Things really are better

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SmallBird

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There is no end to threads highlighting all the ways in which mid level encroachment and administrative overreach have negatively impacted the expected experience of psychiatrists. It is curious that the only part of the argument that doesn't hold is that everyone is that nobody actually seems to be in a worse situation. When I started residency, it was expected that a new grad would make about $160k a year out of training. I remember how some would brag about being able to snag jobs paying $250k by moving to less desirable states in around 2015, and my first attending job in 2017 as a child psychiatrist paid $192k. Despite consistent predictions of everything being terrible, myself and all my colleagues are all doing substantially better than that, for the same amount of work. I think it's fine.
 
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I also graduated residency in 2017 and I feel like I have to make another horizontal move (after my first earlier this year) because salaries keep going up at other employers. My father (graduated psychiatry residency circa 1989) had three employers his entire career and looked dumbfounded when I said I might look to change jobs again next year. Things might be better, but they're also different.
 
my first attending job in 2017 as a child psychiatrist paid $192k. Despite consistent predictions of everything being terrible, myself and all my colleagues are all doing substantially better than that, for the same amount of work. I think it's fine.

With statements like these we should always be looking at the "real" value of our compensation as opposed to the nominal.

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How is your relative purchasing power as a brand new attending in 2022 compared to 2017?

I know for a fact my salary (as a 2nd year attending) is nowhere close to 231k.
 

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this forum is an odd place with the proverbial Schrödinger's psychiatrist who simultaneous earns over a million working 10 hours a week while being replaced by a newly graduated from online diploma mill NP.

Obvious a lot of people get a kick here from measuring themselves against others in endless iwhose dick is bigger contests, measured in $$$ of course.
It’s endlessly amusing I have to say.
 
With statements like these we should always be looking at the "real" value of our compensation as opposed to the nominal.

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How is your relative purchasing power as a brand new attending in 2022 compared to 2017?

I know for a fact my salary (as a 2nd year attending) is nowhere close to 231k.
I was about to make this exact point, the only thing I was unclear on here is your last statement, do you mean you’re much higher or lower than 231k?
 
With statements like these we should always be looking at the "real" value of our compensation as opposed to the nominal.

View attachment 359651

How is your relative purchasing power as a brand new attending in 2022 compared to 2017?

I know for a fact my salary (as a 2nd year attending) is nowhere close to 231k.
Inflation takes out a chunk, but yes, still much improved
 
I was about to make this exact point, the only thing I was unclear on here is your last statement, do you mean you’re much higher or lower than 231k?
Sadly far below. Let's just say there are lifestyle factors that make it rational for me to work at this place and I make up lost income elsewhere.
 
The beauty with psych is unlike the vast majority of other specialties, we can avoid working for the man as a W2. Even with all the NPs seemingly flooding the market, I have never encountered a doc who got on a few insurance panels and couldn't fill up relatively quickly. This type of work is always going to out earn being a W2 at a big box or group, or (gasp) in academics.

I don't see reimbursements dropping for us in the next 10 years either. I think the picture is rosy. Particularly so if you have some sub-specialty expertise and/or neuromod abilities.
 
Things ARE better! Totally agree that the world is falling stuff is way over the top. Show it with some salary data.
 
The beauty with psych is unlike the vast majority of other specialties, we can avoid working for the man as a W2. Even with all the NPs seemingly flooding the market, I have never encountered a doc who got on a few insurance panels and couldn't fill up relatively quickly. This type of work is always going to out earn being a W2 at a big box or group, or (gasp) in academics.

I don't see reimbursements dropping for us in the next 10 years either. I think the picture is rosy. Particularly so if you have some sub-specialty expertise and/or neuromod abilities.
I'm one who didn't. There are saturated areas of Psych in the country.

I'm now relocated to another area and in process of relocating my office. I'll test out this smaller less saturated market.
 
I'm one who didn't. There are saturated areas of Psych in the country.
You had some other factors limiting you compared to the typical outpatient practice. Realistically not prescribing stimulants under any circumstances was almost certainly a big one, this is a sizable chunk of outpatient adult psychiatry off the table.
 
I'm one who didn't. There are saturated areas of Psych in the country.

I'm now relocated to another area and in process of relocating my office. I'll test out this smaller less saturated market.

Hoping the new locale works out better for you.

But just like there are the pp owners making 7 figures, there are those where things don't work out. Always going to be outliers.
 
Sadly far below. Let's just say there are lifestyle factors that make it rational for me to work at this place and I make up lost income elsewhere.
I'm sorry to hear that, but completely understand that may make sense for you. It might be interesting to know your geography - recently I was looking around again and academic positions in California and the usual low-paying areas of Boston and surrounds were all offering > $220k for new attending.
 
You had some other factors limiting you compared to the typical outpatient practice. Realistically not prescribing stimulants under any circumstances was almost certainly a big one, this is a sizable chunk of outpatient adult psychiatry off the table.
I do stimulants. I just required a UDS for patients Q3 months. Out of patient panel of ~120, I had ~15 stimulant.
 
The beauty with psych is unlike the vast majority of other specialties, we can avoid working for the man as a W2. Even with all the NPs seemingly flooding the market, I have never encountered a doc who got on a few insurance panels and couldn't fill up relatively quickly. This type of work is always going to out earn being a W2 at a big box or group, or (gasp) in academics.

That's my experience as well.
The sky is not falling but it is also not raining cush jobs either. I think the average salary growth is just a little bit above inflation.
There's no dearth of terrible jobs out there. There are also good W2 jobs with a good work/balance, high quality of care but these tend to pay less.
What is special about psychiatry is that you can strike that sweet spot of an upper middle class lifestyle with almost part time work hours, lots of time off and while providing good care. This you need to do outside W2 regular employment. I also don't think many fields can provide this kind of setup or flexibility.
 
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