Jump to content

Feeling discouraged as a Psych PA

Recommended Posts

I sent an email to a recruiter asking why they didn't have openings for PAs. Here is their answer: 

"From my understanding our group has historically hired Psych NPs and hasn’t had the need to branch out and hire PAs."

I love psych but sometimes I feel I should go with a different specialty. 

Is there any hope for psych PAs? 

 

Share this post


Link to post
Share on other sites
37 minutes ago, Lightspeed said:

I’m a psyche NP. All I have to say is if one place gives you that reply, there’s plenty of other fish in the sea. It’s a bit disconcerting that a recruiter... the used car salesmen of the provider world... is saying that, but how many of those guys are there in the world?

Do they find it more lucrative to hire independent psyche NPs due to higher wages they can command? (I’ve not dealt at all with them other than my email inbox being flooded, so I don’t know how they get paid for the recruitment they do). That’s kind of a disrespectful way for them to phrase their denial... had a harsh edge to it. Probably not a good place to work through anyway. 

Hows the psych NP job market? What's the typical salary range you've seen for full time jobs doing med management?

Share this post


Link to post
Share on other sites

Former Psych PA here and also found it to be a struggle to find openings for PAs....thus I'm a former psych PA.  One practice is constantly hiring, could be a bad sign, but I keep applying and give my little speech about there being no reason, in Ohio, to exclude a PA from consideration.  I've pretty much had it was being completely excluded from positions because employers simply don't understand.  I applied for a position with UnitedHealth recently.  The posting was for an NP, but in the qualifications it said NP, APRN, CNP, or PA-C.  So, I apply and get an email from the recruiter to set up an interview.  He then responds and says he just realized I'm a PA and not an NP.  They can't hire PAs at this time.  I kindly respond and ask way.  He says "Some states we can use PAC's but Ohio is not one of them currently.  CMS gives us direction on this.".  I don't know all the ins-and-outs of CMS, but I'm trying to understand why CMS would set what states PAs can work for UnitedHealth or not.  I reply with some information about us both having an NPI and both can get reimbursed from CMS.  I worked side-by-side with an NP in acute-rehab and CMS paid is both the same.  He responds back now stating that his director of clinical operations told him PAs can't be used in Ohio because the nursing board says LPNs can't take orders from a PA...To which I provided him a document, from the nursing board, specifically stating LPNs can take orders from PAs, and asked him to kindly give that to his director.  I'm sure they will be calling me with a job offer any time now HAHA

  • Upvote 1

Share this post


Link to post
Share on other sites

I think part of the issue is billing. Many states/insurances will not allow a PA to bill for psychotherapy unless the PA is also an MFT/LCSW (and rightfully so, IMO, as I do not see any PA programs with dedicated didactic/clinical hours towards training to provide real psychotherapy). MDs and psych NPs do get this training, even though it may be somewhat skimpy, it does exist. I know that's a limiting factor in many places, not being able to tack on the therapy code and being reimbursed less is leaving $ on the table.

I think PA psych residencies should include a psychotherapy component, but the few I've looked at have (disappointingly) not included this. PAs are doing this to themselves and should advocate for better/more complete psych training IMO.

Edited by Lexapro
  • Upvote 1

Share this post


Link to post
Share on other sites

One thing that blew my mind was when I met a  PA who had no psych rotation. It was apparently an elective at his school. He got "mental health" hours through his family medicine rotation. He never rotated through a psych specialty setting under the guidance of psychiatrist during his entire program. What kind of BS is that?! I only hope that is an exception to what is typical. This is the kind of stuff that tells me PAs need to beef it up when it comes to psych, especially if they want to make the big psych $$$ which is totally out there. Psych NPs with experience bring in >150k easy.

  • Upvote 1

Share this post


Link to post
Share on other sites
19 hours ago, Lexapro said:

I think part of the issue is billing. Many states/insurances will not allow a PA to bill for psychotherapy unless the PA is also an MFT/LCSW (and rightfully so, IMO, as I do not see any PA programs with dedicated didactic/clinical hours towards training to provide real psychotherapy). MDs and psych NPs do get this training, even though it may be somewhat skimpy, it does exist. I know that's a limiting factor in many places, not being able to tack on the therapy code and being reimbursed less is leaving $ on the table.

I think PA psych residencies should include a psychotherapy component, but the few I've looked at have (disappointingly) not included this. PAs are doing this to themselves and should advocate for better/more complete psych training IMO.

Do you think it would be helpful if I get a MFT license? 

Share this post


Link to post
Share on other sites
On 7/25/2019 at 9:57 PM, Lexapro said:

One thing that blew my mind was when I met a  PA who had no psych rotation. It was apparently an elective at his school.

I did not do a psych-specific rotation either, same as this PA, but yes, did do primary care med management in 18 weeks of family med rotations (12 rural) instead. I was one of the better prepared in my class, having had general, abnormal, and lifespan/developmental psych (only one was required) as well as two separate pastoral counseling classes in seminary and a 50-hour basic chaplain academy before PA school.  Having said all that... man, did I want more!

  • Upvote 1

Share this post


Link to post
Share on other sites

Current psych PA here. I was only the second PA my organization ever hired in behavioural health, and the only reason they considered me was because I did a rotation with them and had preceptors who vouched for me.

 

Therapy training? No. It's pill pushing, as much as I hate to say that. I listen, nod, and offer advice, and that's all the more you need to be able to do for most of these healthcare organizations. Therapists should be the ones doing the psychotherapy heavy lifting.

 

I started in outpatient, where I worked with NPs. They were all seasoned providers, so I can't compare my "new" clinical skills to their many years.

 

But if you have good mentorship, enough time to learn at a reasonable pace, and provisions for psych CME, you can be just as competitive as an NP. Get that CAQ. Keep explaining to places looking to hire an NP that YOU are able to provide the same level and quality of care.

 

I've fought with recruiters as well. Explained myself and my profession more times than I can count. Sometimes it lands me an interview. Sometimes my words fall on deaf ears.

 

Advocate and educate at every opportunity!

 

I love psych, and if I couldn't practice in this specialty, I wouldn't be a PA.

 

Psych or bust. It's so worth it if you're passionate about mental health.

Edited by pa-wannabe
  • Like 2
  • Upvote 2

Share this post


Link to post
Share on other sites

I have a classmate in my state that has been in psych for over a decade and has no issues getting reimbursed for psychotherapy.  So, in my state (OH) it is not an issue of reimbursement.  I did psych in California and was able to bill for it.  However, as stated above, most of these positions are medication management.  Psych NPs and PAs, in my experience, are not scheduled sufficient time with the patient to bill for both the medication management and psychotherapy in one visit.  Psychotherapy has to be a distinct amount of time separate from the medication management.  I don't recall exactly, been out of psych a few years, but my minimum amount of time to bill psychotherapy had to be 16 minutes.  Well, being scheduled 4 patients an hour, I didn't have time to do both and stay on schedule.  We had therapists in the office for them to schedule 50 minute appointments with. It is not in the best interest of the patient to get psychotherapy from more then one person at the same time.  

  • Upvote 1

Share this post


Link to post
Share on other sites

For our practice billing for psychotherapy is essential. I mean all you need to do is meet with a pt for 20 min to be able to bill, so for our model it's money left on the table if we can't. Just depends. Also, I only see 2-3 pts per hour in ouptatient. I refuse to see any more than that as it becomes miserable for me. Now in the inpatient setting 4+ an hour is easy, especially with manic/psychotic patients who are highly symptomatic - that's a brief visit.

Share this post


Link to post
Share on other sites

Join the conversation

You can post now and register later. If you have an account, sign in now to post with your account.

Guest
Reply to this topic...

×   Pasted as rich text.   Paste as plain text instead

  Only 75 emoji are allowed.

×   Your link has been automatically embedded.   Display as a link instead

×   Your previous content has been restored.   Clear editor

×   You cannot paste images directly. Upload or insert images from URL.


×
×
  • Create New...

Important Information

Welcome to the Physician Assistant Forum! This website uses cookies to ensure you get the best experience on our website. Learn More