Effects of ObamaCare on Practice of Psychology

[O Gurl]

Find other data O Gurl. Rather than simply attacking me because I struck a nerve, try to move the discourse further along. I'm fine being wrong-just provide some corrective data

Furthermore, you and Aagman are actually supporting my point in the OP, which was that the ACO system would move towards mid-level providers. When Canadian income brackets with their muddied term, "psychologists", evoke you to point out the problem, you actually help me elucidate my prognostication.

Nope. Not going to chase your unicorn data to support some nonsense theory that expanding healthcare coverage will cap salaries for psychologists or push psychologists out of PP. You introduced this nonsense. Either prove what you or saying or give it a rest.

But nice try in trying to change your entire argument at the end. Just to recap, you tried to freak people out by wrongly asserting that PP psychologists in Canada (your template for "socialized medicine") only make $50/hr. That has been refuted by 1st hand accounts and by the "proof" you provided which only proves that whoever they polled as psychologists are able to work part-time (30 hrs/week) and earn more than most doctoral clinicians in the US. Frightening.

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[docma]

For those who are not in the political fire-fight, here is one fairly short summary on the Patient Protection and Affordable Care Act [PPACA] and ACOs and psychologists potential roles.

http://www.nationalregister.org/trr_spring11_deleon.html

 

[O Gurl]

I still think that this healthcare option is putting a bandaid on a giant, festering wound. Instead of insurance companies denying our claims, it will be the government doing it instead! Big difference!

More fear-mongering with no proof.

This kind of comment is, IMO, everything that is wrong with our political system. There is this nay-saying "this won't work" response to any effort to produce any change in a flawed system. The second half of your comment simply makes no sense because there was (sadly) no public option included in the bill. There will not be some new gov't-run insurance. This bill is simply focused on expanding coverage to the uninsured. Which apparently scares the be-Jesus out of some people.

 

[O Gurl]

For those who are not in the political fire-fight, here is one fairly short summary on the Patient Protection and Affordable Care Act [PPACA] and ACOs and psychologists potential roles.

http://www.nationalregister.org/trr_spring11_deleon.html

Thanks for posting this.

 

[aequitasveritas]

Nope. Not going to chase your unicorn data to support some nonsense theory that expanding healthcare coverage will cap salaries for psychologists or push psychologists out of PP. You introduced this nonsense. Either prove what you or saying or give it a rest.

I am confused as to why you will not try to improve the accuracy of this thread if you are so passionate about its content.

But nice try in trying to change your entire argument at the end. Just to recap, you tried to freak people out by wrongly asserting that PP psychologists in Canada (your template for "socialized medicine") only make $50/hr. That has been refuted by 1st hand accounts and by the "proof" you provided which only proves that whoever they polled as psychologists are able to work part-time (30 hrs/week) and earn more than most doctoral clinicians in the US. Frightening.

WRONG. When the average working week was 30 hrs of base pay the income was not 50 (50 is the highest one can earn) Moreover, if you think 70k/yr is alot....wow. I generate more than that as a psych assistant working 3 days a week in PP.

Moreover, the first hand data you speak of is some anecdotal account of what some post doc "thinks" is the going rate for shrinks in her area. Sorry missy- that doesn't fly as data.

 

[deliciousgoose]

I am confused as to why you will not try to improve the accuracy of this thread if you are so passionate about its content.



WRONG. When the average working week was 30 hrs of base pay the income was not 50 (50 is the highest one can earn) Moreover, if you think 70k/yr is alot....wow. I generate more than that as a psych assistant working 3 days a week in PP.

Moreover, the first hand data you speak of is some anecdotal account of what some post doc "thinks" is the going rate for shrinks in her area. Sorry missy- that doesn't fly as data.

It's not what I "think" is the going rate for psychologists in my area. I work in a private firm and in one of the largest mental health research centers in Canada. I have several family members who are psychologists and academics, and consequently have contact with many psychologists in my major city. I have lived in other major cities in Canada and because of my interest in psychology, and family background, have had extensive contact with practicing individuals there. Depending on the type of work, the private firm I work at charges between $240 and $450 per hour. New private practitioners in other major cities often start at $160-$180/hour.

I really have no clue where you are pulling this data from, but it is a very inaccurate depiction of the current status of psychologists in Canada. The chair of a department recently told me that most new clinical psych graduates in Ontario can expect to make between $80,000 to $100,000 as a starting income.

I find the attitude that some individuals in the States have towards healthcare to be absolutely horrifying. I'm glad you believe you can bootstrap your way out of cancer, but the majority of people can't. Multiple sources have reported on medical bills being the overwhelming cause of bankruptcy in the States.

http://articles.cnn.com/2009-06-05/...ls-bankruptcies-health-insurance?_s=PM:HEALTH
http://www.businessweek.com/bwdaily/dnflash/content/jun2009/db2009064_666715.htm

If your response to individuals being forced to declare bankruptcy to get treatment for life threatening illnesses really is, "**** you, got mine." then maybe you should consider a new profession. Ideally one that doesn't require empathy or rational assessment.

I still think that this healthcare option is putting a bandaid on a giant, festering wound.

This is an accurate assessment of the current healthcare situation in the USA. See this article for one example: http://azstarnet.com/news/science/health-med-fit/article_c8288a3a-8135-5cc9-bf0d-0745071bd74a.html

Instead of insurance companies denying our claims, it will be the government doing it instead! Big difference!

This shows how fundamentally you do not understand the current health care bill or how a single payer system works.

I wonder how many of you anti-health care individuals think that single-payers systems should encourage smoking because in the long-run smokers are cheaper for system. http://www.cbc.ca/news/health/story/2008/02/05/unhealthy-study.html

 

[AcronymAllergy]

I have to run and lead a group in a minute, but a quick google search revealed this: http://www.awcbc.org/common/assets/benefits/healthcare_service_provider_fees.pdf

I can't vouch for the accuracy of the numbers, and didn't look much into their applicability, but if they're in the ballpark, they don't look horrible to me (from what I could tell after a quick glance).

As for salary, I personally would consider $70k a great place to start, especially with a 31-hour work week. But that's just my personal opinion based solely on the numbers mentioned earlier in the thread.

 

[KillerDiller]

I honestly don't understand why the rates of private practice clinicians is such a point of concern for the new legislation. I'm hoping someone can help clarify. Admittedly, my career goals don't include private practice and I don't know that much about running one, but my understanding was that most successful private clinicians see a good portion of clients who pay out of pocket for their services. I don't think these clients are going anywhere considering that most are not paying out of pocket because they can't afford/don't have health insurance. They are paying out of pocket because they can afford to go outside of network, can afford additional sessions, can see who they want to see, etc. So, if people are concerned that their client who pays $150 an hour for services now is suddenly going to be on an affordable health insurance plan that only pays $50/hr for brief EBT, I think that is a bit erroneous.

Can I assume, then, that the problem lies with clients whose services are currently covered by a health insurance provider? I know there is variability in reimbursement rates, but I guess $50/hr doesn't sound that much lower than the other rates I've heard quoted from insurance companies. We advise people on this board that planning a private practice with only clients who pay through insurance is not lucrative. 77K a year working part time is actually higher than what I would think people only taking insurance in PP now would make, assuming this figure takes overhead into account. As for the insurances that pay a good deal more, wouldn't those be the types of luxury insurance plans that employers would be likely to keep anyway, even in the face of the new legislation?

Again, these are genuine questions and I'm hoping people who have looked into the ins and outs of healthcare reform more than I have will have some answers. I'm not trying to push a political agenda.

 

[O Gurl]

I am confused as to why you will not try to improve the accuracy of this thread if you are so passionate about its content.



WRONG. When the average working week was 30 hrs of base pay the income was not 50 (50 is the highest one can earn) Moreover, if you think 70k/yr is alot....wow. I generate more than that as a psych assistant working 3 days a week in PP.

Moreover, the first hand data you speak of is some anecdotal account of what some post doc "thinks" is the going rate for shrinks in her area. Sorry missy- that doesn't fly as data.

You can lay off the "missy" stuff. Seriously.

Yes I would take someone's first hand account who has worked in a Canadian PP over someone who is posting links that refute his own statements. In case you haven't noticed, others (including myself in terms of my VHA argument) have posted links to articles and data to try and move the conversation forward. You are the one struggling to prove your point.

Your reference says nothing about base rates that I can see. It also does not state that $50 is the maximum hourly reimbursement. Again, the link does not differentiate between PP and other settings. It is very curious that some of your prior posts on the dangers of professional school debt and low earnings for psychologists seemed grounded in reality, but you are now acting as if $70K for part-time work is chump change or somehow worse than what most PP psychologists earn in the US right now. According the the 2009 APA Salary Data http://www.apa.org/workforce/publications/09-salaries/index.aspx#section5, private practice clinical psychologists with up to 5 years of experience earned $54,000. For those with 10 to 14 years of experience, the average wage was almost $100,000.

 

[deliciousgoose]

I have to run and lead a group in a minute, but a quick google search revealed this: http://www.awcbc.org/common/assets/benefits/healthcare_service_provider_fees.pdf

I can't vouch for the accuracy of the numbers, and didn't look much into their applicability, but if they're in the ballpark, they don't look horrible to me (from what I could tell after a quick glance).

As for salary, I personally would consider $70k a great place to start, especially with a 31-hour work week. But that's just my personal opinion based solely on the numbers mentioned earlier in the thread.

And just to be clear that is what the Worker's Compensation board will pay, not what private individuals are charged, or even what private insurance companies will pay.

 

[aequitasveritas]

I honestly don't understand why the rates of private practice clinicians is such a point of concern for the new legislation. I'm hoping someone can help clarify. Admittedly, my career goals don't include private practice and I don't know that much about running one, but my understanding was that most successful private clinicians see a good portion of clients who pay out of pocket for their services. I don't think these clients are going anywhere considering that most are not paying out of pocket because they can't afford/don't have health insurance. They are paying out of pocket because they can afford to go outside of network, can afford additional sessions, can see who they want to see, etc. So, if people are concerned that their client who pays $150 an hour for services now is suddenly going to be on an affordable health insurance plan that only pays $50/hr for brief EBT, I think that is a bit erroneous.

Can I assume, then, that the problem lies with clients whose services are currently covered by a health insurance provider? I know there is variability in reimbursement rates, but I guess $50/hr doesn't sound that much lower than the other rates I've heard quoted from insurance companies. We advise people on this board that planning a private practice with only clients who pay through insurance is not lucrative. 77K a year working part time is actually higher than what I would think people only taking insurance in PP now would make, assuming this figure takes overhead into account. As for the insurances that pay a good deal more, wouldn't those be the types of luxury insurance plans that employers would be likely to keep anyway, even in the face of the new legislation?

Again, these are genuine questions and I'm hoping people who have looked into the ins and outs of healthcare reform more than I have will have some answers. I'm not trying to push a political agenda.

Good questions. Im in PP and private insurances are the majority of my clientele. Most people cannot afford the pay out of pocket; clinicians who run a cash-pay system are a very very small minority of elite and old guard psychologists.

The lowest any private insurance pays me is $68 with a $20 copay from the client on top. So 88/ hrs is alot better than 50. The only insurance that pays me $50...Medicare. So this is where my concern is headed. When the govnmt steps in to make things fairer, my concern is that they will succeed.

And Just to reiterate, working under another persons license I currently generate over 80k for only 3 days a week.

 

[aequitasveritas]

You can lay off the "missy" stuff. Seriously.

Yes I would take someone's first hand account who has worked in a Canadian PP over someone who is posting links that refute his own statements. In case you haven't noticed, others (including myself in terms of my VHA argument) have posted links to articles and data to try and move the conversation forward. You are the one struggling to prove your point.

Your reference says nothing about base rates that I can see. It also does not state that $50 is the maximum hourly reimbursement. Again, the link does not differentiate between PP and other settings. It is very curious that some of your prior posts on the dangers of professional school debt and low earnings for psychologists seemed grounded in reality, but you are now acting as if $70K for part-time work is chump change or somehow worse than what most PP psychologists earn in the US right now. According the the 2009 APA Salary Data http://www.apa.org/workforce/publications/09-salaries/index.aspx#section5, private practice clinical psychologists with up to 5 years of experience earned $54,000. For those with 10 to 14 years of experience, the average wage was almost $100,000.

You are right, we don't know alot so far about Canadian PP income. I'd love to see some stats.

I never said that the U.S. PP world is all fine and dandy; in fact I have a real problem with it. My fear is that when the gov steps in to mandate and change things, our salaries might be mandated and changed as well. So until I see evidence to the contrary, I remain skeptical.

The national register ACO document was a glowing review from a few people who seem to be very very on board with the DNC. That's like me providing Ron Paul's review of the Fed and saying that it's proof we don't need the greenback anymore.

 

[O Gurl]

Good questions. Im in PP and private insurances are the majority of my clientele. Most people cannot afford the pay out of pocket; clinicians who run a cash-pay system are a very very small minority of elite and old guard psychologists.

The lowest any private insurance pays me is $68 with a $20 copay from the client on top. So 88/ hrs is alot better than 50. The only insurance that pays me $50...Medicare. So this is where my concern is headed. When the govnmt steps in to make things fairer, my concern is that they will succeed.

And Just to reiterate, working under another persons license I currently generate over 80k for only 3 days a week.

Great. So you started a thread to exclaim that the sky is falling based on a faulty assumption that the Affordable Healthcare Act is a plan to expand Medicare to everyone, despite the fact that there is not even a public option involved.

How logical and responsible.

 

[aequitasveritas]

I have to run and lead a group in a minute, but a quick google search revealed this: http://www.awcbc.org/common/assets/benefits/healthcare_service_provider_fees.pdf

I can't vouch for the accuracy of the numbers, and didn't look much into their applicability, but if they're in the ballpark, they don't look horrible to me (from what I could tell after a quick glance).

As for salary, I personally would consider $70k a great place to start, especially with a 31-hour work week. But that's just my personal opinion based solely on the numbers mentioned earlier in the thread.

Counsel
Counseling - $130/hr (max 10 sessions) PROBLEM

The mind does not change in 10 sessions. You can fix a flat tire, but if the alignment is the cause, it's gonna keep coming back into the shop.

 

[KillerDiller]

Good questions. Im in PP and private insurances are the majority of my clientele. Most people cannot afford the pay out of pocket; clinicians who run a cash-pay system are a very very small minority of elite and old guard psychologists.

The lowest any private insurance pays me is $68 with a $20 copay from the client on top. So 88/ hrs is alot better than 50. The only insurance that pays me $50...Medicare. So this is where my concern is headed. When the govnmt steps in to make things fairer, my concern is that they will succeed.

And Just to reiterate, working under another persons license I currently generate over 80k for only 3 days a week.

Thanks for taking the time to clarify.

 

[deliciousgoose]

Counsel
Counseling - $130/hr (max 10 sessions) PROBLEM

The mind does not change in 10 sessions. You can fix a flat tire, but if the alignment is the cause, it's gonna keep coming back into the shop.

Thanks for ignoring this post of mine:

And just to be clear that is what the Worker's Compensation board will pay, not what private individuals are charged, or even what private insurance companies will pay.

So that $130/hr is without any co-pay. And yes, it is limited to a certain number of sessions in much the same way that many american insurance companies limit the number of sessions covered.

The mind can change in 10 sessions, depending on what the presenting problem is. Also, it is *really* important to remember that this is what the Worker's Compensation Board will pay, how long the Worker's Compensation Board will pay for. The vast majority of PP does not have anything to do with the Worker's Compensation Board's

 

[aequitasveritas]

Great. So you started a thread to exclaim that the sky is falling based on a faulty assumption that the Affordable Healthcare Act is a plan to expand Medicare to everyone, despite the fact that there is not even a public option involved.

How logical and responsible.

Dude,

You have to read a little more about how the ACOs will work. The Org will operate like an HMO, not a PPO.

Furthermore, FEDERAL clerks will access an electronic data base and attempt to shepherd clients to the ACO and away from PP. This increases the revenue of the ACO, which will be regulated by the new stipulations....stipulations like....provider fees.

 

[O Gurl]

Dude,

You have to read a little more about how the ACOs will work. The Org will operate like an HMO, not a PPO.

Furthermore, FEDERAL clerks will access an electronic data base and attempt to shepherd clients to the ACO and away from PP. This increases the revenue of the ACO, which will be regulated by the new stipulations....stipulations like....provider fees.

I do not purport to be an expert in health care policy nor on a law that has not even come into effect yet. I, like many others here, am trying to read up on ACOs and potential impact for psychology. These negotiations are still in effect yet you are confidently claiming to know the exact impact while admitting that some of your concerns are based on Medicare reimbursements. When docma provides a link about ACOs from the National Register that paints a far less bleak picture than you'd like to scare up, you dismiss it as liberal spin (authors must be affiliated with the DNC).

A lot of what was described in that article sounds like quality assurance and utilization review processes that have been the growing trend in business and medicine for years. Of course insurance companies are going to want to see outcomes; push for treatments that are evidence supported; and place limits on the number of sessions covered. In fact, as many have already pointed out, this is already the case for those receiving MH care who are not paying out of pocket. It is already the case within the VHA, which as already stated, outranks private health care alternatives across key variables. Efficiency is something that providers SHOULD strive for. If anyone plans to make their living by retaining lifelong patients, then he/she has ethical issues that are a separate debate from health care coverage.

 

[DynamicDidactic]

Efficiency is something that providers SHOULD strive for. If anyone plans to make their living by retaining lifelong patients, then he/she has ethical issues that are a separate debate from health care coverage.

I think this emphasizes a change in practices. At one time, it was normal for people to seek therapy to become happier or achieve something better. Now, with managed healthcare, services are only for symptom reduction. Instead of assisting clients to achieve more the field is setup to only help them be well enough to get back to work.

Slightly hyperbolic to highlight a point.

 

[AcronymAllergy]

I think this emphasizes a change in practices. At one time, it was normal for people to seek therapy to become happier or achieve something better. Now, with managed healthcare, services are only for symptom reduction. Instead of assisting clients to achieve more the field is setup to only help them be well enough to get back to work.

Slightly hyperbolic to highlight a point.

But then it becomes an issue of: if there isn't a diagnosed illness, should the financial burden still fall on insurance/the healthcare system, or should it instead be displaced to the individual much as would the cost of other self-improvement behaviors (e.g., gym membership, extracurricular tutoring, etc.)?

Additionally, I don't know that having time-limited treatments necessarily means the treatments need to solely be symptom-focused. Part of the issue, of course, will depend on how outcomes are assessed (which, admittedly, would likely be tied heavily to reported symptoms).

 

[O Gurl]

I think this emphasizes a change in practices. At one time, it was normal for people to seek therapy to become happier or achieve something better. Now, with managed healthcare, services are only for symptom reduction. Instead of assisting clients to achieve more the field is setup to only help them be well enough to get back to work.

Slightly hyperbolic to highlight a point.

Well it also reflects the shift in orientation that has taken place in our field outside of managed healthcare. One of the cornerstones of the cognitive therapy, for instance, is helping clients become their own therapist--teaching them the skills to manage life as it comes there way without relying on a therapist indefinitely. Of course this approach will not appeal to everyone (nor should it) . Sure there are therapists who focus on helping people become happier and achieve more, but ask yourself: is this a healthcare concern? If so, then spiritual leaders could start billing as well. There is certainly a place and value to personal growth psychotherapy, but given the nature of our healthcare crisis, I can understand why there is an emphasis on tangible improvements like reduction of symptoms; reducing risk for criminal recidivism; reducing incidents of violence (in cases of domestic violence and/or behavioral disturbances); improved health care outcomes like weight loss and reduced infectious disease risk, etc. I don't know that happiness or lack of life fulfillment is a healthcare crisis. Again, I understand if that is what a therapist is passionate about doing. However, that may require seeing private pay patients, working for nonprofits; or utilizing sliding scale fees.

We as psychologists can't argue to be respected as healthcare providers but also resist being held to standards of healthcare providers.

 

[aequitasveritas]

It's not what I "think" is the going rate for psychologists in my area. I work in a private firm and in one of the largest mental health research centers in Canada. I have several family members who are psychologists and academics, and consequently have contact with many psychologists in my major city. I have lived in other major cities in Canada and because of my interest in psychology, and family background, have had extensive contact with practicing individuals there. Depending on the type of work, the private firm I work at charges between $240 and $450 per hour. New private practitioners in other major cities often start at $160-$180/hour.

I'm calling bull^&*% on this until you prove it.

240-450/hr. I know of some elite analysts in my area who charge this, but they are utterly exceptional and do not reflect the typical talents or pay schedules of 99% of the field.

Perhaps you work in a psychiatric firm?

Much more is needed here for a firm debate. Each side, including mine, is not informed enough to really move this further.

I'm considering this thread derailed.

 

[Therapist4Chnge]

Well it also reflects the shift in orientation that has taken place in our field outside of managed healthcare. One of the cornerstones of the cognitive therapy, for instance, is helping clients become their own therapist--teaching them the skills to manage life as it comes there way without relying on a therapist indefinitely.

That is great in theory, but much tougher to put in practice. I admittedly don't work much with psychiatric populations anymore, but when I did do therapy I worked exclusively with severe pathology (schizophrenia, biploar w. many suicide attempts, lifelong EDs, PTSD, etc) and time-limited CBT interventions won't scratch the surface with them. I had PE patients that did 12-14 sessions and went from severe to moderate report of symptoms (and similar level of functioning improvement).

The biggest problems I have with the proposed structure is that:
-decision making will be taken out of provider's hands and put into the untrained unlicensed non-healthcare professional's hands. People can argue semantics, but at the end of the day the gov't has a seat at the table between the provider & the patient. That is not good healthcare.
-The focus is on cost cutting, which often includes cutting services. The other major way to cut cost...cut reimbursements.

There are other raesons, but I need to finish my notes....so it'll have to wait.
-

 

[O Gurl]

The biggest problems I have with the proposed structure is that:
-decision making will be taken out of provider's hands and put into the untrained unlicensed non-healthcare professional's hands. People can argue semantics, but at the end of the day the gov't has a seat at the table between the provider & the patient. That is not good healthcare.
-The focus is on cost cutting, which often includes cutting services. The other major way to cut cost...cut reimbursements.
-

There is already someone between providers and patients in terms of billing and reimbursement: it is called the insurance company. And guess what, the folks at Blue Cross and Blue Shield are unlicensed, non-healthcare professionals. A point that I have nearly

to a pulp is that there is no evidence of adverse impact from having gov't involved. There is evidence that the VHA is a solid healthcare model. Elected officials and military servicemen are not complaining about their gov't healthcare either. Not to mention: the Affordable Healthcare Act is about expanding access first--NOT cutting existing benefits. I am not sure where you all are getting this from (ressurection of the Death Panels Myth?) or why anyone here is acting like utilization reviews are something new.

Riddle me this: how much farther can a presently uninsured patient get from his/her provider?

 

[deliciousgoose]

I'm calling bull^&*% on this until you prove it.

240-450/hr. I know of some elite analysts in my area who charge this, but they are utterly exceptional and do not reflect the typical talents or pay schedules of 99% of the field.

Perhaps you work in a psychiatric firm?

Much more is needed here for a firm debate. Each side, including mine, is not informed enough to really move this further.

I'm considering this thread derailed.

You can call bull-whatever.

I told you what the recommended starting rates are ($160-$180) and then provided my anecdote of the hourly rates in the firm I work in. It is definitely not a psychiatric firm. I don't know why you are so baffled that rates can be that high in a firm located in the downtown core of a major metropolitan area.

I agree this thread is derailed. All you've done is called bull**** on everyone without providing any rationale for it.

 

[RGirl]

According the Ontario Psychological Association, the recommended hourly fee is $220 (DeliciousGoose, I think you said you were in ON, right?).
http://www.psych.on.ca/files/nonmembers/Recommended Fee.pdf

It is less in Alberta, where some of the above stats were from, but given that this would include Masters-level psychologists, that is not a big surprise.
http://www.psychologistsassociation.ab.ca/site/recommended_fee_schedule

 

[AcronymAllergy]

According the Ontario Psychological Association, the recommended hourly fee is $220 (DeliciousGoose, I think you said you were in ON, right?).
http://www.psych.on.ca/files/nonmembers/Recommended Fee.pdf

It is less in Alberta, where some of the above stats were from, but given that this would include Masters-level psychologists, that is not a big surprise.
http://www.psychologistsassociation.ab.ca/site/recommended_fee_schedule

Heck, if $180/hour is "less," I really might consider moving to Canada after postdoc.

 

[aequitasveritas]

According the Ontario Psychological Association, the recommended hourly fee is $220 (DeliciousGoose, I think you said you were in ON, right?).
http://www.psych.on.ca/files/nonmembers/Recommended Fee.pdf

I bill $160. I do not get this on any insurance claim, and hardly ever from cash pay clients. This proclamation is nice and uplifting, and may loosely be based on going rates like the fed suggesting interest rates, but it is not evidence of earnings.

 

[deliciousgoose]

According the Ontario Psychological Association, the recommended hourly fee is $220 (DeliciousGoose, I think you said you were in ON, right?).
http://www.psych.on.ca/files/nonmembers/Recommended Fee.pdf

It is less in Alberta, where some of the above stats were from, but given that this would include Masters-level psychologists, that is not a big surprise.
http://www.psychologistsassociation.ab.ca/site/recommended_fee_schedule

Yes I am from Ontario, but I was saying $160-$180 starting for major Canadian cities. I was told it was $200+ in Ontario, but didn't have a source so I was trying to be cautious.

Thank you for finding the sources I couldn't.

 

[Sanman]

The discussion is getting off track, but I thought I would leave this link here regarding psychologists not having a seat at the table:

http://www.apa.org/news/press/releases/2009/07/white-house.aspx

 

[aequitasveritas]

Many of you have no idea of how private practice works. People may agree to a consult where they don't know you and are in duress, which often propels them to contract for an initial session. After that, they will only pay for a therapist who is worth her salt and knows what she's doing. Ur talking like "in city A, psychologists can charge this rate, therefore I will get paid this rate" , which is an error of logic. It does not work that way anywhere.

There needs to be real evidence that PP shrinks actually receive those earnings.

If Canadian shrinks are charging the lowest end of your reported fee, $180, and perhaps see 35 clients a week, they are making $315,000.
...not a chance, IMHO

 

[Therapist4Chnge]

The discussion is getting off track, but I thought I would leave this link here regarding psychologists not having a seat at the table:

http://www.apa.org/news/press/releases/2009/07/white-house.aspx

I remember reading that press release....back in 2009. A lot of things can change in almost 3 years. I hope I can be proven wrong, but I believe I read on one of the listservs that we didn't have a representative when the ACO parameters were being set. ACOs are going to dictate how and what we do as professionals.

ps. I swear I'm not this negative in real life...but I did a bunch of reading on ACOs awhile back, and they really scare the heck out of me.

 

[KayJay85]

The discussion is getting off track, but I thought I would leave this link here regarding psychologists not having a seat at the table:

http://www.apa.org/news/press/releases/2009/07/white-house.aspx

I've been following this thread and was looking to add this. Thanks for the info.

It would also be good if we could do this in a voice that is open-minded, evidence-based and willing to consider innovations. I worry that psychology will get into an adversarial, defensive stance rather than seeing some of the significant opportunities for innovation and more effective interdisciplinary care. Yes, there are risks in this change and a lot of the players in this process have their own gain foremost but we have opportunities because we have skills that primary medicine needs. I think it is important to learn who is providing the trainings/warnings as sometimes they have a political agenda in the mix there and we have to be careful not to be frightened away from seeing what opportunities are included in the coming change.

Exactly. This thread has been a prototype for how fear, unfamiliarity, and political posturing can breed misinformation.

 

[deliciousgoose]

Many of you have no idea of how private practice works. People may agree to a consult where they don't know you and are in duress, which often propels them to contract for an initial session. After that, they will only pay for a therapist who is worth her salt and knows what she's doing. Ur talking like "in city A, psychologists can charge this rate, therefore I will get paid this rate" , which is an error of logic. It does not work that way anywhere.

There needs to be real evidence that PP shrinks actually receive those earnings.

If Canadian shrinks are charging the lowest end of your reported fee, $180, and perhaps see 35 clients a week, they are making $315,000.
...not a chance, IMHO

Not to be pedantic, but shrink, at least in Canada, means psychiatrist. And you are right, most psychogists don't work full-time. Maybe of them work 20-30 hours per week. You aren't calculating the cost of office space, fax lines, etc into your estimated of take-home wage.

The OPA recommends $220/hour, and given that other factors are variable (hours, cost of office space etc.) I don't see why this conversation shouldn't be relegated exclusively to hourly rate. You argued that psychogists in Canada received a maximum of $55/hr and that is clearly not true. You further argued that this fictional rate was a reason for individual PPers to be concerned about the recent health bill.

I am seeing a big shift in your stance, but no change in your argumentative perspective.

 

[aagman01]

Lets not be too hard on Acquieveras.........he's a professional school student. He is good proof of why our field is f#$%^. BTW - Canada has no professional schools, and a pretty good market for psychs. I applied to one postdoc position in Toronto so far, and phone and skype interviews went very well. Starting salary for the public sector position I applied to is $75,000. It will increase to about $83,000 after the year of supervision and passing of the EPPP. Acquieveras, good luck in life

No. You have not provided evidence of anything. Your blurb on "absolute negatives" of the affordable healthcare act is then riddled with qualifiers like "may"; "could"; and "likely." You provide a vague WageInfo link for one Canadian province (Alberta) for "psychologists." There is no description of their degree of specialty (PhD vs. PsyD; clinical or academic; private practice or institutional; etc). The overall results table shows that the avg. # of hours worked per week among the sample was 31.5 with an average annual salary of $77K. Uhh.... that actually looks great compared to current US stats for psychologists. And you have the gall to simply ignore comments from those with first hand knowledge of reimbursement rates for PP psychologists in Canada.

I am not sure what prompted you to post this Chicken Little right-wing rant, but so far your efforts to scare training psychologists into rallying against the health care bill are failing.

 

[aequitasveritas]

Not to be pedantic, but shrink, at least in Canada, means psychiatrist. And you are right, most psychogists don't work full-time. Maybe of them work 20-30 hours per week. You aren't calculating the cost of office space, fax lines, etc into your estimated of take-home wage.

I never said anything about take home pay

The OPA recommends $220/hour, and given that other factors are variable (hours, cost of office space etc.) I don't see why this conversation shouldn't be relegated exclusively to hourly rate. You argued that psychogists in Canada received a maximum of $55/hr and that is clearly not true. You further argued that this fictional rate was a reason for individual PPers to be concerned about the recent health bill.

I am seeing a big shift in your stance, but no change in your argumentative perspective.

Actually, I simply provided figures which represent the payment from the socialized programs in Canada. I don't know what private practice psychologists make, and I haven't seen anything so far that truly outlines what the income ranged may be.

 

[aequitasveritas]

Lets not be too hard on Acquieveras.........he's a professional school student. He is good proof of why our field is f#$%^. BTW - Canada has no professional schools, and a pretty good market for psychs. I applied to one postdoc position in Toronto so far, and phone and skype interviews went very well. Starting salary for the public sector position I applied to is $75,000. It will increase to about $83,000 after the year of supervision and passing of the EPPP. Acquieveras, good luck in life

Good luck in Canada. I'm sure you will be missed

 

[O Gurl]

Lets not be too hard on Acquieveras.........he's a professional school student. He is good proof of why our field is f#$%^. BTW - Canada has no professional schools, and a pretty good market for psychs. I applied to one postdoc position in Toronto so far, and phone and skype interviews went very well. Starting salary for the public sector position I applied to is $75,000. It will increase to about $83,000 after the year of supervision and passing of the EPPP. Acquieveras, good luck in life

I am not interested in attacking someone personally, however the introduction of Canada as a comparison model opens a discussion about the differences in how our systems work, from health care access (universal vs. private) to training issues (traditional training vs. professional school proliferation). Whatever Canada has going on is better than the US model in terms of health care outcomes and they are apparently not doing too bad in terms of economic landscape for psychologists.

My bigger gripe with this thread is as follows:

The misinformation

For psychologists I see the effects as following:

2. Absolute negatives: treatment standards will be more granulated and standardized. Longer term txs will likely be met with more resistance. Some illnesses will be excluded from coverage to meet the more concentrated and elevated demand that will arise in these ACOs. Our wages will likely have a cap. Remember, in Canada the highest a psychologist makes is appx $50/hr. So if this ends private practice, our earnings could take a serious plunge. Our methods of tx will also be more subject to bureaucratic demands and regulations.

The challenge:

You are right, we don't know alot so far about Canadian PP income. I'd love to see some stats.

According the Ontario Psychological Association, the recommended hourly fee is $220 (DeliciousGoose, I think you said you were in ON, right?).
http://www.psych.on.ca/files/nonmembers/Recommended Fee.pdf

It is less in Alberta, where some of the above stats were from, but given that this would include Masters-level psychologists, that is not a big surprise.
http://www.psychologistsassociation.ab.ca/site/recommended_fee_schedule

Then the dismissal:

Many of you have no idea of how private practice works.

There does not seem to be openness to a real discussion.

 

[aequitasveritas]

I will leave it to the readers to decide for themselves who has points, and where.

You have not provided actual earning data; u simply gave association fee preferences, which nobody is obliged to pay. Most psychs will charge that, people will negotiate what they can/will pay, and tx ensues on a fee schedule which is likely to be significantly less than the asking price. If I c that psychs actually earn those wages I will stand corrected and admit my fault.

I am not going to pursue this further.

 

[deliciousgoose]

I never said anything about take home pay



Actually, I simply provided figures which represent the payment from the socialized programs in Canada. I don't know what private practice psychologists make, and I haven't seen anything so far that truly outlines what the income ranged may be.

Except that in multiple posts you equated hourly rate with take home pay (see your post that I quoted in the last post. Our responded to.)

 

[aequitasveritas]

Except that in multiple posts you equated hourly rate with take home pay (see your post that I quoted in the last post. Our responded to.)

Not true goose,

The reply above suggests that I think gross= net, which isn't the case anywhere.