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Yes. good catch.
Will anyone actually discuss salary? Let's see...
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A-yup. I am hoping to keep a comfortable 40-45hr/wk at work, and use my spare time for non-psych entrepreneurial pursuits. I think a lot of people get caught up trying to "beat the house" within the current system (e.g. spend their extra time trying to squeeze a few more $'s here and there to increase their income). I'd rather change the battlefield, tweak the rules in my favor, and try and land larger $'s for similar effort.
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Exactly!
I'm not saying I'm disinterested in striking out on my own, of course - I've always thought about it. When I bring it up with my wife she always tells me to basically start trying to scare up some Medicare business (I'm in geriatrics). As you imply above, I consider it a suckers game as well.
I'm holding back for now and researching how I could avoid all of that and go for the (rare, but out there) private pay $.
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I really enjoy the work, so I'll probably always do some portion of clinical work, but I don't want to be reliant on seeing at least x-number of pts to squeak out a living. I also really enjoy research, so that needs to fit in there somewhere too. 
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I would be thrilled with 100K working 40 hours per week. If it was so easy to make 100K in our field then the median wouldn't be so much lower than this. I don't know anyone early career who is making 100K (I know there are a few on the listserve but Mark is in the military). When I've looked at psychologist positions at hospitals, clinics, and a few counseling centers, the starting salary is more like 45-60K for licensed positions and maxes out around 90-100K (probably after 20+ years). The VA pays the highest in my location, but good luck finding an opening at the VA out here (its like getting a tenure track position in a desirable location).
I know someone who owns a large group therapy/testing practice ( 30 years of experience) and he is pulling in big bucks. Clinicians see 10 patients per day and provide very low quality treatment. I had a friend who worked here. They cut corners all the time and basically copy and paste from all their previous testing reports to keep up with the volume. I'm sure tons of unethical stuff is going on in some of these practices that are pulling in big $$$. I also know that they will stop treatment immediately as soon as the insurance denies further sessions.
Another interesting thing to me is that female psychologists are earning a significantly lower salary than male psychologists (for FT positions). I've noticed that within my network and also on this listserve. All the psychologists here who are earning 100K salaries are male not female. Dr. E meanwhile is earning half of this salary, and her salary is somewhat in the range of what I've seen with other early career female psychologists (50-70K is common despite FT work). Are there any female psychologists out there earning six figures?
I know someone who owns a large group therapy/testing practice ( 30 years of experience) and he is pulling in big bucks. Clinicians see 10 patients per day and provide very low quality treatment. I had a friend who worked here. They cut corners all the time and basically copy and paste from all their previous testing reports to keep up with the volume. I'm sure tons of unethical stuff is going on in some of these practices that are pulling in big $$$. I also know that they will stop treatment immediately as soon as the insurance denies further sessions.
Another interesting thing to me is that female psychologists are earning a significantly lower salary than male psychologists (for FT positions). I've noticed that within my network and also on this listserve. All the psychologists here who are earning 100K salaries are male not female. Dr. E meanwhile is earning half of this salary, and her salary is somewhat in the range of what I've seen with other early career female psychologists (50-70K is common despite FT work). Are there any female psychologists out there earning six figures?
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I just love the above-average effect. We're not just snowflakes - we are exceptional snowflakes
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You might be surprised depending on the hospital you look at. Some go cheap and some use regional compensation metrics. For example, I knew one person that got offered under 70k to start at an AMC. Then I know another person who got a 90k starting offer at another AMC.
Oh, the 90k person was female
One explanation offered for the male/female salary gap has been that some women are less inclined to negotiate offers. That doesn't explain eveything, but I can say that this has been the case with a few of my female friends. But of course, that's a huge systemic problem not unique to psychology.
I think that is probably true. I hear that there is flexibility with salary in some hospital positions even though its seems "fixed." I also wonder if female psychologists are less likely to ask for raises or let their colleagues know that they are interested in a chief of psychology/director role. I think many places also assume that men are always supporting their families so they are more likely to consider them for higher level roles.
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You might be surprised depending on the hospital you look at. Some go cheap and some use regional compensation metrics. For example, I knew one person that got offered under 70k to start at an AMC. Then I know another person who got a 90k starting offer at another AMC.
Oh, the 90k person was female
One explanation offered for the male/female salary gap has been that some women are less inclined to negotiate offers. That doesn't explain eveything, but I can say that this has been the case with a few of my female friends. But of course, that's a huge systemic problem not unique to psychology.
I know a few female psychologists making over $100k. Most are in VA positions and my dissertation chair was at an AMC. From my anecdotal experiences, I find my female colleagues are often less likely to move for a position and often more interested in quality of life benefits than $. Most of the time, this is because they are not single and the husband already brings in a very nice salary. More of the men, I find, are either single or have younger, less established spouses willing to move with them. Then again, the average age in my program was ~30 and male spouses were around 35 whereas female spouses were around 25.
PHD12,
I think there is definitely a separate argument in here about ethics vs $ and whether things that happen in practice are faster/time saving or simply producing an inferior product. Personally, I cut and paste testing reports all the time when I was testing, but always tailored important opinions or interpretations about clinical data. I never saw a need to redo a WAIS chart over and over. Also, if you test enough, you run into similar cases. Now I have seen people charge for computer generated reports only and seems flat out unethical. Also, discontinuing to see a client after insurance stops paying (if they do not want to pay) is pretty standard practice assuming the person is not high risk. Then again, I have seen people drop out of therapy because the scheduling does not work between violin lessons and ballet practice.
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But don't you live in California where cost of living is high?
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I'm not really sure why you're using the qualifier "but"? I did use the word "measly" to refer to my 109K salary.
My point is the same, bay area or no. We're not struggling (although we're certainly not wealthy), we own the home we live in, and my wife and I both have jobs where we have a lot of time and flexibility (she works about 30 hours a week and telecommutes two days per week). We could be hustling a lot more but my kids are young and my parents live nearby, and life is short.
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I live in a rural area where the average house hold income is less than $ 50,000.
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Nice!
It's 70K in the county I live in, which should allow folks to run at least some basic back-of-the-envelope adjustments. 109K, of course, is simply the 13/4 pay scale at the VA plus the locality adjustment (which doesn't reflect my yearly bonuses, benefits packages, and fringe benefits).
Again, I think I do OK relative to the bulk of the wage slaves out here in California. But, I recognize that it's not going to allow me to retire at 50, which is what successful entrepreneurship allows one to potentially accomplish..... independence and freedom. Sounds very attractive, I'll admit.
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I think for folks who are willing to live somewhere away from hordes of competition, a private practice could be quite successful. Sometimes rural or suburban areas are also where the cash clients are.
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+1
I live on the outlying edge of my locality - to my west is dense urban development, and to the east is rural. Competition is fierce to my west, to the east - I see possibilities.
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b : a word (as an adjective) or word group that limits or modifies the meaning of another word (as a noun) or word group From Webster.com
You need to use it because you're being rather dishonest by leaving out the fact that you, per your prior posts, mention you have a large amount of student loans and, more importantly, that you live in one of the most expensive areas in the country. Many reading would think that $109K is great money but their impressions may change when they know all the facts
You need to use it because you're being rather dishonest by leaving out the fact that you, per your prior posts, mention you have a large amount of student loans and, more importantly, that you live in one of the most expensive areas in the country. Many reading would think that $109K is great money but their impressions may change when they know all the facts
Median home values in many parts of the bay area are around 800K-1million, especially if you are anywhere near silicon valley. Jay Ro lives more on the outskirts of this locale, but I would imagine that median home values are still at least 500K.
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DIshonesty? Really? Again, I said 109K is "measly." I said I'm "not wealthy." As you point out, I've been open that I have student debt. None of that is relevant to the topic of entrepreneurship vs. salaried work (re PsychevalIII's contributions; which was being discussed until you chimed in). But I'm sorry to disappoint you - we're not struggling financially.
If you want to steer the discussion to how to properly judge people's salaries based on regional cost of living factors and student debt (or any other fixed expense, for that matter), feel free. I could probably contribute some real-world perspective.
However, to suggest it's "dishonest" to fail to mention information about my financial situation (which I've been open about previously) that you feel is relevant to a subject not currently being discussed is bogus. Your charge of dishonesty is, ironically, intellectually dishonest in this context.
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Condo.
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I just looked it up out of curiosity. 2009 data indicated that median house hold income of my rural area is just over $ 35,000 a year. At this time, new construction for homes is $ 99 a foot.
I dont think I could have done as well with my business if I lived in a big city where there was lots of competition.
Having the degree and license is just one (although important) part of the formula. For a private practice I think it is helpful to select an ideal city that has an adequate population, find a place without too much competition, study fee schedules and learn how to most appropriately get paid for the work you are doing, and have a firm no show policy which will likely increase your show rate(I close patients for one year if they have two no shows and it is a part of my informed consent which they sign). People nearly never miss appointments with me. Someone earlier was writing about thinking like a lawyer in 6 minutes blocks of time, I kind of do that for sure. I also think like a pilot looking for an emergency runway in case of a problem. Meaning, my staff and I look at my roster for the day, then we are always anticipating what will happen if patient X does not show and what the plan will be to fill that slot. Were not primary care seeing 7 people an hour and cannot afford one hour to three hour holes in the schedule. For instance, I may see a patient at 8 30 am for an intake, if my 9 am to noon testing patient calls in sick with the flu, assuming there is no pre auth required on the 8 30 am patient for testing, we offer that slot to them to get started on the evaluation. Consequently, nearly 100 % of my billable slots are filled, even if I have a 80 to 90 % show rate. I cannot emphasize enough the importance of mastering how to schedule.
I dont think I could have done as well with my business if I lived in a big city where there was lots of competition.
Having the degree and license is just one (although important) part of the formula. For a private practice I think it is helpful to select an ideal city that has an adequate population, find a place without too much competition, study fee schedules and learn how to most appropriately get paid for the work you are doing, and have a firm no show policy which will likely increase your show rate(I close patients for one year if they have two no shows and it is a part of my informed consent which they sign). People nearly never miss appointments with me. Someone earlier was writing about thinking like a lawyer in 6 minutes blocks of time, I kind of do that for sure. I also think like a pilot looking for an emergency runway in case of a problem. Meaning, my staff and I look at my roster for the day, then we are always anticipating what will happen if patient X does not show and what the plan will be to fill that slot. Were not primary care seeing 7 people an hour and cannot afford one hour to three hour holes in the schedule. For instance, I may see a patient at 8 30 am for an intake, if my 9 am to noon testing patient calls in sick with the flu, assuming there is no pre auth required on the 8 30 am patient for testing, we offer that slot to them to get started on the evaluation. Consequently, nearly 100 % of my billable slots are filled, even if I have a 80 to 90 % show rate. I cannot emphasize enough the importance of mastering how to schedule.
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I was actually complimenting your contributions to this thread earlier this evening to my wife over dinner. I appreciate it.
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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.
Your post made me smile, you sound cool. Heres the thing, what if you could do an evaluation on Saturday from 7 am to noon, and make $1,000. Now, multiply times 47 weeks a year (47 K extra a year) times 25 years (now you have an extra $ 1,175,000 at retirement. Extra!! And we havent even talked about investing that money. I pissed off an edward jones friend of mine who was talking about 12 % earnings and I told him I prefer 300 % and talked with him about a side company I have outside of psychology which I'm a 51 % owner in. It acturally does not generate a ton of money but it pays my morgage every month and then some and I do nothing to earn the money.
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He'd have to cut down on the Friday night bourbon to be going at it at 7AM on Saturday.
But as someone who also enjoys bourbon, I can see how it could taste just as great on Saturday after you've put some money in the bank. I usually work Saturdays on side stuff anyways, although I am not a college football fan so that dilemma is not there for me.
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He'd have to cut down on the Friday night bourbon to be going at it at 7AM on Saturday.
But as someone who also enjoys bourbon, I can see how it could taste just as great on Saturday after you've put some money in the bank. I usually work Saturdays on side stuff anyways, although I am not a college football fan so that dilemma is not there for me.
Too funny. I'm not a college football fan either, but I do have a little itch to go to Brazil for the world cup and my Saturday appointments will help get me there.
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But were they honest compliments?
Oy.
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I love non psych entrepreneurial pursuits myself. I find it extremely helpful to hang out with successful entrepreneurs who know more than me and learn from them. I was talking with a friend of mine the other day who is in his early 40's, he has a law degree, sells real estate, and owns 80 rental houses that he rents out for about 900 a month each ($72,000 / month minus expenses). I was talking with him about paying my house off in the next couple of years, then renting it out (we have professionals like MDs/DOs who come here for a few years then leave who want to rent over buy) for like $ 3,000 a month. He told me I had a horrible idea. He told me after its paid off, sell my house, buy 7 or 8 $50,000 houses, then rent them out for $900 a month and make $ 6,300 to $ 7,200 a month. In our community, housing is in demand. He showed me how to over double my money. He also owns a property management company so I'm not going to be dealing with headaches.
I'm working on a few other things to. Everyone says that there is nothing to do in our community. So, I working on creating some things to do. I have two or three ideas and am having fun!
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The you would have been happy doing many different things. NONE of that sounds in the least bit appealing or fun to me.
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The you would have been happy doing many different things. NONE of that sounds in the least bit appealing or fun to me.
Ditto. If I paid off my house, I would at least want to remain in a nice house even if I sold it.
Property management is not appealing at all. If I were to dabble in a side business, I'd prefer to own a bar or restaurant.
You sound like you have the perfect entrepreneur mindset (lots of energy and able to work 80 hours per week and dabble in multiple pursuits). Your success has nothing to do with being a psychologist or having a PhD. I'm sure you would make good money in any field you were in no matter how crappy it was. I don't think your path is realistic or desirable for many people pursuing a PhD, which is why you are in the top 1% of psychologists in terms of income.
In an area where the houses are only 50K (hard to imagine to me), the job market is probably horrible. Don't people move where the jobs are located near cities or major metropolitan areas? During the housing crash, it seemed to me that prices went down 50-70% in suburban areas whereas the housing market stayed strong and went up in cities (obv. NYC/SF is one example). I guess it is not a bad time to buy when the prices are low.
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Good point. While psychevalll gives many reading this thread some hope, and some pretty good ideas/strategies, my experience is that most of us, just like most of my friends/family, have neither the ability, nor the desire to make that commitment. My life is full of so many other "valuable" things, that I could never consistently commit to anything that took time away from 1. my relationships. 2) the enjoyment I get from listening to old records and relaxin on the couch. Ha! I do wanna PM this fella though, as I do have a side gig possibility and want to get his take on it.
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The you would have been happy doing many different things. NONE of that sounds in the least bit appealing or fun to me.
Its like playing monopoly when you were a kid.
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Well, I would actually get a nicer house than my current one.
Property management is not appealing to me either, that is why I would have someone do it for me.
Owning a bar or restaurant would be cool. There was a house hunters international episode (you can watch on the internet) where a neuropsychologsit by day and bar owner by night was buying a 1/2 million dollar home in french st. martin, you can do anything! A restaurant would be tough but rewarding..... you should try my bananas flambe. Its quite a presentation!
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Your stopping in my tracks a bit on this one, and I have been in the pool having a couple of heinekens so I need to think. I've been licensed for almost 9 years. I'm in my late 30's, which is a euphemism for almost 40 years old. Internship paid about $ 17 k; fellowship paid $ 30 k; first job paid $ 42 K.
I remember reading posts on this forum about why the sky was falling in this field, peope (who I respect) and have read for years like Jon Snow (I think) have voiced concern about PsyD's and quality control (I know brilliant PsyD's), others have voiced concern about mid levels moving in and taking over, others blame insurance companies, etc. I knew I had no power over any of that stuff. I remember having this internal versus external locus of control type feeling. I also knew I couldnt change the system, i.e. fee schedules, managed care, the role of psychology in health care, etc. But I did know that 1 in 4 psychologists were self employed, and I remember feeling like that was my only shot for the life I wanted to live. I think if I would have obtained a M.D. or D.O. degree and got a job for 140 or so out of school I would have had a greater chance of being complacent, and most likely not on this path that I find myself on which I'm happy with. Strangely, I now interview MD's but haven't hired one (psych nurses make 9 bucks a unit less than psychiatrists on the most commonly used cpt codes in my office). Also strangely, a new family doc came to town and came by my office to introduce himself to me, which was nice but felt odd, kind of like is this really happening but in a good way. Anyway, the current field of psychology forced me to struggle, which I didn't much care for, which then challenged me to read 50 business books and then challenged me to become entrepreneurial. I actually think my path is realistic for nearly any psychologist if they want it. There is absolutely nothing special about me. I just didn't want to take the kind of jobs that I saw most of my friends taking in this field so I challenged myself to do something about it.
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I have read a couple of getting started books on private practice. Would you have any top suggestions that may be good for some late night reading?
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I'd actually be interested in this as well. Not that I'm currently planning on going the PP route, but it would be good information to have regardless.
I know T4C and a few others have recommended a few business-related books in the past, so I'd definitely be up for hearing those again, as well as any new ones Psychevallll and others might have.
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This thread is fascinating. I would like to add a few things...
Thank you all for being so open and forthright. The frank discussions are really great, and for lack of a more exciting word, informative. Psychevalll (sp?) I totally understand what you get about saying that what you do is obtainable by others. I do think you have something different though. I personally do not enjoy being that busy. I think this is maybe what erg and some of the others are referring to.
In one of my classes, my professor was asking us to think about what our end career goal would be. I was the only person in the class to not answer private practice. She seemed genuinely surprised. I told her I'd worked in MD offices, and I knew what a hustle it would be. I'd done billing, I didn't want to work with the private practice reimbursement model. She told me (and here in FL) it is quite common that Psychologists will work for a group, so I might not have to do it all on my own. I really honestly would still rather work for a salary and make a bit less with better benefits. Maybe because I'm a military spouse, and that's the lifestyle I'm used to... For real, I get a nervous twitch when I think of planning my day out in 6 minute chunks. HIVES I tell you. I'd enjoy working for someone like you rather than having to plan it myself! I'm totalllllly okay with that too.
So while I am envious of your outlook, and wish sometimes I had your skill set, I realize that it's okay to be me too. I'm not by any means saying what you do is wrong/bad... Just a different lifestyle! That would make me a nervous wreck hah! I've worked production type jobs where they begged me to stay.... I just didn't enjoy it. It not like I'm incapable, I. Just. Didn't. Like. It.
Thank you all for being so open and forthright. The frank discussions are really great, and for lack of a more exciting word, informative. Psychevalll (sp?) I totally understand what you get about saying that what you do is obtainable by others. I do think you have something different though. I personally do not enjoy being that busy. I think this is maybe what erg and some of the others are referring to.
In one of my classes, my professor was asking us to think about what our end career goal would be. I was the only person in the class to not answer private practice. She seemed genuinely surprised. I told her I'd worked in MD offices, and I knew what a hustle it would be. I'd done billing, I didn't want to work with the private practice reimbursement model. She told me (and here in FL) it is quite common that Psychologists will work for a group, so I might not have to do it all on my own. I really honestly would still rather work for a salary and make a bit less with better benefits. Maybe because I'm a military spouse, and that's the lifestyle I'm used to... For real, I get a nervous twitch when I think of planning my day out in 6 minute chunks. HIVES I tell you. I'd enjoy working for someone like you rather than having to plan it myself! I'm totalllllly okay with that too.
So while I am envious of your outlook, and wish sometimes I had your skill set, I realize that it's okay to be me too. I'm not by any means saying what you do is wrong/bad... Just a different lifestyle! That would make me a nervous wreck hah! I've worked production type jobs where they begged me to stay.... I just didn't enjoy it. It not like I'm incapable, I. Just. Didn't. Like. It.
Sanman
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I have to agree with Psychevallll that what he did is doable. I have considered doing something similar within a nursing home setting or even within a private practice if my plans of a VA position or administrative position do not materialize over the next few years. I think that the thing to take away from all this is that private practice is not the simple and easy thing many make it out to be. At the end of the day, healthcare has become a business like any other. There is a good side and a bad side to that fact. It all depends on what your views on business are. There are still avenues that allow you to escape the business end of healthcare, but private practice is certainly not one of them.
D
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2018 - I will be able to retire at age 51 with 50% of my base salary. Not that I would do that, I plan to stay on active duty with the military until 2028, when I will get to retire with about 75% of my base salary (which in today's dollars) is about $77,000 a year plus medical assuming I make O-5.
I should be ok with that.
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While I doubt compensation is going to drop at all for military psychologists, I can't help but wonder if if any changes are on the horizon for folks at the VAs.
With all the cost-cutting, I'd see either mid-level encroachment or (not sure about this one) perhaps pay grade adjustments? I just can't help but wonder if VA hiring is a "bubble" for our field given the oversaturation and our healthcare/budget issues.
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Why in the world was a professor trying to push you to PP? As is illustrated in this thread, PP is one of the hardest (and often least profitable) ways to make a living unless you fancy yourself a business wiz.. And her solution of joining a group is a terrible one! Being in a group is a sure way to cripple your earning potential.
I just got my tax documents from my group PP for 2012. I made 44K after they took their chunk. This is working very full time and working at least one or two 12 hr days per week. I work very hard and feel I have little to show for it. Remember, that 44K doesn't include any health or retirement benefits. Depressing.
Dr. E
Sanman
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44k does suck. How are you billing so little seeing 8+ pts a day, even with a 50% split? I am wondering how good your billing people are. Unless you are talking 44k after taxes. Groups work alright if done the right way. Any licensed person in my practice is a partner and keeps all of their billing minus their contributions to overhead costs.
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I assume it is, personally.
On the one hand, I think there's advantage to getting in while you can. Once you're on the payroll, short of executing a force reduction (which I understand is very rare), they can't take your job or your money away. Even with midlevels theoretically encroaching down the line (which hasn't happened yet at my VA or much anywhere, from what I can tell)....
However, VA employees have all had to undergo pay freezes, which have only recently ended with an anemic 1% (IIRC) raise promised to us this following year - which tracks well below any fair reflection of the rises in the cost of living that have been going on over the past few years (thank you, Federal Reserve!).
I expect that the more generous and valid COLA will be replaced eventually by a "chained COLA" for federal employees, which will slowly erode VA psychologist salaries over time, and I imagine that at some point they'll start hiring MFTs and LCSWs for therapy positions in earnest, which will make it much harder down the line for newly minted psychologists to find gainful employment at the VA. Which, I understand, is currently very difficult, particularly in desirable parts of the country (cities).
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I think Dr. E does all therapy. Is that right? 85/hour X 8 and then cut in half. times 50 weeks/year. adjust for no shows and very possibly a lower rate than IO quoted here and you have a solid 45k-50K earning.
I am positioning myself to make close to that amount (35-40k?) per year doing one pre-op eval per week in a group starting in the fall. I will still have my salary position during the week. We will see how realistic this is depending on the slit I negotiate. But they want somebody bad for it, so. And no-shows are nearly unheard of since its surgery pre-req.
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Cash clients? Just curious because I'd imagine you'd need to make over 1K per eval before the split (then the taxes too).
There are good splits out there for neuropsych work. You don't have to settle for 50/50 or 60/40.
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No, before taxes.
I am trying to figure out why last year was such a bad year as well. Including holidays, I only took off 15 days completely, which was more than the prior year (I wouldn't have done it, but I got married and went on a honeymoon.) One thing is that my practice has a lot of contracts with businesses and when I see those clients, I actually get less than I would get with an insurance client (more like $32). I'm wondering if I saw too many of those cases this year.
Also, there are the cancellations and all the other plagues of PP.
It wouldn't sting half as much if I didn't feel like I continue to make a lot of sacrifices for my career (long hours, typically not getting home until 8pm or later, going in on weekends to catch up on reports or paperwork). If I made 44K at a 9-5 job that would be more palatable.
Dr. E
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I do a handful of ADHD evals, but yes, mostly therapy. Those evals are through insurance and you can usually only bill 2 units (hours) per hour testing. I am a perfectionist and I write detailed reports, so I don't do it for financial gain so much as intellectual stimulation.
Most clients' insurances give me closer to $70 than $85.
Dr. E
