someone is delusional and goes on a killing spree then we can have a discussion, but just because a sociopath did what sociopaths do doesn't mean that a medication, a therapist, a chiropractor, or even treating a vitamin deficiency would change anything about that, unless the idea is chronic chemical sedation and restraint. And in that case then incarceration would be a more reasonable option with stiffer penalties (no pun intended) for antisocial behaviors.

I think it plays in to some of the same fallacies and fantasies as the whole VA wait list scandal. Yes, the whole thing was shady -- but the news of people dying on the wait list played in to a few societal fantasies such as 1) people don't die and 2) if they could go see a PCP a they wouldn't have died.

 

[vistaril]

Probably because that is where the vast majority of people live. Also if you are looking at a low base rate occurrence such as mass murders, it is not a good idea to draw any conclusions without statistical analysis.

Oh and people always blame lack of resources and funding although in our state we rank 7th in spending on mental health and 47th in access to mental health. We are also in top 5 suicide rate. This would point to a system that might not work no matter how much funding is increased.

Obviously we're off topic but the original posted question has been discussed a lot already and isn't as interesting as mass murder.

If you include texas(which gets bashed for mental health resources a ton) and the whole rest of the south the 'vast majority' of the population certainly doesn't live elsewhere. You've got 100 million people or so(more?) in these states with texas in the mix. 1/3 of the country.

I do agree with your middle point though.

 

[smalltownpsych]

I don't know that it's an issue of a system not working in as much as it is realizing there's no "system," we just happen to be assigned the default. Every time some sociopath murders a bunch of people, we hear about needing more access to mental health treatment. Granted, that's in many ways a good thing. But the underlying assumption is that if these sociopaths simply "had access" to mental health treatment that these events wouldn't happen. I think this is a rather faulty view. Sure, if someone is delusional and goes on a killing spree then we can have a discussion, but just because a sociopath did what sociopaths do doesn't mean that a medication, a therapist, a chiropractor, or even treating a vitamin deficiency would change anything about that, unless the idea is chronic chemical sedation and restraint. And in that case then incarceration would be a more reasonable option with stiffer penalties (no pun intended) for antisocial behaviors.

I think it plays in to some of the same fallacies and fantasies as the whole VA wait list scandal. Yes, the whole thing was shady -- but the news of people dying on the wait list played in to a few societal fantasies such as 1) people don't die and 2) if they could go see a PCP a they wouldn't have died.

Great stuff.
There are a lot of flaws in our mental health system and I think one of them is trying to fix problems such as sociopathy or even just bad behaviors. ome of that is pressure being put on us by society, but I do question how we communicate who we are really helping. In my mind, we are much better suited to helping victims than perpetrators and both APAs might be better suited advertising that and let the legal system deal with the bad behavior. Lately, I have even been questioning why we go through so much trouble fighting to keep addicts on psych holds for suicidality when they don't want treatment and we just increase that resistance in an effort to keep them alive. Trust me, everyone wants us to "do something" about it and usually there is not much we can.

 

[whopper]

How does one attach a $ value to benefits?

Healthcare. The employer, if they give health benefits will tell you exactly how much a month they will pay for your health insurance. With my current employer they pay about $1100 a month for my health insurance.

Matching retirement. Employers are allowed to double any money you put into retirement by matching what you put in up to a certain amount. Always, always, always put in the maximum in that will force your employer to match what you put in dollar for dollar.

Pension: This is harder to calculate cause if you get a pension it all depends on how long will live. If you die before you retire this doesn't really affect the dollar amount. If you live 25 years after you retire you get 25 x the annual pension.

Malpractice insurance: will they pay for this?

Academic expenses: Several employers will give you a week off paid for going to a convention, pay a few thousand dollars worth of work-related things such as textbooks, an electronic tablet, etc.

Disability/Death/Accident: Most physician employers will cover these types of insurance for you. The dollar value they end up paying could be several thousand a year.

Other benefits: gym? Current employer lets me use the student gym for a price that is about 10% of a private gym and it's a damned good gym with an Olympic size swimming pool, etc. I also get free food in the attending lounge that amounts to a few thousand a year plus the time saved not going out for food or cooking it myself.