Psych salary...

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vistaril said:
if you repeat a lie enough, maybe it will become reality.

The salary per hour when working psych *right now* for independent contractor positions averages about 130/hr. For salaried positions it is going to come out to average about 100/hr. Now some settings are going to be more than 130/100 and some less.

That may not be the lowest out there(I suspect outpt doc in a box type low acuity urgent care may average 5-10 dollars an hour less), but it's certainly close.

Now not that those numbers(130/100 on average) mean we starve, but to claim it is anything close to 'one of the best' is laughable. By contrast something like EM comes in at around 270/200 on average(roughly double)
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I said 'one of the best' vis... I did not say 'the best'...
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If you list out all the specialties in order of hourly income, psych is probably in the bottom 4. But 3 of the specialties its beating Peds, FM, non-specialty IM encompass a huge percent of total doctors. So psych is one of the lowest paying hourly specialties, but probably at the same time hourly pay is above the median when considering doctors as individuals b/c so many people do peds/FM or primary care IM.
 
st2205 said:
You know, before you posted this I was about to quote the post you quoted above stating "cue a response complaining about the overrated taste of the psych Kool-Aid while raving about the quality of all the other specialty Kool-Aids." While I appreciate that some of the things you state do you have an element of unappreciated truth, it's just too shticky and predictable.
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well what can I say if someone posts something so ludicrous they will continue to get corrected. Like I've said several times I don't have any complaints about what I get paid and feel I am more than fairly compensated, but I'm also not delusional enough to believe that surgeons, anesthesiologists, emergency medicine physicians, various medicine specialties, and many other fields aren't making a lot more....total and per hour.
 
W19 said:
Look at AAMC 'career in medicine' website, you will see most other specialties are working almost 60 hrs/wk while psych is 44-45 hrs.
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dude, just call up some hospital systems or physician employers(IPC, UHS, whatever) and ask them what they pay psychs for a set number of hours(usually based on 40 hr weeks) vs other specialties based on 40 hr weeks. It's not particularly close.

If you play with the numbers enough and suit them to fit your goals, you can make them show what you want.
 
vistaril said:
dude, just call up some hospital systems or physician employers(IPC, UHS, whatever) and ask them what they pay psychs for a set number of hours(usually based on 40 hr weeks) vs other specialties based on 40 hr weeks. It's not particularly close.

If you play with the numbers enough and suit them to fit your goals, you can make them show what you want.
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I was wrong... I was just going by numbers on AAMC website.
 
Armadillos said:
If you list out all the specialties in order of hourly income, psych is probably in the bottom 4. But 3 of the specialties its beating Peds, FM, non-specialty IM encompass a huge percent of total doctors. So psych is one of the lowest paying hourly specialties, but probably at the same time hourly pay is above the median when considering doctors as individuals b/c so many people do peds/FM or primary care IM.
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I'll say just one thing- people underestimate the salary of hospitalist work. It's usually more flexible in terms of variety of different jobs out there(7/7, 18 days a month, some M-F)

It's just not that hard for a hospitalist, if he hustles, to make 375-425k doing nothing but inpatient work. He'd have to bust it, but it's definitely doable. It would be *very* hard for most inpatient psychiatrists to get to that number, even they are a very hard worker. It's possible, but more difficult.

For what it's worth, HCA/IPC/UHS(just to pick 3) pay their hospitalists on average about 20k per year more for 7 on/7 off work than their 7 o/7 off psychiatrist hospitalists. 235k vs 215k base. Now 20k isn't a lot, but it's not trivial either.
 
vistaril said:
I'll say just one thing- people underestimate the salary of hospitalist work. It's usually more flexible in terms of variety of different jobs out there(7/7, 18 days a month, some M-F)

It's just not that hard for a hospitalist, if he hustles, to make 375-425k doing nothing but inpatient work. He'd have to bust it, but it's definitely doable. It would be *very* hard for most inpatient psychiatrists to get to that number, even they are a very hard worker. It's possible, but more difficult.

For what it's worth, HCA/IPC/UHS(just to pick 3) pay their hospitalists on average about 20k per year more for 7 on/7 off work than their 7 o/7 off psychiatrist hospitalists. 235k vs 215k base. Now 20k isn't a lot, but it's not trivial either.
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People always say it's impossible for PCP to make that kind of money... But I saw my cousin tax return (I think it was in 2o10 or 2o11), he made over 370k+ as an internist... He had his own practice, work one saturday and sunday every month as a hospitalist and he is the medical director of a nursing home where he got 3k/month stipend + patients... I asked him how much time at the nursing home and he told me no more than 6 hrs/wk... Now he does not do the hospitalist job anymore because he said 300k is enough for him...
 
BestDoctorEver said:
People always say it's impossible for PCP to make that kind of money... But I saw my cousin tax return (I think it was in 2o10 or 2o11), he made over 370k+ as an internist... He had his own practice, work one saturday and sunday every month as a hospitalist and he is the medical director of a nursing home where he got 3k/month stipend + patients... I asked him how much time at the nursing home and he told me no more than 6 hrs/wk... Now he does not do the hospitalist job anymore because he said 300k is enough for him...
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yeah pretty much....although that stipend is on the low end. 6k/month or so isn't uncommon.

A typical way to make 400k as a hospitalist is:

-take 7/7 hospitalist job for 230-240k
-medical director at a ltc facility(little total number of hours for an extra 65k/year)
-pick up some extra inpatient shifts on your 7 days off for 100k extra(this would require working about 70 days out of those 180 or so you are off)

you'd be working hard, but it wouldn't be impossible. One could also do the same in psych, but it would be harder simply because 7/7s are not as plentiful in psych. And neither is the flexibility in picking up extra shifts.
 
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vistaril said:
yeah pretty much....although that stipend is on the low end. 6k/month or so isn't uncommon.

A typical way to make 400k as a hospitalist is:

-take 7/7 hospitalist job for 230-240k
-medical director at a ltc facility(little total number of hours for an extra 65k/year)
-pick up some extra inpatient shifts on your 7 days off for 100k extra(this would require working about 70 days out of those 180 or so you are off)

you'd be working hard, but it wouldn't be impossible. One could also do the same in psych, but it would be harder simply because 7/7s are not as plentiful in psych. And neither is the flexibility in picking up extra shifts.
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6k/month! That is a lot of money... This is not even amount to a part time job for the time physicians spend at ltc facility....
 
vistaril said:
yeah pretty much....although that stipend is on the low end. 6k/month or so isn't uncommon.

A typical way to make 400k as a hospitalist is:

-take 7/7 hospitalist job for 230-240k
-medical director at a ltc facility(little total number of hours for an extra 65k/year)
-pick up some extra inpatient shifts on your 7 days off for 100k extra(this would require working about 70 days out of those 180 or so you are off)

you'd be working hard, but it wouldn't be impossible. One could also do the same in psych, but it would be harder simply because 7/7s are not as plentiful in psych. And neither is the flexibility in picking up extra shifts.
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vistaril said:
If you play with the numbers enough and suit them to fit your goals, you can make them show what you want.
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This is why playing the average game is a waste of time. Most medical fields involve a lot of diversity.

I know family medicine docs working in ER's, urgent cares, private practice, VA, academic, derm clinics, pain clinics, etc. Some do a combination of multiple of the above. People argue that FM is one of the lowest paying fields, but the FM docs I know pulling 400k don't care about averages. They aren't working crazy hours either - about 45.

There are psychiatrists in academics starting at 140k for full time plus call. Some at the VA start at 230k for equivalent work. A recent graduate in private practice is now up to 280k in one setting. Another general psych doc works academic + forensics + sleep medicine and is well over 400k. All are general psychiatrists with similar hours and no sub-specialty boards. All are happy at their jobs

The only salary that matters is what you can find in a setting you enjoy.
 
st2205 said:
This post brought to you by your friendly folks at Kool-Aid.
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lol....what part sounds like Kool-Aid? That's exactly what the inpatient internists who make >400k do. If you are skeptical you should sign up on a few job boards with internist credentials and you'll see- the average 7/7(which you would get 4 emails about every day) is going to pay 230-245k. Then do the math from there.
 
TexasPhysician said:
This is why playing the average game is a waste of time. Most medical fields involve a lot of diversity.

I know family medicine docs working in ER's, urgent cares, private practice, VA, academic, derm clinics, pain clinics, etc. Some do a combination of multiple of the above. People argue that FM is one of the lowest paying fields, but the FM docs I know pulling 400k don't care about averages. They aren't working crazy hours either - about 45.

There are psychiatrists in academics starting at 140k for full time plus call. Some at the VA start at 230k for equivalent work. A recent graduate in private practice is now up to 280k in one setting. Another general psych doc works academic + forensics + sleep medicine and is well over 400k. All are general psychiatrists with similar hours and no sub-specialty boards. All are happy at their jobs

The only salary that matters is what you can find in a setting you enjoy.
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Agree with almost all this. I also know tons of primary care physicians who aren't working crazy numbers of hours and pull 350-450k+. It's just all about getting the right jobs in the right settings.

And I've always said that it's possible to make >350k in psych as well. I think, relative to the other 'low paying' fields(family, non specialty IM, etc) you just have to be even more of a hustler to do this in psych than a primary care field because there is generally more opportunity to be flexible with different easily available income streams in say family medicine or hospitalist work than psychiatry.
 
BestDoctorEver said:
6k/month! That is a lot of money... This is not even amount to a part time job for the time physicians spend at ltc facility....
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the total amount of time spent per week probably averages about to 6-8 hrs. Which comes out to 30 hours a month. So its good per hour but when you look at how that time is broken up(several different trips in short intervals) its not tremendous.

The biggest plus about these sorts of jobs is that they are typically flexible in when you can do them. If you need to swing by after work one day, one Saturday morning when you're off, etc....you do it on your time more often than not. Whereas most of our jobs aren't always as flexible with time commitments- the pt's often need to be seen at a certain time when(not always but usually) and you've got another job then.
 
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Shikima said:
Don't forget, these jobs are typically W2 employment opportunities and you'll be eaten alive by taxes.
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I have not found this to be the case. There are not that many exemptions out there. What percent difference do you think you can get on a 1099 vs a W-2?
 
There is one thing we have going for us. Psychiatrists can often work into very old ages and the average psychiatrist will work into the 70s and sometimes 80s/90s. It is hard for EM, surgeon and some other specialties to work into older age because the work takes a toll. Also you have to take into account the quality of life tax.

That isn't to say that there aren't other specialties that make more. However, I love being a psychiatrist and so even though I work 50 hours a week, it doesn't seem as much.

Also people always name the psychiatrists who make 6, 7 and 8 hundred thousand dollars etc. Sure, there are people like that but just beware that its not even close to the standard. There are also plumbers that make 250k and RNs that make 200k, the list goes on. The standard is high 100s and low 200s. If you expect something else, chances are you will be disappointed.

BTW, I know a locums psychiatrist who clears a pension of close to 300 from the prison system and still works 32 hours per week at a CMHC making another 200k or so. Hes been doing that for almost 10 years. That's more than most 80 year old neurosurgeons.
 
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Indodo said:
There is one thing we have going for us. Psychiatrists can often work into very old ages and the average psychiatrist will work into the 70s and sometimes 80s/90s. It is hard for EM, surgeon and some other specialties to work into older age because the work takes a toll. Also you have to take into account the quality of life tax.

That isn't to say that there aren't other specialties that make more. However, I love being a psychiatrist and so even though I work 50 hours a week, it doesn't seem as much.

Also people always name the psychiatrists who make 6, 7 and 8 hundred thousand dollars etc. Sure, there are people like that but just beware that its not even close to the standard. There are also plumbers that make 250k and RNs that make 200k, the list goes on. The standard is high 100s and low 200s. If you expect something else, chances are you will be disappointed.

BTW, I know a locums psychiatrist who clears a pension of close to 300 from the prison system and still works 32 hours per week at a CMHC making another 200k or so. Hes been doing that for almost 10 years. That's more than most 80 year old neurosurgeons.
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no its not common for psychs to work into their 80s. And certainly not 90s. I bet you could count on one hand in almost every state the number of psychiatrists in their 90s doing relevant clinical work.....sheeesh.

Most psychiatrists seem to retire about the same age as most other workers.
 
vistaril said:
no its not common for psychs to work into their 80s. And certainly not 90s. I bet you could count on one hand in almost every state the number of psychiatrists in their 90s doing relevant clinical work.....sheeesh.

Most psychiatrists seem to retire about the same age as most other workers.
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I don't know if I'll even be alive at 80, much less 90.

There is a position I wouldn't mind taking if a certain 70 year old psychiatrist would just retire though.
 
Tending Bar?... but then you would have to listen to everyone’s problems.
 
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Indodo said:
There is one thing we have going for us. Psychiatrists can often work into very old ages and the average psychiatrist will work into the 70s and sometimes 80s/90s. It is hard for EM, surgeon and some other specialties to work into older age because the work takes a toll. Also you have to take into account the quality of life tax.
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psychiatry can work into old age but the overwhelming majority shouldn't. much of the worst practice of psychiatry comes from late career psychiatrists who seem happy to dole out benzos and stimulants to everyone and are completely out of touch with good practice, evidence-based care, and in some cases, reality. Advancing age is one of the strongest predictors of boundary violations and lack of adherence to ethical practices in the context of psychotherapy.
 
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splik said:
psychiatry can work into old age but the overwhelming majority shouldn't. much of the worst practice of psychiatry comes from late career psychiatrists who seem happy to dole out benzos and stimulants to everyone and are completely out of touch with good practice, evidence-based care, and in some cases, reality. Advancing age is one of the strongest predictors of boundary violations and lack of adherence to ethical practices in the context of psychotherapy.
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So what you're saying is that in the 2060s we will all look silly repeating all the same things that we feel make us so awesome and elite (not to mention more intellectually polished and sophisticated than our predecessors) right now?
 
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So I guess the con for PES is high stress?
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The nice thing about PES is when you're done you're done. With outpatient, a patient at any moment could call the office and state it's an emergency. With inpatient-someone will have to be on call at least once in awhile for emergencies.

Like I said, at a PES, when you're done you're done.
 
splik said:
psychiatry can work into old age but the overwhelming majority shouldn't. much of the worst practice of psychiatry comes from late career psychiatrists who seem happy to dole out benzos and stimulants to everyone and are completely out of touch with good practice, evidence-based care, and in some cases, reality. Advancing age is one of the strongest predictors of boundary violations and lack of adherence to ethical practices in the context of psychotherapy.
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Perhaps, but I think that is an overgeneralization. Also, I am guessing you are not talking specifically about age but years out of training. I think that has probably more to do with how you keep up with the data. I don't know where I saw this, but there was data that showed physician skills peaking about 5 years out of training.

Alternatively, you can say that instead of an MOC, you should have physicians do a 1/3/6/12 month training (pick a number based on some research that has not yet been done) after 10 years and then take a board exam that is more consistent with initial boards.

Because by your logic (not saying its bad logic) a 55 year old out of residency 25 years is also pretty suspect.
 
Indodo said:
...
Alternatively, you can say that instead of an MOC, you should have physicians do a 1/3/6/12 month training (pick a number based on some research that has not yet been done) after 10 years and then take a board exam that is more consistent with initial boards.
...
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Like this?
http://www.gomerblog.com/2014/07/moc/
 
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LOL.

I think the problem is the cookie cutter nature of these tests, cme requirements, MOC requirements etc can allow people to slip through the cracks. More requirements may be better, only time will tell.

Then again, I would take a 75 year old psychiatrist over any age NP/prescribing psychologist for a variety of reasons but I don't want to start another doctor vs midlevel argument.
 
the national boards are clearly run by sadists
 
I am shocked reading a thread in the GAS forum in which attendings are talking about 7 figures salary... Most are saying it's quasi impossible to make that kind of salary; however, the majority of them are also saying is not that impossible to make 600k+ per annum in anesthesia. I thought only neuro and spine surgeons can only dream about these salaries... Is it even possible to make 400k+/year in psych without having a cash only private practice?


Below is the thread in the Anesthesia forum...

http://forums.studentdoctor.net/threads/7-figure-anesthesia-salaries.924608/
 
splik said:
psychiatry can work into old age but the overwhelming majority shouldn't. much of the worst practice of psychiatry comes from late career psychiatrists who seem happy to dole out benzos and stimulants to everyone and are completely out of touch with good practice, evidence-based care, and in some cases, reality. Advancing age is one of the strongest predictors of boundary violations and lack of adherence to ethical practices in the context of psychotherapy.
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Time since graduation is also a strong predictor of complications in other medical fields, it isn't unique to psych.
 
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W19 said:
I am shocked reading a thread in the GAS forum in which attendings are talking about 7 figures salary... Most are saying it's quasi impossible to make that kind of salary; however, the majority of them are also saying is not that impossible to make 600k+ per annum in anesthesia. I thought only neuro and spine surgeons can only dream about these salaries... Is it even possible to make 400k+/year in psych without having a cash only private practice?

Below is the thread in the Anesthesia forum...

http://forums.studentdoctor.net/threads/7-figure-anesthesia-salaries.924608/
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You are reading about dinosaurs chronicling their last days in paradise.

As you read on, even the guys saying they make 700 now, as partners, acknowledge that they're riding their gravy train into the sunset as we speak (I think "making hay while the sun is still shining" was their choice euphemism). Heck, they essentially guarantee that their income will shrivel as time unfolds. Of course, it is also tactfully (;)) noted by them that when people enter their field in 7 years if they [as partners] are making less themselves, then those graduating residents will be making a shell of what was changing hands merely 5 years ago.

...Trickle, trickle.

Per the rest of your post, I don't know if you are playing naive or what, but a lot of specialties have a decent percentage of practitioners making over 600 in total comp. Haven't you ever come across a copy of MGMA?

If you meant over 1M, then that is obviously very rare [as in only the top 10% in mohs, retina, ortho, neurosurg are hanging out in that ballpark].

Who knows where the top 1% are across all specialties (as it isn't reported). That said, who cares. There are billionaire high school drop-outs. So what? Good for them, but their income doesn't impact our lives.

Pick whatever field you enjoy doing.

Yes, 400+ can be made in psych without having a cash only private practice. Find a desperate hospital and proceed to work like a masochistic dog. It is not the norm.
 
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W19 said:
I am shocked reading a thread in the GAS forum in which attendings are talking about 7 figures salary... Most are saying it's quasi impossible to make that kind of salary; however, the majority of them are also saying is not that impossible to make 600k+ per annum in anesthesia. I thought only neuro and spine surgeons can only dream about these salaries... Is it even possible to make 400k+/year in psych without having a cash only private practice?


Below is the thread in the Anesthesia forum...

http://forums.studentdoctor.net/threads/7-figure-anesthesia-salaries.924608/
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There was a psych doc that made over 7 figures working for the Cali state prison system a year or two ago... Hell, the state of California alone paid 400k+ to over a dozen psychiatrists in 2012: http://rt.com/usa/california-psychiatrist-five-governor-922/

It isn't common, but it's certainly doable. I know a guy that works in prison psych that makes a killing.
 
How do law firms make over $1 Mill... there's your answer. Think about partnership models without the contingency fees. Psychiatric practices can do the same.

Your income is limited only by your entrepreneurship spirit and business acumen.
 
Baller MD said:
Do you need a forensics fellowship to work for a prison?
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Most people in psych aren't exactly jumping at the chance to work behind closed doors one-on-one with unrestrained murderers that are often trying to get drugs from them or have extremely serious psychiatric issues. Here's a fairly typical example:

http://jobs.spb.ca.gov/wvpos/more_info.cfm?recno=529288

Starting pay without OT is $239,340 - $287,592. That's not bad at all, and it's a short drive from LA.
 
Mad Jack said:
Most people in psych aren't exactly jumping at the chance to work behind closed doors one-on-one with unrestrained murderers that are often trying to get drugs from them or have extremely serious psychiatric issues. Here's a fairly typical example:

http://jobs.spb.ca.gov/wvpos/more_info.cfm?recno=529288

Starting pay without OT is $239,340 - $287,592. That's not bad at all, and it's a short drive from LA.
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That's **** pay for that type of job though, no?
 
Baller MD said:
That's **** pay for that type of job though, no?
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You probably can get the high end of that salary if you negotiate. Also, you might be able to work overtime in this type of job... 12 hrs average overtime can augment that salary to about 100k+/year. However, most people might be afraid to work with inmates. I have a relative who used to work at a jail house (not a max security one) as a RN, she told me the inmates are like every other patient. You respect them, they will also respect you...
 
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Baller MD said:
That's **** pay for that type of job though, no?
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As was said previously, that's base pay. You have to keep in mind, that that is salary. Your total comp would probably be substantially higher, as it's a state job with excellent benefits, and this is without overtime. Because you're working with inmates, malpractice generally isn't an issue, so you save money on malpractice insurance, and you won't have to deal with billing headaches and the like since, again, it's a prison. A job is a lot more than just straight take-home salary- if you negotiate for the high end of pay, you're getting 287k for 40 hours of work per week, with paid vacation, CME, retirement, malpractice, etc that likely bring your total comp to $373k (benefits are usually about 30% of a physician's compensation package, per MGMA's data). That puts you roughly on par with the total comp of most specialists, who typically work 55-65 hours a week to gain that level of compensation. Throw in some overtime and work 60 hour weeks for the year (going rate looks to be $137.50 per hour) and you can easily hit over 400k before taxes.
 
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Beargryllz said:
You probably just need a pulse

It's prison, after all
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Not in California. The if-you-have-a-pulse applies mostly to states that aren't paying California money.

To negotiate higher wages or get hired at places within less than 90 minutes of what most folks would consider not pretty awful places to live, you are looking at pretty competitive hires. The last three psychiatrists I know hired at San Quentin all had fellowships and good experience under their belt.


Sent from my iPhone using Tapatalk
 
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Mad Jack said:
Most people in psych aren't exactly jumping at the chance to work behind closed doors one-on-one with unrestrained murderers that are often trying to get drugs from them or have extremely serious psychiatric issues. Here's a fairly typical example:

http://jobs.spb.ca.gov/wvpos/more_info.cfm?recno=529288

Starting pay without OT is $239,340 - $287,592. That's not bad at all, and it's a short drive from LA.
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This is literally a 20 minute drive from my school. If I end up in psych, I'd be very happy getting this job.
 
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