Academic + private practise

[deleted736562]

Hey all,

Just wondering if anyone can chime in on the feasibility of an academic career (mostly research) with a private practice gig on the side. I am very interested in research and would like to pursue an academic career but I also would be interested in a side private practice (first for the $, let's face it) and also because I don't want to turn my back on clinical work and I love therapy. Just wondering if there are any examples people can provide and if this is at all feasible.

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[tr]

Depends on what you mean by academics.
If you mean you want to run a research lab then no, you most likely won't have the time.
If you mean you want to be a clinician-educator who sees patients and teaches within a medical school, and may do some research but doesn't run a lab, then yes, this is very common, although it depends on your specific department as some department chairs try to discourage/forbid this to varying degrees.

 

[MacDonaldTriad]

Most academic contracts take a percentage of your private practice income. They encourage you to see private patients, but then take a chunk of your earnings. I guess the argument is that because you get to use their box top name, they own some credit for your success. Most clinical professors do see private patients. If you are successful in grants to the point you don't need to see patients, good for you. Grants run out and you should always keep the ability to practice your trade and make widgets when things get lean.

 

[dl2dp2]

This question is too complicated to answer on the internet. The bottom line is that it may be feasible (it's fairly obvious there are senior researchers who also have private practices), but may not be feasible for you depending on your CV. So a blanket answer is really not useful. If you want to post your CV we might be able to answer this better.

 

[deleted736562]

Thank you for the responses.

Depends on what you mean by academics.
If you mean you want to run a research lab then no, you most likely won't have the time.
If you mean you want to be a clinician-educator who sees patients and teaches within a medical school, and may do some research but doesn't run a lab, then yes, this is very common, although it depends on your specific department as some department chairs try to discourage/forbid this to varying degrees.

Yep, that's my worries, that it may be too difficult to run a lab and a private practice at the same time. On the other hand, a 75/25 model between clinical and research seems fairly feasible, but I don't know how one could translate it into a private practice model.

This question is too complicated to answer on the internet. The bottom line is that it may be feasible (it's fairly obvious there are senior researchers who also have private practices), but may not be feasible for you depending on your CV. So a blanket answer is really not useful. If you want to post your CV we might be able to answer this better.

Well, needless to say, I'm not posting my CV on here, lol. I'd be interested to know though what do you think are the limiting factors and how feasible this is assuming certain conditions are met. My question of course runs under the hypothetical that one is on a track to develop an independent research career.

 

[dl2dp2]

Well, needless to say, I'm not posting my CV on here, lol. I'd be interested to know though what do you think are the limiting factors and how feasible this is assuming certain conditions are met. My question of course runs under the hypothetical that one is on a track to develop an independent research career.

You really might as well. Give the gestalt. Removing the identifiers.

There're no great answers to your questions. The limiting factors are basically who you are (i.e. your CV), where you at, who you know, and how much money (both personal and institutional) you have/need--so the more detailed these factors can be revealed, the more informative my response would be. Developing an independent research career does not have a very clear "track", and depends a lot on local "mentorship" (what it really means is relationships with various people who would be important in shepherding your grants). Things that work at one place don't work at another. There are also lots of differences in feasibility in terms of content of research in basic vs. applied work, etc.. Most people on this forum don't know what they are talking about. Of the people who are qualified to give you answers, we might not give you real answers if you ask us in real life, and people at the same level who have answers often have very different answers to the same scenario. The answers are also often modulated by context (i.e. is this a formal advisory meeting, some random person I met at SFN, or is this a conversation at a bar?) For example, I'll NEVER tell you in person that you should "give up" (on a research career) based on your CV if I met you in real life (don't want the reputation of not "encouraging the career development of young investigators"), but I just might on the internet. Plus, the answers are not necessarily matching up to reality (i.e. I might have a very vague sense that your career is not very hopeful in the long run, but I don't have real data to back up this intuition...and lets say multiple people you talked to give you different responses, which one do you trust? This is particularly problematic in real life, as I've noticed that the answer to your question depends a lot on whether the person who's got asked that question *wants* something from the one who was asking this question.)

Furthermore, institutions and leadership vision change constantly. So what might work right now might not work in 5 years. So any specific information (i.e. at school X, someone did Y) may or may not be applicable to you once you arrive at school X. And often there's no uniformity in the *application* of the policy, even when the policy is fairly clear. In another word, individual contracts are almost always individualized depending on various factors, most notably relationships. And when there are institutional variances in the favor of an individual (i.e. some policies are differentially enforced), this is almost NEVER revealed to people they don't trust. Nobody wants to invite an EEOC investigation. People typically downplay how much personal money they get, for example.

At some departments, even written contracts get reneged later on. Your choices become either you file a law suit or you leave. Lawsuits are typically not successful. You should think of academic contracts as sort of a "living document" LOL. Things always depend on the instantaneous marketability of your portfolio, and institutions also have extremely short memories.

You can't really trust anyone in real life, so you might as well trust people on SDN.

 

[TexasPhysician]

There are many academic centers that outright forbid private practice + academics. I’ve seen someone fired for it, so it is quite enforceable.

You can do research through your private practice though.

 

[dl2dp2]

There are many academic centers that outright forbid private practice + academics. I’ve seen someone fired for it, so it is quite enforceable.

You can do research through your private practice though.

What does this mean exactly when you are bringing your own research dollars? It's like saying a shopping mall fired a vendor...I don't think that's the right terminology...

 

[michaelrack]

In most academic positions, in addition to resident supervision and other departmental duties, you will spend some time in a faculty practice group in which you will see patients independent of any students/residents. Typically there is some type of split in revenue between the psychiatrist and department.

If you want to have a true private practice independent of the university, that could be a problem. Many but not all academic institutions are disallowing outside work in their contract.

 

[TexasPhysician]

What does this mean exactly when you are bringing your own research dollars? It's like saying a shopping mall fired a vendor...I don't think that's the right terminology...

They don’t care. All work must be approved by these institutions and checks must be paid to the institution. The institution gives you a bonus for the added work if they see fit. Otherwise, pack your bags and go. Some academic centers are very strict with this. If you are a powerhouse, maybe they change their contract for you. The majority will not get this deal.

 

[splik]

At my institution many but not all tenure-track faculty have a faculty practice which is essentially private practice but through the university they take their cut but after that for the better insurances we will be clearing $440 per new pt eval. The rates for psychotherapy are also competitive with what you would make in a cash practice here. But an actual private practice independent of the University is absolutely forbidden.

Really the NE is the only part of the country that for the most part allows faculty to have their own private practice independent of the university (partly because they pay so poorly) and research/tenure track faculty have historically done this in psychiatry.

 

[FlowRate]

Almost all of my professors have a (usually cash-only) private practice on the side. It's the norm for those who aren't doing very intensive research.

 

[psychattending]

People who have successful research careers (i.e. NIH supported research) almost invariably do no more than 20% clinical patient care (outside of research). The vast majority of these people are in major research institutions. Most of those places disallow their faculty from seeing patients outside of the university setting (we don't really have time anyways as we are working 60+ hours doing our jobs and would like to have a home life). People who try doing more clinical work, say a 50-50 split, tend to fall behind the researchers who do 80% research and thus quit being competitive for grants after a couple of years.

 

[splik]

Almost all of my professors have a (usually cash-only) private practice on the side. It's the norm for those who aren't doing very intensive research.

in Boston yes. but the NE is the exception that proves the rule. Most institutions outside of there do not allow faculty to have their own independent private practice.

 

[tortuga87]

The above advice applies to *most* assistant professor physicians on the physician-scientist track, but there are ways around it.

A few more thoughts to the discussion:

1. When academic faculty say that they "do research," they mean that they write grants, attend meetings and supervise research students. The faculty themselves do not actually do the research (or they do very little of it). Instead, they manage research students or PhD post-doc scientists. Once a grant is funded, it tends to be followed only loosely (e.g., following the overarching idea or strategy); this is often how scientists/students can often work on their own ideas that lies within the overarching goals of a PI. Do you want to do research or manage research?

2. What type of research would you want to be involved with? You have to chose this wisely and not just jump into the first thing that sounds cool. As a general rule, the less your research relies on money from others, the more freedom you get. From what I know, this usual translates to: the more math you know, the more freedom you get. For example, bench research is expensive - equipment, facilities, etc. You will never stop writing grants and relying on others if you do bench research. The other side of the spectrum is for example mathematical research done alone - if you can do this, you don't even need a faculty position in a university; just have a private practice and publish alone. Middle of the ground role might be a statistician who supports clinical investigators but also develops his/her own new methods.

 

[deleted736562]

Thank you guys. Awesome input.

You really might as well. Give the gestalt. Removing the identifiers.

There're no great answers to your questions. The limiting factors are basically who you are (i.e. your CV), where you at, who you know, and how much money (both personal and institutional) you have/need--so the more detailed these factors can be revealed, the more informative my response would be. Developing an independent research career does not have a very clear "track", and depends a lot on local "mentorship" (what it really means is relationships with various people who would be important in shepherding your grants). Things that work at one place don't work at another. There are also lots of differences in feasibility in terms of content of research in basic vs. applied work, etc.. Most people on this forum don't know what they are talking about. Of the people who are qualified to give you answers, we might not give you real answers if you ask us in real life, and people at the same level who have answers often have very different answers to the same scenario. The answers are also often modulated by context (i.e. is this a formal advisory meeting, some random person I met at SFN, or is this a conversation at a bar?) For example, I'll NEVER tell you in person that you should "give up" (on a research career) based on your CV if I met you in real life (don't want the reputation of not "encouraging the career development of young investigators"), but I just might on the internet. Plus, the answers are not necessarily matching up to reality (i.e. I might have a very vague sense that your career is not very hopeful in the long run, but I don't have real data to back up this intuition...and lets say multiple people you talked to give you different responses, which one do you trust? This is particularly problematic in real life, as I've noticed that the answer to your question depends a lot on whether the person who's got asked that question *wants* something from the one who was asking this question.)

Furthermore, institutions and leadership vision change constantly. So what might work right now might not work in 5 years. So any specific information (i.e. at school X, someone did Y) may or may not be applicable to you once you arrive at school X. And often there's no uniformity in the *application* of the policy, even when the policy is fairly clear. In another word, individual contracts are almost always individualized depending on various factors, most notably relationships. And when there are institutional variances in the favor of an individual (i.e. some policies are differentially enforced), this is almost NEVER revealed to people they don't trust. Nobody wants to invite an EEOC investigation. People typically downplay how much personal money they get, for example.

At some departments, even written contracts get reneged later on. Your choices become either you file a law suit or you leave. Lawsuits are typically not successful. You should think of academic contracts as sort of a "living document" LOL. Things always depend on the instantaneous marketability of your portfolio, and institutions also have extremely short memories.

You can't really trust anyone in real life, so you might as well trust people on SDN.

I actually think this is very helpful. I think I have a decent idea of what it takes to make it in a research career (essentially hook up with a big name, develop connections and publish in high impact journals). Nonetheless, it's a little disheartening to see how big a role politics / nepotism plays at every stage of the game; whenever pretty much one is embedded in an institution.

 

[Amygdarya]

I think I have a decent idea of what it takes to make it in a research career (essentially hook up with a big name, develop connections and publish in high impact journals).

Ahem, not that the things you mentioned don't matter for a research career, but you forget such minor things as lots of hard work and dedication. You sound like someone who's never done any kind of more or less serious research; you have no idea what you're in for.

 

[deleted736562]

Ahem, not that the things you mentioned don't matter for a research career, but you forget such minor things as lots of hard work and dedication. You sound like someone who's never done any kind of more or less serious research; you have no idea what you're in for.

RIght, because "publishing in high impact journals" happens while sipping your morning coffee? 'Dedication and hard work' are intangibles and not exactly practical advice.

 

[Amygdarya]

RIght, because "publishing in high impact journals" happens while sipping your morning coffee? 'Dedication and hard work' are intangibles and not exactly practical advice.

And “publish in high impact journals” is practical advice for someone who’s never really done research?

Before planning out your brilliant future research career you should try doing some research first and see what it takes to get any decent publication, let alone high impact.

 

[deleted736562]

And “publish in high impact journals” is practical advice for someone who’s never really done research?

Before planning out your brilliant future research career you should try doing some research first and see what it takes to get any decent publication, let alone high impact.

Honey I have multiple publications. I would say, worry about your own projections and distorted inferences, but thanks for your contribution.

 

[justfolks]

Just a patient, but in NYC it seems to be common for people to have a faculty appointment at one of the academic medical centers and also have a private practice (usually cash only) on the side, often off-site in a private office with no hospital involvement that is visible to the private patients. I can't speak to how they allocate their time, but $350-500/session, cash, seems to be pretty common, and my own dr. seems to be pretty consistently busy, judging by why happens if one of us needs to reschedule, so I imagine the private practice does pretty well even if only part time.

 

[notdeadyet]

Just a patient, but in NYC it seems to be common for people to have a faculty appointment at one of the academic medical centers and also have a private practice (usually cash only) on the side, often off-site in a private office with no hospital involvement that is visible to the private patients. I can't speak to how they allocate their time, but $350-500/session, cash, seems to be pretty common, and my own dr. seems to be pretty consistently busy, judging by why happens if one of us needs to reschedule, so I imagine the private practice does pretty well even if only part time.

Keep in mind that you might be talking about private practice psychiatrists with a “volunteer” faculty appointment. These vary in how hard they are to get and at some places they are handed out loosely. Someone can mentor some residents, teach a few classes, supervise a few cases, and call themselves “faculty at Acme University” without having most of Acme’s professional policies apply to them..

 

[dl2dp2]

Just a patient, but in NYC it seems to be common for people to have a faculty appointment at one of the academic medical centers and also have a private practice (usually cash only) on the side, often off-site in a private office with no hospital involvement that is visible to the private patients. I can't speak to how they allocate their time, but $350-500/session, cash, seems to be pretty common, and my own dr. seems to be pretty consistently busy, judging by why happens if one of us needs to reschedule, so I imagine the private practice does pretty well even if only part time.

Depending on your CV, filling a (even part time) private practice of $500/session in New York (or anywhere really) is not trivial at all. It might APPEAR trivial to you, but I can stare at someone's CV for 10 seconds and tell you it won't be possible for them. This is why the OP's question is not easy to answer and your experience has basically zero universal applicability.

 

[Amygdarya]

Honey I have multiple publications. I would say, worry about your own projections and distorted inferences, but thanks for your contribution.

1. Multiple publications can be anything. What matters is what kind of publications they are and what was your personal contribution in each of them.
2. Here's the thing. If someone has a significant research involvement, why would (s)he ask about his/her future career options on a (presumably) anonymous forum instead of discussing them with his/her mentors, collaborators, colleagues in person? That would have been a much more productive discussion. Or even just observe the career/practice choices among the research focused folks he/she works closely with? Your questions betray your lack of involvement in a community like that.

 

[dl2dp2]

Here's the thing. If someone has a significant research involvement, why would (s)he ask about his/her future career options on a (presumably) anonymous forum instead of discussing them with his/her mentors, collaborators, colleagues in person?

This is why I ask for a CV. It's hard to answer the questions without a CV.

However, I would argue as I did above, sometimes you ask mentors and colleagues in person you get biased and inaccurate information. There's some utility for soliciting information from an online forum, but without more information on the profile of the candidate, the discussion limits itself to very vague generalities and anecdotes that are in general not useful for any specific individual. For example, I can look at your CV and tell you even if you made multiple unsuccessful attempts at applying for large grants, that just persist for a few more cycles and you'll get it. However, if you take my advice with the wrong CV, you could potentially waste YEARS of your effort without anything in return. On the other hand, if I was your mentor I might not tell you and leave you hanging, especially if there's significant conflict of interest (i.e. you are working for me for cheap). That scenario is anything but rare in academia.

 

[deleted736562]

1. Multiple publications can be anything. What matters is what kind of publications they are and what was your personal contribution in each of them.
2. Here's the thing. If someone has a significant research involvement, why would (s)he ask about his/her future career options on a (presumably) anonymous forum instead of discussing them with his/her mentors, collaborators, colleagues in person? That would have been a much more productive discussion. Or even just observe the career/practice choices among the research focused folks he/she works closely with? Your questions betray your lack of involvement in a community like that.

I'm not really sure what ticked you off but, if it makes you feel any better, there's nothing of what I wrote that suggested I had "forgotten" about hard work and dedication. That was your own projection, based on whatever reason. Sorry if it came out flippant to mention that one needs papers in a high impact journal, because that was not the intention. Everything else is way off and irrelevant to the discussion, and I'll leave it at that.

 

[justfolks]

Keep in mind that you might be talking about private practice psychiatrists with a “volunteer” faculty appointment. These vary in how hard they are to get and at some places they are handed out loosely. Someone can mentor some residents, teach a few classes, supervise a few cases, and call themselves “faculty at Acme University” without having most of Acme’s professional policies apply to them..

Agreed, many are in the volunteer category for sure, although my dr. isn't. My point is just that if you want to combine some academic and some PP, NYC is a place where that is possible.

 

[justfolks]

Depending on your CV, filling a (even part time) private practice of $500/session in New York (or anywhere really) is not trivial at all. It might APPEAR trivial to you, but I can stare at someone's CV for 10 seconds and tell you it won't be possible for them. This is why the OP's question is not easy to answer and your experience has basically zero universal applicability.

Just a patient, but I agree that one's CV matters, I agree that that it's not a trivial matter to build a PT or FT cash PP, and I agree that simply because some people with very good to excellent CVs can make it work (which I know happens, doesn't mean everyone can. I didn't think I was suggesting anything to the contrary, but I apologize if you thought I was trying to make light, I actually was just trying to provide a data point regarding what some people are able to charge.

 

[aim-agm]

Depending on your CV, filling a (even part time) private practice of $500/session in New York (or anywhere really) is not trivial at all. It might APPEAR trivial to you, but I can stare at someone's CV for 10 seconds and tell you it won't be possible for them. This is why the OP's question is not easy to answer and your experience has basically zero universal applicability.

This is why I ask for a CV. It's hard to answer the questions without a CV. For example, I can look at your CV and tell you even if you made multiple unsuccessful attempts at applying for large grants, that just persist for a few more cycles and you'll get it. However, if you take my advice with the wrong CV, you could potentially waste YEARS of your effort without anything in return..

What sort of things in a CV would tell indicate probable success/failure in this areas?

 

[dl2dp2]

What sort of things in a CV would tell indicate probable success/failure in this areas?

There are way too many unknown variables to give you blanket answers of this type aside from what's already mentioned (i.e. pedigree papers track record etc). For example, a junior investigator and a senior faculty at different stages of their career would have different profiles for continued success. And it depends on what kind of grant you are talking about and what area of research you are going after, since funding agencies shift interests.

Same for PP--and it's a bit more amorphous since I don't have other people's tax returns so hence can't assess for "success". I have some general sense: having a niche and a reputation, savvy with marketing, the usual, but again, since this is so generic it is probably not helpful for you.

To actually give you solid actionable advice based on your profile would verge on actual business consulting as opposed to just chilling on SDN and would have sufficient value that I would probably have to charge you for it.

 

[aim-agm]

There are way too many unknown variables to give you blanket answers of this type aside from what's already mentioned (i.e. pedigree papers track record etc). For example, a junior investigator and a senior faculty at different stages of their career would have different profiles for continued success. And it depends on what kind of grant you are talking about and what area of research you are going after, since funding agencies shift interests.

Same for PP--and it's a bit more amorphous since I don't have other people's tax returns so hence can't assess for "success". I have some general sense: having a niche and a reputation, savvy with marketing, the usual, but again, since this is so generic it is probably not helpful for you.

To actually give you solid actionable advice based on your profile would verge on actual business consulting as opposed to just chilling on SDN and would have sufficient value that I would probably have to charge you for it.

Thanks! I wasn't asking for advice, just wanted to get a sense of the factors you consider.