Is Psych going to become much more competitive in the next few years?

[Blitz2006]

http://www.psychcongress.com/blogs/...nts-great-time-to-choose-psychiatry-specialty

Pretty cool article.

Can we expect Psych to become a 'competitive' specialty in the next decade?

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[IamPsychiatrist]

http://www.psychcongress.com/blogs/...nts-great-time-to-choose-psychiatry-specialty

Pretty cool article.

Can we expect Psych to become a 'competitive' specialty in the next decade?

Psych is the new derm plastics.

Edit:

btw, this is a terrible idea:

In the future, more psychiatrists will work closely with primary care physicians, both side-by-side and as consultants. I like the idea of providing mental health leadership to a system of providers – not just seeing patients, but also educating primary care physicians, mid-level practitioners, case workers, and therapists. For those interested in policy or advocacy, there is much to be done in the sphere of mental health. The practice of telepsychiatry is also growing. Imagine seeing all your patients from home!

I've heard of psychiatrists doing this consulting on thousands of primary care patients a month and never actually SEEING them.

That would be a huge step backward. There certainly must be better ways to leverage than just making sure people's medications are appropriate based upon a clinic note (no actual patient interaction).

 

[F0nzie]

http://www.psychcongress.com/blogs/...nts-great-time-to-choose-psychiatry-specialty

Pretty cool article.

Can we expect Psych to become a 'competitive' specialty in the next decade?

Competitive in the next decade? No. If salaries suddenly jumped to 300k today competitiveness among med student will still lag behind by at least a decade IMO.

 

[Psychotic]

I doubt it, because there aren't that many of us who actually want to do this gig (you know, dealing with crazy people).

If there wasn't a psychiatry option, I have no idea what other MD track I would be on. There wasn't even a backup specialty, much less a close second, for me...scary to contemplate if psychiatry was taken away from me what I would do as an MD. Maybe IM (uggh) with a pathway into palliative care.

 

[Blitz2006]

Competitive in the next decade? No. If salaries suddenly jumped to 300k today competitiveness among med student will still lag behind by at least a decade IMO.

Fair enough. I know the avg. salary is 200k. But correct me I'm wrong, isn't 300k in psych quite feasible?

 

[Blitz2006]

I doubt it, because there aren't that many of us who actually want to do this gig (you know, dealing with crazy people).

If there wasn't a psychiatry option, I have no idea what other MD track I would be on. There wasn't even a backup specialty, much less a close second, for me...scary to contemplate if psychiatry was taken away from me what I would do as an MD. Maybe IM (uggh) with a pathway into palliative care.

I agree, but I also don't think medical student get a good perspective of psych. How much flexibility the is, the wide scope of practice (ranging from C&A to Neuopsych to psychopharmacology) to doing cool stuff like FMRI or Telepsychiatry. I think if medical students have more exposure it may jump start a trend?

 

[IamPsychiatrist]

Competitive in the next decade? No. If salaries suddenly jumped to 300k today competitiveness among med student will still lag behind by at least a decade IMO.

Really? I don't think so.

Radiology was really competitive 5 years ago, now it's starting to change. I think medical students are pretty in tune with what is happening in specialties. I think 2-3 years would be more accurate than 10 year lag.

 

[Psychotic]

I agree, but I also don't think medical student get a good perspective of psych. How much flexibility the is, the wide scope of practice (ranging from C&A to Neuopsych to psychopharmacology) to doing cool stuff like FMRI or Telepsychiatry. I think if medical students have more exposure it may jump start a trend?

Ultimately, not everyone in med school is a good "fit" for the work of psychiatry, in much the same way I am not a good fit for surgery or most of IM, or FM, or EM, etc. Psychiatry is at least a major 3rd year rotation; what we see during the IM rotation (inpatient) is pretty far removed from what most people who enter IM plan to do, and that lack of exposure doesn't seem to prevent them from following that path.

I don't know how anyone can "know" from the limited exposure one gets in med school that they want to go into, say, optho, or radiology, or even derm.

 

[MacDonaldTriad]

It has been an exciting time to be in psychiatry for a very long time now. The 70s seem to been a hay day in interest, but the interest seems flat at about 3% of domestic American grads for the last 3 decades. This might be pay, but I don’t think so, at least not enough to explain the numbers. A lot of it is core and sub I neglect. Good rotations = strong interest. Psychiatry needs to work on its PR. There are a lot of cool things about it, but it is not for everyone. Its traditional lack of “competiveness” is a function of poor exposure to what makes the field so attractive and not all of its lack of competiveness is explained by pay. Medical students are culturally attuned to what is respected and psychiatry doesn’t play well amongst most of their mentors/peers. It isn’t surprising that medical students pick up on these vibes given the nature of their training and entrance requirements. Psychiatry is a diamond in the rough if you like it, and it is a terrible pit if it is something you do because your options are limited. Please don’t do it because it is where you can get in. If you love it, the field is more open than the Pacific Ocean. I don’t like that fact in a lot of ways, but a lot of us benefit from it in other ways.

 

[TexasPhysician]

Fair enough. I know the avg. salary is 200k. But correct me I'm wrong, isn't 300k in psych quite feasible?

300k in any medical specialty is feasible.

 

[Blitz2006]

300k in any medical specialty is feasible.

I agree. But I meant in psych it is reasonably feasible...I don't think 300k is that feasible in fm/peds/im hospitalist....right?

 

[Tyrone Slothrop]

A lot of it is core and sub I neglect. Good rotations = strong interest. Psychiatry needs to work on its PR. There are a lot of cool things about it, but it is not for everyone. Its traditional lack of “competiveness” is a function of poor exposure to what makes the field so attractive and not all of its lack of competiveness is explained by pay. Medical students are culturally attuned to what is respected and psychiatry doesn’t play well amongst most of their mentors/peers.

I studied in Europe and since most fields pay roughly the same, pay isn't really a factor in people's choices. "Prestige" of the field still plays a role though. Our psychiatry block was fantastic. I knew sometime in the second week that I'd found what I wanted to do in medicine. On the other hand the rest of my classmates hated it, I never saw that reaction so universally and so strongly towards any other subject. I think it was because they saw it as "not really medicine".

Another interesting situation was our orthopedics block. I definitely enjoyed it, but again the majority of my class hated it. I think in the US ortho gets a popularity and respect bump because of the money. Once that was out of the picture it was just some boring class about plates, pins, and joint replacements.

It turns out once money is equal, the "prestige" fields are IM and general surgery.

 

[Shikima]

Fair enough. I know the avg. salary is 200k. But correct me I'm wrong, isn't 300k in psych quite feasible?

It is, if you're willing to work 12-15 hours a day.

 

[OldPsychDoc]

I hope it never becomes so competitive that I have to try to sort out the golddigging ROADies apart from those truly interested in caring for the mentally ill.

 

[Shikima]

I hope it never becomes so competitive that I have to try to sort out the golddigging ROADies apart from those truly interested in caring for the mentally ill.

They already exist as benzo cash clinics.

 

[digitlnoize]

I agree. But I meant in psych it is reasonably feasible...I don't think 300k is that feasible in fm/peds/im hospitalist....right?

I think it's reasonably feasible. You need a good business acumen and keep your overhead low, but it's doable. For a quick calculation, based on new rates, seeing a 1/2 hour med mgt + therapy visit pays ~$125 at medicare rates, so $250 per hour. 250 * 40h/wk * 48 wks/yr (4w vacation) = $480,000. -30% ($144,000)overhead (staff, rent, utilities, malpractice, health insurance, etc), which is a high-end number from what most people have told me, leaves $336,000.

And that's doing 40 hours per week. It's close. But, I think it's doable while practicing with a responsible, reasonable rate of patients/day and providing good care. It's DEFINITELY doable if you want to be a pill mill and fill benzo scripts for a 5 minute visit, but I don't think any of us want that. That'd be ~$75/5min * 40 * 48 = $1.7 million before expenses. Sigh. Crime pays. Don't do this. It's not worth it. And it sounds like a horrible life.

Is psych going to get more competitive? If salary survey salaries go up, then yes. I doubt this will happen though. Part of the reason for our "low salary" on surveys is due to our shorter average work week than most doctors. For some reason, we psychiatrists, seem to value our sanity, and thus choose to work less and make less money on purpose. I would argue that our hourly rate is quite competitive with the rest of mainstream medicine (I'd argue on par with EM, maybe a bit less). See Medscape salary surveys for more info. When I present this information to the med students I work with, along with the other aspects of psychiatry that I find interesting (time with patients, diagnostic dilemmas, patient advocacy, shortage needs, "underdog" patients that are often blown off by the rest of medicine, etc), their interest peaks. I am proud to say that I have a fairly high rate of students I've worked with choose to go into psychiatry. Another chunk at least start considering it.

Not all medical students are looking for money, but it helps. That being said, when you present the interesting aspects of psychiatry, the true financial situation, and the need for psychiatrists, you'd be surprised how many you can attract.

 

[vistaril]

I agree. But I meant in psych it is reasonably feasible...I don't think 300k is that feasible in fm/peds/im hospitalist....right?

ummm...yes. Very much so. Many IM hospitalists here cracking 400k if they hustle.

 

[vistaril]

I hope it never becomes so competitive that I have to try to sort out the golddigging ROADies apart from those truly interested in caring for the mentally ill.

oddly enough though(except for anesthesia where every other thread is about $), people on this forum talk about money 5x as much as the those other forums. Now I'm guilty of this too, and this forum obviously contains only a small number of people, but still......

 

[Psychotic]

oddly enough though(except for anesthesia where every other thread is about $), people on this forum talk about money 5x as much as the those other forums. Now I'm guilty of this too, and this forum obviously contains only a small number of people, but still......

Umm, YOU talk about money more than any other poster on the psych forums, not "people."

Money, compensation, etc., is fair game for anybody in or entering medicine.

 

[notdeadyet]

I think it's reasonably feasible. You need a good business acumen and keep your overhead low, but it's doable. For a quick calculation, based on new rates, seeing a 1/2 hour med mgt + therapy visit pays ~$125 at medicare rates, so $250 per hour. 250 * 40h/wk * 48 wks/yr (4w vacation) = $480,000. -30% ($144,000)overhead (staff, rent, utilities, malpractice, health insurance, etc), which is a high-end number from what most people have told me, leaves $336,000.

If you have a consistently 100% capacity business and have achieved 100% reimbursement from Medicare, you have a wunderkind office staff. The math is not this simple.

 

[notdeadyet]

oddly enough though(except for anesthesia where every other thread is about $), people on this forum talk about money 5x as much as the those other forums. Now I'm guilty of this too, and this forum obviously contains only a small number of people, but still......

No, it's usually a small number of folks who turn stuff back to money all the time.

Also, to be fair, finances are pretty clear for most of medicine, as you are working for salary when you come out of the gate. Psychiatry is one of the last fields where you can leave residency and with very little capital hang your shingle. Folks with poor understanding of business (which understandably includes most med students), multiply X hours by Y rates and figure it's easy to make $300k/year working 40 hours per week. This generates a lot of discussion.

 

[Blitz2006]

I think it's reasonably feasible. You need a good business acumen and keep your overhead low, but it's doable. For a quick calculation, based on new rates, seeing a 1/2 hour med mgt + therapy visit pays ~$125 at medicare rates, so $250 per hour. 250 * 40h/wk * 48 wks/yr (4w vacation) = $480,000. -30% ($144,000)overhead (staff, rent, utilities, malpractice, health insurance, etc), which is a high-end number from what most people have told me, leaves $336,000.

And that's doing 40 hours per week. It's close. But, I think it's doable while practicing with a responsible, reasonable rate of patients/day and providing good care. It's DEFINITELY doable if you want to be a pill mill and fill benzo scripts for a 5 minute visit, but I don't think any of us want that. That'd be ~$75/5min * 40 * 48 = $1.7 million before expenses. Sigh. Crime pays. Don't do this. It's not worth it. And it sounds like a horrible life.

Is psych going to get more competitive? If salary survey salaries go up, then yes. I doubt this will happen though. Part of the reason for our "low salary" on surveys is due to our shorter average work week than most doctors. For some reason, we psychiatrists, seem to value our sanity, and thus choose to work less and make less money on purpose. I would argue that our hourly rate is quite competitive with the rest of mainstream medicine (I'd argue on par with EM, maybe a bit less). See Medscape salary surveys for more info. When I present this information to the med students I work with, along with the other aspects of psychiatry that I find interesting (time with patients, diagnostic dilemmas, patient advocacy, shortage needs, "underdog" patients that are often blown off by the rest of medicine, etc), their interest peaks. I am proud to say that I have a fairly high rate of students I've worked with choose to go into psychiatry. Another chunk at least start considering it.

Not all medical students are looking for money, but it helps. That being said, when you present the interesting aspects of psychiatry, the true financial situation, and the need for psychiatrists, you'd be surprised how many you can attract.

I've been a long time reader of SDN and always appreciate your 2 cents DigNoize. Very informative post as always.

So according to your numbers, all psychiatrists should be easily clearing 300k? So does medscape survey give psych an avg. of 200k? I can't imagine psychiatrists working 25-30 hours/week...

And therefore on the flip side, if I chose to work 12 hour days (60 hours/week), is 500K attainable?

 

[Blitz2006]

No, it's usually a small number of folks who turn stuff back to money all the time.

Also, to be fair, finances are pretty clear for most of medicine, as you are working for salary when you come out of the gate. Psychiatry is one of the last fields where you can leave residency and with very little capital hang your shingle. Folks with poor understanding of business (which understandably includes most med students), multiply X hours by Y rates and figure it's easy to make $300k/year working 40 hours per week. This generates a lot of discussion.

Yeah I'm an intern year in the UK, just graduated from med school last year. And they don't teach us any of this finance stuff in med school. I'm not saying I'm doing this for $, but I would like to know what type of lifestyle I'm getting into for the next 40 years. I don't understand why so many people equate interest in money to being evil... I do have loans to payoff, family to provide for, etc.

 

[digitlnoize]

If you have a consistently 100% capacity business and have achieved 100% reimbursement from Medicare, you have a wunderkind office staff. The math is not this simple.

True, but we're also using only Medicare rates, not private insurance (which pays +15-25% MC) or cash (which pays +50-100% MC), which will make up for some of the lost capacity (my academic clinic's no show rate is < 10 %) and reimbursement (also < 10% and we have 2 billers for ~10k patients). Both no shows and faulty reimbursement could be recouped by taking a couple non-medicare private insurances. Full schedules are not difficult to achieve in most areas of the county within a year or two of opening the gates. Obviously there will be a certain % of no shows and unexpected expenses, but the point is, this arguably high end number is still nearly 2x what is being reported in most salary surveys, and is for a 40 hour work week in a medicare only practice with generous vacation time and high overhead. I know the math is MUCH more complicated, but I don't have time to type a full treatise on medical business models right now, so I was just making some quick estimates Suffice it to say that it is reasonable to say that you can expect to AT LEAST clear $225k/yr take home if you own your own solo practice within a few years of opening your door if you know what you're doing. Possibly much more than this much sooner than this. If you hire other doctors and/or (gasp!) mid-levels you can take home a LOT more than this.

Vistaril: stuff about money...

Yes, we talk about money on this forum. Multiple reasons for this.

1. I feel psychiatry lends itself better to entrepreneurs than most other medical fields, especially in today's world, due to lower overhead and lower start up costs. Thus, you would expect to see more people in psych who are business oriented and want their own practices.

2. I feel the salaries in psych are woefully under-estimated by salary surveys and it hurts recruitment, which hurts supply, which hurts OUR PATIENTS. SDN is a great platform for us to promote our specialty and I try to be as evangelical as possible here, while maintaining truth.

3. Did anyone see the recent AMA data on physician compensation? http://www.ama-assn.org/resources/doc/health-policy/prp-phys-comp-methods-2014.pdf
I direct your attention to the graph on page 13: Non-solo, Owner Physicians. For Psychiatry, we are last in % compensation from salary (16%) and most of the compensation for psychiatrists who own their own practice comes not from salary, but from personal productivity. What do these doctors report as their "salary" on the Medscape or other salary surveys? Next, look at the graph on page 14: Non-solo, EMPLOYEE physician. Psychiatry is #3 in % compensation from salary (80%). Hmm. What do THESE psychiatrists report in salary surveys?

If the owners report their salary as avg 180k/yr, then the true psych avg salary for an owner is far higher than this. If the owners report their salary as LOWER than 180k/yr, then they are skewing the avg salary down greatly. This is in addition to the already skewed salary figures due to our shorter work weeks compared to most specialties (Medscape reports 35% work < 30h/wk and 35% work 30-40h/wk = 70% work 40h/wk or less, mostly IMO due to our much higher than average age practicing physicians...we're an old specialty, sorry OPD.)

Thoughts?

 

[digitlnoize]

I've been a long time reader of SDN and always appreciate your 2 cents DigNoize. Very informative post as always.

So according to your numbers, all psychiatrists should be easily clearing 300k? So does medscape survey give psych an avg. of 200k? I can't imagine psychiatrists working 25-30 hours/week...

And therefore on the flip side, if I chose to work 12 hour days (60 hours/week), is 500K attainable?

No. Please don't misunderstand. First, see my above post. The math IS more complicated, this is a very quick and dirty estimate of what is possible with good business acumen. Second, most psychiatrists take jobs as employees, not as owners, which means SOMEONE is getting richer off your productivity. Most of my residency graduating buddies are getting job offers in the 200-250k range, plus benefits for a variety of adult psych gigs. Keep in mind that if you own your own place, there's no benefits, aside from being your own boss and having the POWER, so factor that in.

Finally, most doctors are horrible businessmen. So, even psychiatrists who open their own offices fail miserably. Amongst my fellow residents, I am one of the few who knows (or cares) about billing and coding. I probably read nearly as much about billing/coding and office management as I do about psychiatry. I also have run a couple of (non-medical) businesses before, so I have experience and went into medicine to be my own boss, so I'm a bit "different".

See my other posts for why the average salaries are skewed low. Short answer: higher than average age of psychiatrists, shorter than average work week, and potentially other factors (high proportion of female psychiatrists, who statistically speaking (please understand I'm not trying to be sexist, women are awesome workers and doctors) work fewer hours/week after residency than their male counterparts; owners who report low salary due to higher income from practice income; etc).

 

[F0nzie]

I've been a long time reader of SDN and always appreciate your 2 cents DigNoize. Very informative post as always.

So according to your numbers, all psychiatrists should be easily clearing 300k? So does medscape survey give psych an avg. of 200k? I can't imagine psychiatrists working 25-30 hours/week...

And therefore on the flip side, if I chose to work 12 hour days (60 hours/week), is 500K attainable?

Let me try to make this as simple as possible.

10 hours = 50k
20 hours = 100k
30 hours = 150k
40 hours = 200k
50 hours = 250k
60 hours = 300k

The numbers will shift slightly depending on your geographic location.

 

[vistaril]

True, but we're also using only Medicare rates, not private insurance (which pays +15-25% MC) or cash (which pays +50-100% MC), which will make up for some of the lost capacity (my academic clinic's no show rate is < 10 %) and reimbursement (also < 10% and we have 2 billers for ~10k patients). Both no shows and faulty reimbursement could be recouped by taking a couple non-medicare private insurances. Full schedules are not difficult to achieve in most areas of the county within a year or two of opening the gates. Obviously there will be a certain % of no shows and unexpected expenses, but the point is, this arguably high end number is still nearly 2x what is being reported in most salary surveys, and is for a 40 hour work week in a medicare only practice with generous vacation time and high overhead. I know the math is MUCH more complicated, but I don't have time to type a full treatise on medical business models right now, so I was just making some quick estimates Suffice it to say that it is reasonable to say that you can expect to AT LEAST clear $225k/yr take home if you own your own solo practice within a few years of opening your door if you know what you're doing. Possibly much more than this much sooner than this. If you hire other doctors and/or (gasp!) mid-levels you can take home a LOT more than this.



Yes, we talk about money on this forum. Multiple reasons for this.

1. I feel psychiatry lends itself better to entrepreneurs than most other medical fields, especially in today's world, due to lower overhead and lower start up costs. Thus, you would expect to see more people in psych who are business oriented and want their own practices.

2. I feel the salaries in psych are woefully under-estimated by salary surveys and it hurts recruitment, which hurts supply, which hurts OUR PATIENTS. SDN is a great platform for us to promote our specialty and I try to be as evangelical as possible here, while maintaining truth.

3. Did anyone see the recent AMA data on physician compensation? http://www.ama-assn.org/resources/doc/health-policy/prp-phys-comp-methods-2014.pdf
I direct your attention to the graph on page 13: Non-solo, Owner Physicians. For Psychiatry, we are last in % compensation from salary (16%) and most of the compensation for psychiatrists who own their own practice comes not from salary, but from personal productivity. What do these doctors report as their "salary" on the Medscape or other salary surveys? Next, look at the graph on page 14: Non-solo, EMPLOYEE physician. Psychiatry is #3 in % compensation from salary (80%). Hmm. What do THESE psychiatrists report in salary surveys?

If the owners report their salary as avg 180k/yr, then the true psych avg salary for an owner is far higher than this. If the owners report their salary as LOWER than 180k/yr, then they are skewing the avg salary down greatly. This is in addition to the already skewed salary figures due to our shorter work weeks compared to most specialties (Medscape reports 35% work < 30h/wk and 35% work 30-40h/wk = 70% work 40h/wk or less, mostly IMO due to our much higher than average age practicing physicians...we're an old specialty, sorry OPD.)

Thoughts?

my thoughts are that yes you *can* make more than the averages if you work hard, set things up a certain way, and practice a certain way. I've already made clear my thoughts on this type of mh practice, so I won't go there. So to that extent, yes, salaries are underreported. That said, you can't then use that standard for psychiatry and go by the medscape or mgma standard for things like family medicine and IM. Because in that case(based on potential), salaries are way way way underreported in these areas.

 

[digitlnoize]

And therefore on the flip side, if I chose to work 12 hour days (60 hours/week), is 500K attainable?

Sorry, I didn't answer this. I don't think that is how you get to 500k. It's also not sustainable. If you want to get to 500k, you need a market that can bear a multi-physician practice. By adding mid-levels (therapists, NP's, PA's) and other psychiatrists, you can make money off other people's desire to not run a business, and THAT is how you get yourself to 500k and beyond. I have a dentist friend who did this slowly over his career. He now has a dental school building named after him and >10 offices run by various managers, doctors, and his kids. He never works and paints all the time...very well, I might add.

Fonzie, that's encouraging, thank you. Those are closer to the numbers I get when I calculate my own future "most-likely scenario" using my full resources and knowledge.

 

[F0nzie]

Fonzie, that's encouraging, thank you. Those are closer to the numbers I get when I calculate my own future "most-likely scenario" using my full resources and knowledge.

Yep. You are already ahead of the bell curve which will serve you well when you finally negotiate a contract or start your own business.

 

[Shikima]

Sorry, I didn't answer this. I don't think that is how you get to 500k. It's also not sustainable. If you want to get to 500k, you need a market that can bear a multi-physician practice. By adding mid-levels (therapists, NP's, PA's) and other psychiatrists, you can make money off other people's desire to not run a business, and THAT is how you get yourself to 500k and beyond. I have a dentist friend who did this slowly over his career. He now has a dental school building named after him and >10 offices run by various managers, doctors, and his kids. He never works and paints all the time...very well, I might add.

Fonzie, that's encouraging, thank you. Those are closer to the numbers I get when I calculate my own future "most-likely scenario" using my full resources and knowledge.

Don't forget the relationships you develop with other providers in the community does help build a practice faster and increase longevity.

 

[digitlnoize]

Don't forget the relationships you develop with other providers in the community does help build a practice faster and increase longevity.

Yes! This x 1,000,000. The music store I used to work for had a person whose sole job it was to visit local schools and promote the store. Got us TONS of business from every kid in band within an hour drive. This is part of what I meant by "business skills."

 

[notdeadyet]

Exactly. That's why the simple math calculations don't work very well. The most successful businesses require quite a bit of time outside of patient care to build, develop, and maintain.


Sent from my iPhone using Tapatalk

 

[Blitz2006]

No. Please don't misunderstand. First, see my above post. The math IS more complicated, this is a very quick and dirty estimate of what is possible with good business acumen. Second, most psychiatrists take jobs as employees, not as owners, which means SOMEONE is getting richer off your productivity. Most of my residency graduating buddies are getting job offers in the 200-250k range, plus benefits for a variety of adult psych gigs. Keep in mind that if you own your own place, there's no benefits, aside from being your own boss and having the POWER, so factor that in.

Finally, most doctors are horrible businessmen. So, even psychiatrists who open their own offices fail miserably. Amongst my fellow residents, I am one of the few who knows (or cares) about billing and coding. I probably read nearly as much about billing/coding and office management as I do about psychiatry. I also have run a couple of (non-medical) businesses before, so I have experience and went into medicine to be my own boss, so I'm a bit "different".

See my other posts for why the average salaries are skewed low. Short answer: higher than average age of psychiatrists, shorter than average work week, and potentially other factors (high proportion of female psychiatrists, who statistically speaking (please understand I'm not trying to be sexist, women are awesome workers and doctors) work fewer hours/week after residency than their male counterparts; owners who report low salary due to higher income from practice income; etc).

Awesome thread. Lets keep the momenteum going.

So I've been doing some cross-referencing, the radiology board has a thread which discusses that radiologists come out of residency with offers of 200-250K...

http://forums.studentdoctor.net/threads/radiology-outlook-and-its-challenges.988015/

Post#25 - spoken from a radiologist.

Now I'm not trying to put down radiology, but my food for thought..is parity officially here? If Radiologists and Psychiatrists are both making 250k? Sure IR obviously takes home more, but still...

 

[Blitz2006]

Let me try to make this as simple as possible.

10 hours = 50k
20 hours = 100k
30 hours = 150k
40 hours = 200k
50 hours = 250k
60 hours = 300k

The numbers will shift slightly depending on your geographic location.

Nice. So are there psychiatrists that do 7am to 7pm days? Do attendings start rounding at 7? Or start clinic at 7?

What's the job market like in the big metro areas? Also, I presume income is much higher in Midwest vs. Cali/east coast...?

 

[Blitz2006]

I studied in Europe and since most fields pay roughly the same, pay isn't really a factor in people's choices. "Prestige" of the field still plays a role though. Our psychiatry block was fantastic. I knew sometime in the second week that I'd found what I wanted to do in medicine. On the other hand the rest of my classmates hated it, I never saw that reaction so universally and so strongly towards any other subject. I think it was because they saw it as "not really medicine".

Another interesting situation was our orthopedics block. I definitely enjoyed it, but again the majority of my class hated it. I think in the US ortho gets a popularity and respect bump because of the money. Once that was out of the picture it was just some boring class about plates, pins, and joint replacements.

It turns out once money is equal, the "prestige" fields are IM and general surgery.

I studied in Europe and since most fields pay roughly the same, pay isn't really a factor in people's choices. "Prestige" of the field still plays a role though. Our psychiatry block was fantastic. I knew sometime in the second week that I'd found what I wanted to do in medicine. On the other hand the rest of my classmates hated it, I never saw that reaction so universally and so strongly towards any other subject. I think it was because they saw it as "not really medicine".

Another interesting situation was our orthopedics block. I definitely enjoyed it, but again the majority of my class hated it. I think in the US ortho gets a popularity and respect bump because of the money. Once that was out of the picture it was just some boring class about plates, pins, and joint replacements.

It turns out once money is equal, the "prestige" fields are IM and general surgery.

Valid points, but I kind of disagree.

Ortho here in the UK is losing its appeal because of lack of jobs. Same thing in canada. 2 years ago ortho at western univ. In ontario had 3 unmatched spots out of 5...ppl were shocked.

Dunno about prestige. When I tell people I want to specialise in neuropsych and take part in drug trials and do psychopharmacology people seem a lot more impressed. ...than say my friends who want to be rheumatologist or breast surgeon. I honestly dont see the "prestige" in being a hospitalist. But this isnt a competition abt prestige obviously....

My point is that I think poor exposure to psych is a reason for lack of interest...when I was a med student no one really told me how much neuroscience is in psych. ..we all assumed it was scooped up by neurologists..

I studied in Europe and since most fields pay roughly the same, pay isn't really a factor in people's choices. "Prestige" of the field still plays a role though. Our psychiatry block was fantastic. I knew sometime in the second week that I'd found what I wanted to do in medicine. On the other hand the rest of my classmates hated it, I never saw that reaction so universally and so strongly towards any other subject. I think it was because they saw it as "not really medicine".

Another interesting situation was our orthopedics block. I definitely enjoyed it, but again the majority of my class hated it. I think in the US ortho gets a popularity and respect bump because of the money. Once that was out of the picture it was just some boring class about plates, pins, and joint replacements.

It turns out once money is equal, the "prestige" fields are IM and general surgery.

 

[Leo Aquarius]

Prestige is the temptation of the weak, and the ambush of lifestyle.

 

[Leo Aquarius]

Over 70% of psychiatrists work in an outpatient setting. So rounding on patients is rare. Thus, your day starts more around 8am or 8:30am.

Cali jobs pay very well. Look at the medscape data to see averages by region.
Try this site and type in zip codes for more data.
http://www1.salary.com/psychiatrist-Salary.html

 

[IamPsychiatrist]

Awesome thread. Lets keep the momenteum going.

So I've been doing some cross-referencing, the radiology board has a thread which discusses that radiologists come out of residency with offers of 200-250K...

http://forums.studentdoctor.net/threads/radiology-outlook-and-its-challenges.988015/

Post#25 - spoken from a radiologist.

Now I'm not trying to put down radiology, but my food for thought..is parity officially here? If Radiologists and Psychiatrists are both making 250k? Sure IR obviously takes home more, but still...

Comparing incomes to other jobs shouldn't be a source of satisfaction. With that said, psych pays very well hourly. Among the best in medicine. Definitely top 50%.

I think psych is for certain types. Most med students don't fit this. So I don't see the competitiveness changing drastically.

At the same time, the highest paid docs have the most prestige. If psych earned 700k then the average boards would be 255. Ortho In America vs Europe is a great example of money and culture driving interest.

 

[IamPsychiatrist]

Let me try to make this as simple as possible.

10 hours = 50k
20 hours = 100k
30 hours = 150k
40 hours = 200k
50 hours = 250k
60 hours = 300k

The numbers will shift slightly depending on your geographic location.

This should be a staggering thought. Most general surgeons earn 300k working 60 hrs.

 

[westnile]

I hope it never becomes so competitive that I have to try to sort out the golddigging ROADies apart from those truly interested in caring for the mentally ill.

These were my thoughts, exactly

 

[Shikima]

Nice. So are there psychiatrists that do 7am to 7pm days? Do attendings start rounding at 7? Or start clinic at 7?

Answer is yes. I typically start work at 7am and don't get home between my 2 clinics until about 9/10pm. But that is only Mon-Thurs and only a 7-8 hour day on Fridays. Nothing on weekends.

 

[Shikima]

This should be a staggering thought. Most general surgeons earn 300k working 60 hrs.

Procedures have always paid more, there is more liability/risk involved. However, this should not dissuade or discourage any momemtum in pushing for wellness in any group of people you are helping.

 

[funpebbles]

I have no doubt that psychiatrists in private practice who want to work same hours and are not concerned with providing the best care can earn more than orthopedic/neuro surgeons. Of course this is not a reason to do psych. Does anyone think otherwise?

 

[Leo Aquarius]

Every physician should practice according to the highest ethical standards. This means we must provide the best care. BUT, providing the best care and making tons of money are not mutually exclusive.

How about those psychiatrists working for the jail systems who work overtime in several locations breaking $400K and $500K...

 

[Blitz2006]

Answer is yes. I typically start work at 7am and don't get home between my 2 clinics until about 9/10pm. But that is only Mon-Thurs and only a 7-8 hour day on Fridays. Nothing on weekends.

Hey Shikima.

Impressive. Do you mind giving a brief overview of your typical week?

Do you do pure private practice? Do you mix in any inpatient work? How about ect or telepsych?

I wouldn't mind have variety. ..not sure if I can handle 100% outpatient/private practice. .

 

[Blitz2006]

Every physician should practice according to the highest ethical standards. This means we must provide the best care. BUT, providing the best care and making tons of money are not mutually exclusive.

How about those psychiatrists working for the jail systems who work overtime in several locations breaking $400K and $500K...

So basically psych is a hidden gem...

 

[Psychedelicious]

So basically psych is a hidden gem...

What other conclusion did you think you will achieve by posting the question in a forum filled with psychiatrists?

 

[F0nzie]

So basically psych is a hidden gem...

First he said working for jail systems and then he said working overtime. Not the gem I envision but hey to each his own.

 

[@JackShephard]

First he said working for jail systems and then he said working overtime. Not the gem I envision but hey to each his own.

Well, you have to compare it to other fields in medicine - then those don't seem as bad.

 

[@JackShephard]

Every physician should practice according to the highest ethical standards. This means we must provide the best care. BUT, providing the best care and making tons of money are not mutually exclusive.

How about those psychiatrists working for the jail systems who work overtime in several locations breaking $400K and $500K...

Agreed.