Geri psych "worth it"

[NeuroKlitch]

I am a Psych resident in new york right now debating endlessly if I should do a fellowship. Right now Geri psych and neuropsych have caught my interest . What i see myself doing in the future is working shifts in a psych emergency room either 24s, 12s , and ideally at night , would like to find high paying locums that pay hourly like 200+/hr. On the other hand , I would also like a stable (chill) gig, like contracting with a few nursing homes that I would see on the other days of the week . I know this is all possible without fellowship , but would be I stepping on my own toes by skipping the training . I'm terms of being able to land the job. I would only apply to name / "prestigious" programs , with the idea that it would give me the edge in securing those contracts. But I'm wondering it's even necessary at all and I'm only competing against myself or doing it for my ego. Not interested in academics. Just love old people ans the cpep and want to make big money . Thanks any suggestions appreciated

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[Sushirolls]

On paper, and not interested in academics, simply not worth it.
But sometimes you just got to do what you love. One benefit of the fellowship will be to strategically plan your future private practice. You will get a daily view of a Geri Clinic and what is good and bad with how its run. You can then take that knowledge to shape your future practice. If you are also willing to do nursing homes, you will potentially have a full robust clinic in less than 6 months.

Pick where you want to live. Create your own practice, and make very clear on your website you are a Geriatrician. Pick your age, 65+ or 60+ whatever it might be.

In my area virtually no one is taking any new medicare patients - including the Big Box shops - but they are being sneaky about it because it goes against their non-profit status.

 

[J ROD]

I would say learn as you practice and start cashing those bigger checks a year earlier.

 

[TexasPhysician]

Geri work is not competitive. It doesn’t pay great, and it is higher risk. If money is the determining factor, don’t do the fellowship. If $ is the main factor, I wouldn’t recommend Geri work either.

If you really enjoy it and want to learn as much as you can, it’s only 1 year. A prestigious program can’t hurt your future. It could open the doors to academia as well. You can always moonlight while doing the 1 year fellowship.

 

[NeuroKlitch]

I was under the impressions you could pull like 5k a week per nursing home ?

 

[Merovinge]

I was under the impressions you could pull like 5k a week per nursing home ?

If practicing substandard medicine in rural nursing homes is your thing (i.e. seeing the patient for a few minutes, barely knowing them, throwing whatever sedating/neuroleptics the nurses want at that patient in a completely nonsensical manner), I can confirm they can be very lucrative per hour of time. Of course as these places race to the absolute bottom of care most of it is being done by an NP these days, at least around me.

There may be a separate market for high end nursing home/dementia home care that pays well for geri psych but I would not have any idea about that world.

 

[Psychresy]

I am a Psych resident in new york right now debating endlessly if I should do a fellowship. Right now Geri psych and neuropsych have caught my interest . What i see myself doing in the future is working shifts in a psych emergency room either 24s, 12s , and ideally at night , would like to find high paying locums that pay hourly like 200+/hr. On the other hand , I would also like a stable (chill) gig, like contracting with a few nursing homes that I would see on the other days of the week . I know this is all possible without fellowship , but would be I stepping on my own toes by skipping the training . I'm terms of being able to land the job. I would only apply to name / "prestigious" programs , with the idea that it would give me the edge in securing those contracts. But I'm wondering it's even necessary at all and I'm only competing against myself or doing it for my ego. Not interested in academics. Just love old people ans the cpep and want to make big money . Thanks any suggestions appreciated

Are there many ED only shifts with 12/24 hour shifts available? Can anyone point me to these job ads?

 

[whopper]

If you have a genuine interest in it go for it.
Each branch of psychiatry has it's own pros and cons. Geriatric psych you should know your IM well cause patients are more likely to have medical problems and complications.
Also get used to having a lot of dementia patients where all you can do is only slow their symptoms while getting very few of them improved. I didn't like geri-psych for this reason.

 

[Stagg737]

I was under the impressions you could pull like 5k a week per nursing home ?

It can be done, you can get nearly 5k for 1 day a month in some places, but you will be seeing 25+ residents on those days and likely not provide strong care beyond “do they need to be taken inpatient or not?” If you want to be the sole psychiatrist at a place, be constantly on call, provide good care, and see patients once a week, 5k/week is easily doable in my area, but that’s not really big bucks like you’re looking for.

 

[nexus73]

around me all the nursing homes recently cancelled the contract with the local doc and have "oursourced" to a medical staffing firm from the metro area 5 hours away...and now there isn't a psychiatrist....but an telehealth psych NP who has no idea what she's doing with geriatric patients. So, banking on nursing homes paying big money for your services might not be the best plan when they're clearly willing to pay a staffing company for an unqualified NP. I think you'd be better off skipping the fellowship and trying to find a nursing home job now while your still in residency to see what the market will bear.

 

[Psychresy]

around me all the nursing homes recently cancelled the contract with the local doc and have "oursourced" to a medical staffing firm from the metro area 5 hours away...and now there isn't a psychiatrist....but an telehealth psych NP who has no idea what she's doing with geriatric patients. So, banking on nursing homes paying big money for your services might not be the best plan when they're clearly willing to pay a staffing company for an unqualified NP. I think you'd be better off skipping the fellowship and trying to find a nursing home job now while your still in residency to see what the market will bear.

Do you recommend just calling homes and saying, Im a psychiatrist let me round on your patients once a week/month/etc?

 

[myPsychAlt]

If you have a genuine interest in it go for it.
Each branch of psychiatry has it's own pros and cons. Geriatric psych you should know your IM well cause patients are more likely to have medical problems and complications.
Also get used to having a lot of dementia patients where all you can do is only slow their symptoms while getting very few of them improved. I didn't like geri-psych for this reason.

There's also the fact that Geri ends up about managing family members/caregivers almost as much as C&A does.

 

[psyguru]

Geriatric board certification can be lucrative if you do expert witness work with it (Testamentary Capacity, med mal, etc). However I do these cases with my forensics and BIM board certification (BIM involves dementia).