Realistic CAP income

[MedSchoolFool]

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Love my psych program and plan to do child fellowship no matter what...so please ixnay with the "it's not about the $$" spiels. I just can't seem to get a good idea for how much child pays as compared to adult psych. This is because I keep being told that CAP pays so much better (see those comments on SDN, too) but when I check out any of the online data it doesn't seem to really hold up. Anybody with concrete examples of their own? Thanks to all.

 

[F0nzie]

Here's what you need to know:

1. Child salaries can be SUBSTANTIALLY higher than adult rates in certain settings. I am talking $50/hour or more than adult psychiatrists. Best kept secret.

2. Fair market value is very hard to assess when there are so few child psychiatrists. Don't pay too much attention to what you read online.

3. CPT codes essentially pay the same whether you are seeing an adult or a child. The pay hike comes in with community mental health where a child trained physician is required by the state and NPs cannot substitute or a cash practice.

The discrepancy between adult and child rates are going to keep getting wider IMO.

Smart career move.

I refuse to do it however because I am not crazy and I am not a saint either.

 

[notdeadyet]

1. Child salaries can be SUBSTANTIALLY higher than adult rates in certain settings. I am talking $50/hour or more than adult psychiatrists. Best kept secret.

I don't see this. This means CAP jobs going for about $100K/year more than adult? I'm not seeing it. There's a bump, but it's not as significant as people tend to think, imho.

I think the big difference in potential for CAP is two fold: abundance of jobs (so you have less trouble finding a job in almost any locale) and potential for cash-only private practice.

But I'm not seeing folks getting offers $100K higher in CAP than for adult for comparable conditions.

 

[F0nzie]

I am seeing it.

Check out the offers our child fellows accepted this year:

170k for 20 hours

250k for 30 hours

Child is an underground gold mine

 

[dl2dp2]

I am seeing it.

Check out the offers our child fellows accepted this year:

170k for 20 hours

250k for 30 hours

Child is an underground gold mine

I dunno fonze. With each 1.5 hour eval in child, you'd have to call school, parents, ACS, divorced ex-parents, teachers, court, lawyers, blah blah...the actual per hour might be not as high as you think. While I've heard "shhh, i'm making so much money doing child in this wealthy suburb handing out adderall", I suspect ultimately it's not a "goldmine."

 

[digitlnoize]

I dunno fonze. With each 1.5 hour eval in child, you'd have to call school, parents, ACS, divorced ex-parents, teachers, court, lawyers, blah blah...the actual per hour might be not as high as you think. While I've heard "shhh, i'm making so much money doing child in this wealthy suburb handing out adderall", I suspect ultimately it's not a "goldmine."

This is an exaggeration. While there is more collateral gathering in child, it's not THIS bad. Not every kid comes from a bad family with divorce/legal/school problems. Some will, yes, but the typical patient might require only a couple of calls.

Also, this is why you hire a social worker 🙂

 

[Chimed]

Here's what you need to know:

1. Child salaries can be SUBSTANTIALLY higher than adult rates in certain settings. I am talking $50/hour or more than adult psychiatrists. Best kept secret.

2. Fair market value is very hard to assess when there are so few child psychiatrists. Don't pay too much attention to what you read online.

3. CPT codes essentially pay the same whether you are seeing an adult or a child. The pay hike comes in with community mental health where a child trained physician is required by the state and NPs cannot substitute or a cash practice.

The discrepancy between adult and child rates are going to keep getting wider IMO.

Smart career move.

I refuse to do it however because I am not crazy and I am not a saint either.

That may be true in general and I think you're correct to point out "in certain settings". But I believe the adult salaries have been increasing and I'm not sure the discrepancy is as big as it used to be, UNLESS you're going into certain settings were they desperately need a child psychiatrist.

This was commented on above, but there is an added level of complexity in seeing children that I think most people don't think about in adult work. This is particularly true in diagnostic uncertainty as well as often complex psychosocial issues. I'm 2 months away from finishing my child fellowship and started moonlighting in an adult inpatient unit last year. In many ways going back to working with adults seems so much easier. My pharmacology was a little rusty when I started, but that didn't take too long to get back up to speed.

 

[vistaril]

Love my psych program and plan to do child fellowship no matter what...so please ixnay with the "it's not about the $$" spiels. I just can't seem to get a good idea for how much child pays as compared to adult psych. This is because I keep being told that CAP pays so much better (see those comments on SDN, too) but when I check out any of the online data it doesn't seem to really hold up. Anybody with concrete examples of their own? Thanks to all.

it all depends on the setting and how you want to practice.....

for salaried community mental health positions I would say the average CAP gets 20-25k more. but their job in some ways may be a little crappier(ie occasional travel/field work, terrible parents, etc)

the reimbursement by insurance isn't going to be any different(and perhaps lower if seeing medicaid which you wouldnt in pp), so if you want to make it up in practice you make it up with volume. And by volume I mean running an adderall med check factory. Which some people like.

Cash practice is also a possibility, but it's going to be difficult to do high volume that way(competition from others who can write adderall....peds for example). That said, I bet some of the highest satisfaction psychs are CAP people who do cash and actually spend time with patients and families in their pp. I don't think they are maing huge huge money though just because they arent going to get the massive volume.

Really, the lack of volume is what limits every psychiatrist from making bank.

 

[NJWxMan]

I'm enjoying this thread just a bit too much. Honestly, there is this ongoing myth about collateral that seems to start in PGY1 year and often remains stagnant in non-CAP attending's head till the day they close up shop. I won't say much, but I will say that the vast majority of the time, it is a myth. However, when you seeking collateral, it's an invaluable tool that one only wishes they could have in adult psychiatry. I would not make much of reported CAP salaries. CAP folks normally work part-time. It's not uncommon to meet a CAP that is happy each night, at home with their three young children, making $160G while working 30 hours per week. I make a fellow salary and am at home, happy, and working 40 hours per week.