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500-750k psych job, what's the catch?

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  • FIREshrink
    This is a pill mill. You want no part of it. They are possibly engaging in insurance fraud; I bet they are billing 99214 for every single 13 min face to face visit. It would be hard to justify that based on H/E/MDM but they probably prepopulate your notes so it looks like you're doing more work than you are.

    If you do a good job with follow up patients, you can spend 25 minutes with each of them and legally and ethically bill 99213+90833 for each/most of them. That is 2.47 work rvus, just about five per hour. If you did that six hours per day you'd have 30 work RVUs. The psych median conversion factor is ~$60 per wRVU so that is $1800 for six hours of work. If you work 225 days per year you'd earn $400k per year. 250 days if you want to earn $450k. Do that eight hours per day if you want to earn $540k or $600k respectively.

    This is the going rate in any west cost RVU based outpatient practice. You don't need to go to a pill mill or sacrifice your ethics or treat human beings like numbers to make an excellent living in psychiatry. Psychotherapy is extremely valuable and currently reimbursed very well when performed with E&M by a psychiatrist.

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  • CMartel02
    This volume of patients would easily put you above the 90th percentile in psychiatry for volume or higher. I would say 500k when your clinic is packed is doable, as you would be generating far, far more than that. That said, who wants to do 15 minute follow-ups? Is that what you went through all of that training for? You will be shoving patients out the door. All it takes is one patient not doing well, and your schedule is shot. I would argue this is a poor treatment model, as well. I prefer to do therapy, as well, in 30 to 40 minute appointments. Your patients will appreciate you more, you will come to know them better, can work on their real issues and things come out in longer appointments that wouldn't otherwise. This job sounds like a recipe for burnout. I work long hours and take a lot of call, but I know my patients, feel fulfilled, and when it comes down to dollars and cents, a 99214 and 90833 have equal RVU values.

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  • Lithium
    I can only imagine that most of the self pay patients are getting the Spravato or TMS. Perhaps the rest are really wealthy and demanding. The listing says “most” are 30-55. How many of the rest are under 18?

    I also found WOS’s comment amusing. I think the job market in the whole Mountain West pretty much sucks, which is why I’m doing locums on the EC. Though probably not for too much longer.

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  • nephron
    I suspect that a lot of the physician recruiter offers that are too good to be true are probably too good to be true and just bait and switch offers. I wouldn't recommend going through a physician recruiter, they are only interested in collecting their fees from your future employer and not interested in helping you obtain a position. It's not too hard to find a job on your own, your future employer will appreciate not having to pay some recruiter 20-30K that could have gone into your signing bonus for doing it. Never give a physician recruiter your phone number, you will get spammed for years by recruiters making cold calls telling you about job opportunities.

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  • wideopenspaces
    The catch:
    Las Vegas
    20-30 follow ups a day (+ how many intakes?)
    Supervising mid-level

    I wouldnt touch that job with a 10 ft pole. My friend moved to Vegas after our psych residency. The jobs were so awful there he took a locums job on the east coast just so he didn't have to work in Vegas. Psychiatry is just a giant poop show there for whatever reason. Stay away.

    Look for jobs that keep intakes to 2/day and allow 30 minute med checks on the outpatient side. Unless all you are doing is prescribing adderall all day, 15 minutes just isn't enough time to see your patients and to actually know how they are doing. Good luck in the job search.

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  • FreshPaint
    started a topic 500-750k psych job, what's the catch?

    500-750k psych job, what's the catch?

    Got an email from a recruiter about this job which says 500-750k which sounds hard to believe. Thought I'd see what the WCI community thinks:

    -Full time, Las Vegas, Outpatient
    -The Psychiatry practice is owned by a Solo Psychiatrist MD practitioner. The practice has been in business for 9 years.
    -The practice is currently doing traditional office based visits combined with Telepsych.
    -Each Initial Evaluation is 45 minutes to 1 hour
    -Each follow up med refill visit is 15 minutes
    -You also have opportunities to work in our hospitals and nursing home contracts but is optional.

    The patient case load is:
    Drug & Alcohol Addiction
    Body Disorders
    Bipolar Disorder

    Patient Demographics:
    Most of our patients are Adults and are between the ages of 30-55 years old.
    Most are middle income

    Insurance Mix is comprised of:
    20% Self Pay
    40% Medicaid & Medicare
    40% Major Medical Commercial Insurance
    The Schedule is M-F 9-5 p.m.
    The Salary is between $500,000-$750,000 per year.
    You are expected to see 20-30 follow up patients a day. You will see the same patient every month.

    We have EMR called PBO MD. It takes approximately 2 minutes to complete a note and bill the insurance of the patient.
    We also have TMS and Spravato for our patients.

    Organizational Structure:

    (3) Psychiatrist MDs

    (5) Psychiatric Mental Health Nurse Practitioners

    (3) LCSW Social Workers

    We have RNs, Psych Techs and MAs on staff.

    I'm still in residency so I'm naive to billing calculations, but I don't see how it's possible that an MD owner of a practice would want to pay another MD $500k for this volume of work, unless I'm missing something.