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brady23

Why do people say psychiatry is a low paying specialty?

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Their average hourly rate comes to about $200/hour based on OHIP billing

An initial consultation (which may take an hour) is ~$200

Repeat consultations (which may take 30 minutes each), so they can do about 2 per hour is $210

Even with no-shows, you're still making a decent amount of money (and a psychiatrist I was shadowing did say that the no-shows are not that frequent)

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23 minutes ago, brady23 said:

Their average hourly rate comes to about $200/hour based on OHIP billing

An initial consultation (which may take an hour) is ~$200

Repeat consultations (which may take 30 minutes each), so they can do about 2 per hour is $210

Even with no-shows, you're still making a decent amount of money (and a psychiatrist I was shadowing did say that the no-shows are not that frequent)

Depending on the type of psychiatry, you do a lot of calling around collecting collateral, maybe less so in outpatient referral type practices, but definitely alot of that in in patient. 

Psychiatrists i've worked with have said no-shows is actually a decent enough issue for them. Very varied. Depends on patient population your dealing with.

Overhead as well, and less likely to be able to whiz through patients, like a GP could.  But again, very dependent on practice - one psychiatrist i worked with was definitely to the point and quick (not doing a great job in my opinion).

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Most of the academic ones I've worked with equal their IM colleagues in pay. The ones who aim to make bank surpass their surgical colleagues. Jobs are plentiful currently. The workload in residency is much lighter when compared to almost any other specialty. And of course, you rarely have any need to rush or hurry anywhere.

As for why it has that reputation - I suspect certain subspecialties and outpatient psychiatry is compensated relatively poorly in comparison, which drags down the average. The field also attracts personalities that are less likely to grind for hours and days on end.

Overall it's a fantastic career if you enjoy the nature of it and have the right personality. If compensation is your primary concern, psychiatry remains a great specialty.

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6 hours ago, 1D7 said:

Most of the academic ones I've worked with equal their IM colleagues in pay. The ones who aim to make bank surpass their surgical colleagues. 

But you are comparing a psych busting their ass to an average run of the mill surgeon. I bet if you compared them to a surgeon out to print cash it might be a different story. 

Most of the psychiatrists in my province that I know seem to be on salary. I know of a couple who are FFS and do lots of inpatient work. They seem to be well compensated. 

I agree that if you are able to enjoy working as a psych, its a great career. 

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A consultation in sum total takes more than an hour for most people - for a complex patient you may need to bring them back, and it also takes time to do a decent/thorough consult note, as well as calling for collateral.  The documentation takes up a lot of time in psychiatry.  Additionally, most of my mentors say that they see fewer patients in a day just because of the emotional drain and how mentally taxing it is.

If you want to make a ton of money as a psychiatrist, you probably can.  ECT is quite lucrative, emerg work, other things with premiums.  It's not like we don't make money.  We make very decent money, so it's not absolutely low paying.  But the average psychiatrist typically makes less than the average [some other thing].  We don't have a lot of procedures that can bump income, documentation takes a long time, and there's a particular mental drain that makes it really difficult to just grind through endless numbers of consults.  Also the no show rate does depend on your practice setting and can be quite high.

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Each province has some nuances to billing that can make a difference inter-provincially. 

I suspect, as well, that certain positions in certain provinces compensate better than others. 

In contrast to NLengr’s province, few to none of the psychiatrists in my province are salaried and definitely don’t want to be. 

Youll make bank if you work for it—but it’ll come at some other cost. 

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its a vestige of american-centered thinking in medicine- in US, psych is definitely under-paid, mostly because the surgeons/private practice make obscene amounts of money there. The situation is much different here given our funding/billing structure.

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