Financial incentive to get board certified in addictions?

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Update-
So I moved across the country to work in addictions seeing patients exclusively for addictions because I wanted to try to get BC in addictions via the practice pathway. I was very clear with both my recruiter and the facility about what I wanted and they said "absolutely". It is FAR from addictions, it is hardly psychiatry. Nurses, not NPs, RNs see patients regularly and are supervised by NPS. My role will be to sit in on a patient yearly evaluation with the RN or therapist and make recommendations. !. I can't believe RNs are acting as providers. 2. I got totally lied to, by the facility, I don't know if my recruiter knew.. My recruiter wants me to wait a month and see if it can be what it was stated, but I doubt that. They have one NP who does addictions. They just don't see the role of psychiatrists as I have ever worked. I am a babysitter collecting a little information. (I need to check the schedule and see if I can even meet the deadlines for the practice pathway). I had a semi contract, I asked repeatedly for a specific one, There was NO misunderstanding, it was a lie by the facility. I don't know if my recruiter knew or notI had a bad gut feeling about this. It pays amazing, but I am NOT comfortable seeing a patient once during a year and hoping the RN does her job and the NP supervising the RN does her job. It's a large well known facility.
If anyone knows of a REAL addictions position, please post or pm me. I am living in a very undesirable location, I can't imagine anywhere worse. I hope this is not the future of healthcare. NPs and PAs acting as physicians was bad enough, but RNs???????????????????????? I worry about the future of medicine both as a physician and a patient......…............….........…
 
futuredo32 said:
Update-
So I moved across the country to work in addictions seeing patients exclusively for addictions because I wanted to try to get BC in addictions via the practice pathway. I was very clear with both my recruiter and the facility about what I wanted and they said "absolutely". It is FAR from addictions, it is hardly psychiatry. Nurses, not NPs, RNs see patients regularly and are supervised by NPS. My role will be to sit in on a patient yearly evaluation with the RN or therapist and make recommendations. !. I can't believe RNs are acting as providers. 2. I got totally lied to, by the facility, I don't know if my recruiter knew.. My recruiter wants me to wait a month and see if it can be what it was stated, but I doubt that. They have one NP who does addictions. They just don't see the role of psychiatrists as I have ever worked. I am a babysitter collecting a little information. (I need to check the schedule and see if I can even meet the deadlines for the practice pathway). I had a semi contract, I asked repeatedly for a specific one, There was NO misunderstanding, it was a lie by the facility. I don't know if my recruiter knew or notI had a bad gut feeling about this. It pays amazing, but I am NOT comfortable seeing a patient once during a year and hoping the RN does her job and the NP supervising the RN does her job. It's a large well known facility.
If anyone knows of a REAL addictions position, please post or pm me. I am living in a very undesirable location, I can't imagine anywhere worse. I hope this is not the future of healthcare. NPs and PAs acting as physicians was bad enough, but RNs???????????????????????? I worry about the future of medicine both as a physician and a patient......…............….........…
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Strongly sounds like you are brought on from a liability perspective to take the fall when an adverse event happens. I’d leave yesterday.

Inpatient addiction jobs have been dropping like flies over the last year. There has been a heavy influx of PHP and IOP addiction programs across the nation that has taken patients from traditional inpatient care. The result is multiple large addiction centers closing their doors. You could probably move to a large metro area and pick up 2-3 of these PT gigs rather quickly.
 
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futuredo32 said:
Update-
So I moved across the country to work in addictions seeing patients exclusively for addictions because I wanted to try to get BC in addictions via the practice pathway. I was very clear with both my recruiter and the facility about what I wanted and they said "absolutely". It is FAR from addictions, it is hardly psychiatry. Nurses, not NPs, RNs see patients regularly and are supervised by NPS. My role will be to sit in on a patient yearly evaluation with the RN or therapist and make recommendations. !. I can't believe RNs are acting as providers. 2. I got totally lied to, by the facility, I don't know if my recruiter knew.. My recruiter wants me to wait a month and see if it can be what it was stated, but I doubt that. They have one NP who does addictions. They just don't see the role of psychiatrists as I have ever worked. I am a babysitter collecting a little information. (I need to check the schedule and see if I can even meet the deadlines for the practice pathway). I had a semi contract, I asked repeatedly for a specific one, There was NO misunderstanding, it was a lie by the facility. I don't know if my recruiter knew or notI had a bad gut feeling about this. It pays amazing, but I am NOT comfortable seeing a patient once during a year and hoping the RN does her job and the NP supervising the RN does her job. It's a large well known facility.
If anyone knows of a REAL addictions position, please post or pm me. I am living in a very undesirable location, I can't imagine anywhere worse. I hope this is not the future of healthcare. NPs and PAs acting as physicians was bad enough, but RNs???????????????????????? I worry about the future of medicine both as a physician and a patient......…............….........…
Click to expand...

What does your contract say? Were your duties specified? If you there is no requirement to provide supervision, then don't. Tell them you'll see the patient yourself but will not supervise. You have to be firm about this as it is your license on the line.

It is good that you kept the weekend locums because it gives you options. You can do more of the other locums and drop this position if you don't like it.

Always keep your options open.
 
AD04 said:
What does your contract say? Were your duties specified? If you there is no requirement to provide supervision, then don't. Tell them you'll see the patient I asked repeatedly for a specific contract and didn't get one. I'm actively looking for another job. I don't know if I'll make the cut off time for addictions. I'll have to do the math. I plan to be gone by end of March at the latest.
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I rotated on a non-shady service that had a set up similar to this. Specifically a county-funded in-home Geri Psych team that did 100% house calls. Census of 150, 4 hours of psychiatrist time per week. Patients see psychiatrist on a yearly basis. Patients seen monthly by RNs and most day to day med issues handled by NPs or (sometimes) residents. If this was some hyperspecialized thing operating on a shoestring grant i get it but I assume it is not that.

I get that they lied and the structure is unusual, but if it is not addictions work what population are they actually serving?
 
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Does anyone know if they will extend the practice pathway? I need to get 1420 patient contact hours done by Dec 2020 to apply according to the website.
 
TexasPhysician said:
Unlikely
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That's what I thought. There's no way I will find a position and get all the paperwork done in time to start and finish . I need nine months plus a few weekends to cover holidays a sick day or two to get enough hours. Sucks because I kinda think I could have made this the one area in psych I maybe would love. But, I also would have had to pass the certification exam on my first try, so perhaps this is a blessing in disguise. It just sucks that I left my clinic position that wasn't great but I didn't hate to come here. And, the clinic job has replaced me with an NP.
 
clausewitz2 said:
I rotated on a non-shady service that had a set up similar to this. Specifically a county-funded in-home Geri Psych team that did 100% house calls. Census of 150, 4 hours of psychiatrist time per week. Patients see psychiatrist on a yearly basis. Patients seen monthly by RNs and most day to day med issues handled by NPs or (sometimes) residents. If this was some hyperspecialized thing operating on a shoestring grant i get it but I assume it is not that.

I get that they lied and the structure is unusual, but if it is not addictions work what population are they actually serving?
Click to expand...

I've never worked in this setup, but that makes sense. My thinking was it's very much like a consultative/integrated care psychiatrist. They likely have such a huge number of patients waiting to be seen that the psychiatrist only evaluates once a year, makes detailed recommendations, and in the interim, it's the NP who alerts the psychiatrist if there need to be changes. I'm not sure it's any more unsafe than any other consultative role, assuming the recommendations are clear and patients aren't low-functioning individuals suffering from treatment-resistant psychosis or something. If it's straight-up addiction in a relatively healthy population, I can see this setup.
 
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TexasPhysician said:
Strongly sounds like you are brought on from a liability perspective to take the fall when an adverse event happens. I’d leave yesterday.

Inpatient addiction jobs have been dropping like flies over the last year. There has been a heavy influx of PHP and IOP addiction programs across the nation that has taken patients from traditional inpatient care. The result is multiple large addiction centers closing their doors. You could probably move to a large metro area and pick up 2-3 of these PT gigs rather quickly.
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The other locums physicians don't seem concerned about liability, I asked them. I am planning to leave as soon as I find another position.
 
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downwithDTB said:
I don't plan to treat patients over 30 and very, very few post college. I don't like primary SUD or classic PTSD. The VA doesn't have enough work available in my preferred disorders. Also, I imagine that the VA wouldn't let me do most of my clinical work how I want to, ect.
Click to expand...

What’s classic ptsd?
 
futuredo32 said:
Update-
So I moved across the country to work in addictions seeing patients exclusively for addictions because I wanted to try to get BC in addictions via the practice pathway. I was very clear with both my recruiter and the facility about what I wanted and they said "absolutely". It is FAR from addictions, it is hardly psychiatry. Nurses, not NPs, RNs see patients regularly and are supervised by NPS. My role will be to sit in on a patient yearly evaluation with the RN or therapist and make recommendations. !. I can't believe RNs are acting as providers. 2. I got totally lied to, by the facility, I don't know if my recruiter knew.. My recruiter wants me to wait a month and see if it can be what it was stated, but I doubt that. They have one NP who does addictions. They just don't see the role of psychiatrists as I have ever worked. I am a babysitter collecting a little information. (I need to check the schedule and see if I can even meet the deadlines for the practice pathway). I had a semi contract, I asked repeatedly for a specific one, There was NO misunderstanding, it was a lie by the facility. I don't know if my recruiter knew or notI had a bad gut feeling about this. It pays amazing, but I am NOT comfortable seeing a patient once during a year and hoping the RN does her job and the NP supervising the RN does her job. It's a large well known facility.
If anyone knows of a REAL addictions position, please post or pm me. I am living in a very undesirable location, I can't imagine anywhere worse. I hope this is not the future of healthcare. NPs and PAs acting as physicians was bad enough, but RNs???????????????????????? I worry about the future of medicine both as a physician and a patient......…............….........…
Click to expand...

you keep saying “the pay is amazing” but what exactly is the pay for a ****ty job like this? 300/hr? That’s amazing pay but I doubt it..
 
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clausewitz2 said:
300/hour is a not difficult to achieve rate in bog-standard outpatient insurance-taking practice in my neck of the woods. So....move?
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I feel like 300/hr is the least you'd want to ask for due to the hazards of getting stuck in the bog, along with that awful peaty smell. ;)
 
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What is a parking chair?
 
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futuredo32 said:
Does anyone know if they will extend the practice pathway? I need to get 1420 patient contact hours done by Dec 2020 to apply according to the website.
Click to expand...

Addiction Psychiatry Jobs | Nationwide

www.practicelink.com www.practicelink.com
Here is a list of a hole bunch of addiction jobs. Some of these are very frequent repeat posters. Place some calls.
I believe the practice pathway requires board cert also in the person's primary specialty, too. I hope you locked in the Psych Certification.
 
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prominence said:
What is a parking chair?
Click to expand...
Ohhh you mean "spot savers" ;)

Every year there are dozens of slashed tires, smashed windshields, fist fights, etc that break out over this in Boston. I think last year someone even got shot?!

This is the reason why I rent my own private parking spot to avoid street parking. feels good man
 
Monocles said:
Ohhh you mean "spot savers" ;)

Every year there are dozens of slashed tires, smashed windshields, fist fights, etc that break out over this in Boston. I think last year someone even got shot?!

This is the reason why I rent my own private parking spot to avoid street parking. feels good man
Click to expand...
Or just don’t live in Boston proper....
 
SourceOfDenial said:
What’s classic ptsd?
Click to expand...

Ya know, shell-shock, the DSM version ptsd, with a clearly identified trauma and that you can do prolonged exposure for. I do not enjoy treating PTSD from adult sexual or violence trauma, hence, reason #388363 why I wouldn't do VA psychiatry. This is clearly important work; however, it is not my prefered work and that is fine. I guess I could have just written primary PTSD or even PTSD and it would have been true. Ah well.
 
downwithDTB said:
Ya know, shell-shock, the DSM version ptsd, with a clearly identified trauma and that you can do prolonged exposure for. I do not enjoy treating PTSD from adult sexual or violence trauma, hence, reason #388363 why I wouldn't do VA psychiatry. This is clearly important work; however, it is not my prefered work and that is fine. I guess I could have just written primary PTSD or even PTSD and it would have been true. Ah well.
Click to expand...
shell shock isnt PTSD
 
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Sushirolls said:

Addiction Psychiatry Jobs | Nationwide

www.practicelink.com www.practicelink.com
Here is a list of a hole bunch of addiction jobs. Some of these are very frequent repeat posters. Place some calls.
I believe the practice pathway requires board cert also in the person's primary specialty, too. I hope you locked in the Psych Certification.
Click to expand...
bc in psych third attempt. It is just a huge time crunch to get certified and credentialed in time. The hours have to be done by the end of 2020 .
 
Regarding the addiction medicine board, if some one graduated residency last July, is their any way they would qualify to sit for the exam?
 
splik said:
shell shock isnt PTSD
Click to expand...

I know. I realize that my hasty attempt to draw some circles around some not completely overlapping terms in the venn diagram of historical psychiatric diagnoses with my own term and second ammendment quality comma use to informally explain why I wouldn't work at a VA fell flat. We can just let this one die.
 
psychapp121 said:
you keep saying “the pay is amazing” but what exactly is the pay for a ****ty job like this? 300/hr? That’s amazing pay but I doubt it..
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It's more than I have ever made. At my clinic job, I made $150 an hour as an independent contractor. Weekend moonlighting once a month on a 23 bed unit plus consults is 1500 a day for 8 hours and time and a half for anything over 8 hours and $150 per night to take call.
 
mbgr2014 said:
I'm confused why the practice pathway is your only shot - can't you do one of the Addictions fellowships?
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I would like to actually earn a decent salary. I will do a FP residency but would only do this as a paid job.
 
futuredo32 said:
It's more than I have ever made. At my clinic job, I made $150 an hour as an independent contractor. Weekend moonlighting once a month on a 23 bed unit plus consults is 1500 a day for 8 hours and time and a half for anything over 8 hours and $150 per night to take call.
Click to expand...

23 patients with extra consults to make 1500? Wow
 
psychapp121 said:
23 patients with extra consults to make 1500? Wow
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That's good for me. The unit is rarely full and they just expect a short and sweet follow up with the inpatient population
. The consults are often many. It's more than I have ever made at a job until this crappy one
 
Last edited:
Compensation seems to vary widely depending on region, hospital or facility budget, and how much the hospital or facility wants to screw you.

I've been searching for moonlighting/contractor positions, and have heard everything from $80 per patient to $290 per hr regardless of patients seen (state hospital/prison work). Also recruiters only seem helpful for recruiting for the job du jour; once I ask them to find something different I get a "yes I'll contact you later today" and then not hear from them ever again.
 
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thepoopologist said:
Compensation seems to vary widely depending on region, hospital or facility budget, and how much the hospital or facility wants to screw you.

I've been searching for moonlighting/contractor positions, and have heard everything from $80 per patient to $290 per hr regardless of patients seen (state hospital/prison work). Also recruiters only seem helpful for recruiting for the job du jour; once I ask them to find something different I get a "yes I'll contact you later today" and then not hear from them ever again.
Click to expand...
I had a different experience. My recruiter said in two weeks, I will be seeing addictions patients exclusively and by myself. I mentioned this to a physician at the hospital and he was like, um, no. So I told my recruiter I am actively looking and would love to continue working with his locums company, but if not,,,,,,,,,,,,,,,,,,,,,,,,, He's looking. I would love to do addictions. I have considered staying here just for the money if I can't find an addictions position. As I said it's the most money I have ever made. I'm keeping my weekend hospital job , doing a weekend a month telepsych job (low pay but I am bored here so why not make a little money) and I am keeping my ever shrinking private practice for the time being (I will maybe break even on that).So I go home three weekends a month, four if there is a weekend with 5 weekends. I am applying to every addictions position I can find, but it'd be a time crunch to get credentialed because to get the patient hours in, I would need to start in March and it takes time to credential.
 
futuredo32 said:
I had a different experience. My recruiter said in two weeks, I will be seeing addictions patients exclusively and by myself. I mentioned this to a physician at the hospital and he was like, um, no. So I told my recruiter I am actively looking and would love to continue working with his locums company, but if not,,,,,,,,,,,,,,,,,,,,,,,,, He's looking. I would love to do addictions. I have considered staying here just for the money if I can't find an addictions position. As I said it's the most money I have ever made. I'm keeping my weekend hospital job , doing a weekend a month telepsych job (low pay but I am bored here so why not make a little money) and I am keeping my ever shrinking private practice for the time being (I will maybe break even on that).So I go home three weekends a month, four if there is a weekend with 5 weekends. I am applying to every addictions position I can find, but it'd be a time crunch to get credentialed because to get the patient hours in, I would need to start in March and it takes time to credential.
Click to expand...

I honestly think you should reconsider not doing a fellowship. There are many fellowships where the hours would be very conducive to moonlighting quite a bit. You're already working most weekends. If you continued this in a fellowship, sure you'd make less than now, but you'd be doing something you enjoy more, have less liability, would still probably make attending level money with moonlighting, and its only a year after all.

Sure, by all means keep trying to do the practice pathway, but honestly with how unhappy you've at least talked about on here, at least you'd get reasonably good training and you wouldn't be limited by passing on first attempt, etc.

Also, keep in mind that going to an Addiction medicine fellowship in a place with an in-house FM program might actually give you an in for the residency itself if you still wanted to do it at that point and were well-liked in the program.
 
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hallowmann said:
I honestly think you should reconsider not doing a fellowship. There are many fellowships where the hours would be very conducive to moonlighting quite a bit. You're already working most weekends. If you continued this in a fellowship, sure you'd make less than now, but you'd be doing something you enjoy more, have less liability, would still probably make attending level money with moonlighting, and its only a year after all.

Sure, by all means keep trying to do the practice pathway, but honestly with how unhappy you've at least talked about on here, at least you'd get reasonably good training and you wouldn't be limited by passing on first attempt, etc.

Also, keep in mind that going to an Addiction medicine fellowship in a place with an in-house FM program might actually give you an in for the residency itself if you still wanted to do it at that point and were well-liked in the program.
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I am assuming one would need a letter from a former PD For addictions? I don't have that.
 
futuredo32 said:
I am assuming one would need a letter from a former PD For addictions? I don't have that.
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Did you leave things on bad terms with your former PD? If not, give them a call and have him/her write you a letter.

I think all they actually need is verification of training from your PD and the letters of recommendation can come from anyone. Double check me on that though. I could be wrong.
 
futuredo32 said:
I am assuming one would need a letter from a former PD For addictions? I don't have that.
Click to expand...

While possible at some places, others may not be picky. Something that says you completed residency should suffice which would have been what you got to take the boards. Beggars can’t be choosers as they say. Last I checked, they don’t come close to filling. I talked to an addictions PD who told me they had 1 application in 3 years. No takers. They offered an interview to the 1 person who only completed half the application as they were excited that someone half tried to apply. Some that do an addictions fellowship are actually mandated by state boards as a punishment, so a red flag on your record would not exclude you. I could be wrong, but I would automatically assume you can’t get in.
 
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futuredo32 said:
I had a different experience. My recruiter said in two weeks, I will be seeing addictions patients exclusively and by myself. I mentioned this to a physician at the hospital and he was like, um, no. So I told my recruiter I am actively looking and would love to continue working with his locums company, but if not,,,,,,,,,,,,,,,,,,,,,,,,, He's looking. I would love to do addictions. I have considered staying here just for the money if I can't find an addictions position. As I said it's the most money I have ever made. I'm keeping my weekend hospital job , doing a weekend a month telepsych job (low pay but I am bored here so why not make a little money) and I am keeping my ever shrinking private practice for the time being (I will maybe break even on that).So I go home three weekends a month, four if there is a weekend with 5 weekends. I am applying to every addictions position I can find, but it'd be a time crunch to get credentialed because to get the patient hours in, I would need to start in March and it takes time to credential.
Click to expand...

I'm starting to wonder if your job search approach is off. Where I am (certainly not underserved by psych) there are tons of addiction jobs posted. Yes, we are talking academic/VA/community salaries but that doesn't seem that outside of your compensation history and is way better than fellowship. Yes the postings say they want "fellowship trained" but come on. That's like CL depts saying they want fellowship trained CL while in reality they are hiring residents to cover CL. Have you emailed dept chairs at academic hospitals and VAs? Have you contacted reputable Suboxone/methadone clinics? There may be addiction jobs out there that don't even have ads because either the dept chair/clinic director doesn't want to waste the money or they think they can get a better response by advising a high sud clinic as gen psych. If you include nicotine, MJ and alcohol, I bet every community mental health job has 80%+ commorbid SUD. Can you work that?
 
downwithDTB said:
I'm starting to wonder if your job search approach is off. Where I am (certainly not underserved by psych) there are tons of addiction jobs posted. Yes, we are talking academic/VA/community salaries but that doesn't seem that outside of your compensation history and is way better than fellowship. Yes the postings say they want "fellowship trained" but come on. That's like CL depts saying they want fellowship trained CL while in reality they are hiring residents to cover CL. Have you emailed dept chairs at academic hospitals and VAs? Have you contacted reputable Suboxone/methadone clinics? There may be addiction jobs out there that don't even have ads because either the dept chair/clinic director doesn't want to waste the money or they think they can get a better response by advising a high sud clinic as gen psych. If you include nicotine, MJ and alcohol, I bet every community mental health job has 80%+ commorbid SUD. Can you work that?
Click to expand...
For the pathway to certification it has to be solely addictions for approximately 1420 hours. If you know of any feel free to post or PM.
 
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