How the competitiveness of medical specialties should be...

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SMC123 said:
200 national..in midwest 225..thats working 35-40 hr weeks
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Full disclosure, I'm looking to make 300k. Just wondering how you can make up the difference from a lets's say a salaried job (40hrs fem what I've read) paying 250k? I know others have said that the 50k isn't that big of a difference after taxes, but it certainly ads up to a sizeable amount.
 
vanfanal said:
Full disclosure, I'm looking to make 300k. Just wondering how you can make up the difference from a lets's say a salaried job (40hrs fem what I've read) paying 250k? I know others have said that the 50k isn't that big of a difference after taxes, but it certainly ads up to a sizeable amount.
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60 hours per week
 
I still have a hard time.believing psych can make that mucj without procedures. wouldnt everyone be going into it then?
 
SMC123 said:
I still have a hard time.believing psych can make that mucj without procedures. wouldnt everyone be going into it then?
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EM makes more with comparable hours
 
vanfanal said:
Full disclosure, I'm looking to make 300k. Just wondering how you can make up the difference from a lets's say a salaried job (40hrs fem what I've read) paying 250k? I know others have said that the 50k isn't that big of a difference after taxes, but it certainly ads up to a sizeable amount.
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Don't take a salaried job. You need good business sense to make 300k in psych.
 
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@F0nzie . So a psychiatrist I know fairly well here in California charges $250 per hour and takes no insurance. He works 4 days a week M - Th, 8 to 5. He also takes vacations throughout the year. He clears over $270K a year. It wouldn't seem beyond him to make $300K if he worked 5 days a week. Is this not reasonable to people on this forum?
 
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SMC123 said:
I still have a hard time.believing psych can make that mucj without procedures. wouldnt everyone be going into it then?
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Go chat with a psychiatrist. See what they have to say about income potential. You'll be surprised like I was when I was in med school.

(You think you need procedures to make a high income? Attorneys do it all the time with their hourly fees.)
 
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Two psych docs in south FL told me they make 300k working about 50h hours/wk... Is it difficult to find a part time job (20-24 hrs) with benefits as a psych? One can do that and also work as a contractor. I think it might be easier to make close to 300k working like that without killing yourself...
 
@SMC123 ... We don't have state tax in FL, but these guys were talking about gross pay (not net pay), which would have been the same even with state tax...
 
Leo Aquarius said:
@F0nzie . So a psychiatrist I know fairly well here in California charges $250 per hour and takes no insurance. He works 4 days a week M - Th, 8 to 5. He also takes vacations throughout the year. He clears over $270K a year. It wouldn't seem beyond him to make $300K if he worked 5 days a week. Is this not reasonable to people on this forum?
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That sounds right. I charge $250 per hour in my pp and typically make $1500 on a full day (accounting for no shows and cancellations). Overhead should be around 30k if you streamline it. I also have a part-time job that gives me around 30k in benefits.
 
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SMC123 said:
call? I assumed there were programs without overnight call or weekends
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I'm curious what some of the practicing physicians think about this. Getting ready to apply for Psych, I feel I would inherently want to avoid these residencies as much as ones that are working me 80+ a week.
 
F0nzie said:
That sounds right. I charge $250 per hour in my pp and typically make $1500 on a full day (accounting for no shows and cancellations). Overhead should be around 30k if you streamline it. I also have a part-time job that gives me around 30k in benefits.
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Cash-only? Any difficulty finding pt's willing to pay out of pocket? (would guess this varies on location)
 
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Leo Aquarius said:
I'm posting this for fun mostly. But if med students pulled their heads out of their rear ends and woke up to things that will really matter to them as they get older, the ranking of competitiveness of medical specialties should look something like this:

The Revised Medical Specialty Competitiveness Ranking:


Most competitive (least manual labor, least stressful, lowest malpractice rates, high hourly wage, ease of starting a private practice, great prospects most locations):

Reproductive Endocrinology & Infertility, Allergy & Immunology, Psychiatry


Very Competitive (some manual labor, some stress on the job, low malpractice rates, high hourly wage, good markets in big cities and good prospects beyond):

Dermatology, Pain Medicine


Competitive (some manual labor, some stress on the job, average malpractice rates, medium to high physician hourly wage, semi-saturated markets in big cities with good prospects beyond):

Neurology, PM&R, Pediatrics, Family Medicine, Radiology, Gastroenterology, Rad Onc


Not Very Competitive (lots of manual labor, high stress, average to high malpractice rates, medium to high hourly wage OR saturated markets in big cities with questionable prospects beyond):

Ophthalmology, ENT, Internal Medicine, Cardiology, Anesthesiology, Pathology, Emergency Medicine


Not Competitive At All (very labor-intense, stress big time, long hours, high malpractice rates, extremely long training, high hourly wage, AND saturated markets in big cities):

Urology, Neurological Surgery, Orthopedic Surgery, Ob-Gyn, Colon & Rectal Surgery, Thoracic Surgery, Vascular Surgery


Least Competitive (very labor-intense, very stressful, draining hours, above average malpractice rates, decent hourly wage, AND saturated markets in big cities):

General Surgery
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Leo,

You are my new favorite SDN friend: You think the way I do; You think logically; and most of all, you think economically and fiscally.

Sweet.
 
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"But if med students pulled their heads out of their rear ends and woke up to things that will really matter to them as they get older, the ranking of competitiveness of medical specialties should look something like this"

Please remember that it is very hard at a younger age to imagine what will be important to you in the future. Things change with children, jobs, partners and other things in life. Six years ago I could have not imagined what my life would be like now and what is important to me today. And I am sure that my priorities today will change dramatically in the next six years. That's why lost of students come on these types of forums asking for advice about what the future holds in specialties and whether current physicians are happy. These days, medical students see larger debt loads and the possibility of starting to actually live their lives only well into their 30s, while their friends who didn't have to go through so much school and didn't take on so much debt are in good jobs with good pay, and have a home and a family. I would say that the preoccupation with money and lifestyle is perfectly justifiable based on these circumstances, and it's important that seniors educate and give us insight into what to what becomes important later in life and what kind of future each specialty provides. That's my two cents anyway.
 
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So would you recommend psychiatry as a legit field to go into?
 
SMC123 said:
So would you recommend psychiatry as a legit field to go into?
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Absolutely. If you think you might like it chances are you're right. It has a way of selecting people who will like it. Not being burdened by such ridiculous notions as prestige. Or self-importance.

I made the right choice. The fact that I imagined myself missing the boring, tedious, and tortuous middle road of medicine was ludicrous.

If I had a time machine I would take it to go slap the **** out of myself for broaching such an absurd notion in my mind.
 
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Thats exactly where I am. I know psych is for me. I look forward to setting up rotations for it. I look forward to speaking with patients, rather than doing procedures. In all honesty, I don't even want to do the 4-5 months of primary care during intern year. But the only reason I still look in that direction, is what people will think of me. I will have to live my whole life answering the question "why psych".. and all these other obscure questions kinda like "why job?".. end result to make money so you can provide for your family and live.. for the past 7 months I have been debating this.. every once in a while ill be like no you should do something with prestige.. but i know i will regret it.. the first day of my intern year when i walk into an ICU.. psychiatry gives me happiness.. not a road block.. the tunnel won't still be pitch black.. and the fact that this forum says that you can make a great lifestyle and money out of it if necessary.. well all the important things are there.. i can take the hit on what people say.. i thinkkkkkkkkk :)
 
SMC123 said:
Thats exactly whedire I am. I know psych is for me. I look forward to setting up rotations for it. I look forward to speaking with patients, rather than doing procedures. In all honesty, I don't even want to do the 4-5 months of primary care during intern year. But the only reason I still look in that direction, is what people will think of me. I will have to live my whole life answering the question "why psych".. and all these other obscure questions kinda like "why job?".. end result to make money so you can provide for your family and live.. for the past 7 months I have been debating this.. every once in a while ill be like no you should do something with prestige.. but i know i will regret it.. the first day of my intern year when i walk into an ICU.. psychiatry gives me happiness.. not a road block.. the tunnel won't still be pitch black.. and the fact that this forum says that you can make a great lifestyle and money out of it if necessary.. well all the important things are there.. i can take the hit on what people say.. i thinkkkkkkkkk :)
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Trust me. When I say this. People can blow me. You will, in the end, agree most heartily. I'm working 8o plus hour weeks shepherding the thousands of details of general medical care through a constant revolving door of patients, 10 at a clip. This....is for the f'n boids.

My reason for thinking I would miss it is that I liked learning all about the pathology. A bit fanciful that. There's no nifty academics being narrated in subdued BBC english. It's grimy detail ushering while running full tilt. All day.

The other day I read a psych consult and couldn't stop thinking how radically different the thinking is. Much better. And wonderfully procedureless as you say. I hate procedures. Fluid from here, needle sticking there. Gross and stressful.
 
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I think even when it comes to dictation your patients, or making decisions is so much better in Psych. There are only so many drugs you can give in Psych, you aren't dealing with 12 different systems at one time like in IM. Increase the dose here, decrease the dose here. The dictation is actually like telling a story rather than going into all these medical words you can't even pronounce. Patient came in with acute on chronic renal failure *WTF??!?!
 
A friend of mine is a second-year resident in internal medicine. I ran into him in the elevator the other day. He said he needed help, was depressed, and said he probably needed to see a psychiatrist and asked if I could help. I put a hand on his shoulder and asked if everything was ok. He shrugged and went on his way. I'll call him later. He's not the only one out there.
 
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Silent Cool said:
Leo,

You are my new favorite SDN friend: You think the way I do; You think logically; and most of all, you think economically and fiscally.

Sweet.
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Thanks @Silent Cool. I believe a balanced life is a healthy life. And unlike others on here, I always try to provide facts.
 
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I've heard that some psychiatrists have to work at a few different offices/hospitals to make a decent amount and the job market can be a little trickier than other fields. Any opinoions?
 
SMC123 said:
I've heard that some psychiatrists have to work at a few different offices/hospitals to make a decent amount and the job market can be a little trickier than other fields. Any opinoions?
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What? In the 1 or 2 most competitive markets in the country...for the first couple of years...maybe. Psychiatrists who work multiple jobs want to. Or are building their private practice.

Look...I'm in like the bottom 1% for financial outlook as a physician. In terms of my net value. And I still maintain the old adage. Pick something you like. Or failing liking anything pick something you don't mind doing in a field with a good lifestyle.

The lifestyle is good in psych. The money is not the worst compared to other fields. Particularly per hour. Demand is high. Flexibility is amazing. In the most amazing cities in the country you can still find great work.

The not insignificant inverse of your question is would you rather be an OB if you made 500,000 or a whatever. My answer is no.

But perhaps my likes and dislikes are stronger. Idk.
 
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I did a little experiment to get a quick barometer of the job market. Mind you this is a very simplified and cursory survey. Take the trusted physician job finder website, Merritt Hawkins, and search for total jobs across the country. Here's what I found right now for 12 randomly picked fields:

Family Med - 223 total jobs across the country
Psychiatry (Adult) - 64
Neurology - 36
Ob/Gyn - 32
Pediatrics - 26
Emergency Med - 22
Dermatology - 22
Urology - 19
Neurosurgery - 10
Anesthesiology - 4
Cardiology - 4
Radiology - 2

These same 12 field from the biggest job search site, monster.com:

Family Practice - 443 total jobs across the country
Emergency Medicine - 116
Psychiatry - 108
Pediatrics - 62
Neurology - 39
Urology - 33
Ob/Gyn - 25
Dermatology - 10
Anesthesiology - 8
Radiology - 3
Cardiologist - 3
Neurosurgery - 2


There's a trend on two completely different sites. Should carry some water.
 
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Yes. But if you look at those jobs in more detail, Merritt Hawkins for example, psych is on the lower end of the spectrum for renumeration. There are neurology/anesthesiology/radiology/cardiology jobs with 40-45 hour work weeks that pay at least 300k. The cost of living is very expensive these days and continues to increase.

Leo Aquarius said:
I did a little experiment to get a quick barometer of the job market. Mind you this is a very simplified and cursory survey. Take the trusted physician job finder website, Merritt Hawkins, and search for total jobs across the country. Here's what I found right now for 12 randomly picked fields:

Family Med - 223 total jobs across the country
Psychiatry (Adult) - 64
Neurology - 36
Ob/Gyn - 32
Pediatrics - 26
Emergency Med - 22
Dermatology - 22
Urology - 19
Neurosurgery - 10
Anesthesiology - 4
Cardiology - 4
Radiology - 2

These same 12 field from the biggest job search site, monster.com:

Family Practice - 443 total jobs across the country
Emergency Medicine - 116
Psychiatry - 108
Pediatrics - 62
Neurology - 39
Urology - 33
Ob/Gyn - 25
Dermatology - 10
Anesthesiology - 8
Radiology - 3
Cardiologist - 3
Neurosurgery - 2


There's a trend on two completely different sites. Should carry some water.
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Heck, even dentists & orthodontists make more that what those psych jobs are going for. But, do what you enjoy.
 
@vanfanal. You're not comparing the same things. Keep salaried positions distinct from private practice opportunities.

Dentistry is mostly private practice. Their incomes will be higher than salaried positions of some doctors. So you can't compare them in this.

The positions on these websites are salaried positions. If you want to talk pay, then have a seat my friend. Nobody is arguing Psychiatry pays better than all the other specialties in salaried jobs (it does pay better than a good handful of specialties however). Where psychiatry shines is the huge job market with very decent pay and one of the highest job satisfaction rates, and an easy transition into private practice where you can essentially double your income. Right now I could find a job in any state that pays $250,000 in a salaried spot. I can then slowly build my practice and make $300,000 and more. Not many can claim this.

My above facts serve to support the claim psychiatry enjoys a healthy job market - that was my point nothing else. That's one of the big bonuses of psychiatry. But, if you don't like psych too bad for you. Do what you enjoy. Suffer the wrath of American health care and insurance companies when they bite you in the you know what.
 
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Leo Aquarius said:
A friend of mine is a second-year resident in internal medicine. I ran into him in the elevator the other day. He said he needed help, was depressed, and said he probably needed to see a psychiatrist and asked if I could help. I put a hand on his shoulder and asked if everything was ok. He shrugged and went on his way. I'll call him later. He's not the only one out there.
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wait......he just tells you he 'needs help' and was depressed, and you respond by asking him if everything was ok? Ummmm....he just told you it wasn't. One can hope you listen to patients better than the friend in this made up story.....sheeesh.
 
250k in salary spot? so you would double that outpatient??
 
vistaril said:
wait......he just tells you he 'needs help' and was depressed, and you respond by asking him if everything was ok? Ummmm....he just told you it wasn't. One can hope you listen to patients better than the friend in this made up story.....sheeesh.
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Funny coming from you, the King of Making Things Up.

It's a true story and you can choose not to believe it. Makes no difference to me. In fact, most things you read Vistaril you don't believe if it doesn't suit your complex delusional systems.
 
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SMC123 said:
250k in salary spot? so you would double that outpatient??
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No. Think of it this way. Most salaried jobs in psych pay - from what I've seen - anywhere from $110 to $180 and hour. In your own outpatient setup, you can charge $250 or $300 an hour. There's your doubling effect. After that it's just how many hours you want to work. Comprende?
 
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Please excuse my post. It was late at night and I was venting off some personal frustration. I had just gotten back from the dentist with a huge bill and was angry because they have a free market system whereas physicians in my area are obliged to accept peanuts from the government. Anyway. I'm on my psych elective now and am enjoying it apart from today because I must have caught something off a patient. My attending had a very weird reaction when I called to inform him. It's okay to call in sick right? I don't want to spreading yellow phlegm everywhere.

vanfanal said:
Yes. But if you look at those jobs in more detail, Merritt Hawkins for example, psych is on the lower end of the spectrum for renumeration. There are neurology/anesthesiology/radiology/cardiology jobs with 40-45 hour work weeks that pay at least 300k. The cost of living is very expensive these days and continues to increase.
Click to expand...
 
Leo Aquarius said:
Funny coming from you, the King of Making Things Up.

It's a true story and you can choose not to believe it. Makes no difference to me. In fact, most things you read Vistaril you don't believe if it doesn't suit your complex delusional systems.
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dude I was giving you the benefit of the doubt that you did make it up.....because if you didn't, you need to pay better attention in your interview class- if someone tells you they aren't ok, you don't then immediately ask them if they are ok. Sheeesh.....
 
HooahDOc said:
I did not become a doctor to end up as someone's salaried bitch.
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not sure what you do/want to do, but for psychs doing inpatient they most def want to end up as someone's salaried bitch because the numbers look terrible if they don't. I know people seing 30 inpts a day on collections system to make as much as I will next year. Psych is not a good collections based field.
 
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