Will anyone actually discuss salary? Let's see...

[Psychadelic2012]

I don't know her rent, true. However, there is no reception or billing staff involved, so I suspect it isn't quite so high as mine. Let's agree to disagree.

Well, it certainly helps to explain why you're so miserable. I would also complain incessantly (and, frankly, want to shoot myself) if I was convinced someone with a 200-hour certification had an equal or better salary and career trajectory. I mean that sincerely.

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[JeyRo]

You don't sound bitter; you sound realistic! Many of the ppl posting don't even have their PhDs yet. I have been on both side of the mental health spectrum -- for two years as a V.A. staff psychologist and now as a prescribing psychologist (MP). I can tell you that there is NO comparison between the lifestyle, income, stress level, etc. between prescribing and testing/psychotherapy. I would never go back to the former. My colleagues who have jumped ship state the same.

The writing is on the wall for psychologists, even in the government. While at the VA, we were going through training on Patient Centered Medical Homes. During the presentation, the trainers enumerated each field's contribution to the team. They delineated a physician, a RN, a NP, a dietitian, and a BEHAVIORAL HEALTH PROVIDER (not a psychologist) The government is now even starting to blur the line between PhDs and LCSWs and LPCs.

I'm sure the writing is on the wall but I've seen no evidence in my VA or nationally that there has been any movement (which has been feared for quite awhile) to replace psychologists with MFTs and LCSWs, which is what you're talking about here.

 

[PHD12]

Well, it certainly helps to explain why you're so miserable. I would also complain incessantly (and, frankly, want to shoot myself) if I was convinced someone with a 200-hour certification had an equal or better salary and career trajectory. I mean that sincerely.

There are plenty of high-risk and unappealing professions out there that get paid more than psychologists even though they don't require even a college degree, including firefighters (with overtime), some construction and electrician positions. People that I know with college degrees are all earning more than psychologists overall because they went into finance, technology or business. However, at the end of the day, there was something that made us go into this field despite all the hassles. I'm sure many of us could get into top JD or MBA programs, but there is a reason for why we did not go that path (for me the idea of sitting in front of a computer all day or redacting legal documents sounds horrible). We do very satisfying and interesting work, but often times this comes at a cost (lower salary and higher risk).

 

[pretzels]

I've spent a long time reading this entire thread. Its been very enlightening for a variety of reasons. I'm not even in grad school yet, waiting to hear from any of the eight programs ive applied to, but the more i read on this forum the more i understand what this field really looks like.
I was hoping someone from a forensic background could speak on this topic, explain their internship experience, postdoc / fellowship experience and where they ended up, what that kind of pay looks like, and how comparable it is to others in the forensic subfield of psychology.

I had heard here and there that some forensic psychologists make a comfortable living, but after having read so many stories and anecdotes of psychologists in clinical positions that actually make what i consider great money (after previously believing clinicians in this field were generally making less) i am now skeptical of what i've heard. To me, a good living would be 70k a year, i imagine i could be very comfortably on that in ten years. To hear of any psychologist making six figures would be a very luxurious existence in my mind and yet it sounds like its not uncommon?

So, returning to my point -- any input from a forensic psychologist on their experiences would be greatly appreciated as this field is my current goal. Had to cut this post short for RL, thanks in advance.

 

[fallen625]

There are plenty of high-risk and unappealing professions out there that get paid more than psychologists even though they don't require even a college degree, including firefighters (with overtime), some construction and electrician positions. People that I know with college degrees are all earning more than psychologists overall because they went into finance, technology or business. However, at the end of the day, there was something that made us go into this field despite all the hassles. I'm sure many of us could get into top JD or MBA programs, but there is a reason for why we did not go that path (for me the idea of sitting in front of a computer all day or redacting legal documents sounds horrible). We do very satisfying and interesting work, but often times this comes at a cost (lower salary and higher risk).

Thank you. This is the exact reason I am going into this field, even though threads like this one scare me. I left a six-figure job in finance because it required me to constantly be tied to a blackberry, to have to pull an all-nighter at least once every couple of weeks, and have no predictability over my schedule. Almost everyone who worked at my firm looked miserable (even the managing directors bringing in seven figures).

I know Psychology has a lot of hoops and issues too, particularly when it comes to salary (as compared to other graduate degrees) - but there are issues in every profession out there. I talk to my friends in all sorts of different profession and they have plenty of reasons to complain. I guess we just have to pick our poison.

 

[cara susanna]

I know a clinical psychologist with a forensic background who makes absolute bank doing custody evals. Not many other people in the state do them.

 

[Sanman]

Sorry I meant psychologist in Dr. E's situation. If you are only getting $35 per patient and see 20 patients per week, its pretty close to a low income job like a manicurist.

There is a lot of silliness in this comparison. First off, full-time for any clinician should be at least 30-40 pts/wk. That is $50-70k. Second, as has been pointed out, A nail tech is not taking home the entire $35. If she is a contractor, she has to pay a large percentage to the person that owns the salon to keep the lights on, overhead, etc. The manicurist might be making same percentage as Dr. E, which would mean $17.50/client.

I'm all for honesty, but I think that some of this is just getting to ridiculous. I don't know anyone licensed making $35k. I know several making $50-60k starting out licensed at their post-doc site, but nothing lower than that. I know several that make in the $70k range starting out. I am sure that there are those rare opportunities that are above that range starting, but I haven't sen them much.

 

[Doctor Eliza]

There is a lot of silliness in this comparison. First off, full-time for any clinician should be at least 30-40 pts/wk. That is $50-70k. Second, as has been pointed out, A nail tech is not taking home the entire $35. If she is a contractor, she has to pay a large percentage to the person that owns the salon to keep the lights on, overhead, etc. The manicurist might be making same percentage as Dr. E, which would mean $17.50/client.

I'm all for honesty, but I think that some of this is just getting to ridiculous. I don't know anyone licensed making $35k. I know several making $50-60k starting out licensed at their post-doc site, but nothing lower than that. I know several that make in the $70k range starting out. I am sure that there are those rare opportunities that are above that range starting, but I haven't sen them much.

I'm not saying I'm destitute. I make like $50K a year w/ no benefits. This is a thread where people are talking bluntly about income realities. I agree that none of my licensed friends who are able to see a full caseload are making $35K.

Many people feel like $50K is awesome and would be happy with that in exchange for a career they like. Some days I feel that way, some days I don't. (Today is a don't.) Prospective PhD's need to think about the trade offs involved in this and any profession. My husband's job is similarly compensated to mine but he has benefits and it didn't require grad school. But it is mind-numbingly boring. I know wouldn't have been happy with that. Similarly, my CPA, engineering, and law friends do really well, but that would be miserable for me. Psychology is my interest and talent.

It is up to everyone to decide for him or herself, It is important to make an informed decision. I'm glad people are reading.

Best,
Dr. E

 

[Pragma]

Thank you. This is the exact reason I am going into this field, even though threads like this one scare me. I left a six-figure job in finance because it required me to constantly be tied to a blackberry, to have to pull an all-nighter at least once every couple of weeks, and have no predictability over my schedule.

To be fair, that sounds a little bit like what graduate school was like

 

[Sanman]

I'm not saying I'm destitute. I make like $50K a year w/ no benefits. This is a thread where people are talking bluntly about income realities. I agree that none of my licensed friends who are able to see a full caseload are making $35K.

Many people feel like $50K is awesome and would be happy with that in exchange for a career they like. Some days I feel that way, some days I don't. (Today is a don't.) Prospective PhD's need to think about the trade offs involved in this and any profession. My husband's job is similarly compensated to mine but he has benefits and it didn't require grad school. But it is mind-numbingly boring. I know wouldn't have been happy with that. Similarly, my CPA, engineering, and law friends do really well, but that would be miserable for me. Psychology is my interest and talent.

It is up to everyone to decide for him or herself, It is important to make an informed decision. I'm glad people are reading.

Best,
Dr. E

Not saying that you said so, but PHD12 was taking it a little. In fact, the only full-time 35k position I have ever seen was an academic appointment at a small college. Personally, I think that your position might be one of the worst out there. Frankly, I know others making your salary, but they get benefits and summers off (schools and college counseling centers). Early career private practice is not great (I'm there too and make similar money, but I am transitioning and picking up more clients at my other job) and I would not suggest attempting full time PP unless you are in-network on higher paying insurance networks. Are you paneled anywhere Dr.E? Do you get increased pay for pts with higher reimbursement? For PP, being paneled matters more than a license as that is what will bring you the clientele. Most of the new psychologists I work with saw a large increase in their volume once they got on their first insurance panel.

 

[Doctor Eliza]

Not saying that you said so, but PHD12 was taking it a little. In fact, the only full-time 35k position I have ever seen was an academic appointment at a small college. Personally, I think that your position might be one of the worst out there. Frankly, I know others making your salary, but they get benefits and summers off (schools and college counseling centers). Early career private practice is not great (I'm there too and make similar money, but I am transitioning and picking up more clients at my other job) and I would not suggest attempting full time PP unless you are in-network on higher paying insurance networks. Are you paneled anywhere Dr.E? Do you get increased pay for pts with higher reimbursement? For PP, being paneled matters more than a license as that is what will bring you the clientele. Most of the new psychologists I work with saw a large increase in their volume once they got on their first insurance panel.

I'm actually on most panels that are popular locally and most of them I can "take with me" when I leave (not all though because some I'm on due to my affiliation with the practice). I do get more for insurances that pay more (50-50 split) but most are around $70 (sadly, some pay less). There is also variation in what insurances pay in different cities. My friend 4hrs away gets significantly more (like $20) from one insurance that we both take.

I think I'm also down on PP a lot today because my state list serve has been blowing up about how we are all being (more) screwed over by insurances since Jan 1st. Many have reduced their rates by a few bucks and are giving additional hassles about paying psychologists money they are due. There are a lot of really angry and frustrated PP psychologists out there at all levels.

Best,
Dr. E

 

[PHD12]

I know a clinical psychologist with a forensic background who makes absolute bank doing custody evals. Not many other people in the state do them.

+1 there is a lot of money in child custody evaluations, but you have to be very thick skinned to be in this type of specialty. The psychology boards tend to get frequent complaints about psychologists who do child custody evaluations. I've met a couple of people that do this type of work over the years and they've said that its a very stressful, high conflict job that requires long hours (although you are well-compensated). One psychologist I met does about 40 of these per year and easily pulls in 200K (all out of pocket, no insurance).

 

[Sanman]

I'm actually on most panels that are popular locally and most of them I can "take with me" when I leave (not all though because some I'm on due to my affiliation with the practice). I do get more for insurances that pay more (50-50 split) but most are around $70 (sadly, some pay less). There is also variation in what insurances pay in different cities. My friend 4hrs away gets significantly more (like $20) from one insurance that we both take.

I think I'm also down on PP a lot today because my state list serve has been blowing up about how we are all being (more) screwed over by insurances since Jan 1st. Many have reduced their rates by a few bucks and are giving additional hassles about paying psychologists money they are due. There are a lot of really angry and frustrated PP psychologists out there at all levels.

Best,
Dr. E

Part of this is really getting the majority of your clientele from the higher paying panels and the then filling in a few slots with cash clients. I know my supervisor only takes his cases from those two methods and is filled (not including the money he makes for managing the practice and supervising two of us).

As of now, I am actually making several dollars more for a 90837 and pretty much the same for a 90834 as the previous 90806/90818 (medicare). All this is going to do is make people bill more 90837 codes. I haven't seen how all the panels reacted yet.

 

[Doctor Eliza]

Part of this is really getting the majority of your clientele from the higher paying panels and the then filling in a few slots with cash clients. I know my supervisor only takes his cases from those two methods and is filled (not including the money he makes for managing the practice and supervising two of us).

As of now, I am actually making several dollars more for a 90837 and pretty much the same for a 90834 as the previous 90806/90818 (medicare). All this is going to do is make people bill more 90837 codes. I haven't seen how all the panels reacted yet.

90837 is a huge source of angst on the list serve. One major insurer requires pre-auth for use of the 60 minute code (although apparently it takes a 45 min call and is usually denied). Many therapists did not read carefully and billed a bunch of these and so they were all denied. Some companies do let you get away with it though.

Someone on the list started talking about how maybe we should make a standard session 40 minutes then. This falls within the bounds of the 45 minute code and would allow us to squeeze in an extra client per day. I couldn't see myself doing that, but I see what he was saying.

Best,
Dr. E

 

[Sanman]

90837 is a huge source of angst on the list serve. One major insurer requires pre-auth for use of the 60 minute code (although apparently it takes a 45 min call and is usually denied). Many therapists did not read carefully and billed a bunch of these and so they were all denied. Some companies do let you get away with it though.

Someone on the list started talking about how maybe we should make a standard session 40 minutes then. This falls within the bounds of the 45 minute code and would allow us to squeeze in an extra client per day. I couldn't see myself doing that, but I see what he was saying.

Best,
Dr. E

I believe the low end is 38 min for a 90834 and now 16 min for a 90832. Believe me when I say that my company lets us know that. I don't believe medicare requires any pre-authorization for a 90837 the way they did a 90808/90821. There are many things I have seen people do from cutting down the session time to writing the session note during session with the pt there. It is the only way to get the volume without being there forever.

 

[Pragma]

Discussions like this make me happy not to be a therapist. The conversation about stopping at 38 minutes would be awful.

I feel for you Dr. E. I just hope that alternatives will become available. I know that there is only so long you can remain unhappy with a work situation before some kind of a change becomes more and more attractive.

 

[futureapppsy2]

psyccream and Pragma,

I'd be really interested in hearing about your experiences with R2's, as an R2 professorship my "target job" at the moment, for lack of a better phrase. I'd be particularly interested in hearing how they weigh teaching experience versus publications in the hiring process. Thanks!

Re: child custody evals

From what I've heard, it's in demand and thus can be lucrative, but it's also emotionally exhausting, requires specialized clinical tact, and stressful can be incredibly (up to the point of receiving homicidal threats). FWIW.

 

[AcronymAllergy]

90837 is a huge source of angst on the list serve. One major insurer requires pre-auth for use of the 60 minute code (although apparently it takes a 45 min call and is usually denied). Many therapists did not read carefully and billed a bunch of these and so they were all denied. Some companies do let you get away with it though.

Someone on the list started talking about how maybe we should make a standard session 40 minutes then. This falls within the bounds of the 45 minute code and would allow us to squeeze in an extra client per day. I couldn't see myself doing that, but I see what he was saying.

Best,
Dr. E

I don't work with anyone who bills directly (thank you, VA...), but this is what I've heard re: 90837 as well. It seems that when it first showed up, some people thought it was great, given that it pays more than the former 90806. However, I'm now hearing people starting to say that it's requiring pre-auth, and that the pre-auth generally never goes through. Thus, as Dr. E mentioned, there's thinking that 40 minutes could potentially now become the new 50 minutes.

Not sure why we (i.e., psychologists) didn't raise more of a stink about this as it was happening.

 

[Doctor Eliza]

I don't work with anyone who bills directly (thank you, VA...), but this is what I've heard re: 90837 as well. It seems that when it first showed up, some people thought it was great, given that it pays more than the former 90806. However, I'm now hearing people starting to say that it's requiring pre-auth, and that the pre-auth generally never goes through. Thus, as Dr. E mentioned, there's thinking that 40 minutes could potentially now become the new 50 minutes.

Not sure why we (i.e., psychologists) didn't raise more of a stink about this as it was happening.

As we often say around here, we are notoriously bad at advocating for ourselves. Another issue that often comes up is the issue of "anti-trust" laws. While I don't know much about this, I do know that people get their hands slapped when they mention things on the list serve about exact reimbursement from companies or insinuating that we should all drop a particular insurer. These laws also prevent state assns and APA from advocating for us about rates. (Our assn will fight for us when insurers are cheating us by not fulfilling the contract we signed with them by not paying us, though.) That said, people have noted that the AMA some how has found ways to prevent things like this from happening to their people.

At this point, all we can do is decide as individual psychologists to drop insurers who don't reimburse enough. Sometimes that is feasible and sometimes it is not. I will note that it is also very hard to stop taking an insurance when it means that you will no longer be able to see certain on-going clients (another example of how best business practice is often opposed to compassion and why I will never be rich.)

Best,
Dr. E

 

[Pragma]

psyccream and Pragma,

I'd be really interested in hearing about your experiences with R2's, as an R2 professorship my "target job" at the moment, for lack of a better phrase. I'd be particularly interested in hearing how they weigh teaching experience versus publications in the hiring process. Thanks! .

Well most R2s will want to see evidence of experience and potential in both areas, although it may lean more in one direction depending on the place. I think a rule of thumb is that they usually want to see strong research aspirations because those institutions often want to increase their funding footprint. My Uni was kind of like that and brought me in because I had a strong publication record and research goals that fit really well with the overall University and Department orientation.

That said, these schools sometimes are looking for specific expertise for teaching and mentoring as well. They might want someone who can teach a high level stats course or who fills some other type of need (e.g., assessment expertise).

Overall it is about how you fit and you want to demonstrate strength in both areas. The psychology job wiki is a really good resource for information about academic jobs in the field too.

 

[CriminalPsych]

I've spent a long time reading this entire thread. Its been very enlightening for a variety of reasons. I'm not even in grad school yet, waiting to hear from any of the eight programs ive applied to, but the more i read on this forum the more i understand what this field really looks like.
I was hoping someone from a forensic background could speak on this topic, explain their internship experience, postdoc / fellowship experience and where they ended up, what that kind of pay looks like, and how comparable it is to others in the forensic subfield of psychology.

I had heard here and there that some forensic psychologists make a comfortable living, but after having read so many stories and anecdotes of psychologists in clinical positions that actually make what i consider great money (after previously believing clinicians in this field were generally making less) i am now skeptical of what i've heard. To me, a good living would be 70k a year, i imagine i could be very comfortably on that in ten years. To hear of any psychologist making six figures would be a very luxurious existence in my mind and yet it sounds like its not uncommon?

So, returning to my point -- any input from a forensic psychologist on their experiences would be greatly appreciated as this field is my current goal. Had to cut this post short for RL, thanks in advance.

Here's a nice little link with that info:

http://www.clinicalforensicpsychology.org/what-is-a-typical-forensic-psychology-salary/

 

[roubs]

I'll post mine up, just because it's such an anomaly.

My net pay for next year should be just north of: $105,000.00, I am currently 4 months post internship. I am working in Guam (cost of living is high) and assumes that I will be licensed this year.

I'm curious, is cost of living higher than Hawaii?

 

[futurepsych0]

I have to say as someone who is planning on getting into a PhD programs next year this thread is priceless. I also think it does a decent job encapsulating the state of psychology. We have individuals like markp and therapist4change enjoying six figure salaries while Dr. E is making 50k. I think it's valuable to show aspiring psychologist the uncertainty within this field. Although I would say both example may be outliers having the majority of psychologist making somewhere in the middle 75k-85k? Personally I would like to thank individuals like Dr. E for their realism on the field. I have to admit when I first started college I thought being a psychologist would mean 100k+ salary and prestige (after all I would be a doctor!), but now that I have a bachelors and really looked into the field I see everything isn't sunshine rainbows and puppies. I know it has been said already in this thread but students should really pay attention to these issues. I would also like to say Dr.E I am sorry to hear about your situation (both medically and professionally) and I wish you the best.

 

[Therapist4Chnge]

I have to admit when I first started college I thought being a psychologist would mean 100k+ salary and prestige (after all I would be a doctor!), but now that I have a bachelors and really looked into the field I see everything isn't sunshine rainbows and puppies.

I think the prestige can still be there, but it isn't bestowed just because you completed doctoral training. I think people more familiar with the training requirements can better appreciate the amount of effort required to become a psychologist. Unfortunately psychology has done a pretty poor job of educating the public about the breadth of what we do and the level of education/training required to become a psychologist. Joe & Jane Public view psychologists as Dr. Frazier Crane or their somewhat awkward Intro to Psych professor who gave them extra credit to fill out a survey for someone's dissertation study.

Our state and national leadership really need to do more in this area, but individual clinicians can also chip in during their day to day work. I typically spend a few minutes in the beginning of every intake/consult explaining what I do and how it will contribute to the patient's care. As a neuropsychologist/rehabilitation psychologist I sometimes run into patients who know a bit about the assessment work because of taking an aging parent to be evaluated for Alzheimer's or having their child tested for ADHD, but for the most part it is all new information. Everyone should have a 2-minute 'elevator speech' that explains who they are and what they do, as many patients do not actually know their providers (outside of their PCP and sometimes the main specialist for their primary Dx.) Answering "how are you different than social work/counseling/etc. is a more confusing talk, but every clinicians needs to know how to explain it succinctly.

 

[Pragma]

everything isn't sunshine rainbows and puppies.

No gumdrops either

 

[PHD12]

Thank you. This is the exact reason I am going into this field, even though threads like this one scare me. I left a six-figure job in finance because it required me to constantly be tied to a blackberry, to have to pull an all-nighter at least once every couple of weeks, and have no predictability over my schedule. Almost everyone who worked at my firm looked miserable (even the managing directors bringing in seven figures).

Most clinical psychology doctoral students work 60+ hours per week, including weekends. Many of us were overwhelmed and exhausted throughout graduate school (I'm hoping it gets better afterwards). My friends in finance did not work more hours than I did and sometimes had more autonomy (unless they are doing the hard core investment banking). There is also a myth out there that this field is good for "work-life balance." Psychologists have little autonomy in the majority of clinical positions at hospitals (some VA's may be an exception to this). In many cases, you do not control your schedule and have to demonstrate that 80% or so of your schedule is booked with patients. In my state, psychologists working at hospitals frequently have over 150 cases (don't see patients weekly obviously). This sounds like one of the most stressful jobs out there. I am also seeing more positions that require psychologists to be on call, including at counseling centers. In PP, you are also technically "on call" 24/7 if there is an emergency or crisis situation. Don't go into this field because you think its easier or less stressful than finance or law.

 

[fallen625]

Most clinical psychology doctoral students work 60+ hours per week, including weekends. Many of us were overwhelmed and exhausted throughout graduate school (I'm hoping it gets better afterwards). My friends in finance did not work more hours than I did and sometimes had more autonomy (unless they are doing the hard core investment banking). There is also a myth out there that this field is good for "work-life balance." Psychologists have little autonomy in the majority of clinical positions at hospitals (some VA's may be an exception to this). In many cases, you do not control your schedule and have to demonstrate that 80% or so of your schedule is booked with patients. In my state, psychologists working at hospitals frequently have over 150 cases (don't see patients weekly obviously). This sounds like one of the most stressful jobs out there. I am also seeing more positions that require psychologists to be on call, including at counseling centers. In PP, you are also technically "on call" 24/7 if there is an emergency or crisis situation. Don't go into this field because you think its easier or less stressful than finance or law.

Yup - I was doing investment banking. I have a couple friends in Clinical PhD programs, and although they worked hard, I envied their lifestyle. I cannot explain how hard investment bankers work. During my internship I had to keep timesheets (I was paid hourly) and I averaged 110 hours a week. The corporate lawyers we worked with didn't have it much better. The hours do not get better until you reach director level, usually after an MBA and well into your 30s. This is where the money is in finance.The finance jobs that are not "as intense" as banking don't often get to six figures.

I guess my point to this is that the jobs that people often talk about in these boards (finance, law) are not an easy way to make six figures. I am not saying that psychology is "easier" - all I am saying is that although it has its fair share of trouble, so do other professions. I would hate for someone who really wants to do psychology to go into what they think is an easier/more lucrative field (people often mention business and law here) because of it. It is good to be aware of it for sure, but for some people psychology might still make sense despite of all the negatives (for me, at least, research never felt like work in the same way that finance did - I would miserable being in front of excel for 18+ hours a day for the next 20 years of my life ) It seems to me that everyone has plenty to complain about when it comes to their job / career, regardless of the profession.

 

[psycecream]

Thanks for the update. I guess it is higher in the bay area to adjust for cost of living. Its not a bad deal if you don't mind providing group therapy, psychoeducation, and crisis management (since you can't see patients often). However, with 7-9 intakes per week, your case load is growing exponentially. Its not like you are discharging that number of patients per week. Theoretically, you can build to 350 cases after 1 year, although you are probably not seeing most of them. Sounds pretty stressful, although at least they do compensate well.

It is very true that your caseload gets large. One other thing to consider is that you aren't "managing a caseload" in the same sense that you are responsible for your patients like you would be in any other setting (CMH, UCC, etc). They are basically patients of "the system" and so are supported through groups, emergency room, MDs, nurses, and a chain of hospitals. But yes I was unhappy with seeing patients only once every few weeks and that is part of the reason why the big paycheck was not worth it to me.

I agree with others in the thread who are making the point for undergrads and others just learning about the field: 100k or more out of grad school is very rare and if you expect to waltz into that, you will probably drink from the bitter black dregs of anger and disappointment.

 

[Pragma]

100k or more out of grad school is very rare and if you expect to waltz into that, you will probably drink from the bitter black dregs of anger and disappointment.

Very nice touch

 

[coloradocutter]

Second that fallen 625 - i left corporate law to get a PhD. i saved money while practicing law and then chose my program based on finding a major professor/mentor who appreciated my background and was very senior and did not need a research minion. I found that and have been very happy. Nothing I have done in a PhD program comes close to what I did practicing law. A good week for me was 80 hours, a bad one was a 100. I pulled all nighters a few times a month, and probably 5 times a year I had to travel somewhere for a huge deal/case for a week or more that would result in even more intense hours.

however, i do think that my happiness is based on that comparison. i derive a unique personal satisfaction from what i do. it is intellectually gratifying like law, but more so, and then i actually have meaningful interactions with people on a regular basis and get to see change. it's pretty amazing.

people tell me that i will never make as much money as i did in law, but i really don't subscribe to people's limitations like that. if CEOs knew what psychologists could do, they would pay them so they wouldn't need to pay or deal with lawyers. i believe people that love what they do are in a unique position to surprise everyone and be paid very well for something that they love. my major professor has his hands in about 5 different pots, and he probably makes around $300k. it took him 30 years, but he started making $100k in his early 30s and that was not from being a tenured professor! he doesn't even think about the money and puts much of it back into the community that he loves...

 

[Sanman]

As we often say around here, we are notoriously bad at advocating for ourselves. Another issue that often comes up is the issue of "anti-trust" laws. While I don't know much about this, I do know that people get their hands slapped when they mention things on the list serve about exact reimbursement from companies or insinuating that we should all drop a particular insurer. These laws also prevent state assns and APA from advocating for us about rates. (Our assn will fight for us when insurers are cheating us by not fulfilling the contract we signed with them by not paying us, though.) That said, people have noted that the AMA some how has found ways to prevent things like this from happening to their people.

At this point, all we can do is decide as individual psychologists to drop insurers who don't reimburse enough. Sometimes that is feasible and sometimes it is not. I will note that it is also very hard to stop taking an insurance when it means that you will no longer be able to see certain on-going clients (another example of how best business practice is often opposed to compassion and why I will never be rich.)

Best,
Dr. E

Well, balancing business and ethics is definitely something that needs to be decided by each clinician. Now, the question becomes how to best advocate for the profession. I have heard Dr. Antonio Puente speak about this and one of the issues that comes up is that clinical psychology is part of the healthcare/medical model (billing wise) and the result of that many of those that decide on new codes are not psychologists and used to a procedure centered model rather than a time centered one. I think much like what many physicians complain about today, the issue is not simply about cuts, but rather how these changes affect traditional models of psychotherapy. Being an outpt therapist might hurt with the new codes. However, billing at the nursing home, hospital, or inpt unit means that I can bill for as little as 16 min (90832) if I have to stop by for a quick visit to clam a pt down, check in on how an existing behavioral plan is going or 15 min for a health and behavior code (check-in on pts relaxation exercise, etc). This means that I can see up to 3 pts an hr for brief check-ins in addition to longer sessions and allows me to bill for things that used to be non-billable. Which is fine for me as not everyone needs a full session to have their issue resolved. So, some gain and others lose from these changes. There is money to be made, it is simply a question of whether your ethics/professional opinion agree or disagree with that and whether your position allows you to benefit from these changes.

 

[pearible]

I know a clinical psychologist with a forensic background who makes absolute bank doing custody evals. Not many other people in the state do them.

There's a reason not many people do them - they almost always get real ugly, real fast. I have a friend who does them in our county, and she told me Psychologists who make custody evals a part of their regular practice have the highest rates of malpractice lawsuits.

 

[Doctor Eliza]

I previously mentioned the anti-trust laws as one issue that limits psychologists ability to advocate for themselves with insurance companies (certainly something that is not mentioned in grad school!) This has recently come up among psychologists on our state list serve because people have been having HUGE problems being properly reimbursed after the CPT switch. And there is a lot of discontent about many insurers reducing our rates along with the switch. Many of us are wondering how much we can legally discuss our situation.

Anyway, if you are interested, the following APA document explains a little about how and why psychologists have some real limitations on their ability to band together to try to institute change:

http://www.apapracticecentral.org/reimbursement/maximize/antitrust-faq.pdf

Best,
Dr. E

P.S. I will add that many of the posts on the list serve make me look like Mary Sunshine. There are many unhappy folks in PP out there.

 

[Pragma]

P.S. I will add that many of the posts on the list serve make me look like Mary Sunshine. There are many unhappy folks in PP out there.

I got off of email listservs for that reason. The npsych list got really obnoxious after awhile so I ditched that awhile ago. Bunch of Debbie Downers and felt like high school.

 

[Doctor Eliza]

I got off of email listservs for that reason. The npsych list got really obnoxious after awhile so I ditched that awhile ago. Bunch of Debbie Downers and felt like high school.

Actually, I am a huge fan of this particular list serve. I have learned a lot about the day to day practice of running a business. And it is a great way to figure out resources and referrals.

However, I wish people would learn the difference between "reply" and "reply all."

Dr. E

 

[PsychevalIII]

I work incredibly hard and long hours. I do about 300 evaluations a year at an average of about $ 1,000 an evaluation. I almost do no therapy anymore. As I have mentioned in previous posts, I have several clinicians in my office who generate passive income which is essential to my business model. Psychology and private practice have been good to me.

 

[PHD12]

I work incredibly hard and long hours. I do about 300 evaluations a year at an average of about $ 1,000 an evaluation. I almost do no therapy anymore. As I have mentioned in previous posts, I have several clinicians in my office who generate passive income which is essential to my business model. Psychology and private practice have been good to me.

Thanks for your post. I'm curious how you do 300 evaluations per year while also producing a high-quality product? How many hours per week do you work? I was unsure if you do 300 yourself or does that include your entire staff. All the evaluations that I've done require several hours of testing, collateral information, review of records, and integrating results from multiple tests. It doesn't seem physically feasible to do this many evaluations on your own in one year. Am I missing something?

Also, what is the average salary for clinicians who work in your office? What percentage cut are you taking?

 

[PsychevalIII]

I do the evaluations myself. Something like 6 to 7 evaluations a week, which doesn't seem like that much to me. I know a forensic guy who probably does 15 + evaluations a week and makes 700 to 1 million a year which is crazy. I wrote about him in some past post. But anyway, to keep a high quality product I don't do 400 a year even though I have the business. I know my limits. I think the more you do anything the better and faster you become. Clinical work and report writing is about 65 hours a week average these days.

 

[PHD12]

I do the evaluations myself. Something like 6 to 7 evaluations a week, which doesn't seem like that much to me. I know a forensic guy who probably does 15 + evaluations a week and makes 700 to 1 million a year which is crazy. I wrote about him in some past post. But anyway, to keep a high quality product I don't do 400 a year even though I have the business. I know my limits. I think the more you do anything the better and faster you become. Clinical work and report writing is about 65 hours a week average these days.

Thanks. When you started out, how did you generate referral sources? How did you form those connections and sell your expertise when you were early in your career?

 

[PsychevalIII]

Last year I made this post essentially describing what I did.

I went to a public school, APA approved, received good training, got licensed, paid my dues for 2-3 years, worked very, very hard, went into private practice, got busy, hired another, then another, then another, and another, blaw, blaw, etc. Now, I'm finally not classified as early career, but am looking at early retirement in the next 5 to 8 years. Dream big, then implement.

I have seven additional clinicians in my group. 5 therapists and 2 nurse practitioners.

To answer your question, I joined rotary and the chamber of commerce, I met with pediatricians, family doctors, dentists, OB/GYN's, lawyers, probation officers, etc. I did presentations on my services offered with job core, vocational rehab, adult protective services, child protective services, the police department, fire department, and major companies in my area. I also set up meetings with "the competition" which was essentially other mental health care providers, i.e. nurse practitioners, psychiatrists, other psychologists, and counselors. I learned about the types of patients they work well with and when to refer to them, and they learned about my practice and what I had to offer. Another thing I did is obtained a release to communicate with a patient's primray care provider and have been good about providing integrative and collaborative care. Its the standard of care, and it generates lots of business and referals from docs who had previously never heard of me.

Advertising:

My company is in the phone book in multiple locations, a 52 weeks add in the news paper, and a web site. I am looking to buy a billboard (not rent one) and then put up my companies advertisement maybe 3 to 4 months of year, then rent out the billboard space the other 8 to 9 monhts a year. I'm never without 30 to 50 business cards in my pocket and am always ready for my 30 second elevator pitch. I really love what I do and feel like I was made for this job.

 

[erg923]

What would you say to folks who do not want to, or literally cannot, work 65-70 hours weeks though?

I'm curious how you have balanced family obligations (if you have any) with that non-stop schedule? I have a wife who would not support such a schedule, and even if she did, I value family dinners, being active in my church, and quality time with my child in the evenings......and college basketball and fishing.

 

[Member6523]

What would you say to folks who do not want to, or literally cannot, work 65-70 hours weeks though?

I'm curious how you have balanced family obligations (if you have any) with that non-stop schedule? I have a wife who would not support such a schedule, and even if she did, I value family dinners, being active in my church, and quality time with my child in the evenings......and college basketball and fishing.

One of my neuro supervisors works 36-37 hours per week (he takes half days) and clears over $300k a year. He's private practice neuropsychology for upper class people and does forensic practice as well, but hey, someone's gotta do it.

 

[PsychevalIII]

Everything comes at a price, working less, working more, etc. I sometimes have that song by the eagles Take it to the Limit stuck in my head where it says, "you can spend all your time making money..." I think everyone is different, people's health status, people's energy level, etc. Luckily, I have been healthy and have a personal tempo that is a bit higher than most. My girlfriend is a bit younger and keeps up with me without me driving her nuts. I enjoy my personal life, and have been skiing 5 times this ski season, go to the gym twice a week, and vacation out of the country twice a year. So I try to have some balance, but have missed out on some things for sure. I have this great cartoon in my office that shows a kid in a baseball uniform and his dad on the way out the door. It says, "I won't be able to attend your final game. I'm giving a speech on family values." This is a reminder for me to keep things in check!

 

[PHD12]

One of my neuro supervisors works 36-37 hours per week (he takes half days) and clears over $300k a year. He's private practice neuropsychology for upper class people and does forensic practice as well, but hey, someone's gotta do it.

Posts like these perpetuate myths in the field about salary in psychology and how easy it is to make money. Just to be clear....anyone making over 150K in our field is in the top 5-10% of income earners. 300K and you looking at less than 1% of psychologists. I'm not saying its not possible, but not everyone can be in the top 1% or even top 10%. It doesn't really seem possible to clear 300K if you are working less than 40 hours per week...perhaps you are have some misinformation there.

ACCORDING TO SALARY SURVEYS (APA), IF YOU EARN 100K OR MORE IN THIS FIELD YOU ARE IN THE TOP 10-25% OF DOCTORAL LEVEL PSYCHOLOGISTS (this depends on the number of years of experience you have). The median salary in our field is between 65-85K.

 

[erg923]

Everything comes at a price, working less, working more, etc. I sometimes have that song by the eagles Take it to the Limit stuck in my head where it says, "you can spend all your time making money..." I think everyone is different, people's health status, people's energy level, etc. Luckily, I have been healthy and have a personal tempo that is a bit higher than most. My girlfriend is a bit younger and keeps up with me without me driving her nuts. I enjoy my personal life, and have been skiing 5 times this ski season, go to the gym twice a week, and vacation out of the country twice a year. So I try to have some balance, but have missed out on some things for sure. I have this great cartoon in my office that shows a kid in a baseball uniform and his dad on the way out the door. It says, "I won't be able to attend your final game. I'm giving a speech on family values." This is a reminder for me to keep things in check!

Interesting. That is likely the difference between myself and the uber financially successful folks. I don't do anything fast and am probably not viewed as high energy by many people. Fishing and golf are my favorite hobbies for goodness sake. Skiing sounds cold and tiring. My wife and I are foodies. I like to stay in on fridays nights and drink bourbon. If given the choice between making money and doing an assessment on Saturday or havin some beers and watchin the game with my wife and friends, I will choose the former every time. Darn...

Maybe I am the SLAC professor type after-all (wasn't my original plan). I am still struggling with sticking with this faculty thing.

 

[Member6523]

Posts like these perpetuate myths in the field about salary in psychology and how easy it is to make money. Just to be clear....anyone making over 150K in our field is in the top 5-10% of income earners. 300K and you looking at less than 1% of psychologists. I'm not saying its not possible, but not everyone can be in the top 1% or even top 10%. It doesn't really seem possible to clear 300K if you are working less than 40 hours per week...perhaps you are have some misinformation there.

ACCORDING TO SALARY SURVEYS (APA), IF YOU EARN 100K OR MORE IN THIS FIELD YOU ARE IN THE TOP 10-25% OF DOCTORAL LEVEL PSYCHOLOGISTS (this depends on the number of years of experience you have). The median salary in our field is between 65-85K.

Forensic work and neuropsychological evaluations of the 1 percenters...it's not that far fetched. He is among the top 5% but trust me when I say I'm right.

 

[Therapist4Chnge]

Forensic work and neuropsychological evaluations of the 1 percenters...it's not that far fetched. He is among the top 5% but trust me when I say I'm right.

Yes...that kind of money is possible, but how probable for the average psychologist? Forensic psychologist? Neuropsychologist? It is pretty far fetched when you consider the bell curve of pay in the field. The curve shifts to the right for certain specialties, but most clinicians won't be from those specialties.

The reimbursement rates are going down (again), insurance companies are finding more ways to screw individual providers, and then there are the looming ACO related problems on the horizon. Most students think they will be the exception, but they won't be the exception.

I hope my #'s are consistently in the top 1%-5% of earners, but that assumes quite a few things going right: low no-show rate, high collection rate of billable $'s, some higher $ forensic work to make up for getting stiffed by the insurance billing, etc. To generate a $150k in earnings (pre-tax), billables will have to be around $225k/yr., assuming total overhead is kept at or under 30%. The cost of a psychometrician, billing company, and office space quickly chip away at that 30% figure. Taking 4 wks of vacation/non-billing, a practice needs to collect $4700/wk.

Earning $300k/yr is doable for high rate cash pay practices w. additional passive $'s (taking a cut of multiple providers), but that is truly rarified air in today's world of practice. These numbers assume a HIGH level of productivity, which really can suck any and all fun out of the work.

 

[Psychadelic2012]

If given the choice between making money and doing an assessment on Saturday or havin some beers and watchin the game with my wife and friends, I will choose the former every time. Darn...
.

You mean the latter, right?

 

[JeyRo]

It's about choices. I choose leisure time and time with my kids (having kids, period) and my measly 109K per year on a barely 40 hour per week workweek, vs. 300K-plus and 70-80 hour workweeks.

Sure, I could get an early retirement that way but I'd miss out on far too much. My kids are young.

If I had no kids and a young, understanding girlfriend I might try and go for making the big bucks too. It sounds like potentially a fun way to spend ones time, actually. Entrepreneurship can be very rewarding.

 

[Sanman]

It's about choices. I choose leisure time and time with my kids (having kids, period) and my measly 109K per year on a barely 40 hour per week workweek, vs. 300K-plus and 70-80 hour workweeks.

Sure, I could get an early retirement that way but I'd miss out on far too much. My kids are young.

If I had no kids and a young, understanding girlfriend I might try and go for making the big bucks too. It sounds like potentially a fun way to spend ones time, actually. Entrepreneurship can be very rewarding.

I'd take the 109k and 40 hrs as well. I won't exactly be crying myself to sleep. Especially, since my SO pulls in good money as well. I really don't view 100k at that hard to make. Many of the better salary positions make that. I agree that 150k+ is tough and requires good business sense. The other issue becomes what one considers quality work/treatment. Working with medicaid/medicare pts outside out an academically funded institution shows how low the bar really is. God knows, almost no one gets truly quality treatment. It is simply managing pts within a system. Luckily, I seem to have a talent for jugglig pts//responsibilities and crisis management.