Pay in child vs adult psychiatry

[g4m3r2]

Hey everyone,

I'm wondering about the pay for adult vs child psychiatrists.

The available information seems to be largely out of the States, and I was hoping to get some Canadian perspectives. 

Multiple attendings have said you make about the same as adult but I don't understand how this can be so because most times you will have a parent and each consult would work out to be essentially 2x the pay per consult compared to adult at least for Ontario.

I realize it's not all about the money. At the same time I 1) believe that people should be paid more if they spent more time in training and 2) can't say with certainty that I like the work that much more than adult psychiatry especially given the additional training/exam requirements needed to become a CAP.

Thanks!

[bearded frog]

16 hours ago, g4m3r2 said:

Multiple attendings have said you make about the same as adult but I don't understand how this can be so because most times you will have a parent and each consult would work out to be essentially 2x the pay per consult compared to adult at least for Ontario.

??? You don't bill separately to talk to parents... Unless I'm confused about what you're writing here.

[CGreens]

20 hours ago, bearded frog said:

??? You don't bill separately to talk to parents... Unless I'm confused about what you're writing here.

In Ontario, psychiatrists often bill both A197 ($237.45, consultative interview with the parent(s) of a patient under 22) and A198 ($237.45, consultative interview with the patient under 22) when they see a new consult with a patient aged 21 or younger, with their parents/caregiver present in the room for at least part of the session. Combined billing of $475. Sometimes, they may also bill the consult extension code if it's a long interview.

A similar billing practice applies to A191 and A192, which are billed for a patient aged 65 or older with dementia, and an interview with the caregiver. Payment is same as for A197 and A198. Geriatric psych has become quite lucrative with quick inpatient BPSD consults. 

[bearded frog]

48 minutes ago, CGreens said:

In Ontario, psychiatrists often bill both A197 ($237.45, consultative interview with the parent(s) of a patient under 22) and A198 ($237.45, consultative interview with the patient under 22) when they see a new consult with a patient aged 21 or younger, with their parents/caregiver present in the room for at least part of the session. Combined billing of $475. Sometimes, they may also bill the consult extension code if it's a long interview.

A similar billing practice applies to A191 and A192, which are billed for a patient aged 65 or older with dementia, and an interview with the caregiver. Payment is same as for A197 and A198. Geriatric psych has become quite lucrative with quick inpatient BPSD consults. 

Damn... as a pediatrician who literally talks to parents all day we are being ripped off!

To OP then, I imagine there isn't much of an increase as you could probably see two adult patients in the time it takes to sort out the family situation having to do two separate interviews.

[PrinceVegeta]

Keep in mind that child/parent consults (and managing the frequently complex family dynamics) can mean that they take longer than adult ones. 

[Persephone]

On 8/13/2024 at 5:43 AM, g4m3r2 said:

Hey everyone,

I'm wondering about the pay for adult vs child psychiatrists.

The available information seems to be largely out of the States, and I was hoping to get some Canadian perspectives. 

Multiple attendings have said you make about the same as adult but I don't understand how this can be so because most times you will have a parent and each consult would work out to be essentially 2x the pay per consult compared to adult at least for Ontario.

I realize it's not all about the money. At the same time I 1) believe that people should be paid more if they spent more time in training and 2) can't say with certainty that I like the work that much more than adult psychiatry especially given the additional training/exam requirements needed to become a CAP.

Thanks!

A geri psychiatrist who did the math told me it takes years to catch up with the lost income from doing an extra year of residency even though sub-specialists bill higher paid tariffs, so you have to really be in it for the love of it to sub-specialize in psychiatry. But also, I've seen vastly different take home incomes based on how ppl optimize and stuff, regardless of sub-spec or not. Either way, you're going to be well off.