Anyone know if there are jobs out there especially in good states such as Florida or the West Coast?
2 weeks on, 2 weeks off Psychiatry Jobs Possible?
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Best way would be to find a like minded doc, and present yourself to a place as a package deal.
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Possible, it's out there but the more odd the type of job you want the less likely you can find it. There's locums all across the country but it might not be in a place you'd like to be.
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Good States? Florida? Am I missing something?
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Haven't looked at jobs yet, but will start in the next couple of years. Is it reasonably easy to find locums jobs in large cities, LA/SD for example. Any ballpark as to what hourly rates of locums look like? One of my senior residents has mentioned anything from 130-300/hr. Had this been your experience too?
with locums, keep this in mind- there is a reason why it is a locums job. These arent jobs people want, for one reason or another. Sometimes it is a situation where the outfit has someone out for a month or two or can't find anyone temporarily, but more often than not they are doing the locums thing to avoid 'locking in' a provider at a physician level salary. In a lot of these cases the psychaitrist before was let go and the position is actively in transition from what was staffed by a psychiatrist to what will be staffed by a psych np.
And they just need a locums for a couple months while they get the collab worked out to staff it with a psych np. So this doesn't represent a good thing or opportunity in any sense, but rather is a position that saw a psychiatrist thrown out on their ass a month earlier and soon to be replaced by an np with an armchair collab agreement in place. Just out of principle I wouldnt touch crap like that, and you shouldnt either
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Yeah that's good to keep in mind. I get random emails through doximity about jobs and sometimes click through. I notice these jobs sometimes talk about temp to hire. Would a set up like this be something that would likely be a better option to pursue?
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these are not jobs you need to pursue. I would stay away
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You make it sound like it's tough to find a decent locums job out there. I'd love to find a decent locums (or any) job, 40 hours a week, minimum 200/hr. Anywhere between SD and LA. Am I crazy to think this will happen?
eh.....200/hr seems a little high. 160/hr seems more reasonable. Just to prevent people from reply after reply saying "oh yes there are 200-250/hr jobs"....yes, I know this. there are also 145-160 hr locums jobs, and the 150-160 hr jobs are going to be the ones people are more likely to find some satisfaction in working.
But sure, it's possible. But then what's next....to do it for 6 weeks and then pack your crap up an hour and a half away and live in another extended stay while you do it a different place for another 6 week? And then pack up again 60 more miles down the road?
I mean the very nature of these jobs is that they are transient and unappealing. or, as I said before, DONT WANT psychiatrists in them for long for some reason.
So no...you're not going to do it and enjoy it and do it in a stable situation for long.....if that were the case it wouldn't be a locums job.
What is your long term career goals? You realize that working crap locums jobs won't further those right??
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Definitely don't want to have to pick up and move around to different cities. I guess I was assuming in a large metro area, I'd be able to find enough work without having to move. Maybe this was just wishful thinking.
My ideal work situation is inpatient gig in the morning (4x10s), be out by early afternoon. Slowly build a private practice in the afternoons/early evenings with at least some focus on addictions. Throw in 4-6 ER night shifts a month. Find one of those 48 hour weekend rounding gigs to do once a month. Generally take Fridays off or maybe half days if the pp really starts to build. Ideally all of that would allow me to hit between 4-500k a year. Loans are big and going back to socal is expensive. Longer term, once my loans are paid and the pp is really in full swing, I'd love to use those rich worried well to subsidize a very low cost addiction clinic a day or two a week.
Too ambitious?
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1) If you know what metro you want to live in, just take a job there and if you want to supplement your income try to find extra work. I just don't get this desire to find a locums position. Those arent good stable positions...for a reason. They either don't want to have a psych permanently or they cant keep one permanently. Either way that means you don't want to be there long. And why would you look to take a job that isnt going to be there but just a couple months? The whole strategy makes no sense
2) I don't know whan an ER shift is? I have covered numerous units over the years at big hospitals and not small hospitals. Not a single one has paid to have a psychiatrist work in the ER. Who would even pay for that as there is no need for it...the ED doc just calls me or someone else to admit the patient and we see the pt the next day. That sounds more like a residency thing.
3) The inpatient gig in the morning makes sense, but if you want to pop in and out you just want to get a contract, not be hospital employed. Get your own stipend to cover the psych hospital or some component of it, and then do the billing yourself to. IOW, think like a businessperson and it just being another contract and then find other contracts as well. Or more outpt.
4) Yes you can get weekend rounding gigs....but you likely wont get paid by the hour. You are going to be paid to cover a unit. Like a typically get 3k to cover a 40 bed hospital, but Im not there all weekend. I'll get in around 9am and leave around 1-2pm each day. Nobody cares how long it takes, just that it gets done and is flat fee for that. The group that gets the contract will likely hire other people to fill in for some weekends as they dont want to cover every weekend.
I think you have some good ideas, and sure if you work hard I think you can make 400k. Thats a good bit less than what I make and although I work hard, I don't work super hard. But I don't think you really know how the business of things work yet- you are applying a residency like mindset to some of it....you'll find out once you get out there and start
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If they're getting care at an addiction clinic, chances are they're not the worried well. You're going to have to work more than that if you want to make half a million a year. If you're signed on to do 4 10-hour shifts for your inpatient gig that's paying as much as you hope to make half a million a year, it's going to be difficult to leave early everyday.
Many places have psych EDs and they pay a lot to have them staffed.[/QUOTE]
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Glad someone else said it, that was my thought within .01 seconds of reading that. OP if you think Florida is desirable, strongly recommend starting there for work over the west coast, there is a profound difference in competitiveness and availability of jobs.
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The correctional gigs I've seen are in like 240-280/hr range. Is corrections really that bad?
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Look here:
Home Page - PracticeLink
Explore PracticeLink for a wide range of physician jobs and resources in PracticeLink Magazine to use in your physician job search.
www.practicelink.com
[/QUOTE]
This is very rare. Im sure there has been a psych ED that has paid a psychiatrist somewhere at some point in time.....but it's certainly not a common model. Why would it when it makes so much more sense for the ED doc to just admit(or not admit) them to the psych service and the psychiatrist will see them and do an initial note the next day.
Pretty much every residency program has residents work down in the 'psych ED' and do rotations out of that, and of course an attending staffs it I suppose. So it has a place in training and creating additional things/sites for residents.....but as a business model it wouldnt make a lot of sense because I don't see where the money comes to fund it. If you had insured patients, yeah the psychiatrist in the psych ED who admits the patient could do a H/P and bill for it....but that just means the psychiatrist on the unit won't be able to. it's a zero sum game and no new no billing revenue is collected. Insurers companies arent going to pay for a new patient eval in both the ED and the floor....they don't recognize such silly distinctions
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200/hr is the new minimum.
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Dude, stop talking so confidently about things you don't know.
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Where? What type of job? Short term crappy locums assignments? Not doubting, just a resident trying to figure out what I should be looking for in a couple of years.
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Regular jobs. Suburban. Outpatient and inpatient
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but as a business model it wouldnt make a lot of sense because I don't see where the money comes to fund it. If you had insured patients, yeah the psychiatrist in the psych ED who admits the patient could do a H/P and bill for it....but that just means the psychiatrist on the unit won't be able to. it's a zero sum game and no new no billing revenue is collected. Insurers companies arent going to pay for a new patient eval in both the ED and the floor....they don't recognize such silly distinctions
[/QUOTE]
The money in Psych EDs comes from opening up beds for throughput in the main ED and decreasing (or eliminating) length of stay in inpatient psych. That’s the business model.
[/QUOTE]
The money in Psych EDs comes from opening up beds for throughput in the main ED and decreasing (or eliminating) length of stay in inpatient psych. That’s the business model.
fine...start listing all these psych EDs that have all these open/paid 'psych ED' shifts. If they are common surely you can pick a state and list 15 or so such places in that state that do this. Again, if it were common.
The money in Psych EDs comes from opening up beds for throughput in the main ED and decreasing (or eliminating) length of stay in inpatient psych. That’s the business model.
[/QUOTE]
how does a psychiatrist being paid by the ED 'open up beds' throughout the main ED? That makes no sense. The ED doc isn't going to wait until the psych comes in the next day to move them out of the ED. He's going to admit or discharge the patient themselves just as quickly as the psych would. Maybe he calls the psych at home or maybe he doesn't...everyone has a different arraignment. but no...the presence of a psych doesn't 'open up beds' in the ED. patients still get dispo'd.
Now to your second point....depending on the payor mix, this wouldn't even enhance revenues(assuming you are saying an inperson psych in the ED would be more likely to DC). Hell it may hurt revenues. If you have a decent payer mix(ie lots of medicare vs self pay) and you have a discharge happy psych down in the ED preventing them from getting up to psych from ED, that hurts the bottom line. So not only are you out what you are paying the psych, you are losing admissions/money.
You just seem like you don't understand how admissions/discharges work in most community hospitals. What happens is the ED doc is usually going to do what they are going to do regardless of what the psych says. Sometimes they will call and I'll be like "dude, I've admitted this guy 4 times in the last 3 months and he's FOS. Can you please you just get him out?". Sometimes they do, and sometimes I have to just discharge the patient the next day when I round. But having a psych down there in the ED to personally see all these patients just doesn't make a lot of sense from a logistical standpoint.....you have 24 hrs t see the patients from when they are admitted and can only submit one initial eval code anyways.
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How about just one city?
Emergency Psychiatry Services | Mount Sinai - New York
At Mount Sinai, we offer psychiatric emergency care 24 hours a day and provide treatment for a range of psychiatric conditions like psychotic disorders.
www.mountsinai.org
Comprehensive Psychiatric Emergency Program - NewYork-Presbyterian
Our Hospital-based emergency psychiatric services provide a full psychiatric assessment, stabilization, extended observation, treatment, and referral of patients 18 and older.
Department of Emergency Medicine Clinical Services | NYU Langone Health
Doctors in NYU Langone’s Ronald O. Perelman Department of Emergency Medicine treat patients with compassion.
Kings County Behavioral Health Services Program Commended for Patient Care
Praised as a “Model” program for psychiatric treatment.
lmao....I haven't clicked on those links but none of them speak against any of what I am saying. My residency program had a 'psych ED' and 'psych EMS' section as well. It was a rotation people rotated through and was covered by different attendings. But what people here are referring to our community shifts one can do in a psych ED for pay. Like for example somewhere I could go to and say "hey I'm looking to pick up some extra work. Can I do an 8 or 12 hr shift in your psych ED for hourly pay". I know those are not common. Im sure one exists somewhere, but they certainly aren't common. Show me links advertising shift work in such a place for psychiatrists....
in fairness, such a thing doesn't exist in ANY field really. People take call from the ED. They may go in and see a patient there depending on the need and situation(although most community psychs don't). but outside of residency situations(or attendings who are employed in an academic program to teach the residents) they don't do shift work for pay just in the ED.
in fairness, such a thing doesn't exist in ANY field really. People take call from the ED. They may go in and see a patient there depending on the need and situation(although most community psychs don't). but outside of residency situations(or attendings who are employed in an academic program to teach the residents) they don't do shift work for pay just in the ED.
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Where did anyone say community ED? These are psych EDs and many places have them. I personally moonlight at two different psych EDs, one where I work (not part of my regular job duties) and one across town as an external moonlighter/1099.
Again, stop talking about things you clearly don't know. It's obnoxious.
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Not only a psychiatric specific EDs relatively common, especially in larger systems/hospitals, but crisis stabilization units are also increasingly trendy as a way to divert from inpatient and free up ED space quicker. Clear pluses and minuses to the model but when I worked in one the ED staff/attending's LOVED it and heavily pushed to keep it expanding.
My co-resident took his first job exclusively working in a psych wing of a huge ED, can be a great job if you like that patient population as it's pure shift work with no call, no outpatient, no inpatient responsibilities.
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The point is you are comparing the Beyonce of American geography to the Kelly Rowland. Nothing against Kelly at all, but Beyonce gonna Beyonce. In medical terms, its like applying to Harvard or Indiana University, IU is great but these are not comparable in terms of competitiveness.
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I'd say this is more like comparing Beyonce to William Hung. But hey, I'm biased.
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And more like Harvard v. University of Phoenix
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Dedicated psych ED at our shop is inside the psych hospital but accessible to outside via external doors. Bills as an outpatient hospital-based clinic. BAM there's your revenue.
It is sufficiently profitable for our system that it moved recently from increasingly cramped space on the ground floor amongst offices to taking up an entire -floor- of the hospital itself, renovated all fancy and built out specifically to the design specs of the psych ED service line. Our system is enough of a vampire squid stuck to the face of local insurers that there is basically zero chance they did this if they thought it would lose money.
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Bisco you should call Insight Telepsych (see my other thread). They are offering around $200 per hour pure telepsych outpatient eat what you kill model (in my other thread). I suspect there's not a dearth of patients. Not my thing but you don't need to locum. Esp. with telepsych being more and more acceptable even for inpatient/ER, I personally think locum will die.
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So Florida is considered less competitive than the West coast in terms of competitiveness for psychiatry employment opportunities? Interesting...does this include residency as well? How competitive are University of Washington and OHSU?
I'm guessing University of Arizona - Phoenix is considered not that competitive? Unless you meant University of Phoenix as a reference to the online degree school. In which case, lol.
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The latter, but I was alluding more towards QOL, unless Florida Man is your favorite super hero.
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The whole world at large finds the West Coast to be about the maximum in terms of competitiveness/desirability, take a look at the state of California's GDP when you get a chance. UW is an incredible medical establishment in general and OHSU is also very solid; the top Cali places go without saying. West Coast residencies are absolutely among the most competitive, particularly any of the named programs in Cali. The Atlantic NE programs will always have the history and name recognition but most folks these days would rather live on the West coast then the Atlantic NE region and doctor's are increasingly chasing lifestyle over other factors.
Im more concerned about psychiatry attending jobs. I did one year of residency in Socal before transferring to the North east. My hospital in Socal was dying for a psychiatrist. So hopefully it should be fine to find a job there.
Im intensifying my search for 2 weeks on, 2 weeks off. Im willing to work in a not so desirable area. Im talking to a recruiter now to see if they have any openings. If anyone has any information, please let me know.
So far Im finding a lot of jobs listed on the APA website. Listed below. Im also talking to a few locum companies who have such gigs open for 2 weeks on 2 weeks off. Thanks everyone.
jobs.psychiatry.org
Recent Jobs - 2 weeks - APA JobCentral
View - 2 weeks jobs available on APA JobCentral. Search for and apply to open jobs from APA JobCentral.
jobs.psychiatry.org
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I looked for job on both states (California e FL). I ended up in CA.
FL jobs usually pay significantly less than CA. However, CA has a higher cost of living and more taxes. Most of doctors in CA are just middle class (at least in the bay area), so you won't be able to live like the top 1-3%.
I would happily move to Miami area if I could find a job that match my current salary.
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Tbh job listed earlier looks interesting. What are some of the best employed jobs with PTO that people have seen? VA provides 25 vacation, 13 sick leave, 10 federal holiday and usually some cme time as well.
That tbh job above seems to be a pretty good deal as well. Any other examples of generous PTO?
That tbh job above seems to be a pretty good deal as well. Any other examples of generous PTO?
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VA is the best I've seen. Especially given that you can roll over up to 80 vacation days and unlimited sick days. I have an attending who literally has hundreds of PTO days accrued. I doubt you'd find that anywhere else.
