So can we talk money?

[prominence]

To get $200/hour moonlighting, I would have to drive three hours to work with people wearing stripes.

I wouldn't recommend breaking the law for that kind of hourly rate

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[Sophie]

The highest I've seen is about $290k for corrections or state hospitals after about 3-5 years worked.

I don't know if they still are, but last year the prison in Stockton was offering starting pay of $282k (impatient or outpatient) with no mandatory call or weekends, and the option to work four 10 hour days per week. Most of the docs I spoke to lived in San Francisco (nasty commute), East Bay, or Sacramento.

 

[PistolPete]

I don't know if they still are, but last year the prison in Stockton was offering starting pay of $282k (impatient or outpatient) with no mandatory call or weekends, and the option to work four 10 hour days per week. Most of the docs I spoke to lived in San Francisco (nasty commute), East Bay, or Sacramento.

There's probably a reason why they're offering that much... because it's Stockton. And you're working with mentally ill criminal offenders. And no EMR. So.... yea.

 

[Doctor Bagel]

What is the psychiatry equivalent of selling out? Suboxone for cash? Adult ADHD clinic for cash?

I was idly thinking about opening up a one half time suboxone clinic + one half time traditional private practice psychotherapy clinic. The guaranteed income from the suboxone could help with the drier periods while building up therapy patients. Ideally both cash and of course no overlap in patients. I think you'd need separate locations and everything.

 

[clausewitz2]

I was idly thinking about opening up a one half time suboxone clinic + one half time traditional private practice psychotherapy clinic. The guaranteed income from the suboxone could help with the drier periods while building up therapy patients. Ideally both cash and of course no overlap in patients. I think you'd need separate locations and everything.

Yeah, the people who will turn up and pay cash for psychotherapy will probably only come the one time if they have to share a waiting room with the average person on suboxone.

 

[clusterF]

Kaiser starting pay is 275K in norcal. In underserved areas there is a golden handcuff of over 200k offered as well.
In addition to benefits and bonuses that will get you very close to 400k.

You will work very hard for that money though.

Regarding us being in cardio/ortho/derm etc range...not even close. The good medical specialties have plenty of people getting close to or into 7 figures.

 

[smalltownpsych]

Yeah, the people who will turn up and pay cash for psychotherapy will probably only come the one time if they have to share a waiting room with the average person on suboxone.

Solution would be to have the suboxone patients come to the back door and just hand out the drugs in the alley.

 

[Shikima]

Kaiser starting pay is 275K in norcal. In underserved areas there is a golden handcuff of over 200k offered as well.
In addition to benefits and bonuses that will get you very close to 400k.

You will work very hard for that money though.

Regarding us being in cardio/ortho/derm etc range...not even close. The good medical specialties have plenty of people getting close to or into 7 figures.

On W2, lose more than 50% to taxes.

 

[clausewitz2]

Solution would be to have the suboxone patients come to the back door and just hand out the drugs in the alley.

There is a suboxone clinic in our neck of the woods that is famous for a) not bothering with drug testing and b) sharing a parking lot with an inpatient rehab. And a liquor store.

 

[Blitz2006]

Kaiser starting pay is 275K in norcal. In underserved areas there is a golden handcuff of over 200k offered as well.
In addition to benefits and bonuses that will get you very close to 400k.

You will work very hard for that money though.

Regarding us being in cardio/ortho/derm etc range...not even close. The good medical specialties have plenty of people getting close to or into 7 figures.

I'm not sure thats true anymore about other specialties making nearly 1 million: I read a lot of the other boards to stay in the mix. Some examples (Average Salaries):

ENT: 400-600k -> http://forums.studentdoctor.net/threads/salary.615393/
Cardiology: 350-400k -> http://forums.studentdoctor.net/threads/cardiology-job-market.1019969/page-4
Derm: Non-Mohs, 450K, for Mohs- 550k -> http://forums.studentdoctor.net/threads/salaries.1150060/
Rads: 325k -> http://forums.studentdoctor.net/threads/salary-discrepancy.1126617/

I understand that a lot of this data is anecdotal, but they are real life examples and i think relatively accurate. I'm sure in each of those specialities, there are a few random ppl making 1 million (ie. businessperson who is cosmetic dermatologist), but I don't think thats the norm.

The hours a cardiologist puts in is much more than the average psychiatrist. So if a psych person works cards hours, I honestly think that he/she will make same as a non-interventionalist cardiologist. Derm guys also work hard to make that 500k, I don't think its an 'easy 40 hour week' if you want to make good money.

Also need to remember that malpractice and overhead is extremely low in psych. Here in NYC area, 12k malpractice is the average, 20k if you do ECT. Pain doctor I know in this area, anesthesiologist, pays 32k (100% private clinic). That thread on ENT says the average overhead cost is around 300k....

To match into Derm/ENT requires not just hard work but some luck as well, unlike psych. and as we know, Rads job market is terrible and these guys are crushing 2-3 fellowships and still scrambling to lock up a job.

So I dunno, psych is looking good overall, and the reimbursements are only increasing in our field. And I do know cash only psychiatrists in the area hitting 500k (I admit this is only possible in large market areas, but still), and I hear the pastures are even greener for child psych.

Just my 2 cents,

 

[Blitz2006]

I don't know if they still are, but last year the prison in Stockton was offering starting pay of $282k (impatient or outpatient) with no mandatory call or weekends, and the option to work four 10 hour days per week. Most of the docs I spoke to lived in San Francisco (nasty commute), East Bay, or Sacramento.

I've seen ads for Cali Prison jobs over 350k, so isn't this on the lower side for a prison job?

 

[chicagochildpsych]

Not so easy even in big cities to get Psychitarists anymore. I had a similar offer , only the offered rvu was $50, they seemed like ready to negotiate and this is a big city. I let it go just cos I have been on call so much in my current job that I am looking to go private outpatient. I think money in private outpatient with good insurance patients should be comparable. Correct me if I am wrong.

im


I'm doing about 12 hour days 6-7 days per week, doing about 50 rvu per day, always on call, and closing in on 600k, but it's not sustainable. I'm getting burned out.

 

[Blitz2006]

im


I'm doing about 12 hour days 6-7 days per week, doing about 50 rvu per day, always on call, and closing in on 600k, but it's not sustainable. I'm getting burned out.

To earn 400k, what type of hours would be required? 5 x 12 hours?

 

[nexus73]

im


I'm doing about 12 hour days 6-7 days per week, doing about 50 rvu per day, always on call, and closing in on 600k, but it's not sustainable. I'm getting burned out.

Are you getting $40 per RVU?

 

[hypoman]

I was idly thinking about opening up a one half time suboxone clinic + one half time traditional private practice psychotherapy clinic. The guaranteed income from the suboxone could help with the drier periods while building up therapy patients. Ideally both cash and of course no overlap in patients. I think you'd need separate locations and everything.

How much can you make running a Suboxone clinic?

 

[chicagochildpsych]

Are you getting $40 per RVU?

About 55 per rvu, I like to take my time with patients

 

[nexus73]

About 55 per rvu, I like to take my time with patients

Do you think you should get more as a child psychiatrist?

 

[chicagochildpsych]

I would take more, but I'm making a neurosurgeon salary, it's hard to complain

 

[notdeadyet]

I've seen ads for Cali Prison jobs over 350k, so isn't this on the lower side for a prison job?

Prison jobs in California are all CDCR and have a standard (good) pay. It starts at about $238K/year and goes up about $12K/year (at least for your first five years). It also has an amazing retirement scheme.

You won't get an entry job at CDCR for $350K/year. Stockton was starting at about $300K/year, but I'm not sure whether they stopped doing that (they were and are having a tough time hiring). You do see contract work for over $350K, but that's through an agency (it's a flat rate of $200/hour). They have it for Coalinga and/or Atascadero. But those wages are 1099, so you take a tax hit and have no benefits. The big boon for CDCR work is that you can work there 20 years and then draw a very fat retirement with great health benefits. People who work there tend to stay a while.

But remember that California has not been building prisons in what most people would consider desirable locales for a while. And I don't mean just rural areas: CDCR doesn't tend to build them in mountains or forests either, with a small handful of exceptions.

 

[Blitz2006]

Sounds good. I double checked the ad on APA Job Central. It's actually an inpatient job at Modesto for 368k, 8am to 5pm. No call. You can earn 2k for call.

I'm sure the environment is terrible, but still an impressive salary!

Sent from my SM-N910V using Tapatalk

 

[PistolPete]

I hear terrible things about Napa State Hospital... you can google it. Not enough staffing, psychiatrist assaulted, etc.

There's a reason why many of the State Hospitals have trouble hiring. You should talk to people who actually work there. One of the deal breakers for me is patient's who have been there for 20+ years, and there's no EMR! :/

 

[Trousseau]

Honestly, the salary thing is a big roadblock for me. I've seen on Medscape the avg is ~210-220K, but I've also heard that you can expect to start at 185K, or lower in VA jobs (let alone academia, but I'm not going into academia in any field, so whatever).

Do these sums of money refer to 40-45 hrs/week job with no call? How do they vary by location (are they much worse in SF or NYC)?

Thanks

 

[Doctor Bagel]

Honestly, the salary thing is a big roadblock for me. I've seen on Medscape the avg is ~210-220K, but I've also heard that you can expect to start at 185K, or lower in VA jobs (let alone academia, but I'm not going into academia in any field, so whatever).

Do these sums of money refer to 40-45 hrs/week job with no call? How do they vary by location (are they much worse in SF or NYC)?

Thanks

Here's a summary of medscape data from 2014. Average salary is $197k nation wide -- $218k in California but closer to $200k elsewhere. It doesn't seem that they separate out full-time from part-time work. I'm certainly hoping the very significant pay disparity between men and women is secondary to women working less. I doubt that's 100% it, but that's a huge divide ($40k/year). It seems that most of the respondents did work full-time, though.

http://www.medscape.com/viewarticle/823698

 

[Trousseau]

Here's a summary of medscape data from 2014. Average salary is $197k nation wide -- $218k in California but closer to $200k elsewhere. It doesn't seem that they separate out full-time from part-time work. I'm certainly hoping the very significant pay disparity between men and women is secondary to women working less. I doubt that's 100% it, but that's a huge divide ($40k/year). It seems that most of the respondents did work full-time, though.

http://www.medscape.com/viewarticle/823698

Right, but it seems to have gone to 216K in the 2015 Medscape. Is there a particular reason for the rise, or is it just sampling issues or margin of error?

http://www.medscape.com/features/slideshow/compensation/2015/psychiatry#page=2

As for women, I'm afraid I'm as clueless as you are.

On a related note, is it true that it's harder for minority physicians to join private practice groups in Psych? That's a persistent rumor I've heard.

 

[Doctor Bagel]

Right, but it seems to have gone to 216K in the 2015 Medscape. Is there a particular reason for the rise, or is it just sampling issues or margin of error?

http://www.medscape.com/features/slideshow/compensation/2015/psychiatry#page=2

As for women, I'm afraid I'm as clueless as you are.

On a related note, is it true that it's harder for minority physicians to join private practice groups in Psych? That's a persistent rumor I've heard.

Makes sense -- people let in people who are like them. There's a lot of hide the ball with salary information, too, which hurts outsiders.

It doesn't seem like medscape's data collection is particularly scientific.

 

[Trousseau]

Makes sense -- people let in people who are like them. There's a lot of hide the ball with salary information, too, which hurts outsiders.

It doesn't seem like medscape's data collection is particularly scientific.

I know my home program teaches PGY4s and Fellows about the job search, but I don't know how many other programs do that. I guess I'm interested in my home program, but I've heard the hours are nasty, and you work a lot of 24-hr shifts. Not sure how it is at other programs, but the residents have told me that ours is worse on that front.

Regarding the race thing, I guess I meant more like men face in OB/GYN, where a lot of women don't want to see them and they have trouble getting hired at various firms. Is there any significant push from patients to avoid minority physicians that may drive hiring discrepancies?

 

[splik]

Right, but it seems to have gone to 216K in the 2015 Medscape. Is there a particular reason for the rise, or is it just sampling issues or margin of error?.

there has been an increase in psychiatrist salaries in some places (where I am they were quite low and have gone up by upwards of 25k in the past year)

The VA has increased psychiatrist salaries since this last scandal. And then the CPT code changes a few years have also improved reimbursement for psychiatrists and also more places are allowing 30minutes for follow up with the new psychotherapy add-on codes. The ACA (whatever people think of it) has in many parts of the country flooded the system with more people who are insured, and insurances are increasingly removing some of the barriers like limits on mental health visits and prior authorization for psychiatric treatment etc (though still a long way to go). The increased demand for psychiatric services from the insured have also increased waiting times which could potentially be increasing a market for cash pay for those who don't want to wait. I don't know if that last point is true but its possible.

 

[Trousseau]

physicians from minority backgrounds get paid less, but I haven't heard it harder to get into group practice. not that group practice is a big thing in psychiatry, people tend to go into solo private practice. There are fewer minority psychiatrists in academia, but that is mainly because of the pay being lower.

there are of course patients who don't want to see a doctor who is black (or of some other racial background) and I have heard some really horror stories from residency. but i dont think most people care. though it is interesting, i wonder if it is harder to have a successful cash private practice in psychiatry if you're black? but i don't think kaiser and the like care about that sort of thing and many larger employers are trying to diversify their workforce.

The idea of solo practice sorta scares me a bit right now. On the other hand, I've heard a lot of that fear is a function of medical students being a risk averse group of people. I've also heard that there are lots of resources to help you get set up.

 

[Blitz2006]

Right, but it seems to have gone to 216K in the 2015 Medscape. Is there a particular reason for the rise, or is it just sampling issues or margin of error?

http://www.medscape.com/features/slideshow/compensation/2015/psychiatry#page=2

As for women, I'm afraid I'm as clueless as you are.

On a related note, is it true that it's harder for minority physicians to join private practice groups in Psych? That's a persistent rumor I've heard.

Yeah I'm now starting to get skeptical about these Medscape surveys.

I know for a fact that in Manhattan, group practice is offering 205k, and another inpatient unit is offering 210k with benefits (9-5, no call). And NYC psychiatrists are the lowest paid (outside of cash practices) in the country.

So how is the average only 216k? The only plausibile explanation is that part timers are dragging it down....

 

[notdeadyet]

The idea of solo practice sorta scares me a bit right now. On the other hand, I've heard a lot of that fear is a function of medical students being a risk averse group of people. I've also heard that there are lots of resources to help you get set up.

That fear is natural and helpful.

Leaving residency to start a private practice without ever having worked in one has a lot of risk. The actual risk of completely tanking is pretty minimal, as if you're on insurance panels, you will likely have a steady panel of patients almost no matter where you are.

But the is a very big risk of not working to your full potential. Common business advice is not to open a bar if you've never worked in a bar. Better advice is to not open a bar if you've never worked in a good, profitable bar. This advice isn't unique to any specific type of business.

You can certainly hang your own shingle right after residency and you'll likely do just fine. But you might consider looking at practices in your area that you respect, working there for a year or so to g a good peek under he hood, then hang your own shingle.

 

[scootad.]

The medscape salary survey underestimates salaries for many specialties not just Psych. The problem is the other frequently cited survey, MGMA, tends to overestimate salaries. So it's hard to find an accurate one.

 

[Shikima]

The medscape salary survey underestimates salaries for many specialties not just Psych. The problem is the other frequently cited survey, MGMA, tends to overestimate salaries. So it's hard to find an accurate one.

MGMA is quite low for psychiatry. The numbers just don't add up unless you're including part-time people with that.

 

[Doctor Bagel]

MGMA is quite low for psychiatry. The numbers just don't add up unless you're including part-time people with that.

Where do you find the MGMA data? It looked like it wasn't publicly available. It's annoying because employees use that to set salaries.

 

[TexasPhysician]

Where do you find the MGMA data? It looked like it wasn't publicly available. It's annoying because employees use that to set salaries.

You pay for it or convince a recruiter/employer to show some of it.

Employers use it to help them negotiate. It is nothing more than a negotiation tactic to keep salaries low.

 

[scootad.]

When I googled it I found this link http://www.nejmcareercenter.org/article/compensation-in-the-physician-specialties-mostly-stable/

The review article mentions a bunch of different specialties but not psych for some reason.

 

[nexus73]

MGMA and AMGA surveys aren't cheap, but if several doctors buy in together it makes it less painful.

 

[Trismegistus4]

But you're working two full weekends out of four which kinda sucks.

I don't think working two weekends out of four would be mandatory. I get the impression weekends would be negotiable. Though of course that means less money.

Kaiser starting pay is 275K in norcal. In underserved areas there is a golden handcuff of over 200k offered as well.
In addition to benefits and bonuses that will get you very close to 400k.

Yeah, I saw a job ad recently for Santa Cruz, I believe on Practicelink, that mentioned a $200k relocation bonus for housing (e.g., a down payment.) They probably make you sign like a 10 year contract for that.

 

[Doctor Bagel]

I don't think working two weekends out of four would be mandatory. I get the impression weekends would be negotiable. Though of course that means less money.

And if you could make that kind of money working 2 weekends, I imagine the money would still be pretty good working just one weekend a month. I'm already doing that and making nowhere near the number you got. Of course I'm also in one of those places where people want to live although I can't say that's helped hiring that much anywhere I've been working recently.

 

[psychMDhopefully]

Can Somebody explain to me what the catch is with this job? Besides it being in Arkansas, are they working 15hr days or something? Base salary of 315k?

http://www.practicelink.com/jobs/468140/physician/psychiatry/Arkansas/ASR Arkansas Hospital

 

[psychMDhopefully]

physicians from minority backgrounds get paid less

Why? Racial discrimination when applying to jobs offered by private groups? I browse different medical groups sometimes, and i'm surprised by how often everybody in the group is white.

 

[Shikima]

Can Somebody explain to me what the catch is with this job? Besides it being in Arkansas, are they working 15hr days or something? Base salary of 315k?

http://www.practicelink.com/jobs/468140/physician/psychiatry/Arkansas/ASR Arkansas Hospital

Contact them and ask.

 

[TexasPhysician]

Can Somebody explain to me what the catch is with this job? Besides it being in Arkansas, are they working 15hr days or something? Base salary of 315k?

http://www.practicelink.com/jobs/468140/physician/psychiatry/Arkansas/ASR Arkansas Hospital

315k may be low for such a gig depending on details. Rounding on up to 20 beds/day, acting directorship role, and call.

 

[SoulinNeed]

Anyone know what salaries are looking like in the Chicagoland area (including the city and surrounding suburbs)?

 

[Doctor Bagel]

Can Somebody explain to me what the catch is with this job? Besides it being in Arkansas, are they working 15hr days or something? Base salary of 315k?

http://www.practicelink.com/jobs/468140/physician/psychiatry/Arkansas/ASR Arkansas Hospital

Hmm, wonder if it's here.

http://www.whiteriverhealthsystem.com/services/stepping-stone-white-river-medical-center

Arkansas is not all bad, but I don't think I'd like to live in Batesville. Probably an OK place if you're married, have a family and like going to church, though. Also probably super cheap. I'd bet location is the biggest negative. It doesn't sound like you'll be covering 20 patients because presumably they've got someone already covering the 12 beds.

 

[vistaril]

Can Somebody explain to me what the catch is with this job? Besides it being in Arkansas, are they working 15hr days or something? Base salary of 315k?

http://www.practicelink.com/jobs/468140/physician/psychiatry/Arkansas/ASR Arkansas Hospital

Im sure it's a base that(after a year probably) if you don't meet the rvu or collections numbers you have to pay them back. Those are not uncommon.

The thing to look for in jobs like this is how many beds you get(which is going to determine your rvus and collections) and how efficiently is their system setup for you to generate the rvus with those beds.

 

[doctorpilgrim]

Vistaril, what formula are you using, Are you taking no of bed days per year multiplied by wrvu multiplied by dollar amount and then using it for a shift.
Another simple way is to demand 75th percentile salary for 12 to 14 beds for 230 days of shifts.
Another variable is call which can be 1 in 2 and consult work which can be time consuming.
And also do you have a system that is efficient.
The hospitals don't want to share this data and new physicians get manipulated.

 

[SoulinNeed]

Can someone tell me what the catch is with this job? Some shady math?

http://www.indeed.com/viewjob?cmp=I...76dc2e7e2593e4e&q=child+psychiatrist+$175,000

 

[PistolPete]

Can someone tell me what the catch is with this job? Some shady math?

http://www.indeed.com/viewjob?cmp=Institute-for-Personal-Development-(IPD)&t=Outpatient+Psychiatrist&jk=a76dc2e7e2593e4e&q=child+psychiatrist+$175,000

Might be a bad job/bad area and they need a psychiatrist badly?

 

[SoulinNeed]

Might be a bad job/bad area and they need a psychiatrist badly?

I've never heard of Institute for Personal Development, but they seem legit (website has clinicians with info on them). The location is out there, but the job (simply based on its description seems OK). Hmmmmm, not sure.

 

[Shikima]

Everyone needs a psychiatrist to dump upon.