Psych job flexibility...

[W19]

Advertisement - Members don't see this ad

I have been hearing that the job market for psych physicians is not bad; therefore, are employers willing to let docs work 4 days/wk 10hrs/day? because that will give someone the flexibility to get another part time job if he/she wants to. Is there anyone in this forum who has that type of schedule?

 

[nitemagi]

Yes.

 

[Frazier]

Yes, I've seen numerous job listings that offer that very thing.

 

[Leo Aquarius]

Yes. Plenty of 4 days a week options for psychiatrists out there.

You can have a happy life outside of work in our profession.

 

[FranzLO]

Just to get a feel for it, how flexible are some of these opportunities? How easy is it to work 20 hours if you want or 60, or even on Saturdays? I have no idea where I would fall into this but the options are really cool. Are there other specialties that offer this flexibility? How does the flexibility change depending on if the job is PP (including joining a group), academics, other employment, etc? I am just a student so I am mostly curious. I also wonder what are some other common models.

 

[Baller MD]

To add to the questions above: how common are "eat-what-you-kill" type of practices?

 

[Shikima]

I'm only working about 34-36 hours per week right now in PP and maintaining the same level of earnings compared to last year at the VA as my primary practice with augmentation in PP which equaled about 60-65 hrs/week. I am in a 'eat-what-you-kill' practice model and it is working out quite well. It also helps that I'm the youngest psychiatrist in my area of practice.

 

[F0nzie]

I'm only working about 34-36 hours per week right now in PP and maintaining the same level of earnings compared to last year at the VA as my primary practice with augmentation in PP which equaled about 60-65 hrs/week. I am in a 'eat-what-you-kill' practice model and it is working out quite well. It also helps that I'm the youngest psychiatrist in my area of practice.

Tired of sitting around all day with no-shows and getting paid for it? 🙂

 

[SomeDoc]

It also helps that I'm the youngest psychiatrist in my area of practice.

How so?

 

[Shikima]

Tired of sitting around all day with no-shows and getting paid for it? 🙂

PP? No show.. they get charged. Still have overhead costs to cover.

 

[Shikima]

How so?

They're old?

 

[SomeDoc]

I'm only working about 34-36 hours per week right now in PP and maintaining the same level of earnings compared to last year at the VA as my primary practice with augmentation in PP which equaled about 60-65 hrs/week.

They're old?

I was thinking more on the lines of having a smaller referral base/less bargaining power with managed care or partner contracts compared the the more established psychiatrists.

 

[Shikima]

I was thinking more on the lines of having a smaller referral base/less bargaining power with managed care or partner contracts compared the the more established psychiatrists.

Not really. Retirement will soon be on them. There are many gaps in coverage as we speak which boosts my ability to bargain whomever needs coverage towards an arrangement which benefits me more strongly. In essence, working smartly and efficiently for the same earnings rather than 'just hard'.

 

[Leo Aquarius]

A family medicine doctor at a major integrated managed care consortium (ala Kaiser) told me lots of psychiatrists are retiring soon, and that the shortage will just get bigger in my city. She said she would personally take my CV and give it to their HR department after I graduate.

 

[Baller MD]

A family medicine doctor at a major integrated managed care consortium (ala Kaiser) told me lots of psychiatrists are retiring soon, and that the shortage will just get bigger in my city. She said she would personally take my CV and give it to their HR department after I graduate.

59 percent of current psychiatrists are over the age of 55.

 

[Leo Aquarius]

59 percent of current psychiatrists are over the age of 55.

That number sounds right to me. A huge plus for psychiatry is their lifetime earnings. If surgeons retire on average in their mid 60s, and psychiatrists retire 10 years later on average, then thats significant additional lifetime salary.

What the family doctor told me doesn't discount the above fact, in fact it reinforces that concept that lots of psychiatrists are older.

 

[OldPsychDoc]

Some of us are older to start with though, too. 20% of my med school class was over 30 at matriculation, and we had a bumper crop of psychs at graduation, a majority of whom were from that "geriatric" cohort. Us old folk might be drawn to the more leisurely lifestyle...

 

[F0nzie]

PP? No show.. they get charged. Still have overhead costs to cover.

Nah I meant at the VA. I remember having a 50% no show rate and farting around alot. Not a bad deal. Getting paid to chill. Good old tax payer money.

 

[Shikima]

Nah I meant at the VA. I remember having a 50% no show rate and farting around alot. Not a bad deal. Getting paid to chill. Good old tax payer money.

Not anymore, constant pressure to double-book appointments to keep no show rates at less than 5%. Also, if they no show you have to do 3 phone calls, sending letters, and all kinds of other nonsense.... in essence, harrass them to go to their appointments. Never mind that they're adult individuals who can make up their own minds.

 

[F0nzie]

Not anymore, constant pressure to double-book appointments to keep no show rates at less than 5%. Also, if they no show you have to do 3 phone calls, sending letters, and all kinds of other nonsense.... in essence, harrass them to go to their appointments. Never mind that they're adult individuals who can make up their own minds.

Double booking sounds a bit extreme. That means potentially seeing 4 patients an hour. If you had a check-in system with 4 rooms in a circle you could see 30-40 patients without a problem. You lose precious time when patients settle in your office and get their stuff together to leave. I think a better solution with the current setup would be 3 patients an hour and hire a medical assistant to do the phone calls, letters, and RN support.

 

[Shikima]

Double booking sounds a bit extreme. That means potentially seeing 4 patients an hour. If you had a check-in system with 4 rooms in a circle you could see 30-40 patients without a problem. You lose precious time when patients settle in your office and get their stuff together to leave. I think a better solution with the current setup would be 3 patients an hour and hire a medical assistant to do the phone calls, letters, and RN support.

Yeah the VA doesn't necessarily give you a MA or RN support to do all that work. Fortunately appointments are capped at 30 and 60 minutes each depending if a f/u or new intake. And there is a ton of other work that you have to complete that they require, AIMS, PCL, ETOH screening, vaccinations, lipids, etc..... all that needs to be completed in time.

 

[Cinclus]

Nah I meant at the VA. I remember having a 50% no show rate and farting around alot. Not a bad deal. Getting paid to chill. Good old tax payer money.

This was what I observed during my month-long VA outpatient rotation, though I was told the no-show rate was much worse than usual during my time there (it was actually over 50%, I would say).

 

[doubledeuce80]

Just to get a feel for it, how flexible are some of these opportunities? How easy is it to work 20 hours if you want or 60, or even on Saturdays? I have no idea where I would fall into this but the options are really cool. Are there other specialties that offer this flexibility? How does the flexibility change depending on if the job is PP (including joining a group), academics, other employment, etc? I am just a student so I am mostly curious. I also wonder what are some other common models.

i just finished training in july and have been working psych er shifts avg of 5-10 days per month and traveling the rest of the time for last 6 months. i can cover all my expenses (note: loans are still on deferment) and has been amazing. i have lots of colleagues that work part time in psych er and then pp. i plan to start my "grown up job" soon. if you can handle the work/intensity, psych er is a great option for flexibility.

 

[Cinclus]

i just finished training in july and have been working psych er shifts avg of 5-10 days per month and traveling the rest of the time for last 6 months. i can cover all my expenses (note: loans are still on deferment) and has been amazing. i have lots of colleagues that work part time in psych er and then pp. i plan to start my "grown up job" soon. if you can handle the work/intensity, psych er is a great option for flexibility.

How easy is it to find full-time work in emergency psychiatry? Do most moderately-sized cities have these opportunities?I absolutely loved the month I spent in emergency psych; it has been my favorite rotation as a student.

 

[st2205]

How easy is it to find full-time work in emergency psychiatry? Do most moderately-sized cities have these opportunities?I absolutely loved the month I spent in emergency psych; it has been my favorite rotation as a student.

That's great. It'll likely be your least favorite in residency, particularly at about 3 am.

 

[Baller MD]

That's great. It'll likely be your least favorite in residency, particularly at about 3 am.

Does it compensate more than outpatient?

 

[chicagochildpsych]

My model is see about 2-8 inpatients, 5-20 partial hospital patients between 6:30 and 2pm, and about 15 in the afternoon, wrapping up at about 7. It's brutal, but at about 60 wrvu per day, around 55 per rvu, you do the math.

 

[Frazier]

My model is see about 2-8 inpatients, 5-20 partial hospital patients between 6:30 and 2pm, and about 15 in the afternoon, wrapping up at about 7. It's brutal, but at about 60 wrvu per day, around 55 per rvu, you do the math.

I remember you gave some numbers before... how did you come across this position?

Was it an advertised opening? Connections?

 

[PsychMD_recruiter]

Schedule flexibility will depend on who you work for/with and what setting you work in. You could conceivably work 4 - 10 hour days, less than 40 hours/week, etc. Telepsychiatry tends to be a very flexible option. There are also telepsychiatry opportunities that allow you to work as a psychiatric consultant to ED docs. The options are almost limitless. If you are completing your residency in June 2015, now is the time to lock down your full or part time gig. Happy hunting!

 

[chicagochildpsych]

I contacted about 20 recruiters, and went through 15+ interviews, started out on salary and moved to a production model after quickly building a practice. We are hiring, pm if interested. Really need Geri psych folks. Also, be aware that the more relaxed 35 hour a week docs do about 250k, it's about how much you much you want to make.

 

[doubledeuce80]

How easy is it to find full-time work in emergency psychiatry? Do most moderately-sized cities have these opportunities?I absolutely loved the month I spent in emergency psych; it has been my favorite rotation as a student.

I've worked in four different psych emergency rooms in four different cities now and all were looking for full-time people. I really like psych er work, but a lot people don't like the intensity, the nights, the internal medicine cross-over, or the lack of continuity & high recidividism. My experience has been most large cities and some moderate size cities have a psych er, but I don't know nationally. I would recommend looking in places you might potentially live and/or moonlighting in one in residency to get a better feel for it.

 

[doubledeuce80]

Does it compensate more than outpatient?

I think it depends. If you're doing cash only private practice in wealthy area, you can make significantly more than psych er. Otherwise my impression is psych er hourly rates are similar to typical outpatient jobs. However, the main advantages of psych er is opportunity for flexible scheduling (i.e time of day and as many days off as you want), clock in/clock out shift work (i.e. no calls from pt/pharmacy/family when shift is done), and no overhead (i.e. office space, billing, assistants, etc...). The main disadvantages are minimal continuity and difficult pt population. A lot of people start in psych er after finishing residency to have money coming in while they build their private practice and then titrate down the er shifts over time. FYI The psych er I work in we make anywhere from 160-190$ per hour

 

[Shikima]

My model is see about 2-8 inpatients, 5-20 partial hospital patients between 6:30 and 2pm, and about 15 in the afternoon, wrapping up at about 7. It's brutal, but at about 60 wrvu per day, around 55 per rvu, you do the math.

RVUs can be different, depending on the contract. Did you notice this when you were interviewing at different institutions?

 

[chicagochildpsych]

Absolutely, I negotiated my rvu dollar amount and saw their rvu reimbursements per cot code and had it negotiated in my contract before signing. I get paid the standard amount per wrvu as per apa guidelines.

 

[Baller MD]

Absolutely, I negotiated my rvu dollar amount and saw their rvu reimbursements per cot code and had it negotiated in my contract before signing. I get paid the standard amount per wrvu as per apa guidelines.

Quoted for future reference.

 

[heyjack70]

My model is see about 2-8 inpatients, 5-20 partial hospital patients between 6:30 and 2pm, and about 15 in the afternoon, wrapping up at about 7. It's brutal, but at about 60 wrvu per day, around 55 per rvu, you do the math.

How much Desoxyn are you taking daily?

 

[Mad Jack]

To add to the questions above: how common are "eat-what-you-kill" type of practices?

Much of the time you're better off without this sort of arrangement if you're employed due to the state of psych reimbursement. Cash only, on the other hand, can really be awesome if you have a full practice and are self employed. Or so I gather from the psychiatrists I know.

 

[chicagochildpsych]

How much Desoxyn are you taking daily?

None, just a hard worker

 

[prone2xl]

How so?

SomeDoc any chance you could PM Me.? i can't find a way to send u a message.. thanks

 

[TexasPhysician]

I think it depends. If you're doing cash only private practice in wealthy area, you can make significantly more than psych er. Otherwise my impression is psych er hourly rates are similar to typical outpatient jobs. However, the main advantages of psych er is opportunity for flexible scheduling (i.e time of day and as many days off as you want), clock in/clock out shift work (i.e. no calls from pt/pharmacy/family when shift is done), and no overhead (i.e. office space, billing, assistants, etc...). The main disadvantages are minimal continuity and difficult pt population. A lot of people start in psych er after finishing residency to have money coming in while they build their private practice and then titrate down the er shifts over time. FYI The psych er I work in we make anywhere from 160-190$ per hour

Psych ER can pay much more than hourly outpatient in my area, but they also want you to take some night shifts......