Looking for a moonlighting gig to supplement income

[deleted310399]

Hi Folks ,

I am a BC general adult Psychiatrist in the south east . I currently have a full time OP job that I am reasonably happy with . I supplement this with weekends and after hour calls at the current institution . This extra work is about to dry up in the next 2-3 months so I am looking to supplement with a moonlighting position . My OP full time position is 4 days a week and will have no additional call once the extra work is done . I would prefer Tele-psych in an Inpatient unit for 2 weekends a month.

Any suggestions ? Please PM me if you have any leads.

Thank you

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[NickNaylor]

You could check out Doctor On Demand - it's a telehealth-based outpatient company. A friend of mine is working part time for them and really likes it. The pay is also pretty solid. They will pay for you to get licenses in additional state if you're not able to get enough patients to fill your schedule with your current licenses. I have no personal experience with the company but he has been working with them for about a year and a half at this point and has only increased the amount of time he is spending with them.

 

[liquidshadow22]

Wonder if it's better than teladoc?

 

[Username2015]

Doctor on demand was worse than teladoc when I interviewed. Dr on demand paid less and had more restrictions on when you work and how much time you spend per visit.

Teladoc allowed for setting your schedule (no mandatory night or weekend hours), paid more, and made it easy to extend a visit duration if you want (although you won’t get paid more for that).

 

[jbomba]

Doctor on demand was worse than teladoc when I interviewed. Dr on demand paid less and had more restrictions on when you work and how much time you spend per visit.

Teladoc allowed for setting your schedule (no mandatory night or weekend hours), paid more, and made it easy to extend a visit duration if you want (although you won’t get paid more for that).

How much are they paying?

 

[NickNaylor]

Doctor on demand was worse than teladoc when I interviewed. Dr on demand paid less and had more restrictions on when you work and how much time you spend per visit.

Teladoc allowed for setting your schedule (no mandatory night or weekend hours), paid more, and made it easy to extend a visit duration if you want (although you won’t get paid more for that).

Interesting, that hasn't been the experience of my buddy - at least he's never mentioned anything like that - but perhaps things have changed.

 

[Username2015]

Interesting, that hasn't been the experience of my buddy - at least he's never mentioned anything like that - but perhaps things have changed.

Yeah sometimes their policies change, I suspect depending on the supply of doctors versus demand, by specialty, or by state.

 

[Username2015]

How much are they paying?

Teladoc pays $160 per intake and $75 per follow up

Doctor on Demand pays $~140 per intake, and $46 per follow up

MD live paid the best by far ($200 intake, $90 per follow up) but requires at least 4 years of post-residency experience. It also seems to have different billing codes based on duration, while the other two companies seem to only offer 2 visit types.

 

[NickNaylor]

Yeah sometimes their policies change, I suspect depending on the supply of doctors versus demand, by specialty, or by state.

Interesting... even the pay structure you mentioned above is fundamentally different from my buddy's pay structure (roughly ~$170/face-to-face hr). Just to be clear, though, he's in psychiatry.

 

[jbomba]

Teladoc pays $160 per intake and $75 per follow up

Doctor on Demand pays $~140 per intake, and $46 per follow up

MD live paid the best by far ($200 intake, $90 per follow up) but requires at least 4 years of post-residency experience. It also seems to have different billing codes based on duration, while the other two companies seem to only offer 2 visit types.

Thanks for the info. How much does this work out to on an hourly basis for you? If one wanted to add a couple weeknights a week would the volume be there?

Or additionally, are you aware of any telepsych companies that would allow you to be the entire weekend on call doctor like someone might do in an inpatient unit?

 

[Username2015]

Yes, there are telepsych companies that are essential staffing companies. They find a clinic or hospital that needs a doctor and connect you (the doctor) with that hospital or clinic. You see patients electronically, and the EMR you use is what's used by the clinic or hospital.

Iris, Genoa, FasPsych, etc. Join facebook telepsychiatry connections group to learn more.

 

[the5thelement]

Teladoc pays $160 per intake and $75 per follow up

Doctor on Demand pays $~140 per intake, and $46 per follow up

MD live paid the best by far ($200 intake, $90 per follow up) but requires at least 4 years of post-residency experience. It also seems to have different billing codes based on duration, while the other two companies seem to only offer 2 visit types.

Here is a review from a physician i found for Teladoc - looks like one to avoid!!
" the actual patient population is incredibly demanding and have very unrealistic expectations. patients have repeatedly called for chest pain and sudden loss of vision. others wanted me to order durable medical equipment or fill out disability paperwork. and if they don't get what they want, they leave the doctor a bad review, which TELADOC also holds against the doctor. the majority of the patients seek antibiotics for variations of the common cold. even if you are trying to a be a good doctor, you get pushed to give the 'customer' what they want. thats right folks, patients are customers now. how medicine has fallen.

the senior administrators are very arrogant and approach the working physicians, the ones who are trying to take care of the patients/customers, in a very superior attitude,to dictate care and have unrealistic work demands. they are also quick to report physicians to the NPDB(the national practitioner data bank) for bogus reasons to justify their legitimacy as a relevant health care entity.

when TELADOC first started out, it was a new kid on the block. I would advise any physician considering working for TELADOC to stay away, far away, unless they want to deal with hostile management, unrealistic patient expectations/demands, high risk/liability to one's license, poor compensation, and loss of career. The same may apply to all of telemedicine but right now, TELADOC, is a big threat to its own doctors.

 

[Sushirolls]

That description of toxic admin forcing the view point of customers first is a rising cultural tide. Becoming more apparent even in Big Box shops.

Healthcare is, and will continue to change.

I posit more future trainees need to pull their heads out of the sand and realize things will not be rosy out there and need to be prepared to own their career and open their own practice. Best buffer against these toxic Admins most often connected with Big Box shops.

 

[Username2015]

The primary care part of teladoc is a bit more like urgent care — those physicians aren’t having long term relationships with patients. I think teladoc can do a better job of setting patients’ expectations so they recognize the limitations of a one off visit with an urgent care or primary care doctor. They do have training on how to say no to patients (eg regarding antibiotics) in the right way

Psychiatry seems to be different where you do become their outpatient provider. I haven’t had entitled patients so far and I inform patients of Teladoc’s policies (eg no controlled substances) and it has not been an issue. I also spend more time with each patient than I’m paid for so that probably helps.

My only complaint so far is that it is hard to reach someone at teladoc when you have questions (eg about billing, features, or policy).

The admin taking the side of patients without giving doctors the benefit of the doubt sounds concerning if true. These big companies may ultimately lead to the uber-ization of medicine.

 

[Yoyomama88]

The primary care part of teladoc is a bit more like urgent care — those physicians aren’t having long term relationships with patients. I think teladoc can do a better job of setting patients’ expectations so they recognize the limitations of a one off visit with an urgent care or primary care doctor. They do have training on how to say no to patients (eg regarding antibiotics) in the right way

Psychiatry seems to be different where you do become their outpatient provider. I haven’t had entitled patients so far and I inform patients of Teladoc’s policies (eg no controlled substances) and it has not been an issue. I also spend more time with each patient than I’m paid for so that probably helps.

My only complaint so far is that it is hard to reach someone at teladoc when you have questions (eg about billing, features, or policy).

The admin taking the side of patients without giving doctors the benefit of the doubt sounds concerning if true. These big companies may ultimately lead to the uber-ization of medicine.

You typically see the patients longer than 3 or 4 visits?

 

[Username2015]

Yes, the idea is that you’re their outpatient psychiatrist.

 

[bobby pen]

The primary care part of teladoc is a bit more like urgent care — those physicians aren’t having long term relationships with patients. I think teladoc can do a better job of setting patients’ expectations so they recognize the limitations of a one off visit with an urgent care or primary care doctor. They do have training on how to say no to patients (eg regarding antibiotics) in the right way

Psychiatry seems to be different where you do become their outpatient provider. I haven’t had entitled patients so far and I inform patients of Teladoc’s policies (eg no controlled substances) and it has not been an issue. I also spend more time with each patient than I’m paid for so that probably helps.

My only complaint so far is that it is hard to reach someone at teladoc when you have questions (eg about billing, features, or policy).

The admin taking the side of patients without giving doctors the benefit of the doubt sounds concerning if true. These big companies may ultimately lead to the uber-ization of medicine.

I was considering teledoc myself. Do they reimburse for no shows/cancellations with in a certain time frame?

 

[Username2015]

They are supposed to compensate for now shows. I just had a no show so I will have to wait a few weeks before I can check to see that I’m actually compensated for it.

 

[Psychresy]

I see a fair number of locums correctional jobs 1-2 hours outside major metros paying really high hourly rates - $300-350/hr for 4x10s a week. I can only imagine these are pretty terrible jobs in pretty terrible facilities that not many people want. My question is, would it be a bad idea to work one of these jobs my first year out of residency so I could completely pay off my loans and save up a downpayment for home?

Quick math would indicate these jobs are paying between 6-700k/year which would allow me to do both of the above. Any major reasons not to do this for that first year?

 

[robellis]

I see a fair number of locums correctional jobs 1-2 hours outside major metros paying really high hourly rates - $300-350/hr for 4x10s a week. I can only imagine these are pretty terrible jobs in pretty terrible facilities that not many people want. My question is, would it be a bad idea to work one of these jobs my first year out of residency so I could completely pay off my loans and save up a downpayment for home?

Quick math would indicate these jobs are paying between 6-700k/year which would allow me to do both of the above. Any major reasons not to do this for that first year?

Try it and see, if you make it out with all limbs intact then you were successful

 

[Yoyomama88]

I see a fair number of locums correctional jobs 1-2 hours outside major metros paying really high hourly rates - $300-350/hr for 4x10s a week. I can only imagine these are pretty terrible jobs in pretty terrible facilities that not many people want. My question is, would it be a bad idea to work one of these jobs my first year out of residency so I could completely pay off my loans and save up a downpayment for home?

Quick math would indicate these jobs are paying between 6-700k/year which would allow me to do both of the above. Any major reasons not to do this for that first year?

Yea go for it, not easy to make that money anywhere else in psych

 

[Psychresy]

Try it and see, if you make it out with all limbs intact then you were successful

Is it irresponsible to take this kind of job though? As in, will my license be constantly at risk, will it look bad on a CV, etc?

 

[Sushirolls]

Is it irresponsible to take this kind of job though? As in, will my license be constantly at risk, will it look bad on a CV, etc?

Just did a quick search function for you. This has been discussed fairly thoroughly.

Prison Psychiatry

Hello, I’ve been looking at a few Prison Psychiatry jobs in California and have come across a few positions in California that pay north of 500k. Is this something that is common for these types of jobs? I understand that they are tough positions and that could be the reason for the increased...

forums.studentdoctor.net

Correctional / prison psychiatry

Pgy4 here looking jobs right now. Anyone with correctional or prison ( state or federal) psychiatry experience? Would it suit a new grad?

forums.studentdoctor.net

Working in correctional mental health?

I just saw some of the phenomenal rates of working in Correctional Mental Health from a recruiter. Upwards of $230/hour. Does anyone have any insight on why it is so lucrative compared to other settings? it seems like a traditional outpatient gig with 12-14 patients per day. What are the...

forums.studentdoctor.net

 

[thepoopologist]

Is it irresponsible to take this kind of job though? As in, will my license be constantly at risk, will it look bad on a CV, etc?

It just depends.

From the patient side:
1. The risk is severe physical injury, patients threatening to sue you to triggering internal investigations over whatever allegations they throw at you.
2. Possible subpoenas for whatever reasons

From the colleague side:
1. If they don't like you they could impede your re-credentialing (I know someone who was up for recredentaling and another doc found a 3 month gap in their CV from 20 years ago and used that as an excuse to delay it for 3 months until the top top people intervened)
2. Write the medical board about your practices (a contractor I worked with was terminated and then a supervisor sent a note to the medical board about their supposed practices)
3. Apathetic administration who will leave you to your own devices. This is good or bad depending on who you ask.

Lets not forget Covid and all the infected in these facilities

On the other hand, if you're adept at navigating these waters you can make a lot of money. There are people who've navigated these waters for 10+ years and do well.

 

[Psychresy]

It just depends.

From the patient side:
1. The risk is severe physical injury, patients threatening to sue you to triggering internal investigations over whatever allegations they throw at you.
2. Possible subpoenas for whatever reasons

From the colleague side:
1. If they don't like you they could impede your re-credentialing (I know someone who was up for recredentaling and another doc found a 3 month gap in their CV from 20 years ago and used that as an excuse to delay it for 3 months until the top top people intervened)
2. Write the medical board about your practices (a contractor I worked with was terminated and then a supervisor sent a note to the medical board about their supposed practices)
3. Apathetic administration who will leave you to your own devices. This is good or bad depending on who you ask.

Lets not forget Covid and all the infected in these facilities

On the other hand, if you're adept at navigating these waters you can make a lot of money. There are people who've navigated these waters for 10+ years and do well.

Well taken. That confirms much of what I expected these places to be like. I'm hopeful I can make it a year unscathed and then quickly get out and move on to greener pastures. The ability to make 700k in a year and pay off my six figure loans is just too appealing at this point in my life. Appreciate the input though.

 

[Alvydas]

I see a fair number of locums correctional jobs 1-2 hours outside major metros paying really high hourly rates - $300-350/hr for 4x10s a week. I can only imagine these are pretty terrible jobs in pretty terrible facilities that not many people want. My question is, would it be a bad idea to work one of these jobs my first year out of residency so I could completely pay off my loans and save up a downpayment for home?

Quick math would indicate these jobs are paying between 6-700k/year which would allow me to do both of the above. Any major reasons not to do this for that first year?

I am somewhat skeptical that the hourly rate is in the $300-350/h range. I work for Amwell and we have similar positions (onsite, tele, correctional care, etc) but I know that the rate is not that high. We do have long-term contracts and I'm currently recruiting for CA/FL/PA so if I can be a resource, please let me know.
[email protected]

 

[robellis]

I am somewhat skeptical that the hourly rate is in the $300-350/h range. I work for Amwell and we have similar positions (onsite, tele, correctional care, etc) but I know that the rate is not that high. We do have long-term contracts and I'm currently recruiting for CA/FL/PA so if I can be a resource, please let me know.
[email protected]

What’s the hourly rate?

 

[Alvydas]

What’s the hourly rate?

I'd rather not post it on the open forum but it's closer what others have shared. I just wanted to say that jobs that post this high hourly rate are probably fishing for CVs or something else.

 

[jbomba]

Has anyone actually heard of anyone getting paid in that 3-350/hr range for a very undesirable facility?

 

[splik]

Has anyone actually heard of anyone getting paid in that 3-350/hr range for a very undesirable facility?

Yes there are actual locum jobs in CA and NY state that pay in this range. prison and state hospital work. I've also seen good locum jobs that pay a little less (i.e. high 200s) not in corrections but in hard to recruit areas.

 

[jbomba]

Yes there are actual locum jobs in CA and NY state that pay in this range. prison and state hospital work. I've also seen good locum jobs that pay a little less (i.e. high 200s) not in corrections but in hard to recruit areas.

The good jobs seem like a better move than going to work in the atmospheres described for just a bit more an hour.

 

[deleted310399]

After talking to a few people about this , the general consensus seems to be to try and steer clear of the big names like Teladoc . A word of mouth position where you can deal directly with the recruiter/administration is pretty ideal . There are otherwise good positions out there that just chronically need Locums to fill in because their location makes it hard to hire/retain people. The trick is of course to be able to find them.

 

[thepoopologist]

Well taken. That confirms much of what I expected these places to be like. I'm hopeful I can make it a year unscathed and then quickly get out and move on to greener pastures. The ability to make 700k in a year and pay off my six figure loans is just too appealing at this point in my life. Appreciate the input though.

From what I understand in speaking to a limited number of contractors, the agency takes a cut so if its $350/hr you're getting $325/hr in reality. Also some agencies don't pay on time or pay once every couple of months and will take out even more if you want a more regular pay schedule since they'd be fronting the money. Depending on the facility you go to and the situation you're placed in, your experience could range from nothing at all (the majority of people) to PTSD like trauma. The possibility of hostage situations, rape, stabbings/attempted murder are priced into your hourly rate. The reason most people think an hourly rate is high is because they can't find or keep people however to add more context the situation is that everything is broken, they don't want to fix it, and the easiest thing to do to make up for the severe short staffing is to raise rates for contractors and not fix anything else. Keep in mind everyone from the guards to the floor staff is a government worker holding a nearly unfire-able position, i.e. they don't care, so the ground is a lot shakier than you may think.

Again, you make it out unscathed then you're money. A lot of contractors do very well for themselves despite everything.