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  • #82999
    KCKC
    Participant

    I am twenty seven year old college English instructor in the middle of taking classes in clinical lab technology at the community college in order to get a better sense of medicine before diving into premed prereqs. I figure this would also give me a medical career to fall back on if my dreams of being a psychiatrist fall through. I would love to talk with any psychiatrist to get a better sense of what that position entials. My mother worked as an occupational therapist in a state mental hospital and so the DSM 4 was coffee table reading but I have yet to have a discussion with a working doctor about the field. Any help would be greatly appreciated.
    thanks in advance
    kimberly

    #83001
    fwmdfwmd
    Participant

    Hi KC,
    I am a 32 yo psychiatrist with 2 sons. I have been in private practice for 1 1/2 yrs. There are so many things I could tell you, but not enough space to write. Generally speaking, I love my job. Having said that, I must say that it is not at all what I expected it to be. In order to meet my expenses, I have to see way too many patients and have NO time for therapy or the stuff you see in movies. What specific questions do you have?

    #83002
    fwmdfwmd
    Participant

    KC,

    I practice solo and have the flexibility of scheduling my hours etc. I work about 24 hours per week. On clinic days I see about 20 pts.- 50 minutes for new pts. and 15 min. for follow-ups. I do mostly medication checks in an affluent community which is primarily insurance-based. The problems comes with managed health care. Paperwork, paperwork, paperwork and phone calls to insurance co. for every little detail. it seems like so much time is spent trying to justify your actions so they will pay the low reimbursments (if they feel like it that day). This is the frustrating part. Seeing the patients is the fun part. Now psychologists are trying to get prescription priviledges in TX. To make a long story short, you may want to find more about this in your local area before you spend literally hundreds of thousands of dollars getting a medical degree and not be able to pay back loans. This is the reality of mental health these days.

    #83004
    KCKC
    Participant

    Would the financial situation be any easier if you worked for a hospital? Were there drawbacks in that aspect of the field that led you to set up your own practice?

    #83005
    fwmdfwmd
    Participant

    It depends where you work and how many hours you are willing to spend working. For example, I get paid the same for an office visit and hospital visit. It makes more sense to see patients in the clinic unless you are trying to build up a practice. Hospital work in general takes more time and if you add in the time it takes to get to and from the hospital, it’s generally not worth it unless you see a ton of patients. Which means that you do only hospital work or you spend over 100 hours a week (add in call nights, etc. it may be more depending). I know at least two collegues who left hospital work for this reason. You also have more liability (sicker patients). I am not willing to spend that much time away from my family. My situation is also such that my husband is a physician and I need to be home for the kids. The problem with reimbursments and cost of practice is universal to medicine regardless of specialty. Medicare pays less each year and our cost to practice (malpractice ins., rent, employee salaries) go up every year. I have not had a conversation with any doctor that says otherwise. If you look on this website, you may notice that most young physicians are in the same boat. I am not trying to discourage you from your life dream. I am hoping that you talk with psychiatrists in your area and assess the situation before you find out ten years later that maybe your dream is a fantasy. :cloud9:

    #83007
    KCKC
    Participant

    I really appreciate your candor. It does make me think twice about being so focused on one particular goal. I am enjoying the lab medicine courses that I’m taking and I may decide to just stick with that. We’ll see how things go.

    #83008
    horsemanhorseman
    Participant

    KC,
    YOu may not know that medical technologists are in extremely short supply these days. All kinds are needed, including laboratory technologists, cytotechnologists, and radiology technicians. It is easy to get a postiion with reasonable and very flexible hours.You may enjoy working in one of these areas (on the way to) or if you decide not to pursue an M.D. or D.O. degree.

    #83010
    psychpsych
    Participant

    I’m also a psychiatrist in solo practice. I work about 25 hours a week seeing patients and then about 10 in billing/paperwork/phone calls. I love it!!! Of my patients, about half are in regular psychotherapy plus meds, and about half are just med management. I only participate with Medicare and 1 local insurance company, which means that most of my patients pay me directly at full fee. This is very workable where i am (Baltimore) where there are enough patients who are very willing to pay for a good, aggressive, psychiatrist who also does therapy. I get a lot of hand-me-down patients who are sick of the 10-15 min med management style of large practices. My new evals are 90-120 minutes, my psychotherapy sessions or compliated med management sessions are 45-50 minutes, and my regular med followups are 20-25 minutes. I could make more money if I did shorter visits, but I couldn’t provide the kind of care I want to provide. I still think I make excellent income. I work Tues-Fri, 9-3 except one night I work til 9pm because I work with so many medical people who can’t get away during the day. Please don’t give up. Psychiatry is a great place for women especially moms. I don’t do any hospital work because I want to keep the control over my schedule and my income. I have no benefits and get health through my husband and pay for my own disability, life, malpractice insurance and retirement. That part is a bummer but the flexibility and autonomy are worth it.

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