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Kaiser is 250/hour for their per diem.
Graduating psych residents…Job offers
- Thread starter EDlover23
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Where is this?
I remember being a med student and rotating at a Kaiser and hearing the per diem psychiatrists were getting 1k/8hr day.... This wasn't that long ago...
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Redwood City, California
Wow this was NorCal too. Rates have really increased.
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You have to live in California though right?
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My guess is none of these are remote all in person?
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Let me check real quick:
$325/hr - in person correctional (Stockton)
$325/hr - in person correctional (Vacaville)
$250/hr - in person correctional (Napa)
$225/hr - hybrid (50% TMS, 50% outpatient, Los Altos)
$175-200/hr - remote consultant (100% nonclinical, AI and mobile apps)
$240-300k - in person outpatient including TMS (Minneapolis)
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Here are a few job offers I remember off the top of my head:
$268k outpatient specialty CAP clinic, community hospital/clinic with academic appointment, with coverage of one weekend on inpatient CAP every 6-8 weeks, PTO 3 weeks per year, 3% match on 401k, $2500/year CME.
$300k outpatient remote and in person, 40 hours per week with 30 min per day of admin time, adult 1 hour intake CAP 2 hour intakes, 20-30 min follow-ups (they require 25% being 20 min follow-ups) 6 weeks PTO + 10 paid holidays, $2500/year CME, 3% 401k match. Telephone on call coverage split among psychiatrists.
$300k outpatient all remote or hybrid, with bonus RVU over 6500 annual RVU at $45/wRVU, 3 weeks PTO, 3% 401k match, 1 hour adult intake and 3 hour CAP intake, telephone on call coverage split among psychiatrists.
$350k outpatient in person or hybrid or productivity based ($200 per initial and $150 per follow-up, $3k per TMS treatment) whichever is higher that month at payroll, with TMS, ketamine, and IOP options, 40 clinical hours per week. Unpaid vacation if on productivity so you can take as much time off as you want, but first year is 15 days PTO. 3% match on 401k. No call requirement.
$268k outpatient specialty CAP clinic, community hospital/clinic with academic appointment, with coverage of one weekend on inpatient CAP every 6-8 weeks, PTO 3 weeks per year, 3% match on 401k, $2500/year CME.
$300k outpatient remote and in person, 40 hours per week with 30 min per day of admin time, adult 1 hour intake CAP 2 hour intakes, 20-30 min follow-ups (they require 25% being 20 min follow-ups) 6 weeks PTO + 10 paid holidays, $2500/year CME, 3% 401k match. Telephone on call coverage split among psychiatrists.
$300k outpatient all remote or hybrid, with bonus RVU over 6500 annual RVU at $45/wRVU, 3 weeks PTO, 3% 401k match, 1 hour adult intake and 3 hour CAP intake, telephone on call coverage split among psychiatrists.
$350k outpatient in person or hybrid or productivity based ($200 per initial and $150 per follow-up, $3k per TMS treatment) whichever is higher that month at payroll, with TMS, ketamine, and IOP options, 40 clinical hours per week. Unpaid vacation if on productivity so you can take as much time off as you want, but first year is 15 days PTO. 3% match on 401k. No call requirement.
yoloswagpoop42069
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Those 325/hr jobs sound nice, minus paying CA taxes, and living where ever the hell Stockton is.
Always been curious about correctional jobs. I think I deal with those with ASPD pretty well.
I have always been curious about what the real risk of getting clobbered in those places are. Like real physical violence towards you the psychiatrist leading to significant bodily injury.
Psychiatric positions available at a non-profit county-contracted agency located in Los Angeles and Riverside counties. Outpatient medication management services utilizing telepsychiatry (from your home or office). 8-10 hours per day; pick any days from Monday- Saturday. Adult patients: 90 minute intakes, 60 minute second appointments, 30 minute follow up appointments. Child/Adolescent patients: 120 minute intakes, 60 minute second appointments, 30 minute follow up appointments. 1-2 hours of administrative time per scheduled day. Residents in training are paid $150-165 per hour. Attending are paid $175- 200 per hour.
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Are these community psych patients? Mainly psychosis and bipolar?
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Correctional safety varies by setting. Overall, it's safe. It's still safe but less so in a setting where larger proportions of the patients are new to that location, withdrawing, and won't be at that location much longer.
So in general:
Jails are safe but the least safe, since people will not be there for a year, are new, and haven't had time to withdraw.
Intake / processing prisons are the next least safe, since people will likely not be there for 10 years, might now be detoxing after having been in jail but with access to their drugs, and might not have been receiving treatment in the jail or community.
Longer term prisons are the most safe. People there 20+ years aren't looking to fight with the psychiatrist and add another couple years to their sentence for assaulting them. They either have a recent exacerbation of a previously stable condition, have a new onset condition, or have been receiving treatment for years. You might be their doctor for 20+ years there, just like in the community.
There's also the levels of care for corrections. Generally there's the equivalent of outpatient (monthly or Q3, etc), IOP (day programs separate from the gen pop), and IP (think state hospital, qMonth notes but the unit is up to 60 patients). Just like non-corrections, the safest is OP and the most dangerous is IP.
Imo, these same patients are more dangerous when admitted to a community hospital during times free of incarceration than they are while incarcerated.
I've heard of many non-psychiatrists getting hurt all the time, just like in the community (techs, RNs, etc). The prison is generally too desperate for psychiatrists to not protect them to some degree. The inmates in general always know better than to attack a psychiatrist who is nice to them but might not shy away from attacking the CO who yells at them.
Yes, we treat community/underserved Psychiatric patients. We treat adults and C/A suffering from a variety of disorders including depression, anxiety, bipolar and psychosis. Many of the C/A patients suffer from ADHD.
yoloswagpoop42069
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Great answer man. Are you forensically trained?
Why does corrections pay so much? Because the place is depressing to walk into and generally work in?
Why does corrections pay so much? Because the place is depressing to walk into and generally work in?
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I did not do a forensic fellowship, and a forensic fellowship isn't helpful for correctional work. I did do my residency at a forensic hospital, though.
You've got most of the reasons why corrections pays well accurately. The biggest factor is that prisons are required to provide psychiatric services to their inmates. Well, they're required to not be intentionally indifferent. Anyway, combine the mandate with the desperation caused by the unpleasant environment, less than ideal population, terrible formularies, unpleasant staff, stigma, and lack of awareness of the realities of the setting- it ends up driving up the pay.
W-2 jobs in corrections are in general very poorly compensated. Thankfully for those who are willing to 1099, this means that there are almost always openings.
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Depends on how many factors like w2 vs 1099, location etc
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One of the positions I posted previously is HCA in the midwest. Copied it here:
Inpatient averaging 18-20 patients a day. $250k base with significant RVU bonus (lowest paying physician in group was still clearing $450k, most clearing $500k). Weekend call Q4 weekends, full (mediocre) benefits and loan repayment. Hospital is still hiring.
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For 20 patients a day, that's not great money. I know places in the Midwest where inpatient doctors are making close to 750k for seeing 20 patients a day. I still think that's too many patients to do a good job but seeing 20 patients a day AND making around 450k is a raw deal.
That seems bad and surprising for HCA. 20 patients a day is plus weekends is like 11000 RVUs which at median (and if you're going to work for HCA you should AT LEAST get the 60% percentile) should be around $650k. Here the HCA hospital is paying $350k base for no weekends and 11 - 12 patients.
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Some may be making more, idk. I did an initial with them but didn't go in depth with pay structure as I accepted another position before then. I have heard of HCA hospitals offering much better deals than this in other locations, but I'm not aware of anywhere paying >$650k for 20 inpatients. Would be interested in hearing about those positions if you don't mind DMs. A buddy did residency at an HCA program and said the inpatient docs were making around $350k-400k with residents working under them and leaving around noon most days.
Another listing I got earlier today:
Hello, Dr. XYZ- A western Illinois facility is adding additional Child and Adolescent and General Psychiatrists to their well-established program. Opportunity features:
- Join a team of 7 Psychiatrists
- 41 beds comprised of 10 adult behavioral medicine, 16 adult psychiatric service, and 15 child and adolescent beds
- Choose from outpatient, inpatient, or a mixture of both
- Sub-specialty interests can be accommodated
- Compensation is $325K with up to $50K signing bonus
- $150-300K student loan repayment
- Up to $15K for relocation, generous benefits, CME with allowance, PTO
- This quaint town sits on the bluffs on the banks of the Mississippi River
I get multiple e-mails for positions like this on a weekly basis all over the country.
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Stockton, CA is basically why they are paying that much. Its basically one of the most dangerous cities in CA, with being among the top in crime and with some of the highest likelihood of being a victim of crime. It is safer than only 3% of US cities. I remember talking to a recruiter about a position before I knew where it was, and the first thing he said was, don't worry about all the crimes you see when you Google the city, just don't every go southwest of x road after dark and live in a gated community and you'll be fine...
As for safety within the facility, it'll vary from facility to facility. Someone I knew had her husband and a nurse killed by inmates trying to escape through the medical bay. The facilities were notorious for cutting staff in order to save money. They kept having incidents where people were getting hurt because of it, so it was just a matter of time before there was a fatality.
This was not in CA, and I don't know how the prisons compare, but its basically a huge industry that function often to make money for the private companies that run the prisons. Its in their interest to have less staff and house (and retain) as many inmates as possible.
Yeah, I have a friend at one as well. They offer $350k+ to graduating residents, but the work just doesn't seem rewarding. He got the impression that either you had to not care what went on there or you had to burn yourself out trying to do right by patients while simultaneously getting them out the door quickly.
Where was this? Feel free to DM
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Interesting, I am licensed in the #1, #2, and # 3 states, as well as #14 (Tennessee).
Do you happen to know if they cover for travel/lodging or on your own if coming from out of state?
If your primary residency is not CA, do you still end up paying CA taxes?
On your own is what I heard. I also hear suicide is high in some of those facilities.
You do pay taxes in CA if the work is done in CA
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So, uh, how do we get in on this remote consultant gig?
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remote consultant sounds like a sweet deal indeed, sounds like you are a reviewer for medical insurances? (basically approving or denying prior auth requests and such?)
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Good post, I think I would be more concerned walking down the street in Stockton than being inside the prison given the area.
Thoughts on this job?
ER coverage by tele. 185 per consult. 6 or 12 hour shifts. Average 1 consult per hour.
I particularly like the 7p-1a shift... Seems like a decent way to add extra income after the work day without having to give up sleep.
ER coverage by tele. 185 per consult. 6 or 12 hour shifts. Average 1 consult per hour.
I particularly like the 7p-1a shift... Seems like a decent way to add extra income after the work day without having to give up sleep.
This is a larger tele company isn’t it? I did something like this for a little bit but realized I can’t stand the shift and waiting for things to happen for me to make money I preferred to have it all lined up. But for an easy way to increase your income and can be good. It will likely take a while to fully spin up to the point you get full volume so take that into account.
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I think this is really bad, you’re essentially on call for free and they can call you for any reason without a consult and you don’t get paid. You should have a base pay just for being on call
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Yes, these jobs basically put all the financial risk on you and none on the employer. It's significant value for the ER just to have someone available to possibly see their psych patients so they don't have to sit taking up an ER bed for another 12 hours while they wait for a psych consult to come. You should be paid a base rate just to be available and then per patient on top of this.
They mentioned for a 6 hour shift they have not had a provider with fewer than 5 consults in the past 3 years. It sounds like the floor is 5 consults.
My understanding is you aren't there "on call" as in, available for questions, med orders, etc. You are strictly there to see patients, so if they are calling its because there is a consult to be seen.
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You’re the on call psychiatrist..good luck defending yourself when they call with questions and your response is “no questions only consults” and there’s a bad outcome and they document that
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You don't know that that's the set up. They very well may only call the psychiatrist to see new patients and otherwise the ED doc manages the other established patients over night. Not every system has an on-call psychiatrist to manage everything.
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Right but you have to set aside that time to be available for consults. That's valuable in and of itself, I'd want to be paid if I can't go hike or reliably be able to go to my kids sports event or go out to dinner without being interrupted by a consult. You're setting aside that time and should be compensated for that.
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Yeah the only way I could see this being acceptable is if I'm already required to be on-site somewhere (like twiddling thumbs at a TMS clinic) or I'm already on-call for somewhere else. Of course, they'd all have to be okay with that setup.
Yeah that's true. Although im thinking more along the lines of taking something like a 7p to 1 a shift. I'll be hanging a t home after dinner with the family anyways. I can still get to bed and get my 7 hours. Seems like not a bad way to bring in an extra 50 to 100K a year.
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You aren't hanging around your family for **** if you are taking 5 ED consults from 7pm-1am. That's a busy evening and as much work as my friend did in an average 8 hour shift being in-person in a psych ED. I have no idea how anyone could see that as being a relaxing evening to be doing the most acute/litigious work possible in our field where you don't even have the advantage of knowing the case managers/social worker/ED team well.
Well ya I'd be working..my point was not much happens after the kid goes to bed at 8. Not like I'm missing Saturday afternoon stuff.
Spoke with a psych resident saying he's getting offers in the 220-280k/year range. Kind of matches what I see on MGMA in the context of a new grad but we're also in a low paying region I think. Online people only ever seem to post about making 300+ on 40 hours/week. What's more typical?
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The median salary for a psychiatrist is about 275-280k. Thus half of psychiatrists make more than that, and half make less. Over 400k is going to be in the 90th percentile for psychiatrists. There are of course huge geographical differences and other variables. As I've said before, this forum tends to have the proverbial Schrödinger's psychiatrist who is losing his job to an NP freshly graduated from an online diploma mill while simultaneously earning a million a year working 10 hours a week.
That said, it is not hard to find jobs paying over 300k though will vary by market.
This is exactly why I stopped doing that job similar to the one listed. They paid $30 an hour or something to have you there. Which I am sorry my time is worth more to me than that.
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Thoughts on pay for an inpatient job...
1099, 12 patients, county hospital with good support, M-Th 32 hours a week, $230/hr. A lot of lower income patients which would qualify me for student loan repayment per a state sponsored program (not PSLF).
1099, 12 patients, county hospital with good support, M-Th 32 hours a week, $230/hr. A lot of lower income patients which would qualify me for student loan repayment per a state sponsored program (not PSLF).
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You would qualify even as a 1099?
D
deleted1150906
would you have to stay all 8 hours everyday? Or could you leave early once rounding is complete?
