How likely is it to make $375-400k in Psych?

[finalpsychyear]

Its funny, I would guess about 50% of people I knew as premeds truly considered going into medicine to be a calling or some higher purpose. Now just about everyone I know (residents, attendings especially non-academic ones) see it as what it truly is, a job. The point of a job is to provide yourself an income. Yes you should strive to do a good job, just as a pilot, an engineeer, an accountant, a lawyer, etc should. 1. Because its the right thing to do but 2. because if you don't you may not have a job for long. But none of those people view their jobs as callings to the extent that some imply that physicians should. Why is that?

There is some type of societal brainwashing at work that doctors care abt the patient first and nothing else really matters. That's played out great for whoever has pushed that narrative and less so for docs.

Also, being good at your job and one prioritizing money aren't related.

I can be a great cosmetic dermatologist doing 100% botox but if someone not established won't or can't pay it's OK to refuse service.

It's exactly this guilt tripping narrative that everyone has pushed that doctors as a whole are scrapping for scraps as a whole in the Healthcare industry when u compare their pay to the total industry.

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[FlowRate]

I wonder about the percentage of people with business/finance/CS degree that make 100-150k bestrewn the age of 23-30. My impression is that it might be only the top 10%.

I always go back to this.

The Top 1 Percent: What Jobs Do They Have?

Explore the occupations and industries of the nation's wealthiest households.

archive.nytimes.com

Isn't that wealth and not income? Tons of family money types in medicine. And also having lots of wealth enables being in other lower-paying careers (teachers.)

How many hours of actual work a week is required for 40 patient billable hours? I realize that there is other stuff like charting/insurance to deal with

Highly variable. I've never actually run my own private practice. But definitely stuff outside of patient appointments, even absent billing and what not, will take at least some time usually.

I love that graphic, but it's not really relevant to the discussion. That shows households in the 1% which is quite different than single earners, otherwise there's no way teachers would be the 5th highest career in the top 1 percenters. It's also talking about the top 1%, which is $400k/yr, very different from 100k/yr.

As above. Pretty sure it's referring to wealth and not income.

 

[Stagg737]

Thats why I applaud the psychiatrists who are seeing as many as 40,50, sometimes 80 patients per day. Thats called hustling

I'm all for hustling, but that kind of patient volume in psych is only reasonable if your patients are completely stable and just coming in for their med refill. Even then, 40/day is still something I'd never advocate for and higher than that is just a failed standard of care imo.

Isn't that wealth and not income? Tons of family money types in medicine. And also having lots of wealth enables being in other lower-paying careers (teachers.)

As above. Pretty sure it's referring to wealth and not income.

Maybe, would love to see the article again but I don't pay for news. I thought it was based on household income though. Idk how they could accurately determine actual net worth on a large scale like that...

 

[psychmd03]

Its funny, I would guess about 50% of people I knew as premeds truly considered going into medicine to be a calling or some higher purpose. Now just about everyone I know (residents, attendings especially non-academic ones) see it as what it truly is, a job. The point of a job is to provide yourself an income. Yes you should strive to do a good job, just as a pilot, an engineeer, an accountant, a lawyer, etc should. 1. Because its the right thing to do but 2. because if you don't you may not have a job for long. But none of those people view their jobs as callings to the extent that some imply that physicians should. Why is that?

I’d actually argue being good at your job can very easily create flywheel of more opportunities to make more money. So if you want to make more money focusing on doing a good job is a great way to do it. It’s how I’ve picked up all my work and turned down many more opportunities. I just slowly slide in be nice, work well with my team, treat my patients, don’t get complaints and slowly I have more offers for coverage. Then do a good job when I cover and all of a sudden someone else has some work etc etc. So for those that want to maximize their monetary opportunities they should for sure focus on doing a good job not just straight volume.

I'm all for hustling, but that kind of patient volume in psych is only reasonable if your patients are completely stable and just coming in for their med refill. Even then, 40/day is still something I'd never advocate for and higher than that is just a failed standard of care imo.

Or the very sick IP which make it very clear very quickly if you’re doing a good job or not.

 

[Splenda88]

I’d actually argue being good at your job can very easily create flywheel of more opportunities to make more money. So if you want to make more money focusing on doing a good job is a great way to do it. It’s how I’ve picked up all my work and turned down many more opportunities. I just slowly slide in be nice, work well with my team, treat my patients, don’t get complaints and slowly I have more offers for coverage. Then do a good job when I cover and all of a sudden someone else has some work etc etc. So for those that want to maximize their monetary opportunities they should for sure focus on doing a good job not just straight volume.

Or the very sick IP which make it very clear very quickly if you’re doing a good job or not.

The few hospitalists I know that are making > 500k are very good at their job.

I was a RN for ~8 years and based on my experience, there is a far higher % of nurses that go into nursing strictly for $$$ than physicians. The public love nurses and yet they dont like doctors.

 

[FlowRate]

Maybe, would love to see the article again but I don't pay for news. I thought it was based on household income though. Idk how they could accurately determine actual net worth on a large scale like that...

Good point. I did some digging. IPUMS is basically census data and does not have wealth information. There are sources for wealth information (Federal Reserve Survey of Consumer Finances), but I'm not sure if there's sufficient info in that survey to make the chart referenced and IPUMS is what they did reference in the chart. In other words, NYT was probably using the worth wealth semi-wrong in that infographic/article. Whereas they have used it more specifically in other pieces on distribution of income and distribution of wealth.

 

[MedMan80]

I'm a little frustrated at how little i am making, however i get solace in the lower hours i have to do at this PHP job. Once the kids are a little older I will venture my little feet into private practice..

 

[OMSWeebHours]

I'm a little frustrated at how little i am making, however i get solace in the lower hours i have to do at this PHP job. Once the kids are a little older I will venture my little feet into private practice..

what are the hours like? Tbh I wouldn't mind making on the relatively lower end if there's a lot more time

 

[MedMan80]

what are the hours like? Tbh I wouldn't mind making on the relatively lower end if there's a lot more time

30-40hr a week, more on the lower end

 

[OMSWeebHours]

30-40hr a week, more on the lower end

Sounds very good, my goal is to work a normal schedule eventually even if I have to put a bit more time in early on (probably not like the 80 hour weeks though, part of the reason I could never do surgery despite some procedures being interesting lol) and make less than other specialties (still being a physician pays pretty well regardless for the most part)

 

[finalpsychyear]

I'm a little frustrated at how little i am making, however i get solace in the lower hours i have to do at this PHP job. Once the kids are a little older I will venture my little feet into private practice..

Are you at least getting median pay for the field if you are full time hours?

 

[jbomba]

I’d actually argue being good at your job can very easily create flywheel of more opportunities to make more money. So if you want to make more money focusing on doing a good job is a great way to do it. It’s how I’ve picked up all my work and turned down many more opportunities. I just slowly slide in be nice, work well with my team, treat my patients, don’t get complaints and slowly I have more offers for coverage. Then do a good job when I cover and all of a sudden someone else has some work etc etc. So for those that want to maximize their monetary opportunities they should for sure focus on doing a good job not just straight volume.

Or the very sick IP which make it very clear very quickly if you’re doing a good job or not.

Fully agree with the top. I think what's even more, or the most important, is being likeable. I chat it up with everyone. I make everyone feel like I'm their friend. I've been told by medical directors, oh the nurses think you're great, which has led to more shifts being offered to me, better standing in their eyes, a referral to another job I am considering. I'm way less formal than all of my residency attendings were but it seems to resonate with staff and patients. This has been the best thing to get me in the door and patients continuing to come back.

Learning to network/schmooze is a great tool that will take you far. I did a bunch of this in my life before a change to medicine and it seems like it translates well. I think we (in medicine) hammer home professionalism and can get too worried about saying the wrong thing at times, which can come across as stiff to other people and patients. I'm sure I say stupid things or look like an idiot at times but overall this lower key approach has helped on the job/money front.

 

[MedMan80]

Are you at least getting median pay for the field if you are full time hours?

yup

 

[calvinhobbes]

Friend makes 450k inpatient child psych. Very possible just need to be willing to leave a bigger city

 

[EastSide]

If that is your goal look for an inpt role that has the ability to start early and end by 1-2pm and then scoot to your next afternoon gig be that locums, outpt or telehealth.

None of my attendings leave this early. Although I have read many anecdotal stories on attendings leaving after rounds (7a-1p), how common is this really? Specifically in the NE or the east coast.

Do you see this changing in the future as psych will become saturated and there would be fresh grads willing to work from 8-5pm?

 

[FlowRate]

None of my attendings leave this early. Although I have read many anecdotal stories on attendings leaving after rounds (7a-1p), how common is this really? Specifically in the NE or the east coast.

Do you see this changing in the future as psych will become saturated and there would be fresh grads willing to work from 8-5pm?

Most of my attendings were content with pretty cush inpatient gigs many of them got grandfathered into. They did low amounts of work and just hung around to be available if residents had any questions.

One of my attendings was, a little to his detriment, really interested in working hard. He did inpatient stuff in the morning and PHP/outpatient/substance use stuff in the afternoon. He was mostly not available except by brief call for inpatient related stuff after 1PM. Several other attendings at the other unit we worked at who also seemed to be much less available after around 2PM.

 

[Stagg737]

None of my attendings leave this early. Although I have read many anecdotal stories on attendings leaving after rounds (7a-1p), how common is this really? Specifically in the NE or the east coast.

Do you see this changing in the future as psych will become saturated and there would be fresh grads willing to work from 8-5pm?

Can't speak specifically to NE/east but in the midwest (and most places from those I've talked to) it's quite common. A typical FT inpatient load (<12 patients) should not take you significantly past noon unless you're doing a lot of therapy with them or are arriving late. Almost all the inpatient docs I talk with are either leaving well before 5pm (typically well before 3pm) or see higher patient volumes and get paid for it.

I don't see this changing unless the fresh grads are just unfocused or inefficient with their work or allow themselves to be abused. I actually speak directly with our PGY-3's and 4's about job expectations when I work with them.

 

[sloh]

Can't speak specifically to NE/east but in the midwest (and most places from those I've talked to) it's quite common. A typical FT inpatient load (
I don't see this changing unless the fresh grads are just unfocused or inefficient with their work or allow themselves to be abused. I actually speak directly with our PGY-3's and 4's about job expectations when I work with them.

What time do they get in and start rounding?

 

[Candidate2017]

None of my attendings leave this early. Although I have read many anecdotal stories on attendings leaving after rounds (7a-1p), how common is this really?

If your attending stays after rounds, here's a general rule of thumb: They're a lazy bum and/or dumb.

When you grow up, don't be a lazy or dumb attending. Go cover a 2nd unit or go to clinic. In medicine, we round on patients then leave (yes, contrary to popular belief, psych is part of medicine). Does IM or surgery hang around after rounding? No, they go to clinic or OR.

Please remember leaving the unit =/= done working. Notes, orders, admissions, answering calls and pages, catching up on sleep after being on call all night/all week (attendings do not have work hour restrictions), and sometimes floor/ED consults etc. are all part of post-round work. In a resident program, most of the work is handled by residents, hence if your attending is hanging around, they're a lazy bum.

Hanging around after rounding also encourages bad behavior from patients such as asking to talk with doctor yet again (e.g., argue) about why they don't need meds except for controlled substances, why they aren't manic, why they need to be discharged today. It also encourages bad behavior from nurses such as punting every patient request to the doctor instead of setting boundaries.

 

[comp1]

So as you're probably all aware, the VA has tours of duty. You stay (or are immediately available by telehealth) during your tour of duty. For outpatient, it's pretty clear as they schedule patients during your tour of duty. It can be a bit disorienting for people coming from inpatient in other systems because you also still...stay during your tour of duty. Good managers will spread meetings throughout the day so that you're productive the whole time. They'll have med floor or ED consults built in so that you aren't just seeing inpatients and the flow is a bit more variable. I do agree that nurses setting boundaries is really important and it's also really important to not always run to them whenever a patient asks to see you. However, the tour of duty setup allows you to really help educate both nurses and other medical specialties about how to handle things themselves throughout the day. My main point is that sometimes attendings are actually being paid to stay after rounds.

 

[sloh]

So as you're probably all aware, the VA has tours of duty. You stay (or are immediately available by telehealth) during your tour of duty. For outpatient, it's pretty clear as they schedule patients during your tour of duty. It can be a bit disorienting for people coming from inpatient in other systems because you also still...stay during your tour of duty. Good managers will spread meetings throughout the day so that you're productive the whole time. They'll have have consults built in so that you aren't just seeing inpatients and the flow is a bit more variable. I do agree that nurses setting boundaries is really important and it's also really important to not always run to them whenever a patient asks to see you. However, the tour of duty setup allows you to really help educate both nurses and other medical specialties about how to handle things themselves throughout the day. My main point is that sometimes attendings are actually being paid to stay after rounds.

Parkinson’s Law: work expands to fill the time available for its completion.

 

[comp1]

Parkinson’s Law: work expands to fill the time available for its completion.

Eh, plus/minus in government. It really has to deal with how well the manager manages things.

 

[brosa]

At my place attendings cannot leave after rounding. They have to stay till 4pm. It does not really matter because there is a no compete, so people cannot work at other places anyway.

 

[psychmd03]

At my place attendings cannot leave after rounding. They have to stay till 4pm. It does not really matter because there is a no compete, so people cannot work at other places anyway.

Why would anyone take a job like that? A non complete plus making you stay all day to twiddle your thumbs while losing out on a chance to make a good chunk more money or pick up a hobby.

 

[TexasPhysician]

Why would anyone take a job like that? A non complete plus making you stay all day to twiddle your thumbs while losing out on a chance to make a good chunk more money or pick up a hobby.

You’d be surprised. This is relatively common. People are willing to read or relax at work to keep an easier gig.

 

[Bartelby]

You’d be surprised. This is relatively common. People are willing to read or relax at work to keep an easier gig.

Agreed. Let's say you make $300k to work an 8-4 job where you do high-quality work, have time to spare, and virtually never stay late or find the work you need to do spilling outside of the bounds of work. You can also do CME, literature reviews, just relaxing, whatever you'd like aside from paid work during that time. Doesn't seem too terrible to me.

Some people are going to insist on working as hard as possible to make much more, but if you can be happy with a typical salary this kind of setup isn't bad.

 

[SmallBird]

Agreed. Let's say you make $300k to work an 8-4 job where you do high-quality work, have time to spare, and virtually never stay late or find the work you need to do spilling outside of the bounds of work. You can also do CME, literature reviews, just relaxing, whatever you'd like aside from paid work during that time. Doesn't seem too terrible to me.

Some people are going to insist on working as hard as possible to make much more, but if you can be happy with a typical salary this kind of setup isn't bad.

But I think the best option is to find a setup that is as you say but where they don’t really mind if you leave early to go relax. I get very antsy by 2pm and this is a great time to go and telework.

 

[finalpsychyear]

Agreed. Let's say you make $300k to work an 8-4 job where you do high-quality work, have time to spare, and virtually never stay late or find the work you need to do spilling outside of the bounds of work. You can also do CME, literature reviews, just relaxing, whatever you'd like aside from paid work during that time. Doesn't seem too terrible to me.

Some people are going to insist on working as hard as possible to make much more, but if you can be happy with a typical salary this kind of setup isn't bad.

I can't wait to work those hours 4 days a week in about 5 years as I gradually sunset into scaling back ideally most from home. Glad i started more intense it's tough to do it the other way imo.

 

[Merovinge]

Agreed. Let's say you make $300k to work an 8-4 job where you do high-quality work, have time to spare, and virtually never stay late or find the work you need to do spilling outside of the bounds of work. You can also do CME, literature reviews, just relaxing, whatever you'd like aside from paid work during that time. Doesn't seem too terrible to me.

Some people are going to insist on working as hard as possible to make much more, but if you can be happy with a typical salary this kind of setup isn't bad.

Absolutely, this is very common for hospitalists who cannot leave until swing shift takes over, but are often done with work and either waiting for an admission or just hanging out in case of emergency. One of my good friends has a job that is basically exactly what you just described and he's certainly happy with his career.

 

[Marasmus1]

Agreed. Let's say you make $300k to work an 8-4 job where you do high-quality work, have time to spare, and virtually never stay late or find the work you need to do spilling outside of the bounds of work. You can also do CME, literature reviews, just relaxing, whatever you'd like aside from paid work during that time. Doesn't seem too terrible to me.

Some people are going to insist on working as hard as possible to make much more, but if you can be happy with a typical salary this kind of setup isn't bad.

That`s me except that I make low 200s (however, moonlighting here and there brings it to 260k). Full time Outpatient Psych. On average, I see 1 to 2 patients a day. Rest of the time is divided by research, teaching at med school, teaching resident and fellow didactics and individual supervision with fellows. I opted myself out of the admin work other than once a month departmental faculty meeting. No admin oversight. Whether I teach or research completely depends on me on that particular week as long as I stay scholarly productive and residents like me. On top of that I use 9 weeks of PTO annually.

It is all about perspective I believe. Some may find this setup laziness and being dumb. I would not exchange it with any commercially posted jobs

 

[calvnandhobbs68]

That`s me except that I make low 200s (however, moonlighting here and there brings it to 260k). Full time Outpatient Psych. On average, I see 1 to 2 patients a day. Rest of the time is divided by research, teaching at med school, teaching resident and fellow didactics and individual supervision with fellows. I opted myself out of the admin work other than once a month departmental faculty meeting. No admin oversight. Whether I teach or research completely depends on me on that particular week as long as I stay scholarly productive and residents like me. On top of that I use 9 weeks of PTO annually.

It is all about perspective I believe. Some may find this setup laziness and being dumb. I would not exchange it with any commercially posted jobs

Ha I mean I'd take 200K to see 1-2 patients a day and give lectures, I don't think any of the academic jobs I've known of are anywhere near that though.

 

[Stagg737]

Why would anyone take a job like that? A non complete plus making you stay all day to twiddle your thumbs while losing out on a chance to make a good chunk more money or pick up a hobby.

Keep in mind the person you're responding to is still a resident. Their academic attendings may have other responsibilities outside of patient care (research, teaching, committees, etc) that they fill that time with (I do). I agree that for a private job that policy sucks, but academia is different.

That`s me except that I make low 200s (however, moonlighting here and there brings it to 260k). Full time Outpatient Psych. On average, I see 1 to 2 patients a day. Rest of the time is divided by research, teaching at med school, teaching resident and fellow didactics and individual supervision with fellows. I opted myself out of the admin work other than once a month departmental faculty meeting. No admin oversight. Whether I teach or research completely depends on me on that particular week as long as I stay scholarly productive and residents like me. On top of that I use 9 weeks of PTO annually.

It is all about perspective I believe. Some may find this setup laziness and being dumb. I would not exchange it with any commercially posted jobs

I remember when you were posting looking for advice about this position. Glad it worked out for you and that you're enjoying it so much.

 

[brosa]

Keep in mind the person you're responding to is still a resident. Their academic attendings may have other responsibilities outside of patient care (research, teaching, committees, etc) that they fill that time with (I do). I agree that for a private job that policy sucks, but academia is different.


I remember when you were posting looking for advice about this position. Glad it worked out for you and that you're enjoying it so much.

That is correct, although most of the people in my hospital don't do research. Teaching may be like 1h a month or something. Random meetings and committees yes. People mostly get the job because they are fresh-grad or they are from a different state and have zero networking around here. Almost everyone falls into one of these two categories.

 

[Merovinge]

That`s me except that I make low 200s (however, moonlighting here and there brings it to 260k). Full time Outpatient Psych. On average, I see 1 to 2 patients a day. Rest of the time is divided by research, teaching at med school, teaching resident and fellow didactics and individual supervision with fellows. I opted myself out of the admin work other than once a month departmental faculty meeting. No admin oversight. Whether I teach or research completely depends on me on that particular week as long as I stay scholarly productive and residents like me. On top of that I use 9 weeks of PTO annually.

It is all about perspective I believe. Some may find this setup laziness and being dumb. I would not exchange it with any commercially posted jobs

Assuming you are doing real research that is pushing forward clinical medicine and take seriously the job of training the next generation of psychiatrists, anyone calling you lazy is a f***ing idiot.

Lazy is working for an insurance company denying claims to give people the care they need to live and recover from mental illness. Clinical research is the bedrock that I rely upon to take care of patients all day and I appreciate every MD, PhD, research assistant, nurse, grant writer, journal editor, and everyone else involved in the process.

 

[Candidate2017]

It is all about perspective I believe. Some may find this setup laziness and being dumb. I would not exchange it with any commercially posted jobs

Looks like my "lazy and dumb" comment has taken a life of its own. To clarify, I'm responding regarding the resident's attendings:

Residents are doing most/all of the work, and if their attendings are just sitting around post-rounds instead of actually doing something (clinic, research, golf), that is kind of lazy.

OTOH if a community doc can get a chill gig, then that's pretty smart because it frees you up to purse other activities you may enjoy, which may or may not involve psychiatry, additional jobs, or other monetary pursuits.

At my place attendings cannot leave after rounding. They have to stay till 4pm. It does not really matter because there is a no compete, so people cannot work at other places anyway.

Physicians traditionally round at hospitals then leave, but remain available by pager. Unfortunately, a number of psychiatrists believe taking up the yoke of employed status is nice. But as an employee, you may need to punch the clock. However, I guarantee your CMO and CEO enjoy long lunches outside the hospital as well as afternoons golfing. Heck, go ahead and invite them out on your dime. While they're out lunching and golfing with you, none of them will ask why you aren't still at the hospital.

Also, non-competes are dumb. They wouldn't exist if enough physicians said no.

 

[calvinhobbes]

Child psych pays that, can do mix of outpatient and inpatient and clear 400k easily

 

[Trismegistus4]

Residents are doing most/all of the work, and if their attendings are just sitting around post-rounds instead of actually doing something (clinic, research, golf), that is kind of lazy.

While I think I kind of understand what you are getting at, I don't think "lazy" is the right word. If somebody went out and played golf instead of sitting in their office twiddling their thumbs, that wouldn't be lazy? What if instead they went home and played video games, would that be lazy?

 

[Ellomate]

Very likely. I have several long term 1099 jobs. They all pay 250/hour or more. Some of these jobs I can do at the same time (cover inpatient unit for 8 hours and take outpatients in the afternoon) so I can double up. I should make 600k a year working 45 hours a week.

since all 1099, what does the 600k come out to after all taxes/insurance/etc

 

[brosa]

Why would anyone take a job like that? A non complete plus making you stay all day to twiddle your thumbs while losing out on a chance to make a good chunk more money or pick up a hobby.

Not that many options in the city, and most other places also have a non compete or similar work.

Btw, for people who are making bank, could y'all share how you were able to find those opportunities?

I will likely sign with Talkiatry, since they dropped their non compete, but here is what I have tried so far:

Account on indeed, DocCafe, and Practice Link. All with updated CV, which contains my email and phone number. I also open the sites and check the jobs available from time to time. I answer all recruiters email telling that I am seeking a remote position.

So far I did some calls with major chains, that did not appear very good, and some random private practices that had horrible job. Someone offered me 220k lol.

Not sure what I am missing, I cant comprehend how people are making 600-700k with the same specialty that I am having a hard time finding something on the 300s.

 

[Crayola227]

Not that many options in the city, and most other places also have a non compete or similar work.

Btw, for people who are making bank, could y'all share how you were able to find those opportunities?

I will likely sign with Talkiatry, since they dropped their non compete, but here is what I have tried so far:

Account on indeed, DocCafe, and Practice Link. All with updated CV, which contains my email and phone number. I also open the sites and check the jobs available from time to time. I answer all recruiters email telling that I am seeking a remote position.

So far I did some calls with major chains, that did not appear very good, and some random private practices that had horrible job. Someone offered me 220k lol.

Not sure what I am missing, I cant comprehend how people are making 600-700k with the same specialty that I am having a hard time finding something on the 300s.

Talkiatry is about the dumbest gimmicky name I've heard in a long time

I dunno man, I know some people figure out all kinds of ways to make bank in various specialties, but if it's far off the average, then, it isn't average. I never thought psych was something for most people to go into if they wanted to make a lot of money relative to other docs. The lifestyle part of the specialty was always in the hours, not the pay. A lot of docs and specialties are in the mid 250s for pay.

I hope someone better than me can show you how

 

[icysky]

Not that many options in the city, and most other places also have a non compete or similar work.

Btw, for people who are making bank, could y'all share how you were able to find those opportunities?

I will likely sign with Talkiatry, since they dropped their non compete, but here is what I have tried so far:

Account on indeed, DocCafe, and Practice Link. All with updated CV, which contains my email and phone number. I also open the sites and check the jobs available from time to time. I answer all recruiters email telling that I am seeking a remote position.

So far I did some calls with major chains, that did not appear very good, and some random private practices that had horrible job. Someone offered me 220k lol.

Not sure what I am missing, I cant comprehend how people are making 600-700k with the same specialty that I am having a hard time finding something on the 300s.

What region are you located in? Are you a US citizen?

Honestly, networking is how you’ll find the good or unicorn jobs. Most jobs posted on those sites are likely ones that can’t fill, and/or usually have strings attached to them or paid too low. Might want to go to some local chapter meetings and talk to some nice attendings and see if they know of any opportunities. I found my jobs or side gigs through networking.

 

[TexasPhysician]

Not that many options in the city, and most other places also have a non compete or similar work.

Btw, for people who are making bank, could y'all share how you were able to find those opportunities?

I will likely sign with Talkiatry, since they dropped their non compete, but here is what I have tried so far:

Account on indeed, DocCafe, and Practice Link. All with updated CV, which contains my email and phone number. I also open the sites and check the jobs available from time to time. I answer all recruiters email telling that I am seeking a remote position.

So far I did some calls with major chains, that did not appear very good, and some random private practices that had horrible job. Someone offered me 220k lol.

Not sure what I am missing, I cant comprehend how people are making 600-700k with the same specialty that I am having a hard time finding something on the 300s.

Few problems with your strategy:

1. You want an all remote job. Remote psychiatrists are not in-demand for patient care compared to in-person. The vast majority of pharmacies in my major metro area are already enforcing Ryan Haight despite the federal exemption. Some even have a filling radius now. A patient 60 miles away has to drive 10 miles closer to pick up his Rx because pharmacies near him require the physician to be within 50 miles for controlled meds to easily enforce RH. If someone applies for a job with me (I don’t list jobs), I automatically decline to interview if they are wanting remote. Most better paying private practice jobs will require some in person because of these pharmacy issues. Otherwise we are spending $$ to recruit patients that we will lose.

2. You are searching with recruiters and PracticeLink. This is how the worst of the worst jobs generally recruit. They prefer to search high and low for desperate psychiatrists that will accept less pay and pay recruiters more to find them. They hope the psychiatrist gets lazy and sticks around for less $$. It works sometimes. The best jobs never need to use recruiters or postings. They network and call who they want.

3. Most here aren’t earning $600K+ with 1 job. It is about being efficient with multiple jobs. When I am in-person at clinic, there will end up being no-shows or easy patients that free up time. Instead of watching tv or whatever others do when bored, I hop on a fully remote job I have (doesn’t involve seeing patients) or a partially remote job that I have and log time there. No one cares that I’m doing multiple jobs simultaneously as long as I produce good work. These remote PT jobs are only sticking with me because they are flexible. They don’t pay as well as my in-person work. If those jobs went in-person or required set hours, I’d hand in my resignation immediately. These weren’t jobs ever listed online either.

4. I don’t work as an “employee” ever. It is my business all around or I’m a contractor. I want the better tax deductions, and I want control to maximize revenue for me. Employee jobs have less stress/management at the expense of everything else. I consider employee jobs to be retirement type jobs. When I left fellowship, I told one potential employer (they offered me a position) that I would take this 1 job they had (psychiatrist was planning to retire within 2 years). They understandably said that the older psychiatrist (with many health issues) still had that job, and they couldn’t guarantee that I would be chosen for that role when he retired. It was essentially 3 clinical hours/day for FT. The other positions they had didn’t match that awesomeness. I passed, and have not been an employee since fellowship.

 

[brosa]

What region are you located in? Are you a US citizen?

Honestly, networking is how you’ll find the good or unicorn jobs. Most jobs posted on those sites are likely ones that can’t fill, and/or usually have strings attached to them or paid too low. Might want to go to some local chapter meetings and talk to some nice attendings and see if they know of any opportunities. I found my jobs or side gigs through networking.

South Central. I am not a US citizen, but I am not on a J1. I am in a very unique position where I need a remote job for a while, before I am able to relocate tho. That seems to be the major issue, but even without that the local jobs don't seem good and I can't relocate anyway.

Few problems with your strategy:

1. You want an all remote job. Remote psychiatrists are not in-demand for patient care compared to in-person. The vast majority of pharmacies in my major metro area are already enforcing Ryan Haight despite the federal exemption. Some even have a filling radius now. A patient 60 miles away has to drive 10 miles closer to pick up his Rx because pharmacies near him require the physician to be within 50 miles for controlled meds to easily enforce RH. If someone applies for a job with me (I don’t list jobs), I automatically decline to interview if they are wanting remote. Most better paying private practice jobs will require some in person because of these pharmacy issues. Otherwise we are spending $$ to recruit patients that we will lose.

2. You are searching with recruiters and PracticeLink. This is how the worst of the worst jobs generally recruit. They prefer to search high and low for desperate psychiatrists that will accept less pay and pay recruiters more to find them. They hope the psychiatrist gets lazy and sticks around for less $$. It works sometimes. The best jobs never need to use recruiters or postings. They network and call who they want.

3. Most here aren’t earning $600K+ with 1 job. It is about being efficient with multiple jobs. When I am in-person at clinic, there will end up being no-shows or easy patients that free up time. Instead of watching tv or whatever others do when bored, I hop on a fully remote job I have (doesn’t involve seeing patients) or a partially remote job that I have and log time there. No one cares that I’m doing multiple jobs simultaneously as long as I produce good work. These remote PT jobs are only sticking with me because they are flexible. They don’t pay as well as my in-person work. If those jobs went in-person or required set hours, I’d hand in my resignation immediately. These weren’t jobs ever listed online either.

4. I don’t work as an “employee” ever. It is my business all around or I’m a contractor. I want the better tax deductions, and I want control to maximize revenue for me. Employee jobs have less stress/management at the expense of everything else. I consider employee jobs to be retirement type jobs. When I left fellowship, I told one potential employer (they offered me a position) that I would take this 1 job they had (psychiatrist was planning to retire within 2 years). They understandably said that the older psychiatrist (with many health issues) still had that job, and they couldn’t guarantee that I would be chosen for that role when he retired. It was essentially 3 clinical hours/day for FT. The other positions they had didn’t match that awesomeness. I passed, and have not been an employee since fellowship.

I appreciate the words. I understand that the remote requirement is my major issue. I am also aware that the jobs that ended up on Practice Link are not the best ones around, although that is pretty much what I have been able to find. I have not find any value in attending input since it is a cycle. People graduate -> go into academia with no experience in other jobs -> only know academia. I don't have attendings with private practice or locums experience, for example. I see that as a silver lining tho, since people who go private don't tend to look back.

I have been looking for alternative routes, which has been slow and almost useless, but found out that Talkiatry dropped their non compete so I may join them. I am also aware I will have this issue again once I relocate, so I want to be as prepared as possible.

Btw I did not do psych for the money, but things are so expensive nowadays that it seems impossible not to worry about it lol

 

[MusicDOc124]

I make $375 base. I get paid extra for call, which I cover 1 weekend per month. Adds up to about an extra $40k/year. I receive an annual bonus of up to $25k. Last few years, every received whole 25k. I expect the minimum I may receive if ever not getting the full amount is still about $15k.

I expect $425-430k this year. This is 1 position, W-2, inpatient with 30-32 clinical hours, 8-10 admin/academic hours. I have med students, residents, and fellows on my service. Most patients I've had in 1 day is 14. Least has been 6. I typically have 11-13 patients on my unit. I'm inpatient in northeast near big metro areas, but not in the metro itself. No active supervision of NPPs either. It's possible (by request) for 1 when my service goes over 15. Max for my unit is 20.

I have a private gig on the side plus other ventures that will get me to between 6-700k this year.

 

[Splenda88]

The few hospitalists I know that are making > 500k are very good at their job.

I was a RN for ~8 years and based on my experience, there is a far higher % of nurses that go into nursing strictly for $$$ than physicians. The public love nurses and yet they dont like doctors.

This is still true after 3 years working as a hospitalist

People think physicians are a bunch of aloof individuals

 

[FlowRate]

South Central. I am not a US citizen, but I am not on a J1. I am in a very unique position where I need a remote job for a while, before I am able to relocate tho. That seems to be the major issue, but even without that the local jobs don't seem good and I can't relocate anyway.



I appreciate the words. I understand that the remote requirement is my major issue. I am also aware that the jobs that ended up on Practice Link are not the best ones around, although that is pretty much what I have been able to find. I have not find any value in attending input since it is a cycle. People graduate -> go into academia with no experience in other jobs -> only know academia. I don't have attendings with private practice or locums experience, for example. I see that as a silver lining tho, since people who go private don't tend to look back.

I have been looking for alternative routes, which has been slow and almost useless, but found out that Talkiatry dropped their non compete so I may join them. I am also aware I will have this issue again once I relocate, so I want to be as prepared as possible.

Btw I did not do psych for the money, but things are so expensive nowadays that it seems impossible not to worry about it lol

Are there local psych or multispecialty group practices or health systems with psych service lines? Even if they don't have jobs posted, figure out their HR or Psych dept contact numbers and give them a call. (That is, if local non-remote is viable for you. Same for when you want to move to a new region.)

 

[drechie]

I make $375 base. I get paid extra for call, which I cover 1 weekend per month. Adds up to about an extra $40k/year. I receive an annual bonus of up to $25k. Last few years, every received whole 25k. I expect the minimum I may receive if ever not getting the full amount is still about $15k.

I expect $425-430k this year. This is 1 position, W-2, inpatient with 30-32 clinical hours, 8-10 admin/academic hours. I have med students, residents, and fellows on my service. Most patients I've had in 1 day is 14. Least has been 6. I typically have 11-13 patients on my unit. I'm inpatient in northeast near big metro areas, but not in the metro itself. No active supervision of NPPs either. It's possible (by request) for 1 when my service goes over 15. Max for my unit is 20.

I have a private gig on the side plus other ventures that will get me to between 6-700k this year.

Can I PM you?

 

[MusicDOc124]

Can I PM you?

Sure!

 

[psychmd03]

Not that many options in the city, and most other places also have a non compete or similar work.

Btw, for people who are making bank, could y'all share how you were able to find those opportunities?

I will likely sign with Talkiatry, since they dropped their non compete, but here is what I have tried so far:

Account on indeed, DocCafe, and Practice Link. All with updated CV, which contains my email and phone number. I also open the sites and check the jobs available from time to time. I answer all recruiters email telling that I am seeking a remote position.

So far I did some calls with major chains, that did not appear very good, and some random private practices that had horrible job. Someone offered me 220k lol.

Not sure what I am missing, I cant comprehend how people are making 600-700k with the same specialty that I am having a hard time finding something on the 300s.

Personally I have two jobs both inpatient both flexible. Though at one I do generate the numbers you’re talking about actually more. But I work most days of the month and do extra coverage for others when they are off.

Both hospitals are set up to cater to docs that don’t stick around. So lots of communication via secure text/chat (phone calls for some but I hate calls so they all text for me). So the set up has to be right to make it work as well. I feel quite lucky to have what I do so I have a hustle hard now mentality and if these jobs go away at least I milked them plus got the compounding snow ball rolling early.

 

[Psych19]

I make $375 base. I get paid extra for call, which I cover 1 weekend per month. Adds up to about an extra $40k/year. I receive an annual bonus of up to $25k. Last few years, every received whole 25k. I expect the minimum I may receive if ever not getting the full amount is still about $15k.

I expect $425-430k this year. This is 1 position, W-2, inpatient with 30-32 clinical hours, 8-10 admin/academic hours. I have med students, residents, and fellows on my service. Most patients I've had in 1 day is 14. Least has been 6. I typically have 11-13 patients on my unit. I'm inpatient in northeast near big metro areas, but not in the metro itself. No active supervision of NPPs either. It's possible (by request) for 1 when my service goes over 15. Max for my unit is 20.

I have a private gig on the side plus other ventures that will get me to between 6-700k this year.

At that total income... you ever question whether it's worth it to work those weekends, given I'm guessing your total marginal tax rate has to be North of 50% on the extra $40k/year? Or are the weekends mandatory for this gig?