Another compensation question

[upright]

Can anyone share insight as to why the MGMA report list psych's median income as ~190k? I keep hearing everyone on here say you can get a >200k job at 40hrs/wk straight out of residency.

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[digitlnoize]

I think the reasons are many. First, over 55% of psychiatrists are over 55yo and many have probably begun scaling back their hours. Second, there is a large % of females in psychiatry, who are statistically more likely to work part time. Third, many docs have a salaried job, but do other stuff on the side. Only the salary gets reported. Finally, academic salaries and salaries in certain cities (NYC) are significantly lower.

Probably many other reasons, but that's a start.

 

[whopper]

There's a high variability with mean income,and factor in that a lot of psychiatrist work 40 hour work weeks, and a lot of other professions don't such as surgeons.

 

[michaelrack]

State hospital psych jobs, as well as VA psych positions are usually less than 190K, lowering the average. Many comm mental health positions are less than 190K

 

[classof2011]

State hospital psych jobs, as well as VA psych positions are usually less than 190K, lowering the average. Many comm mental health positions are less than 190K

Wait, so what setting is left to even it out? If we think that the Academics, State Hosps, VAs, Comm Centers, and NYC/Big city Psychiatrists are potentially bringing down the mean?

I'm asking this as a legitimate question btw. My sarcasm is usually much more subtle, haha.

What other settings are there?

 

[nitemagi]

Private practice.

 

[digitlnoize]

Not all state hospitals pay that. I know there are a few newer docs making over 200k at my state hospital.

 

[upright]

What's a reasonable private practice average?

 

[nitemagi]

What's a reasonable private practice average?

Where in the country? Seeing what population? Cash only or with insurance? Therapy too? If so what kinds?

 

[nitemagi]

I think it's not uncommon to make 300+ if you run a good practice with insurance, but I honestly have no solid facts to back that up.

I started a small private practice and charge $200/hr to start, here in LA. Cash only. And I am cheap for this town. Most charge in the range of $300/hr if they're good and established, which I aim to be at as my practice is around a while.

 

[ghost dog]

I think it's not uncommon to make 300+ if you run a good practice with insurance, but I honestly have no solid facts to back that up.

I started a small private practice and charge $200/hr to start, here in LA. Cash only. And I am cheap for this town. Most charge in the range of $300/hr if they're good and established, which I aim to be at as my practice is around a while.

Would this sort of practice focus primarily on psychotherapy, if you are charging by the hour ?

I'm not a psychiatrist, and practice in Canada ( and thus not acquainted with private US psych practice ).

If so, how much of this sort of training do you guys receive in residency? Just curious.
I find it simply impossible to get a Canadian psych to perform this modality, unless they are a resident in training. Much more success with psychology ( and then only covered by private insurance).

 

[nitemagi]

Would this sort of practice focus primarily on psychotherapy, if you are charging by the hour ?

I'm not a psychiatrist, and practice in Canada ( and thus not acquainted with private US psych practice ).

If so, how much of this sort of training do you guys receive in residency? Just curious.
I find it simply impossible to get a Canadian psych to perform this modality, unless they are a resident in training. Much more success with psychology ( and then only covered by private insurance).

I can only speak to my own experience, and every practice and residency is different. Often people offer 1-2 areas of specialization.

I offer specialization in both psychopharm and psychotherapy. I trained in CBT, DBT, and basic psychodynamic psychotherapy during residency. I ran a DBT group for a year, did 1:1 skills training, all with supervision. Carried 6-8 patients for 1-2 years each during residency for either psychodynamic or CBT focused therapy. Did additional training at the Beck Institute (admittedly not ACT certified yet). Also did training in hypnotherapy. Currently in analytic training at one of the psychoanalytic institutes in LA.

It's generally uncommon to have psychiatrists that do medication management well and ANY kind of psychotherapy. A lot of the older psychiatrists do a specific area of therapy (like analysts) and little med management. Other therapists usually do 1-2 forms of therapy. I like the idea of being a generalist, and someone that others can send patients to when they are struggling in treatment.

I recognize that I'm still a work in progress, though.

My current PP is only a couple of days a week, and isn't even full (only started it <6 mos ago). Most people either have a side job to make sure the bills are paid while they build a PP, or they get on insurance panels to fill their practice then peel them off one at a time.

 

[F0nzie]

Many different professionals are licensed to offer psychotherapy and they can do it for half the price. Seems like a competitive market to get involved with.... Sad we don't get reimbursed to our level of training.

Given the shortage of psychiatrists and overabundance of therapists it is probably more resourceful to do meds and refer to a therapist. But I would also argue that good psychopharmacology is greatly enhanced by knowing your patient well...and no better way than with psychotherapy.

Kudos to the psychiatrists that offer med management and psychotherapy and holding their ground in a time with harsh reimbursement realities.

 

[ghost dog]

I can only speak to my own experience, and every practice and residency is different. Often people offer 1-2 areas of specialization.

I offer specialization in both psychopharm and psychotherapy. I trained in CBT, DBT, and basic psychodynamic psychotherapy during residency. I ran a DBT group for a year, did 1:1 skills training, all with supervision. Carried 6-8 patients for 1-2 years each during residency for either psychodynamic or CBT focused therapy. Did additional training at the Beck Institute (admittedly not ACT certified yet). Also did training in hypnotherapy. Currently in analytic training at one of the psychoanalytic institutes in LA.

It's generally uncommon to have psychiatrists that do medication management well and ANY kind of psychotherapy. A lot of the older psychiatrists do a specific area of therapy (like analysts) and little med management. Other therapists usually do 1-2 forms of therapy. I like the idea of being a generalist, and someone that others can send patients to when they are struggling in treatment.

I recognize that I'm still a work in progress, though.

My current PP is only a couple of days a week, and isn't even full (only started it <6 mos ago). Most people either have a side job to make sure the bills are paid while they build a PP, or they get on insurance panels to fill their practice then peel them off one at a time.

I didn't realize psych had this much in depth training in these treatment modalities ; it really is impossible to find a specialist to perform this type of treatment in Canada ( or at least covered by medicare !).

 

[nitemagi]

I didn't realize psych had this much in depth training in these treatment modalities ; it really is impossible to find a specialist to perform this type of treatment in Canada ( or at least covered by medicare !).

It varies between residencies. ACGME only requires baseline "competence" in a range of therapies, which is loosely defined and particularly not delineated as to how it should be assessed. So there's a range.

That sucks that Canada makes it so unavailable. Maybe that'll change in the years to come.

 

[WhoisJohnGalt]

300 is higher than my 75 figure.

It seems a given that 350K is achievable, at least. Why don't more people know this?

I really don't think it's a secret. I'm sure most of us know several wealthy psychiatrists. This seems to be news only to you?