Often health systems considering telepsychiatry services expect services to cost far less than market rates for on-site. Psychiatrists are in high demand, and they have nearly unlimited practice options; these facts are well established. A primary advantage of utilizing telepsychiatry over traditional on-site providers is the reduced cost of adding psychiatric services to your program/system/facility. Traditional on-site staffing not only limits recruitment to a provider that is willing/able to travel to the facility, but also builds in some inherent inefficiency into the desired coverage model. Only large facilities can justify the cost of full-time consultants, and a local/community model is not only cost prohibitive (if you can find it at all) but often buys only the available portion of a practitioner’s time; not the portion of time the program needs most.
A psychiatrist’s ability to generate income is limited only by their desired patient population, location and employment/compensation model. Doctors who are willing to see high numbers of patients can generate very high incomes. Many full-time private practitioners work for cash and can charge whatever the market bears. In a world where an ever-increasing number of professionals tele-commute, work remotely, or share their time between multiple projects/employers; physicians are able to practice wherever they want in a variety of delivery models. As urban commutes become increasingly stressful and counterproductive, physicians are opting for roles that allow them to work from home, and like other remote professionals, they will not accept reduced hourly compensation simply because “getting to work,” no longer requires fighting traffic.
Consider that a telepsychiatrist (while unlikely to be cheaper “by the hour,”) will spend a greater percentage of their working hours providing direct patient care, or consulting indirectly with allied health or physician colleagues. At the very least, telepsychiatry eliminates walking between units, walking between buildings, driving from a hospital to a clinic, or repeatedly logging in and out of health records. More importantly, you eliminate the “why am I here,” inefficiency so frustrating to most on-site psychiatrists who show up for an urgent psych consult hours later (but as fast as they could get there) only to find that the hospitalist/intensivist, case manager or other requesting professional is no longer available, the patient away from their bed for a test or scan, asleep, sedated, too intoxicated to evaluate, etc. Telepsychiatrists can be available where/when needed, delivering care with the highest possible clinical benefit.
Lastly, as the deficit between clinical demand and clinical resources deepens, we must all commit to utilizing every hour of professional time efficiently. Psychiatrists are profoundly aware of their scarcity and demand. They know that health care operators need their services far more than they need the extra work. This reality, combined with growing tele-practice opportunities requires operators constantly and thoughtfully listen to providers and deliver working environments they enjoy. Physicians who do not enjoy their work, especially telepsychiatrists can change jobs as easily as they change service locations . . . no longer does changing jobs require pulling kids out of school and packing a moving van. If our physicians don’t enjoy their work, they can and do “swipe left.”