So can we talk money?

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How much money are you making (or would make assuming you worked full-time)

  • $400k/year or more

    Votes: 26 16.3%

  • $300,000 to $399,000

    Votes: 28 17.5%

  • $250,000 to $299,000

    Votes: 27 16.9%

  • $200,000 to $249,000

    Votes: 44 27.5%

  • $150,000 to $199,000

    Votes: 20 12.5%

  • Less than $150k/year

    Votes: 15 9.4%
  • Total voters
    160
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Doctor Bagel said:
Really? And they are able to fill those positions? Working fulltime in community mental health here would put you in the low 200s.
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wow i had no idea people were making that much in community mental health just a little way away. Though your state is known for being one of the best for reimbursement for mental health. They are able to fill because there are enough do-gooders who like working with that population and my understanding is they are fairly low stress jobs and they might not have the same pressure to churn through patients in the same way that they might elsewhere. It seems common for people to work part-time though and do private practice and I've also heard of people later in their career going to community mental health having been burnt out of therapy heavy private practice, wanting to work in multidisciplinary teams, wanting the benefits etc.

Definitely don't know of any CMHCs around here that 200k+!
 
Not that I know for sure, because it's majorly none of my business, and I've never asked, but just going by 'clinicians wanted' ads for the CMHC that my Psychiatrist works at, that require the applicant to more or less perform the same duties/responsibilities as him - again I'm not too sure if he's delegating responsibility for the running of the clinic to concentrate on other projects within the clinic system, or if he's stepped down completely - the starting salary was around $150,000 AUD with an upper level of around $405,000 plus a remuneration package (typically covers things like bonus pay for overtime, being on call, and so on), depending on experience/seniority/whatever else. So presumably someone coming into the position for a shared delegation of responsibility at say a clinician level would receive a lower rate of pay than someone coming in as a lead clinician, consultant, or senior consultant. I can make an educated guess that my Psychiatrist, being a lead clinican/senior consultant in the role prior to presumably delegating or stepping down (and I am making a huge assumption there) would have probably been on around the $350-405k mark (plus whatever bonuses were given as part of any sort of remuneration package) per year in gross wages. Which of course all sounds great in theory, being able to earn that amount of money, except the optimum word here is 'earn' - just my own personal observations but it did seem the higher up the wage bracket/seniority ladder you go, the more observably high pressure things appear to become (he's employed in other positions as well within the CMH and University/Higher Education sectors, but I have no idea what his pay rate is for those). So I guess it's a balance between how much do you want to earn versus how hard do you want to work.
 
Doctor Bagel said:
Salary information from an anonymous psychiatrist --

"I make in the mid 300's per year by combining a mediocre-paying but very flexible full time inpt psych position with a lucrative weekend coverage locums assignment. That's one way to make more than 300k; the other main way is to combine a salaried job with a private practice. It's hard to make above 275k at a single position."
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In other words, work 6 to 7 days a week? Or serious overtime?
 
splik said:
wow i had no idea people were making that much in community mental health just a little way away. Though your state is known for being one of the best for reimbursement for mental health. They are able to fill because there are enough do-gooders who like working with that population and my understanding is they are fairly low stress jobs and they might not have the same pressure to churn through patients in the same way that they might elsewhere. It seems common for people to work part-time though and do private practice and I've also heard of people later in their career going to community mental health having been burnt out of therapy heavy private practice, wanting to work in multidisciplinary teams, wanting the benefits etc.

Definitely don't know of any CMHCs around here that 200k+!
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Do gooders driving down salaries for all of us. Are these people working 40 hours or more like 3 to 4 days a week? With the later, I could see $150k making sense. Here, community seems to pay around $100/hour with various adjustments. I'm also not sure about these great benefits unless you work for the government in some way. My community job benefits are pretty average and way worse than VA/university type of benefits, which is similar to the benefits at the other community places I talked to. Here, the county farms out their community mental health needs to various community mental health agencies who then employ psychiatrists. Perhaps it would be different if the county were the direct provider? I'm guessing that would lead to better benefits. I'm also not sure I'd associate low stress with community work -- the schedule volume is equivalent to Kaiser and definitely more than the VA or the academic clinic. The primary saving grace are the no shows.
 
Just received an email about a job in the middle of nowhere in Oklahoma (2 hours from Oklahoma City, town population of about 10k) offering $275k/year inpatient with no call for a state facility. This is a town where you could buy the equivalent of a mansion for $300k. I personally would be miserable living in this town, but hey, I guess you can do well if you want to go to a middle of nowhere. Other info about this town -- 18% of people have college degrees, high plains type of terrain with few trees, not so great weather and probably about 90% southern baptist/90% republican.
 
I think computers have slowed us down bigtime. I type around 80 wpm but it's not fast enough because of all the clicking.

When I was an EM scribe in the early 2000s we had templates where we could quickly check boxes and jot down notes. Looking back, the old system was more balanced when it came to time spent with patients and time spent with documentation.
 
One thing that I have found incredibly useful with new technology is my touch screen laptop in combination with Google Chrome and using the "OK Google" voice recognition. It's almost always spot on and I can blaze through tons of information this way. Now if only this can be incorporated into an EMR...
 
Do they not have dictation-based EMRs?
 
Doctor Bagel said:
Salary information from an anonymous psychiatrist --

"I make in the mid 300's per year by combining a mediocre-paying but very flexible full time inpt psych position with a lucrative weekend coverage locums assignment. That's one way to make more than 300k; the other main way is to combine a salaried job with a private practice. It's hard to make above 275k at a single position."
Click to expand...


Totally agree with that, it seems everyone practicing around here does a regular gig and then several weekend or small contract jobs to get up in that range. Weekend coverage ranging from 1-4k/weekend, and something like covering a corrections center or eating disorders unit, etc. can be 180-300/hour. If you are willing to drive around and do small contracts like that regularly you can almost double your salary in most geographic locations.
On the topic of negotiation, my biggest regret was not negotiating my first job contract hard enough. I accepted an offer that I probably could have negotiated up quite a bit. My advice is to get as much information about the area, how long they have been looking for someone, etc and then negotiate HARD if they really need you.
 
asdf0987 said:
Totally agree with that, it seems everyone practicing around here does a regular gig and then several weekend or small contract jobs to get up in that range. Weekend coverage ranging from 1-4k/weekend, and something like covering a corrections center or eating disorders unit, etc. can be 180-300/hour. If you are willing to drive around and do small contracts like that regularly you can almost double your salary in most geographic locations.
On the topic of negotiation, my biggest regret was not negotiating my first job contract hard enough. I accepted an offer that I probably could have negotiated up quite a bit. My advice is to get as much information about the area, how long they have been looking for someone, etc and then negotiate HARD if they really need you.
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Is that because all subsequent jobs are based on % raise of your first salary?
 
PistolPete said:
Is that because all subsequent jobs are based on % raise of your first salary?
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Not necessarily, as other factors (location, hours, call etc) will always factor into your negotiation too. For me, I feel that both call and salary could have been better negotiated. Also, things like asking for a 4-day work week, more time per appointment, etc. can be negotiated too. Salary at your next job might be lower but it might have no call, a 4-day workweek, and 60 minute (or even 90!!) new patient slots or whatever else you might prefer in your ideal job.
 
F0nzie said:
I think computers have slowed us down bigtime. I type around 80 wpm but it's not fast enough because of all the clicking.

When I was an EM scribe in the early 2000s we had templates where we could quickly check boxes and jot down notes. Looking back, the old system was more balanced when it came to time spent with patients and time spent with documentation.
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People need to learn to work with the technology. Learn some programming and you can create a program where you click boxes and it generates a note with all of the necessary points hit for billing. Takes 2 minutes to finish documentation.
 
n=32 and those earning >300k is almost at 50%. Not bad.
 
Amygdarya said:
Skewed sampling?
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I'd say there's a bit of a response bias or untruthful reporting... but what do I know. If it's really possibly to pull >$400,000 in psychiatry... that's great to hear. It just seems really difficult since that would mean $160/hr @ 50 hrs/wk for 50 wks/yr. I would be curious to hear if that's actually feasible. 🙂
 
SpartanWolverine said:
I'd say there's a bit of a response bias or untruthful reporting... but what do I know. If it's really possibly to pull >$400,000 in psychiatry... that's great to hear. It just seems really difficult since that would mean $160/hr @ 50 hrs/wk for 50 wks/yr. I would be curious to hear if that's actually feasible. 🙂
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It's feasible. However, I try to avoid more than 30 hours of patient encounters per week as I start developing psychiatric symptoms myself.

This is me right around the 30 hour mark
 
Maybe.

Although I don't know why anyone would lie on an anonymous SDN poll.

Do you think it's the cash only guys in larger markets that are crushing 400k?


SpartanWolverine said:
I'd say there's a bit of a response bias or untruthful reporting... but what do I know. If it's really possibly to pull >$400,000 in psychiatry... that's great to hear. It just seems really difficult since that would mean $160/hr @ 50 hrs/wk for 50 wks/yr. I would be curious to hear if that's actually feasible. 🙂
Click to expand...
 
Blitz2006 said:
Although I don't know why anyone would lie on an anonymous SDN poll.

Do you think it's the cash only guys in larger markets that are crushing 400k?
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Ask ChicagoChildPsych guy who claims to bring in 500K+. I believe he's cash only.
 
I met a child psychiatrist in long island that charges $600/hr. He was saying there are psychiatrists in Manhattan that charge up to $900/hr.

Obviously this is not sustainable for 40 hour weeks, and probably on doable in the LA/SF/NYC markets, but you can do some simple, quick math and figure out u can "do ok"


SpartanWolverine said:
Wow, that's wild. Glad to hear the opportunity is out there if that's what you're looking for.
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I met a psychiatrist who claims to earn $125-150 per patient in his inpt service. And he sees about 2o pts per day. That's $2500-$3000 per day! And he makes an additional income from his private clinic. I don't know how much I believe him because it almost seems too good to be true. Why doesn't everyone do this instead of making ~150-200 per hour?
 
maybe because many (possibly most) psychiatrists would rather gouge their eyes out than do inpatient work every day?

20 is a lot of patients especially if you are doing admissions and discharges, and outpatient work on the side. you are either providing crappy care and having unsatisfactory encouters or working quite hard especially if you dont have someone like a nurse practitioner handling all the busy work and discharges for you.
 
Doctor Bagel said:
Average posted salaries for psychiatrists look a lot lower than what average pay actually is. I always wonder if I'm missing something.
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Emergency med lagged for several years--surveys were still reporting 220-250 as being average when 300 was more likely; I wonder if the higher earners in each specialty are afraid of divulging on those surveys.

scudiera said:
Curious about how many of the big earners are CAP boarded. Hoping some gen psych are 300+.
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There always seemed to be conflict in the CAP surveys and the rumors. Huge demand but low reported income -- were all the private practice folks keeping their income a secret?
 
splik said:
maybe because many (possibly most) psychiatrists would rather gouge their eyes out than do inpatient work every day?

20 is a lot of patients especially if you are doing admissions and discharges, and outpatient work on the side. you are either providing crappy care and having unsatisfactory encouters or working quite hard especially if you dont have someone like a nurse practitioner handling all the busy work and discharges for you.
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Is inpatient really worse than a busy outpatient medication management clinic? I do some inpatient work, and it's actually way better than busy day in my community clinic -- fewer patients, better pay, more flexibility with how I spend my time rather than having all patients scheduled for the same length. Getting paged in the middle of the night sucks, but as a non-resident, I don't ever have to go in, so it's not so horrible. Why do psychiatrists hate inpatient work so much?

About pay and lots of patients, I work at a place where they switched to a hospitalist model. I was talking to one of the nurses yesterday, and he said it used to be that the previous doctors would come in and round on a ton of patients (yeah, like 20) and leave by 10:30 to go to their other jobs. I'm suspecting those guys were making serious money. They apparently expressed the notion that treatment doesn't happen in the inpatient unit so why bother spending time with people. Not a notion I agree with, especially because I'm seeing now how treatment happens in the outpatient world for these people, and it doesn't really happen there either.
 
flight24 said:
I met a psychiatrist who claims to earn $125-150 per patient in his inpt service. And he sees about 2o pts per day. That's $2500-$3000 per day! And he makes an additional income from his private clinic. I don't know how much I believe him because it almost seems too good to be true. Why doesn't everyone do this instead of making ~150-200 per hour?
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That rate is about right for new evals, not follow-ups. If you see multiple new evals per hour, you can make a lot, but the care is just bad.
 
TexasPhysician said:
That rate is about right for new evals, not follow-ups. If you see multiple new evals per hour, you can make a lot, but the care is just bad.
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He said that he made that amount for follow-ups, which is why I found it hard to believe. What's the going rate for follow-ups in your area?
 
Doctor Bagel said:
Is inpatient really worse than a busy outpatient medication management clinic? I do some inpatient work, and it's actually way better than busy day in my community clinic -- fewer patients, better pay, more flexibility with how I spend my time rather than having all patients scheduled for the same length. Getting paged in the middle of the night sucks, but as a non-resident, I don't ever have to go in, so it's not so horrible. Why do psychiatrists hate inpatient work so much?

About pay and lots of patients, I work at a place where they switched to a hospitalist model. I was talking to one of the nurses yesterday, and he said it used to be that the previous doctors would come in and round on a ton of patients (yeah, like 20) and leave by 10:30 to go to their other jobs. I'm suspecting those guys were making serious money. They apparently expressed the notion that treatment doesn't happen in the inpatient unit so why bother spending time with people. Not a notion I agree with, especially because I'm seeing now how treatment happens in the outpatient world for these people, and it doesn't really happen there either.
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Maybe the only thing worse than inpatient is CMH. I have worked in both settings and am now working in an outpatient clinic affiliated with a private hospital. The only way I could go back to CMH is if I was to be the director. Of course, from what I have seen, those positions pay about half what I get paid now so why would I do it? Hmmm. Maybe that's one reason why they are so poorly run.
 
asdf0987 said:
On the topic of negotiation, my biggest regret was not negotiating my first job contract hard enough. I accepted an offer that I probably could have negotiated up quite a bit. My advice is to get as much information about the area, how long they have been looking for someone, etc and then negotiate HARD if they really need you.
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I just got a job offer , and the starting salary for BE is 227,000 while for BC is 237,000. I just took the boards on 9/24 so I guess I'm BE even if I feel pretty confident. So my question is how do you negotiate with one year experience. I didn't negotiated with my previous employer but after reading from experienced docs like you, I feel compelled to do it, I just don't know how to make that case. Btw, it's a four ten hour day but no Mondays or Fridays off ,no calls and roughly 25 patients. I was told by the director to call HR to get salary and benefits info so who would I be negotiating salary with then?
 
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I know a Substance attending in a Major Northeast Metro Area, Dual Unit 20-30 pts. Highly efficient SWs helping out significantly with efficiency. Full Time job, no weekend/ O/N coverage. Attending usually finished work within 4-5 hours a day. Salary Base rate(based on 14 pts) + Productivity bonus + 8% of billing per patient( i forget if the 8% is for each additional pt above 14 or for everyone) = apprx 400k after bonus. High stress, but if you work fast = total of 22-25hrs per week sometimes 30hrs.
 
Yellow mellow said:
I just got a job offer , and the starting salary for BE is 227,000 while for BC is 237,000. I just took the boards on 9/24 so I guess I'm BE even if I feel pretty confident. So my question is how do you negotiate with one year experience. I didn't negotiated with my previous employer but after reading from experienced docs like you, I feel compelled to do it, I just don't know how to make that case. Btw, it's a four ten hour day but no Mondays or Fridays off ,no calls and roughly 25 patients. I was told by the director to call HR to get salary and benefits info so who would I be negotiating salary with then?
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One way to go about it is to accept the lower salary with expectation of getting a higher amount once BC. I would ask both the director and the hr people how that would look and work. That way they are taking less risk and they can get to know you a bit better before giving you 250k or so. Also, you will know the job better so you will know better what the salary should be. In the meantime you are gaining experience and next job you will have even more bargaining power.
 
Yellow mellow said:
I just got a job offer , and the starting salary for BE is 227,000 while for BC is 237,000. I just took the boards on 9/24 so I guess I'm BE even if I feel pretty confident. So my question is how do you negotiate with one year experience. I didn't negotiated with my previous employer but after reading from experienced docs like you, I feel compelled to do it, I just don't know how to make that case. Btw, it's a four ten hour day but no Mondays or Fridays off ,no calls and roughly 25 patients. I was told by the director to call HR to get salary and benefits info so who would I be negotiating salary with then?
Click to expand...

Years experience is worthless. Don't downplay your worth. Psychiatrists with 25 years experience don't receive higher reimbursements from insurance companies than those with 1 year experience. I negotiate hard and expect to walk if not paid what I feel is appropriate.
 
Not in the job market yet, but have some data to offer based on my near-miss of going into academics as an adult psych.

Academic-affiliated CMHC (about 50% of work covered by residents on inpatient, 80% in outpatient, 100% on consult.). 190k starting, around 210 with call if you do it twice a month. Laid back inpt census and outpatient schedules. High no show rate in outpatient. Mostly uninsured, rest medicare/medicaid. no private insured.

Academic department (100% resident coverage on inpatient and consult, 50% for outpatient positions. Inpatient attendings also see direct-care outpatient most afternoons). 140k starting. And ending. 80%+ private, rest medicaid, little to no uninsured. No noshows to speak of. Similarly laid back schedule however. Which made the salary offered very confusing.

Both were midwest. I found it hard not to laugh at the latter one.
 
I make $100k now as a 4th year. I can't imaging making just 40k more after completing 12 years of insanely hard training.
 
masterofmonkeys said:
Not in the job market yet, but have some data to offer based on my near-miss of going into academics as an adult psych.

Academic-affiliated CMHC (about 50% of work covered by residents on inpatient, 80% in outpatient, 100% on consult.). 190k starting, around 210 with call if you do it twice a month. Laid back inpt census and outpatient schedules. High no show rate in outpatient. Mostly uninsured, rest medicare/medicaid. no private insured.

Academic department (100% resident coverage on inpatient and consult, 50% for outpatient positions. Inpatient attendings also see direct-care outpatient most afternoons). 140k starting. And ending. 80%+ private, rest medicaid, little to no uninsured. No noshows to speak of. Similarly laid back schedule however. Which made the salary offered very confusing.

Both were midwest. I found it hard not to laugh at the latter one.
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With the second one, so there was no way to make additional money? Like could you see your own private pay patients in clinic or were you stuck with medicaid types of patients for clinic, too? If not, wow, that salary sucks. Did anybody take the job?
 
masterofmonkeys said:
Academic-affiliated CMHC (about 50% of work covered by residents on inpatient, 80% in outpatient, 100% on consult.). 190k starting, around 210 with call if you do it twice a month. .
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Unless call on weekends was minimal, I would take the 190k with no call and then make much more than an extra 20 k doing call 1-3 weekends per month somewhere else
 
masterofmonkeys said:
Academic department (100% resident coverage on inpatient and consult, 50% for outpatient positions. Inpatient attendings also see direct-care outpatient most afternoons). 140k starting. And ending. 80%+ private, rest medicaid, little to no uninsured. No noshows to speak of. Similarly laid back schedule however. Which made the salary offered very confusing.
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This happens, and IMHO is very exploitative. They end up getting candidates who are primarily women who cannot move or negotiate very much due to family and other outside circumstances. Usually these positions also have very high turnover.
 
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