It's this a permanent expectation or do you see things getting back to where they are now in 4-5 years?
Ok, so I think there are lots of scenarios, and I'll try to outline the best and the worst.
The best is that psychiatry salaries will take a hit for a limited time, i.e. a year or less. Possibly, programs that were planning to expand will postpone doing so.
The worst case scenario is that health systems that are hemorrhaging money right now (because the lose money on every COVID patient and aren't making money from elective surgeries and such), and when the dust settles they will be so far in the red that even with gov't bailouts they will be forced to either declare bankruptcy or cut services mercilessly. This will probably affect psychiatry because it tends to be a money-loser and isn't as bread and butter as internal medicine or primary care. The result will be that psychiatrists will have to go increasingly into private practice, which is not terrible in itself, but you'd have to find other private practices to join, and some of the ones currently in existence are small businesses that won't survive the crisis. I personally think that going into 100% solo private practice right out of residency is inappropriate and irresponsible. At the same time, many of the people who will need mental health care won't be able to access it due to massive unemployment. Some will be lucky enough to get on medicaid due to low income alone, but medicaid reimbusements and insurance payouts are hardly the same thing.
tl;dr paradoxically decreased demand due to unemployment, greater supply due to large health systems letting psychiatrists go and small private practice groups going out of business = lower salaries, more need to start your own private practice.
Why would you accept a job below the average salary?
I'm not accepting a below average salary now. I'm just saying I would if the field of psychiatry shrinks and/or there's a new, lower normal for psychiatry salaries in a couple of years.
Your skills are valuable and you should expect the best circumstances for yourself. The way you talk about yourself makes it sound like you are graduating from cashier school and are about to be crushed by the changing economic wind.
I live in fear that everything I've worked for will be taken away. It's a thing no one is really immune to, and if you have cataclysmic events in your life, you never really stop looking over your shoulder. The pandemic is just another reason for this fear to grow stronger. That, and the fact that now that I'll be out of residency, the buck will increasingly stop with me.
And I know that if my future employer ruptures the contract I probably didn't want to work for them anyway. To be clear, they've given no indication that anything about my job or my contract will change. I just don't know them directly yet and there's no guarantee that they are in fact trustworthy.
I didn’t say it was the norm, I said it wasn’t uncommon. From my friend group, probably 15-20%.
Rotating through off-service rotations when I was an intern, this was true for the IM, DM, and peds residents I ran into as well.
