Pediatric subspecialties income - why lower than internal medicine

[ellorie]

6 hours ago, NLengr said:

Peds appointments take FOREVER, even as a surgical specialist. Annoyed me to no end as a resident.

 

And the whole peds hospital itself was a giant box of unmedicated anxiety. Drove me God damned nuts. Every single staff in the place (MDs, nurses, allied health, janitors etc.) were always on the edge of a mental breakdown. Hospital should have just put SSRIs directly into the building's water supply.

Yeah it’s pretty unbelievable. The difference between a child psychiatry consult and an adult psychiatry consult is unreal. It took me about five minutes on service to definitively rule out that career path. And don’t even get me started on call.  None of them understand the concept of a focused emerg assessment because god forbid you didn’t ask the suicidal fourteen year old about what age they were toilet trained. 

[Hellothere77]

27 minutes ago, ellorie said:

Yeah it’s pretty unbelievable. The difference between a child psychiatry consult and an adult psychiatry consult is unreal. It took me about five minutes on service to definitively rule out that career path. And don’t even get me started on call.  None of them understand the concept of a focused emerg assessment because god forbid you didn’t ask the suicidal fourteen year old about what age they were toilet trained. 

Wait are you admitting that you failed to ask that? You monster

[LittleDaisy]

2 hours ago, ellorie said:

Yeah it’s pretty unbelievable. The difference between a child psychiatry consult and an adult psychiatry consult is unreal. It took me about five minutes on service to definitively rule out that career path. And don’t even get me started on call.  None of them understand the concept of a focused emerg assessment because god forbid you didn’t ask the suicidal fourteen year old about what age they were toilet trained. 

I don't understand how relevant it is to a suicidal 14 year old boy ? 

In PEDS CTU, the staff would have sent me back to ask a asthmatic 5 year old boy's parents when was their house constructed ( lead poison)? 

I think that it's good to be thorough, but sometimes it's irrelevant to patient care. 

[LostLamb]

5 hours ago, ellorie said:

Yeah it’s pretty unbelievable. The difference between a child psychiatry consult and an adult psychiatry consult is unreal. It took me about five minutes on service to definitively rule out that career path. And don’t even get me started on call.  None of them understand the concept of a focused emerg assessment because god forbid you didn’t ask the suicidal fourteen year old about what age they were toilet trained. 

As a child and adolescent psych trainee, albeit at a different centre than @ellorie, I would not paint all child psych experiences with the same brush. 

I cannot remember the last time I asked about toilet training in ER...save for the kid who is still experiencing enuresis or has a history of conduct disordered behaviour. It doesn’t help one decide to admit or discharge. 

We have longer consults in C&A psych usually because we have to evaluate twice as many people—caregiver and child—(plus sometimes throw in a call to a community agency and child & family services)....the benefit in child psych is we can still bill by the time we take...and the phone calls to whichever service/family we call...big difference to being limited to consult codes that have to cover double time when talking to all these people for a med/surf consult. It only makes sense things are slower and overall “less lucrative.” In the big scheme of things, we all self select into these fields—for psych, I really don’t mind taking the time now if it assists me taking less later—therapeutic alliance and complete history is everything. 

[bearded frog]

Y'all crazy. Pediatric medicine is so much more interesting and enjoyable than adult medicine. Although I'm biased.

Another thing that lowers peds subspeciality pay is volume, currently a lot of subspecialists have trouble with job opportunities. They're out there usually, but not necessarily in desirable places to live. When your city only needs X number pediatric cardiologists and X+N would like to live and work there, that drives compensation down.

[PremedToronto]

On ‎6‎/‎9‎/‎2019 at 3:08 PM, Wachaa said:

I don't go into peds because I don't like to talk like I'm 5 years old, and then have to try convincing the parents my medical degree > their google search.

I don't think we talk like we are 5 years old. This might be why you had a more difficult time convincing parents about your medical degree

 

[Wachaa]

3 hours ago, PremedToronto said:

I don't think we talk like we are 5 years old. This might be why you had a more difficult time convincing parents about your medical degree

  

Haha it was just an example. Having supervised medical students and residents in rotations, exams, etc, I would say nearly all of them, when their patient is <12 years old, would speak in that level. It's not so much an issue when you work in acute settings where the patient is very sick, but when the patient is 100% healthy and the parents are paranoid, whatever BS they dig up in an online search will be worth more than what you have to say. People come all the time asking for referrals for second opinions.