ED psychiatry

[polly-o]

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do EDs ever have an in-house, full time psychiatrist or do they always seek a pscyh consult? i have seen that there are electives that one can do for emergency psychiatry, but was unsure whether if you like this you can do "full-time EM psychiatry". thanks for any input.

 

[atsai3]

do EDs ever have an in-house, full time psychiatrist or do they always seek a pscyh consult? i have seen that there are electives that one can do for emergency psychiatry, but was unsure whether if you like this you can do "full-time EM psychiatry". thanks for any input.

Some hospitals have a separately functioning psychiatric emergency service. For example, SF General and Harborview Medical Center (Seattle).

-AT.

 

[Doc Samson]

MGH and Columbia also spring to mind.

 

[Chewbacca Jung]

Rochester, NY has a great one, and New Mexico too.

I don't know if any attendings spend their full time in those locations though, most the attendings I worked with just rotate through. But then again, I don't know many psychiatrists who spend their "full-time" in an one place.

Anyway, i think they are great environments for learning. If you're like me and like the ED much more than inpatient medicine, you'd probalby like the Psych ED setting as well.

 

[Caetano-MD]

I did a sub-i at U of Miami's psych ED and it was wild. It's a free-standing psych ED and very busy, fun and great attendings. The best thing about Miami are its awesome residents--but I would underline that I spoke spanish most of the night--with the residents AND patients.

Check it out...it's a great place.

 

[Hurricane]

University of Cincinnati (where I went to med school) has one of the busiest free standing psych ERs. My current program (UTSW) has a very busy one at Parkland which is the county hospital for Dallas. Besides some of the places already mentioned, I also remember from interviews that Emory had a busy Psych ER at their county hospital.

Although some attendings do ER work full-time, most do a couple days a week. One attending told me she would get bored doing outpatient work all the time, so she works in the ER a couple nights a week to keep herself sharp. Another does it because he is in private practice but has to work so many hours for the university to get their benefits.

 

[kugel]

There is more talk every year about dev'ping an Emergency Psychiatry fellowship. Emerg Psych is my life and I love it. There is a small, but growing # of us choosing this as a career.

In CA, every county is req'd to have a "receiving center" for those on police hold as "danger to self/others" (here known as "5150"). In the larger counties, that is a 24-hr Psych Emerg Service (PES) or Emerg Treatment Services (ETS). In smaller counties, this is a service on-call to the medical ER.

In Atlanta, Grady Hospital (downtown county hospital) runs a very effective PES. In Albuquerque, the PES is across campus from the University Hospital and is the front door to the county MH Center.

Miami's PES has a great reputation and very busy (and very little English spoken).

As suggested by others, you can make this your career, or you can do it part-time or as a form of moonlighting. If you decide to do it as full-time job for a few years, you can make an enormous amt $ as a Locum Tenens, see lots of great places, and then decide where you want to settle down knowing that you have 10x more vital experience in "who needs to be admitted and who doesn't" under your belt than your peers.

 

[JMD]

I know Rochester (NY), Bellevue, and Buffalo all have really nice Comprehensive Psychiatric Emergency Programs (CPEP). There is at least one attending on duty at all times and there are 72 hour extended observation beds. Some also have a separate C+A emergency psych area with a child psychiatrist on duty. After being exposed to this resource in medical school, I was really surprised during residency interviews to find that these comprehensive psych ERs are a luxury that many places do not have. I have been told that funding and laws in many states make it unfeasible to support them.

I have heard of some horror stories in places with no "receiving centers" as Kugel mentioned are present in Cali,which included a psych patient being handcuffed to a bed for days in an ER that wasn't equipped to handle them and what seems to be higher incidence of police brutality against mentally ill patients because they have no designated protocol for where to take/how to deal with dangerous patients.

So, to answer your question, yes there are full-time ER Psych positions out there.

 

[Adam_K]

One place I'd like to add to the list of programs with excellent Psych Emergency Services: Hennepin County Medical Center in Minneapolis (part of Hennepin/Regions). Their setup is pretty awesome.

 

[Adam_K]

There is more talk every year about dev'ping an Emergency Psychiatry fellowship.

Anyone guess what the possibility of this taking place might be?

I have little desire to do a traditional C/L fellowship just so that I can work in the PES.

 

[MBK2003]

Anyone guess what the possibility of this taking place might be?

I have little desire to do a traditional C/L fellowship just so that I can work in the PES.

Columbia has a 1 year Psych ER Fellowship (not ACGME accredited) that's been around for years. It's a part-time position 5d/wk. Feel free to PM me if you want details and contact info.

MBK2003

 

[Afrikyn]

I know that there are psychiatrists who work full time in a psych ER. I am wondering if they make as much money as ER physicians. I tried to do a google search but i could not find this information.

 

[jjbmsiv]

250,000 bucks a year? I highly doubt it. I've gotten the impression any hospital shrink who cracks 200,000/year is in great company (though my experiences have only been in academia settings). Even so, while the psychiatrist would be more specialized than a regular ED doc, I think that very fact precludes equal salary.

 

[hippiedoc13]

.

 

[hippiedoc13]

I know that there are psychiatrists who work full time in a psych ER. I am wondering if they make as much money as ER physicians. I tried to do a google search but i could not find this information.

Most of the psychiatrists I worked with in the Psych ER do a few shifts a week there, plus see a few private practice patients one or two days a week. We didn't talk salary specifics but they said Psych ER shift work is VERY well paid--I guess that shows you what a demand there is for people who can/will do this much-needed work.

 

[jjbmsiv]

Given that I'm interested in ER Psych as career (well, that or consults), could somebody volunteer how much a full-time position would expect to pay in salary? While I'm being persnickity, give the location too (ie, northeast, south), since physician pay certainly seems to depend on location.

 

[Adam_K]

Given that I'm interested in ER Psych as career (well, that or consults), could somebody volunteer how much a full-time position would expect to pay in salary? While I'm being persnickity, give the location too (ie, northeast, south), since physician pay certainly seems to depend on location.

A while back, I saw an advertisement for a full time PES psychiatrist at the VA in L.A. starting at about 200k. However, I've also been told that this is not very competitive given the high cost of living and the potential to earn much more in private practice in the same area.

 

[jjbmsiv]

Heh. I bet 200 grand in L.A. buys you a nice studio apartment on the sleazy side of town.

 

[icebreakers]

what kind of money do ED psychiatrists make typically? do they work few days a week and have their own practice too?

 

[prominence]

anyone know of any free-standing psych ER's in/or near the houtson, tx area?