Psychiatry Recruitment: How Supply and Demand are Changing the Game for Employers
As the thought leader in its field, AMN Healthcare produces a series of surveys, white papers, speaking presentations and other resources intended to provide insight into physician and APP supply and demand, compensation, practice patterns, recruiting strategies and related trends.
Our recently published white paper, Psychiatry: Supply, Demand, and Recruiting Trends, examines trends in the recruitment of psychiatrists, including current supply and demand projections, compensation in the specialty, and recommendations for recruiting these highly sought-after health professionals.
Sounding off on Psychiatry’s “Silent Shortage”
The shortage of physicians in the United States has been well documented, with a variety of organizations, including the American Medical Association (AMA), the Health Resources and Services Administration (HRSA), the Association of American Medical Colleges AAMC), and multiple state medical and specialty societies projecting a doctor deficit.
In April 2022, the AAMC projected a shortage of up to 86,000 physicians by 2036 (The Complexities of Physician Supply and Demand: Projections From 2021 to 2036). The report emphasized that this projection is contingent upon the “hypothetical future growth in the number of medical residency positions nationwide.” Should this growth not materialize, the forecasted shortages could be significantly higher.
The AAMC report also notes that “if communities underserved by the nation’s healthcare system could obtain care at the same rate as populations with better access to care, the nation would need approximately 202,800 physicians as of 2021.”
While a looming physician shortage now is generally acknowledged, the shortage of psychiatrists has historically been underreported.
The lack of emphasis long given to the psychiatry shortage is partially rooted in pervasive stigmas about mental illness in the United States. Those suffering from depression and other forms of mental illness frequently are reluctant to discuss their condition and are often reluctant to seek treatment. While the symptoms of those with heart, lung, orthopedic or other
physiological problems typically are readily apparent, the symptoms of those with psychological problems often are not.
Historically, if government and other payers pay well for a procedure, particular attention is given to that procedure. Cardiology procedures and orthopedic surgery procedures usually fall into this highly desirable “profit center” category. Psychiatry, by contrast, is not a profit center for most hospitals (psychiatric services are not covered by some insurance companies) so such services sometimes are not given a high priority.
As a general rule, mental health problems in the United States, their causes, cures and those who suffer from them, tend to be swept under the carpet. For these reasons, AMN Healthcare has long referred to the dearth of psychiatrists as the “silent shortage.”
The Shifting Focus on Mental Health
Fortunately, mental healthcare now is the receiving more attention than it has it the past, as is the growing need for more psychiatrists and other behavioral healthcare professionals. The focus on mental health is a result of a high rate of behavioral health problems among the patient population, as reported by the National Alliance on Mental Illness (NAMI):
- One in every five adults in America experiences some form of a mental illness
- Nearly one in 20 adults in America (13.6 million) live with a serious mental illness
- 60% of adults with a mental illness received no mental health services in the previous year
- Suicide is the 2nd leading cause of death in youths ages 10-34
- The average delay between onset of mental health symptoms and intervention is 8-10 years
- Over $193 billion dollars in lost earnings a year result from serious mental illness
- 24% of state prisoners have “a recent history of a mental health condition”
Higher Demand Driving Higher Pay
The growing demand for psychiatrists is reflected in the average salaries being offered to recruit them. The chart below shows average salary offers made to psychiatrists over the last several years as tracked by AMN Healthcare’s 2024 Review of Physician and Advanced Practitioner Recruiting Incentives:
Current Recruiting Conditions and Recommendations
Recruiting psychiatrists today is extremely challenging due to the large number of openings. Job openings for psychiatrists have been pervasive for years, but the recruiting picture has been complicated recently by the growing number of telepsychiatry practice opportunities that are being offered.
Prior to the COVID-19 pandemic, telepsychiatry opportunities were available to psychiatrists but the level of compensation was significantly lower than what they would typically be offered in an on-site setting. At that time, some psychiatrists were happy to take a pay cut if they were offered the opportunity to work from home.
By contrast, after the onset of COVID, virtually all psychiatrists began working from home and were not obliged to take a pay cut in order to do so. Today, we are seeing some employers encouraging psychiatrists to come back on-site, but many psychiatrists have resisted.
Given the prevailing demand for psychiatrists, employers generally are not in a position to reduce pay for psychiatrists if they want to continue working from home. To do so would severely impair their ability to recruit new psychiatrists and retain the ones they have. As a result, most employers find they must offer the same level of compensation to psychiatrists whether they are working on-site or working remotely.
The movement toward telepsychiatry also reduces the importance of location as a factor influencing compensation. The difference makers in telepsychiatry recruiting today come down to compensation, patient volume, and effective hiring processes.
Compensation
Psychiatry candidates usually focus on the base salary when considering compensation. Often, they do not factor the bonus potential into their evaluations as bonuses are not guaranteed. In the first half of 2024, competitive base salaries for psychiatrists are in the $350,000 to $370,000 range and may go higher for inpatient positions.
Patient Volume
Low patient volumes in the 10-12 patients per day range for outpatient are also considered attractive. The dedicated support of psychiatric RNs and MAs, and a 7-on/7-off schedule for inpatient positions are additional features that many candidates find favorable.
Flexibility and Urgency
It is important to be flexible in terms of practice structures and candidate parameters. There is a valuable resource of psychiatrist candidates available who have J-1 visa and H-1B visa requirements, so it is a good idea to understand the immigration requirements of these candidates. It cannot be overstressed that a sense of urgency is of the utmost importance.
Given the number of opportunities psychiatrist candidates have to choose from, it is important to have an efficient system of communication and decision making in place so that offers can be made in a timely manner.
Staying Ahead of the Psychiatry Recruitment Curve
In addition to the recommendations referenced above, it is important when recruiting psychiatrists to follow the general best practices for all types of physician recruiting. These include a thorough analysis of the opportunity to assess strengths and weaknesses, clear lines of communication, agreement on candidate parameters, appropriate resource allocation, responsiveness, and the sense of urgency.
