I'm looking into Kaiser as a less than full time position (like .7 or .8 across 3-4 days a week). It sounds like they're struggling, like most places, to hire psychiatrists. Does anyone have experience with Kaiser allowing outside work?
kaiser permanente outside work
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If you are 1099 you can work outside, if you're employed then you can't.
That's how it was when I interviewed recently.
That's how it was when I interviewed recently.
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There are some differences depending on where you are but in general if you are employed with them then you can't do any clinical work elsewhere and they may require you to turn over all the money from forensic work even. Basically, they own you even if you are 0.7 FTE. However there are definitely some regional variations so it depends where you are talking about and also on your chief.
Yeah, the whole point of them is that they own you. There are lots of salaried positions that don't have this requirement. Look elsewhere if this is something that's important to you. There are many, many reasons that their salaries are slightly higher than elsewhere in the community. This is one of them.
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The Golden handcuffs.
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Like others said, in the region I'm familiar with, you can do outside work if you are 0.5 FTE or less which also means no benefits.
It's actually quite restrictive what they consider outside work. I thought it was outside "clinical" work but I think it's actually defined as any outside work that uses your clinical expertise (including consulting, for example.)
It's actually quite restrictive what they consider outside work. I thought it was outside "clinical" work but I think it's actually defined as any outside work that uses your clinical expertise (including consulting, for example.)
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You can’t even volunteer outside your job if you want to and they want to know all about it and approve / deny it. Horrible company and as someone said above, yes they own you. That’s why there is such a high attrition rate and they always have openings, because people quit often. At least in California there is no such thing as a non-compete clause so you can quit any time and start another job as often as you’d like. I think most Kaiser contracts ask you notify the job within 30 days prior to you quitting, but they can’t force you to stay.
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I wouldn't go so far as to say horrible company or high attrition rate. The opposite, actually, in my region. Just have to know if you're a good fit for the job or not (in other words, if you're wanting to do a bunch of side-gigs and real-deal-psychotherapy or not.) It would be hard to find a better W2 psychopharm job.
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Yeah, you can't even do medical surveys if you work for kaisers, its exclusionary criteria. Fairly strict.
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What do they typically pay their psychiatrists out of curiosity?
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Depends on region. ~$300k with excellent benefits outside of CA and ~$350-400k in CA. More details discussed in recent pay thread.
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I agree, my wife looked into working for them and the position was highly competitive. They had 4 applicants for the one spot and this was the second round where they took 0 from the first pool of applicants. It's a way better setup than Lifestance or similar VC owned OP psychopharm job, you always have less patients per day with Kaiser and get to focus on quality, albeit with some annoying metrics (like time until patient is seen). They do use golden handcuffs to dissuade you from leaving after a few years to start your own PP, but it would still be doable, or you just live the cushy life and enjoy your top 1% salary.
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was this for a psych job? What sort of handcuffs did they have, retention bonus?
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I don't know the details for other regions. The first part is sign on bonus (repaid if leave before year 3). A very generous pension (if/when you qualify--after like 20 years) for anyone who joined more than like 5 years ago. Anyone who joined more recently is no longer eligible for a pension (but does have a replacement that's a better deal if you leave BEFORE retirement/pension eligibility.) Then there's the part where you get a couple of perks around years 3/5/10. (Eligibility for certain shareholder perks, increase in PTO)
The handcuffs are generally a sign on bonus that is required to be paid back in full if you do not complete your term of service. This is different from say, the VA, where the sign on bonus has to be paid back pro-rated to the amount of your term that you completed.
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No, she's a surgeon. Handcuffs were the same as above with bonus paid back if leaving before x year. Never got an offer so we didn't get the full details. This was in Portland, so fairly desirable but not tipity top tier city. Her field is definitely not oversaturated either to have 8 candidates for the one spot.
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Does anyone have any experience working for Kaiser? Would love to hear your perspective on day to day operations.
I myself have spoken to a couple who enjoy the work, but do admit it is a lot of work and if you are inefficient it is not a good place to land.
Right now, many Kaisers seem to be quoting 60 min intakes, 30 minute follow ups with about 12 patients per day. Typically 1 hour per day is set aside to address email.
TIA
I myself have spoken to a couple who enjoy the work, but do admit it is a lot of work and if you are inefficient it is not a good place to land.
Right now, many Kaisers seem to be quoting 60 min intakes, 30 minute follow ups with about 12 patients per day. Typically 1 hour per day is set aside to address email.
TIA
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Do you have any more specific questions about it? Exact details will vary by region. Are you applying to a specific region?
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That's a broad way of asking that question. Being a physician group, there's not a strong pro-midlevel sentiment (and good bit of frustration with overreach.) We do have some NP's, the number of which is department and market specific. Two in psych and no push to hire more since we're not having a hard time filling any spots that may open with physicians. Lots of individual docs in the department (myself included) who are relatively against midlevels as "independent" "specialists."
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I have worked with multiple psychiatrists who either worked for Kaiser or went to Kaiser from the VA. I applied for a position myself but they would not consider me at the time because I didn't have the addiction cert yet. I am surprised by descriptions of 30 or 60 minute appointments, I have always understood it to be high volume. Here they seem to own you for a certain number of new evals per week. Forever, no matter what your caseload is. How you manage those referrals is up to you, you can refer back, push follow-ups out into the distant future, etc. My closest coworker here burned out at Kaiser and the psychiatrist we lost to them was the kind of person who just doesn't seem to get bothered by pt volume. Although she later tried to recruit me to join her so maybe that changed.
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You're probably in California by that description. The state passed a law that required HMO's to have X number of intake appointments per week for their psychiatrists. (or some very similar permutation to that) For that reason, there is more of a focus on actively managing your panel/repatriating patients back to primary care in that region.
Kaiser I'm talking to okayed outside work as an expert witness.
The clinic has 60-minute intakes 30-minute follow ups. Sounds like at least 1 new patient per day maybe 2, scheduled for 11-13 total per day 8-5pm, though there is a requirement to work a certain amount after 5pm to be available for people who work during the day, so you have a late start day once or twice a week.
One aspect that's kind of annoying, is patients message you directly. Some messages are handled by a clinic nurse, but many get forwarded on to you. I was told you have wide latitude in how you handle it. If for example a patient is having a problem with a new medication, you can handle it through messaging, like lowering the med dose, or stopping it, starting something else instead etc....Or you could tell them you need to get them into the clinic for follow-up before making changes. Not that you will always have space available to get them in.
My most recent outpatient job all messages went to RN who would handle probably half the questions, other half RN would talk to me and 99% of the time I could tell them what to do and it was handled without me having to directly contact the patient. Sounds like with Kaiser that 50% the doctor handles directly.
Kaiser also does not have flexibility to work 4 x 10-hour days. Most of the employed clinic jobs local to me have shifted to allowing this, basically working 8 hours straight through 8-4 or 8-5 with lunch, and 2 hours of documentation time at end of day, with the goal being to have no documentation to do so you can just leave at 5. Then you get Friday off.
Kaiser does pay slightly better than other employed outpatient jobs and has better benefits. And with sign on bonus requiring 3 years or so, I think for many people you can get into the system and build up a practice over 1-2 years, 3rd year gets busier, and you can decide if the Kaiser system works for you. If so great. If not, you can bail after the time requirement for sign on bonus passes.
One unclear thing is new patients never seem to stop. Even if you've been there 10 years you get new patients every day/week and it doesn't really make sense how that works, like you must be pretty proactive in sending back to PCP because there's no way natural attrition is high enough on its own to avoid having follow ups scheduled 4 months out.
The clinic has 60-minute intakes 30-minute follow ups. Sounds like at least 1 new patient per day maybe 2, scheduled for 11-13 total per day 8-5pm, though there is a requirement to work a certain amount after 5pm to be available for people who work during the day, so you have a late start day once or twice a week.
One aspect that's kind of annoying, is patients message you directly. Some messages are handled by a clinic nurse, but many get forwarded on to you. I was told you have wide latitude in how you handle it. If for example a patient is having a problem with a new medication, you can handle it through messaging, like lowering the med dose, or stopping it, starting something else instead etc....Or you could tell them you need to get them into the clinic for follow-up before making changes. Not that you will always have space available to get them in.
My most recent outpatient job all messages went to RN who would handle probably half the questions, other half RN would talk to me and 99% of the time I could tell them what to do and it was handled without me having to directly contact the patient. Sounds like with Kaiser that 50% the doctor handles directly.
Kaiser also does not have flexibility to work 4 x 10-hour days. Most of the employed clinic jobs local to me have shifted to allowing this, basically working 8 hours straight through 8-4 or 8-5 with lunch, and 2 hours of documentation time at end of day, with the goal being to have no documentation to do so you can just leave at 5. Then you get Friday off.
Kaiser does pay slightly better than other employed outpatient jobs and has better benefits. And with sign on bonus requiring 3 years or so, I think for many people you can get into the system and build up a practice over 1-2 years, 3rd year gets busier, and you can decide if the Kaiser system works for you. If so great. If not, you can bail after the time requirement for sign on bonus passes.
One unclear thing is new patients never seem to stop. Even if you've been there 10 years you get new patients every day/week and it doesn't really make sense how that works, like you must be pretty proactive in sending back to PCP because there's no way natural attrition is high enough on its own to avoid having follow ups scheduled 4 months out.
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Curious about other organizations having a solid "pension plan." From what I understand depending on the Kaiser you go to each will have a different type of retirement plan.
Some offer simple matching, other contribute a portion of salary, while others offer pension plans.
Anyone else know of another organization that offers pension plans?
Some offer simple matching, other contribute a portion of salary, while others offer pension plans.
Anyone else know of another organization that offers pension plans?
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Federal or Military. Federal offers you 1% of your salary for every year you work starting at 5 years of service. They average your highest 3 years to determine how much they pay. If you worked 7 years, you get 7% of your high-three average. If you make it to 20 years of service, you get 1.1% per year, so 22%. Retirement age is 62 though you can claim less at 60 I believe.
Not exactly sure how the military pension works but my understanding is it can't be beat. You have to put 20 full years of service in to qualify for it, though.
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This is specific to whatever region you're interviewing with. Totally fine in my region.
