How likely is it to make $375-400k in Psych?

[comp1]

My psych residency was pretty much like the college experience i didn't really get due to a BS/MD accelerated program. I figure thats pretty much the life i missed out on in my early 20s but luckily i was still mid 20s at the start of it with a somewhat chill residency for the most part so i basically worked out, played tennis, and dated as my main full time hobby.

That is how psych residency should be everywhere.

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[luckybuck]

My psych residency was pretty much like the college experience i didn't really get due to a BS/MD accelerated program. I figure thats pretty much the life i missed out on in my early 20s but luckily i was still mid 20s at the start of it with a somewhat chill residency for the most part so i basically worked out, played tennis, and dated as my main full time hobby.

Sounds nice. Wish that was my experience

 

[TexasPhysician]

I truly have never understood those that complained that med school and residency were so hard they didn’t have a good life. It wasn’t that hard or time consuming. Now where I will agree is the lost opportunity cost of going backwards in net worth while those in fintech were moving forward (as long as they are smart with their work and spending)

We aren’t all as smart as you.

 

[luckybuck]

And you know, you're doing something actually useful with your life instead of making a big pile of money a bigger pile of money.

The point of a job is to make money.

 

[calvnandhobbs68]

The point of a job is to make money.

If you're honestly that reductive then I'll just say it, you're probably a terrible psychiatrist. So yeah no wonder you're unhappy and comparing yourself to finance bros.

 

[luckybuck]

If you're honestly that reductive then I'll just say it, you're probably a terrible psychiatrist. So yeah no wonder you're unhappy and comparing yourself to finance bros.

I'm not a terrible psychiatrist. I can guarantee you that

 

[Splenda88]

I truly have never understood those that complained that med school and residency were so hard they didn’t have a good life. It wasn’t that hard or time consuming. Now where I will agree is the lost opportunity cost of going backwards in net worth while those in fintech were moving forward (as long as they are smart with their work and spending)

I was a non traditional student in my 30s. My med school classmates partied more than most people that were in their 20s.

 

[clausewitz2]

Let's keep it civil, y'all.

 

[calvnandhobbs68]

Let's keep it civil, y'all.

I can certainly rephrase that as stating that someone who has the mindset that the "point of a job is to make money" is starting down a slope that can often end up in engaging in:
- Fraudulent behavior
- Unethical behavior
- Behavior that compromises patient safety/wellness for personal enrichment or profit seeking

Let's also keep in mind that these forums are easily searchable and open to patients to view as well. I would wonder what patients would think when they peruse the psychiatry forums online and come across such statements.

 

[psychmd03]

My psych residency was pretty much like the college experience i didn't really get due to a BS/MD accelerated program. I figure thats pretty much the life i missed out on in my early 20s but luckily i was still mid 20s at the start of it with a somewhat chill residency for the most part so i basically worked out, played tennis, and dated as my main full time hobby.

Our residency was known to be a middle ground of “hard and “easy” call was rough but it wasn’t all the time. Night float made it hard but you had a weekend always through the month. And if you prioritized workouts, and a social life there was plenty of life to be lived. I could agree more.

That is how psych residency should be everywhere.

Absolutely

I was a non traditional student in my 30s. My med school classmates partied more than most people that were in their 20s.

A few of the med students I know seem to continue this tread

 

[OMSRealWeebHours]

I echo the above--if you're looking to walk into a publicly posted, 40-hour, W2 employee position and make 375+ then there will be other (significant) caveats to the position.

All physicians convert their time to money, unless they have ownership stake in a larger enterprise and siphon profit off of employees (scale -> income.)

It would be relatively trivial, logistically, for a psychiatrist to convert their time into 400k per year in private practice. Billing Medicare (in my metro), you'd need to see about 35 hours of patients per week. Seems like many PP docs prefer to work less than that, though. I estimate that you'd be earning about $450k if you were willing to work 40 patient-care (billable) hours per week (which is not the same as 40 hours of work per week.) That's with the assumption that you don't have out of control expenses/high no-show rate/etc.

How many hours of actual work a week is required for 40 patient billable hours? I realize that there is other stuff like charting/insurance to deal with

 

[Stagg737]

I wonder about the percentage of people with business/finance/CS degree that make 100-150k bestrewn the age of 23-30. My impression is that it might be only the top 10%.

I always go back to this.

The Top 1 Percent: What Jobs Do They Have?

Explore the occupations and industries of the nation's wealthiest households.

archive.nytimes.com

I love that graphic, but it's not really relevant to the discussion. That shows households in the 1% which is quite different than single earners, otherwise there's no way teachers would be the 5th highest career in the top 1 percenters. It's also talking about the top 1%, which is $400k/yr, very different from 100k/yr.

$100k/yr is around the 82nd percentile for individuals in 2023. 33.5mil individuals in the US made over $100k in 2023. Making over $250k was harder and less than 5mil individuals did in 2023 (data in link, lots of fun numbers to crunch here). I agree that it's probably not a huge percentage of people in their 20's in finance making much more than $100k/yr (old data on that site says $100k is 99th percentile for 23 yo but only 86th percentile for 29 yo), but it's not as difficult as it was even 5 years ago ($100k for 29yo was 91st percentile). I'd be curious to see if it's more difficult to do that vs gaining acceptance to med school. Here's the link: Income Percentile Calculator for the United States

This site as $100k/yr as 68th percentile for "financial managers" with median income being $75k. They don't have data for job/degree AND age, but they say that for ages 23-30 yo the individual median income is only $26,500. So probably a lot of unaccounted for variables and a poor representation of what you're asking. This site also says median pay for physicians is only $205k with $395k/yr being the 75th percentile for what that's worth. Income Percentiles by Occupation and Education Level - Personal Finance Data

I can certainly rephrase that as stating that someone who has the mindset that the "point of a job is to make money" is starting down a slope that can often end up in engaging in:
- Fraudulent behavior
- Unethical behavior
- Behavior that compromises patient safety/wellness for personal enrichment or profit seeking

Let's also keep in mind that these forums are easily searchable and open to patients to view as well. I would wonder what patients would think when they peruse the psychiatry forums online and come across such statements.

They weren't really wrong at all though. The reason most people work, including physicians, is to make money. Hopefully people will do something they enjoy a little and find purpose from, but how many people do you honestly know would continue to do their specific job if they were only paid the minimum to get by (housing, food, transport, downtime)? If this were a communist society where everyone got equal pay for hours worked you really think most physicians would still choose to be physicians with everything our job entails? I almost certainly wouldn't given the level of responsibility and liability we have...

I also think there's a big difference between saying the point of a job is to make money and the point of a job is to make as much money as possible through any means necessary. Your statements are implying the latter is inevitable or at least likely, which certainly happens but imo is not to be expected.

 

[luckybuck]

Let's keep it civil, y'all.

Thank you, hopefully we can all do so...

 

[luckybuck]

Its funny, I would guess about 50% of people I knew as premeds truly considered going into medicine to be a calling or some higher purpose. Now just about everyone I know (residents, attendings especially non-academic ones) see it as what it truly is, a job. The point of a job is to provide yourself an income. Yes you should strive to do a good job, just as a pilot, an engineeer, an accountant, a lawyer, etc should. 1. Because its the right thing to do but 2. because if you don't you may not have a job for long. But none of those people view their jobs as callings to the extent that some imply that physicians should. Why is that?

 

[finalpsychyear]

Its funny, I would guess about 50% of people I knew as premeds truly considered going into medicine to be a calling or some higher purpose. Now just about everyone I know (residents, attendings especially non-academic ones) see it as what it truly is, a job. The point of a job is to provide yourself an income. Yes you should strive to do a good job, just as a pilot, an engineeer, an accountant, a lawyer, etc should. 1. Because its the right thing to do but 2. because if you don't you may not have a job for long. But none of those people view their jobs as callings to the extent that some imply that physicians should. Why is that?

There is some type of societal brainwashing at work that doctors care abt the patient first and nothing else really matters. That's played out great for whoever has pushed that narrative and less so for docs.

Also, being good at your job and one prioritizing money aren't related.

I can be a great cosmetic dermatologist doing 100% botox but if someone not established won't or can't pay it's OK to refuse service.

It's exactly this guilt tripping narrative that everyone has pushed that doctors as a whole are scrapping for scraps as a whole in the Healthcare industry when u compare their pay to the total industry.

 

[luckybuck]

Thats why I applaud the psychiatrists who are seeing as many as 40,50, sometimes 80 patients per day. Thats called hustling

 

[FlowRate]

I wonder about the percentage of people with business/finance/CS degree that make 100-150k bestrewn the age of 23-30. My impression is that it might be only the top 10%.

I always go back to this.

The Top 1 Percent: What Jobs Do They Have?

Explore the occupations and industries of the nation's wealthiest households.

archive.nytimes.com

Isn't that wealth and not income? Tons of family money types in medicine. And also having lots of wealth enables being in other lower-paying careers (teachers.)

How many hours of actual work a week is required for 40 patient billable hours? I realize that there is other stuff like charting/insurance to deal with

Highly variable. I've never actually run my own private practice. But definitely stuff outside of patient appointments, even absent billing and what not, will take at least some time usually.

I love that graphic, but it's not really relevant to the discussion. That shows households in the 1% which is quite different than single earners, otherwise there's no way teachers would be the 5th highest career in the top 1 percenters. It's also talking about the top 1%, which is $400k/yr, very different from 100k/yr.

As above. Pretty sure it's referring to wealth and not income.

 

[Stagg737]

Thats why I applaud the psychiatrists who are seeing as many as 40,50, sometimes 80 patients per day. Thats called hustling

I'm all for hustling, but that kind of patient volume in psych is only reasonable if your patients are completely stable and just coming in for their med refill. Even then, 40/day is still something I'd never advocate for and higher than that is just a failed standard of care imo.

Isn't that wealth and not income? Tons of family money types in medicine. And also having lots of wealth enables being in other lower-paying careers (teachers.)

As above. Pretty sure it's referring to wealth and not income.

Maybe, would love to see the article again but I don't pay for news. I thought it was based on household income though. Idk how they could accurately determine actual net worth on a large scale like that...

 

[psychmd03]

Its funny, I would guess about 50% of people I knew as premeds truly considered going into medicine to be a calling or some higher purpose. Now just about everyone I know (residents, attendings especially non-academic ones) see it as what it truly is, a job. The point of a job is to provide yourself an income. Yes you should strive to do a good job, just as a pilot, an engineeer, an accountant, a lawyer, etc should. 1. Because its the right thing to do but 2. because if you don't you may not have a job for long. But none of those people view their jobs as callings to the extent that some imply that physicians should. Why is that?

I’d actually argue being good at your job can very easily create flywheel of more opportunities to make more money. So if you want to make more money focusing on doing a good job is a great way to do it. It’s how I’ve picked up all my work and turned down many more opportunities. I just slowly slide in be nice, work well with my team, treat my patients, don’t get complaints and slowly I have more offers for coverage. Then do a good job when I cover and all of a sudden someone else has some work etc etc. So for those that want to maximize their monetary opportunities they should for sure focus on doing a good job not just straight volume.

I'm all for hustling, but that kind of patient volume in psych is only reasonable if your patients are completely stable and just coming in for their med refill. Even then, 40/day is still something I'd never advocate for and higher than that is just a failed standard of care imo.

Or the very sick IP which make it very clear very quickly if you’re doing a good job or not.

 

[Splenda88]

I’d actually argue being good at your job can very easily create flywheel of more opportunities to make more money. So if you want to make more money focusing on doing a good job is a great way to do it. It’s how I’ve picked up all my work and turned down many more opportunities. I just slowly slide in be nice, work well with my team, treat my patients, don’t get complaints and slowly I have more offers for coverage. Then do a good job when I cover and all of a sudden someone else has some work etc etc. So for those that want to maximize their monetary opportunities they should for sure focus on doing a good job not just straight volume.

Or the very sick IP which make it very clear very quickly if you’re doing a good job or not.

The few hospitalists I know that are making > 500k are very good at their job.

I was a RN for ~8 years and based on my experience, there is a far higher % of nurses that go into nursing strictly for $$$ than physicians. The public love nurses and yet they dont like doctors.

 

[FlowRate]

Maybe, would love to see the article again but I don't pay for news. I thought it was based on household income though. Idk how they could accurately determine actual net worth on a large scale like that...

Good point. I did some digging. IPUMS is basically census data and does not have wealth information. There are sources for wealth information (Federal Reserve Survey of Consumer Finances), but I'm not sure if there's sufficient info in that survey to make the chart referenced and IPUMS is what they did reference in the chart. In other words, NYT was probably using the worth wealth semi-wrong in that infographic/article. Whereas they have used it more specifically in other pieces on distribution of income and distribution of wealth.