Where Does All the Money Go

[RGMSU]

Is one issue a glutted market? If so, psychology programs need to take this into consideration. I have often argued about this with reference to prescribing psychologists, in the sense that glutting the market for both psychologists and psychiatrists by attempting to blur them together is not good for either profession. Maybe a glutted market isn't the issue. One pickle for psychologists is that you can't really shorten appointment times and be effective in therapy, and it's hard to argue that you should get paid more for talk therapy (in the minds of most people), so it kind of puts you between a rock and a hard place. This is the issue that many generalist physicians have faced - they need to see more patients, but they can't. They can't talk anybody into paying them more per visit. Hence, the proliferation of mid-levels working under a physician and bringing in extra bacon. Now, the problem is trying to keep the mid-levels from straying out on their own and taking our patients with them. Trust me, the grass ain't always greener....

[JackD]

This thread is so dry. All words. Lets look at some pictures.

These are the pay distributions for various health care professionals in chicago.

Clinical Psychologist




Counseling Psychologist





Cardiologist



Chiropractor



Dentist



Dermatologist



ER Doctor



Nurse Practitioner



Psychiatrist

[Keeg]

If you are in it for the money only, become a psychiatrist. If you don't consider 75k enough to be a bread winner, then you are delusional. Half that at 37.5k is enough to be a bread winner, and some people support their family with a lot less.

Also, if loans are a problem, skip the PsyD, with all the outrageous loans, and get a PhD. One of the problems, that is limiting wages, is that the professional schools are plugging out so many psychologist that the market is getting flooded. If the professional schools had the same strict admissions guidelines and limited admissions numbers as normal schools, then this would be much less of a problem.

[RGMSU]

Again, before you start comparing PhDs to NPs to MDs, etc, consider the work responsibilities. A cardiologist spends all day running cath leads up people's femoral arteries to their aortas and coronary arteries. Psychiatrists make more than psychologists because they have reduced most of their practices to ten-minute med checks. I think psychologists should make more. I don't see any evidence they should make as much as a physician, but I'm sure some people on here would disagree. In the era of declining physician salaries, you will have a hard time finding a pay raise, just like the rest of us. We'll see what any of us make after healthcare is revamped. Somehow, I doubt anybody's salaries will go up honestly. Hah, have any of you folks ever followed an ER doc around for a 12 hour shift? You might want to before you compare your salary to theirs. Personally, I think chiropractors are worth about half what a psychologist is worth, so we can agree on that.

[RGMSU]

Originally Posted by Keeg

Also, if loans are a problem, skip the PsyD, with all the outrageous loans, and get a PhD. One of the problems, that is limiting wages, is that the professional schools are plugging out so many psychologist that the market is getting flooded. If the professional schools had the same strict admissions guidelines and limited admissions numbers as normal schools, then this would be much less of a problem.

The market glut is what I figured. I'm curious - what is the normal debt for the PsyD?

[Keeg]

Originally Posted by RGMSU

The market glut is what I figured. I'm curious - what is the normal debt for the PsyD?

110k Median for a PsyD, but it will usually be higher for those going to professional schools.

[cara susanna]

I was going to say, cardiologists deserve that high pay. They're pretty much always working.

[WannaBeDrMe]

Originally Posted by Keeg

If you are in it for the money only, become a psychiatrist. If you don't consider 75k enough to be a bread winner, then you are delusional. Half that at 37.5k is enough to be a bread winner, and some people support their family with a lot less.

Also, if loans are a problem, skip the PsyD, with all the outrageous loans, and get a PhD. One of the problems, that is limiting wages, is that the professional schools are plugging out so many psychologist that the market is getting flooded. If the professional schools had the same strict admissions guidelines and limited admissions numbers as normal schools, then this would be much less of a problem.

Great post!

JackD, it really sounds like your perception of things is very different from my own. For example, I have friends who live comfortably in Chicago on FAR less than $100k a year. As the above poster said, I know many people who are breadwinners with combined poverty-level incomes. What is possible and what you're comfortable with are two entirely different scenarios that you aren't articulating as such within your posts.

The reasons you chose to pay $120k for a degree are your own. I can tell you, at 30, I began looking at psychology as a professor when I was 13 years old. Since that time, I've kept up with market trends, researched programs, and worked closely with professionals. There was never a time that I understood this field to be one where I would make major cash out of school. Especially not enough cash to cover $120k debt in a short amount of time...

I've said on this board since I came that I didn't see how this market could sustain continued growth in mental health care. The fact is that for most people, it's viewed as a luxury item. It will be (has been) one of the first things to go in a lot of people's routine. Worse still are the cuts of reimbursement rates. North Carolina's Medicaid reimbursement rates dropped for the 2nd or 3rd time this year last month... I think I've seen about a dozen cuts since I've been practicing... and again, I'm young and new to the field.

I don't remember who brought up SLP's and PT's but I don't think they go into it for the money. They don't make that much more than social workers in my state. They were almost in worse shape than behavioral health. My state had OT's, PT's, and SLP's on the chopping block COMPLETELY for Medicaid reimbursement. That would wipe out many people's entire income since most special needs kids receive Medicaid to cover the gap in coverage/care for those particular services.

Rates have been cut across the board. I have dentist friends. CUT. I have doctor friends. CUT. I have psychologist friends. CUT. I am a clinical social worker. CUT. Two of my friends, an SLP and a PT, just got laid off from their jobs of 5 years... CUT. Healthcare, as a whole, is suffering because it is a non-essential (sadly) expense. Fix the rotting tooth or buy your kid a halloween costume? Treat your PTSD or put food on your table? Get the mammogram or buy a new pair of shoes?

As a specialist in human behavior, I think if you look closely enough you'll see that things are drawing up to an inevitable conclusion for this period in time. As the economy and market stabalize, the climate will exist for increased rates (maybe, depends on policy shake outs). For now, however, to stay in business, a client must feel that the service warrants the cost. LOVE the posts that call it a business... those are so smart and I agree 100%...

I can't wait to have my doctorate so I can grow my personal business as I expand my scope of practice. For what it's worth, like T4C, I've always have a multi-pronged career path. There's never been a moment where I didn't plan to have my hands in direct practice, publishing, advocacy, policy, and teaching and I think that's the difference between myself (still above water) and others who have had to leave the field in recent months.

I also agree with Keeg on the over-satuaration... not just of psychologists, of all mental health professionals. You have MD's, PhD's, LPA's, LPC's, LCSW's, MHC's, MDiv's, MEd's, EdS's, PA's, NP's, RN's, and who knows who else all trying to cling to the same branch of the treatment tree. While cardiologists, dermatologists, allergists, etc all have their own branch that people would flock toward separately. Our branch was bound to snap off the tree eventually.

[JackD]

Look, if you guys are happy with the current pay for psychologists then great, looks like things are going to work out for you in this career. However, by the shock that we saw from some of the grad students and prospective grad students, it seems few people actually knew about a lot of this. And certainly I am not the only one pointing to these things as problems. They are real too. No one here is making it up for kicks. But it looks like for some of you, the problems don't exist, either you are already making a lot or your pay is just fine, and that is great (no sarcasm there).

Do remember though, there is nothing wrong with you advocating that you get better compensation. As people have said, be forceful about it and it is ok to think of yourselves as business people too.

[RGMSU]

Originally Posted by Keeg

110k Median for a PsyD, but it will usually be higher for those going to professional schools.

Wow, just wow. That's all I can think of to say about that debt versus income ratio.

[Cosmo75]

Originally Posted by erg923

That sound like a great PP, but how much of finding an opp like that is luck? Id love to be one of those that can fall into alreadu succesful group PP, but i suppose the pessimist in me thinks that that really takes luck. That, and feel like I have little skill to build a thriving group PP, therefore i truley would have to find one that is hiring.

So the question is, (besides getting some business skills/savy) what can/should one do to find opps like that?

I have to disagree that it takes "luck" to fall into an already successful private practice. I think it takes networking and hard work early on in your graduate school career to establish relationships for future opportunities. If you don't do that when you're in school, then yes your life is going to be more difficult when you finish because so much about getting good jobs (in psych or not) is about who you know, not what you know or what is printed on your diploma.

I have my post-doc because I built a solid relationship with an excellent research psychologist over my entire 5 years of grad school. The post-doc was mine for the taking. I have another excellent relationship with a PP psychologist with a thriving group practice that has approached me more than once now to work part time for him. I'd make a snarky comment about being a lowly professional school grad, but that's off topic.

PSYDR's post is spot on.

[hamsterpants]

As hard as this thread was to read - especially while finishing up my apps. I am glad these issues were brought up. So thank you all for sharing your perspectives.

If I do get accepted and attend, I need to go into this with as much awareness as possible. I am more of a research gal myself so some stuff is not applicable but much is food for thought.

And if I get rejected, I will reread this thread to feel better - a little rationalization never hurt.

Originally Posted by JackD

Look, if you guys are happy with the current pay for psychologists then great, looks like things are going to work out for you in this career. However, by the shock that we saw from some of the grad students and prospective grad students, it seems few people actually knew about a lot of this. And certainly I am not the only one pointing to these things as problems. They are real too. No one here is making it up for kicks. But it looks like for some of you, the problems don't exist, either you are already making a lot or your pay is just fine, and that is great (no sarcasm there).

Do remember though, there is nothing wrong with you advocating that you get better compensation. As people have said, be forceful about it and it is ok to think of yourselves as business people too.

[Rick55]

Originally Posted by edieb

uuuh, $90k/year after 10 years (after 16 years or so if you count schooling, internship, post-doc), is not good money and you could definiitely not be the breadwinner for a family with that amount of $$.


I could become a social worker and be making the same amount after 10 years in the field. Meanwhile. other doctoral level providers start higher than $90K/year upon graduation. I think a big problem with our field is we expect so little (90K) in return for so much

Say what? My family income is in the top 10% for my area of the country, and my wife makes a lot less than I do. I'm doing more than fine (I own a large four bedroom house, I'm saving a ton of money for retirement, and save $1,000 per month for my kids college). I would argue (strongly) that you need to do a little research about how much people actually make in the U.S. How many families do you think make over $100,000 per year even with two incomes? My brother has an M.S. in environmental engineering and makes a little over $100,000 per year. He is a regional manager for a major engineering firm in NYC and has about 75 engineers working under him. Guess what the guys under him make with engineering degrees from good schools (many with masters degrees)? Let me give you a hint, it's not over $100,000 (not to mention that NY is one the highest cost of living areas in the country). It sounds like you would only be satisfied with M.D. level money. People need to do their research and make an informed decision about whether or not to go into clinical psychology *before* they go to grad school. I'm actually making more money than I expected to at this point, so I am quite happy. However, I researched my decision to go to grad school very carefully before I applied. I knew exactly what I was getting into. It's turned out great for me; your mileage may vary.

[Rick55]

Originally Posted by RGMSU

Wow, just wow. That's all I can think of to say about that debt versus income ratio.

IMHO, people who take on that kind of debt and are unhappy about it after the fact didn't do their homework before applying to grad school. I personally would never, ever consider going into that kind of debt for a degree in clinical psych. If that type of program had been my only option, I would certainly be in a different profession today.

[psychmama]

Originally Posted by Rick55

IMHO, people who take on that kind of debt and are unhappy about it after the fact didn't do their homework before applying to grad school.

Agreed. And if a person has done their homework and decides to take on that kind of debt for their education, then it's their choice and we should not judge them idiots for it. We all try to make the choices that are best for us. Who are we to assume we have the exact same ordering of priorities as someone else?

[hkusp]

Originally Posted by Rick55

IMHO, people who take on that kind of debt and are unhappy about it after the fact didn't do their homework before applying to grad school. I personally would never, ever consider going into that kind of debt for a degree in clinical psych. If that type of program had been my only option, I would certainly be in a different profession today.

I totally agree. Spending 100K+ for just a grad degree is not sustainable, especially if you plan on working in community mental health. That is on top of your costs for an undergrad degree. Unfortunately, the academic world that creates PhDs does not teach them to look at their skills as marketable but rather for the "fun of it" or to "help people." I think we have a lot to learn from business professionals that are making way more than we are as they demand more for their skills.

Part of the problem with the stats for psychology salaries is the split between pay for academic careers and pay for clinical careers. Most universities only pay around 50-70K for a full tenured professor, upwards of to 100K for those on top of the research one heap. This pulls down the average for those clinical positions anywhere from 80K to 150K.

In reference to what to do about community mental health centers that only pay 40K. Simply don't work there. Once these places figure out that NO psychologist will work for that, they will either start hiring mid levels or they will find some more money. From a business perspective, they will only pay you what they can get away with and no one should blame them for that. Every time a psychologist takes a position for that amount of money, they hurt the rest of us in our ability to demand higher wages.

I think things will change once mental health parity (2008) fires up in 2010, but we still have to wait until 2014 for 80% parity. I think things will change even more when we start learning how to better advocate for our profession.

[krisrox]

Originally Posted by hkusp

I think things will change even more when we start learning how to better advocate for our profession.

I think this is key. Psychologists, and especially PsyD's, being seen as second-rate can change if we give a good name to the title.

[Psy01]

Originally Posted by psychmama

Agreed. And if a person has done their homework and decides to take on that kind of debt for their education, then it's their choice and we should not judge them idiots for it. We all try to make the choices that are best for us. Who are we to assume we have the exact same ordering of priorities as someone else?

I'm sorry, but whatever their priorities are, their decision could still not be well thought out. That's assuming they have their priorities straight anyway.

[Therapist4Chnge]

Originally Posted by Psy01

I'm sorry, but whatever their priorities are, their decision could still not be well thought out. That's assuming they have their priorities straight anyway.

There is a lot of judgment in this statement......

[psychmama]

Originally Posted by krisrox

I think this is key. Psychologists, and especially PsyD's, being seen as second-rate can change if we give a good name to the title.

I agree. If you talk to many clients/patients, they'll tell you that psychologists have been immensely helpful to them. Why doesn't the APA fashion a public relations campaign highlighting the ways in which psychologists benefit the public? I see features like this in the APA monitor. Guess what? The public doesn't read the Monitor -- just us psychologists read it! This, in my view, is preaching to the choir.

edit: And let's not forget that we're up against the big pharmaceutical companies, who are everywhere promoting the wonders of Abilify, Lexapro, Wellbutrin and the like. We need to fight back!

[Psy01]

Originally Posted by Therapist4Chnge

There is a lot of judgment in this statement......

There's nothing wrong with judgment. That's what the human brain does - it evaluates. This is a necessary component of problem solving.

People frequently act as if making judgments about others is a bad thing, which is ridiculous, black and white thinking. Everybody makes judgments in one way or another. Problems arise not in judgment itself, but in the manner in which it is done. Making judgments about others is necessary. Making judgments in certain ways is another matter.

[Psy01]

Originally Posted by psychmama

edit: And let's not forget that we're up against the big pharmaceutical companies, who are everywhere promoting the wonders of Abilify, Lexapro, Wellbutrin and the like. We need to fight back!

I so agree with this. I am SOOOO sick of all those advertisements.

[Psychology 76]

Originally Posted by Psy01

I so agree with this. I am SOOOO sick of all those advertisements.

+1

I never see anything psychology related except for the occasional hypnosis infomercial which is just an embarrassment especially when that adds to the public's perception of psychology.

[Rick55]

Originally Posted by psychmama

Agreed. And if a person has done their homework and decides to take on that kind of debt for their education, then it's their choice and we should not judge them idiots for it. We all try to make the choices that are best for us. Who are we to assume we have the exact same ordering of priorities as someone else?

I agree 100%. Everyone makes their own (I would hope reasonably informed) decisions.

This thread seems a bit strange to me. Most psychologists don't get rich. This should be "common sense" to anyone even thinking about entering this field. Most people with doctoral degrees in physics, physiology, engineering, and many other professions aren't getting rich either. That being said, psychologists can do just fine. Look at the data. Only about 10% of people in the U.S. make more than $82,000 per year. Only about 6.5% make more that $100,000 and of course that includes the uber-rich like Donald Trump. Clinical psychologists have the potential to get into that top 10% bracket and then some. We don't get rich, but can do very well relative to most people.

[Rick55]

Originally Posted by hkusp

Part of the problem with the stats for psychology salaries is the split between pay for academic careers and pay for clinical careers. Most universities only pay around 50-70K for a full tenured professor, upwards of to 100K for those on top of the research one heap. This pulls down the average for those clinical positions anywhere from 80K to 150K.

Yes, but those are also 9 to 10 month contract salaries with significant potential to make additional outside income through consulting and clinical work. Plus, many have outrageously good benefits by today's standards (e.g., actual pensions).

http://research.apa.org/salaries07/table1.pdf

[positivepsych]

Look, I don't believe psychologists should make psychiatrist money. In CA, psychiatrists can start at $146-248K, but they went to med school and residency for eight years. We often take that long, but we can finish in six (4 years + 1 year internship + 1 year post-doc). Thus, I think we at least deserve to start at 1/2 of what psychiatrists can potentially make ($75-125K), though we start at nearly 1/4th of their salaries ($40-60K), with little advancement!

Instead, here's my arguement: psychologists should make just as much as other allied doctoral-level health care providers: Pharmacists, Dentists, Optometrists, and Podiatrists. Unlike physicians, most of them provide outpatient services that require little risk. I believe they also go to school for 4 years, plus 1-2 years of residency specialization if they like (though not required like us). My friends who went to Pharmacy/Dental school at age 22, are making 100+K at age 26, working 36-40 hours/week in outpatient settings with full benefits.

Yes, no one absolutely "needs" a six-figure salary (though I would argue that living in LA, SF, or NYC, that's actually not that much money). It's about fairness: if 4-year doctoral health professionals make $100+K, we definitely should too. Furthermore, it's particularly pathetic when health care providers with BS/MS degrees are making more than us.

The issue is supply and demand. Fresh psychiatry grads have headhunters recruiting them with 30+ job offers, while most psychologists have to scramble to find a job. True story: I was talking to a clinical health psychologist who splits time between a hospital and private practice in CA. When I asked her how she got her job, she told me that she had to apply for an MSW position at the hospital (at their pay rate), and convince them to hire her even though she's a psychologist! I heard in So. Cal, Kaiser doesn't even hire psychologists! :-O The proliferation of professional school PsyDs and MSW/MFTs have caused an oversupply relative to demand, so they can pay us whatever they want, since they have no shortage of applicants. This problem is only going to get worse.

[Psychology 76]

Originally Posted by Rick55

I agree 100%. Everyone makes their own (I would hope reasonably informed) decisions.

This thread seems a bit strange to me. Most psychologists don't get rich. This should be "common sense" to anyone even thinking about entering this field. Most people with doctoral degrees in physics, physiology, engineering, and many other professions aren't getting rich either. That being said, psychologists can do just fine. Look at the data. Only about 10% of people in the U.S. make more than $82,000 per year. Only about 6.5% make more that $100,000 and of course that includes the uber-rich like Donald Trump. Clinical psychologists have the potential to get into that top 10% bracket and then some. We don't get rich, but can do very well relative to most people.

Well said. And thanks for pointing out the other doctoral degree comparison. I think if your going to compare psychologist salary it should be with people with Phds rather than MDs.

Does anyone have a good source for salary comparisons from Phd's in various science fields?

[RGMSU]

Originally Posted by Psychology 76

Well said. And thanks for pointing out the other doctoral degree comparison. I think if your going to compare psychologist salary it should be with people with Phds rather than MDs.

Does anyone have a good source for salary comparisons from Phd's in various science fields?

You will not find typical PhD salaries to be encouraging for comparison.

[RGMSU]

Originally Posted by positivepsych

Instead, here's my arguement: psychologists should make just as much as other allied doctoral-level health care providers: Pharmacists, Dentists, Optometrists, and Podiatrists. Unlike physicians, most of them provide outpatient services that require little risk. I believe they also go to school for 4 years, plus 1-2 years of residency specialization if they like (though not required like us). My friends who went to Pharmacy/Dental school at age 22, are making 100+K at age 26, working 36-40 hours/week in outpatient settings with full benefits.

Furthermore, it's particularly pathetic when health care providers with BS/MS degrees are making more than us.

It's not about the doctoral degree. It's about associated risk with who you're treating and for what. Some of the BS/MS people you're talking about are seeing patients for medical conditions that require assumption of some risk. Actually, feet are pretty important to us. So, podiatry services are something most people are willing to pay for. Dentistry is more complicated than you're letting on. It requires some creative skill and some dexterity. Optometrists make their money by selling glasses and contacts. If pharmacists make a mistake, somebody could quite literally die. To get paid the big bucks, you have to be offering something somebody's willing to pay for. And, like I said, I doubt anybody is getting a pay increase right now. In case you haven't noticed, they're talking about pay DECREASES. If you think people are going to pay more for a psychologist at the same time that they are willing to pay less for a physician, it ain't gonna happen. You folks need to get control of your profession and stop the schools that are basically functioning as degree mills. If every psychologist had prescription rights today and could claim to be assuming medical risk through prescribing, their salaries likely wouldn't increase one dime, because the market would be glutted with people to prescribe psychotropics on every street corner. Until you guys discover a business model that you can sell to the American consumer as worth it, and get control of your glutted market, you're stuck between a rock and a hard place. Sometimes an outsider's opinion is pretty darn accurate, if you haven't noticed.

[Rick55]

Originally Posted by psychmama

I agree. If you talk to many clients/patients, they'll tell you that psychologists have been immensely helpful to them. Why doesn't the APA fashion a public relations campaign highlighting the ways in which psychologists benefit the public? I see features like this in the APA monitor. Guess what? The public doesn't read the Monitor -- just us psychologists read it! This, in my view, is preaching to the choir.

edit: And let's not forget that we're up against the big pharmaceutical companies, who are everywhere promoting the wonders of Abilify, Lexapro, Wellbutrin and the like. We need to fight back!

Insurance companies care about outcome data and cost effectiveness. I think you "fight back" with evidence-based practices that are cost effective.

Many practicing psychologists have harmed our standing by not using evidence-based treatments, imho. For example, I do a lot of work with OCD and am amazed that I come across clients that have been treated ineffectively for years with psychodynamic therapy and other psychotherapies that have no proven effectiveness in treating OCD. Why should insurance companies be expected to pay for treatment by psychologists who do not even read the research literature in their own field? Even a layperson can google sites like the OC foundation and clearly see that the expert consensus based on the empirical literature is that OCD is treated with cognitive-behavioral therapies especially with an exposure and response prevention component. Sadly, many clients come to me after years of ineffective psychotherapy for OCD. They often come to me after "discovering" empirically-based treatments for OCD online (I am listed as a provider in the OC foundation treatment provider directory). The fact that they find out about evidence-based treatment this way rather than from treating licensed psychologists is beyond disgraceful for our field. Before we ask for more "respect" or more money, we need to have our house in much better order than it is right now.

Here's a good recent article that addresses many of the issues our field is facing:

http://www.psychologicalscience.org/...i/pspi_9-2.pdf

[Rick55]

Originally Posted by RGMSU

It's not about the doctoral degree. It's about associated risk with who you're treating and for what. Some of the BS/MS people you're talking about are seeing patients for medical conditions that require assumption of some risk. Actually, feet are pretty important to us. So, podiatry services are something most people are willing to pay for. Dentistry is more complicated than you're letting on. It requires some creative skill and some dexterity. Optometrists make their money by selling glasses and contacts. If pharmacists make a mistake, somebody could quite literally die. To get paid the big bucks, you have to be offering something somebody's willing to pay for. And, like I said, I doubt anybody is getting a pay increase right now. In case you haven't noticed, they're talking about pay DECREASES. If you think people are going to pay more for a psychologist at the same time that they are willing to pay less for a physician, it ain't gonna happen. You folks need to get control of your profession and stop the schools that are basically functioning as degree mills. If every psychologist had prescription rights today and could claim to be assuming medical risk through prescribing, their salaries likely wouldn't increase one dime, because the market would be glutted with people to prescribe psychotropics on every street corner. Until you guys discover a business model that you can sell to the American consumer as worth it, and get control of your glutted market, you're stuck between a rock and a hard place. Sometimes an outsider's opinion is pretty darn accurate, if you haven't noticed.

Great post. I don't think it's all about risk though. It's also about the cost/benefit of the services that are provided. Much of the rest of this post I completely agree with. Psychologists need to demonstrate that as a profession, we use science-based practices on a regular basis. The supply/demand issue is also a very important one, but unlike medicine, APA apparently has no answers.

[RGMSU]

The real reason I'm concerned about this, in case anybody is wondering, is because I'm afraid we're all about to be fighting for every dime of reimbursement. The wheels are in motion for costs to be cut everywhere to everybody. Regardless of what letters we have behind our names, or will have behind our names for those of us who are students, we need to be very vigilant about trends that suggest that people view healthcare as an entitlement rather than a service we all trained very hard or are training very hard to provide. We also need to be vigilant about our own autonomy. I know this frequently runs against the prevailing political sentiments in psychology and psychiatry, but we'd better be careful how much we trust politicians to represent our interests.

[edieb]

Originally Posted by RGMSU

It's not about the doctoral degree. It's about associated risk with who you're treating and for what. Some of the BS/MS people you're talking about are seeing patients for medical conditions that require assumption of some risk. Actually, feet are pretty important to us. So, podiatry services are something most people are willing to pay for. Dentistry is more complicated than you're letting on. It requires some creative skill and some dexterity. Optometrists make their money by selling glasses and contacts. If pharmacists make a mistake, somebody could quite literally die. To get paid the big bucks, you have to be offering something somebody's willing to pay for. And, like I said, I doubt anybody is getting a pay increase right now. In case you haven't noticed, they're talking about pay DECREASES. If you think people are going to pay more for a psychologist at the same time that they are willing to pay less for a physician, it ain't gonna happen. You folks need to get control of your profession and stop the schools that are basically functioning as degree mills. If every psychologist had prescription rights today and could claim to be assuming medical risk through prescribing, their salaries likely wouldn't increase one dime, because the market would be glutted with people to prescribe psychotropics on every street corner. Until you guys discover a business model that you can sell to the American consumer as worth it, and get control of your glutted market, you're stuck between a rock and a hard place. Sometimes an outsider's opinion is pretty darn accurate, if you haven't noticed.

Your post is illogical and condescending. You really need to learn to express your arrogance in a more nuanced manner.


I didn't know all psycholgosits do is hand out hugs and kisses with my PHD. Pondering the issue, I think psychological work is very valuable. For instance, I know many neuropsychologists who deal with diagnostic issues of life and death including having a key role in WADA operations. Clinical psychologists also deal with issues of life and death. Apparently you have never seen a BPD patient with intense suicidality or a persons suffereing form melancholic depression who refuses to even get up out of a chair. I have dealt with many issues of ife and death and patients tossed aside by psychiatrists who just prescribe a pill for everything. I think my work is as valuable as yours, and I have a feeling that all the patients whom I have had the pleasure to collaborate with would agree.

The idea of reimbursement going down or staying the same if RxP is illogical, too. As evidenced in Louisiana and New Mexico, most psychologists have not sought the extra training and, for the ones who have, salaries have increased exponentially. Being from Louisiana, I can attest to this.

[Therapist4Chnge]

Originally Posted by RGMSU

It's not about the doctoral degree. It's about associated risk with who you're treating and for what.

Do chiropractors, optometrists, and dentists deal with actively suicidal patients on a daily basis? I'd think the associated risk dealing with these populations is higher on a day to day basis. Many of my pts. not only are at risk, but have proven histories of attempts....so I think that would pose more of a risk than an "adjustment" for a soccer mom?

ps. I completely agree with you about watching out for our interests, as politicians do not have our best interests at heart.

[edieb]

RGMSU is very oblivious to any real issues and then comes on here and is arrogant to say his outside opinion is "right on target" If he keeps up, I am going to have to put him on "ignore", lol. I can't take it!

[Psychology 76]

Originally Posted by RGMSU

You will not find typical PhD salaries to be encouraging for comparison.

Do you have a source I can look at? The one I found on pay scale had psychology profs making around the same as other science profs but I'm not sure how reliable it is..

[Buzzwordsoldier]

Originally Posted by RGMSU

It's not about the doctoral degree. It's about associated risk with who you're treating and for what. Some of the BS/MS people you're talking about are seeing patients for medical conditions that require assumption of some risk. Actually, feet are pretty important to us. So, podiatry services are something most people are willing to pay for. Dentistry is more complicated than you're letting on. It requires some creative skill and some dexterity. Optometrists make their money by selling glasses and contacts. If pharmacists make a mistake, somebody could quite literally die. To get paid the big bucks, you have to be offering something somebody's willing to pay for. And, like I said, I doubt anybody is getting a pay increase right now. In case you haven't noticed, they're talking about pay DECREASES. If you think people are going to pay more for a psychologist at the same time that they are willing to pay less for a physician, it ain't gonna happen. You folks need to get control of your profession and stop the schools that are basically functioning as degree mills. If every psychologist had prescription rights today and could claim to be assuming medical risk through prescribing, their salaries likely wouldn't increase one dime, because the market would be glutted with people to prescribe psychotropics on every street corner. Until you guys discover a business model that you can sell to the American consumer as worth it, and get control of your glutted market, you're stuck between a rock and a hard place. Sometimes an outsider's opinion is pretty darn accurate, if you haven't noticed.

I work in a hospital-based psychiatric department. The criteria by which we screen our patients is whether they constitute a risk of harm to self or others. There's more to this question than who takes on more risk...

Our specialty is poorly defined, the services intangible and the outcomes indeterminate, the clients either impoverished or fleeing a lynch mob, etc. We are the janitorial arm of the police. How much do the beat cops make in your districts?

[RGMSU]

Originally Posted by Therapist4Chnge

Do chiropractors, optometrists, and dentists deal with actively suicidal patients on a daily basis? I'd think the associated risk dealing with these populations is higher on a day to day basis. Many of my pts. not only are at risk, but have proven histories of attempts....so I think that would pose more of a risk than an "adjustment" for a soccer mom?

ps. I completely agree with you about watching out for our interests, as politicians do not have our best interests at heart.

It is a matter of perceived intervention. I'm not saying you don't keep someone from committing suicide. But, doesn't a minister or a social worker or whoever do so as well? And, it's a matter of skill. Optometrists are providing a specific product, as are dentists. I've already said that I think chiropractors are a crock of crap, so I agree with you totally there. I'm not saying that I believe psychologists aren't providing a tangible service. I'm saying that is the PUBLIC PERCEPTION in many cases. Apparently, some of your colleagues can't understand the concept of debating a point versus stating personal opinion. I have already said that the debt to income ratio for a psychologist on average sounds rather ridiculous to me. To put it plainly, there is only so much most people are going to pay to sit on a couch and chat. AGAIN, I'M NOT SAYING THAT'S ALL YOU DO. I'M SAYING THAT IS PART OF THE IMAGE PROBLEM!!! That isn't condescending. It's just the reality of the way people view it. Now, another thing that is being misunderstood. My comments about glutting the market with people prescribing psychotropics. I'm not saying it has happened in Louisiana. I'm saying it COULD happen nationally. Would it necessarily? No. But it could. Apparently you folks haven't learned your lesson about glutting markets either. The only thing dumber than making a mistake once is making the same mistake twice. For those who can't understand a metaphor (not you T4C but some of your colleagues around here). You allowed the market for talk therapists to become glutted. It drove your salaries down. Now, if you allow the market for prescribing psychologists to become glutted, it will drive your salaries down again. That's really not a complicated principle at all. It's no skin off my nose. All I'm saying is if you want to make more money, come up with a way to appear to be offering a specific product more people are willing to pay more money for. And, make sure to control your new market more tightly so it doesn't get ripped out from under you again. And, yes, I'm aware that there are some neurosurgical teams and whatnot where neuropsychologists play roles. I have no idea what they make. Never claimed to. I thought we were talking about average psychologists. Last time I checked a psychologist working with a neurosurgeon wasn't exactly the average job description.

[RGMSU]

Originally Posted by edieb

RGMSU is very oblivious to any real issues and then comes on here and is arrogant to say his outside opinion is "right on target" If he keeps up, I am going to have to put him on "ignore", lol. I can't take it!

Hah, one of your own colleagues said my posts were "great."

[wrsparks]

I've been following this thread, and I really think everyone has brought up some excellent points. This is a lot of food for thought...

RGMSU: I also think you have some good points as someone who is an "outsider". There are somethings that I think you gloss over though, and that is what is getting their hackles up (including mine ). I think though when I read hard enough, you are basically saying what others are saying.
Also, I would say that a minister is not trained in suicide prevention. I don't know about a social worker. Either way, there is research about suicide and suicide prevention and specific training which makes this sort of intervention most effective. Not to mention all the legal stuff. I would say this is a acquired skill. But really, this isn't that relevant to the OP so we'll leave it at that.

I sometimes wonder if we find ourselves in this situation of lack of monetary compensation due to the nature of the profession. We self select into this area, and are perhaps mediators, soothers, problem solvers of the non-direct kind. I just think that if MDs and lawyers were getting paid as little as us for the amount of blood sweat and tears they wouldn't be saying, "Well... it's not that bad."I don't know, I'm kind of mad for all of us, and mad that the APA hasn't been working harder for us.

[positivepsych]

Physicians save lives. But psychologists make life worth living. :-)

I disagree. The problem is not public perception, or even actual value added. Our work is very valuable, and most patients are satisfied with the services we provide. No one I talk to in the public questions the need for psychologists. Most people have experienced depression and anxiety, and would gladly pay if they could keep it from interfering with their lives. If anything, our importance has been increased lately with the struggles people face in this recessions and the shootings in the news.

Psychologists are just as critical as dentists, pharmacist, optometrists, podiatrists, etc. Lest you forget, pharmacists have been called glorified pill-counters, dentists tooth mechanics, and optometrists having the easiest job of asking "1 or 2?" All of these stereotypes are silly. It's pointless to debate which job is more difficult, creative, important, etc. because we all do different but necessary services.

The difference is that their mid-levels enhance their income, not take away from it. Dental hygenists work for dentists, and pharmacy techs work for pharmacists. Instead of having MSWs/MFTs work for us, we've allowed them to practice independently and basically replace us cheaply. Furthermore, most of my friends get their Pharm.D. and D.D.S. degrees from major four-year universities, not Alliant/Agrosy/Fielding like the new wave of psychologists.

Remember, prior to the 1990s, Ph.D. clinical psychologists were often reimbursed fully and unquestionably by insurance companies, and were not competing with MSWs/MFTs/PsyDs. Psychologists used to be able to easily make $100+K in private practice before the managed care clampdown. Until the supply & demand issue is addressed, our salaries and reimbursement will be suppressed because corporations always try to get away with saving money. Supply and demand, that's it.

Unfortunately, this isn't going to change anytime soon. Academic clinical psychologists have their heads up their asses. They mostly don't want to train clinicians because they want to mold researchers like themselves, and don't care about issues their clinical colleagues face, because they have tenured salaries. The APA is corrupt, and gets kickbacks from accrediting all these professional schools. If you want this to end, get political and join organizations like NAPPP, or lobby/unionize for change.

[Therapist4Chnge]

Originally Posted by wrsparks

Also, I would say that a minister is not trained in suicide prevention. I don't know about a social worker. Either way, there is research about suicide and suicide prevention and specific training which makes this sort of intervention most effective. Not to mention all the legal stuff.

The research has shown that there are gaps in suicide assessment and prevention work across the board (RN, LPC, Ph.D, etc), and that many providers over-estimate their ability to prevent suicides, and under-estimate the complexities of the work.

[psychmama]

Originally Posted by wrsparks

I sometimes wonder if we find ourselves in this situation of lack of monetary compensation due to the nature of the profession. We self select into this area, and are perhaps mediators, soothers, problem solvers of the non-direct kind. I just think that if MDs and lawyers were getting paid as little as us for the amount of blood sweat and tears they wouldn't be saying, "Well... it's not that bad."I don't know, I'm kind of mad for all of us, and mad that the APA hasn't been working harder for us.

Bingo! I think you hit upon one of our major problems as a profession. I got out of law because I'm one of those mediator self-soother types. I hate fighting about money, but I'm realistic enough to see that this is a problem.

[wrsparks]

T4C, you are right. It is lacking. I think my point is we are trying to systematically address it rather than taking a crack at it like a minister would.

[RGMSU]

Originally Posted by wrsparks

I just think that if MDs and lawyers were getting paid as little as us for the amount of blood sweat and tears they wouldn't be saying, "Well... it's not that bad."I don't know, I'm kind of mad for all of us, and mad that the APA hasn't been working harder for us.

I never said "it's not that bad." As a matter of fact, I believe at least two of my previous posts say that I think the debt to income ratio as expressed on here for psychologists is ridiculous. Good luck getting it to change after what was passed tonight. We're all about to fight for every penny. If you think physicians don't have these same issues, think again. One of the worst mistakes our guild made was allowing nurse practitioners to become "independent" in some states. I don't think most people believe they have the same skill set as a physician, but they certainly frequently advertise that they do. I mention this as a comparison to PhD versus the master's level workers that have been mentioned in psychology. I think it's time for the bosses (the ones most highly trained) to start being the bosses again in multiple fields of healthcare.

[RGMSU]

Originally Posted by positivepsych

Physicians save lives. But psychologists make life worth living. :-)

Psychologists are just as critical as dentists, pharmacist, optometrists, podiatrists, etc. Lest you forget, pharmacists have been called glorified pill-counters, dentists tooth mechanics, and optometrists having the easiest job of asking "1 or 2?" All of these stereotypes are silly. It's pointless to debate which job is more difficult, creative, important, etc. because we all do different but necessary services.

I agree with all that. Medicine has it's own stereotypes that I hate among various specialties.

Originally Posted by positivepsych

Furthermore, most of my friends get their Pharm.D. and D.D.S. degrees from major four-year universities, not Alliant/Agrosy/Fielding like the new wave of psychologists.

I hesitate to touch this one, so as not to offend, but I have to say I think you have a point here. This is one of the concerns I have expressed about prescribing psychologists. What exactly will be the nature of the institutions granting these degrees? For that matter, I don't particularly like some of the standards I see among nurse practitioner programs.

Originally Posted by positivepsych

Psychologists used to be able to easily make $100+K in private practice before the managed care clampdown.

Managed care is a ship no provider should have ever allowed to leave the harbor. Now we have about a dozen entities between us and our patients. I'm afraid that isn't ever going to change, and in fact might get worse. It could change, but it sure as heck wouldn't be easy to turn that ship around.

[edieb]

Originally Posted by positivepsych

Physicians save lives. But psychologists make life worth living. :-)

I disagree. The problem is not public perception, or even actual value added. Our work is very valuable, and most patients are satisfied with the services we provide. No one I talk to in the public questions the need for psychologists. Most people have experienced depression and anxiety, and would gladly pay if they could keep it from interfering with their lives. If anything, our importance has been increased lately with the struggles people face in this recessions and the shootings in the news.

Psychologists are just as critical as dentists, pharmacist, optometrists, podiatrists, etc. Lest you forget, pharmacists have been called glorified pill-counters, dentists tooth mechanics, and optometrists having the easiest job of asking "1 or 2?" All of these stereotypes are silly. It's pointless to debate which job is more difficult, creative, important, etc. because we all do different but necessary services.

The difference is that their mid-levels enhance their income, not take away from it. Dental hygenists work for dentists, and pharmacy techs work for pharmacists. Instead of having MSWs/MFTs work for us, we've allowed them to practice independently and basically replace us cheaply. Furthermore, most of my friends get their Pharm.D. and D.D.S. degrees from major four-year universities, not Alliant/Agrosy/Fielding like the new wave of psychologists.

Remember, prior to the 1990s, Ph.D. clinical psychologists were often reimbursed fully and unquestionably by insurance companies, and were not competing with MSWs/MFTs/PsyDs. Psychologists used to be able to easily make $100+K in private practice before the managed care clampdown. Until the supply & demand issue is addressed, our salaries and reimbursement will be suppressed because corporations always try to get away with saving money. Supply and demand, that's it.

Unfortunately, this isn't going to change anytime soon. Academic clinical psychologists have their heads up their asses. They mostly don't want to train clinicians because they want to mold researchers like themselves, and don't care about issues their clinical colleagues face, because they have tenured salaries. The APA is corrupt, and gets kickbacks from accrediting all these professional schools. If you want this to end, get political and join organizations like NAPPP, or lobby/unionize for change.

good post, except NAPPP is actually worse than the APA in lowering the standards of the profession. For ex, NAPPPP is threatening to sue the federal gov't to end the statute requiring APA-accredited internships for V.A. psychologists. They have started a new "degree" called the "doctor of behaviroral health" for psychologists-only -- the degree is offered at some online university. Even one of the leaders of NAPPP is a psy.d. from a very low ranking professional school. IN addition, people who write for their newsletter are alumni of Fielding, an online grad program. Talk about a race to the bottom.

[wrsparks]

Originally Posted by RGMSU

I never said "it's not that bad." As a matter of fact, I believe at least two of my previous posts say that I think the debt to income ratio as expressed on here for psychologists is ridiculous. Good luck getting it to change after what was passed tonight. We're all about to fight for every penny. If you think physicians don't have these same issues, think again. One of the worst mistakes our guild made was allowing nurse practitioners to become "independent" in some states. I don't think most people believe they have the same skill set as a physician, but they certainly frequently advertise that they do. I mention this as a comparison to PhD versus the master's level workers that have been mentioned in psychology. I think it's time for the bosses (the ones most highly trained) to start being the bosses again in multiple fields of healthcare.

You might want to reread. I was referring to "we" as in present and future psychologist saying to ourselves that it isn't that bad. I'm pretty sure everyone is pretty aware of your intense concern over the present state of affairs.

[RGMSU]

Originally Posted by wrsparks

You might want to reread. I was referring to "we" as in present and future psychologist saying to ourselves that it isn't that bad. I'm pretty sure everyone is pretty aware of your intense concern over the present state of affairs.

That was a mis-read on my part. Honestly, my only goal in even paying any attention to the psychology forums is to try to have an interdisciplinary approach and see the common ground. There are reasons I am repetitious about my supposed "intense concerns."

[Therapist4Chnge]

Originally Posted by edieb

good post, except NAPPP is actually worse than the APA in lowering the standards of the profession. For ex, NAPPPP is threatening to sue the federal gov't to end the statute requiring APA-accredited internships for V.A. psychologists. They have started a new "degree" called the "doctor of behaviroral health" for psychologists-only -- the degree is offered at some online university. Even one of the leaders of NAPPP is a psy.d. from a very low ranking professional school. IN addition, people who write for their newsletter are alumni of Fielding, an online grad program. Talk about a race to the bottom.

Seriously?! Good lord. Lowering standards is NOT the way to go about change.