Psych NPs - Threat or Asset?

[Leo Aquarius]

Now I'm doubly motivated to start a successful multidisciplinary clinic where I will hire the best psych NP and psychologist, and we will enjoy working as a team. I've seen it done, and nothing can stop me.

Vistaril can kiss my ass.

---

Members don't see this ad.

 

[billypilgrim37]

Calm down, Leo. Vistaril has been following the Fox News playbook since day one (change the question until it matches something that is so obvious that he can lol at how dumb we all are). He's not going to permit you nuance. It is very common for a psychiatrist to own a practice and employ (either by salary, or by a percentage cut, or various other ways) therapists or even NPs. And it's not that uncommon for psychologists to own a practice and employ (under those same terms) a psychiatrist. Whopper had a setup like that for a while. I know a NP (married to a psychiatrist colleague) who works in that kind of a setting for someone else, and I know of a child psychiatrist around here who worked for a psychology practice.

V has been contributing more positively than in the past. But he's not always going to allow for someone else's reality (or even the reality of a conversation--why answer a question directly when he can expand the scope and force you to play right-wing whack-a-mole). It's hard to not engage him BC he's so cocksure, and you don't want such biased info to go unchecked, but it's best to take an MI approach when possible.

 

[JourneyAgent]

Calm down, Leo. Vistaril has been following the Fox News playbook since day one (change the question until it matches something that is so obvious that he can lol at how dumb we all are). He's not going to permit you nuance. It is very common for a psychiatrist to own a practice and employ (either by salary, or by a percentage cut, or various other ways) therapists or even NPs. And it's not that uncommon for psychologists to own a practice and employ (under those same terms) a psychiatrist. Whopper had a setup like that for a while. I know a NP (married to a psychiatrist colleague) who works in that kind of a setting for someone else, and I know of a child psychiatrist around here who worked for a psychology practice.

V has been contributing more positively than in the past. But he's not always going to allow for someone else's reality (or even the reality of a conversation--why answer a question directly when he can expand the scope and force you to play right-wing whack-a-mole). It's hard to not engage him BC he's so cocksure, and you don't want such biased info to go unchecked, but it's best to take an MI approach when possible.

That's a very useful and insightful comment on how to approach interpersonal dissonance. I sort of arrived at something proximal but have difficulty executing consistently.

I think it's particularly irking to those of who are constructing a lot of hopeful plans around a career in psychiatry.

I don't know if there's just ample room for a lagging cynicism in the field. Or whether the impending and current economic conditions--In my view germane to the original topic--are really impacting what level of practice is attainable in the work force. But it's enough to stir up emotion when being accosted by a condescending nihilism about the field as you're making preparations to get married to it.

 

[AnnoyedByFreud]

Now I'm doubly motivated to start a successful multidisciplinary clinic where I will hire the best psych NP and psychologist, and we will enjoy working as a team. I've seen it done, and nothing can stop me.

Vistaril can kiss my ass.

Hey Leo, I know a ton of psych NP classmates (myself included) who would absolutely love to work in a collaborative practice with a great psychiatrist. This is assuming they are paid fairly (heh).

 

[vistaril]

You idiot. Why do you twist things? You have a warped, dramatized understanding of anything and everything people say. Get out of medicine. I never meant that people would NEED to work for me you stupid ass.

Don't you ever put words into my mouth again that I never said. I hate people like you. I hope you get sued the first year you enter practice.

I probably shouldn't have said the word 'need', but sheeesh leo take it easy. But back to the issue...why would the 'best' psychologists choose to work for you? I'm just not sure what they get out of the arrangement(at least one that is financially beneficial to you)...yeah, you could give them referrals, but remember they can also give you referrals.

 

[vistaril]

Calm down, Leo. Vistaril has been following the Fox News playbook since day one (change the question until it matches something that is so obvious that he can lol at how dumb we all are). He's not going to permit you nuance. It is very common for a psychiatrist to own a practice and employ (either by salary, or by a percentage cut, or various other ways) therapists or even NPs. And it's not that uncommon for psychologists to own a practice and employ (under those same terms) a psychiatrist. Whopper had a setup like that for a while. I know a NP (married to a psychiatrist colleague) who works in that kind of a setting for someone else, and I know of a child psychiatrist around here who worked for a psychology practice.

V has been contributing more positively than in the past. But he's not always going to allow for someone else's reality (or even the reality of a conversation--why answer a question directly when he can expand the scope and force you to play right-wing whack-a-mole). It's hard to not engage him BC he's so cocksure, and you don't want such biased info to go unchecked, but it's best to take an MI approach when possible.

Well it all depends on the arrangement. One of my jobs now actually involves me a weekend day here and there working for an agency owned by a few social workers.

Someone(either you or Leo) threw the term 'collaborative' around, but what I see when psych nps and psychiatrists work in the same building for outpt isn't really collaboration. The nature of the billing makes it such. Say Leo does open a practice one day and hires a psych np. That psych np is going to be seeing their own patients independently Sure, the possibility is there for the psych np to go to Leo and say "hey, I don't know what to do here can you help me out", but even then Leo is not likely to see the patient. After all, the insurance company(or pt) isn't going to reimburse twice on that very same day for the office visit for a similar service(you could, or at least very recently, bill med mgt from a psych and therapy from another provider on the same day).

I think it's also very important to differentiate salaried providers vs providers who give a cut(30-32% is fairly typical) of their revenue. The former is a true 'working for' situation. The latter has everything to do with working capital and such. I don't consider the latter 'working for' in any real sense, and I think that's going to continue to be a much more common arrangement, especially for psychologists(but also for psych nps as health care changes in the future).

 

[priorities2]

Don't most mental health providers collaborate in.. what do they call them.. those weekly, biweekly or monthly meeting type things where they all sit around and discuss cases and best plans of action?