How to make money in psychiatry

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sluox said:
100% this. Tho, one could argue that you can brute force it by working 100000 hours a week at $150 an hour, which is why I wanted his CV.
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You can just pick up 2 inpatient gigs paying 300k a piece and make 600k, it’s not rocket science but does require commitment and hard work and arguably substandard care
 
robellis said:
You can just pick up 2 inpatient gigs paying 300k a piece and make 600k, it’s not rocket science but does require commitment and hard work and arguably substandard care
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Right, you mean work 40 hours at one facility, then at night/weekend go work for a different facility for overnight coverage. Rinse repeat several days a week. Yup. That's what I would have recommended if his CV was judged "below average". Ironically you'd probably still be working less than your typical private surgeon or cardiologist if you are efficient.
 
sluox said:
Right, you mean work 40 hours at one facility, then at night/weekend go work for a different facility for overnight coverage. Rinse repeat several days a week. Yup. That's what I would have recommended if his CV was judged "below average". Ironically you'd probably still be working less than your typical private surgeon or cardiologist if you are efficient.
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Full-time inpatient work does not always equal 40 hours at one facility, there were a plethora of old-school docs doing this before and still plenty doing it now. I trained in fellowship with a guy working 2 FT inpatient and having his own outpatient and now know a guy in my new city working >3 FTE jobs. There's even a few docs I know working essentially two full-time jobs at the same hospital (e.g. seeing 35 pts/day).

I recommend against any of the above and don't think any of these individuals provide the same level of care as doctor's working reasonable case loads, but it's certainly still very doable in the field.
 
Private practice concierge clinics!!

A group of grads near my area started a group practice and charge *deep breath* $2000 a pop for child/adolescent evals. They have a waitlist. All my friends who charge 600+ an hour have no end to their list as well. 🙀
 
Merovinge said:
Full-time inpatient work does not always equal 40 hours at one facility, there were a plethora of old-school docs doing this before and still plenty doing it now. I trained in fellowship with a guy working 2 FT inpatient and having his own outpatient and now know a guy in my new city working >3 FTE jobs. There's even a few docs I know working essentially two full-time jobs at the same hospital (e.g. seeing 35 pts/day).

I recommend against any of the above and don't think any of these individuals provide the same level of care as doctor's working reasonable case loads, but it's certainly still very doable in the field.
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Does one hold down two inpatient gigs by simply rounding on one unit then going to another later in the day? I'm guessing guys doing this are pulling in 500k+?
 
Psychresy said:
Does one hold down two inpatient gigs by simply rounding on one unit then going to another later in the day? I'm guessing guys doing this are pulling in 500k+?
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The person I know of in my area who does this goes to one unit in the morning and the other in the afternoon. Easily doable for smaller units/patient loads (<8 patients) if you have someone assisting with notes or intakes, but again depends on the standard of care you're holding yourself to.
 
Psychresy said:
Does one hold down two inpatient gigs by simply rounding on one unit then going to another later in the day? I'm guessing guys doing this are pulling in 500k+?
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While not good care, I have met someone that rounds at 2 hospitals before lunch and then does outpatient in the afternoon.
 
TexasPhysician said:
While not good care, I have met someone that rounds at 2 hospitals before lunch and then does outpatient in the afternoon.
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That seems like a bit much, but rounding on 12-14 in the morn and in the afternoon seems pretty doable. If you could somehow negotiate Fridays off I feel like three day weekends would definitely leave me recharged enough to do this.
 
Psychresy said:
That seems like a bit much, but rounding on 12-14 in the morn and in the afternoon seems pretty doable. If you could somehow negotiate Fridays off I feel like three day weekends would definitely leave me recharged enough to do this.
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If I understand him correctly, the person is rounding at two different hospitals in the morning and then doing outpatient in the afternoon.
 
reca said:
If I understand him correctly, the person is rounding at two different hospitals in the morning and then doing outpatient in the afternoon.
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Yeah that's what it sounds like. That's a bit too much imo, but without the outpatient clinic seems doable
 
psyguru said:
I get referrals for a wide variety of cases nationwide from FFD, med mal, PI, will contest, competency to stand trial, NGRI, capital mitigation, medical board cases, court-martials, TBI cases, fear of imminent death, immigration cases, etc.
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You're forensics, right? Could someone without forensics fellowship do these types of evals?
 
Monocles said:
Private practice concierge clinics!!

A group of grads near my area started a group practice and charge *deep breath* $2000 a pop for child/adolescent evals. They have a waitlist. All my friends who charge 600+ an hour have no end to their list as well. 🙀
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Wow 2K for a C&A eval and they have a waitlist as new grads? How did they advertise? That's insane.
 
Mass Effect said:
Wow 2K for a C&A eval and they have a waitlist as new grads? How did they advertise? That's insane.
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6 MDs and all their rates are

  • 120 minute initial evaluation: $2,000
  • 30 minute medication management and supportive therapy: $500
  • 50 minute medication management and therapy: $1,000
  • 50 minute coaching session: $1,000

Fees — Hartselle & Associates

Luxury care in a private pay setting.
www.hartselleandassociates.com www.hartselleandassociates.com

Not here to comment or cast judgement on the ethics of charging premium blah blah, but they are certainly on the right side of the market curve! 😲
 
Monocles said:
6 MDs and all their rates are

  • 120 minute initial evaluation: $2,000
  • 30 minute medication management and supportive therapy: $500
  • 50 minute medication management and therapy: $1,000
  • 50 minute coaching session: $1,000

Fees — Hartselle & Associates

Luxury care in a private pay setting.
www.hartselleandassociates.com www.hartselleandassociates.com

Not here to comment or cast judgement on the ethics of charging premium blah blah, but they are certainly on the right side of the market curve! 😲
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I don't think I'll ever have any guilt about raising my fees again!
 
Monocles said:
6 MDs and all their rates are

  • 120 minute initial evaluation: $2,000
  • 30 minute medication management and supportive therapy: $500
  • 50 minute medication management and therapy: $1,000
  • 50 minute coaching session: $1,000

Fees — Hartselle & Associates

Luxury care in a private pay setting.
www.hartselleandassociates.com www.hartselleandassociates.com

Not here to comment or cast judgement on the ethics of charging premium blah blah, but they are certainly on the right side of the market curve! 😲
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Holy crap

I can kinda see what happened though they’re all on faculty at Brown and looks like they had/have their day jobs there initially. So have that stable initial income while this gets built up and the pedigree/referral base.
 
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They are not the only practice doing this. It’s not like brown pays a lot.
 
I'm guessing this type of thing would be much more difficult without ties to an academic center serving as referral base?
 
What would you consider the "sweet spot" in terms of hours worked and salary in the context of taxes, given that the difference between 400k salary and a Million comes out to 200k in some states. I imagine that it would look like 30-40 hours a week for 400k. Or are these considered typical.
 
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NeuroKlitch said:
What would you consider the "sweet spot" in terms of hours worked and salary in the context of taxes, given that the difference between 400k salary and a Million comes out to 200k in some states. I imagine that it would look like 30-40 hours a week for 400k. Or are these considered typical.
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What states are you paying 67% tax on income between $400,00 and 1 million?

Fl just looked this up and fwiw the difference in Calif is 300k. although this is with no deductions. I would imagine at $1 million a year you would have a good accountant who could find ways to deduct or defer certain things.
 
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Monocles said:
6 MDs and all their rates are

  • 120 minute initial evaluation: $2,000
  • 30 minute medication management and supportive therapy: $500
  • 50 minute medication management and therapy: $1,000
  • 50 minute coaching session: $1,000

Fees — Hartselle & Associates

Luxury care in a private pay setting.
www.hartselleandassociates.com www.hartselleandassociates.com

Not here to comment or cast judgement on the ethics of charging premium blah blah, but they are certainly on the right side of the market curve! 😲
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What exactly is coaching?
 
Psychresy said:
I'm guessing this type of thing would be much more difficult without ties to an academic center serving as referral base?
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Don't academic centers have something in your contract that you shouldn't be doing that though? I know some academic centers don't even allow you to have a PP outside of their own faculty-run PP.
 
Mass Effect said:
Don't academic centers have something in your contract that you shouldn't be doing that though? I know some academic centers don't even allow you to have a PP outside of their own faculty-run PP.
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Depending on the region I guess. A lot of northeast psych programs actually encourage this so they can pay less in their academic salaries.

"The only full-time psychiatrists at Harvard are ones bad at math" 🤣
 
Monocles said:
Depending on the region I guess. A lot of northeast psych programs actually encourage this so they can pay less in their academic salaries.

"The only full-time psychiatrists at Harvard are ones bad at math" 🤣
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So the thinking is they work enough for the clout and then have a PP on the days they're not there? And they funnel patients to the PP from the work they do during the week? How much does Harvard pay anyway?
 
Yeah, they should take this down. Most places just don't put their fees up for all to see.
 
Techmed07 said:
Yeah, they should take this down. Most places just don't put their fees up for all to see.
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There are plenty of places that put up their fees for all to see. I'd say it's about 50/50 if you look at the private practices and psychologytoday in my area. If it was having a significant drain on the ability to recruit patients, I don't think they'd have a waiting list.
 
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PSS. did you do a fellowship in forensic psychiatry to do legal work?
 
blazing said:
Oh wow. you guys are awesome. I didn't think I would have so many responses. For some reason I didn't get any alerts when a response came through. FYI, some of my cardiology and ortho friends get offers of 500 K and above. That's what I want to aim for. I am willing to work hard but I don't know if that's achievable as a psychiatrist. I am wondering if I should apply for pain management fellowship. What about becoming a hospital administrator and slowly working up to become a CEO. Some of you guys talked about starting private practice or doing legal consults. It can be lucrative but will definitely take time to build such practice. No one is gonna flock to you on the first day. How am I gonna afford to eat expensive sushi when I only have one patient show up to my private practice on the first day. Again I am willing to put in the hours just wondering which pathway has the least resistance to make at least 500K. Thanks for reading you guys are awesome!!!!

PS. I didn't realize there was a second page now. I don't know how you can work inpatient during the day and cover nights. How do you sleep? I want to make money but I want to get enough sleep so I can provide good care the next day. As far as rounding in two hospitals, who is gonna do cross over or if a patient gets violent on the floor. Would you feel comfortable with NP doing crossover calls if a patient gets violent.

Someone asked about my CV. I don't know why that matters. It's not like a hospital is gonna pay you more for going to Harvard. FYI, I went to a top 20 meds school but is attending a small town/rural university program.
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You seem pretty fixated on a very high salary. Why do you want to psychiatry?
 
blazing said:
Oh wow. you guys are awesome. I didn't think I would have so many responses. For some reason I didn't get any alerts when a response came through. FYI, some of my cardiology and ortho friends get offers of 500 K and above. That's what I want to aim for. I am willing to work hard but I don't know if that's achievable as a psychiatrist. I am wondering if I should apply for pain management fellowship. What about becoming a hospital administrator and slowly working up to become a CEO. Some of you guys talked about starting private practice or doing legal consults. It can be lucrative but will definitely take time to build such practice. No one is gonna flock to you on the first day. How am I gonna afford to eat expensive sushi when I only have one patient show up to my private practice on the first day. Again I am willing to put in the hours just wondering which pathway has the least resistance to make at least 500K. Thanks for reading you guys are awesome!!!!

PS. I didn't realize there was a second page now. I don't know how you can work inpatient during the day and cover nights. How do you sleep? I want to make money but I want to get enough sleep so I can provide good care the next day. As far as rounding in two hospitals, who is gonna do cross over or if a patient gets violent on the floor. Would you feel comfortable with NP doing crossover calls if a patient gets violent.

Someone asked about my CV. I don't know why that matters. It's not like a hospital is gonna pay you more for going to Harvard. FYI, I went to a top 20 meds school but is attending a small town/rural university program.
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Are you a Med student?
 
blazing said:
Oh wow. you guys are awesome. I didn't think I would have so many responses. For some reason I didn't get any alerts when a response came through. FYI, some of my cardiology and ortho friends get offers of 500 K and above. That's what I want to aim for. I am willing to work hard but I don't know if that's achievable as a psychiatrist. I am wondering if I should apply for pain management fellowship. What about becoming a hospital administrator and slowly working up to become a CEO. Some of you guys talked about starting private practice or doing legal consults. It can be lucrative but will definitely take time to build such practice. No one is gonna flock to you on the first day. How am I gonna afford to eat expensive sushi when I only have one patient show up to my private practice on the first day. Again I am willing to put in the hours just wondering which pathway has the least resistance to make at least 500K. Thanks for reading you guys are awesome!!!!

PS. I didn't realize there was a second page now. I don't know how you can work inpatient during the day and cover nights. How do you sleep? I want to make money but I want to get enough sleep so I can provide good care the next day. As far as rounding in two hospitals, who is gonna do cross over or if a patient gets violent on the floor. Would you feel comfortable with NP doing crossover calls if a patient gets violent.

Someone asked about my CV. I don't know why that matters. It's not like a hospital is gonna pay you more for going to Harvard. FYI, I went to a top 20 meds school but is attending a small town/rural university program.
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You should do pain or switch out of psych if $500k offers with 0 entrepreneurship skills is your goal. That won’t happen here. Psych has amazing fluctuations in revenue, but straight offers are mostly $200-350k. That is still much more than administrators though.
 

Psychresy. haha nice one. I love psych. Loved reading about psych and taking care of the patient population. I don't understand why people think doing psych deserves low salary. Are you saying teachers deserve making minimal wage if they love teaching. I don't think so. Maybe you think psych deserves low salary but I don't.​

 
blazing said:

Psychresy. haha nice one. I love psych. Loved reading about psych and taking care of the patient population. I don't understand why people think doing psych deserves low salary. Are you saying teachers deserve making minimal wage if they love teaching. I don't think so. Maybe you think psych deserves low salary but I don't.​

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Ok I’m convinced you’re a Med student now or premed, finish your schooling and go through rotations then decide what you enjoy
 
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