Career in the future

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EissMachine

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I've been reading alot of the threads on this forum and I've been gathering that there are currently some problems within the Psychology community. My question is this: is a major in Psychology and going on to graduate school going to be worth it in the future. Is the compensation going to be there? is the job going to be there is what I'm asking. Is a Masters going to be enough, or is a PhD the way to go. I've always been interested in Psychology, taken a couple of clases on it. I think I would like helping people work out their problems, but being in a position where everything is still open to me (college freshman) I'm afraid of getting into a field and then realizing it's a dead end deal. Any advice or comments would be greatly appreciated. Thank you.
 
Paendrag said:
There are always problems in professional communities.



Depends how you define "worth."






Heh, depends on what you want to do and how much money you want to make.

You want to help people, as you said. There are many ways to help people. My guess is that you mean in an applied sense, which still offers many paths. Do you want to work with children, adults, or geriatrics? Do you want to primarily do assessments, therapy, or both? What kind of patients do you want to work with? Rich folks with existential crises, poor people struggling to meet basic needs, psychotic folks, personality disorders, learning disorders, etc. . . ?




I'd take a look at school psychology as one potential path.

I define worth as getting good compensation for putting in 10 years of schooling. As far as what I want to do in the field, it's sort of hard for me to get too specific because I'm just starting college. Let me ask a more basic question, and perhaps a more selfish one: Where's the money in the field?
 
Paendrag said:
Good compensation is a personal thing. I am comfortable with low six figures. There is a huge range of income in psychology. If you run your own practice, have several clinicians working for you, and don't see medicaid/medicare patients, you might pull down >$500,000. If you work for a Department of Children and Families, only do therapy, and see medicaid/medicare patients you might make $30,000. The hot areas at the moment are pediatrics, health psychology, school psychology, and neuropsychology. Assessment pays better than therapy. Working in a rich area pays better than working in a poor area. Private practice pays better than the alternative.

I would definitely be comfortable in the low six figures as well. Thanks for the info.
 
EissMachine said:
I would definitely be comfortable in the low six figures as well. Thanks for the info.

Hi EissMachine,

BUT a low six figure is very far from the mean.
According to the US Dept of Labor/Bureau of Labor Statistics
Occupational Employment and Wages, May 2004 Report


--------------------------------------------------------------------------------

19-3031 Clinical, Counseling, and School Psychologists
Diagnose and treat mental disorders; learning disabilities; and cognitive, behavioral, and emotional problems using individual, child, family, and group therapies. May design and implement behavior modification programs.

Mean Annual Wage: $60,810

Please check out the link:


http://www.bls.gov/oes/current/oes193031.htm

Peace. 🙂
 
Paendrag said:
That's because they lump everything together. Check out the standard deviation. 60,000 may be the mean, but there are much better studies done by researchers within their specialties (for example neuropsychology median income is $110,000). I know people in school psych who have starting salaries >$70,000. There are alot of factors, as I said before, that go into what can be earned. Six figures is not a hard thing to accomplish in psychology.

Please provide link to data. Thank you.
 
PublicHealth said:
Wrong. You're probably referring to the survey by Sweet et al. (2003): http://www.ncbi.nlm.nih.gov/entrez/...&dopt=Abstract&list_uids=14591431&query_hl=11

If that's the case, the MEAN salary for neuropsychologists who responded to this survey (excluding outliers) was $104,132, with a MEDIAN salary of $83,000. Please check your sources before citing erroneous figures.

It's also interesting to note that even in this survey the trend that is reported is of increasing hours of labor AND decreasing wages.

National Academy of Neuropsychology/Division 40 of the American Psychological Association Practice Survey of Clinical Neuropsychology in the United States

Part II: Reimbursement experiences, practice economics, billing practices, and incomes

Jerry J. Sweet, , a, b, Edward A. Peck, III c, Carolyn Abramowitzd and Sharon Etzweilere

a Neuropsychology Service, Evanston Northwestern Healthcare Medical Group, 909 Davis St., Suite 160, Evanston, IL 60201, USA
b Northwestern University Medical School, Chicago, IL, USA
c Neuropsychological Services of Virginia, Richmond, VA, USA
d Finch University of the Health Sciences/Chicago Medical School, North Chicago, IL, USA
e Loyola University of Chicago, Chicago, IL, USA

Accepted 28 August 2002. ; Available online 25 March 2003.




Abstract
Leaders of the National Academy of Neuropsychology and Division 40 (Clinical Neuropsychology) of the American Psychological Association determined that current information on the professional practice of clinical neuropsychology within the United States was needed. These two organizations co-sponsored a national survey of U.S. clinical neuropsychologists that was conducted in September 2000. The primary goal of the survey was to gather information on such topics as: practitioner and practice characteristics, economic variables (e.g., experience with major third party payors, such as Medicare and managed care), practice expenses, billing methods, experiences with Current Procedural Terminology (CPT) codes, time spent on various clinical tasks, use of assistants, and income. In this second of two articles describing the survey results, reimbursement experiences, practice economics, billing practices, and incomes are highlighted. Survey results indicate that neuropsychologists frequently have difficulty gaining access to membership on managed care panels. For those who gain access, managed care companies often limit provision of services; this is quite often perceived as negatively affecting quality of patient care. It is very common for neuropsychologists to feel obligated to provide more services to managed care and Medicare patients than are allowed to be billed to the insurance carrier; these hours are typically "written off." Numerous CPT codes are used to bill the same clinical service. Awareness of Medicare practice and billing expectations is variable among practitioners, as is awareness of public aid/Medicaid billing status. Professional income is influenced by years of licensed practice, practice setting, gender, types and amounts of non-clinical professional activities, and types and amounts of reimbursement sources within one’s clinical practice. Income of neuropsychologists has only a minimal relationship to percentage of clinical practice per week. Within the context of prior surveys, neuropsychologists are engaging in more clinical hours per week and, nevertheless, compared to data from 1993, are reporting decreased income. These and other findings are presented and discussed.

Author Keywords: Current Procedural Terminology (CPT); Medicare; Division 40
 
Also, it should be noted that the occupational handbook lumps masters and doctoral level providers together for a single average. It's true that reimbursement is going down. However, this is also true of medicine. In fact, correct me if I am wrong, but neuropsych bills under a medical testing code. As far as the future is concerned, who can tell. Your guess is as good as mine. I will say I wouldn't want to be a psychiatrist if psychologist RxP passes and it will lead to greater compensation. School psychology is doing pretty well now and the jobs are there. Get tenured in a good district and you'll pretty much be set for life. If you want to make money there are ways to do so in any career. I recently read about a psychologist who is charging cash only to clients to work on money/spending problems specifically. I wonder if he ever tells his clients that they shouldn't be wasting money on him? 😛 I've also met an internist that set himself up as an "acne specialist" and does mostly derm stuff. If you know where the money is and how to work the system you'll be rich, just look at Dr. Phil.
 
Paendrag said:
Sweet's group is conducting a new salary assessment currently that is a little better controlled. That data should be interesting.

I agree. Any idea when it will be published?
 
Sanman said:
Also, it should be noted that the occupational handbook lumps masters and doctoral level providers together for a single average. It's true that reimbursement is going down. However, this is also true of medicine. In fact, correct me if I am wrong, but neuropsych bills under a medical testing code. As far as the future is concerned, who can tell. Your guess is as good as mine. I will say I wouldn't want to be a psychiatrist if psychologist RxP passes and it will lead to greater compensation. School psychology is doing pretty well now and the jobs are there. Get tenured in a good district and you'll pretty much be set for life. If you want to make money there are ways to do so in any career. I recently read about a psychologist who is charging cash only to clients to work on money/spending problems specifically. I wonder if he ever tells his clients that they shouldn't be wasting money on him? 😛 I've also met an internist that set himself up as an "acne specialist" and does mostly derm stuff. If you know where the money is and how to work the system you'll be rich, just look at Dr. Phil.

Hi Sanman,
The average is for clinical, counseling, and school psychologists. As far as I know both clinical and counseling psychologists have to be doctoral degree recipients while school psychologists can be either doctoral or masters level.
I know for a fact that In FL someone with an MA or MS in psychology cannot be licensed as a clinical or counseling psychologist (nor as a school psychologist as that requires an M.Ed.)
I understood that that was the case throughout the country; please correct me if you know of anyone who with a masters level degree is licensed as a clinical or counseling psychologist.
Someone with an MA or MS in psychology who is licensed as a mental health counselor is not part of that category as in the same handbook there's a category for masters level professionals, i.e., MSW, MHC, MFT.
Peace.

P.S. I do agree with you that school psych and pediatric neuropsych are good financial bets as these practitioners do provide a needed and sought after service; so much so that even when insurance won't cover psychoed evals many parents are willing to do so. But that's for folks interested in working with children/adolescent populations. And I also agree with you that money can be made in any field BUT by looking at the average wage in a field we're focusing on the probability. I mean, Dr. Phil is an outlier, isn't he?
 
hey Sasevan,
I am not sure how they calculate salaries in the handbook, however, it suggests that the entry level position in the psychology field is a masters degree in the education component of the survey. I know that the APA suggests 65k for clinical psych and 72k for school psych. I should say it is probable to make six figs if you are interested in money. My point abour Dr. Phil is that he chased the money before becoming famous. He made 7 figs as a consultant to oprah in the beef trial. Psych is a broad field that is not licensed strictly and therefore you can train amd qualify in any specialty easily. Money can come of it is important to you. Just look at psych as a business. The school psych/ peds neuropsych field is what i"m interested in, so hopefully it continues to do well.
 
Sanman said:
hey Sasevan,
I am not sure how they calculate salaries in the handbook, however, it suggests that the entry level position in the psychology field is a masters degree in the education component of the survey. I know that the APA suggests 65k for clinical psych and 72k for school psych. I should say it is probable to make six figs if you are interested in money. My point abour Dr. Phil is that he chased the money before becoming famous. He made 7 figs as a consultant to oprah in the beef trial. Psych is a broad field that is not licensed strictly and therefore you can train amd qualify in any specialty easily. Money can come of it is important to you. Just look at psych as a business. The school psych/ peds neuropsych field is what i"m interested in, so hopefully it continues to do well.

Hey Sanman,

1. Where did you see that suggestion?
I believe the salaries are calculated according to the profession and the academic degree required to obtain that profession, e.g., for psychiatrist it would mean MD/DO, for clinical psychologist the PhD/PsyD, for school psychologist the M.Ed. Remember that clinical psychologists and school psychologists are regulated by different provisions and have different educational programs (at least in FL), i.e., school psych is not a specialization of cl psych like heath, forensic, and neuro. Often times the work of school psych and cl psych with a specialization in child/adolescent psych are very similar but they are in fact seperate fields. Therefore, training and qualifying are not interchangeable between cl (child/adolesc) psych and school psych. In FL at least, a school psych cannot hold themselve out to be a cl psych precisely because they don't hold a doctorate and a cl psych (even one specialized in pediatrics) cannot hold themselve out as a school psych. In FL at least, the different professional titles are protected.

2. Do you have a link to that APA figures?
The 65k for cl psych is not too far from the 60k in the handbook. It certainly is much closer than to the suggestion of a low six figure being the average.

3. I agree that anything is possible, including making six figures for a minority; I know several cl (forensic and neuro) and school psych who all make over 110k but they have each been in practice for over 10 years and each works about 60 hrs a week. Its good money but it comes to about $37/hr. And BTW, 3 of the 4 that I'm thinking about are in individual private practice which means they don't have benefits such as health insurance and pension plan. I guess what I'm trying to say is that: I agree with you that if money is important to you and you look at psych as a business that you can make money but IMO that's a lot of ifs and while possible its not probable for the majority of practitioners.

4. I believe that school psych/ped neuropsych is among the very best bets for making money. Good luck; you should be fine financially in that area.

Peace.
 
Paendrag said:
How can you say the minority? In neuro the mean is over 100K. The median is dependent on where and how you work. Compare this to the business world, and other non-medical degrees including law, it's a pretty good bet that you'll make over a 100K if that is your goal. The standard billing rate for neuropsychology is over $200/hr for clinical cases. You collect on less than that, the percentage of which dictates your success. I know people personally who make more than 250K doing neuropsychology. I know people, in one clinic day a week, are able to generate 30,000-50,000 dollars year. It isn't that hard. . . yet.

Where are these neuropsychologists and what exactly are they doing to generate such incomes? These are VERY high figures! I suspect that these folks have many years of experience and specialize in forensic neuropsychology.
 
Paendrag said:
The one day a week figures are normal neuropsychs. The clinical part of my job (one day a week) generated about 60K last year. The 250K+ include heavy forensics.

Where are you located?
 
Paendrag said:
How can you say the minority? In neuro the mean is over 100K. The median is dependent on where and how you work. Compare this to the business world, and other non-medical degrees including law, it's a pretty good bet that you'll make over a 100K if that is your goal. The standard billing rate for neuropsychology is over $200/hr for clinical cases. You collect on less than that, the percentage of which dictates your success. I know people personally who make more than 250K doing neuropsychology. I know people, in one clinic day a week, are able to generate 30,000-50,000 dollars year. It isn't that hard. . . yet.

You don't see how if the mean for cl psych is 60K how the majority are not making in the low six figures?
Your citing the neuropsych survey, even if accurate, would only account for the mean in neuropsych to be just above 100K.
The majority of cl psych are not neuropsych; additionally, to even say that the mean in neuropsych is in the low six figures could be misleading to the OP since it is not making explicit that the mean is not for entry level neuropsych and that even according to the neuropsych survey the mean has been dropping for the entire field.

Between 30-50K for one day? You don't think that's a big range? Also, one day? Does that include testing, scoring, interpreting, writing up the report, providing feedback/follow-up to the referral source and/or patient? How much actual office/home time is that one day?
 
Paendrag said:
About 12 hours total. A 12 hour day isn't so bad for a one day a week clinical obligation.

I guess we all would like to know more about you, your training background, current location of practice, client base, etc. Details, please! The information you report seems too good to be true. If you must remain anonymous, leave out names of schools, hospitals, etc, but please give us a better sense of who you are and what you do so that we can determine if you're representative of most clinical neuropsychologists or if you're an outlier resisting regression to the mean.
 
Paendrag said:
I'm saying that the jobs that people do in clinical psychology are so diverse that quoting a group mean is very misleading. As an M.D., would you judge your potential earnings against the mean for all M.D.s or the specialty to which you are intending on pursuing?

The specialty; but specialization is very regulated in medicine so the analogy is flawed. In cl psych one can function one day a week as a gen pract, another as a forensic, and still another as a neuro therefore it is very difficult to break down the group mean into sub-spec. That may well be the reason why the Dept of Labor uses group mean for cl psych but specialty means in medicine.

Misleading because, it isn't entry level? Why? Entry level business is about 30K, but you wouldn't catch someone saying that being a bank executive is not profitable. Besides, entry level in many clinical psych specialties is higher than the mean you quoted for the entire field. Relative to dropping incomes, my understanding is that's true across most healthcare professions because of insurance company and government (medicaid/medicare) reductions in reimbursement rates. I also think supply and demand will even out the specialties a bit (e.g. neuropsychology is a very popular specialty now for grad students, supply should bring down earnings a bit).

Another analogy that is flawed as entry level business is an AA or BA/BS while entry level cl psych is doctorate; along with that added education comes, for many, a big financial debt, and for all many years of small earnings.
How do you know that entry level in many cl psych spec is higher than the group mean? Please provide data if this assertion rests on anything else than speculation.
I agree about the drop in income in many healthcare professions but a decrease in wages in a lower earning group (e.g., cl psych) is arguably going to have a greater negative impact than a similar decrease in a higher earning group (e.g., med).
I agree about anticipating a drop in income for neuropsych.

Yes, it's a big range, but it's a good amount of money, don't you think?

30-50K a good amount of money? No, I don't think so; especially when you consider years of education and financial debt.

About 12 hours total. A 12 hour day isn't so bad for a one day a week clinical obligation.

50k divided by 12 hrs is c. $83/hr. I thought you said that neuropsych earn $200/hr or was that just what they bill? I mean I bill $250 for initial intake but most insurance (incl copay) will reimburse $75. I also doubt whether your experience of the time it takes to do a neuropsych eval is accurate and/or whether it can be generalized. From my experience working with colleagues who do them it is at least 18 hrs (more like 2 days work at least) and the highest earning neuropsych I know makes 150K doing evals 6 days a week; this after being in business for over 10 years. Also, she's in private practice so no health insurance/pension plan.
 
Paendrag said:
I've said I'm in the Chicagoland area before. It's actually not a bad place to be for psychology. I'm not going to keep denying places until one of you guesses the right one though. That's a little silly.

No need to deny. You're at Northwestern. Chicagoland, Jerry Sweet, etc...
 
Paendrag said:

How's the program there? I take it that the $250K+/year earner was Jerry Sweet?

I'm curious to know more about postdoctoral training in clinical neuropsychology. What is your typical day like? What types of patients do you evaluate? Any unusual cases? To what extent are you expected to do psychotherapy?
 
Paendrag said:
I don't know what Dr. Sweet's take home pay is and I wouldn't post it if I did. He is very active in forensics. Postdoctoral training in neuropsych is diverse. There is a match program for neuropsych postdocs, http://www.appcn.org/, but it isn't a necessity that one get a postdoc that way. Northwestern/ENH has a few match positions and a ffew non match positions. Some postdocs require extensive psychotherapy, some require none.

So, what's your story?

Thank you. I am aware of APPCN. I'm a second-year student at an osteopathic medical school in a large city 😛 Currently considering psychiatry and neurology for residency.
 
Paendrag said:
18 hours!! What the hell are they doing? That's just plain inefficient.
🙁

Wow. I feel drain trying to dialogue with you on this and other issues and I think it has to do with what I perceive as an arrogant attitude on your part that tends to devalue those with different credentials, practices, or perspectives; as well as with what I perceive to be on your part a tendency to be argumentative, to not respond to points that others make, and to recount your experiences as generalizable evidence.

For my part, I'm confident that I've answered the OP's question regarding what is the probable remuneration that he or she can expect as a clinical psychologist and I see no reason to continue to go round-and-round with you. I'm sure the OP will be able to differentiate between empirical and anecdotal evidence.

Good luck in your post-doc; maybe in the future, as an entry level licensed neuropsychologist, you will develop a different perspective as to what is the reality out here.

Peace.
 
Paendrag said:
In any case, I think that my continued participation in this forum has outlived its utility.

I disagree. You should stay.
 
Psychologyfiend said:
I disagree. You should stay.

I second that. How can you leave when you just stated the following?:

"In the context of a debate, especially in a forum like this, there is a tendency, or at least it is my tendency, to argue extremes in an aggressive manner and there is a purpose to that (it sparks discussion)."
 
Paendrag, albeit you can be argumentative dismissive and the like, I think you should stay. You are right, even if playing devil's advocate, you are take an OP's question through the motions and give/challenge opposing views.

Hope that made sense!

Stay why dont ya? 🙂
 
Paendrag said:
In my opinion, posters such as yourself, public health, and anasazi, who have left, or are in the process of leaving clinical psychology are presenting unrealistically negative viewpoints and portraying psychology through an unnecessarily bleak lens. You've chosen to pursue medicine after aborting psychology and now wish to convince others that the assumptions underlying your decision are valid.

I resemble that remark!

Seriously though, I left psychology for a number of reasons. Most of which I won't recount here, as it will be perceived as "psychology bashing." The truth is, as I've stated before...it just wasn't for me. I had quite a few extremely negative personal experiences and a constant forced sense of inadequacy when compared to the physicians. I envied their freedom, independence in decision making, and ability to treat. It was my unique problem - something I with which I took personal issue. So I got out. I didn't want to say for the rest of my life "what if I just applied to med school?" Now, I don't have to worry about it. Psychology is a wonderful field for the right person. I just had different goals and needs.

You won't leave. You love arguing too much. 🙂
Can't say I blame you.
 
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