Any way for Psych. to make big $$$?

[Therapist4Chnge]

Manicsleep is definitely falling prey to confirmation bias, but nothing anyone writes will change that so......

The best way to make money is to find ways to maximize passive and active income and/or be recognized as an expert (and charge like it).

---

Members don't see this ad.

 

[Manicsleep]

Look out, the psychology cops are out. Scared psychiatrists better play nice.

Can I see data supporting your assertion that an psychiatrists can do research, testing and therapy as well as psychologists? I need data. I must have it.

First prove it the other way. Then I might consider spending time on it.

I would totally agree that the variability in psychologists training is quite large. However, I'm going to have to disagree that it is any better for psychiatrists...

RE: psychologists, I agree.
RE: Psychiatrists:
1) You aren't qualified to make this judgment.
2) You're wrong.

I also agree that there is wide variability in both fields, so Im not sure how pointing this out in regards to psychologists helps further the argument that is trying to be made. I do think that, rather than a sarcastic appeal for empirical support for manicsleep's argument, the most appropriates questions, IMHO, would be:

1. Well, what does this mean to you? Is there a "Less than I" inference that comes from this belief? Do you feel this effects your ability to work collaboratively or take suggestions from psychologists with a multidisciplinary treatment team setting?

2. Yes, I am aware that you can legally bill 96118, but I'm not sure I understand why you want to? I have always been taught that the differences in training result in differing roles for the two practitioners, no? Thus, the act that you can (from a billing perspective) perform a 6 hour diagnostic neuropsych eval, complete with an MMPI-2 means...what exactly? Would this really be appropriate? Is that your role? Or was the point to demonstrate that you simply could do this if you wanted?

Nice try. To answer your question however. I am able to and do take suggestions from all mid level providers. Be they NPs, RNs, psych techs, psychologists or social workers.

Why do I point out my ability to do neuropsych testing? Because I have done it. I have used it for research and the comprehension of that modality allows me to understand mental health in a better way.

The main underlying basis is why point out the variability. It is not the same of course. To even consider that is preposterous much less to believe that its actually true.

The variability is much wider in psychology. Demonstration? You can't be a psychiatrist online. Is that clear enough?

 

[Therapist4Chnge]

RE: psychologists, I agree.
RE: Psychiatrists: You aren't qualified to make this judgment. You're wrong.

And how are you qualified to make a judgement about psychologists?

 

[loveoforganic]

Oh hey, this thread looks familiar.

 

[mahasanti]

An interesting 2006 survey of MD, PhD, PsyD and MSW programs and the therapy training offered/required:

http://rr4cc.org/pdf/National_Survey_Psychotherapy.pdf

This really doesn't show how effective each group is at providing therapy (nor how effectively taught they are in each modality), but it shows that:

1. 93% of MD programs require CBT supervision compared to 53% of PhD, 20% of PsyD and 21% of MSW programs

2. 96% of MD programs require psychoanalytic/pyschodynamic supervision compared to 10% of PhD (only 57% offered), 8% of PsyD, and 15% of MSW programs.

3. 72% of MD programs offered DBT supervision, compared to 69% of PhD, 56% of PsyD, and 46% of MSW programs.

4. "The 2 disciplines with the largest
number of students and emphasis on clinical training—
professional clinical psychology (PsyD) and social
work—had the largest percentage of programs (67.3%
and 61.7%, respectively) not requiring a didactic and
clinical supervision in any EBT."

And many more interesting tidbits.

 

[Manicsleep]

And how are you qualified to make a judgement about psychologists?

I am trained and qualified to do everything a psychologist does in clinical psychology.
As a psychiatrist, I am an expert in the field.
Personally, I am also trained to make judgments about clinical training and have done so for various medical specialties, mostly psychiatry as well as mid levels such as clinical psychology.

 

[Manicsleep]

Great post mahasanti.

Back to the threads point though.

What would you rather have...or how much would you give up?

Money vs headache.
Me, I enjoy the business aspect of the private life. I enjoy spending hours getting it right and then moving to the next project, expanding, trying a new idea etc.

I have a cousin who is an AOA, former chief from a top west coast program but works 8-5 as a PCP for kaiser. His main hobby is to complain but always states that he is happy. I have told him to get a concierge job but he states that it will be a headache (which is true initially).

So are you the adventurous risk taker or the drone or somewhere in between. Or are you just lost?

 

[erg923]

I am trained and qualified to do everything a psychologist does in clinical psychology.
As a psychiatrist, I am an expert in the field.
Personally, I am also trained to make judgments about clinical training and have done so for various medical specialties, mostly psychiatry as well as mid levels such as clinical psychology.

I see. Enough said...Guess I cant debate with a supervisor since I'm a "mid level." You're crackin me up pal...

Ill look you up as a study resource when I take my ABPP-CN oral exam, you gonna charge me per hour?

 

[Ollie123]

Good lord, I remember this guy now, and I can already see this is going to be like arguing with a child, and not worth my time (I'm sorry, "DOCTOR" five-year-old - we wouldn't want to bruise any overly-inflated egos there, would we?).

Go get some research training, and learn why "You're wrong" is probably not the best way to make your case. Or convince us you have adequate training in research for you to be functionally equivalent to someone with a BA in psychology, let alone a PhD.

 

[Manicsleep]

Good lord, I remember this guy now, and I can already see this is going to be like arguing with a child, and not worth my time (I'm sorry, "DOCTOR" five-year-old - we wouldn't want to bruise any overly-inflated egos there, would we?).

Go get some research training, and learn why "You're wrong" is probably not the best way to make your case. Or convince us you have adequate training in research for you to be functionally equivalent to someone with a BA in psychology, let alone a PhD.

Don't expect to come in here and demand answers. I don't need to convince you of anything, this is a psychiatry forum, you need to provide the data. Still, I notice none of you have commented on Mahasanti's post.

You must have overlooked it even with your excellent training. I will repost it for you. Or perhaps ad hominem attacks are easier for you as you have nothing real to say.

An interesting 2006 survey of MD, PhD, PsyD and MSW programs and the therapy training offered/required:

http://rr4cc.org/pdf/National_Survey_Psychotherapy.pdf

This really doesn't show how effective each group is at providing therapy (nor how effectively taught they are in each modality), but it shows that:

1. 93% of MD programs require CBT supervision compared to 53% of PhD, 20% of PsyD and 21% of MSW programs

2. 96% of MD programs require psychoanalytic/pyschodynamic supervision compared to 10% of PhD (only 57% offered), 8% of PsyD, and 15% of MSW programs.

3. 72% of MD programs offered DBT supervision, compared to 69% of PhD, 56% of PsyD, and 46% of MSW programs.

4. "The 2 disciplines with the largest
number of students and emphasis on clinical training—
professional clinical psychology (PsyD) and social
work—had the largest percentage of programs (67.3%
and 61.7%, respectively) not requiring a didactic and
clinical supervision in any EBT."

And many more interesting tidbits.

 

[Manicsleep]

I see. Enough said...Guess I cant debate with a supervisor since I'm a "mid level." You're crackin me up pal...

Really, is that what your psychology instructors teach you? Too bad. I think you should be allowed to discuss, as long as you have some basis for debate. Getting frustrated and falling apart or laughing hysterically (whichever you mean by cracking up)...is just unfortunate.

 

[edieb]

The variability is much wider in psychology. Demonstration? You can't be a psychiatrist online. Is that clear enough?[/QUOTE]

But you CAN be one with a medical degree from a medical school based in the third world (India, Pakistan)... and most are. After all, psychiatry is the LEAST competitive residency to gain entrance into. enough said

 

[maranatha]

Can I see data supporting your assertion that an psychiatrists can do research, testing and therapy as well as psychologists? I need data. I must have it.

I agree with Manicsleep here. I would really like to see the research that shows PhD therapists have better therapy outcomes then other mental health providers such as clinical SW's, master level therapists, or psychiatrists. Where is that data?

I'll take it with a grain of salt, but my clinical experience doesn't support that having a PhD makes one a better or worse therapist. In fact, some of our best therapists are clinical SW's and psychiatrists and I'm at a major academic center with some very well known psychologists.

 

[Majesty]

The variability is much wider in psychology. Demonstration? You can't be a psychiatrist online. Is that clear enough?

But you CAN be one with a medical degree from a medical school based in the third world (India, Pakistan)... and most are. After all, psychiatry is the LEAST competitive residency to gain entrance into. enough said

Racism wont get you anywhere. Medical schools around the world are where the best and brightest go. Not sure where your data about least competetive is from but it doesn't matter. It is still medicine. The least competetive physician is still a physician.

Also, psychiatrists have to pass the steps 1,2,3 of the boards. They have to do a residency in the United States. They also have to pass written and oral boards to be board certified.

My MR/DD patients can sign up for a program at university of phoenix. The ones with resources not only can but do. Although I encourage them to use the local city college, regardless of the increased rigor. enough said?

 

[Manicsleep]

But you CAN be one with a medical degree from a medical school based in the third world (India, Pakistan)... and most are. After all, psychiatry is the LEAST competitive residency to gain entrance into. enough said

This means what, other than you still aren't qualified to judge medicine and that you may be a racist?

I would totally agree that the variability in psychologists training is quite large. However, I'm going to have to disagree that it is any better for psychiatrists...

And the data?

Convince us you have adequate training in research for you to be functionally equivalent to someone with a BA in psychology, let alone a PhD.

Psychologists from their blackened ivory towers calling us arrogant and 'deciding' that we don't rely on objective measurement. When given data, they hide. Yet, perhaps what is most telling, where is the self regulation when their own are guilty of the delinquencies for which they are, so they claim, ever vigilant?

It is a fraud, a hoax, a scam, a sham...indeed a horrible joke! Some of us have been tricked by this whopper of a lie. Unfortunately, those worst off are the poor psychologists themselves that have partaken from the kool aid.

 

[erg923]

I'm not going to partake in further debate with someone who utilizes such authoritarian reasoning and posturing as the basis for argument (i.e., I am an "expert," thus, I can do anything you can do and moreover, have right to judge the quality of your training model, your competencies, etc.). Most would agree that this is slightly off-putting in tone, to say the least. I also don't feel the need to justify my professions existence, although unfortunately, I can get dragged into correcting gross misperceptions, overgeneralizations, etc. Probably a mistake on my part since this debate has been played out since my bretheren emerged from their testing closets in the 1930s. Fortunately for me and most others in our medical center, we have never actually experienced psychiatrists (or any other medical professional who refers to us) with this unfortunate belief system. I know this because of multiple discussions regarding this and similar issues in which all were humble in admitting the limits of their training and competencies (as well as the value and knowledge the nonmedical psychology model can bring to patient care).....something you appear to have great difficulty doing. I think THAT is really what is unfortunate here.

I will simply state (and maybe ask as well) that you appear to have had some bad experiences with psychologists. This is unfortunate. So, I suppose the questions is: What happened? Also, what do you belief the role of psychology services in patient care to be? How might this differ from the beliefs of your colleagues who do not hold your same belief system?

Lastly, in one of my final posts on the topic, and in attempt to let you guys get back to original topic, all of us know that there is no good research (other than anecdotal stories and peopole personal experiences) that demontrates the superiority of one type of practitioner (psychiatrist vs psychologist) over the other in patient psychotherapy outcomes. So really, this whole arguement is moot. With proper training in psychopathology and psychotherpay im sure we can all do some good out there. I see no point in arguing further about who has the bigger mental health slong...

 

[edieb]

QUOTE=Manicsleep;10167834]This means what, other than you still aren't qualified to judge medicine and that you may be a racist?

Your throwing the racism card out does not obfuscate the fact that medical schools in the third world offer lesser quality than American schools. However, it soes highlight the fact that you are afraid of the facts.

Some hospitals even forbid foreign medical graduates, particularly those who graduate from schools in the Caribbean from completing residency in their hospitals. Furthermore, it is well known that psychiatry in general, and psychiatric residencies in particular, are the lowest rung in the medical field and that all but the top tier residencies have to beg for med students to fill their spots/positions. There are even posts on this board from other physicians about attesting to this fact.

Are there psychologists who are sub par? Yes, just like in any other profession, we have schools with less than stellar reputations (Fieding, Argosy). However, overall, a very small # of psychologists from these schools. However, psychiatrists are not one to be throwing stones when it comes to quality control

 

[Manicsleep]

Psychiatrists and psychologists do not bring different and equally important skills to the mental health treatment table. Everyone is not above average, regardless of what you were told.

All things being equal...training, facilities, the illness, the patient, time allowed to treat etc...the psychiatrist is always superior in the mental health arena.

Can we all do some good out there? Sure and we should. Lets not spread falsehoods. Lets not say that US trained psychiatry residents, be they AMGs or IMGs, are in any way comparable to a huge percentage of psychologists who have extremely poor clinical training.
Lets try to answer challenges of data, for example that previously posted, that indicate that US trained psychiatrists are much better at the 'supposed' hallmarks of psychology...CBT, DBT, psychodynamic therapy etc.
Don't get angry at being called a mid-level because that is a step up. Per the DEA, medical psychologists are mid levels.

The problem is that there are foolish people that may actually believe these lies to be true. Patient's lives are at risk.

 

[Ibid]

All things being equal...training, facilities, the illness, the patient, time allowed to treat etc...the psychiatrist is always superior in the mental health arena.

Can we all do some good out there?

.

Depends how you would define "always superior". Who has done the least harm over the last 100yrs? Considering that a little humility to go with the tenacious defense may be in order.

 

[Therapist4Chnge]

Lets try to answer challenges of data, for example that previously posted, that indicate that US trained psychiatrists are much better at the 'supposed' hallmarks of psychology...CBT, DBT, psychodynamic therapy etc.

As a scientist I'm trained to look at all of the data and not just the parts that fit my agenda. If you were objective you'd recognize the significant limitations of the posted study. For instance, the study does not address effectiveness of the actual psychotherapy within each group, nor does it address the effectiveness of teaching. The study examines which sites/organizations have stated requirements.

A well trained scientist wouldn't "assume" (thank you Benny Hill) anything about the research but what was actually studied. How you extrapolate "better" from that study is akin to saying that no speeding occurs in any state because there are statutes in place to address the limits of speed. The reality of the situation is that the ACGME may "require" psychotherapy be taught, but the reality is that many programs, by the admittance of many psychiatry residents, do not adequately provide the training. Why do so many prospective psychiatry residents have to ask around to find programs that actually provide any substantial training in psychotherapy? Just because there is a posted speed limit does not mean people actually abide by it.

Don't get angry at being called a mid-level because that is a step up. Per the DEA, medical psychologists are mid levels.

While this is obviously an attempt to troll, it is a clear example of a lack of objectivity. Again, as a scientist I was taught to be on the look out for bias, and your tone and implications show your true colors. As a point of fact, the discussion is not about medical psychologists. Your straw man has no place in the discussion.

The problem is that there are foolish people that may actually believe these lies to be true. Patient's lives are at risk.

Indeed, which is why humility (as a previous poster referenced) is not only recommended but required.

 

[Manicsleep]

A well trained scientist wouldn't "assume" (thank you Benny Hill) anything about the research but what was actually studied. How you extrapolate "better" from that study is akin to saying that no speeding occurs in any state because there are statutes in place to address the limits of speed. The reality of the situation is that the ACGME may "require" psychotherapy be taught, but the reality is that many programs, by the admittance of many psychiatry residents, do not adequately provide the training

Instead of showing us how the data is poor, show us better data that supports your position. Your assertions have no data whatsoever. You are refuting actual data with pathetic anecdote. This is the mighty scientist and his rigor?

Your attack started better than your colleagues' but was found lacking nonetheless. Regarding the assume, I wasn't involved, you're alone on that one. Now stop the childish name calling. You were taught a lesson. Go back to the drawing board.

 

[Manicsleep]

It would make great comedy, if only it were fiction.

Posturing as defenders of scientific rigor and psychotherapy, they command us to provide data and admonish us for statements with which they don't agree. Some how they became the keepers of the scientific flame after taking a statistics course. They have certain gullible psychiatrists believing that all psychologists get excellent psychotherapy training, better than psychiatrists even.

Where does it end when their ideas the argued? Base discourse. Ad hominem attacks. No attempt to actually answer data with data per their own so-called standard. Frustrated and wildly inaccurate remarks in an attempt to elicit reactionary response and to keep the discourse despite real basis for argument.

 

[erg923]

I think many would be more willing to engage in discussing some empirical data with you were a little more collegial and respectful, and would quit with this ugly tone of treating the debate as some sort of intellectual "one-upmanship" chess match. I mean look at your last post (and some of your other phraseology for that matter) for goodness sake....it reads like you're on a mountain (throne maybe?) making a proclamation to your people. Prior to that, Therapist4change was "taught a lesson"?......"drawing board." My wife nearly fell out of her chair in hysterics when she read that. Come on man, get real! People don't wanna retort or engage with that kind of nonsense. In case you haven't noticed (or didn't think of it this way), it makes people much less interested in debating with you, not more. It really does ruin the intellectual mood, at least for me it does.

I look upon the intellect as a kind of sacred thing, and to have a conversation with the aim of putting the other fellow down, showing that you are more resourceful and/or agile at debate, seems to me, a corruption of the intellect, and frankly, a silly way to spend one's time. Thus, I will therefore refuse further debate with you until such a time as your attitude changes (e.g., openness, reciprocal respect for your colleagues profession) and I start to see at least a fraction of the humility that the average human possesses.

 

[michaelrack]

That is very good. So I can now say I know of one psychiatrist out of dozens that knows DBT, yet all of those dozens are treating borderline patients using psychotropics and without referring them to someone that can do DBT, and psychotropics aren't the recommended treatment for borderline PD, DBT is.


Ironically in Ohio, I'm seeing the DBT utilization and I still don't think it's what I'd like it to be. Several state mental health boards are directing their members to have at least a few trained in DBT and are implementing DBT programs and 24-hr DBT therapists to prevent the cycle where borderlines get rehospitalized over and over.

Is DBT a psychotherapy that can realistically be done in a small psychiatry (or psychology) private practice? Don't you need a team of therapists to provide both the individual tx as well as the groups as well as support for the individual therapist? Certainly one can use elements of DBT in private practice, but I don't see how DBT can be realistically done, as described by Linehan, in a typical private practice.

 

[Therapist4Chnge]

Is DBT a psychotherapy that can realistically be done in a small psychiatry (or psychology) private practice? Don't you need a team of therapists to provide both the individual tx as well as the groups as well as support for the individual therapist? Certainly one can use elements of DBT in private practice, but I don't see how DBT can be realistically done, as described by Linehan, in a typical private practice.

If you adhere to a strict DBT model...then it'd be difficult/impossible to do out of a 1-doc shop, particularly when you include all of the non-billable time. With that being said, setting up a DBT-informed practice is much more feasible.

 

[pingouin]

[borrowing Doc Samson's gruff moderator voice]

Thanks, michaelrack, for getting the discussion back on topic.

Please remember to keep your discourse civil on these forums. It's not appropriate to air grievances about a particular profession in that profession's forum- in fact, we consider it a TOS violation. Within the TOS, when you're in your home forum, feel free to be as critical as you want of other professions.

[hands back gruff voice]

 

[Manicsleep]

Is DBT a psychotherapy that can realistically be done in a small psychiatry (or psychology) private practice? Don't you need a team of therapists to provide both the individual tx as well as the groups as well as support for the individual therapist? Certainly one can use elements of DBT in private practice, but I don't see how DBT can be realistically done, as described by Linehan, in a typical private practice.

The severity of illness, evaluated longitudinally and acutely determines the amount of resources a patient will need. When starting out we used a lot of resources but we (I) were determined to do it. However, even if the patient is not very stable, an independent practitioner can do DBT if the patient was willing to pay for the time. Because, you are correct, it would require a lot of time. So I have a team of therapists.

In our case we use psych techs (only because they take call) that my colleagues and I train with weekly pseudo M&Ms, a lot of which are with borderlines. All the psych techs have to be aware of the treatment plan of everyone in DBT group. Initially all borderlines will test you and use a lot of time and resources but eventually this will plateau and they will use less time and resources than if you didn't do DBT.

 

[digitlnoize]

How do psychiatrists make big bucks again?

 

[TexasPhysician]

How do psychiatrists make big bucks again?

By argueing with other mental health providers I guess.......

How much does it pay to give "talks" for pharm companies? Say I live in Dallas, and get asked to give a talk in Chicago. Would I get paid all travel expenses plus enough to equal more than a normal day's wage to do this? Would all my talks need to be in Dallas to be worthwhile?

 

[Gordon Sims]

QUOTE=Furthermore, it is well known that psychiatry in general, and psychiatric residencies in particular, are the lowest rung in the medical field.. [/QUOTE]

IMO even if this fallacy were true, which it is not, ALL psychiatrists are physicians and thus several rungs higher than psychologists. After all, it's commonplace to hear of psychiatrists hiring psychologists to work under them but I have yet to hear of a psychologist hiring psychiatrists.

 

[futureapppsy2]

QUOTE=Furthermore, it is well known that psychiatry in general, and psychiatric residencies in particular, are the lowest rung in the medical field..

IMO even if this fallacy were true, which it is not, ALL psychiatrists are physicians and thus several rungs higher than psychologists. After all, it's commonplace to hear of psychiatrists hiring psychologists to work under them but I have yet to hear of a psychologist hiring psychiatrists.[/QUOTE]

*sigh*.... Psychiatrists are not automatically a "couple of rungs up" over psychologists, who are NOT midlevels. For one thing, what about the sizeable number of psychologists who teach med students or supervise psychiatry residents?

Couple of points on this thread as a whole:

-The fact that (unaccredited) online PhDs in clinical psych is offered mean very, very little when you consider that most states won't license people with those degrees, nor would they be competitive for decent internships (again, often, if not always, a licensing requirement). (Yeah, Fielding is accredited, but they do require face-to-face didactics and training/experience--I don't think it's the best model by any means, which I think is somewhat reflected in their relatively low match rates). Analogously, you can have a bunch of take-all-comers Caribbean (or wherever) schools, but if those students don't pass the boards and match into residencies, that's a weeding process, as it is in psych.

-It makes me cringe a bit to see psychotherapy being treated so cavalierly by
so many posters. From what I know working with clients (though not technically as a therapist, as a disclaimer) and from talking to faculty and advanced grad students, psychotherapy, especially with certain disorders, co-morbidities, or client populations (mandated, BPD, etc) can be really challenging and take a lot of skill. It's not something you can learn--or become truly proficient at--with minimal training. Skilled, evidence-based psychotherapy can make a huge positive difference in clients' lives. Similarly, poor psychotherapy may cause damage or at the very least, waste time and money.

-I agree that there's a range of competency/incompetency across any field. I do think psych should have tighter accreditation rules for programs, though the internship match can serve as a--partial and *far* from perfect--check.

 

[benjee]

really? I have never heard of it that psychiatry residency is the lowest rung in medical field. All I have heard of was lots of belittle comments of primary care from different specialities. And quite a constrast, psychiatry was seen as life savers especially when needed/consulted for determined capacity,sucidality ...etc.

 

[BritTrooper]

I have got a tremendous amount of respect for clinical psychologists. The ones I work with are outstanding and we both really enjoy learning from one another.

However you are comparing physician with non-physician with the accompanying salary difference, billing, competitiveness and prestige etc etc.

Psychiatrists will always be at the top of the food chain (in general) relative to other tier providers of mental health care, its not an insult but a reality.

 

[sundog1973]

How do psychiatrists make big bucks again?

Apparently, you need to be born with a penis. According to the salary surveys I am seeing, over the past five years, male psychiatrists working full time, salaried positions consistently make $25-30K more than their female counterparts.

I would be interested to know why, as well as to get this thread back on track.

 

[michaelrack]

Apparently, you need to be born with a penis. According to the salary surveys I am seeing, over the past five years, male psychiatrists working full time, salaried positions consistently make $25-30K more than their female counterparts.
.

It's due to the Y chromosome and the effect of testosterone on the developing male brain. The penis is incidental

 

[Gordon Sims]

*sigh*.... Psychiatrists are not automatically a "couple of rungs up" over psychologists, who are NOT midlevels. For one thing, what about the sizeable number of psychologists who teach med students or supervise psychiatry residents?

Psychologists fulfill one component in the psychiatry resident's education. Nothing more.

 

[Suenya]

None of these people, there are graduates from IVY league schools here, know any more than me with respect to therapy.

I only know of one Ivy League school that has a strong clinical psych program with a strong practitioner component. Top programs are generally elsewhere. Interesting that you focused on that though.

It is interesting how psychologists differentiate themselves from psychiatrists as if they are scientists and we arent. All physicians learn stats and some excel in the field.

The stats I've learned in medical school are a joke in both breadth, depth, and education regarding choice of appropriate statistics, compared to what I learned as an undergrad psych major. Perhaps we learn more in the clinical years or in residency. I was told by one of the residents at one of the top psych residencies that they felt like they had to do most of their scientific training from mentors or come prepared from earlier voluntary research experiences. It's interesting that your experience seems to be different, but that's quite a stretch to say all physicians learn stats, because I was appalled by the level of stats education we're exposed to personally.

Medicine is a science. Psychiatrists are scientists. Most psychologists are not. Scientist-Practioner propaganda is...well I will just quote what has already been said.

I don't know about other areas of psychology (I assume you mean in clinical practice, because those that are actually working as researchers in related fields like social or health psych would seem to be scientists), but the education at the clinical psych PhD programs I considered all seemed to be far, far better training as scientists than medical school. Which is not to say that most physicians aren't scientists as well, just that I have trouble believing that they are "more scientisty" than psychologists that seem to have a far more direct training in science and research.

 

[Suenya]

Majesty, are you serious?

Medical schools around the world are where the best and brightest go.

Do you actually believe that? There are tons of PhD programs that are more competitive than medical schools, and quite a few that are on par with top medical schools without being the top of their field.

What an arrogant, ignorant point of view. Or perhaps insecure? I don't really know, but you would have to be pretty ignorant to not realize how incorrect that statement is. I would think anyone that attended medical school would realize that most of their classmates, while perhaps great future doctors, are far from the best and brightest.

Do some of the "best and brightest" attend medical school? No doubt. Do they go into other fields as well? Yup. Is everyone at medical school the best and brightest? Hell no. Same with other fields. Have whatever views you want about mean quality of training or the unevenness of programs in other fields, but actually thinking that medical school gets the best and brightest is just silly.

 

[Chimed]

I only know of one Ivy League school that has a strong clinical psych program with a strong practitioner component. Top programs are generally elsewhere. Interesting that you focused on that though.


The stats I've learned in medical school are a joke in both breadth, depth, and education regarding choice of appropriate statistics, compared to what I learned as an undergrad psych major. Perhaps we learn more in the clinical years or in residency. I was told by one of the residents at one of the top psych residencies that they felt like they had to do most of their scientific training from mentors or come prepared from earlier voluntary research experiences. It's interesting that your experience seems to be different, but that's quite a stretch to say all physicians learn stats, because I was appalled by the level of stats education we're exposed to personally.


I don't know about other areas of psychology (I assume you mean in clinical practice, because those that are actually working as researchers in related fields like social or health psych would seem to be scientists), but the education at the clinical psych PhD programs I considered all seemed to be far, far better training as scientists than medical school. Which is not to say that most physicians aren't scientists as well, just that I have trouble believing that they are "more scientisty" than psychologists that seem to have a far more direct training in science and research.

Yeah, I also didn't have that much of an indepth stat experience in medical school and agree with some of your other points. In general, a medical school education followed by a psychiatry residency doesn't train someone to be a scientist in the strictest definition. What they do prepare you for is how to be a clinician and how to critically evaluate information and research in order to make informed decisions to treat patients. I was required to do research in medical school, but I know that isn't typical. In my general residency, I wasn't required to do research; but my program did emphasis how to evaluate evidence based practices and how to think critically. As a child fellow, I'm doing additional training in a research track and will get lots of exposure to being a "scientist". However, I opted to do that and I wouldn't get that kind of research exposure otherwise.

 

[BritTrooper]

Medical schools around the world are where the best and brightest go.

I dont understand who would disagree with such a blindingly obvious comment. Also obvious is that not all medical schools attract the same quality candidates.

People who are at the top of finance are pretty smart too but judging from the current economy, they are better left out of the discussion.

 

[snarfer]

Furthermore, it is well known that psychiatry in general, and psychiatric residencies in particular, are the lowest rung in the medical field and that all but the top tier residencies have to beg for med students to fill their spots/positions. There are even posts on this board from other physicians about attesting to this fact.

However, psychiatrists are not one to be throwing stones when it comes to quality control

Interesting post. I think I can count on one hand the number of non MD therapists who do not make condescending and ill informed remarks toward psychiatrists in my career.

Even if some may agree with you, I have seen the most obnoxious surgeons or ED docs cower in fear during psychiatric emergencies (i.e. dystonic reaction or hyperactive delirium). Most seasoned docs are extremely appreciative of psychiatrists.

To the original poster, if you have the motivation, efficiency and brain that can handle 60-70 hrs workload of what we do per week, and your brain does not literally explode, you will do well financially. Having proficiency in ECT/TMS and neuroimaging help at contract time.

I work for a large group private practice and part time at a university center. They take care of the billing. I see 30% adults, 70% children as I am board certified in both. I do adult ECT and TMS and consultations. I can interpret scans. I see 4-5 therapy patients per week for 45-50 minute sessions. The rest medical management, ECT and TMS. I also have a grant at the medical school so I do research there in addition to staffing the ECT and tMS clinics. Both places pay me well, combined >350K for 60-70+ hrs per week. I take 1 weekend call every two months. My days usually start at 7am and end at 7 or 8pm. Sometime 9pm. Six days per week.

The ENTs, orthopods, dermatologists, cardiologists, GIs, etc.. all work really really hard for their $400,000+. If we are willing to work their hours (6:30am-8/9pm) 70+ hours, six days per week, most of us can make just as much.

 

[michaelrack]

The ENTs, orthopods, dermatologists, cardiologists, GIs, etc.. all work really really hard for their $400,000+. If we are willing to work their hours (6:30am-8/9pm) 70+ hours, six days per week, most of us can make just as much.

I think most dermatologists are only working 60 hours for their $400,000+

 

[Suenya]

I dont understand who would disagree with such a blindingly obvious comment.

Rofl.

 

[whopper]

The typical and tired psychology vs. psychiatry debate has restarted, all with the usual arguments restated. A lot of those arguments IMHO are baloney.

I've known psychologists and psychiatrists from the Ivy League that were terrible. I've known people from "lesser" schools do very good work. Some people didn't go to the Ivy League simply because they could not afford it, but their scores and work were of very high quality, yet people here again and again try to categorize the work of individuals based on schools or professions. Two of the top hundred medical doctors in the country I've worked with are not at an Ivy League. They're at U. of Cincinnati and Case Western. One of them was at...

God forbid...Wright State before he went to U. of Cincinnati. (Oh heaven's no!). Both are psychiatrists, but I guess that since they are psychiatrists, how could they possibly be in the top 100 medical doctor ranking? After all, if psychiatrists are supposed to be the bottom of the medical lot, how could these two psychiatrists be ranked as top medical doctors out of the hundreds of thousands of medical doctors in "higher" fields such as surgery?

And why is it that psychiatry residency spots are all taken, yet surgery had several spots not taken? Oh no!

Whatever.

In any case, this thread should be about the title of the thread.

 

[Doc Samson]

Good grief - OPD and I take a few days off for a conference and an iatry vs. ology war breaks out (despite the best efforts of Pingoin borrowing my moderator voice).

Enough of the posturing - get the thread back on track or the lock looms.

 

[billypilgrim37]

I think your follow-up poster should relate to thread length and probability of being turned into an antipsychiatry or psychiatry vs psychology war.

 

[sundog1973]

Good grief - OPD and I take a few days off for a conference and an iatry vs. ology war breaks out (despite the best efforts of Pingoin borrowing my moderator voice).

Enough of the posturing - get the thread back on track or the lock looms.

Great idea! In an effort to get back on track, here's a question: is it really just a matter of working longer hours (i.e. seeing more patients, simply doing *more*), like it is in most other specialties, to become a top earner? Seems like a simplistic statement, but from my perspective, it's pretty clear it's true.

 

[TheWowEffect]

Great idea! In an effort to get back on track, here's a question: is it really just a matter of working longer hours (i.e. seeing more patients, simply doing *more*), like it is in most other specialties, to become a top earner? Seems like a simplistic statement, but from my perspective, it's pretty clear it's true.

Yes....and also working smart.

 

[OldPsychDoc]

Great idea! In an effort to get back on track, here's a question: is it really just a matter of working longer hours (i.e. seeing more patients, simply doing *more*), like it is in most other specialties, to become a top earner? Seems like a simplistic statement, but from my perspective, it's pretty clear it's true.

It's true, and also if you look around for "top earners", it's really more about being a business person, adopting a more entreprenurial business model--e.g. if you want to make "big bucks" you should be owning a practice, hiring midlevels to see a higher volume of patients, etc. It's not what everybody wants to do, however...

 

[zenman]

It's due to the Y chromosome and the effect of testosterone on the developing male brain. The penis is incidental

Nope. A male, having 2 brains, trumps a female with 1 brain.