Hello, I am a resident in a low tier residency in NYC. I am thinking I dont want a fellowship as I want to be a general bread and butter type of psychiatrist. I wonder if a lack of fellowship from a low tier residency will cause me to have trouble finding a desireable job. Also, I would like to have a cash based primarily psychotherapy part time private practice, in addition to my fill time day job at a hospital. Does a brand name fellowship help a lot with that?
private practice and job opportunities
- Thread starter alona1988
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Business sense and networking are more important than a brand name fellowship when it comes to filling psychotherapy cash only practice.
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This probably doesn't matter. There are a lot of jobs everywhere, some of them are more desirable than others. If you just do a thorough survey you should be able to find something good.
I don't think fellowship is the issue here. The issue here is competition. None of the ABPN fellowships really contributes to this type of career. You'd need to market yourself as a specialist who does a particular kind of therapy for a particular kind of patient. Especially for cash, my sense is that people do look at credentials. This can benefit from "remedial" credentialing (i.e. analytic institute vs. CBT training etc at a prestigious institution). A generic ABPN fellowship even at a named institution may or may not help, unless you want to focus on that particular subspecialty niche. You can also fix this by dropping your fees. A third way is to start with taking an insurance. If you focus on therapy with a small panel of patients, insurance paperwork isn't too tedious. I wouldn't worry too much about this. Just start your practice slowly, get a few hours and play around with it a bit if this is strictly a part time endeavor.
Cash psychopharm practice is much easier regardless of your credentials, especially if you are willing to drop your fees. You are not in competition with other qualified therapists. If you want to subspecialize, getting a fellowship at a named place certainly helps.
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Why should a patient see you for therapy over a therapist with a PhD and years of therapy experience? What have you got that they don't?
When it comes to cash, patients are extremely shrewd with how and where they spend their hard-earned money. You have to fill a critical void or else it's a no go. (I started a very small niche cash practice myself and have kept it small for a reason.)
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I think some people will look for experience. But, I think the majority of people don't care and will just go to random mid-levels who hung out a shingle. They probably appreciate someone who will do "supportive" therapy for years on end and never truly challenge them or hold the dyad responsible for meeting appreciable goals. You may appeal to the more well off, discerning consumer with experience and credentials, but most patients really don't care.
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I should start a fellowship in treating the neurosis of the rich. Maybe it could be combined with an MBA program or some kind of practice management credential.
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wouldn't that just be adding an MBA to analytic training?
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I know of an "anti-aging clinic" that charges thousands of dollars and they basically tell you to lose weight if you're overweight, exercise then tell you to take green tea and resveratrol.
That's it.
Thousands of dollars for this BS? (Yeah I know there is data backing up green tea and resveratrol but you didn't need an MD and get a charge of thousands of dollars to be told this).
I knew of some other guy selling false hope to schizophrenics selling that it could be a caffeine allergy. Now in case you didn't know caffeine allergies might cause psychosis (there is some data out there but it's not strong), but if that's the case all you got to do is stop caffeine and if the person gets better you can target that as the prime suspect.
The person selling the caffeine allergy charged over $10,000, ran a bunch of tests that I would've ordered anyways, plus a few more for some antibodies (that I could've ordered myself in fact I offered to do so) and it was of no use whatsoever. The clinician also wasn't a physician. He had a master's degree.
I remember telling the person's mother something to the effect of...., "I can tell you this isn't a caffeine allergy but if you think it is we'll put a diet restriction on caffeine and if he has it he'll show improvement within a short period of time. There's no need to fly him to another state and pay this kind of money."
Well money is what this patient's family had, and lots of it. The mother was really finding various quacks to feed into her neurosis.
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most anti-aging clinics are also doing things like Sermorelin and testosterone (for men) these days; and some will do weight loss (with phentermine, etc)
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Where I practice I see phentermine very often given by PCP for weight loss
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How is this not practicing medicine without a license?
