Psychiatry at a glance

Physician Compensation Report, June, 2003

Central pay range: MGMA 25th and 75th percentiles, 2001--$135,000 to $182,000; AMGA 20th and 80th percentiles, 2001--$131,000 to $187,000; these pay figures are for general adult psychiatry.

Pay direction: Up slowly in recent years, barely keeping pace with inflation. Psychiatry is among the lowest-paid specialties; some benchmark sources even peg general adult psychiatry pay below primary care levels. Pay levels in child psychiatry, which has a shortage, are higher and rising faster than are adult psychiatry levels.

Clinical practitioners: About 45,000; psychiatry and ob/gyn are the two largest nonprimary specialties in numbers of physicians.

Entries to field per year: Approximately 800 residency entrants per year. Training after medical school is three-year residency.

What psychiatrists do/subspecialties: Treat problems of unusual fears, depression, substance abuse and many other mental conditions. Subspecialties include child, geriatric and forensic psychiatry. Today psychiatrists tend to emphasize drug therapy and hospitalization, while psychologists and social workers handle most psychotherapy.

Common reimbursement methods: Discounted fee-for-service and capitation. Reimbursement prices have been cut aggressively for years, and the labyrinthine terms and conditions of access for both inpatient and outpatient care make psychiatry by far the most "managed" kind of care. Rates paid to psychiatrists for psychotherapy generally are no higher than rates paid to psychologists and social workers.

Common group structures: Most psychiatrists are in solo or small-group practices, often in partnership with or employing psychologists and social-worker therapists. Many also are in community clinics and hospital-owned and academic multispecialty practices.

Main professional society: American Psychiatric Association, Washington, D.C., (888) 357-7924 or www.psych.org.

Previous PCR items on psychiatry: (1) factors affecting compensation, 12/01, p. 6; (2) compensation trends in 2000, 1/17/01, p. 3; (3) compensation trends in 2002, 3/02, p. 4; (4) compensation indicators in 2002, 10/02, p. 7.