Work Schedule Flexibility in Psychiatry

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Thruster

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I was wondering how feasible it would be to create a 12hr/day x 3 day schedule, or 7 on 7 off in psychiatry? Has anyone come across such jobs, or been able to negotiate such a schedule? I really value my time off and don't mind working very hard for a few days a week with the rest off, or some combination thereof.

Also, how much vacation have you guys negotiated for in your current jobs?
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If you're in private practice you can do whatever you want. Haven't seen any employed positions that are 12 hours or 7 on/7 off, except maybe state hospitals which allow you to do four 10 hour days per week.
 
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Psych emergency rooms allow for this, depending on location.

Also look at locum tenen positions. Some of them I've seen advertise the 7 on, 7 off thing. I think it's usually a sign of desperation, but it seems to be out there.
 
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Thruster said:
I was wondering how feasible it would be to create a 12hr/day x 3 day schedule, or 7 on 7 off in psychiatry? Has anyone come across such jobs, or been able to negotiate such a schedule? I really value my time off and don't mind working very hard for a few days a week with the rest off, or some combination thereof.

Also, how much vacation have you guys negotiated for in your current jobs?
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I've heard of salaried jobs, doing inpatient work, that are scheduled this way. Basically a "psych hospitalist". These do exist and are becoming more common. I think HCA does it, if you're into that kind of thing...

If you have your own place, you can certainly do this. Patient's would appreciate the morning/evening hours in a 12 hour day. You may be able to use this to negotiate too, saying that you'll do 3 12's and that'll give the practice evening hours...maybe some places would be open to it.
 
digitlnoize said:
If you have your own place, you can certainly do this. Patient's would appreciate the morning/evening hours in a 12 hour day. You may be able to use this to negotiate too, saying that you'll do 3 12's and that'll give the practice evening hours...maybe some places would be open to it.
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The thought of 12 hours of medication management visits and/or therapy makes me shudder...
 
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A hospital in our area runs all of their inpatient psych units on a hospitalist model--7 on/7 off.
Allows patients to be seen (and billed for) by a primary psychiatrist 7 days a week without resorting to staff call or moonlighters.
 
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OldPsychDoc said:
A hospital in our area runs all of their inpatient psych units on a hospitalist model--7 on/7 off.
Allows patients to be seen (and billed for) by a primary psychiatrist 7 days a week without resorting to staff call or moonlighters.
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I think this is great for patients, weekend coverage seems to end up literally doing nothing and all the patients just sit there an extra day or two
 
OldPsychDoc said:
A hospital in our area runs all of their inpatient psych units on a hospitalist model--7 on/7 off.
Allows patients to be seen (and billed for) by a primary psychiatrist 7 days a week without resorting to staff call or moonlighters.
Click to expand...
Would you know the availability of these jobs presently.I've read that hospitals for the mentally ill have significantly decreased in number since the 1980s,due to which psychiatry-hospitalists are not very much in demand.Do you see such kind of '7 on 7 off' or '4 on 3 off' jobs increasing in number in the future?( say in half a decade).
Also what would be the approximate salaries being offered to psychiatry-hospitalists?.Are they as much as those being offered to I.M. hospitalsts?.
 
Worried-doc said:
Would you know the availability of these jobs presently.I've read that hospitals for the mentally ill have significantly decreased in number since the 1980s,due to which psychiatry-hospitalists are not very much in demand.Do you see such kind of '7 on 7 off' or '4 on 3 off' jobs increasing in number in the future?( say in half a decade).
Also what would be the approximate salaries being offered to psychiatry-hospitalists?.Are they as much as those being offered to I.M. hospitalsts?.
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Salary will depend on the number of patients per day and the geographic location of the hospital. My guess would be somewhere between around 225-250K/year for a typical 12 bed unit. Bigger cities will probably be able to pay less because the supply of psychiatrists is greater.
 
It's possible as other have said. If you are not covered by another doc on your off days, you will still daily calls regarding problems. You'll end up working some on the off days.
 
I looked at taking an inpatient job that was 7 on/7 off. I've even seen a couple of places proposing 14 days on, 14 days off (I think those would mostly be places out in the boonies where you'd have a hard time convincing most people to live there, so they're hoping to get people to fly in for a couple weeks and then go home for a couple weeks).
I think it is true that this model is mostly used by places that are having a hard time recruiting, so if you can think of a rural / underserved hospital that you'd like to work at, I'd try pitching the idea to them and see if they are open to trying it.
 
peppy said:
I looked at taking an inpatient job that was 7 on/7 off. I've even seen a couple of places proposing 14 days on, 14 days off (I think those would mostly be places out in the boonies where you'd have a hard time convincing most people to live there, so they're hoping to get people to fly in for a couple weeks and then go home for a couple weeks).
I think it is true that this model is mostly used by places that are having a hard time recruiting, so if you can think of a rural / underserved hospital that you'd like to work at, I'd try pitching the idea to them and see if they are open to trying it.
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Similar to what you mentioned...how common/feasible is it to take a job working 3-4 days in the boonies, then coming back home for 3-4 days? Mabye something 3-4 hours outside a major west coast city for instance..
 
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I think psychiatrists are in enough demand that most hospitals in underserved areas would be open to working on a non-traditional schedule with you as long as there is a practical way to make sure that the patients have coverage every day. The only thing that would really be a barrier would be figuring out who would fill in for you on the days you're not there. At the place I was considered working for, they were using locum tenens to fill in the off weeks for the doc who had wanted a 7 on/7 off schedule. You'd have to ask the place you're interested in if they would be willing to hire a locum tenens person to fill in for your off days.
 
There's a guy near me who does days at what we call community service boards in my state, which consists of med management and then moonlights at a private facility from 6-9 PM at night. I was scheduled to see him at 6 and didn't see him until 8 PM, so not sure how late he stays, but later than 9 PM. It ended up not being a match because the soonest he could get me in for a follow-up was 3 months out, and my initial appointment to see him I believe was about 8 months. I thought it would be nice and peaceful to see someone at night, but the place looked like there had been an outbreak--packed to the gills.

Psychiatry is a field where the patients will wait for you. If a new psychiatrist came to my town they would be booked solid in no time--you could tell them you only meet 2 AM to 6 AM at McDonald's and they'd come see you. The university here can't even get a psychiatrist to come and they've been trying (supposedly) for years (our school has been in the news for mental health issues). There's only one new psychiatrist who came here and he left for an inpatient facility within a couple of months. Somehow we must scare people off. I've been told it's the reimbursement rates, but I don't know why our area would be bad in particular. It's a wealthy area.
 
I found jobs near Philly that were 14 on 14 off for around $200K, no vacation. They were pretty much overnight coverage for multiple inpatient units and emergency departments. I wasn't interested.


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yanks26dmb said:
how common/feasible is it to take a job working 3-4 days in the boonies, then coming back home for 3-4 days? Mabye something 3-4 hours outside a major west coast city for instance..
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I know lots of folks doing this from SF and LA. There are a lot of jobs at either Napa, Coalinga, and Atascadero state hospitals. Starting pay is about $240K and they work 4 days a week, 10 hours a day. A couple of the folks I know doing this drive out on their "Monday" for 2-4 hours (depending on where they live), rent a cheap apartment in these places and stay three nights, and drive home after their last shift, leaving three days and four nights at home.

Alternately, there are a lot of contract jobs at places like Stockton (as well as the state hospitals mentioned above) that pay very high hourly rates and you can stack the hours and work 3-4 days/week. They provide housing while you are there (but no benefits).

Also, you don't need to go to the boonies for such jobs. There are jobs within easy commute of LA/SF (one hour or less) that you can work 3-4 days/week and make a nice salary. I commute 40 minutes to a PES that pays about $2400/shift.

Keep in mind, the situations, salaries, and opportunities I'm describing above are VERY different from one locale to the next.
 
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13 hours for that one.


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notdeadyet said:
I know lots of folks doing this from SF and LA. There are a lot of jobs at either Napa, Coalinga, and Atascadero state hospitals. Starting pay is about $240K and they work 4 days a week, 10 hours a day. A couple of the folks I know doing this drive out on their "Monday" for 2-4 hours (depending on where they live), rent a cheap apartment in these places and stay three nights, and drive home after their last shift, leaving three days and four nights at home.

Alternately, there are a lot of contract jobs at places like Stockton (as well as the state hospitals mentioned above) that pay very high hourly rates and you can stack the hours and work 3-4 days/week. They provide housing while you are there (but no benefits).

Also, you don't need to go to the boonies for such jobs. There are jobs within easy commute of LA/SF (one hour or less) that you can work 3-4 days/week and make a nice salary. I commute 40 minutes to a PES that pays about $2400/shift.

Keep in mind, the situations, salaries, and opportunities I'm describing above are VERY different from one locale to the next.
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Thanks for all of that info. I'm from socal...so anything near san diego or LA would be amazing. I always assumed I'd have to drive 3 hours into the desert but glad to hear that may not totally be the case.

Are these arrangements you talked about relatively easy to land?
 
Im post 24hr call w/o sleep and read this as "waxy flexibility in psychiatry" haha
 
notdeadyet said:
I know lots of folks doing this from SF and LA. There are a lot of jobs at either Napa, Coalinga, and Atascadero state hospitals. Starting pay is about $240K and they work 4 days a week, 10 hours a day. A couple of the folks I know doing this drive out on their "Monday" for 2-4 hours (depending on where they live), rent a cheap apartment in these places and stay three nights, and drive home after their last shift, leaving three days and four nights at home.

Alternately, there are a lot of contract jobs at places like Stockton (as well as the state hospitals mentioned above) that pay very high hourly rates and you can stack the hours and work 3-4 days/week. They provide housing while you are there (but no benefits).

Also, you don't need to go to the boonies for such jobs. There are jobs within easy commute of LA/SF (one hour or less) that you can work 3-4 days/week and make a nice salary. I commute 40 minutes to a PES that pays about $2400/shift.

Keep in mind, the situations, salaries, and opportunities I'm describing above are VERY different from one locale to the next.
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So if you work 15 shifts you'd be making 36,000 a month,which would fetch 400k+ a year.That's more than what private practitioners would be making? Sounds incredible!
 
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Worried-doc said:
So if you work 15 shifts you'd be making 36,000 a month,which would fetch 400k+ a year.That's more than what private practitioners would be making? Sounds incredible!
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It's probably a night shift.
 
Nope, it's a day shift, but weekend.

It's also a very busy PES and by the end of my shift, I'm pretty drained. It's also 1099, so no pension, retirement or health benefits.
 
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Word of mouth. My old residency program would get pinged from different hospitals, companies, and services looking for moonlighters and full-timers. Our PD would send these out to the licensed residents (and recent grads who asked to be kept on the list). Outside of that, I asked folks I knew who were moonlighting where the good gigs were. Once I started working one gig, I'd inevitably meet folks who also recommended others. By the time I finished residency, I think I'd worked at four or five different PES/inpatient units.

This is why I think location is probably more important for residency than people think. You get roots where you train and get on people's radar, which makes finding jobs a lot easier. This advantage levels out a bit after you've moved to a place, but local training gives benefits even beyond the first few years if you went to a good program.
 
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