Show me the money! How to search for a job using income as a primary criterion?

[Trismegistus4]

I'm in my PGY-4 year of psychiatry residency, and have no interest in doing a fellowship, so it's time to start the job search. I understand that psychiatrists in high demand, so I should have no trouble finding a decent job. However, the advice I've read states that a job applicant shouldn't even discuss compensation until the 2nd interview. This would mean one would have to filter the jobs to which one applies on the basis of geographical location, practice setting, type of organization, employment vs. contract, straight salary or hourly wage vs. RVU-based, etc. The problem is, probably the two most important factors to me are income and geographical location. I'd like to find a job that pays as well as I can possibly find, in an area where I'd want to live--other factors be damned. I care less about whether I'm doing inpatient vs. outpatient, or the size of the organization, for example, than I do about how much money I'll be making. Is there any way to narrow down my job search primarily by potential income? Or am I going to have to go on a million second interviews, only to walk out the door once they tell me I'll be making $150k?

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[Shikima]

I always begin discussions early on about the work environment, job details and expectations, call responsibilities, time off/CME and what the pay scale will be at the first meeting. At the 2nd interview, if I do go on one (typically I'm doing things on the phone at this point), I ask for a copy of the contract to review.

 

[wolfvgang22]

I do the same thing. Don't be afraid of asking anything. You can ask nearly anything if you are friendly and ask tactfully. Not getting good answers is almost as informative as getting good answers. Same as talking to patients. Know what the position should pay before you even ask, and what is acceptable to you.

 

[milesed]

I'd choose the area you want to live in and then search for the type of work that is most enjoyable for you. Income comes after those. Many I know took the bigger $$ jobs to leave after 1-2 years of misery.

 

[TexasPhysician]

I ask what the salary is before interviewing out of my city if it's important. No sense on wasting money.

 

[F0nzie]

Or am I going to have to go on a million second interviews, only to walk out the door once they tell me I'll be making $150k?

How much $ do you want?

 

[Trismegistus4]

I do the same thing. Don't be afraid of asking anything. You can ask nearly anything if you are friendly and ask tactfully. Not getting good answers is almost as informative as getting good answers. Same as talking to patients. Know what the position should pay before you even ask, and what is acceptable to you.

How do I know what it should pay? I'm exhibit A in the oft-cited phenomenon of physicians knowing nothing about business. In fact, I've never been good at negotations (e.g., car buying) in general. How would I have any idea what a reasonable number would be? It would be a stab in the dark.

I'd choose the area you want to live in and then search for the type of work that is most enjoyable for you. Income comes after those. Many I know took the bigger $$ jobs to leave after 1-2 years of misery.

I know what you mean, and I agree with you in some sense; for example, if call was more than once per week and usually entailed actually having to go in, that would probably make the job unappealing to me no matter how much they were offering. But there are other major factors I do care about less than money; for example, inpatient vs. outpatient.

How much $ do you want?

I don't know. More than $150k. But like I said above, how do I know how much I can get?

 

[whopper]

Be careful about money. Some places offer more money cause you're going to get punched in the face every few months.
Every job has it's pros and cons and I know some jobs that pay a lot more money but no one wanted to take them once they knew what was going on.

I'm going to bring in one hospital I know of in NJ.
1-about $250K a year plus you can work other places almost restriction free. So do some side work, realistically get about $275K/year
2-Expect to get punched in the face every few months.
3-The place looks like a stalag out of WWII Germany (This ought to be a major hint about what hospital I'm talking about). No good places to eat in it. Wanting to eat outside of it is a long trip out.
4-You will have almost no ability to network outside that hospital because it's cut off from the rest of the community.
5-staff member incompetence was prevalent. Staff members up to the 80s were having sex with patients. Things finally got better but that culture still remains although the sex is not out in the open. E.g. 1 to 1s are not expected to be done so they have to use two to ones.
6- NJ has the highest taxes in the country minus NYC. NJ also has almost no tax deductible options when it comes to things like building up a college tuition fund for your kids among several other things. People in NJ have attitude problems.

Want to work there?

Pay is of course important but you got to weigh it in with everything.

 

[Trismegistus4]

Want to work there?

Of course not, but what I'm saying is that I'd rather have that job show up in my initial list of potentials, and have to cross it off upon learning of the factors you describe, than have my initial list of potentials cluttered with places that are great to work at but pay $150k.

 

[zolof]

.

 

[Shikima]

 

[jakeislove]

Be careful about money. Some places offer more money cause you're going to get punched in the face every few months.
Every job has it's pros and cons and I know some jobs that pay a lot more money but no one wanted to take them once they knew what was going on.

I'm going to bring in one hospital I know of in NJ.
1-about $250K a year plus you can work other places almost restriction free. So do some side work, realistically get about $275K/year
2-Expect to get punched in the face every few months.
3-The place looks like a stalag out of WWII Germany (This ought to be a major hint about what hospital I'm talking about). No good places to eat in it. Wanting to eat outside of it is a long trip out.
4-You will have almost no ability to network outside that hospital because it's cut off from the rest of the community.
5-staff member incompetence was prevalent. Staff members up to the 80s were having sex with patients. Things finally got better but that culture still remains although the sex is not out in the open. E.g. 1 to 1s are not expected to be done so they have to use two to ones.
6- NJ has the highest taxes in the country minus NYC. NJ also has almost no tax deductible options when it comes to things like building up a college tuition fund for your kids among several other things. People in NJ have attitude problems.

Want to work there?

Pay is of course important but you got to weigh it in with everything.

Does this place's name begin with a B?

 

[Shikima]

I can get you a job for about $250k/year with as much ER call and InPt experience as you like. You'll be a slave to the system effectively...

 

[Trismegistus4]

On my search I came upon some places to work ,before my current job, that seemed to god to be true. Flexible hours, great clean area, in a wonderful location, not too busy patient wise, lots of SW support for non clinical things, even heard from one of my friends who worked there that it gets so slow and he has extra time to read and do other things, but then the salary came up and it was similar to your quote. So it seems like one would be happy but that's too low of a salary in my opinion for a specialty.

So, you found a job you are happy with? How did you find your current job, and what's it like?

I can get you a job for about $250k/year with as much ER call and InPt experience as you like. You'll be a slave to the system effectively...

I hate ERs. That's one non-negotiable for me.

 

[whopper]

Does this place's name begin with a B

No.


But I think I know which one you are talking about and unless that hospital's psych department reformed (and it could've) since I've seen it (about 10 years ago), don't touch that place with a 10 foot pole. Ten years is a long time. Maybe it did get better.

 

[Therapist4Chnge]

Beware of places that offer significantly more money because there is almost always a reason….risk of altercations, miserable work environment, crappy call, poor/no support staff, higher hours, etc. You will probably never hurt for opportunities to make more money (well above $150k)…you just need to avoid the truly malignant places.

 

[clusterF]

Generally you can always make more than 150k in private practice if you are willing to wait the 1-2 years for your practice to build. Spend the other time moonlighting inpatient, although you may not get the money you want/have to commute etc. If money and geography are most important, that is the way to go.

 

[vistaril]

There is nothing at all with making it very clear to them from the very first conversation that what you are looking for is money.

A typical exchange that I have participated in as as follows:

In house recruiter: hey would you be interestd in doing inpatient in (insert some place I might consider)

Me: what does it pay?

In house recruiter: that would vary depending on experience, credentials, etc

Then when I don't respond, a get 2-3 follow up emails over the next few days, basically asking for my number to arrange a phone call and again fishing for interest. And then I respond: look, I asked you a question during our last exchange that you gave a bull**** response to that didn't offer anything of value. That told me that you aren't the kind of guy I want to deal with. Bye now.

The reason a recruiter(either in house or not) gives a bs answer like the above could be because that's the company line and they don't want to box themselves in on a salary floor, or because the salary they are offering is quite mediocre. Either way, when they refuse to answer it tells you to not waste your time.

And of course there may be some difference depending on experience or credentials. That's why it is acceptable to give a range. If they tell me the job pays 200-230 depending, that's a useful response and the recruiter will be seen as a no bull**** straight shooter. But if I ask an in house recruiter a question and they intentionally are evasive, well that's it they have lost their shot....

And for the recruiters who will give you a number that is too low, there is nothing wrong with saying- sorry not interested. I can do much better and am not interested in working for that. That saves both parties the time of a phone convo that has no point.

 

[vistaril]

On my search I came upon some places to work ,before my current job, that seemed to god to be true. Flexible hours, great clean area, in a wonderful location, not too busy patient wise, lots of SW support for non clinical things, even heard from one of my friends who worked there that it gets so slow and he has extra time to read and do other things, but then the salary came up and it was similar to your quote. So it seems like one would be happy but that's too low of a salary in my opinion for a specialty.

This is very true....when it comes to jobs, you aren't going to have it all. In general if you want good money from just one job, you are going to have to hustle at that job. Now what some people do is take a bs slack job that doesn't pay much, and then cherry pick extra locums or moonlighting gigs that are the most dollars for the least effort to make their total pay good. But then you are working two jobs.

But if you want to make 230 or more in psych with one job, it's almost certainly going to involve some hustling or hard work to some degree.

 

[vistaril]

I'm in my PGY-4 year of psychiatry residency, and have no interest in doing a fellowship, so it's time to start the job search. I understand that psychiatrists in high demand, so I should have no trouble finding a decent job. However, the advice I've read states that a job applicant shouldn't even discuss compensation until the 2nd interview. This would mean one would have to filter the jobs to which one applies on the basis of geographical location, practice setting, type of organization, employment vs. contract, straight salary or hourly wage vs. RVU-based, etc. The problem is, probably the two most important factors to me are income and geographical location. I'd like to find a job that pays as well as I can possibly find, in an area where I'd want to live--other factors be damned. I care less about whether I'm doing inpatient vs. outpatient, or the size of the organization, for example, than I do about how much money I'll be making. Is there any way to narrow down my job search primarily by potential income? Or am I going to have to go on a million second interviews, only to walk out the door once they tell me I'll be making $150k?

First off tris, any outpt job that you take that isn't for the govt is going to be dependent on how much revenue above costs you are generating yourself. So that's sorta up to you. The money you are paid doesn't fall from the sky- it is based on hat you are producing. So how many patients you seeing per hour, what are they paying with, etc....outpt non govt jobs are easy to calculate about what you are going to make.

Inpatient can be a bit different....but in many places it is still the same principle. Seems like more and more hospitals in cities now are contracting their staff psych jobs to groups and having the groups bill themselves...eat what you kill. So if your average census is 17 and you are doing an average of 3 admissions per day...well do the math on the 3 h/ps and then the daily followip billings. The math doesn't lie. There may be a stipend on top of this in th contract to treat the uninsured.

So short answer- focus less on what they will pay you and more about how to get yourself in a system where you are producing more money. Because the two are directly related. If you are t producing much money, they aren't going to pay you much.

 

[Trismegistus4]

Beware of places that offer significantly more money because there is almost always a reason….risk of altercations, miserable work environment, crappy call, poor/no support staff, higher hours, etc. You will probably never hurt for opportunities to make more money (well above $150k)…you just need to avoid the truly malignant places.

I know. I saw one job ad recently that seemed too good to be true, until I really looked at what they were saying about the call schedule, and you could sort of infer that you'd have some sort of call-type responsibility 50% of weekends. No thanks.

There is nothing at all with making it very clear to them from the very first conversation that what you are looking for is money.

Did you mean there is nothing at all wrong with making it very clear?

This is very true....when it comes to jobs, you aren't going to have it all. In general if you want good money from just one job, you are going to have to hustle at that job. Now what some people do is take a bs slack job that doesn't pay much, and then cherry pick extra locums or moonlighting gigs that are the most dollars for the least effort to make their total pay good. But then you are working two jobs.

But if you want to make 230 or more in psych with one job, it's almost certainly going to involve some hustling or hard work to some degree.

Don't people do that with multiple jobs that are part-time? Working two jobs per se doesn't bother me, but if that amounts to two full-time jobs, that's probably too much for me.

So short answer- focus less on what they will pay you and more about how to get yourself in a system where you are producing more money. Because the two are directly related. If you are t producing much money, they aren't going to pay you much.

I'm aware of that. But in a sense, that's six of one, half a dozen of the other. Job ads don't typically mention what kind of RVUs you're going to be able to generate any more than they quote salary figures. So how does one filter jobs by revenue-generating opportunity?

 

[jakeislove]

No.


But I think I know which one you are talking about and unless that hospital's psych department reformed (and it could've) since I've seen it (about 10 years ago), don't touch that place with a 10 foot pole. Ten years is a long time. Maybe it did get better.

I didn't see the reply until now.

The place I'm talking about doesn't seem to have improved any. I'll see how the interview goes and hope better opportunities are presented.

 

[zolof]

This is very true....when it comes to jobs, you aren't going to have it all. In general if you want good money from just one job, you are going to have to hustle at that job. Now what some people do is take a bs slack job that doesn't pay much, and then cherry pick extra locums or moonlighting gigs that are the most dollars for the least effort to make their total pay good. But then you are working two jobs.

But if you want to make 230 or more in psych with one job, it's almost certainly going to involve some hustling or hard work to some degree.

This is true. Everywhere I search, I mean everywhere that offered more than 240 or so to start had some call associated
and all the other docs I know that make well above the average are all hustling and basically doing overtime, moonlighting etc, basically working two diff jobs.

 

[clusterF]

What is the geographic location?

 

[Shikima]

Saw a job offering $315k/year.... sounded great being near top tier university, lots of activities and dining experiences, and close to sports.