Does Telepsychiatry pay OK?

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MajorAllday

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I've seen that a few Telepsych places are hiring full time positions? Do these pay decently well, or is it generally still really low?

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This is like asking "does psychiatry pay ok?" telepsychiatry includes everything from outpatient private practice to corrections and everything in between (inpatient, ER, cmhc, general hospital, VA) etc. As such there is considerable variability in pay, also geographically. some gigs require you to come to a specific facility, others require you to be in the same state, others still anywhere in the world. some pay hourly, some by patient, some are salaried etc. you're asking the wrong question. but you should expect to make at least the same as you would seeing patients in person
 
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I'm starting Genoa telepsych part time for extra income. It's 150 an hour whether the patient shows or not. You work from home and pick when you want to work.
 
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I haven't done telepsych, but have done telemed with several organizations, including ones that offer telemed services only and those that use telemed as just a part of the services they offer. I agree with splik that it's hard to generalize whether it pays well, because the types of positions are so variable. I can say with confidence, though, that the flexibility that some of these positions offer is awesome. Some positions have a lot of flexibility with your schedule or shifts, and you might be able to do the work form home or while you travel. For some people, this is worth compromising with the salary and other aspects of compensation.
 
I'm starting Genoa telepsych part time for extra income. It's 150 an hour whether the patient shows or not. You work from home and pick when you want to work.
I have a friend who works for this company as a pharmacist and had talked to me about the telepsych program. Which state are you in if you don't mind me asking
 
Michigan but I think they are nationwide. It's mostly for CMHs which I hate. I am just doing it til I have more patients at my private practice and hopefully by some miracle of God I am applying to FP next year and maybe do 10 hours of therapy and the rest FP.
 
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I have a friend who works for this company as a pharmacist and had talked to me about the telepsych program. Which state are you in if you don't mind me asking
how has his experience been with them. And Mich.
 
Generally still on the low side. Iris told me $135ish per hour, 20-ish hours for full benefits. They are a very reputable company. Staffing CHMCs, lots of no-shows. Still. I probably wouldn't do this full time unless it's $200+/ hour range with or without no-shows.
 
Generally still on the low side. Iris told me $135ish per hour, 20-ish hours for full benefits. They are a very reputable company. Staffing CHMCs, lots of no-shows. Still. I probably wouldn't do this full time unless it's $200+/ hour range with or without no-shows.
Why is that? Too busy? Wouldn't $135/hr be pretty good if we were talking full time 40 hrs/wk? $200/hr and we're at about $400K. That seems like a lot.
 
Why is that? Too busy? Wouldn't $135/hr be pretty good if we were talking full time 40 hrs/wk? $200/hr and we're at about $400K. That seems like a lot.

135*40*48=259, and I'm not sure they take care of self employment tax once you hit that many hours. 40 clinical hours would translate to a 50/55 week, which is very busy. A typical outpatient job is 40 hours with about 30 hours of clinical work, and so then this salary level is on the low side for CHMC and I bet their benefits aren't as good compared to a state/VA job. Also, IRIS wants a minimum commitment, how much exactly I don't remember, and my current job situation doesn't allow for that.

Hour by hour I'm getting paid much more in face to face old fashioned private practice and thus far have not had trouble getting patients. It's inefficient as a use of my time. Your milage might vary. But I agree under the right circumstances it can be a good gig (for example if you like living in a rural area with low cost of living and no good community jobs--though typically in such a scenario there ARE local "partnership track" community jobs that pay 350k+).
 
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You can make 500k doing just telepsychiatry. W2 income. I actually know one person who does that.
 
Why is that? Too busy? Wouldn't $135/hr be pretty good if we were talking full time 40 hrs/wk? $200/hr and we're at about $400K. That seems like a lot.

$135 is low.

Compare to the lowest salaries job that I’ve ever been offerred:
Academic - $190k with 4 weeks vacation and all holidays off plus sick days. Call is rounding 2 weekends per year which may take 10 hours total (easy). Retirement benefits were $16k/year. Health benefits for family were worth about $13k (really good plan with large university discount from low risk).
2 half days were for academic tasks. 2 half days of supervising residents. Total compensation is about $219k

$135 contact is about $240k with similar days off, not including relaxed supervision and academic stuff. Add costs of insurance for the family and even Gold Obamacare plans can’t match that of the academic hospital. Cost to match is about $17k/year. $240k is now $223k after those expenses. Sure you may save 2k on commuting costs.

So $225k is > $219k, but the work is harder. This is compared to the worst offer I have received.
 
$135 is low.

Compare to the lowest salaries job that I’ve ever been offerred:
Academic - $190k with 4 weeks vacation and all holidays off plus sick days. Call is rounding 2 weekends per year which may take 10 hours total (easy). Retirement benefits were $16k/year. Health benefits for family were worth about $13k (really good plan with large university discount from low risk).
2 half days were for academic tasks. 2 half days of supervising residents. Total compensation is about $219k

$135 contact is about $240k with similar days off, not including relaxed supervision and academic stuff. Add costs of insurance for the family and even Gold Obamacare plans can’t match that of the academic hospital. Cost to match is about $17k/year. $240k is now $223k after those expenses. Sure you may save 2k on commuting costs.

So $225k is > $219k, but the work is harder. This is compared to the worst offer I have received.
Sorry, I thought $135 was including benefits. Didn't realize that it came out of the 135. I guess it just depends on where you are. Yeah, 135 equating to $240K isn't much.
 
$135 is low.

Compare to the lowest salaries job that I’ve ever been offerred:
Academic - $190k with 4 weeks vacation and all holidays off plus sick days. Call is rounding 2 weekends per year which may take 10 hours total (easy). Retirement benefits were $16k/year. Health benefits for family were worth about $13k (really good plan with large university discount from low risk).
2 half days were for academic tasks. 2 half days of supervising residents. Total compensation is about $219k

$135 contact is about $240k with similar days off, not including relaxed supervision and academic stuff. Add costs of insurance for the family and even Gold Obamacare plans can’t match that of the academic hospital. Cost to match is about $17k/year. $240k is now $223k after those expenses. Sure you may save 2k on commuting costs.

So $225k is > $219k, but the work is harder. This is compared to the worst offer I have received.

I have heard of some tele's counting the lunch and another admin hour every day as part of the total paid hrss and even that was above the hourly wage here but did not include benefits.
 
Why are there so many money grubbing medical students on the psych forum?

Who cares by the time you’d be done with residency it probably won’t be the same companies in the same setup anyway
Money grubbing? Psychiatry for many is not a high paying field especially if you do psychotherapy (I do because I like it and don't want to be a prescription writing factory). I owe 377k in student loans and don't earn nearly as much as other physicians. But the loan is huge and needs to be paid off.
 
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Why are there so many money grubbing medical students on the psych forum?

I've been wondering about the money grubbing attitudes that have been popping up. Going into medicine is going to practically guarantee top 10 percentile salary regardless of specialty or location. Is it because psych is attracting more lifestyle applicants?

Money grubbing? Psychiatry for many is not a high paying field especially if you do psychotherapy (I do because I like it and don't want to be a prescription writing factory). I owe 377k in student loans and don't earn nearly as much as other physicians. But the loan is huge and needs to be paid off.

I question the point of going to med school if you are going to owe $377k in student loans. Unless you're doing military or somehow know for sure you are going to a very high paying field.
 
Money grubbing? Psychiatry for many is not a high paying field especially if you do psychotherapy (I do because I like it and don't want to be a prescription writing factory). I owe 377k in student loans and don't earn nearly as much as other physicians. But the loan is huge and needs to be paid off.

Why is a medical student asking “which companies and how many hours a week”?

There is a disproportionate amount of “how much money can I make” questions on this forum from medical students specifically. It’s almost as if people who can’t make it into derm are trying to reassure themselves that they too can make 400k in a relatively uncompetitive field.

It makes more sense for residents who are actually trying to find jobs. A medical student asking “which company and how many hours” to make 400 grand makes no sense unless you’re trying to reassure yourself that it can actually be done. The man said it’s possible, unless you’re trying to find one of these jobs (like the OP) why do you need that information?
 
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Why are there so many money grubbing medical students on the psych forum?

Who cares by the time you’d be done with residency it probably won’t be the same companies in the same setup anyway

My loans are ridiculous, I grew up without a lot of money, and want a level of security after 8+ years of school/training. If that makes me money grubbing, so be it, I'm money grubbing.
 
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My loans are ridiculous, I grew up without a lot of money, and want a level of security after 8+ years of school/training. If that makes me money grubbing, so be it, I'm money grubbing.
I grew up really poor, ie in a trailer park and had ketchup sandwiches. I put myself through undergrad working two or three jobs at a time as I was too afraid to take out loans, no one in my family went to college and my neighbors didn't graduate from high school so I was not comfortable taking out student loans. I guess a level of security is relative. I have a place to live, an apartment not a nice one, but decent and in a safe neighborhood, a car that runs and food and clothes. A lot of my patients have an associates or bachelors or rich parents and make far more money than I ever will.
Who knows what the future holds for medicine? What field pays well now could end up being a low paying field in the future. I think happiness trumps money as long as I have the basics.
 
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Why is a medical student asking “which companies and how many hours a week”?

There is a disproportionate amount of “how much money can I make” questions on this forum from medical students specifically. It’s almost as if people who can’t make it into derm are trying to reassure themselves that they too can make 400k in a relatively uncompetitive field.

It makes more sense for residents who are actually trying to find jobs. A medical student asking “which company and how many hours” to make 400 grand makes no sense unless you’re trying to reassure yourself that it can actually be done. The man said it’s possible, unless you’re trying to find one of these jobs (like the OP) why do you need that information?

whats wrong with reassuring yourself it can be done...? People have different preferences..just because you wanna make 200k doesn't mean others are content with that.
 
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You know what there is a disproportionate amount of on this forum? Thread highjacking. Every employment thread inevitably breaks down into questions of greed, "why this and why that". This is a job. People want to make money from a job. People have questions about the money they can make from that job. Residents, Attendings, medical students. It's acceptable all round to ask.
 
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All night shifts and 60 hrs/week?

The only way that is possible is someone doing 80 hrs a week. I do tele and know several people who do and no one makes anywhere near that.

Also for the med students psych likely won't have the salaries your hearing of by the time you actually start practicing in the field with several of the changes happening starting in 2018. If you want money in psych esp the numbers being quoted in this forum work 80 hrs a week with no time for fun or open a cash only practice in some wealthy area and pray no one is already doing that... hint your better off trying to do the 80 hrs.

99% of you in med school are likely going to make 150-250k in psych for 40 hr weeks. This whole 60-80 hr extrapolation of salaries looks good on paper. If you actually work 8a-8p for 5 days in a row plus paperwork.. rinse and repeat for 48 weeks a year your likely going to burn out. You'll understand when you get to residency. Psych is emotionally draining. Those higher hours are just easier in a procedural specialty. You'll only understand when you get there. Pick psych if you really enjoy it. You'll be disappointed if you think your going to make bank.
 
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Why is a medical student asking “which companies and how many hours a week”?

There is a disproportionate amount of “how much money can I make” questions on this forum from medical students specifically. It’s almost as if people who can’t make it into derm are trying to reassure themselves that they too can make 400k in a relatively uncompetitive field.

It makes more sense for residents who are actually trying to find jobs. A medical student asking “which company and how many hours” to make 400 grand makes no sense unless you’re trying to reassure yourself that it can actually be done. The man said it’s possible, unless you’re trying to find one of these jobs (like the OP) why do you need that information?

I wonder if these students know they can make 300-400 if they are working 60-70 hrs as a pcp...

*waits as inbox is flooded with 100's of PMs*
 
students psych likely won't have the salaries your hearing of by the time you actually start practicing in the field with several of the changes happening starting in 2018

Wha is going to happen in 2018?
 
The only way that is possible is someone doing 80 hrs a week. I do tele and know several people who do and no one makes anywhere near that.

Also for the med students psych likely won't have the salaries your hearing of by the time you actually start practicing in the field with several of the changes happening starting in 2018. If you want money in psych esp the numbers being quoted in this forum work 80 hrs a week with no time for fun or open a cash only practice in some wealthy area and pray no one is already doing that... hint your better off trying to do the 80 hrs.

99% of you in med school are likely going to make 150-250k in psych for 40 hr weeks. This whole 60-80 hr extrapolation of salaries looks good on paper. If you actually work 8a-8p for 5 days in a row plus paperwork.. rinse and repeat for 48 weeks a year your likely going to burn out. You'll understand when you get to residency. Psych is emotionally draining. Those higher hours are just easier in a procedural specialty. You'll only understand when you get there. Pick psych if you really enjoy it. You'll be disappointed if you think your going to make bank.

Considering most new grads are getting offers starting at 230k+ I doubt people outside of academics will make 150k lol. If you start a successful pp you could be in the 300s+ if you play your cards right
 
The only way that is possible is someone doing 80 hrs a week. I do tele and know several people who do and no one makes anywhere near that.

Also for the med students psych likely won't have the salaries your hearing of by the time you actually start practicing in the field with several of the changes happening starting in 2018. If you want money in psych esp the numbers being quoted in this forum work 80 hrs a week with no time for fun or open a cash only practice in some wealthy area and pray no one is already doing that... hint your better off trying to do the 80 hrs.

99% of you in med school are likely going to make 150-250k in psych for 40 hr weeks. This whole 60-80 hr extrapolation of salaries looks good on paper. If you actually work 8a-8p for 5 days in a row plus paperwork.. rinse and repeat for 48 weeks a year your likely going to burn out. You'll understand when you get to residency. Psych is emotionally draining. Those higher hours are just easier in a procedural specialty. You'll only understand when you get there. Pick psych if you really enjoy it. You'll be disappointed if you think your going to make bank.

Psychiatry is taking a pay cut? Why?
 
Obama willed it.

I see no reason why psych income will be cut beyond any other field. Any job involving insurance is at the mercy of reimbursement.


True. Previous poster expects 99 percent to be earning between 150-250k. Significantly more than 1% are earning >250k now. Do you also believe that many psychiatrists are going to see their income fall?

Totally hard to predict, but his/her post takes a view point I haven't seen expressed on this forum before.
 
True. Previous poster expects 99 percent to be earning between 150-250k. Significantly more than 1% are earning >250k now. Do you also believe that many psychiatrists are going to see their income fall?

Totally hard to predict, but his/her post takes a view point I haven't seen expressed on this forum before.
Stick around. It's been expressed before, because of concerns around the ACA and new changes to how reimbursement is doled out.
 
Obama willed it.

I see no reason why psych income will be cut beyond any other field. Any job involving insurance is at the mercy of reimbursement.

You take primarily no insurance correct so i doubt it will affect you. There is some talk about having the therapy add ons phasing out over the next few years and psych being strictly EM or therapy codes but not combined like they currently are.

True. Previous poster expects 99 percent to be earning between 150-250k. Significantly more than 1% are earning >250k now. Do you also believe that many psychiatrists are going to see their income fall?


Totally hard to predict, but his/her post takes a view point I haven't seen expressed on this forum before.

Insurances were mandated to provide mental health coverage under the Obama Care Rules. Realize before this wasn't standard in most insurance plans until obama care came along and there were disparities even with plans such as medicare who didn't cover the 80/20 split like with most other services. With removing the mandate for health insurance expect to see less people have it which will drive up costs including deductibles, co-pays, and overall coverage for a lot of patients. And also realize that those EM codes are more or less paying what they did several years ago so they are not really adjusted for inflation aside from maybe medicare but even that has been pretty stagnant. Also, medicare/medicaid are requiring more and more quality crap and one nonsense thing after the next or you will be hit with a massive across the board cuts for all your medicare/medicaid cpt codes.

Also, private practice is a beast. Im doing it now and i had an ideal setup with family members also being physicians. Cash practice... easier said then done.. Even Insurance based unless your looking at taking mostly medicare/medicaid and now the push for 2018 will be managed care medicaid which for docs means more regulations and paperwork along with most likely lower fees of even the paltry medicaid rates. Keep in mind for those hoping to start PP in 5-7 years it will take time even with insurance unless your in a really deficient area. Even then your going to have a side job with your PP and it will take a few years to transition to a full time private practice. There is some selection bias on this website where you only hear about psych and patients flooding to their gates. I have a few classmates who are still trying to build their PP and they are very disappointed in how long it is taking and how tough it is. Also you also have NPs and the like competing for business which is expanding much faster than most of you probably know. The model in medicine is more and more larger hospital systems eating up other ones and then usually containing those patients within their system. Ex: Hospital buys 10 pcp private practices and now they have a staff psych and/or several NPs and now all the patients are going to be essentially referred in that system. I do think the current 150-250k inflation adjusted for 5-7 years times of course really does encompasses the future salaries with where healthcare is headed.

Also, keep in mind medicare used to be considered a low payer back in the day with private insurance paying much better. Now that model has flipped where medicare pays much better than lots of private insurances. Expect that disparity to only increase in time as unless you have a large group with negotiating power your going to get crap rates as a single entity private doc.
 
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You take primarily no insurance correct so i doubt it will affect you. There is some talk about having the therapy add ons phasing out over the next few years and psych being strictly EM or therapy codes but not combined like they currently are.



Insurances were mandated to provide mental health coverage under the Obama Care Rules. Realize before this wasn't standard in most insurance plans until obama care came along and there were disparities even with plans such as medicare who didn't cover the 80/20 split like with most other services. With removing the mandate for health insurance expect to see less people have it which will drive up costs including deductibles, co-pays, and overall coverage for a lot of patients. And also realize that those EM codes are more or less paying what they did several years ago so they are not really adjusted for inflation aside from maybe medicare but even that has been pretty stagnant. Also, medicare/medicaid are requiring more and more quality crap and one nonsense thing after the next or you will be hit with a massive across the board cuts for all your medicare/medicaid cpt codes.

Also, private practice is a beast. Im doing it now and i had an ideal setup with family members also being physicians. Cash practice... easier said then done.. Even Insurance based unless your looking at taking mostly medicare/medicaid and now the push for 2018 will be managed care medicaid which for docs means more regulations and paperwork along with most likely lower fees of even the paltry medicaid rates. Keep in mind for those hoping to start PP in 5-7 years it will take time even with insurance unless your in a really deficient area. Even then your going to have a side job with your PP and it will take a few years to transition to a full time private practice. There is some selection bias on this website where you only hear about psych and patients flooding to their gates. I have a few classmates who are still trying to build their PP and they are very disappointed in how long it is taking and how tough it is. Also you also have NPs and the like competing for business which is expanding much faster than most of you probably know. The model in medicine is more and more larger hospital systems eating up other ones and then usually containing those patients within their system. Ex: Hospital buys 10 pcp private practices and now they have a staff psych and/or several NPs and now all the patients are going to be essentially referred in that system. I do think the current 150-250k inflation adjusted for 5-7 years times of course really does encompasses the future salaries with where healthcare is headed.

Also, keep in mind medicare used to be considered a low payer back in the day with private insurance paying much better. Now that model has flipped where medicare pays much better than lots of private insurances. Expect that disparity to only increase in time as unless you have a large group with negotiating power your going to get crap rates as a single entity private doc.

You may be correct which is more reason to go cash-only. If anything, insurance issues have made it easier in recent years. It is very doable with a business mind-set. I’m located in a major city without a large deficiency of psychiatrists. If you market well and do good work, people will come.

Maybe I should be a consultant to pp or franchise. Despite offering $175/hr, I struggle to find C&A docs that want to join me part-time. Maybe I should offer a salary instead.

I’ve actually had people turn me down for $140/hr telepsych even with seeing much higher volume there . An extra $35/hr doesn’t seem to be worth the ability to practice without wearing pants.
 
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Do you also believe that many psychiatrists are going to see their income fall?
.
yes of course. we are in another golden age of compensation for psychiatrists. the last time things were this good were in the 1970s. there is a natural ebb and flow of compensation in different specialties and pay has gone up substantially in recent years due to several things including mental health parity, the ACA, changes to the CPT codes, lawsuits affecting corrections, managed care, and the VA, and concern over access to mental health. but the rates of increase in compensation are unsustainable. at the same time there has been a significant expansion in the number of psychiatry residency positions (apparently by 34% in the past 5 yrs), the number of new psych residency programs continues to grow, the number of new medical schools and medical school class sizes continue to grow, 3 states have passed psychologist prescribing bills in the past 3 years indicated growing momentum in this movement, and the AANP predicts a 31% job growth for NPs from 2014-2024.

That said, I don't anticipate that psych NPs will be trained in massive numbers however; only 2.4 of NPs train in mental health, and most NPs working in psych settings are FNPs not psych NPs - it's just not popular despite psych NPs being the 2nd highest paid specialty for NPs. I also don't anticipate a huge number of psychologists prescribing medications even as the RxP movement gathers momentum and even though we will definitely see several more states in the next few years pass legislation allowing psychologists to prescribe. Most of the decline in reimbursement will have nothing to do with these factors.
 
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You may be correct which is more reason to go cash-only. If anything, insurance issues have made it easier in recent years. It is very doable with a business mind-set. I’m located in a major city without a large deficiency of psychiatrists. If you market well and do good work, people will come.

Maybe I should be a consultant to pp or franchise. Despite offering $175/hr, I struggle to find C&A docs that want to join me part-time. Maybe I should offer a salary instead.

I’ve actually had people turn me down for $140/hr telepsych even with seeing much higher volume there . An extra $35/hr doesn’t seem to be worth the ability to practice without wearing pants.


Im sure you have a lot of business savy and all. But being in the 2nd most populous state in the country while also I think Texas has a pretty low number of Psych docs compared to other parts of the country and adding to the fact that you are C&A is def a huge huge plus for your type of set up as you can attract kids/adults.
 
Im sure you have a lot of business savy and all. But being in the 2nd most populous state in the country while also I think Texas has a pretty low number of Psych docs compared to other parts of the country and adding to the fact that you are C&A is def a huge huge plus for your type of set up as you can attract kids/adults.

Maybe low compared to Cali and NY. I’ve got 3 residency programs within 1.5 hour radius of my office. C&A certainly helps.

A local telepsych company somehow swoops up a lot of recent grads. They salary C&A at $220k.
 
Maybe low compared to Cali and NY. I’ve got 3 residency programs within 1.5 hour radius of my office. C&A certainly helps.

A local telepsych company somehow swoops up a lot of recent grads. They salary C&A at $220k.

I did some quick searching and found this: in short your state is in a huge shortage and has a location quotient of under 1 where 1 would be average employment and more details in the first link

Psychiatrists

Texas Lawmakers Must Address Mental Health Workforce Shortage
No Quick Fix for Texas' Shortage of Psychiatrists

P.S. Im moving to texas ;)
 
Maybe low compared to Cali and NY. I’ve got 3 residency programs within 1.5 hour radius of my office. C&A certainly helps.

A local telepsych company somehow swoops up a lot of recent grads. They salary C&A at $220k.
That's pretty low, isn't it? I wonder how they're managing that? Good hours?
 
I did some quick searching and found this: in short your state is in a huge shortage and has a location quotient of under 1 where 1 would be average employment and more details in the first link

Psychiatrists

Texas Lawmakers Must Address Mental Health Workforce Shortage
No Quick Fix for Texas' Shortage of Psychiatrists

P.S. Im moving to texas ;)

Interesting data. Seems Iowa is the place to be with highest income, low cost of living, and high shortage. Anywhere in the middle of the US or SE has a shortage though. Got a job for you in Texas though if interested.
 
No. You can admit to various inpatient centers, ER consults, cruise ship consults, etc. Usually bonus pay to do night shifts

Had no idea. That's good, I'll happily do all night shifts sitting/sleeping at home, and have a regular life during the day!
 
I sure would like to tell a psy-chi-a-tree how much the conversion of carbon dioxide to oxygen means to me and my family.
 
You may be correct which is more reason to go cash-only. If anything, insurance issues have made it easier in recent years. It is very doable with a business mind-set. I’m located in a major city without a large deficiency of psychiatrists. If you market well and do good work, people will come.

Maybe I should be a consultant to pp or franchise. Despite offering $175/hr, I struggle to find C&A docs that want to join me part-time. Maybe I should offer a salary instead.

I’ve actually had people turn me down for $140/hr telepsych even with seeing much higher volume there . An extra $35/hr doesn’t seem to be worth the ability to practice without wearing pants.

You're hiring for telepsych in Texas?? PMed :)
 
A good way to supplement income is by doing expert witness work and IMEs. This year my goal is to invoice 200 hours. Per hour it pays close to triple the clinical rate for someone just out of forensic fellowship. With time the rate can creep up to about 5 times the clinical rate per hour. However, it is not steady work early in your career. The work is harder in some respects but at times can mentally challenging and interesting. It's not for everyone. You will encounter interesting cases, both civil and criminal.
 
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