No. I would argue that the most successful psychiatrists make the most bank doing things other than general high repetition routine “medication management”. That in particular has a fixed low value. Managing medication also has very different levels of complexity. For example, sub-specialists (i.e. child, addiction) etc the complexity involved in deal with a fairly complex regimen easily be comparable or exceed any typical cognitive sub specialist (i.e. neurology/rheumatology, etc). This type of services are mainly cash only and market rates exceed insurance reimbursement by quite a bit. People are not stupid. Patients and family know that the value in having a quality child psychiatrist correctly manage a problem adolescent’s med regimen is potentially HUGE in terms of long term career and academic functioning, if not literally life or death. I literally have people on Medicaid emptying their savings to pay me FULL CASH to get their meds right.
There are also psychiatrists who focus their practice on psychotherapy or combined treatment. This, believe it or not, is in high demand. As you can imagine, if you have a good insurance plan, it’s easier to deal with one person who does both meds and therapy than having split treatment. So these people end up filling first and make MORE money than your typical employed med mill psychiatrist. Secondarily, typically a psychiatrist is much better as a “point person” for case management in a private practice setting. This type of service also IMO has enormous value.
The *average* EMPLOYED psychiatry job may be mostly a bunch of 99213 visits, but the variance there is huge. I think a typical US grad can get into a fairly engaging career pathway in this field. Remember, about 40-50% of psychiatrists who are actively practicing don’t take ANY insurance—they are not employed.
