Reasonable hourly rates?

[uhmocksuhsillen]

---

Members do not see this ad.

Really stuck between psych and em. I absolutely love shift work and if I end up going with psych I'd love to find shift work. Doing 12s or 24s to maximize the number of total days off each month is my goal as I've got a pretty serious side hobby/job.

The high hourly rate in em makes less hours doable but unsure what hourly psychiatry rates are like. Can anyone shed light?

 

[Blitz2006]

Really stuck between psych and em. I absolutely love shift work and if I end up going with psych I'd love to find shift work. Doing 12s or 24s to maximize the number of total days off each month is my goal as I've got a pretty serious side hobby/job.

The high hourly rate in em makes less hours doable but unsure what hourly psychiatry rates are like. Can anyone shed light?

Keep in mind that ER has the highest burnout, and Psych has arguably one of the lowest:

Report reveals severity of burnout by specialty

You can work until 75 if you do Psych (if you want).

And if you really love Psych and ER, why not do Psych ER? I know Psychiatrists in the east coast that do 3 x 12s per week, make around 210-240k, and then do private practice on the other 2 days of the week. You can clear 300k pretty easily if you had a setup like that.

 

[TexasPhysician]

I’ve seen friends do 48 hr psych shifts for $5500. Mostly intakes and 5/2/1’s on a 100+ bed psych facility with about 12 hours to sleep here and there. The pay isn’t great/hr, but that’s 5 days off per week.

 

[uhmocksuhsillen]

Keep in mind that ER has the highest burnout, and Psych has arguably one of the lowest.

You can work until 75 if you do Psych (if you want).

And if you really love Psych and ER, why not do Psych ER? I know Psychiatrists in the east coast that do 3 x 12s per week, make around 210-240k, and then do private practice on the other 2 days of the week. You can clear 300k pretty easily if you had a setup like that.

Wow that's a pretty great option, didn't realize it was available...I love the psych pts in the ER too.

Just two other questions...

Easy to find those jobs in most major metros?
Is there potential for working in more rural area for higher rates?

Thanks for the advice, really good to hear.

 

[Blitz2006]

Wow that's a pretty great option, didn't realize it was available...I love the psych pts in the ER too.

Just two other questions...

Easy to find those jobs in most major metros?
Is there potential for working in more rural area for higher rates?

Thanks for the advice, really good to hear.

Yes. I'm getting hammered with job offers for psych ER jobs.

Of course the rates and availability is much better in small town Midwest America. But if you want to Boston or Philly or NYC, you can still find a decent job. A lower rate, but definitely doable.

This is the problem with Psychiatry teaching in medical school, it only exposes 10% of what Psychiatrists do (inpatient).

Sent from my SM-G955U using Tapatalk

 

[uhmocksuhsillen]

Yes. I'm getting hammered with job offers for psych ER jobs.

Of course the rates and availability is much better in small town Midwest America. But if you want to Boston or Philly or NYC, you can still find a decent job. A lower rate, but definitely doable.

This is the problem with Psychiatry teaching in medical school, it only exposes 10% of what Psychiatrists do (inpatient).

Sent from my SM-G955U using Tapatalk

Great thanks for that info. I'm west coast, but I'll assume our areas are comparable.

 

[dl2dp2]

Yes. I'm getting hammered with job offers for psych ER jobs.

Of course the rates and availability is much better in small town Midwest America. But if you want to Boston or Philly or NYC, you can still find a decent job. A lower rate, but definitely doable.

Not necessarily. There are *definitely* $200+/hour ER jobs in all of the 3 cities, typically located in public facilities for overnight shifts.

However, if you get into a reputable psych program, you'll soon understand why these jobs have a problem recruiting. The real sweet (and competitive) gigs in psych are not ER gigs. The top 10% of outpatient jobs in psych are comparable to the best lifestyle specialties and make a typical EM job look like a pile of garbage..You can maximize the number of days off AND have 100% choice in when these days off are AND never have to work nights and weekends ever again AND for comparable salary and somewhat higher location independence. You might change your mind when you start residency...

That said, the average hourly rate in EM is higher (~250ish). If you are an average physician in either field, you'll make more money in EM. Perhaps by 20-30% (i.e. lower 200k vs. upper 200k-lower 300k). The lifestyle is still far better and more conducive to "serious hobby" in psych IMHO. You can't really enjoy hobbies when your circadian clock is all kinds of messed up. I've also noticed that at least right now my EM buddies are getting squeezed institutionally, and as junior people in a group they really get a lot of undesirable shifts, and get squeezed to work more (even when they don't want to). So you might get 25 hours a week, you might NOT. Sure you make more $ but the control is rather poor. In psych it's a buyers market. You do whatever you want to do. Employers typically kiss up to you rather than the other way around. This obviously can change in 10 years, but that's the state of the world right now.

 

[uhmocksuhsillen]

I’ve seen friends do 48 hr psych shifts for $5500. Mostly intakes and 5/2/1’s on a 100+ bed psych facility with about 12 hours to sleep here and there. The pay isn’t great/hr, but that’s 5 days off per week.

That's also great info. Thanks.

 

[Monocles]

A lot of private psychotherapists on the east coast charge $200+ per hour cash only, no insurance. You can work as many or as few hours as you want in that case.

 

[Blitz2006]

A lot of private psychotherapists on the east coast charge $200+ per hour cash only, no insurance. You can work as many or as few hours as you want in that case.

Yep. $300 is the standard rate in NYC

Sent from my SM-G955U using Tapatalk

 

[uhmocksuhsillen]

A lot of private psychotherapists on the east coast charge $200+ per hour cash only, no insurance. You can work as many or as few hours as you want in that case.

I've always heard that and knew it to be the case, but...for someone in a decent city (SF, la, NYC) how easy would it be to fill out at 40 hrs a week with cash only?

 

[justfolks]

Yep. $300 is the standard rate in NYC

Sent from my SM-G955U using Tapatalk

Just a patient, but I would say it's more like 350 per therapy session in NYC, esp. for someone who has some connection with a well-known/respected hospital, either locally or nationally. Older drs. who have been around a while will charge more, given their greater experience, something in the 400-500 range per therapy session (45 mins.) would not be surprising.

 

[Blitz2006]

Definitely not easy.

Realistically, what people do is half in a clinic or hospital job (ie. CL) and half cash private practice, so like 20 and 20 hours.

I'm sure there are a few people that fill up 40 hour weeks private practice, but it's definitely uncommon.

Yes, there are psychiatrists that charge 400 to 500, but I think the majority are 300 to 350 in NYC....

Sent from my SM-G955U using Tapatalk

 

[Blitz2006]

Not necessarily. There are *definitely* $200+/hour ER jobs in all of the 3 cities, typically located in public facilities for overnight shifts.

However, if you get into a reputable psych program, you'll soon understand why these jobs have a problem recruiting. The real sweet (and competitive) gigs in psych are not ER gigs. The top 10% of outpatient jobs in psych are comparable to the best lifestyle specialties and make a typical EM job look like a pile of garbage..You can maximize the number of days off AND have 100% choice in when these days off are AND never have to work nights and weekends ever again AND for comparable salary and somewhat higher location independence. You might change your mind when you start residency...

That said, the average hourly rate in EM is higher (~250ish). If you are an average physician in either field, you'll make more money in EM. Perhaps by 20-30% (i.e. lower 200k vs. upper 200k-lower 300k). The lifestyle is still far better and more conducive to "serious hobby" in psych IMHO. You can't really enjoy hobbies when your circadian clock is all kinds of messed up. I've also noticed that at least right now my EM buddies are getting squeezed institutionally, and as junior people in a group they really get a lot of undesirable shifts, and get squeezed to work more (even when they don't want to). So you might get 25 hours a week, you might NOT. Sure you make more $ but the control is rather poor. In psych it's a buyers market. You do whatever you want to do. Employers typically kiss up to you rather than the other way around. This obviously can change in 10 years, but that's the state of the world right now.

Yes, there are jobs that pay $200 an hour, but tend to be on the rare side. From what I've seen, the majority on East coast in big cities pay around 150 to 175..

But I agree with what you said about job market. While ER has a great job market, psych is amazing. You can cherry pick what you want.

And the main thing is flexibility. If you get bored of psych ER, you can swing into outpatient...rehab...inpatient...CL..

With ER, it's pretty much ER or Urgent Care. But yes, overall money is better for average ER physician, but if you work hard (50 to 60 hrs a week), and in a big city, the ceiling is much higher in psych.

Sent from my SM-G955U using Tapatalk

 

[Jules A]

Are there really that many EDs that staff round the clock with psychiatrists? In my experience in the Baltimore/DC area most psych EDs are staffed by social workers. The rare hospitals that use psychiatrists aren't staffed overnight with the exception of the hospitals affiliated with a university who use their residents.

 

[clausewitz2]

Are there really that many EDs that staff round the clock with psychiatrists? In my experience in the Baltimore/DC area most psych EDs are staffed by social workers. The rare hospitals that use psychiatrists aren't staffed overnight with the exception of the hospitals affiliated with a university who use their residents.

Our psych ED is only entirely resident dependent between 11 PM and 1 AM. Not so bad because it is a PGY-1/2 and a PGY3/4 moonlighting typically. That said this is possible mainly because we essentially have one attending who is a vampire and works only overnight shifts all week. Not sure what will happen when he retires.

 

[Amygdarya]

Are there really that many EDs that staff round the clock with psychiatrists? In my experience in the Baltimore/DC area most psych EDs are staffed by social workers. The rare hospitals that use psychiatrists aren't staffed overnight with the exception of the hospitals affiliated with a university who use their residents.

I think *CPEPs* have to have at least one psychiatry attending on site all the time. Vs. regular EDs that can use psych consults whenever they're available.

 

[Shikima]

You guys need to get the word out and routinely ask for 200/hr and not accept anything less.

 

[MiddleRoad]

Definitely not easy.

Realistically, what people do is half in a clinic or hospital job (ie. CL) and half cash private practice, so like 20 and 20 hours.

I'm sure there are a few people that fill up 40 hour weeks private practice, but it's definitely uncommon.

Yes, there are psychiatrists that charge 400 to 500, but I think the majority are 300 to 350 in NYC....

Sent from my SM-G955U using Tapatalk

Disagree with this. In NYC, LA, and SF it is pretty common to fill a full time private practice, especially if you train at the right program or work for a few years at the right academic center after residency. It’s all about connections and word of mouth reputation. In these cities, $200/hr would be on the low end for PP psychiatrists, who don’t take insurance.

If you’re getting $300 per session (which would be minimum for typical PP psychiatrist in NYC) and work 30 hours/week, that’s $9000 per week before expenses. Considering that annual business expenses probably wouldn’t exceed $50K (tax deductible), you can extrapolate what the annual income could be.

 

[Monocles]

Keep in mind that your overhead costs should be pretty low too. Once had an attending say "the only thing you need to start your own private practice is a tent in your backyard". Given that we live in Boston, having a backyard is actually pretty expensive...

 

[surfguy84]

Keep in mind that your overhead costs should be pretty low too. Once had an attending say "the only thing you need to start your own private practice is a tent in your backyard". Given that we live in Boston, having a backyard is actually pretty expensive...

I'm your experience how long would it take to fill up 35 hrs a week at 250/hr (picked an arbitrary average rate based on discussion on this thread)?

 

[Armadillos]

I know a lot of people are on salary maximizing paths here, but curious what people think is considered good for community/public mental health jobs?

Was talking with someone near my hometown and sounds like they are making about 170k: for 8-4pm, 1hr intake, 30 min followup, never have to work after hourscall/weekends/holidays and get an hour of charting time plus half hour lunch a day built in.

Obviously way less than you could make in the private sector, but seems like it could be a relaxed lifestyle or a way to ease self into life as an outpatient attending which I’ve heard can be a tough transition.

 

[Mass Effect]

And the main thing is flexibility. If you get bored of psych ER, you can swing into outpatient...rehab...inpatient...CL..

You're forgetting more subspecialized stuff like women's mental health, bariatric psychiatry, transplant psychiatry, psych onc. I know a psychiatrist working at an infertility clinic in reproductive psych with pretty good hours and what I can only assume is good pay, given her lifestyle.

I think *CPEPs* have to have at least one psychiatry attending on site all the time. Vs. regular EDs that can use psych consults whenever they're available.

Pretty sure this isn't true. At least some academic places I know of have residents on site and attendings available via phone.

 

[Amygdarya]

Pretty sure this isn't true. At least some academic places I know of have residents on site and attendings available via phone.

Could it be location/state dependent? In the locations I’m familiar with CPEPs at academic hospitals have at least one psych attending on site all the time (in addition to residents) vs. residents covering psych consults at medical ED (no CPEP on site) at night with an on call attending available by phone.

 

[Blitz2006]

Keep in mind that your overhead costs should be pretty low too. Once had an attending say "the only thing you need to start your own private practice is a tent in your backyard". Given that we live in Boston, having a backyard is actually pretty expensive...

Yes. This is the biggest plus for psych. Lowest overhead in the game.

The average is around 20 to 25%. Compared to other specialities where I've heard it's 40 to 50, and dentists are 50 to 70.

Sent from my SM-G955U using Tapatalk

 

[FlowRate]

Yes. This is the biggest plus for psych. Lowest overhead in the game.

The average is around 20 to 25%. Compared to other specialities where I've heard it's 40 to 50, and dentists are 50 to 70.

Sent from my SM-G955U using Tapatalk

Yeah last time I looked into this pretty sure AAFP recommended assuming a 50% overhead as standard for FP.

 

[MiddleRoad]

I'm your experience how long would it take to fill up 35 hrs a week at 250/hr (picked an arbitrary average rate based on discussion on this thread)?

This depends on connections to the community where you practice. If you trained with good standing at a local residency or work at a local hospital where you’ve established connections, you can typically fill a practice within a few months. You can also build things by networking with local docs in other specialties and non-MD therapists.

 

[DD214_DOC]

Keep in mind that ER has the highest burnout, and Psych has arguably one of the lowest:

Report reveals severity of burnout by specialty

You can work until 75 if you do Psych (if you want).

And if you really love Psych and ER, why not do Psych ER? I know Psychiatrists in the east coast that do 3 x 12s per week, make around 210-240k, and then do private practice on the other 2 days of the week. You can clear 300k pretty easily if you had a setup like that.

Realize that psych's, "low burnout", is still about 35%

 

[WingedOx]

Realize that psych's, "low burnout", is still about 35%

(sigh)... burnout to an extent is part of the game wherever. I'm just about ready to go home on a Friday and I get a call from a patient's wife that he's wandering around the city not fully clothed without his cell phone. Dammit. I love what I do, but sometimes, these people...

 

[W19]

You guys need to get the word out and routinely ask for 200/hr and not accept anything less.

1099 or W2?

 

[Blitz2006]

Realize that psych's, "low burnout", is still about 35%

Right. But its the lowest in the field of medicine...(at least according to this medscape survey)