Some opinions from someone who makes more, and used to work more:
1) The idea that psychology is a zero sum game is incredibly misguided and is likely holding people back. It simply doesn't follow the laws of economics when there is a third party payor, and when there are options to innovate.
2) Innovation is always possible. Someone got the CPT for psychometricians added. Same for the behavioral component for fMRI. Outside the typical clinical game, there are many many opportunities.
3) Jobs, by definition, pay you less than you bring in. It might be wise to consider this in #1.
4) In general, the career is defined by selling your time for money. Therefore, your income is generally limited by the time you are willing to sell. However, there are many work arounds for this problem. You can find payors that are willing to pay more. You can use technicians as force multipliers, so that you can bill more hours per day. You can sell other services that are not time defined. DO NOT TRY TO SELL A BOOK. Everyone tries that. It's embarrassing.
5) Psychologists should LOVE it when another psychologists makes bank. Negotiations benefit from references to averages, SDs, and all. Do you want to try to argue that you deserve $80k because that is the average (let's face it: you'd be dumb AF to say median), or would you like to say that you deserve $150k because that is the average?
6) It is foolish to bet on extraordinary outcomes. It is reckless to bet money you don't have. There is a reason the lotto doesn't take credit cards. I specifically avoid saying how much I make on here, because it is an outlier, and I do not want students to go to a crappy school, take on a ton of debt, and hope they can replicate an outlier experience of some ***** on the internet. ( I didn't have student loan debt).
7) There seems to be a sweet spot for work vs. quality of life. At least in my experience, at around 70hr/week you have to start paying for things to be handled (e.g., shopping, laundry, etc). At 90hrs+, money no longer matters because I was so tired I couldn't care how nice anything was.
8)
@voyeurofthemind There is a danger in making money above the median. Imagine if you got offered $30k for a job. You'd laugh, right? Now imagine if almost all jobs are like that. Even if you don't need the money for your lifestyle, you are used to your work being valued higher. Beware.
9) There are many ways to increase psychologists' median salaries.
a. It is likely, that the best way to do so is to contribute to the APA and state practice directorates, and CALL (not email) your state senator when things come up such as new CPT codes. It's like $200/yr.
b. Support RxP, if only for the ability to order imaging because covid taught us the limitations of having no real telehealth services.
c. Support workers' rights stuff, as our services can only be used if workers are free to take time off work to get to our offices.
d. Track every 15 min interval of your day. Learn CPT codes for all of the things you do but don't think are billable: record review, team conferences, phone calls, etc. They exist. Start submitting those, even if they don't pay.
e. Watch how physicians work, try to mimic it. They set the rules in billing. It's stupid to fight it.
f. Memorize statistics. People respond to stupid things like, "48% of patients with X respond to Y."
g. Do NOT be one of those idiots that creates problems without having a solution. It makes our profession look childish. Looking at you, anyone that says "someone should do something.".
h. Work when you are at work! Process things on your own time. If the field looks like it is lazy, people will pay like it's lazy. If ER docs can have patients die, and go back to the next patient, you can get through another few sessions.
i. Know the usual and customary rates for your area. Sample them every year. Increase your rates every year when the insurance companies send out their annual survey. Encourage your colleagues to do so as well.
j. Use the Dr. title. I know, you like engendering comfort with your patients by having them call you by your first name. But it makes you look lesser.
k. Build up other psychologists in public, criticize in private! The profession has a sick tendency to snark at other psychologists publicly. It makes us look childish. Medicine doesn't do that. While the entire torture thing was awful, you can't tell me that there wasn't a physician in the background monitoring vitals. That didn't come up, because they kept their mouths shut.
l. Always know what you bring in. Use that information in negotiations. "You're offering $100k/yr, with about $25k in benefits. I'm guessing you think I'll bring in about $200k gross. Here's some numbers from the last two years that show I really bring in $350k. Would that change what you offer?"
m. Always negotiate HARD with insurance companies and always ask for raises.
n. Buddy up to as many legislators as possible. A muffin basket once a quarter costs like $200/yr. That's a cheap price to pay.
, and allows for some savings. When things come (like having a kid or two in college), i can pick up another class, see some more clients, etc. to help cover the costs. I'm not talking 80 hours per week- If i work a solid 40 hours, be efficient with my time (85-90% billable time), and occasionally put in an evening or weekend, I can get to between 125-150% of my "day job" salary. If crisis hits (like losing a job or really needing to leave a crappy positions), it's nice to have options.
