By Jeff Waddill Jul 30, 2011
The demand for psychiatrists is expected to increase in the years to come, thanks to the public’s ongoing need for mental health services combined with an overall decline in the number of psychiatrists available. This demand will also increase given the decline in the number of U.S. medical school residents choosing psychiatry as a specialty.
In addition, psychiatrists, on average, are among the oldest types of specialists in the U.S. Almost 55 percent of psychiatrists are 55 years old or older, compared to about 33 percent of all physicians. Those who choose to work locum tenens psychiatry assignments prefer inpatient mental health facilities for a number of reasons:
1. The scope of work presented at inpatient facilities is typically more appealing to psychiatrists. Outpatient assignments focus primarily on writing scripts and seeing a large volume of people for checkups in a brief amount of time. Inpatient assignments present a diverse group of case types; typically with more acute symptoms. Inpatient psychiatrists make rounds with their peers to discuss patient issues and treatments and may also participate in group therapy sessions. The expansive portfolio of assignment opportunities appeals favorably to psychiatrists.
2. Location is also a factor for psychiatrists who typically prefer urban settings to rural ones, and who will then find more inpatient assignments available in urban areas. Outpatient clinics tend to be located in more rural areas, or outside of urban areas, which are less desired by psychiatrists. Urban locations tend to offer more opportunities for a greater variety of caseloads. Also, for psychiatrists transitioning to and from different facilities while on assignment, larger urban facilities usually have more support staff in place to smooth the on-boarding process.
3. Compensation is higher for assignments at inpatient than outpatient facilities. A greater demand for psychiatrists at inpatient hospitals means those facilities are willing to pay more for those services. The divergent manner in which hospitals and outpatient clinics are reimbursed for services also contributes to higher pay at hospitals. Psychiatrists who place a premium on salary will find the highest rates at inpatient hospitals.
Dr. Frank Hoffman, clinical psychiatrist, offers several reasons for why he prefers inpatient assignments.
"With an inpatient setting, I get to choose how much time to spend with each patient. There are those who are more available to participate in their treatment (I am primarily a psychotherapist) and thus I want to spend more time with them. The outpatient setting means someone else controls how I spend my time.
"The support staff at inpatient facilities is a big plus as well. They are usually familiar with many of the frequent readmits, can help streamline the rules and requirements of their particular facility and offer guidance in outpatient dispositions in the area. It would take a locums many days or even weeks to become familiar with all of these local requirements and especially the politics of the hospital (which really does play a huge role sometimes).
"Also, locums tend to come in two groups: older retiree types, like me, and those just out of training who have yet to decide where to settle for their practice. Both groups have much to offer and to learn in the inpatient setting. The first group gets to re-educate themselves in the current psychopharmacologic approaches while the younger group get more on-the-job training in using what they learned in the academic arena.
"Because of the acute nature of these inpatient units, both groups get to see more immediate responses to treatment modalities. This is a plus for us both in terms of job satisfaction and reinforcement of available tools, Of course, if we stay at a facility long enough we also get to see what happens to those who show immediate response while in house and what happens when they return to their community. Over time, this really helps us sharpen our skill.”
Do you agree that inpatient psychiatry assignments are seen as a more favorable assignment among psychiatrists? Let us know in the comments below.
Jeff Waddill is Divisional Vice President of Staff Care.