Outliers in psych pay

[jerkoutnow2]

Another one of the money threads but this time for shrinks

 

http://www.fin.gov.on.ca/en/publications/salarydisclosure/pssd/orgs.php?pageNum_pssd=3&organization=hospitals

 

Look at psych pay at ontario shores centre for mental health sciences

 

Psych 'salaries' roughly average 350-400k, one person hit a 500k salary

 

who said psychs get paid the least??

[Let'sGo1990]

interesting stuff.

 

related question - with the increasing emphasis on mental health and preventative med, is it possible that remuneration for psychs in the future will increase?

[NLengr]

interesting stuff.

 

related question - with the increasing emphasis on mental health and preventative med' date=' is it possible that remuneration for psychs in the future will increase?[/quote']

 

I don't think by much. Not enough to move them out of the bottom 3rd on average anyway.

 

They have no procedures (except ECT), see few patients per day (so you'd need a big increase per patient appointment to influence salary), have good hours (so hard to get after hours incentive bonuses) and their skill set isn't looked upon as highly skilled and extremely valuable by others in the healthcare field (rightly or wrongly). All those are going to hold it back when it comes to increasing compensation.

 

Psych will continue to be a lower paid specialty IMO.

[Let'sGo1990]

I don't think by much. Not enough to move them out of the bottom 3rd on average anyway.

 

They have no procedures (except ECT), see few patients per day (so you'd need a big increase per patient appointment to influence salary), have good hours (so hard to get after hours incentive bonuses) and their skill set isn't looked upon as highly skilled and extremely valuable by others in the healthcare field (rightly or wrongly). All those are going to hold it back when it comes to increasing compensation.

 

Psych will continue to be a lower paid specialty IMO.

 

Thanks. Pretty much what I figured. I asked the question since I'm not sure where psych is on the supply demand curve right now, and I thought that in the event that there's an undersupply, remuneration might change (to serve as an incentive) with the increasing emphasis on mental health/preventative med.

 

edit: can anyone tell me more about psych and private billings?

[NLengr]

Thanks. Pretty much what I figured. I asked the question since I'm not sure where psych is on the supply demand curve right now' date=' and I thought that in the event that there's an undersupply, remuneration might change (to serve as an incentive) with the increasing emphasis on mental health/preventative med.

 

edit: can anyone tell me more about psych and private billings?[/quote']

 

Unlike the free market, medicine doesn't really tend to follow market forces when it comes to compensation.

[Renin]

Thanks. Pretty much what I figured. I asked the question since I'm not sure where psych is on the supply demand curve right now' date=' and I thought that in the event that there's an undersupply, remuneration might change (to serve as an incentive) with the increasing emphasis on mental health/preventative med.

 

edit: can anyone tell me more about psych and private billings?[/quote']

 

Private shrinks are billing about $250 to 300/hr for individual therapy. About $400/hr for groups.

 

The "average" pay for psychiatrists is typically lower because they don't work full time hours. A lot of psychiatrists will job share or work part time.

 

Like GP's, psychiatrists are not "tied" to a hospital, and you can hang up a shingle to advertise your services. You can bill whatever you want if you're a private contractor, but there are "industry" rates. There are, of course, set rates if you want to bill the government.

 

There is a large demand right now for psychiatrists in the geriatric population as well as the child/adolescent population. If you are willing to work in an underserved area, the need is even larger.

[NikiFM]

What is the situation like for trying to get the salary jobs at hospitals, is it competitive? Just curious to what are some upsides to being independent or part of a hospital as a psychiatrist?

[NLengr]

What is the situation like for trying to get the salary jobs at hospitals, is it competitive? Just curious to what are some upsides to being independent or part of a hospital as a psychiatrist?

 

If you avoid salary (ie fee for service) you can incorporate. That lets you save a TON of money on taxes etc. Plus generally FFS billers make lots more than salary, even before you include incorporation. The only time salary is good is if you are in a specialty where you don't have enough volume (a good example is some Peds super subspecialties) to get enough billings for FFS in a certain location, but you have your heart set on working at that location.

 

Also, the more independent you are, the more freedom you have from hospital/govt beauracratic BS. Salary leaves you at the whim of the BS. You can stiil work at a hospital as FFS (most in hospital docs are FFS, not salary).

 

95-99% of the time you are worse off on salary as a physician.

[spontaneouscombustion]

Psych is actually one of the good ones to go on salary. You can really only do that if you work for a hospital though. At my centre, all the salaried psychiatrists make ~$300k/year which seems pretty good considering that they get benefits, an office, a secretary, and the ability to use their office for their private practice as well (so in reality, they're making far more than 300k). The other benefit of salary is that you don't have to worry about no-shows, which can be a big issue in psych.

 

From what I've been told, the money is good if you're salaried. If you're in private practice, you'll be making a bit less than a GP - which isn't so bad either.

 

Not all centres are like this. As far as I know, there aren't any salaried psychiatrists in Toronto.

[airhohle]

If you avoid salary (ie fee for service) you can incorporate. That lets you save a TON of money on taxes etc. Plus generally FFS billers make lots more than salary, even before you include incorporation. The only time salary is good is if you are in a specialty where you don't have enough volume (a good example is some Peds super subspecialties) to get enough billings for FFS in a certain location, but you have your heart set on working at that location.

 

Also, the more independent you are, the more freedom you have from hospital/govt beauracratic BS. Salary leaves you at the whim of the BS. You can stiil work at a hospital as FFS (most in hospital docs are FFS, not salary).

 

95-99% of the time you are worse off on salary as a physician.

 

Why cant pathologists do this?

[youngdad]

In-patient psych is lucrative.

But its still psych.

[Real Beef]

In-patient psych is lucrative.

But its still psych.

 

... I totally agree.

[bloh]

Hardly see any RNs below 100k. Cool...

[WtsupDoc?]

Hardly see any RNs below 100k. Cool...

 

The list is only of those making > $100,000

 

The Public Sector Salary Disclosure Act, 1996 (the act) makes Ontario's public sector more open and accountable to taxpayers. The act requires organizations that receive public funding from the Province of Ontario to disclose annually the names, positions, salaries and total taxable benefits of employees paid $100,000 or more in a calendar year.

[mavrik13]

Psych is actually one of the good ones to go on salary. You can really only do that if you work for a hospital though. At my centre, all the salaried psychiatrists make ~$300k/year which seems pretty good considering that they get benefits, an office, a secretary, and the ability to use their office for their private practice as well (so in reality, they're making far more than 300k). The other benefit of salary is that you don't have to worry about no-shows, which can be a big issue in psych.

 

From what I've been told, the money is good if you're salaried. If you're in private practice, you'll be making a bit less than a GP - which isn't so bad either.

 

Not all centres are like this. As far as I know, there aren't any salaried psychiatrists in Toronto.

 

This does not sound like psych from anyone (resident or staff) that I've talked to in any location. I would imagine 300k would be quite the exception to psych salaries.

[NikiFM]

So is the difference in how lucrative psych is mostly due to whether it is inpatient or not? And are these 300k salary jobs really desirable and competitive in the field?

[BigM]

So is the difference in how lucrative psych is mostly due to whether it is inpatient or not? And are these 300k salary jobs really desirable and competitive in the field?

 

A lot of it seems to be salary vs. fee for service (salary being much higher). Many of the salary jobs are at the provincial tertiary care hospitals. That said, if you work hard with FFS there is a huge income potential as well.

[youngdad]

So is the difference in how lucrative psych is mostly due to whether it is inpatient or not? And are these 300k salary jobs really desirable and competitive in the field?

 

Listen to me. Psych blows.

[supafield]

Listen to me. Psych blows.

 

Don't be too diplomatic now...

 

I'm excited to be heading toward a career in Psych! Had a great clerkship experience in a field with broad opportunities and plenty of demand. Quickly changed my mind after being set on family/emerge for a couple years.

 

Certainly not a field for everyone as evidenced in this thread. Give it a chance though. Was always interested by the material but never thought I would want to "give up the rest of medicine." Was quickly convinced otherwise though when doing it as a clerk.

[ChemPetE]

Don't be too diplomatic now...

 

I'm excited to be heading toward a career in Psych! Had a great clerkship experience in a field with broad opportunities and plenty of demand. Quickly changed my mind after being set on family/emerge for a couple years.

 

Certainly not a field for everyone as evidenced in this thread. Give it a chance though. Was always interested by the material but never thought I would want to "give up the rest of medicine." Was quickly convinced otherwise though when doing it as a clerk.

 

That, and if you can manage to get a consult liaison psych job, there still is a tonne of medicine involved, not to mention neuropsychiatry. You don't have to give it up if you don't want to.

[spontaneouscombustion]

This does not sound like psych from anyone (resident or staff) that I've talked to in any location. I would imagine 300k would be quite the exception to psych salaries.

 

Its the norm for the salaried staff here (mid-sized Ontario teaching centre...not too many of them, so wouldn't be hard to figure out where).

[Renin]

That, and if you can manage to get a consult liaison psych job, there still is a tonne of medicine involved, not to mention neuropsychiatry. You don't have to give it up if you don't want to.

 

Or ER psychiatry

[youngdad]

Don't be too diplomatic now...

 

I'm excited to be heading toward a career in Psych! Had a great clerkship experience in a field with broad opportunities and plenty of demand. Quickly changed my mind after being set on family/emerge for a couple years.

 

Certainly not a field for everyone as evidenced in this thread. Give it a chance though. Was always interested by the material but never thought I would want to "give up the rest of medicine." Was quickly convinced otherwise though when doing it as a clerk.

 

I'm sorry. Its not like me to be so rude.

I am not an anti-psychiatry zealot, but the current state of the practice and science of psychiatry is sadly misguided. There are so many people that are suffering from mental illness who need medicines and quality therapy. It is saddening that the world of psychiatry has gravitated toward the lucre of the exclusive 10 minute neuropsychopharmacology visit.

When you look at psychiatry residency programs make sure you ask how much time and expertise is devoted to teaching you how to do good talk therapy. You might be surprised and you should be alarmed.

Psychiatry (rather psychiatrists) have ground the pursuit of understanding the mind and its relation to health down to molecules. Psychiatry has become the whore of the pharmaceutical industry and most psychiatrists do not realize it because they think their molecules help them understand the mind. Nor do they care because many of them are getting wealthy by propagating the myth.

Psychiatry has stopped the pursuit of understanding the mind.

It is a fascinating field. It should attract some of the most brilliant physicians. But it will take a LOT of brilliant people with a LOT of balls to change the direction its going.

 

If you are interested in psychiatry I would recommend reading "Unhinged" by Daniel Carlat. Its not a long read and its by a psychiatrist that is doing a lot of work to improve the integrity of the field.

[youngdad]

No rebuttal?

Tell me I'm wrong.

[Bede]

I'll bite. I really don't know much about psych but what evidence is there that CBT or other talk therapies are more efficacious than time? I just read a meta-analysis that showed that something like 30% of major depressive episodes spontaneously remit within 30 days or something.

 

Perhaps psychiatry has turned to pharmaceuticals because it works much better than talk therapy.