Advice on Production-Based Telepsychiatry Position

[AD04]

Here's what I know:

- 1099 gig
- $80 / patient (new or follow-up)
- per physician owner, possible to see up to 3 patients / hr
- malpractice covered
- medical license covered
- equipment will be provided

Downside:

- not sure how much unpaid / administration work is required
- not sure about no-show policy (do I twiddle my thumb and not get paid?)
- not sure if 3 patients / hr is sustainable (if practice has the volume or the efficiency)
- I could be loaded with a bunch of new patients and my hourly rate would drop
- few thousand dollar penalty if I leave before 1 yr

Anything else I should be aware of? Is this a good gig or not?

In hourly-based telepsychiatry positions, how many patients are schedule per hour?

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[futuredo32]

What type of patient population? If it's CMH, the one where I worked had a huge no show rate . The patients have transportation difficulties, noncompliant, and some really hard lives. I would definitely ask about what happens if there are no shows. I briefly worked at a clinic that was in an upper middle class area as a locums at an hourly rate, and I didn't read the contract well enough. When people didn't show, I got nothing. It was an hourly rate ONLY if the patients showed. I made the mistake of not reading the contract. After a few weeks I left. I have worked a few locums jobs and they have all been x amount per hour or a day, this was the only time it was per hour only if the patient showed. I have since learned to read the contract .
I would negotiate a higher fee for new evals and accept less for med managements or a flat hourly rate whether the patient shows or not. You will have nothing but new evals I am assuming until you build a patient base. Is this a full time job or just part time? As is, you could come out really low financially. ASK your questions and negotiate for what you want. If this job doesn't pan out there are TONS more.

 

[Shufflin]

Here's what I know:
Downside:

- not sure how much unpaid / administration work is required
- not sure about no-show policy (do I twiddle my thumb and not get paid?)
- not sure if 3 patients / hr is sustainable (if practice has the volume or the efficiency)
- I could be loaded with a bunch of new patients and my hourly rate would drop
- few thousand dollar penalty if I leave before 1 yr

THAT is a red flag. Something is fishy and it's not in your favor.

 

[AD04]

I would negotiate a higher fee for new evals and accept less for med managements or a flat hourly rate whether the patient shows or not. You will have nothing but new evals I am assuming until you build a patient base. Is this a full time job or just part time? As is, you could come out really low financially.

To be fair, he is willing to put me on salary for 6 months -1 year until I build up the patient base. Hours are what I want it to be. They're looking for 20 hours / week minimum.

THAT is a red flag. Something is fishy and it's not in your favor.

It is to recoup their cost since they will pay for malpractice, licensing, credentialing, and equipment.

My concern is about the fee structure. It could either be really good or really bad.

 

[TexasPhysician]

Production based telepsychiatry is generally a bad deal for the psychiatrist. Too many downside risks.

 

[dl2dp2]

I wouldn't NEVER do this job. You are looking at what is likely 50%+ overhead being skimmed off your production.

Given that telepsych is getting close to $200 an hour with or without no-shows, the rates they are offering are very very bad.

 

[Shufflin]

If they were confident about the benefits over the risks, as a healthy job opportunity should be, they wouldn't hold you accountable for their upside risks. That should be on them.

Still it's a red flag to me.

 

[uhmocksuhsillen]

I wouldn't NEVER do this job. You are looking at what is likely 50%+ overhead being skimmed off your production.

Given that telepsych is getting close to $200 an hour with or without no-shows, the rates they are offering are very very bad.

Are those rates relatively commonplace and/or are they difficult to find without having some kind of connection?

It seems telepsych rates have been creeping up pretty steadily the last 5ish years. Do you foresee this trend continuing, holding steady, falling any time soon?

 

[trophyhusband]

Are those rates relatively commonplace and/or are they difficult to find without having some kind of connection?

It seems telepsych rates have been creeping up pretty steadily the last 5ish years. Do you foresee this trend continuing, holding steady, falling any time soon?

Should go up in 2020 since CMS is going to allow Medicare Advantage plans to offer full telemedicine benefits in that year (though how that's going to work is still up for discussion).

 

[Madden007]

who's paying 200/hr for telepsychiatry?