What should be the difference?
Interesting! I heard Boston is a low-paying market, but things must be different for moonlighting rates?
That and don't forget to factor in quality of life. How flexible is the job? What kind of cases are you dealing with? It can be easy money or super hard money and it comes at a cost too. So glad to have autonomy of one's own practice and getting to do and focus on where your passion is!
In my experience, insurance is way more consistent payment and client flow. Unless you collect at time of service for cash. But even then, it's not uncommon for patients to not have the money at time of service. Statistically, insurance has been both more the consistent payor and more steady source of income, cash tends to fall off in economic uncerainty.
This number is actually 1-2 years out of date. Friends who are starting at BWH and BI as newly minted attendings next year are 200-210k. Even academia is now bumping up to 200k to stay competitive.
Boston used to be low. Even 5 years prior when I was still a med student, attendings in the Harvard system were getting ~120-140k for full time academia because they wanted the "harvard name". Many academic attendings make even less (sub 100k) as PART TIME and then roll bank in private practice by advertising as "harvard faculty"
Likely hard to get more than 30-40+ hours from any SINGLE locums/moonlighting job, but if you're part of a locums group you can easily piece together up to 2-3 jobs if you're really hardcore.
The person I got the numbers from said to expect $160-180K as an initial offer but that you could probably negotiate up to low $200K.
Rookie question, but generally it's hard to negotiate academic contracts, correct?
Definitely less leeway or leverage than with community contracts, but still some room for negotiation.
120-140k sounds absolutely miserable. Glad to hear that even the Boston academic institution are offering increased compensation! I wonder what drove the increase in pay when Boston remains as saturated as ever (or so I've heard).
PP market may be saturated, but outside of that definitely not. If anything, like a lot of medicine, more of a maldistribution.
Yep. But Boston COL ain't cheap either. I hear 1 bedroom to rent (downtown area) is slowly approaching NYC prices..
Sadly Mass is one of the most restrictive states in terms of telepsych. Covid has temporarily relaxed some of the restrictions in bigger hospitals and academic institutions, but to the best of my knowledge most locums work is still done in person.
This is pure speculation, but in the recent years big locums groups have made really a really aggressive push in recruiting psych residents. Supposedly one group has successfully consolidated "more than half of independent psychiatrists" (however you define that) in the state of Mass. From friends who work for them it is pretty lucrative. Whether or not you agree with them philosophically, one cannot deny that they are driving up pay rates for psychiatrists via bulk negotiations (the company negotiates on docs behalf with big hospitals) and securing these $200/hour contracts.
Generally, insurance patients are more easily referred and generally don't pay much more than what they are expecting to pay based on their insurance (they'll pay a copay or whatever else they need to meet their deductible). They have much less effective income to lose in seeing you, so they are more likely to keep going and feel they are losing money.
Yes that is definitely very lucrative. Great to hear that psychiatrists in MA are benefiting from collective bargaining! Can't say I feel bad for Boston academia when they've kept rates low for so long...haha. What locums groups are these? There are some corporate management groups like TeamHealth making in-roads into psychiatry in certain markets. I wonder if corporate management will be the norm for psychiatry in the future. Not sure how I feel about it because emergency medicine people seem to complain about corporate groups a lot.
This is based on what a psychiatrist who runs a cash based practice told me. He says it took him decades to build enough of a cash-only patient base for it to make sense to stop taking insurance and how cash based practices are much more competitive compared to insurance based ones, particularly because patients can very easily take their business elsewhere. But this is ultimately an N of 1 in manhattan.
That's resident moonlighting money
What happens in the event of needing a sick day last minute?
Bear induced PTSD...how do you know the bear doesn't have human induced PTSD? huh?! huh?! Where's their support >.>. I'm sure the bear would have a very different story...Health disparities I tell you.
Ain't that the truth! On a side note, many of my colleagues who work in healthcare systems, got salary cuts due to covid. Not drastic ones fortunately, but I assume this is the help subsidize other parts of the system that were hit harder with so much closing up. whereas in practice I always had the option to work (and make) more if I wanted. No cuts here. I'm telling you people, PP is the way MD/DO's can get back some of what we deserve: more competitive pay rates, better lifestyle, don't need to supervise mid levels if you don't want to, more practicing autonomy, etc.
On the topic of Bear health disparities:
