outpatient psychiatry is generally the best money/time set up?

[finalpsychyear]

I am in a position where I need to make a career decision. Currently, I do telehealth and 1 day PP and am very comfortable. However, I have moved to a top 12-14 city which is a 1.5 hr drive from my PP and have been told by various drug reps that wait times for private insurance psychiatry are 6-8 months and GROWING and there is even a market for cash psych in my area so you know the shortage is legit.

There are multiple free standing behavioral hospitals always looking for a unit director where you round on 18-20 pts daily and pay you a stipend plus you bill separate (these stipends alone range 6500-10k/mo, 1 wknd of rounding, anywhere 1:4 or 1:7 week your on phone call 24/7 for said facility)

Is it agreeable that while taking an inpt gig would provide immediate $$ that over time developing outpatient private pay in this area with TMS would likely hands down be the best from a business stand point even if the inpt would provide a quicker initial payout?

I really don't want to do inpt psych due to the weekend rounding and being on phone call anywhere from 1 week every 4 or 1 week every 7 cause my sleep really dictates my mood, health etc and i think it is a given that your lifestyle would always be far great with the outpatient psych set up ?

I feel like i go back and forth as the inpt seems like easy money in a sense while the outpt will take time and far more effort to get going. Maybe those that have done inpt can shed light on the toll it takes on them over time as i hear burnout can be high?

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[Stagg737]

Generally speaking, any job where you can be the boss and build your own company will likely have the greatest opportunity for high payout. Also speaking generally, I think it's easier to do this with an outpt gig than inpt. It also depends on what the pay difference is though. If you're going to start at $200k as the outpt and $350k with inpt for the first 5-7 years, that's a big difference that you can invest and make a lot of passive income off of in the long run.

 

[finalpsychyear]

Generally speaking, any job where you can be the boss and build your own company will likely have the greatest opportunity for high payout. Also speaking generally, I think it's easier to do this with an outpt gig than inpt. It also depends on what the pay difference is though. If you're going to start at $200k as the outpt and $350k with inpt for the first 5-7 years, that's a big difference that you can invest and make a lot of passive income off of in the long run.

My plan would be to keep my existing set up the way it is and slowly replace one day of telepsych (4 days currently) with a full day of outpatient PP in the new location. Worst case scenario it takes me a year to fill 1 day a week with private insurance although that would be odd considering the wait is 6-8 months based on what i have heard from patients,drug reps, etc.

Currently, my 1 day a week PP generates at least what roughly 2 days of telepsych pays. The longer i do telepsych in a way i guess i am losing money. However it took me about a year to get my 1 day PP going but that is in a much smaller area (30k population vs 300k in new area) and i only did minimum marketing (met 2-3 pcps). It does feel good to have a solid paycheck every few weeks from telepsych but now i am at the point where i probably need to take a bit of a risk but am a bit risk averse which i need to get over.

 

[Jules A]

There are multiple free standing behavioral hospitals always looking for a unit director where you round on 18-20 pts daily and pay you a stipend plus you bill separate (these stipends alone range 6500-10k/mo, 1 wknd of rounding, anywhere 1:4 or 1:7 week your on phone call 24/7 for said facility)

Do you have a preference inpatient vs outpatient? Although I'm all about the gross I believe working in an area you enjoy is the best way to tolerate the hours needed to make an exceptional income. The inpatient set up you describe sounds like high volume and considerable paperwork if you are billing for yourself. I would also recommend asking about the medical support at a freestanding psych hospital. It is surprising they require attendings to rotate weekends for rounding and call. The better facilities in my area generally have weekend staffing which is attractive to new and especially young talent.

If I were going to start a boutique practice I would get in with local cash only therapists who already have clients in need of med management which should fill your practice quickly.

 

[finalpsychyear]

Do you have a preference inpatient vs outpatient? Although I'm all about the gross I believe working in an area you enjoy is the best way to tolerate the hours needed to make an exceptional income. The inpatient set up you describe sounds like high volume and considerable paperwork if you are billing for yourself. I would also recommend asking about the medical support at a freestanding psych hospital. It is surprising they require attendings to rotate weekends for rounding and call. The better facilities in my area generally have weekend staffing which is attractive to new and especially young talent.

If I were going to start a boutique practice I would get in with local cash only therapists who already have clients in need of med management which should fill your practice quickly.

My preference is highly towards outpatient psych. I did a considerable amount of inpt during residency and then during 4th year i did 0. I started to feel inadequate after not doing inpt for so long after graduating in 2016, thus summer of 2017 did several weekend moonlighting shifts as an attending covering a 20 bed unit, consults, and the ER from Fri- Sun evening having to round sat and sun plus all er and floor consults.

I was glad that the hardest part of all that was the annoying EMR system and lack of sleep from constant calls throughout the night and my skills were just fine and the 3k i was getting from the hospital was absolutely not worth it.

The attendings I know who make an exceptional income in this area, they all do inpatient psych in the am typically starting 530-6am (earning director stipends and self billing) then are usually at their outpatient office by 1pm after rounding on nearly 20 inpatients.

I think i much prefer a 9-10am start time and building as close to a 30-35 hour private insurance as possible. It might be less money then the above combo of inpatient am and outpatient pm, yet i will never have wknds, night call, and something about not starting MY OWN business till 10am if i want and taking vaca whenever is sorta priceless.

 

[NickNaylor]

I think this is heavily dependent on what area you're talking about, but I agree with the above that, in general and over the long run, you're likely to make more money running a solo practice than working for an employer. The devil is in the details, though, and how effective a business manager you are.

 

[uhmocksuhsillen]

Does it really take a year to fill one day of insurance pp? I was under the impression the waiting list were so long it was reasonably easy to fill quickly.

 

[AD04]

Does it really take a year to fill one day of insurance pp? I was under the impression the waiting list were so long it was reasonably easy to fill quickly.

That is very uncommon. Even a cash practice should fill faster than that.

For maximize income long-term, I agree with the private practice route.

If OP is serious about private practice, he should get a mentor or partner who is successful.

 

[TexasPhysician]

Does it really take a year to fill one day of insurance pp? I was under the impression the waiting list were so long it was reasonably easy to fill quickly.

The insurance practices that I’ve seen can fill 40 hours in under 6 months. It took me closer to 1 year as all cash.

 

[yanks26dmb]

The insurance practices that I’ve seen can fill 40 hours in under 6 months. It took me closer to 1 year as all cash.

A resident at a program I interviewed at talked about doing group med management sessions multiple days a week as a way to increase income/allow you to spend more time doing 1 on 1 therapy with other patients. Any idea about this type of set up?

 

[Sushirolls]

I've offered shared medical appointments for an OUD / suboxone clinic before. Insurance contracts dictate no patients can be forced into them. Patients have to voluntary opt into them and have the right to opt out of them. About half of a 90+ patient panel opted in. The majority of the pregnant patients opted in, especially for a pregnancy / early mother group I ran. Dropped the additional group therapy I was doing after local medicaid put a time stamp for group therapy at 50 or 60 minutes. I was typically doing 30-35 minutes and didn't really want to stretch it out just for that.

Shared medical appointments are quite fun, and very versatile. The charting though is draining, and really the most difficult hurdle. The time I spent documenting after the fact, almost equated to same as doing individual appointments. Patients typically enjoy them for many reasons, except when exes or exes family discord bleeds into the appointment.

If you are running paper charts, this can easily be doable. Electronic is a bit more tricky.

 

[NickNaylor]

Does it really take a year to fill one day of insurance pp? I was under the impression the waiting list were so long it was reasonably easy to fill quickly.

In my neck of the woods, most folks say that you'll be filled with a waiting list in 6-9 months if taking insurance.

 

[leftpinky]

Yeah, should not take terribly long. I do cash pay on the side and I get 3-5 new patients every week and I'm only available for 10 hours of clinic per week. This is also a very expensive cash pay practice, but it's in the downtown of a major tech hub where the insurance tends to reimburse 60-80% of their costs. All the advertising is basically online at a few websites. If I wanted to stay in this outpatient cash model with super high functioning patients, I would imagine I could get 150 or so patients by the end of residency, which would be more than what VA/community docs make at most places.

 

[AD04]

Yeah, should not take terribly long. I do cash pay on the side and I get 3-5 new patients every week and I'm only available for 10 hours of clinic per week. This is also a very expensive cash pay practice, but it's in the downtown of a major tech hub where the insurance tends to reimburse 60-80% of their costs. All the advertising is basically online at a few websites. If I wanted to stay in this outpatient cash model with super high functioning patients, I would imagine I could get 150 or so patients by the end of residency, which would be more than what VA/community docs make at most places.

Impressive. Never heard of anyone setting up a cash practice during residency. Would you mind sharing the websites where you advertise?

 

[nrmp]

@finalpsychyear, could you please tell how much were you able to make through telepsych? I am considering to supplement my outpatient with telepsych if it is worth it? I don't have any experience with tele but really interested in it due to flexibility of scheduling

 

[leftpinky]

Impressive. Never heard of anyone setting up a cash practice during residency. Would you mind sharing the websites where you advertise?

I actually don't do advertising, but the clinic I work for does. Another resident at my place also does this and I know of at least one from another residency nearby who does this too. It's basically just the regular websites they advertise on, doximity, health grades, etc...Other psychiatrists in town charge more and want to see you more, so even though we charge a lot, it's reasonable for the town.

 

[Shufflin]

There are some fantastic inpatient gigs out there, albeit uncommon, that rival outpatient rates. I'm fortunate to have one, and it earns more per hour than my outpatient practice which charges $400/hr. Don't get me wrong, I'm very willing and able to do outpatient, but my inpatient gig is so good for the $$/hr that I'm sticking with it.

 

[jbomba]

There are some fantastic inpatient gigs out there, albeit uncommon, that rival outpatient rates. I'm fortunate to have one, and it earns more per hour than my outpatient practice which charges $400/hr. Don't get me wrong, I'm very willing and able to do outpatient, but my inpatient gig is so good for the $$/hr that I'm sticking with it.

How does one find these inpatient gigs?

 

[Shufflin]

How does one find these inpatient gigs?

Find a city you want to work in, then contact hospitals and see what they offer. The great gigs are probably not advertised, in fact, in my experience, they're just word-of-mouth but they usually welcome cold calls.

If that doesn't work, then just start an inpatient gig anyway and get to know the main psychiatrists in the area. Whispers of gem opportunities will eventually wisp your way.

 

[Monocles]

There are some fantastic inpatient gigs out there, albeit uncommon, that rival outpatient rates. I'm fortunate to have one, and it earns more per hour than my outpatient practice which charges $400/hr. Don't get me wrong, I'm very willing and able to do outpatient, but my inpatient gig is so good for the $$/hr that I'm sticking with it.

Can you briefly describe what that means? like is it academic, corporate, etc? Do you have to work weekends or nights?

I am interested in doing inpt (hopefully will match CAP next week!) but I've always heard that the money is better for outpt than inpt in terms of child psych. Not sure if that's true and would appreciate some seasoned opinions!

 

[Shufflin]

Can you briefly describe what that means? like is it academic, corporate, etc? Do you have to work weekends or nights?

I am interested in doing inpt (hopefully will match CAP next week!) but I've always heard that the money is better for outpt than inpt in terms of child psych. Not sure if that's true and would appreciate some seasoned opinions!

Sure, happy to help. Nice to hear a fellow psychiatrist wants to do inpatient. So basically here's the deal. Regarding inpt work, there's the employee model and the indie contractor model. With a salary you're going to get a guaranteed income but the $$ per hour won't be impressive, obviously.

As an independent contractor, that all changes. You get paid per encounter. You generally keep all of the pro fee, and the facility gets its share. You only pay a billing service a small percentage, so you keep anywhere from 90 to 95% per encounter which is fantastically awesome. Can you imagine if an oncologist, surgeon, or radiologist, got to keep 95% of their physician fees? There would be mass hysteria, parties, fireworks and DJs on every hospital floor. I'm thinking you won't find this in academia. I would look at non-academic hospitals. As for which non-academic hospitals, I have no insight as to trends or how to find them. You gotta look hard or get lucky, or both.

As for call and overnights, both are expected. The frequency depends on how many work with you. I negotiated no overnights so I have a great situation. Where I work people want weekends because it's such a good deal. I fight to secure 1 to 2 weekends a month.

 

[AD04]

Sure, happy to help. Nice to hear a fellow psychiatrist wants to do inpatient. So basically here's the deal. Regarding inpt work, there's the employee model and the indie contractor model. With a salary you're going to get a guaranteed income but the $$ per hour won't be impressive, obviously.

As an independent contractor, that all changes. You get paid per encounter. You generally keep all of the pro fee, and the facility gets its share. You only pay a billing service a small percentage, so you keep anywhere from 90 to 95% per encounter which is fantastically awesome. Can you imagine if an oncologist, surgeon, or radiologist, got to keep 95% of their physician fees? There would be mass hysteria, parties, fireworks and DJs on every hospital floor. I'm thinking you won't find this in academia. I would look at non-academic hospitals. As for which non-academic hospitals, I have no insight as to trends or how to find them. You gotta look hard or get lucky, or both.

As for call and overnights, both are expected. The frequency depends on how many work with you. I negotiated no overnights so I have a great situation. Where I work people want weekends because it's such a good deal. I fight to secure 1 to 2 weekends a month.

Do you get paid a stipend as well (i.e. a cut of the facility fees)? For example, for working on weekends? If not, you may be leaving money on the table.

How are you able to see patients so quickly to make what you make hourly? Do you have residents doing the work?

 

[psyguru]

One option to maximize income is to find a low volume job (I used to have one where I saw 6 patients a week plus about 2 hours of paperwork or sitting in meetings a day) and do forensic expert witness work on the side where 80% of the work (record review, report writing, calling attorney) can be done during the down time at the day job. Expert work pays above $400 per hour.

Currently my job is not so low volume. Last 2 months I believe my forensic income was above my day job income. I believe it was well worth doing the forensic fellowship as you will see the most interesting cases and the money is not bad.

Sent from my SM-G965U using Tapatalk

 

[Shufflin]

Do you get paid a stipend as well (i.e. a cut of the facility fees)? For example, for working on weekends? If not, you may be leaving money on the table.

How are you able to see patients so quickly to make what you make hourly? Do you have residents doing the work?

Manged care pays over $120 per follow up. You can see 5 patients in an hour comfortably, without rushing, as follow ups. New evals pay around $300 and you could do 2 in one hour, 3 if a patient is too far fetched to have a meaningful conversation. Mind you, rates differ by geography and contract.

And yes I do receive a monthly bonus in addition.

 

[Jules A]

Can you briefly describe what that means? like is it academic, corporate, etc? Do you have to work weekends or nights?

I am interested in doing inpt (hopefully will match CAP next week!) but I've always heard that the money is better for outpt than inpt in terms of child psych. Not sure if that's true and would appreciate some seasoned opinions!

In my area unless you are talking high end boutique practice inpt and outpt are similar, $250,000-$325,000. The notable exception being rural clinics on the edge of the earth where crystal meth is sprinkled on breakfast cereal that understandably pay $300k+. The largest barrier seems to be docs who don't discuss pay with peers or are poor at negotiating. Since inpatient tends to be less desirable I believe it should pay more and would consider that during negotiations.

 

[nrmp]

In the private practice I work with, follow up pay comes to average $70 and for new eval average comes to $150, considering +/- for some insurances. From those rates you have to take out 30% overhead and denials. Is this normal or poor rates and waste of time? just want to see how other practices are doing.

 

[Shufflin]

In the private practice I work with, follow up pay comes to average $70 and for new eval average comes to $150, considering +/- for some insurances. From those rates you have to take out 30% overhead and denials. Is this normal or poor rates and waste of time? just want to see how other practices are doing.

Sounds more like Medicare rates. If so, then you're getting a fair deal. It also depends on how you're coding.

Three great benefits of inpatient over outpatient:

• No overhead
• No no-shows
• No busy social work and extraneous paperwork, just notes

 

[dl2dp2]

In the private practice I work with, follow up pay comes to average $70 and for new eval average comes to $150, considering +/- for some insurances. From those rates you have to take out 30% overhead and denials. Is this normal or poor rates and waste of time? just want to see how other practices are doing.

This is not unusual but unfortunately not a great scenario. F/u should be at around $175-$200, intakes can be variable but should be in the $250 range from insurance. Even Medicare rates are higher than this now. This sounds more like MedicAID rates. If your insurance pay is at that level and negotiation attempts fail, you should be rest assured that most of the providers in your area are out-of-network.

Let me guess, the owner of the said practice is a non-MD, and you are not expected to have equity partnership. Or, if the MD owns the practice, that person is him/herself not in network. Price caps introduces artificial scarcity.

Generally speaking, any job where you can be the boss and build your own company will likely have the greatest opportunity for high payout. Also speaking generally, I think it's easier to do this with an outpt gig than inpt. It also depends on what the pay difference is though. If you're going to start at $200k as the outpt and $350k with inpt for the first 5-7 years, that's a big difference that you can invest and make a lot of passive income off of in the long run.

This is absolutely the right answer. Owners of IOP/inpatient facilities (this is more common in subspecialty settings, i.e. addiction, women's mental health, children, etc) can have a total higher income because they run a larger business. However, it is true that owning an outpatient practice as a business is the far easier choice if that's the road you want to go down. I also agree with posters above that at employee level, average out total number of hours worked inpt/outpt are typically fairly comparable in salary.

 

[zolof]

Sure, happy to help. Nice to hear a fellow psychiatrist wants to do inpatient. So basically here's the deal. Regarding inpt work, there's the employee model and the indie contractor model. With a salary you're going to get a guaranteed income but the $$ per hour won't be impressive, obviously.

As an independent contractor, that all changes. You get paid per encounter. You generally keep all of the pro fee, and the facility gets its share. You only pay a billing service a small percentage, so you keep anywhere from 90 to 95% per encounter which is fantastically awesome. Can you imagine if an oncologist, surgeon, or radiologist, got to keep 95% of their physician fees? There would be mass hysteria, parties, fireworks and DJs on every hospital floor. I'm thinking you won't find this in academia. I would look at non-academic hospitals. As for which non-academic hospitals, I have no insight as to trends or how to find them. You gotta look hard or get lucky, or both.

As for call and overnights, both are expected. The frequency depends on how many work with you. I negotiated no overnights so I have a great situation. Where I work people want weekends because it's such a good deal. I fight to secure 1 to 2 weekends a month.

good job thats great for you.
Do you have any recommendations/company that you particular recommend that specialize in inpatient billing.

 

[Shufflin]

good job thats great for you.
Do you have any recommendations/company that you particular recommend that specialize in inpatient billing.

Thanks!
Find a person who has at least 10 years experience. New billers make mistakes and you end up losing income from them.

 

[nrmp]

Sounds more like Medicare rates. If so, then you're getting a fair deal. It also depends on how you're coding.

Three great benefits of inpatient over outpatient:

• No overhead
• No no-shows
• No busy social work and extraneous paperwork, just notes

Yes I would say pretty good number of medicare and medicaid patients. At this rate seeing 20 patients a day might come around $220000 after taking out overhead with no benefits. Yours looks like going above $400000/yr?

 

[nrmp]

This is not unusual but unfortunately not a great scenario. F/u should be at around $175-$200, intakes can be variable but should be in the $250 range from insurance. Even Medicare rates are higher than this now. This sounds more like MedicAID rates. If your insurance pay is at that level and negotiation attempts fail, you should be rest assured that most of the providers in your area are out-of-network.

Let me guess, the owner of the said practice is a non-MD, and you are not expected to have equity partnership. Or, if the MD owns the practice, that person is him/herself not in network. Price caps introduces artificial scarcity.



This is absolutely the right answer. Owners of IOP/inpatient facilities (this is more common in subspecialty settings, i.e. addiction, women's mental health, children, etc) can have a total higher income because they run a larger business. However, it is true that owning an outpatient practice as a business is the far easier choice if that's the road you want to go down. I also agree with posters above that at employee level, average out total number of hours worked inpt/outpt are typically fairly comparable in salary.

You are right more medicaid/medicare patients than plain commercial insurances and owner is seeing the same, not out of network

 

[Stagg737]

Does it really take a year to fill one day of insurance pp? I was under the impression the waiting list were so long it was reasonably easy to fill quickly.

Depends where you are. If you're 200 miles out in the country, certainly could. If you're in a major metro or near one, you should be able to fill a full weekly schedule within a few months (a few being 3-6).

 

[Shufflin]

Yes I would say pretty good number of medicare and medicaid patients. At this rate seeing 20 patients a day might come around $220000 after taking out overhead with no benefits. Yours looks like going above $400000/yr?

Because I do more than inpatient work I go well above this figure.

Try to find a place where you can wear different hats. I think it leads to better job satisfaction and income.

 

[nrmp]

Because I do more than inpatient work I go well above this figure.

Try to find a place where you can wear different hats. I think it leads to better job satisfaction and income.

Waw above that figure for psych is really good! I have to look for opportunities where you can wear different hats, that seems like a good idea instead of just being in full-time outpatient. Seeing 15-20 patients 60% with medicare/medicaid feels like working too hard for many unstable patients for below average income. Though I do inpatient just 1:4 which is not much.

 

[finalpsychyear]

Manged care pays over $120 per follow up. You can see 5 patients in an hour comfortably, without rushing, as follow ups. New evals pay around $300 and you could do 2 in one hour, 3 if a patient is too far fetched to have a meaningful conversation. Mind you, rates differ by geography and contract.

And yes I do receive a monthly bonus in addition.

what coding are you using for 120 per follow up..... 99233 cpt code +/- add on code 90833?

In my area medicare pays 105 dollars for a 99233 and 200 for the initial admit for cpt 99223 for inpt care.

 

[Shufflin]

what coding are you using for 120 per follow up..... 99233 cpt code +/- add on code 90833?

In my area medicare pays 105 dollars for a 99233 and 200 for the initial admit for cpt 99223 for inpt care.

yes those codes mostly, there are some others

 

[zolof]

yes those codes mostly, there are some others

Do

yes those codes mostly, there are some others

How does you day usually average out in terms of getting out on time, meaning with team meetings and such, legal issues, etc. Do you have other psychiatrists the competing for seeing patients who might be on rvu or are you pretty much it. Im asking because I was recently offered kind of similar set up, but trying to negotiate the scheduling and census, might be offered 7/7off.

 

[Trismegistus4]

There are some fantastic inpatient gigs out there, albeit uncommon, that rival outpatient rates. I'm fortunate to have one, and it earns more per hour than my outpatient practice which charges $400/hr. Don't get me wrong, I'm very willing and able to do outpatient, but my inpatient gig is so good for the $$/hr that I'm sticking with it.

In your opinion, would it be possible to find the kind of inpatient gig which some psychiatrists squeeze into the morning only and then have their own outpatient practice in the afternoon, but instead of doing that, do just the inpatient gig, thus essential still making decent money for what amounts to a half-time job? Since taking my current outpatient job and growing to hate outpatient, I've been thinking that would pretty much be my dream job. Instead of hustling all morning and again all afternoon to make $500k, just be content with making $250k, take my time with the inpatient work, and be done by 2PM every day. Is this feasible? Ever known anyone who did it?

 

[Shufflin]

Do


How does you day usually average out in terms of getting out on time, meaning with team meetings and such, legal issues, etc. Do you have other psychiatrists the competing for seeing patients who might be on rvu or are you pretty much it. Im asking because I was recently offered kind of similar set up, but trying to negotiate the scheduling and census, might be offered 7/7off.

I'm a hound for getting out on time. I make it a big priority. Multi-tasking is how I do it. I do paperwork while getting reports from nursing, write scripts while discussing cases, etc. You gotta multi-task, no down-time. Inpatient units conference call me so I just keep working while running through the patients on the phone which only takes a few minutes.

Go to a place where team meetings are kept to a minimum, and complete tasks in parallel when you're not seeing patients.

 

[Shufflin]

In your opinion, would it be possible to find the kind of inpatient gig which some psychiatrists squeeze into the morning only and then have their own outpatient practice in the afternoon, but instead of doing that, do just the inpatient gig, thus essential still making decent money for what amounts to a half-time job? Since taking my current outpatient job and growing to hate outpatient, I've been thinking that would pretty much be my dream job. Instead of hustling all morning and again all afternoon to make $500k, just be content with making $250k, take my time with the inpatient work, and be done by 2PM every day. Is this feasible? Ever known anyone who did it?

My friend, I'm doing what you're talking about.

I reached this very same point as you. I thought outpatient would be amazing, and ended up not liking it very much. To my surprise I found my inpatient gig to be amazing. I have entire teams of great nurses and social workers who are all so easy going and enjoyable to work with doing lots of the heavy lifting so i can focus on practicing psychiatry. I was working 2 inpatient gigs making a killing, and due to a special turn of events of a new leadership position at one of the places where I work, I decided to stop the second gig and now make the same amount as both places. Once you pay off all your debt, numbers don't matter as much, seriously. 500K or 300K with no debt, it won't matter very much, but your happiness will matter.

Now I work half days like you're talking about. It's very do-able. Forget hustling all morning and then repeating in the afternoon. Finish by noon like me, go jogging in nature, then pick up your kids from school, and enjoy life like you're semi-retired. I earn over 600K, but to be fair that's because I do inpatient work, partial hospital PHP/IOP work, and telepsychiatry covering an ER at the one place I'm at plus I have an executive leadership position. Work somewhere really close to home. I'm a 10 minute drive from my hospital which is bliss.

 

[Ironspy]

My friend, I'm doing what you're talking about.

I reached this very same point as you. I thought outpatient would be amazing, and ended up not liking it very much. To my surprise I found my inpatient gig to be amazing. I have entire teams of great nurses and social workers who are all so easy going and enjoyable to work with doing lots of the heavy lifting so i can focus on practicing psychiatry. I was working 2 inpatient gigs making a killing, and due to a special turn of events of a new leadership position at one of the places where I work, I decided to stop the second gig and now make the same amount as both places. Once you pay off all your debt, numbers don't matter as much, seriously. 500K or 300K with no debt, it won't matter very much, but your happiness will matter.

Now I work half days like you're talking about. It's very do-able. Forget hustling all morning and then repeating in the afternoon. Finish by noon like me, go jogging in nature, then pick up your kids from school, and enjoy life like you're semi-retired. I earn over 600K, but to be fair that's because I do inpatient work, partial hospital PHP/IOP work, and telepsychiatry covering an ER at the one place I'm at plus I have an executive leadership position. Work somewhere really close to home. I'm a 10 minute drive from my hospital which is bliss.

This is my dream. What part of the country are you in?

 

[clausewitz2]

In your opinion, would it be possible to find the kind of inpatient gig which some psychiatrists squeeze into the morning only and then have their own outpatient practice in the afternoon, but instead of doing that, do just the inpatient gig, thus essential still making decent money for what amounts to a half-time job? Since taking my current outpatient job and growing to hate outpatient, I've been thinking that would pretty much be my dream job. Instead of hustling all morning and again all afternoon to make $500k, just be content with making $250k, take my time with the inpatient work, and be done by 2PM every day. Is this feasible? Ever known anyone who did it?

There is an inpatient attending here who is notorious for being gone from the building no later than noon each day and is not running a side hustle to the best of anyone's knowledge, so yes. It's academics though so definitely not 250K.

 

[finalpsychyear]

My friend, I'm doing what you're talking about.

I reached this very same point as you. I thought outpatient would be amazing, and ended up not liking it very much. To my surprise I found my inpatient gig to be amazing. I have entire teams of great nurses and social workers who are all so easy going and enjoyable to work with doing lots of the heavy lifting so i can focus on practicing psychiatry. I was working 2 inpatient gigs making a killing, and due to a special turn of events of a new leadership position at one of the places where I work, I decided to stop the second gig and now make the same amount as both places. Once you pay off all your debt, numbers don't matter as much, seriously. 500K or 300K with no debt, it won't matter very much, but your happiness will matter.

Now I work half days like you're talking about. It's very do-able. Forget hustling all morning and then repeating in the afternoon. Finish by noon like me, go jogging in nature, then pick up your kids from school, and enjoy life like you're semi-retired. I earn over 600K, but to be fair that's because I do inpatient work, partial hospital PHP/IOP work, and telepsychiatry covering an ER at the one place I'm at plus I have an executive leadership position. Work somewhere really close to home. I'm a 10 minute drive from my hospital which is bliss.

Hi. Great set up. How many hours a week do you pull adding up all those various responsibilities plus the admin role?