What is a “reasonable” psychiatric expert hourly consultant fee (not for court testimony)?

[geripsyched]

Hi, everyone! I recently received an inquiry from a federal agency to potentially assist an investigation that would utilize my psychiatry subspecialty training and expertise (I am going to keep some of the details vague). There would be no court appearance or litigation. Rather, I would assist in interviewing patients (involves traveling to different states), developing protocol to properly assess the issue, reviewing records, and writing up an internal report. This work could involve hundreds of hours and span much of a year. I have never done anything remotely like this and have never served as a consultant. They said I could charge a “reasonable fee” but, not surprisingly, were unable to provide a typical range of what this might be. My first hit on Dr. Google found a rate of $500/hour (on the lower end). This seems high to me but I live in flyover land. Any thoughts on what a “reasonable” consultant hourly fee may be?

Thank you!

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[WisNeuro]

There's record review, interview, report writing, travel fees, etc. Do you have any mentors in this area that can share a fee schedule with you?

 

[comp1]

This seems too complicated to do if you don't have significant experience with whatever the heck this is already. Going from "How much do I charge for this?" to "writing a protocol" seems like quite a leap. I have a feeling you're going to get taken advantage of (at best). Make sure there is an easy exit clause.

 

[geripsyched]

This seems too complicated to do if you don't have significant experience with whatever the heck this is already. Going from "How much do I charge for this?" to "writing a protocol" seems like quite a leap. I have a feeling you're going to get taken advantage of (at best). Make sure there is an easy exit clause.

I apologize. Writing a protocol is not the right terminology! I spent too much time in research, and this shouldn't be anything like that (e.g., thankfully no IRBs with seemingly arbitrary and semi-relevant comments to address). On a brief intro talk, they told me that had a group of lawyers who needed help on how to ask a specific and vulnerable population questions that would yield the information they are trying to obtain. Although I haven't done consulting before, I have the skillset they ostensibly need (e.g., I work closely with their target population, in the various settings they are interested in, and my PhD is even relevant). This could be interesting work that may positively impact this vulnerable population, something I tried to achieve but never did with my research. I just have no idea what a ballpark hourly rate would be (I make about $200-$250/hr when seeing patients in private practice, so perhaps $400/hr?).

Good point about having an easy out clause - I'll be sure to ask about this if I become more involved.

I don't have mentors to turn to about this unfortunately. Makes sense that the fees could vary based on the activity.

 

[splik]

charge them what you like. Take into consideration what would be worth it to do all that traveling and report preparation. If it's too much you can negotiate a lower fee - we call it a "government discount" - and go from there. The federal courts actually have ranges for hourly rates for experts by region (which tend to be on the lower side but they can pay more than that). The feds won't pay you in advance, but the federal government always pays its bills. If they happen to be late, they'll pay with interest! That said, it is a good idea to provide an estimate of hours needed as you go along and have it approved - get it in writing.

 

[PsyDr]

Buy SEAK's billing survey.

And try not to laugh during the polygraph, regardless of how dumb the questions are. They HATE that.

 

[whopper]

I charge $750/hr. I used to charge much less than this, but seriously forensic work has become a pain in the ass. Why? Cause I have to cancel patients, and sometimes I'm asked to testify with only a few days notice ahead of schedule. I get the fear that a lawyer won't pay me after I've done dozens of hours of work for them and if that happens your only recourse is to go after them in court. Such a lawyer knows the court system much better than you and then you'll likely have to pay another lawyer to fight this. That hasn't happened to me yet but I've seen other colleagues where such a thing did happen. When it did happen those colleagues usually just accepted the fact that they're not going to get paid over $10,000 and just never work with that lawyer again.

I've said this before. Expert witness testimony can make a lot of money but it's hard money, while seeing patients is usually (not all the time) easy money. You get a patient stable and they continue seeing you, and you've worked to get all of their major fires put out, that patient usually just wants a refill and a pleasant conversation. That's easy money.

 

[dl2dp2]

There's no "typical" fee. I find that variations in cash private practice w.r.t. clinical fees can be 2-5x! I would charge 1.2x your practice clinical fees, as a start. If your schedule gets full, increase your fees.

 

[splik]

I charge $750/hr. I used to charge much less than this, but seriously forensic work has become a pain in the ass. Why? Cause I have to cancel patients, and sometimes I'm asked to testify with only a few days notice ahead of schedule. I get the fear that a lawyer won't pay me after I've done dozens of hours of work for them and if that happens your only recourse is to go after them in court. Such a lawyer knows the court system much better than you and then you'll likely have to pay another lawyer to fight this. That hasn't happened to me yet but I've seen other colleagues where such a thing did happen. When it did happen those colleagues usually just accepted the fact that they're not going to get paid over $10,000 and just never work with that lawyer again.

I've said this before. Expert witness testimony can make a lot of money but it's hard money, while seeing patients is usually (not all the time) easy money. You get a patient stable and they continue seeing you, and you've worked to get all of their major fires put out, that patient usually just wants a refill and a pleasant conversation. That's easy money.

This! I have been stiffed before (twice - but not for huge amounts), and trying to get paid is sometimes quite stressful (particularly if you are conflict averse and don't like talking about money like me). Interestingly, in many states, lawyers don't have an ethical obligation to pay their experts! the bars in those states see this as a contract issue to be taken up in small claims court. That said, I do find having a replenishable retainer helps as well as does providing estimates of hours and costs as you go along.

Sometimes forensic money is "easy" though. Sometimes you get the retainer and the case settles. My retainer is usually non-refundable, and sometimes my being declared as an expert helps settle the case so its basically free money. Same for canceled depositions etc. I also do like reviewing records which I usually do in bed. Sometimes that's all I have to do. I also enjoy being a consultant as that's quite fun and not too difficult where you help the attorneys with their case strategy and depositions and cross-examination of psychological/psychiatric experts and don't serve as a declared expert yourself etc. Report preparation is tedious and some reports can be over 30 pages or longer (though the aim is keep things short and sweet). Depositions can also be quite painful.

 

[whopper]

Add to this, I've noticed several lawyers think along the lines of not if the issue at hand is right or wrong, but more if they could get away with it in terms of law. E.g. several institutions fight in a legal manner knowing the other person will give up. The big institution with a team of lawyers on retainer can keep this going on indefinitely while the little guy has to fight for every inch.

Trial lawyers often times are in a constant state of mentally fighting. Such a profession may have it's appeal for a young scrappy professional, but long-term it leads to issues such as substance abuse, broken relationships, etc. Getting to the point you work with a lawyer, you do say $15,000 of work for them and they decide not to pay you, don't expect their sense of right and wrong to dictate what's going on. More like, "hey I'm not going to pay the doctor, and I know if he takes legal action against me he knows he'll be spending 10x that much in legal fees and time devoted to suing me that he could've made up seeing patients so he'll give up." And from what I've seen several do give up.

Then add to this it's not like there's an online source for expert witnesses to know who the scumbag lawyers are that won't pay you. I'm being snarky but frank-I've seen online forums for rating providers of various illegal activities (e.g. Joe on 6th street, Internet phone # will get you quality activity, 4 out of 4 stars, with dozens of positive ratings), but no source of information to let me know if the lawyer I'm going to work with is going to pay me.

The only protection other than experience in working with local lawyers is in your contract have a retainer fee (an upfront fee) and a milestone written in where if you do not get paid via increments you will not continue to work. I have that written into my expert-witness contract and you may have to be a pain in the ass with that lawyer where you want the cordial relationship and remind them to pay you or no more work.

My last expert witness case, the defendant had to have all of his monetary transactions approved by a third party because he was inappropriately accused of having dementia, so payments were tied up for several days. Then add to this in the middle of the case he wanted a new lawyer, and I told the new lawyer I wouldn't restart working on the case until I got paid from the prior lawyer who delayed payment likely because of the third party and not due to bad intent.

It was the first time I suspected a lawyer was going to play hardball with paying me, and I did get paid, and it did turn out it was likely because the third party situation with no bad intent on anyone, but for weeks the issue was bugging the heck out of me. I had to make a declaration I was not going to do anymore work until I got paid. Also the new lawyer had to spend a lot of time and effort to figure out what was going on with why it was taking weeks to get me paid from the prior lawyer. I remember saying to myself, "yep it finally happened to me." Well I did get paid, but each case, unless I know the lawyer well, I get the suspicion the guy's going to screw me. Unfortunately I've seen colleagues screwed over with getting paid, and I've worked on several cases where I did get paid, but worked with the lawyer enough to see this lawyer was a total scumbag who was completely into doing anything, even if illegal and unethical so long as no one could prove it and he could get away with it.

One particular case in mind occurred where I was asked to work on the defense for a physician, and after I reviewed the case I told the lawyer there were several strong defenses because the physician he was defending didn't commit the problems in the case, and it was very much glaring the problems were caused by a specific other physician. The lawyer got mad, told me his partner was defending the other physician and that guy was a big money producer for them cause he always gets sued, and that I really screwed up on this cash-cow case cause now he can't work with me. Lawyers aren't supposed to compromise the defense of their client so that their partner's defenses for other clients could better work out, it violates their code of ethics, but here it was happening. Then the lawyer pointed out that in the future, if he works with me, it's better for him to lay out everything I'm supposed to say and I should just say yes and that I would get paid an extra special amount. Seriously this type of below the belt experience I've seen in expert witness work just under half the time.

I also did a rotation while a resident with a forensic psychiatrist who pretty much said anything the lawyer wanted to say even if it was completely inappropriate. Lo and behold while I'm a fellow I see this guy considered a high up guy in AAPL. I remember seeing him testify that if a doctor or nurse was physically assaulted, the patient shouldn't be held accountable even if it was clear that the patient knew what they were doing because "it comes with the territory," and that it would "violate" our professional ethics to seek legal action against the patient. WTF. And no one in my residency seemed to know or care this was how this guy operated. No one at AAPL ever saw this guy testify in person, no they just saw his AAPL articles (that I thought were weak but whatever).

 

[WisNeuro]

This is why I mostly work for IME companies, and only work directly with a lawyer if they've been personally vetted by several of my colleagues. I have never not been paid, and I have never been asked to have a specific opinion or change my report in any way aside from fixing typos or clarifying a statement.

 

[TexasPhysician]

$250-750/hr. There is a wide range.

If I want an exceptional attorney, I’m paying $650/hr 2 years ago.

 

[Geraltofrivia]

Add to this, I've noticed several lawyers think along the lines of not if the issue at hand is right or wrong, but more if they could get away with it in terms of law. E.g. several institutions fight in a legal manner knowing the other person will give up. The big institution with a team of lawyers on retainer can keep this going on indefinitely while the little guy has to fight for every inch.

Trial lawyers often times are in a constant state of mentally fighting. Such a profession may have it's appeal for a young scrappy professional, but long-term it leads to issues such as substance abuse, broken relationships, etc. Getting to the point you work with a lawyer, you do say $15,000 of work for them and they decide not to pay you, don't expect their sense of right and wrong to dictate what's going on. More like, "hey I'm not going to pay the doctor, and I know if he takes legal action against me he knows he'll be spending 10x that much in legal fees and time devoted to suing me that he could've made up seeing patients so he'll give up." And from what I've seen several do give up.

Then add to this it's not like there's an online source for expert witnesses to know who the scumbag lawyers are that won't pay you. I'm being snarky but frank-I've seen online forums for rating providers of various illegal activities (e.g. Joe on 6th street, Internet phone # will get you quality activity, 4 out of 4 stars, with dozens of positive ratings), but no source of information to let me know if the lawyer I'm going to work with is going to pay me.

The only protection other than experience in working with local lawyers is in your contract have a retainer fee (an upfront fee) and a milestone written in where if you do not get paid via increments you will not continue to work. I have that written into my expert-witness contract and you may have to be a pain in the ass with that lawyer where you want the cordial relationship and remind them to pay you or no more work.

My last expert witness case, the defendant had to have all of his monetary transactions approved by a third party because he was inappropriately accused of having dementia, so payments were tied up for several days. Then add to this in the middle of the case he wanted a new lawyer, and I told the new lawyer I wouldn't restart working on the case until I got paid from the prior lawyer who delayed payment likely because of the third party and not due to bad intent.

It was the first time I suspected a lawyer was going to play hardball with paying me, and I did get paid, and it did turn out it was likely because the third party situation with no bad intent on anyone, but for weeks the issue was bugging the heck out of me. I had to make a declaration I was not going to do anymore work until I got paid. Also the new lawyer had to spend a lot of time and effort to figure out what was going on with why it was taking weeks to get me paid from the prior lawyer. I remember saying to myself, "yep it finally happened to me." Well I did get paid, but each case, unless I know the lawyer well, I get the suspicion the guy's going to screw me. Unfortunately I've seen colleagues screwed over with getting paid, and I've worked on several cases where I did get paid, but worked with the lawyer enough to see this lawyer was a total scumbag who was completely into doing anything, even if illegal and unethical so long as no one could prove it and he could get away with it.

One particular case in mind occurred where I was asked to work on the defense for a physician, and after I reviewed the case I told the lawyer there were several strong defenses because the physician he was defending didn't commit the problems in the case, and it was very much glaring the problems were caused by a specific other physician. The lawyer got mad, told me his partner was defending the other physician and that guy was a big money producer for them cause he always gets sued, and that I really screwed up on this cash-cow case cause now he can't work with me. Lawyers aren't supposed to compromise the defense of their client so that their partner's defenses for other clients could better work out, it violates their code of ethics, but here it was happening. Then the lawyer pointed out that in the future, if he works with me, it's better for him to lay out everything I'm supposed to say and I should just say yes and that I would get paid an extra special amount. Seriously this type of below the belt experience I've seen in expert witness work just under half the time.

I also did a rotation while a resident with a forensic psychiatrist who pretty much said anything the lawyer wanted to say even if it was completely inappropriate. Lo and behold while I'm a fellow I see this guy considered a high up guy in AAPL. I remember seeing him testify that if a doctor or nurse was physically assaulted, the patient shouldn't be held accountable even if it was clear that the patient knew what they were doing because "it comes with the territory," and that it would "violate" our professional ethics to seek legal action against the patient. WTF. And no one in my residency seemed to know or care this was how this guy operated. No one at AAPL ever saw this guy testify in person, no they just saw his AAPL articles (that I thought were weak but whatever).

This terrifies me

Edit: Make sure for ANY work you do for another state, you don't need a license for that state. If you're ever subpoenad, and you did literature review or whatever (chart review), you're "practicing without a license"

 

[AcronymAllergy]

Agreed with the above--if you can check with colleagues nearby to get a ballpark, that's probably the best option. At a minimum, you could just charge your regular clinical rate. But always get paid in advance, or at least have a sufficient retainer; although if you're working for a third-party company, this may be less of an issue. It isn't unheard of for attorneys/firms to "consult" with you on a case solely to get you conflicted out with opposing counsel; so if that happens, you at least want to be paid for your time. Relatedly, have a rate sheet that clearly spells out various stipulations, such as what you're paid if X or Y happens (e.g., late cancellations for appointments/depositions/trial testimony, etc.). Also, getting paid in advance may make it easier to explain that you're paid for your time, not for your opinion.

Also, generally speaking, bill for everything. Attorneys do it and expect it, but some may take advantage if the expert/consultant is shy about this. 15-minute phone call? Send an invoice. Reviewing a few records? Send an invoice. And if you're slated for deposition/testimony but haven't been paid, I'd be very hesitant to proceed with said deposition/testimony before having a check in hand.