Employee VS. Owning Practice

[beezley]

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When I chat with physicians in other specialties about my decision to go into psych (which I have a lot of opportunity to do since I am on surg right now). I have heard multiple times about psychiatrists who start out being employed by their community hospital, getting disgruntled and then leaving and setting a private practice where they are happier with the setup and make way more $$$$.

While I personally see the appeal of being employed and not having to worry about hiring/firing, office space, setting up a practice, etc.,especially when coming out of residency in debt and in need of income. I wonder if in the long run I would be more happy being my own boss and more in control of my time.

So here are my q's:

Does this vary state to state? I am in the upper midwest.

Do you make lots more $$ in private practice? If so, why and how?

Are you even taught in residency how to go about setting up your own business?

If not, would the best way to learn about this be to have sort of a mentor, someone who has a set-up similar to what you envision?

I chatted with a physician recruiter from my hometown and was told there they offer a signing bonus, moving allowance and a 2 year income guarantee to set up a private practice. This seems like a good thing to me, is this common?

 

[michaelrack]

Most psych residents aren't taught much about business, except for a little bit about transference/counter-transference related issues related to payment.

It's hard to start a profitable private practice straight out of residence. It takes time to get on insurance panels, malpractice, etc. I would advise you to work in an employed position for 2-3 years (could be at a state hosp, community mental health center, or psych private practice), and then break away into your own private practice- just make sure to have a lawyer analyze any non-compete clauses you are asked to sign.

 

[Anasazi23]

You certainly can make a lot of money in private practice. Though as stated, it often can take some time to build up a patient base. I've received advice from successful private psychs that one sure-fire way is to sign up for some insurance panels in the beginning so that you have people calling for appointments, then to phase them out for cash later if you so choose.

I would argue that more residencies do have a class or series of classes of business psychiatry. How to set up a practice, bill, etc. Many residencies even have local attorneys and financial investor people come to speak on analyzing business physician contracts and assets - I know my residency did this.

Countertransference issues in collecting payment?
I know...we had talks on this too...

 

[Chimed]

I've received advice from successful private psychs that one sure-fire way is to sign up for some insurance panels in the beginning so that you have people calling for appointments, then to phase them out for cash later if you so choose.

Can you explain what an insurance panel is? 😳

 

[Anasazi23]

I was simply referring to putting yourself on the list to be a covered provider for a particular insurance company. i.e. "I'm on the blue cross insurance panel." Meaning, you are listed as a provide of psychiatric services for Blue Cross. Patients will see your name on their provider list, and will be referred to you as being a provider within a certain radius of a patient, when they call up their insurance looking for psychiatrists that take their insurance.