Salary Question

[RevDO]

Hello,

I am wondering if it is reasonable to make $300k+ in psych working around 40 hours/week. People I've talked to say you can make "a lot" in psych but have been hesitant to discuss actual numbers. I don't mind working hard and want to provide good care for my patients but I also want to be able to pay off my loans and live a good life after putting in all this work. Additionally, I would be interested in having more than one job potentially, something like work in a suboxone clinic for a few hours in the morning then round on inpatient and outpatient in the afternoons/on Fridays or something like that. Is this sort of practice set up realistic? One of the things I love about psychiatry is how many settings and patient populations you can work with.

Thank you!

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[wolfvgang22]

It is possible. Whether it is reasonable depends on location, how much you bill per hour, etc. This is literally asked here every week, I'd do a search of this forum and read a lot. Yes, the clinical work you describe is common.

 

[Bartelby]

300k+ is definitely achievable with a standard full-time job (40 hours). You may run over hours occasionally depending on the setup but can keep it close to within those bounds.

What you mentioned (several hours of Suboxone clinic in the AM + inpatient rounding + outpatient panel) should yield well over 300k but should take well over 40 hours and would probably be very stressful. You can do several part time jobs but I would recommend pacing yourself if you want work-life balance.

 

[Stagg737]

something like work in a suboxone clinic for a few hours in the morning then round on inpatient and outpatient in the afternoons/on Fridays or something like that

It's certainly reasonable to spend a half day seeing inpatients and then having an outpatient position or second job in the afternoon, depending on inpatient load of course. I'd imagine you could hit $300k gross income doing that in most regions without significant difficulties.

 

[RevDO]

It is possible. Whether it is reasonable depends on location, how much you bill per hour, etc. This is literally asked here every week, I'd do a search of this forum and read a lot. Yes, the clinical work you describe is common.

I'm interested in working in the Southeast, South, or Southwest. I guess I don't know that much about billing and what is reasonable. Surely, there is reasonable billing but also billing that starts pushing the line. I've taken a look at some of the different job offering posts and it seems like most of them are somewhat significantly under $300k. I guess I'm just wondering if its common, everybody "knows a guy who knows a guy" who is making $500k working 40 hours a week but I'm more interested in what is probably average. Things I read say up to mid 200's is average and other places people say low 300's is common. I'm trying to be proactive about learning about my financial future.

300k+ is definitely achievable with a standard full-time job (40 hours). You may run over hours occasionally depending on the setup but can keep it close to within those bounds.

What you mentioned (several hours of Suboxone clinic in the AM + inpatient rounding + outpatient panel) should yield well over 300k but should take well over 40 hours and would probably be very stressful. You can do several part time jobs but I would recommend pacing yourself if you want work-life balance.

Thank you. I would be ok with going over 40, I just don't want to end up in a situation where I'm expected to work 50+ hours/week. There is a lot to my life outside of medicine. I have a lot of interests in psychiatry so maybe I'm just a bit too excited right now and once I'm getting through residency I'll have a better idea of 1-2 things I like the most.

 

[Stagg737]

I'm more interested in what is probably average. Things I read say up to mid 200's is average and other places people say low 300's is common. I'm trying to be proactive about learning about my financial future.

Both of those statements are true, setting plays a huge role in average pay. Outpatient PP where it's not connected to a "Big Box Shop", with a reasonable no-show rate $300k is fairly common unless you're only taking medicare/caid. If you're looking at academic programs or places where you're just another cog, and you're looking at low to mid-200's in most places. Geography can also play a huge role. There's so many variants that "average" can change significantly depending on what types of jobs you're looking at.

 

[RevDO]

It's certainly reasonable to spend a half day seeing inpatients and then having an outpatient position or second job in the afternoon, depending on inpatient load of course. I'd imagine you could hit $300k gross income doing that in most regions without significant difficulties.

This is really exciting to hear. I've found my inpatient clinical experiences to be fascinating, rewarding, and important but I would also like to work doing therapy with higher functioning patients as well. I think this sort of set up would let me accomplish this. I've seen job postings on Merritt Hawkins that advertise being out around in the early afternoon for inpatient jobs and didn't know if this was a common thing. Seems like the pay for the one I saw was abnormally high though. I appreciate you sharing your thoughts, thank you!

 

[calvnandhobbs68]

I would also add though that when people are saying 40 hours a week they’re likely referring to 8 patient contact hours a day (so truly 40 patient hours of contact time a week). Probably would translate more into 9 even 10 hour days in the office/working at home doing notes and wrapping admin stuff up.

Definitely less common to be getting to that range with less than 40 actual patient contact hours per week.

 

[Splenda88]

This one week on/off... 63 hrs for 2 wks. Not sure how good that offer for psych. It would be a good offer for IM

• 50 Average daily encounters (15 per doc)
• 100+ bed location
• 4 Physician FTE & 2 Psych. Certified APPs, and 2 Medical APP’s for Hospital Medicine
• 7 on 7 off schedule, 9 hour days
• September 1st start date
• UNITs-Adult, Dual Diagnosis, Adolescent (unit) and Geriatric
• Substance Suboxone license required

Compensation- 275-290k base, 20k sign-on, Up to 5k relocation, RVU bonus.

 

[Stagg737]

This one week on/off... 63 hrs for 2 wks. Not sure how good that offer for psych. It would be a good offer for IM

• 50 Average daily encounters (15 per doc)
• 100+ bed location
• 4 Physician FTE & 2 Psych. Certified APPs, and 2 Medical APP’s for Hospital Medicine
• 7 on 7 off schedule, 9 hour days
• September 1st start date
• UNITs-Adult, Dual Diagnosis, Adolescent (unit) and Geriatric
• Substance Suboxone license required

Compensation- 275-290k base, 20k sign-on, Up to 5k relocation, RVU bonus.

This actually doesn’t seem too bad for someone that likes that schedule. What would call look like and what are benefits? Safe to assume that you’re on call for 7 straight when you’re on?

 

[Mass Effect]

These jobs are available in a lot of places. I literally see jobs like that in my inbox at least once every week or two. Usually, these are private practice and/or non-academic inpatient units. As mentioned above though, most of these are 40 contact hours a week. Many (most?) psychiatrists don't see patients 40 hours a week. Psych is a sweet gig because for that 250K, many are seeing patients only 32 hours with 8 hours of admin at least. Some even less (but may also get paid less). I'm also seeing a lot of jobs like above with 7 days on/7 days off schedule.

 

[Psychresy]

In med school I had an attending who got paid essentially to be on tele call for an ED (perhaps more than one, I'm not sure). Whenever a call came through he'd jump on webcam and see the patient. Anyone know how common this kind of thing is? Seems like it'd be a pretty chill way to do some weekend work.

 

[NeuroKlitch]

This one week on/off... 63 hrs for 2 wks. Not sure how good that offer for psych. It would be a good offer for IM

• 50 Average daily encounters (15 per doc)
• 100+ bed location
• 4 Physician FTE & 2 Psych. Certified APPs, and 2 Medical APP’s for Hospital Medicine
• 7 on 7 off schedule, 9 hour days
• September 1st start date
• UNITs-Adult, Dual Diagnosis, Adolescent (unit) and Geriatric
• Substance Suboxone license required

Compensation- 275-290k base, 20k sign-on, Up to 5k relocation, RVU bonus.

Would this job require C&A fellowship? I've been browsing a lot of potential jobs on indeed and I find that C&A jobs usually start at 300k base + productivity , while general is around 200k. Is it just me or does it seem like child is necessary these days to land competitive jobs. I've been considering addiction or geriatric fellowship but seems like Child is really the only sure way to land a 32 patient hour work week with 350k+ potential without pushing 50 hours or doing multiple jobs.

 

[Splenda88]

Would this job require C&A fellowship? I've been browsing a lot of potential jobs on indeed and I find that C&A jobs usually start at 300k base + productivity , while general is around 200k. Is it just me or does it seem like child is necessary these days to land competitive jobs. I've been considering addiction or geriatric fellowship but seems like Child is really the only sure way to land a 32 patient hour work week with 350k+ potential without pushing 50 hours or doing multiple jobs.

No it does not...

 

[calvnandhobbs68]

Would this job require C&A fellowship? I've been browsing a lot of potential jobs on indeed and I find that C&A jobs usually start at 300k base + productivity , while general is around 200k. Is it just me or does it seem like child is necessary these days to land competitive jobs. I've been considering addiction or geriatric fellowship but seems like Child is really the only sure way to land a 32 patient hour work week with 350k+ potential without pushing 50 hours or doing multiple jobs.

What?

I'm pretty familiar with the child job market right now and nobody's getting a salaried 32 hour work week making 350k unless you've got your own cash only private practice. Those jobs you're seeing on Indeed or whatever...notice they usually say "300k total compensation". They're including a lot more than the actual salary you get in that number typically.

 

[Psychresy]

Why don't more people do locums if they just want a higher salary? Most of us probably have a working spouse so benefits become less a deal I'd imagine..

 

[Splenda88]

Why don't more people do locums if they just want a higher salary? Most of us probably have a working spouse so benefits become less a deal I'd imagine..

Many docs have their spouses stay at home raising kids and enjoying the upper-upper middle class lifestyle while they themselves are working hard.

 

[WisNeuro]

Many docs have their spouses stay at home raising kids and enjoying the upper-upper middle class lifestyle while they themselves are working hard.

I actually don't know any doc couples in our peer group like this. In our inner circle we have MD/DVM, MD/JD, MD/PHD, MD/SW, DO/NPx3, MD/MBA. .I can't think of a single friend or physician colleague who has a stay at home spouse. I'm sure it happens, it's just not common in my circles.

 

[robellis]

I actually don't know any doc couples in our peer group like this. In our inner circle we have MD/DVM, MD/JD, MD/PHD, MD/SW, DO/NPx3, MD/MBA. .I can't think of a single friend or physician colleague who has a stay at home spouse. I'm sure it happens, it's just not common in my circles.

That is unfortunate for their kids

 

[sloh]

I actually don't know any doc couples in our peer group like this. In our inner circle we have MD/DVM, MD/JD, MD/PHD, MD/SW, DO/NPx3, MD/MBA. .I can't think of a single friend or physician colleague who has a stay at home spouse. I'm sure it happens, it's just not common in my circles.

Any of the couples have 1 spouse working part-time? Seems to be a good balance to prevent skills atrophy and still have a life outside of raising kids.

 

[NickNaylor]

Many docs have their spouses stay at home raising kids and enjoying the upper-upper middle class lifestyle while they themselves are working hard.

R u me

 

[clausewitz2]

Any of the couples have 1 spouse working part-time? Seems to be a good balance to prevent skills atrophy and still have a life outside of raising kids.

This seems pretty common in my circles. A lot of psychiatrists married to therapists, for whom sustaining a boutique private practice becomes much easier when it doesn't have to be mainly responsible for food on the table or making the mortgage payments.

 

[WisNeuro]

Any of the couples have 1 spouse working part-time? Seems to be a good balance to prevent skills atrophy and still have a life outside of raising kids.

A couple of the female MDs went down to .8FTE after having kids.

 

[tr]

That is unfortunate for their kids

Why? I think it's stressful for the *parents* to juggle two demanding jobs plus child rearing. I don't see why there would be any specific adverse impact on the children, as long as the family is financially and socially stable.

Breadwinners and Losers: Does the Mental Health of Mothers, Fathers, and Children Vary by Household Employment Arrangements? Evidence From 7 Waves of Data From the Longitudinal Study of Australian Children - PubMed

In Australia, as in many industrialized countries, the past 50 years have been marked by increasing female labor-force participation. It is popularly speculated that this might impose a mental-health burden on women and their children. This analysis aimed to examine the associations between...

pubmed.ncbi.nlm.nih.gov

 

[WisNeuro]

Why? I think it's stressful for the *parents* to juggle two demanding jobs plus child rearing. I don't see why there would be any specific adverse impact on the children, as long as the family is financially and socially stable.

Breadwinners and Losers: Does the Mental Health of Mothers, Fathers, and Children Vary by Household Employment Arrangements? Evidence From 7 Waves of Data From the Longitudinal Study of Australian Children - PubMed

In Australia, as in many industrialized countries, the past 50 years have been marked by increasing female labor-force participation. It is popularly speculated that this might impose a mental-health burden on women and their children. This analysis aimed to examine the associations between...

pubmed.ncbi.nlm.nih.gov

Exactly, SES is pretty much the big variance factor. The daycare that kids of docs/lawyers/etc are in are most likely very enriching stimulus-wise, as well as social engagement with kids their age. Most of the pearl clutching about kids in daycare is generally unfounded beliefs backed up by traditional social mores than any actual data.

 

[twospadz]

Hello,

I am wondering if it is reasonable to make $300k+ in psych working around 40 hours/week. People I've talked to say you can make "a lot" in psych but have been hesitant to discuss actual numbers. I don't mind working hard and want to provide good care for my patients but I also want to be able to pay off my loans and live a good life after putting in all this work. Additionally, I would be interested in having more than one job potentially, something like work in a suboxone clinic for a few hours in the morning then round on inpatient and outpatient in the afternoons/on Fridays or something like that. Is this sort of practice set up realistic? One of the things I love about psychiatry is how many settings and patient populations you can work with.

Thank you!

I'm a PGY 4 in the NE. I signed a contract that will pay me 340k-350k a year for ER psychiatry gig starting in July. I work 13 days out the month (avg 40 hours per week a month) and have a guaranteed consecutive 10 days off every month. I get paid different rates depending on if I work on the weekends, days or nights (I do all 3 during the month). The rate ranges between 155-205 an hour. I negotiated this because I want to travel internationally every month. Also I plan to work the other days that are not the consecutive 10 days at other per diem gigs to boost me to over 400k a year. However there are negatives:

1. Long hour shifts (which I actually like): 8-24 hour shifts.
2. No benefits (I negotiated this; I was offered full time with benefits, part time with partial benefits or per diem): I took the per diem
3. Working weekends for some of these shifts during the month.

The positive is that my schedule is already made 6 months in advance so I know exactly when I will work. Im not married or have kids. OP if you want over 300k there will be sacrifices. You just have to know what to give up. However, this job works for me for now especially since I really like ER psych. I also have two per diem jobs I signed on at two different hospitals (one is my residency moonlight job).

 

[robellis]

Why? I think it's stressful for the *parents* to juggle two demanding jobs plus child rearing. I don't see why there would be any specific adverse impact on the children, as long as the family is financially and socially stable.

Breadwinners and Losers: Does the Mental Health of Mothers, Fathers, and Children Vary by Household Employment Arrangements? Evidence From 7 Waves of Data From the Longitudinal Study of Australian Children - PubMed

In Australia, as in many industrialized countries, the past 50 years have been marked by increasing female labor-force participation. It is popularly speculated that this might impose a mental-health burden on women and their children. This analysis aimed to examine the associations between...

pubmed.ncbi.nlm.nih.gov

It is well documented that it is much better for the baby to be with mom during the first year of life, when mom has baby and goes back to work in 3 months or whatever it is that’s an issue. There’s also emerging data that presence of mom (or dad) in the house with the kids is beneficial outside of the first few years of life. In my experience, when kids come home and find mom there, it shows the parents have put the child first and nothing is more important than the child, if you send them to daycare because you are “passionate about your career” well the kids will know where your priorities are..I’ve also seen this through clinical experience..note this is especially true if you can afford to stay at home and are refusing to do so in order to further your career, if you are low income and cannot afford to stay home that is a different discussion

Eric Bettinger: Why Stay-at-Home Parents are Good for Older Children

www.gsb.stanford.edu

 

[WisNeuro]

I'm not sure the Norway study really emphasizes your point here. Also, much of the longitudinal lit (e.g., Carvel, 2001) suggests that most of the variance in negative childhood outcomes is largely related to SES/economic factors.

 

[WisNeuro]

Additionally, followups from that same Bettinger dataset (Elstad, Baaken, 2015) show that most of the grade effect looks to be be subsumed in the lower percentage of earners, with variance explained by income. Also looking at similar countries to Norway in terms of social safety nets, mothers with longer hour PT jobs or FT jobs had kids with better cognitive test scores than women with lower hour PT jobs or stay-at-home (Kunn-Nelen et al., 2014). Also suggestive of much of the variance being soaked up by economic factors.

At the very least, the data is equivocal, I have not seen anything even remotely compelling to suggest working parents in high SES households have children with worse outcomes than those with a stay-at-home parent.

 

[Freddie Mercury]

DO/NPx3.

Surely at least one of his wives can stay home with the kids?

 

[WisNeuro]

Surely at least one of his wives can stay home with the kids?

Got to bring in the bills for the Mormon family

 

[psychacad]

I'm a PGY 4 in the NE. I signed a contract that will pay me 340k-350k a year for ER psychiatry gig starting in July. I work 13 days out the month (avg 40 hours per week a month) and have a guaranteed consecutive 10 days off every month. I get paid different rates depending on if I work on the weekends, days or nights (I do all 3 during the month). The rate ranges between 155-205 an hour. I negotiated this because I want to travel internationally every month. Also I plan to work the other days that are not the consecutive 10 days at other per diem gigs to boost me to over 400k a year. However there are negatives:

1. Long hour shifts (which I actually like): 8-24 hour shifts.
2. No benefits (I negotiated this; I was offered full time with benefits, part time with partial benefits or per diem): I took the per diem
3. Working weekends for some of these shifts during the month.

The positive is that my schedule is already made 6 months in advance so I know exactly when I will work. Im not married or have kids. OP if you want over 300k there will be sacrifices. You just have to know what to give up. However, this job works for me for now especially since I really like ER psych. I also have two per diem jobs I signed on at two different hospitals (one is my residency moonlight job).

Yep. I think that's the smart route for an "easier" 300k. Moonlighting at various gigs and working overnight especially in places where you can sleep at least 5-6 hours. So while on paper it's 40 hours/week, it's actually much less. There's a gig I work at where I sleep soundly for half the shift, lol. No contract obligations also mean you can move on on a whim. They can do that as well, but if you have multiple gigs like that the risk is low. And they need us. So there, 300k and you are not bound by mean bosses, big box shop shackles and bureaucracy. And you can routinely take extended time off.

 

[sloh]

"Why Child Care Has Little Impact on Most Children's Development"

SAGE Journals: Your gateway to world-class research journals

Subscription and open access journals from SAGE Publishing, the world's leading independent academic publisher.

journals.sagepub.com

"Nonmaternal infant care is the most controversial issue in childcare research. Within a broad range of safe environments, quality variations in child care have only small and temporary effects on most children's development. With a few exceptions that can be explained by correlations between family and childcare characteristics, studies both in the United States and elsewhere fail to find any long-term effects. These results do not apply to children from low-income homes, for many of whom high-quality child- care programs supply missing elements of emotional support and intellectual opportunities. Nor do the results apply to dreadful environments where children are neglected and abused, which can have lasting and devastating effects on children. Such settings rarely appear in studies of child care.

Quality variation within the range of centers studied does not have a major impact on the development of children from ordinary homes. Given the learning opportunities and social-emotional supports that their homes generally offer, child care of mediocre to good quality is not a unique or lasting experience for such children. For most children, parents supply the genes and the home environments, which correlate with the care they select for their children outside of the home. We should not be surprised, therefore, that child care per se adds little to the powerful impact of parents on their children's development.

At 24 months of age, children in center-based care, where the ratio of infants to caregivers was 8:1, had poorer cognitive and language development than children in family day care or at home with their mothers (these latter two groups did not differ from each other). These results persisted after controls for maternal education, IQ, income, and occupational status. However, at 42 to 48 months, no differences were found between children who had received early care in understaffed centers and those who bad been cared for in homes."

Judith Rich Harris' "The Nurture Assumption"

"A related issue concerns the effects of day care. When only families with problems put their kids into day-care centers, institutional care was thought to be bad for young children. Now day-care centers are used by well-off families as well as the not-so-well-off, and it no longer seems to matter whether babies or preschoolers spend most of their daylight hours there or at home. In a 1997 review, a developmentalist asked the question, “Do infants suffer long-term detriments from early nonmaternal care?” The studies she reviewed, she concluded, “have demonstrated that the answer is ‘no.’” Even the variation in quality among day-care centers makes less difference than you might think: “The surprising conclusion from the research literature is that variation in quality of care, measured by experts, proves to have little or no impact on most children’s development.”

 

[robellis]

Additionally, followups from that same Bettinger dataset (Elstad, Baaken, 2015) show that most of the grade effect looks to be be subsumed in the lower percentage of earners, with variance explained by income. Also looking at similar countries to Norway in terms of social safety nets, mothers with longer hour PT jobs or FT jobs had kids with better cognitive test scores than women with lower hour PT jobs or stay-at-home (Kunn-Nelen et al., 2014). Also suggestive of much of the variance being soaked up by economic factors.

At the very least, the data is equivocal, I have not seen anything even remotely compelling to suggest working parents in high SES households have children with worse outcomes than those with a stay-at-home parent.

What are the outcomes? How attached your children are to you? How close your relationship is? Whether they tell you everything or have secrets? Whether when they grow up they want to continue to engage with you and live near you versus move across the country? The depth of the relationship and the happiness it brings both to you and the child? Those aren’t the typical outcomes but life and human experience are much deeper than what can always be studied..when we start talking about these outcomes..well I think the picture becomes a little more clear. Life is about priorities, some people choose their kids others choose their work, neither might be good or bad based on the typical “outcomes” but look around you and observe for yourself the consequences of people’s decisions and their relationships with their kids.

 

[WisNeuro]

What are the outcomes? How attached your children are to you? How close your relationship is? Whether they tell you everything or have secrets? Whether when they grow up they want to continue to engage with you and live near you versus move across the country? The depth of the relationship and the happiness it brings both to you and the child? Those aren’t the typical outcomes but life and human experience are much deeper than what can always be studied..when we start talking about these outcomes..well I think the picture becomes a little more clear. Life is about priorities, some people choose their kids others choose their work, neither might be good or bad based on the typical “outcomes” but look around you and observe for yourself the consequences of people’s decisions and their relationships with their kids.

I see no issue with these outcomes in my friends and colleagues who have children and both work. I mean, you do you. But, to claim that people who work are somehow damaging their children is simply egocentric BS based on the available evidence.

 

[robellis]

I see no issue with these outcomes in my friends and colleagues who have children and both work. I mean, you do you. But, to claim that people who work are somehow damaging their children is simply egocentric BS based on the available evidence.

If you don’t see an issue I suggest you look harder but you’re right we can all choose to behave how we like and we’ll see what happens as life unfolds, I wish you the best

 

[WisNeuro]

If you don’t see an issue I suggest you look harder but you’re right we can all choose to behave how we like and we’ll see what happens as life unfolds, I wish you the best

I imagine some people will be sure to find whatever it is that they want to see, but we can also back up what we believe with data when it is available. I wish you the best as well.

 

[tr]

What are the outcomes? How attached your children are to you? How close your relationship is? Whether they tell you everything or have secrets? Whether when they grow up they want to continue to engage with you and live near you versus move across the country? The depth of the relationship and the happiness it brings both to you and the child? Those aren’t the typical outcomes but life and human experience are much deeper than what can always be studied..when we start talking about these outcomes..well I think the picture becomes a little more clear. Life is about priorities, some people choose their kids others choose their work, neither might be good or bad based on the typical “outcomes” but look around you and observe for yourself the consequences of people’s decisions and their relationships with their kids.

So.. when the measurable outcomes don't fit your hypothesis, you claim that there are other, unmeasurable outcomes which, if measured, which they cannot be, would prove uniparental care superior to multiple/alloparental care?

I would say my personal life observations agree with the data, which are that children from economically advantaged, stable homes do well, and children from unstable, economically disadvantaged homes do poorly. Children of loving, stable, securely attached parents tend to grow up and have good relationships with those parents as well as with others in their lives. Children of erratic, insecurely attached, neglectful or abusive parents tend to grow up and have bad relationships with those parents, and often difficulty forming healthy relationships with others as well.

Parental employment is relevant mostly insofar as it contributes to financial stability.

 

[Splenda88]

Exactly, SES is pretty much the big variance factor. The daycare that kids of docs/lawyers/etc are in are most likely very enriching stimulus-wise, as well as social engagement with kids their age. Most of the pearl clutching about kids in daycare is generally unfounded beliefs backed up by traditional social mores than any actual data.

Shocking rich people have it easier...

It's nice to be rich in the US because the system favors you heavily.

 

[tr]

note this is especially true if you can afford to stay at home and are refusing to do so in order to further your career, if you are low income and cannot afford to stay home that is a different discussion

Ah yes, High income parents who stay home are taking the high road and sacrificing their careers to nurture their children in ways that will have long term benefits. Low income parents who stay home are lazy gits who ought to get a job and earn their paltry WIC. I've seen this argument before. It's nauseating.

If you really want to throw your weight behind the parent-at-home cause, instead of wringing your hands about the harms wrought upon upper middle class children by their Montessori daycares, you should be campaigning for UBI so parents who hate their stressful crappy low-income jobs at the Amazon warehouse can stay home with their kids instead.

 

[robellis]

Ah yes, High income parents who stay home are taking the high road and sacrificing their careers to nurture their children in ways that will have long term benefits. Low income parents who stay home are lazy gits who ought to get a job and earn their paltry WIC. I've seen this argument before. It's nauseating.

If you really want to throw your weight behind the parent-at-home cause, instead of wringing your hands about the harms wrought upon upper middle class children by their Montessori daycares, you should be campaigning for UBI so parents who hate their stressful crappy low-income jobs at the Amazon warehouse can stay home with their kids instead.

I see I struck a nerve..not here to argue as well agree to disagree

 

[NeuroKlitch]

No it does not...

Even with the adolescent unit ?

I'm a PGY 4 in the NE. I signed a contract that will pay me 340k-350k a year for ER psychiatry gig starting in July. I work 13 days out the month (avg 40 hours per week a month) and have a guaranteed consecutive 10 days off every month. I get paid different rates depending on if I work on the weekends, days or nights (I do all 3 during the month). The rate ranges between 155-205 an hour. I negotiated this because I want to travel internationally every month. Also I plan to work the other days that are not the consecutive 10 days at other per diem gigs to boost me to over 400k a year. However there are negatives:

1. Long hour shifts (which I actually like): 8-24 hour shifts.
2. No benefits (I negotiated this; I was offered full time with benefits, part time with partial benefits or per diem): I took the per diem
3. Working weekends for some of these shifts during the month.

The positive is that my schedule is already made 6 months in advance so I know exactly when I will work. Im not married or have kids. OP if you want over 300k there will be sacrifices. You just have to know what to give up. However, this job works for me for now especially since I really like ER psych. I also have two per diem jobs I signed on at two different hospitals (one is my residency moonlight job).

Nice. This is exactly what I'm interested in. My current residency program is the only psych ER for a population of roughly 500k so this what we basically molded to do (although I wouldn't want to stay here after residency ).Are these gigs common?

 

[medhead1990]

Yep. I think that's the smart route for an "easier" 300k. Moonlighting at various gigs and working overnight especially in places where you can sleep at least 5-6 hours. So while on paper it's 40 hours/week, it's actually much less. There's a gig I work at where I sleep soundly for half the shift, lol. No contract obligations also mean you can move on on a whim. They can do that as well, but if you have multiple gigs like that the risk is low. And they need us. So there, 300k and you are not bound by mean bosses, big box shop shackles and bureaucracy. And you can routinely take extended time off.

"Moonlighting at various gigs and working overnight especially in places where you can sleep at least 5-6 hours. So while on paper it's 40 hours/week, it's actually much less. There's a gig I work at where I sleep soundly for half the shift, lol."

What was the context of this magical unicorn I am curious. Getting paid to sleep has always been a dream of mine... get it dream (my dad jokes are on fleek right now!)

 

[Mad Jack]

Would this job require C&A fellowship? I've been browsing a lot of potential jobs on indeed and I find that C&A jobs usually start at 300k base + productivity , while general is around 200k. Is it just me or does it seem like child is necessary these days to land competitive jobs. I've been considering addiction or geriatric fellowship but seems like Child is really the only sure way to land a 32 patient hour work week with 350k+ potential without pushing 50 hours or doing multiple jobs.

Unless it is cash or private only, child tends to pay less due to the nature of the work. You see less patients due to the coordination and other aspects. That being said, the private jobs can be very nice

 

[finalpsychyear]

How much do benefits add up for a full time psych job that pays 250k salary plus benefits? 30-40k tops? Basically you would need close to 300 1099 to be equivalent?

 

[Ironspy]

How much do benefits add up for a full time psych job that pays 250k salary plus benefits? 30-40k tops? Basically you would need close to 300 1099 to be equivalent?

Depends on what the benefits are. Crappy ones are <50k. Great ones can be >50k if we are talking about good highly subsidized insurance for a family where someone has $$ needs, life insurance, retirement match, payroll taxes etc.

 

[comp1]

I'm W2 for life. The benefits are quite extensive. I did the math. My employer pays $50 monthly for life insurance, $1050 monthly for health insurance (single plus one), $300 in Medicare taxes, $1290 in social security taxes, $3600 in pension and $1080 in 401k matching. I understand most places aren't going to get a pension, but hopefully you're getting better matching in your 401k. It's still a chunk of money, particularly since it's all either tax free or at least tax deferred to when I am in a much more favorable bracket.

 

[Sushirolls]

Employer life insurance is usually far less than what you get on open market.
After having had to purchase life insurance, I'm glad I have non employer policy. So much more.

 

[finalpsychyear]

had a colleague tell me he got offered 1099 of 300 ish in midwest outpatient for 30 hours doing tele x 48 wks/yr but no bennies. I guess he wasn't lying then i thought it was a bit high for midwest geography and being tele.

 

[forchinet121]

had a colleague tell me he got offered 1099 of 300 ish in midwest outpatient for 30 hours doing tele x 48 wks/yr but no bennies. I guess he wasn't lying then i thought it was a bit high for midwest geography and being tele.

How many patients per hour? That’s a very important component