ED Telepsych

[MeddPerson]

I would like to inquire about telepsych opportunities. I've seen a lot of post on here about doing outpatient visits via telepsych, but what about the ED? Is it difficult getting a job covering tele consults from an ED? Is it possible to do this full-time? Is this usually done via a telehealth company or a few one-off clinicians that have an agreement with the ED? Do these gigs pay a reasonable rate?

I think I read one post recently about the quality of care not being the best doing this, but not much was mentioned about the job opportunities of someone who decides to do this type of work.

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[mistafab]

Any note i’ve read from telepsych in the ED has been bottom of the barrel care at an outside hospital. From the setups i've seen available in our EMR/care everywhere, it is a SW who actually sees the patient, and a psychiatrist just signs off on any decision they made. The notes are atrocious. The quality of care appears atrocious - but again, I can only see what is documented. Not sure if they are getting sued or not for what they are doing. I'm sure it would lead a telepsych ED provider to bias towards admission given the minimal engagement with the patient - then the question is what is the point? Just have the ED physician admit everyone.

I can't speak to actual jobs or opportunities - I have no clue.

 

[NickNaylor]

At the large county hospital that I work in the ED in, we've had a couple of docs that function in a telepsych role. We had one doc that wasn't located in the state but worked in a telepsych capacity. Her contract wasn't renewed - not because she was a bad clinician but because the logistics of telehealth in an ED setting make this challenging. We had to have patients consent to a telehealth assessment - if they refused and no one else was around to see the patient, the patient just wouldn't get seen. It was much more difficult to manage acutely agitated patients without someone physically there to see the patient and communicate with staff immediately. Filling out legal paperwork for patients that need to be admitted under court commitment was a total hassle.

As with all things, I think the quality of care will depend on the clinician. In our very busy ED with plenty of physicians and midlevels available to work, though, it just didn't make sense.

 

[psych_0]

I see patients via telepsych in the ER and it is pretty straight forward. I see the patient, make a decision to admit or send home, sometimes start meds, sometimes not. If there is legal paperwork that needs to be filled out to admit them on an involuntary basis, I just fill out a PDF copy and send to the charge nurse. Paperwork takes me all of about 45 seconds because it is prefilled with my info so I just input the date and reason for admission. Some patients are agitated and screaming, so those intakes are short...but that would also be the case if I was there in person. In my experience, ER telepsych is almost no different than in person telepsych but your miles may vary based on the tele program used and the staff who help run the logistics.

 

[J ROD]

I know of a place where there are ED psychiatrist working directly for the ED and paid the same as ED docs. Work shift work just like ED docs. etc. Get paid 330K per year. South east. Place has a great deal of turnover. Usually has a job listed. Heard from some that have worked it. Called it "blood money". Made me reconsider as I was considering. They see in person and tele to smaller satellite facilities.

 

[GHPA]

Have been doing telepsych part time in ED since 5-6 yrs ago. First with a subsidy of Locum Tenens, later with a group from HCA. With a good system, my service is as good as in person (at least I hope so ). We usually spent at least 60 min per patient, including 20-30 min interview, calling family and writing note. 12 hour shift work from home. 3-4 shifts a week will be in low to high 300K a year. It's totally doable and I enjoy that, as it is different from my own PP for the rest of the week. They help with malpractice, credentialing and equipment. Only thing is you have to like C/L type of work.

 

[yanks26dmb]

Have been doing telepsych part time in ED since 5-6 yrs ago. First with a subsidy of Locum Tenens, later with a group from HCA. With a good system, my service is as good as in person (at least I hope so ). We usually spent at least 60 min per patient, including 20-30 min interview, calling family and writing note. 12 hour shift work from home. 3-4 shifts a week will be in low to high 300K a year. It's totally doable and I enjoy that, as it is different from my own PP for the rest of the week. They help with malpractice, credentialing and equipment. Only thing is you have to like C/L type of work.

Very interested in doing something like this, perhaps part time to supplement private practice. If you're able would you mind PMing details of employers/hiring managers?