Compensation question please

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As splik explained above, psychiatrists *are* physicians who should be capable to help in this situation.
By your logic, none of the specialists - or even generalist pediatricians (because kids are apparently a different species with their own physiology) - are “physicians”.

Obviously I’m aware psychs are technically physicians...but an outpatient psychiatrist who does medical management all day or an outpatient psychotherapist who don’t even remember how to manage hypertension and certainly are not up to date on the newest guidelines of emergency training should not be responding to emergencies unless they are the last resort. If it’s something trivial then obviously we are better than nothing but if it’s like a code or something significant you should be stepping out of the way for the real physicians to step up. Maybe I’m wrong and I’m certainly open to changing my view but from the psychs around me who are not interested in anything medically related, I’ll take an internist, pediatrician, etc over them any day of the week.
 
yes.

I can't comment on my own salary/practice income/contract revenue, but I know several psychiatrists who make in this range and higher

Love psych but also want to make a lot of money, if I'm being honest. Does it take a lot of luck to be one of those outliers making 500k? Or can you just hustle your way to that level by putting in hours comparable to a surgical field (as someone alluded to re: telepsych above)
 
This is what I don't understand. I frequently see or hear about telepsych jobs paying 140-160/hr. 50*160*50 is 400k. Work surgeon hours and you're well above 500 even.

Why is this not feasible? Not disagreeing just trying to understand the market better.

This is feasible and not particularly difficult. Outpatient per hour gigs are now also paying $150 per hour+. ERs are paying $200+. However, I don't know if you are in residency or what, but you'll soon realize doing 50 hours of telepsych on CHMC/prison a week may very well be TOUGHER on people than surgery and will burn you out faster than a wildfire in San Diego.

Furthermore, I don't know of a SINGLE psychiatrist who takes only 2 weeks of vacation a year.

You are a real baller in psychiatry if you work <30 hours a week (in 3 days), make 500k, and take 6-8 weeks of vacations a year. NOW this is NOT possible in surgery (maybe derm), but there's a small fraction of psychiatrists who manage to end up achieving this. On a more feasible note, it's not hard to make 300k, esp. as a solo practitioner (i.e. total net profit vs. W2) and get that lifestyle anywhere. This is why it's extremely difficult to recruit for a facilities job outside of coastal areas for < 300k these days.
 
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This is feasible and not particularly difficult. Outpatient per hour gigs are now also paying $150 per hour+. ERs are paying $200+. However, I don't know if you are in residency or what, but you'll soon realize doing 50 hours of telepsych on CHMC/prison a week may very well be TOUGHER on people than surgery and will burn you out faster than a wildfire in San Diego.

Furthermore, I don't know of a SINGLE psychiatrist who takes only 2 weeks of vacation a year.

You are a real baller in psychiatry if you work <30 hours a week (in 3 days), make 500k, and take 6-8 weeks of vacations a year. NOW this is NOT possible in surgery (maybe derm), but there's a small fraction of psychiatrists who manage to end up achieving this. On a more feasible note, it's not hard to make 300k, esp. as a solo practitioner (i.e. total net profit vs. W2) and get that lifestyle anywhere. This is why it's extremely difficult to recruit for a facilities job outside of coastal areas for < 300k these days.

That makes sense, great to know. I am applying to psych programs, so I don't know what the toll of 50 hrs/wk pure psych is like for months on end. Will keep all of this in mind.
 
You know what I mean. When you’re on board a plane and they call for a physician, they’re not asking for you...
I figure odds are pretty good that they'll need someone to administer IM Haldol and Ativan to subdue an agitated and intoxicated belligerent someday.
 
If someone goes into cardiac arrest on a plane, does it really matter what kind of doctor responds? Aren't you just going to do CPR and use the idiot proof AEDs? So, essentially, can't almost anyone do that anyway?
Assuming it's cardiac arrest. And that the flight attendant should be making that diagnosis.
 
To make decent $ in psych, become established in an area and do a good job. Get a good reputation. Opportunities will present themselves. Pick up side gigs- weekend psych unit coverage, methadone clinic, etc. Be willing to travel some, especially for weekend assignments. Consider rounding on several inpatient units. Leverage yourself, be willing to supervise NP's. Be willing to be on call most of the time. Above all, take good care of your patients.
 
yes.

I can't comment on my own salary/practice income/contract revenue, but I know several psychiatrists who make in this range and higher

The average doesn’t make this. The answer is still no. Do a few people carry several different gigs and work the hours to make this? Yes. I live in the highest paying region in the US. More psychiatrists here make this type of money than anywhere else. But, they work for it. Let’s not all pretend psych is actually derm. It isn’t. Some of the worst psychiatrists make the most money.
 
The average doesn’t make this. The answer is still no. Do a few people carry several different gigs and work the hours to make this? Yes. I live in the highest paying region in the US. More psychiatrists here make this type of money than anywhere else. But, they work for it. Let’s not all pretend psych is actually derm. It isn’t. Some of the worst psychiatrists make the most money.
To make decent $ in psych, become established in an area and do a good job. Get a good reputation. Opportunities will present themselves. Pick up side gigs- weekend psych unit coverage, methadone clinic, etc. Be willing to travel some, especially for weekend assignments. Consider rounding on several inpatient units. Leverage yourself, be willing to supervise NP's. Be willing to be on call most of the time. Above all, take good care of your patients.

No disagreements here, you willing to do all the above and you’ll happily find yourself in the neighborhood of that kind of money. But I especially like the point of taking good care of patients, because it can be easy to burn out and treat some of the most vulnerable patients like widgets.
 
This is what I don't understand. I frequently see or hear about telepsych jobs paying 140-160/hr. 50*160*50 is 400k. Work surgeon hours and you're well above 500 even.

Why is this not feasible? Not disagreeing just trying to understand the market better.

You can make above 500k — it’s just that you will work and live like a surgeon. You’ll also probably become a master of working your diagnoses so that they are optimized for billing. And lastly, most unfortunately, you’ll have a list of 40 patients at 3 hospitals and a clinic to see each day, as well as the 4 ECTs you squeeze in, in the morning, before you start your day which means everyone may receive some pretty terrible care. Won’t pretend to be an expert about telepsych. I don’t know anything about the compensation mechanism there.
 
I figure odds are pretty good that they'll need someone to administer IM Haldol and Ativan to subdue an agitated and intoxicated belligerent someday.
Is there a nurse on board?
You can make above 500k — it’s just that you will work and live like a surgeon. You’ll also probably become a master of working your diagnoses so that they are optimized for billing. And lastly, most unfortunately, you’ll have a list of 40 patients at 3 hospitals and a clinic to see each day, as well as the 4 ECTs you squeeze in, in the morning, before you start your day which means everyone may receive some pretty terrible care. Won’t pretend to be an expert about telepsych. I don’t know anything about the compensation mechanism there.
I don't know about elsewhere in the country, but no one around here really does ECT for the money, even in well-optimized spots.
 
Is there a nurse on board?

I don't know about elsewhere in the country, but no one around here really does ECT for the money, even in well-optimized spots.

Yeah. The hospital here eats the cost and pays the physician per patient. Somehow they make it worth their time. We have in house and don’t rent a surgical suite, have CNP anesthesiologists, and nursing staff it all. Perform inpatient and outpatient consults for a huge radius. Elsewhere I know it doesn’t work that way.
 
The average doesn’t make this. The answer is still no. Do a few people carry several different gigs and work the hours to make this? Yes. I live in the highest paying region in the US. More psychiatrists here make this type of money than anywhere else. But, they work for it. Let’s not all pretend psych is actually derm. It isn’t. Some of the worst psychiatrists make the most money.
I mostly agree. I know bust good and bad psychiatrists who make a lot
 
Don’t forget working in the middle of nowhere, where you can easily make $300K+ with a 40-50 hour work week.

Why would anyone do that when you could work somewhere highly desirable doing telepysch and make the same?

Assuming someone doesn't prefer middle of nowhere...
 
Why would anyone do that when you could work somewhere highly desirable doing telepysch and make the same?

Assuming someone doesn't prefer middle of nowhere...
Lower cost of living —> can do more with your money. More leverage in negotiating contracts. Some places will cover airfare in addition to salary, so you can live somewhere desirable. You don’t have to work surgery-esq hours to reach that salary range. But most importantly, you aren’t doing telepsych day in and day out.
 
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You know what I mean. When you’re on board a plane and they call for a physician, they’re not asking for you...

Then I guess it sucks that I replied the last time they asked for a physician. All that happened was the guy was fine and the crew was put at ease.
 
Lower cost of living —> can do more with your money. More leverage in negotiating contracts. Some places will cover airfare in addition to salary, so you can live somewhere desirable. You don’t have to work surgery-esq hours to reach that salary range. But most importantly, you aren’t doing telepsych day in and day out.

This is actually something that I'd be interested in. How long are you away from home? Is there an option to load up your hours and minimize your days; i.e. 12s or 24s?
 
This is actually something that I'd be interested in. How long are you away from home? Is there an option to load up your hours and minimize your days; i.e. 12s or 24s?
It’s variable. I’ve talked with several attendings that do this in my area (I’m in the middle of nowhere, so it’s not all that uncommon here - different from locum work). Of the two I know the most details, one would fly her own plane in and shared a condo with another pyschiatrist doing a similar thing. She usually worked 1 week per month, occasionally 2, but was usually at the hospital from 6am - 8 or 9pm and took a disproportionate amount of overnight call the 1-2 weeks she was there. The other usually averaged 40-50 hours per week and would fly home Thursday or Friday and come back on Mondays. I honestly don’t find it all that appealing (I guess having a legit excuse to fly your own plane if you’re into that is a plus), but all of the attendings I’ve talked to that do this seemed happy with their work/life balance and compensation, and seem to have a “work hard, play hard” attitude.
 
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Then I guess it sucks that I replied the last time they asked for a physician. All that happened was the guy was fine and the crew was put at ease.

Did they know you were a psychiatrist? Lol
 
Did they know you were a psychiatrist? Lol

Can't remember if I said it or not, but honestly, it doesn't matter. I'm a DOCTOR, which is what they wanted. Not sure why you think there's a difference.
 
Can't remember if I said it or not, but honestly, it doesn't matter. I'm a DOCTOR, which is what they wanted. Not sure why you think there's a difference.

My friend is a physicist; he's also a DOCTOR, but I wouldn't want him anywhere near me during an emergency 😉
 
Perhaps brush up on the differences between a PhD and an MD/DO before completing med school. I hear that's important.

Lol you’re too sensitive bro...I’m on your team im gonna be a “doctor” too but at least I admit that I’m not going to be a medical expert in the laymen’s definition...also you said doctor which a physicist is not MD/DO so perhaps you be more precise in your language
 
They don't ask for a physician... they ask for a doctor... and actually a psychiatrist is perfectly capable of dealing with most medical calls on planes (usually psychiatric anyway lol) and has sufficient knowledge to be directed by the folks on the ground for what to do.

I've been on 3 flights where this happened, and 2 were addressed by psychiatrists.

I will also say that in all 3 instances, I mainly sat quietly waiting for someone with more training than me to stand up. Once they asked a second time for "anyone with medical training", and when I was about to press the call button, I watched a couple more senior people (one was a psychiatrist) stand up. Apparently I was not the only one waiting for someone else to do it.

Did they know you were a psychiatrist? Lol

They often check/request your medical licenses on the plane. If you have one, you're basically the best they have. You usually get comp money/vouchers from the airline.
 
Lol you’re too sensitive bro...I’m on your team im gonna be a “doctor” too but at least I admit that I’m not going to be a medical expert in the laymen’s definition...also you said doctor which a physicist is not MD/DO so perhaps you be more precise in your language
As a complete bystander to this conversation, you're a real tool dude.
 
I figure odds are pretty good that they'll need someone to administer IM Haldol and Ativan to subdue an agitated and intoxicated belligerent someday.
Yeah, I’m pretty sure they don’t have Haldol and Ativan in the medical kit. I’ve often wondered this, though. Probably just P.O. Benadryl.

Lol you’re too sensitive bro...I’m on your team im gonna be a “doctor” too but at least I admit that I’m not going to be a medical expert in the laymen’s definition...also you said doctor which a physicist is not MD/DO so perhaps you be more precise in your language
Should a pathologist respond, and should the lay view dictate? Should an internist not respond because the lay people don’t want a medical “emergency” managed by an intern?
 
They often check/request your medical licenses on the plane. If you have one, you're basically the best they have. You usually get comp money/vouchers from the airline.
Sweet. Maybe I’ll respond should this ever happen (never happened thus far and I’ve flown a lot).
 
They often check/request your medical licenses on the plane. If you have one, you're basically the best they have. You usually get comp money/vouchers from the airline.

They did ask about my license, but they never actually checked it in my case. I thought it was a little odd at the time because I could have been anyone.
 
You usually get comp money/vouchers from the airline.
Obviously, I’m very much not a lawyer, but I’ve been told Good Samaritan laws only protect you from lawsuit if you are not compensated (in the air- laws vary a lot between states as well as ground vs. air). I might be wrong, but I’d turn down any money or voucher just in case.
 
Obviously, I’m very much not a lawyer, but I’ve been told Good Samaritan laws only protect you from lawsuit if you are not compensated (in the air- laws vary a lot between states as well as ground vs. air). I might be wrong, but I’d turn down any money or voucher just in case.
Not compensated by the patient, I'd imagine. The airline is just being a bro.
 
Obviously, I’m very much not a lawyer, but I’ve been told Good Samaritan laws only protect you from lawsuit if you are not compensated (in the air- laws vary a lot between states as well as ground vs. air). I might be wrong, but I’d turn down any money or voucher just in case.

Think of it this way: if the airline didn't pay you, could you make them? No. So if they give you something it's a gift, not compensation for services rendered.
 
Think of it this way: if the airline didn't pay you, could you make them? No. So if they give you something it's a gift, not compensation for services rendered.
There was a case of psychiatrist who assisted on board an aircraft for a medical call, received nothing from the airline, was upset about it, and billed the airline for services rendered. when they didn't pay it, he took them to court. he lost.

ETA: how did this thread get off topic. not only completely derailed to talk about how much psychiatrists can make (which happens whey too much... clearly a lot of castration anxiety on this forum) but now onto psychiatrists assisting in emergencies!
 
Obviously I’m aware psychs are technically physicians...but an outpatient psychiatrist who does medical management all day or an outpatient psychotherapist who don’t even remember how to manage hypertension and certainly are not up to date on the newest guidelines of emergency training should not be responding to emergencies unless they are the last resort. If it’s something trivial then obviously we are better than nothing but if it’s like a code or something significant you should be stepping out of the way for the real physicians to step up. Maybe I’m wrong and I’m certainly open to changing my view but from the psychs around me who are not interested in anything medically related, I’ll take an internist, pediatrician, etc over them any day of the week.

Are you a nurse? They get confused sometimes when they call a code or a stroke alert and I show up in a white coat that says, "Psychiatry".
 
Are you a nurse? They get confused sometimes when they call a code or a stroke alert and I show up in a white coat that says, "Psychiatry".

Wait are you joking? Are you saying that as a psychiatrist you want to run medical codes? I admit I’m only a med student but I guess I’m in a very strange hospital then because I’ve never seen anything like that...I doubt the nurses around here would even let a psychiatrist near a code lol
 
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Wait are you joking? Are you saying that as a psychiatrist you want to run medical codes? I admit I’m only a med student but I guess I’m in a very strange hospital then because I’ve never seen anything like that...I doubt the nurses around here would even let a psychiatrist near a code lol

I wouldn't assume just because you haven't seen something that it is very strange. I get the feeling from reading your posts there's a great number of things you haven't seen or experienced that most certainly are not strange or uncommon.
 
Wait are you joking? Are you saying that as a psychiatrist you want to run medical codes? I admit I’m only a med student but I guess I’m in a very strange hospital then because I’ve never seen anything like that...I doubt the nurses around here would even let a psychiatrist near a code lol

Some psych residency programs require ICU rotations, EM, etc that would require knowing about running a code. Psychiatrists are first physicians.
 
Some psych residency programs require ICU rotations, EM, etc that would require knowing about running a code. Psychiatrists are first physicians.

Yeah I could certainly see an off-service psych resident participating in a code; however, an attending psychiatrist running a code? I don't think that's the norm where I'm at
 
Yeah I could certainly see an off-service psych resident participating in a code; however, an attending psychiatrist running a code? I don't think that's the norm where I'm at

Agreed. Think my attendings would drop dead themselves if the crash cart rolled by with the expectation they lead it.
 
Agreed. Think my attendings would drop dead themselves if the crash cart rolled by with the expectation they lead it.

Yeah, as a resident with fairly recent IM exposure and ACLS training I think I could run a code if I really had to right now, but I expect over time I will be less and less capable in that department, and that's ok by me.

As a barely related tangent, the other day I had a patient who needed a blood draw for clozapine in clinic and the LPN (who draws blood every day) couldn't get it after several attempts. My attending wanted me to try and was getting rather insistent. It was a struggle not to laugh in his face, but I managed it, as I explained that this is not a skill that I ever really had in the first place, let alone retained after 4 years of disuse since medical school. I was not going to put my patient through that for no reason.

Reflecting on the incident afterwards, I think it was probably about my attending's insecurity about not being able to do it himself. I have no such insecurity and was mainly just confused why he thought I should be able to swoop in and save the day on a tough stick. I'm not sure how many physicians trained these days in any non-surgical specialty are good phlebotomists, but perhaps older psychiatrists who had those sorts of skills at one point and lost them over time might be sensitive about it?
 
The average doesn’t make this. The answer is still no. Do a few people carry several different gigs and work the hours to make this? Yes. I live in the highest paying region in the US. More psychiatrists here make this type of money than anywhere else. But, they work for it. Let’s not all pretend psych is actually derm. It isn’t. Some of the worst psychiatrists make the most money.

You'd be surprised... I'm from LA and I've heard of a Derm and an Ortho Surg not making a lot as well (n=2). Point is don't think just because someone becomes a Derm they're set for life, they have to work for it too.
 
You'd be surprised... I'm from LA and I've heard of a Derm and an Ortho Surg not making a lot as well (n=2). Point is don't think just because someone becomes a Derm they're set for life, they have to work for it too.

Haha. Maybe in LA.
 
You'd be surprised... I'm from LA and I've heard of a Derm and an Ortho Surg not making a lot as well (n=2). Point is don't think just because someone becomes a Derm they're set for life, they have to work for it too.

Or did you mean they have to negotiate for it? Although there are many factors not having negotiation skills or the stones to require appropriate compensation are significant predictors of low salaries.
 
Or did you mean they have to negotiate for it? Although there are many factors not having negotiation skills or the stones to require appropriate compensation are significant predictors of low salaries.

More like “listen, there’s 80+ Derm physicians applying for this one spot. We’re underpaying and we still have a lot of options to choose from, so feel lucky to even get this position IF youre chosen.”

Supply and demand is true in any field, and especially in LA. The good thing about primary care is EVERYONE needs one as opposed to specialists.

I’ve heard Ophthalmologists getting paid as low as $150k here (literally fm docs making more because there’s still a shortage for them in comparison to too many ophthalmologists in LA). Cardiologists are **** out of luck here and need to move like 100+ miles away from work. And the specialists here have STACKED resumes. Many graduated from great programs, mostly all MD, and many have AOA. But the specialist DO’s have been doing well in private practice, but it would be hard for them to get hired I think (exception being if they did their residency in LA or a top place).
 
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