Expected income in PP

[Sanman]

Some men just want to watch the world burn

View attachment 374881

Kindly deposit those funds into my bank account, so I can retire.

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[smalltownpsych]

Last year I paid myself about 45k in income and my business lost 30k. That being said, we have been able to weather the startup costs and have paid much of that back and are on a much different trajectory this year. First six months we have made a slim profit and have made up for some of the startup costs. The next goal is to get enough cash reserves and revenue to start investing in real estate. The tricky part of this business is how to make passive income. I have learned how to generate income for my own work which is great and there was a time when I struggled with that aspect of valuing my own work. First six months of the year 130k in gross and 75k was my sole direct billing for services so 55k mixed/shared revenue. Projected for next six months is 150k in gross with only 50k my direct billing and the practice generating 100k.

 

[Sanman]

Last year I paid myself about 45k in income and my business lost 30k. That being said, we have been able to weather the startup costs and have paid much of that back and are on a much different trajectory this year. First six months we have made a slim profit and have made up for some of the startup costs. The next goal is to get enough cash reserves and revenue to start investing in real estate. The tricky part of this business is how to make passive income. I have learned how to generate income for my own work which is great and there was a time when I struggled with that aspect of valuing my own work. First six months of the year 130k in gross and 75k was my sole direct billing for services so 55k mixed/shared revenue. Projected for next six months is 150k in gross with only 50k my direct billing and the practice generating 100k.

I appreciate the honest look at the numbers. Not a lot of people want to do that. Anything you would have done differently?

 

[smalltownpsych]

I appreciate the honest look at the numbers. Not a lot of people want to do that. Anything you would have done differently?

Sort of honest. 😉 It sounds worse than it actually was and the loss is what our accountant was able to come up with for the IRS. Where we really struggled was in lost income going from a 130k a year job and not having income for almost six months. Also, some of the business loss includes my salary so it’s not really a loss and also quite a few expenses such as home office and some travel and marketing factor into that equation too.

There is nothing I would really do differently, I invested more in furniture and office space and hiring a full time office staff than some might, but I also factored this into the type of business I am planning.

This year, the business will still not be technically very profitable but some of that will be because we are paying back money we put in. We like low taxes so it’s good to not make a lot of profit and next year the extra money will likely go towards a property as we go into the next phase of starting either a residential treatment or residential aftercare type of program or blend of both. We’ll see what arises.

 

[texanpsychdoc]

I am a completely online practice (part time) and seeing about 10-12 patients a week, I grossed $7,600 last month. I will be scaling my practice to see 25 a week in October with a projected gross income of $3675 (weekly), working 40 weeks out of the year, I am expecting a gross income of $147K. I have EXTREMELY low overhead (at most is $300 a month) but does not factor things lack deducting taxes, retirement, etc. This figure does not account for any passive income I get from my contracts which tends to be $183 a week for now, but will be dramatically increasing soon.

My only overhead are my monthly payments for EHR, Psychology Today, Mental Health Match, and accounting firm. I do everything myself for the most part. I don't have admin assistants or an office location.

 

[iliketohelppeople]

I am a completely online practice (part time) and seeing about 10-12 patients a week, I grossed $7,600 last month. I will be scaling my practice to see 25 a week in October with a projected gross income of $3675 (weekly), working 40 weeks out of the year, I am expecting a gross income of $147K. I have EXTREMELY low overhead (at most is $300 a month) but does not factor things lack deducting taxes, retirement, etc. This figure does not account for any passive income I get from my contracts which tends to be $183 a week for now, but will be dramatically increasing soon.

My only overhead are my monthly payments for EHR, Psychology Today, Mental Health Match, and accounting firm. I do everything myself for the most part. I don't have admin assistants or an office location.

Congrats on the income! Have been following your posts in quite a few threads, as I am thinking of going a similar way (still teaching until the time is right). While the threads you have started have been really helpful as I am thinking about the general organization/portions, any other resources/information you would recommend for someone looking to go a similar path?

 

[texanpsychdoc]

Congrats on the income! Have been following your posts in quite a few threads, as I am thinking of going a similar way (still teaching until the time is right). While the threads you have started have been really helpful as I am thinking about the general organization/portions, any other resources/information you would recommend for someone looking to go a similar path?

I honestly just do a lot of reading online, including this forum and look at various threads by physicians to see if there's anything I could incorporate/expand upon. I love to watch "Private Practice Skills" channel on Youtube. I don't necessarily care for Dr. Fang's sociopolitical views she injects into her commentary at times, but business-wise she is solid and has good advice for those looking to not only start or maintain a practice, but one that is cash pay. My practice is insurance-based...I've often considered making some Youtube videos on how to go about that. I would recommend looking at therathink.com as a good place for CPT code stuff. As far as mechanics of establishing a business (LLC), marketing (print, digital, and cold call), getting on insurances, getting an EHR system, accounting, creating templates for notes/reports, crafting practice policies and informed consent...these are all things I have done 100% on my own and continue to do so. I would recommend looking into LegalZoom for a nice streamlined process to set up your LLC/PLLC. I love SimplePractice for my EHR/telehealth platform. I use Psychology Today and Mental Health Match as my two primary directories in addition to being listed in the insurance companies' directories (which tend to have low turnout for me as I am listed in their telehealth section and not the brick and mortar section). I looked at my state board's rules regarding informed consent and crafted it based on that as well as policies that align with how I want to run my business; it also comes with a lot of trial and error...I learn a lot along the way and modify things accordingly based on what doesn't work well or is clearly communicated to my patients. I belong to several Facebook groups (i.e., PSYPACT Psychologists, The Testing Psychologist Community, Insurance Credentialing and Billing for Mental Health Clinicians, and several state local therapy/psychologist groups) where I learn from more seasoned professionals in private practice (they have been the most helpful navigating insurance and honing my business approach). I spend a lot of my time marketing, more-so doing email campaigns, some cold calling, but a lot of networking; I tend to be on the Facebook groups a lot to see potential referrals and market my practice.

I would say if you can start building your practice now in a position of "power" (i.e., currently employed in a full time job), then you can use your earnings to start up your business and not worry about needing to get in patients ASAP to start earning money to pay your bills. Give yourself 4-8 months to build and scale your practice so you can figure out the ins and outs of things, figure out what your no show and cancellation percentages will look like, develop a consistent marketing schedule, and have a general plan of how you want to grow the business over the next 12 months, and ideally what you will want to do the following year. For example, now that I have achieved a consistent patient load, I have insurance billing down like a science (no rejected or denied claims since getting in network with my 3 companies), I have a very solid approach in setting and enforcing boundaries with no shows and late cancellations ($125 fee really lights a fire), I also remind my patients 72 hours in advance with a text and email reminder. My notes are very simple and streamlined so that I am always submitting my note, collecting their co-pay, submitting their claim, and re-scheduling their follow up before I close out of the video session....leaving me about 8 minutes to go pee before my next client. I am very efficient with my time and plan every day. I keep my overhead low. I screen calls/prospective clients for overall fit and do not always return every person's voice message, especially from those in which someone else is calling to schedule a session on behalf of another person (that just sets a poor foundation from the onset, such as triangulation issues). I have hired on 2 contractors and skim a % off of their earnings in a tiered fashion, so that's passive income for me there. I have since developed a wait list that is 3-4 weeks out that has about 8 people on it; this allows me to have a steady pipeline of patients so that if I get a cancellation, I can fill that slot with someone on my wait list, and, when I finally go full time in PP, I won't be frantically waiting for 10 more people to call me for me to fill my remaining slots to complete 25 per week....I would have them queued up in my waitlist and will just plug them into my newly opened slots (I've already been doing this). My goal by the end of this yeah, now that my insurance companies have been increasing their rates ($178 for a 90791 and $153 for a 90837) and with more cash pay clients coming on board, my next goal is to go from seeing 5 a day to 4 a day while still maintaining my 40 work week year. Eventually, I will add more contractors and get more cash pay clients so I can see 3 people a day while maintaining a 40 week year all while hitting $14K monthly income.

One last thing....IMO, being a business owner really means you are in the relationship-making business. A lot of my time is spent creating and maintaining relationships with others, especially would-be referral sources, so, do what you can to make that happen. I will be putting on an all-expenses paid 3-course steak dinner for 10 people at a nice upscale steakhouse in the coming months (this will likely cost me about $1000). I will be strategic in selecting the people I want to invite for the dinner to serve as referral sources for me..and give a nice 20 minute presentation in the process.

 

[texanpsychdoc]

I will say in full transparency, that despite being in network with BCBS and United (soon to be with Aetna), my practice is not full. I know folks say "if you take insurance, your practice will fill quickly," and that has been somewhat true, but not completely. I am still trying to iron out how I am getting referrals and also ensuring I have a steady pipeline of folks (by having a wait list and dedicated one hour a week to doing intakes).

 

[Sanman]

I will say in full transparency, that despite being in network with BCBS and United (soon to be with Aetna), my practice is not full. I know folks say "if you take insurance, your practice will fill quickly," and that has been somewhat true, but not completely. I am still trying to iron out how I am getting referrals and also ensuring I have a steady pipeline of folks (by having a wait list and dedicated one hour a week to doing intakes).

Certainly it will fill quickly compared to cash only. That said, availability will also dictate how full you are. I would bet good money you will not have a problem filling a Tues-Thurs 7pm slot. I used to have multiple folks always calling for those.

 

[iliketohelppeople]

I honestly just do a lot of reading online, including this forum and look at various threads by physicians to see if there's anything I could incorporate/expand upon. I love to watch "Private Practice Skills" channel on Youtube. I don't necessarily care for Dr. Fang's sociopolitical views she injects into her commentary at times, but business-wise she is solid and has good advice for those looking to not only start or maintain a practice, but one that is cash pay. My practice is insurance-based...I've often considered making some Youtube videos on how to go about that. I would recommend looking at therathink.com as a good place for CPT code stuff. As far as mechanics of establishing a business (LLC), marketing (print, digital, and cold call), getting on insurances, getting an EHR system, accounting, creating templates for notes/reports, crafting practice policies and informed consent...these are all things I have done 100% on my own and continue to do so. I would recommend looking into LegalZoom for a nice streamlined process to set up your LLC/PLLC. I love SimplePractice for my EHR/telehealth platform. I use Psychology Today and Mental Health Match as my two primary directories in addition to being listed in the insurance companies' directories (which tend to have low turnout for me as I am listed in their telehealth section and not the brick and mortar section). I looked at my state board's rules regarding informed consent and crafted it based on that as well as policies that align with how I want to run my business; it also comes with a lot of trial and error...I learn a lot along the way and modify things accordingly based on what doesn't work well or is clearly communicated to my patients. I belong to several Facebook groups (i.e., PSYPACT Psychologists, The Testing Psychologist Community, Insurance Credentialing and Billing for Mental Health Clinicians, and several state local therapy/psychologist groups) where I learn from more seasoned professionals in private practice (they have been the most helpful navigating insurance and honing my business approach). I spend a lot of my time marketing, more-so doing email campaigns, some cold calling, but a lot of networking; I tend to be on the Facebook groups a lot to see potential referrals and market my practice.

I would say if you can start building your practice now in a position of "power" (i.e., currently employed in a full time job), then you can use your earnings to start up your business and not worry about needing to get in patients ASAP to start earning money to pay your bills. Give yourself 4-8 months to build and scale your practice so you can figure out the ins and outs of things, figure out what your no show and cancellation percentages will look like, develop a consistent marketing schedule, and have a general plan of how you want to grow the business over the next 12 months, and ideally what you will want to do the following year. For example, now that I have achieved a consistent patient load, I have insurance billing down like a science (no rejected or denied claims since getting in network with my 3 companies), I have a very solid approach in setting and enforcing boundaries with no shows and late cancellations ($125 fee really lights a fire), I also remind my patients 72 hours in advance with a text and email reminder. My notes are very simple and streamlined so that I am always submitting my note, collecting their co-pay, submitting their claim, and re-scheduling their follow up before I close out of the video session....leaving me about 8 minutes to go pee before my next client. I am very efficient with my time and plan every day. I keep my overhead low. I screen calls/prospective clients for overall fit and do not always return every person's voice message, especially from those in which someone else is calling to schedule a session on behalf of another person (that just sets a poor foundation from the onset, such as triangulation issues). I have hired on 2 contractors and skim a % off of their earnings in a tiered fashion, so that's passive income for me there. I have since developed a wait list that is 3-4 weeks out that has about 8 people on it; this allows me to have a steady pipeline of patients so that if I get a cancellation, I can fill that slot with someone on my wait list, and, when I finally go full time in PP, I won't be frantically waiting for 10 more people to call me for me to fill my remaining slots to complete 25 per week....I would have them queued up in my waitlist and will just plug them into my newly opened slots (I've already been doing this). My goal by the end of this yeah, now that my insurance companies have been increasing their rates ($178 for a 90791 and $153 for a 90837) and with more cash pay clients coming on board, my next goal is to go from seeing 5 a day to 4 a day while still maintaining my 40 work week year. Eventually, I will add more contractors and get more cash pay clients so I can see 3 people a day while maintaining a 40 week year all while hitting $14K monthly income.

One last thing....IMO, being a business owner really means you are in the relationship-making business. A lot of my time is spent creating and maintaining relationships with others, especially would-be referral sources, so, do what you can to make that happen. I will be putting on an all-expenses paid 3-course steak dinner for 10 people at a nice upscale steakhouse in the coming months (this will likely cost me about $1000). I will be strategic in selecting the people I want to invite for the dinner to serve as referral sources for me..and give a nice 20 minute presentation in the process.

Thanks for the really thoughtful reply. Wish I had more than a 'like' button to give you. I have definitely been perusing this forum, but that is a good word on the professional groups.

 

[Wendi22]

Hi Everyone- Sorry in advance if this is not the place to ask this question (I attempted to find a relevant thread). I am looking to do some independent contracting for a PP. I need an NPI but prefer not to use my SSN. The owner of the PP said that I need to apply for an individual PP and select sole proprietor (i.e., use my SSN). The owner also said billing will likely occur under their NPI 2 but is unsure if my SSN will show up anywhere. Is there a way around using my SSN? Can I apply for an EIN and use that instead? Thank you for any help!

 

[WisNeuro]

Hi Everyone- Sorry in advance if this is not the place to ask this question (I attempted to find a relevant thread). I am looking to do some independent contracting for a PP. I need an NPI but prefer not to use my SSN. The owner of the PP said that I need to apply for an individual PP and select sole proprietor (i.e., use my SSN). The owner also said billing will likely occur under their NPI 2 but is unsure if my SSN will show up anywhere. Is there a way around using my SSN? Can I apply for an EIN and use that instead? Thank you for any help!

Even if they bill under the clinic NPI (NPI - II) they will still be using your NPI as the rendering provider. Are you saying that you want to form an LLC and have the LLC be the technical "contractor?"

 

[Wendi22]

Even if they bill under the clinic NPI (NPI - II) they will still be using your NPI as the rendering provider. Are you saying that you want to form an LLC and have the LLC be the technical "contractor?"

That is what I thought. Thanks.

I read you can get an EIN so you don’t have to use your SSN without getting an LLC.

My whole thing is not wanting my SSN number to show up on billing stuff. Is there no way around this when you do independent contracting for an existing PP with an LLC?

 

[WisNeuro]

That is what I thought. Thanks.

I read you can get an EIN so you don’t have to use your SSN without getting an LLC.

My whole thing is not wanting my SSN number to show up on billing stuff. Is there no way around this when you do independent contracting for an existing PP with an LLC?

You still need your NPI as the rendering provider. What "billing stuff" do you not want your SSN on? It's not on any of my regular billing stuff.

 

[Wendi22]

You still need your NPI as the rendering provider. What "billing stuff" do you not want your SSN on? It's not on any of my regular billing stuff.

Someone informed me that if I use my own SSN to get a NPI, it would show up on information that clients’ receive. They made it sound like your SSN would just be floating out there for everyone to see. Obviously, that would not be what I want so I was fearful about using it to get a NPI.

 

[WisNeuro]

Someone informed me that if I use my own SSN to get a NPI, it would show up on information that clients’ receive. They made it sound like your SSN would just be floating out there for everyone to see. Obviously, that would not be what I want so I was fearful about using it to get a NPI.

I do not think this is true. Regardless, if you are billing for your services now, you already have an NPI I.

 

[Wendi22]

I do not think this is true. Regardless, if you are billing for your services now, you already have an NPI I.

Thank you! Nope not billing yet and have not done so.

 

[WalterKovacs]

Early career psych here, just accepted an offer at a group practice full time. 60/40 split, 25 direct billable hours for 48 weeks, medical, dental and vision insurance, no paid vacations, holidays or personal days. Owner estimated around 140k. I'm so green here and have been reading this thread full of great advice. I am excited to get to work but also worry about being taken advantage of. Any guidance/questions to consider would be appreciated!

 

[WisNeuro]

Early career psych here, just accepted an offer at a group practice full time. 60/40 split, 25 direct billable hours for 48 weeks, medical, dental and vision insurance, no paid vacations, holidays or personal days. Owner estimated around 140k. I'm so green here and have been reading this thread full of great advice. I am excited to get to work but also worry about being taken advantage of. Any guidance/questions to consider would be appreciated!

Just keep track of what you r are billing (CPT codes) and you can see what you're bringing in. 140 plus benefits for what is essentially a .8FTE is decent for non-self employed positions. I've seen better, but I far more often see worse. The usual here is 50/50 splits with mediocre to bad benefits.

 

[Sanman]

Early career psych here, just accepted an offer at a group practice full time. 60/40 split, 25 direct billable hours for 48 weeks, medical, dental and vision insurance, no paid vacations, holidays or personal days. Owner estimated around 140k. I'm so green here and have been reading this thread full of great advice. I am excited to get to work but also worry about being taken advantage of. Any guidance/questions to consider would be appreciated!

The job sounds decent. Is there a non-compete clause in your contract? At this stage, the biggest things you can do are to learn and protect yourself. The split seems decent and that is a pretty good compensation. Are you being paid based on billables or collections? I agree with @WisNeuro about tracking your billables and you can decide whether the position is worth keeping or if you would rather move on.

Also, it should leave plenty of time for evening vigilante activities.

 

[SomeGreatNotion]

Early career psych here, just accepted an offer at a group practice full time. 60/40 split, 25 direct billable hours for 48 weeks, medical, dental and vision insurance, no paid vacations, holidays or personal days. Owner estimated around 140k. I'm so green here and have been reading this thread full of great advice. I am excited to get to work but also worry about being taken advantage of. Any guidance/questions to consider would be appreciated!

Is that 140k estimate directly tied to the billable hours or is this being offered as a salary? If tied to billable hours, that 140k estimate seems high to me. Essentially, for each of the 1200 yearly billable hours you are getting ~$116 and the practice is receiving $78 which means the total received is $194. If the practice is cash only I can see it. If insurance is accepted I am more skeptical as the estimated rate is certainly more than the average received by my group practice though I imagine there may be regional/code differences.

All in all if your estimates are correct, I agree this is a decent position.

 

[WisNeuro]

Is that 140k estimate directly tied to the billable hours or is this being offered as a salary? If tied to billable hours, that 140k estimate seems high to me. Essentially, for each of the 1200 yearly billable hours you are getting ~$116 and the practice is receiving $78 which means the total received is $194. If the practice is cash only I can see it. If insurance is accepted I am more skeptical as the estimated rate is certainly more than the average received by my group practice though I imagine there may be regional/code differences.

All in all if your estimates are correct, I agree this is a decent position.

Depends, if they're in an area where 90837 is pretty commonly accepted without pushback, they're grossing 175k just based on Medicare numbers. Even if they are taking insurance, presumably your mix is not 100% Medicare, or even close. Definitely doable depending on payor mix and what the practice has negotiated.

 

[erg923]

Is that 140k estimate directly tied to the billable hours or is this being offered as a salary? If tied to billable hours, that 140k estimate seems high to me. Essentially, for each of the 1200 yearly billable hours you are getting ~$116 and the practice is receiving $78 which means the total received is $194. If the practice is cash only I can see it. If insurance is accepted I am more skeptical as the estimated rate is certainly more than the average received by my group practice though I imagine there may be regional/code differences.

All in all if your estimates are correct, I agree this is a decent position.

Early career psych here, just accepted an offer at a group practice full time. 60/40 split, 25 direct billable hours for 48 weeks, medical, dental and vision insurance, no paid vacations, holidays or personal days. Owner estimated around 140k. I'm so green here and have been reading this thread full of great advice. I am excited to get to work but also worry about being taken advantage of. Any guidance/questions to consider would be appreciated!

140K is with counting 20 total days off per year and is an "estimate?"

You have to remember that 5 days of that will often be the traditional Thanksgiving Holidays, Christmas Holidays, and New Years Holidays. That's 14-15 total days of more traditional "time off" that supposedly doesn't impact your compensation. But then....what about sick days or time for medical stuff? Still not terrible on paper for a first job, but with a family or childcare needs??? Sick days, emergencies, medical appts, or surgeries? What's left? A work week or 2 at best? And, the 140k was an "estimate" anyway.

5 weeks (outside the traditional Monday holidays) of total time off in a year is essentially what we (as a family anyway) count on for our vacations, long weekends etc. at this point. And that's not counting at least a few sick days and/or medical stuff or so per year (dentist, checkups/consults, tests, procedures, etc.).

I would imagine it would end up being substantially less than that 140k once your whole life and the payor mix and/or no shows (paid for no-shows/cancellations?) is actually factored in. Do they schedule 25 hours a week for you and hope for that.... or schedule like 30 hours and hope for cancelations and no shows?

But again, new grad with some hustle and no family? Not bad if not in a high COLA.

All therapy/intake's all day long can get old quick, too. Make sure you think about that. And what is the admin support like? PAs, insurance forms, scheduling/phone calls, copies, supplies, etc.

 

[AcronymAllergy]

Early career psych here, just accepted an offer at a group practice full time. 60/40 split, 25 direct billable hours for 48 weeks, medical, dental and vision insurance, no paid vacations, holidays or personal days. Owner estimated around 140k. I'm so green here and have been reading this thread full of great advice. I am excited to get to work but also worry about being taken advantage of. Any guidance/questions to consider would be appreciated!

As others have said, $140k/year for 48 weeks of 25 billable hours/week + insurance doesn't jump out to me as a bad deal. Although there aren't paid days off, they're of course accounting for time off by calculating based on a 48-week year. But as was asked above, a lot may depend on how this estimate was calculated, how you're going to be scheduled, and if the $140k is a more firm salary offer or a less firm true estimate based on collections.

 

[smalltownpsych]

Sounds like a pretty good deal to me to get you started. It sounds like a setup similar to a job that I had for almost five years. I probably worked a little more like 30 billable hours and was paid about 150k. The main way a setup like this doesn’t work is if you are inefficient or ineffective as a clinician. Some people confuse the two and think that efficiency is counter to efficacy. Experience has taught me otherwise. I naturally lean toward being helpful and accommodating and unstructured so a focus on money and time being money helps me to set appropriate limits and boundaries.

 

[MCParent]

I’m sure he choose a good one, so this is not directed at him, but I think people overestimate the likelihood of making $$$$ in venture. For every Google/Facebook/Uber/etc, there’s tons of startups just getting by and probably even more that are going broke. I know of one tenured psychology professor who quit to work for Facebook/Meta, got laid off about a year later, and still can’t find a full-time job (he’s location-bound to the state where he was faculty). There are lots of people for whom tech/venture is a great move, but it’s not guaranteed mountains of money or even guaranteed employment. If/when I leave academia, it’d be for government work (very nearly did so this past year but decided to try out tenure—not 100% sure if I made the right choice).

I was doing lgbtq+ affirming work in Texas. In addictions class I promoted harm reduction and taught about how badly the gov’t bungles drug policy. In my sport psych class I covered the history of racism, sexism, and transphobia in sports in the US and internationally.
Pretty sure my name was on some lists in the Texas legislature. I feel vastly more job security and institutional support than I did in academia.

 

[WisNeuro]

I was doing lgbtq+ affirming work in Texas. In addictions class I promoted harm reduction and taught about how badly the gov’t bungles drug policy. In my sport psych class I covered the history of racism, sexism, and transphobia in sports in the US and internationally.
Pretty sure my name was on some lists in the Texas legislature. I feel vastly more job security and institutional support than I did in academia.

Are you doing pure industry work now? Any clinical side work?

 

[MCParent]

Are you doing pure industry work now? Any clinical side work?

No clinical work now or planned. I’d been doing it very part time, partially for the money but also because I was teaching graduate core clinical skills courses and I think it’s insane when people teach those classes but haven’t seen a patient in 10 years. It is very nice to know that my backup career pays great. Before I left academia I’d had an offer to join a boutique psychiatry practice at about 250k. But I never really wanted to do ft clinical work.
Current job is a mix of philanthropy and industry. I love it. Actual team science approach, actual valuing of implementation science.

 

[WisNeuro]

No clinical work now or planned. I’d been doing it very part time, partially for the money but also because I was teaching graduate core clinical skills courses and I think it’s insane when people teach those classes but haven’t seen a patient in 10 years. It is very nice to know that my backup career pays great. Before I left academia I’d had an offer to join a boutique psychiatry practice at about 250k. But I never really wanted to do ft clinical work.
Current job is a mix of philanthropy and industry. I love it. Actual team science approach, actual valuing of implementation science.

That's awesome! Glad to hear it. I have to say, almost every single person I know who transitioned fully or largely away from clinical/academic work (I'm about 60-70% forensic) has not regretted the decision. Though I do know one clinical academician who just secured a pretty hefty bag.

 

[erg923]

No clinical work now or planned. I’d been doing it very part time, partially for the money but also because I was teaching graduate core clinical skills courses and I think it’s insane when people teach those classes but haven’t seen a patient in 10 years. It is very nice to know that my backup career pays great. Before I left academia I’d had an offer to join a boutique psychiatry practice at about 250k. But I never really wanted to do ft clinical work.
Current job is a mix of philanthropy and industry. I love it. Actual team science approach, actual valuing of implementation science.

Anymore to say? I always kind of wondered where these implementation science jobs were for the dozen or so hardcore clinical science Ph.D programs out there. Always seems like they would go into fairly traditional academia to me, but for 20 years that guild has been preaching "implementation science jobs" along with traditional academic positions.

I know Humana has some Ph.D.s doing population health research, along with what I suppose would be considered implementation research and work for a good decade or so.

 

[WisNeuro]

Anymore to say? I always kind of wondered where these implementation science jobs were for the dozen or so hardcore clinical science Ph.D programs out there. Always seems like they would go into fairly traditional academia to me, but for 20 years that guild has been preaching that there are jobs that exist and pay well.

I know Humana has some Ph.D.s doing population health research, along with what I suppose would be considered implementation research and work for a good decade or so.

I'll take a job wherein I let people repeatedly kick me in the nuts before I work for Humana. By far one of the worst insurers in this area.

 

[erg923]

I'll take a job wherein I let people repeatedly kick me in the nuts before I work for Humana. By far one of the worst insurers in this area.

Big HQ here. Only reason I know. I don't work for them.

 

[Sanman]

I'll take a job wherein I let people repeatedly kick me in the nuts before I work for Humana. By far one of the worst insurers in this area.

Humana offers that too. Unfortunately, that is a 1099 contractor position only. For some reason, the health insurance premiums were killing them....

 

[futureapppsy2]

Humana offers that too. Unfortunately, that is a 1099 contractor position only. For some reason, the health insurance premiums were killing them....

Hell, you can even pay them for the pleasure of getting kicked in the nuts repeatedly.

 

[futureapppsy2]

I was doing lgbtq+ affirming work in Texas. In addictions class I promoted harm reduction and taught about how badly the gov’t bungles drug policy. In my sport psych class I covered the history of racism, sexism, and transphobia in sports in the US and internationally.
Pretty sure my name was on some lists in the Texas legislature. I feel vastly more job security and institutional support than I did in academia.

Yeah, that's also a driving reason that I want to leave academia for government, ngl. Not the primary one, but definitely a big one. So, I feel you there.

 

[erg923]

Hell, you can even pay them for the pleasure of getting kicked in the nuts repeatedly.

Lol. Man...I had a Humana plan years ago when with VA. Never had any problems getting stuff for myself, wife, and children.

 

[MCParent]

Anymore to say? I always kind of wondered where these implementation science jobs were for the dozen or so hardcore clinical science Ph.D programs out there. Always seems like they would go into fairly traditional academia to me, but for 20 years that guild has been preaching "implementation science jobs" along with traditional academic positions.

I know Humana has some Ph.D.s doing population health research, along with what I suppose would be considered implementation research and work for a good decade or so.

Anyone is super welcome to follow me on LinkedIn, btw

https://www.linkedin.com/in/mike-parent-phd-mba-8b238475

Well; traditional academic programs did a nightmarishly bad job of preparing students even for their most common jobs in practice. I literally had to do my PP work shops starting out with defining costs, revenue, and profit and telling people they need to track those. They obviously then didn’t touch any other kinds of business topics such as brand management, client relations, networking, etc. And, tbh, they also do a terrible job of preparing people to actually be professors and participate in the basic tasks of that job, like interviewing applicants to the lab (ie hiring), managing students, etc. Then there was zero on actual higher admin stuff like policy writing. I did an MBA to compensate for my lack of training in any of that. And that’s from me, who LOVED grad school and had the best advisor I could imagine having. It wasn’t even on the training program radar to cover those topics.

I’m not familiar with the implementation of the psych science model enough to comment on it in specific but I’d take a bet that the same issues persist. There might be grant writing training, but I’m betting it’s probably for K awards R01s and not SBIR/STTRs. I wonder if psych science is infected with a parallel of the “you shouldn’t want to make money as a therapist” mindvirus but applied to producing R01 clinical trials as the apec of human morality. I’ll also say that my perception has been that a fair number of people want to be professors mostly bc they want to do whatever they want; I dont think the idea of leading collaborations among multiple stakeholders including community folks throughout design and implementation is super appealing to a very non-zero number of them.

I think psych folks who are interested should go look at LinkedIn jobs. I know LOTS of people who have just never looked at or considered jobs in industry or at philanthropy orgs. Scanning the jobs can give people a basic idea of what those positions are looking for.

Happy to say more about other specific things; broad topic so not sure how useful all that was.

 

[erg923]

Anyone is super welcome to follow me on LinkedIn, btw

https://www.linkedin.com/in/mike-parent-phd-mba-8b238475

Well; traditional academic programs did a nightmarishly bad job of preparing students even for their most common jobs in practice. I literally had to do my PP work shops starting out with defining costs, revenue, and profit and telling people they need to track those. They obviously then didn’t touch any other kinds of business topics such as brand management, client relations, networking, etc. And, tbh, they also do a terrible job of preparing people to actually be professors and participate in the basic tasks of that job, like interviewing applicants to the lab (ie hiring), managing students, etc. Then there was zero on actual higher admin stuff like policy writing. I did an MBA to compensate for my lack of training in any of that. And that’s from me, who LOVED grad school and had the best advisor I could imagine having. It wasn’t even on the training program radar to cover those topics.

I’m not familiar with the implementation of the psych science model enough to comment on it in specific but I’d take a bet that the same issues persist. There might be grant writing training, but I’m betting it’s probably for K awards R01s and not SBIR/STTRs. I wonder if psych science is infected with a parallel of the “you shouldn’t want to make money as a therapist” mindvirus but applied to producing R01 clinical trials as the apec of human morality. I’ll also say that my perception has been that a fair number of people want to be professors mostly bc they want to do whatever they want; I dont think the idea of leading collaborations among multiple stakeholders including community folks throughout design and implementation is super appealing to a very non-zero number of them.

I think psych folks who are interested should go look at LinkedIn jobs. I know LOTS of people who have just never looked at or considered jobs in industry or at philanthropy orgs. Scanning the jobs can give people a basic idea of what those positions are looking for.

Happy to say more about other specific things; broad topic so not sure how useful all that was.

I too also only practice in a consultant role now. I used to do more clinical work, but the therapy role I did in the Athletics Department was recently taken over by mid-levels (mostly due to an interim AD who dismantled a few years worth internal program building).

My full-time employed role leaves me in a bizzaro, "in-between land" of clinical and business needs/operations. Nevertheless, it is pretty good and fully work-from-home. I really can't go back to an outpatient office (or any office) at this point.

I too am astonished at how highly educated people don't know the basics of mental health treatment plan writing and CPT coding, much less overall best practice in clinical service delivery.

 

[Sanman]

Anyone is super welcome to follow me on LinkedIn, btw

https://www.linkedin.com/in/mike-parent-phd-mba-8b238475

Well; traditional academic programs did a nightmarishly bad job of preparing students even for their most common jobs in practice. I literally had to do my PP work shops starting out with defining costs, revenue, and profit and telling people they need to track those. They obviously then didn’t touch any other kinds of business topics such as brand management, client relations, networking, etc. And, tbh, they also do a terrible job of preparing people to actually be professors and participate in the basic tasks of that job, like interviewing applicants to the lab (ie hiring), managing students, etc. Then there was zero on actual higher admin stuff like policy writing. I did an MBA to compensate for my lack of training in any of that. And that’s from me, who LOVED grad school and had the best advisor I could imagine having. It wasn’t even on the training program radar to cover those topics.

While I cannot speak to the clinical science/research side of things, I completely agree with your assessment that grad school does a poor job of preparing one for the realities of clinical practice, especially outside something like the VA. For all the negative things I can say about my first job, they did a good job teaching clinicians coding and business operations. That was when I discovered that I really had a talent for that side of things and something I had a chance to flush out later at smaller practices. Unfortunately, I also learned that while I was good at business operations, it was really easy to be underpaid and undervalued as a middle manager. I now teach didactics on CPT coding and other operations related topics. These end up being some of the most highly rated didactics by the students.