Dismiss Notice
SDN members see fewer ads and full resolution images. Join our non-profit community!

Which subspecialties of psychiatry pay the least/most?

Discussion in 'Psychiatry' started by XWing5000, Apr 11, 2018.

  1. splik

    splik Professional Cat at Large
    Physician Faculty

    Joined:
    Nov 30, 2009
    Messages:
    3,455
    Likes Received:
    4,109
    Status:
    Attending Physician
    there are 37000 psychiatrists in practice, not sure where 25000 came from. also it's important to remember that most NPs working in psychiatry are not psych NPs, they are FNPs. So in addition to the small number of Psych NPs you also have twice as many FNPs working in psychiatry. Incidentally, the psych NPs seem to resent the FNPs for "taking their jobs" and claiming that these FNPs are not qualified to work in their role. the irony of it all.

    there are lots of cash only and concierge NPs offering mental health services in states with independent practice. some charge more than psychiatrists do.
     
  2. Thread continues after this sponsor message. SDN Members do not see this ad.

  3. OldPsychDoc

    OldPsychDoc Senior Curmudgeon
    Physician Moderator Emeritus SDN Advisor

    Joined:
    Dec 2, 2004
    Messages:
    6,026
    Likes Received:
    3,264
    Status:
    Attending Physician
    Pulled that # off the BLS website--Psychiatrists--and now I see that that accounts for only employed psychiatrists, not "self-employed workers"(obviously a big chunk they missed.)
    However, the point still remains: Psychiatric NPs are not exactly "extremely rare".
     
    FlowRate likes this.
  4. michaelrack

    michaelrack All In at the wrong time
    Physician SDN Advisor

    Joined:
    Dec 22, 2007
    Messages:
    3,743
    Likes Received:
    852
    Status:
    Attending Physician
    My guess is that the psychiatrists all have more than one job, so overall they are working more hours than the NP's. That is the situation I am in at my main job. The NP works more hours than me there, but overall, I probably work at twice as many hours
     
  5. MedMan80

    Joined:
    May 23, 2017
    Messages:
    55
    Likes Received:
    25
    There was a concierge NP charging patient's 2500/mo here in NYC, seeing kids mind you, the pharmacology was so horrible i won't mentioned it here out of fear of identifying the cases..
     
    ziggyhope likes this.
  6. NRP

    NRP

    Joined:
    Dec 5, 2012
    Messages:
    46
    Likes Received:
    60
    Wait wait wait. I don't know any of the lingo here, but each patient/family was charged 2500 a month to see this person?
     
  7. NickNaylor

    NickNaylor Thank You for Smoking
    Physician Lifetime Donor Classifieds Approved

    Joined:
    May 22, 2008
    Messages:
    16,461
    Likes Received:
    6,909
    Status:
    Resident [Any Field]
    Our local community systems are overflowing with PMHNPs. We have them in our PED (at least 2 on staff) and the outpatient CMHC has predominantly PMHNPs, such that it’s almost a guarantee that you will be seeing an NP unless you’re on an ACT team.
     
    FlowRate likes this.
  8. WisNeuro

    WisNeuro Board Certified Neuropsychologist
    Psychologist

    Joined:
    Feb 15, 2009
    Messages:
    7,701
    Likes Received:
    5,649
    Status:
    Psychologist
    Yeah, psychiatric NPs outnumber the psychiatrists down in our OP clinic here. When I was leaving the VA, they had started to hire more and more as well. The last place I was brought on 2 in the last year I was there to backfill some positions. There are shortages, and it sure seems like a lot of systems are going to hire whoever they can to meet productivity demands, MD/DO or not.
     
  9. AD04

    Joined:
    Dec 27, 2011
    Messages:
    90
    Likes Received:
    23
    Status:
    Resident [Any Field]
    Any reason for profit-driven entity to hire psychiatrists over NPs? Doesn't insurance reimburse 80% for NPs? If so, why not just hire 2 NPs instead of 1 psychiatrist and make profit through volume? Any penalties legally for having NPs and no psychiatrists?
     
  10. TexasPhysician

    Moderator Physician

    Joined:
    Sep 1, 2008
    Messages:
    4,234
    Likes Received:
    1,070
    Status:
    Attending Physician
    I thought it was 85%?

    Another psychiatrist friend was just fired today and replaced with a NP. It is becoming increasingly common that NP’s are not being added to supplement us but instead replace us.
     
  11. zolof

    Joined:
    Jul 25, 2011
    Messages:
    71
    Likes Received:
    16
    Status:
    Attending Physician

    That is crazy.
     
  12. calvnandhobbs68

    calvnandhobbs68 I KNOW NOTHING

    Joined:
    May 20, 2010
    Messages:
    3,051
    Likes Received:
    958
    Status:
    Resident [Any Field]
    Guess the only thing that’s bigger in Texas is the amount of NPs.

    Live in a state that doesn’t allow independent practice folks. Then when they try to lobby for independent practice you’ll have enough doctors in the state to lobby back against it. These stories are worrying but the one plus psych has that most specialities don’t have is the relatively low overhead for private practice. You need a lot more overhead for almost all other specialities, much less the hospital based ones who have no option but to work for another hospital or get paid less.
     
    #61 calvnandhobbs68, Apr 19, 2018 at 6:00 PM
    Last edited: Apr 19, 2018 at 6:21 PM
  13. ryerica22

    Joined:
    Aug 2, 2017
    Messages:
    40
    Likes Received:
    5
    Status:
    Resident [Any Field]
    Honestly, there is so much of a demand for Psychiatrists that it doesnt matter which subspecialty you go in. You don't even have to do a fellowship to do well.
     
  14. AD04

    Joined:
    Dec 27, 2011
    Messages:
    90
    Likes Received:
    23
    Status:
    Resident [Any Field]
    You're right about the 85%, which is ridiculous. But reality is reality. ¯\_(ツ)_/¯

    I wonder if independent NPs are held to the same standard of care in malpractice lawsuits. In the case you mentioned, it's best not to work for those types of employers anyways as they place short-term profits over patient care. Once the NPs mess up, the plaintiffs will go after the employer and there will be no physician to fall back on.

    I wonder how many of the politicians who voted for independent NPs see NPs over physicians for their own personal care.

    Being a psychiatrist is good in the sense of flexibility. You can always open up your own practice and advertise yourself as a physician. You will get patients. When given the option, most people would rather see a physician than an NP anyways.
     
  15. b52bomber

    Joined:
    May 6, 2017
    Messages:
    15
    Likes Received:
    16
    Status:
    Resident [Any Field]
    I have seen much questionable pharmacology by NPs out in the public. These patients invariably de compensate and come into the psych ED where they are admitted...I read through the notes and try to figure out what their medication regimen, but it has me scratching my head. Usually it’s with how they try to dose the LAIs....


    Sent from my iPhone using SDN mobile
     

Share This Page