Forensics Pay (are they really going there?)

[psych1234567]

Yes I am lol. Look, I’ve been interested in forensics for a long time and am going into the specialty regardless of pay. If I made no more than I would as a general psychiatrist, I would still do it because I find it to be the most interesting field in psychiatry imo.

That being said, there is no transparency in forensic psychiatry as to the income opportunity. I’ve read a bunch of posts on here and Reddit talking about how either the sky is the limit and others saying you won’t make anything because it’s impossible to break into. Some say it’s not possible to fill most of your time with forensic work and then others say it’s relatively easy once you put in a year or two to be mostly forensic. Then you look online and essentially no one makes their rates available for the public. I’ve looked at the seak data and someone on here mentioned that, while they are pretty high per hour, they are grossly low for forensic psychiatrists they know. Then there are people on here who say they can’t get a lawyer to even pay their regular clinic fee of $300/hr for review. Others saying that they are charging $750/hr without issue. I get that there are a lot of factors here such as experience and marketing and who you know but man, it would be nice to have some sort of transparency for people who want to go into the field. The job isn’t all about money (I would’ve picked a different field of medicine if it was to me) but it is still a job.

Idk, I guess I’m rambling. At the end of the day, I guess my question is, if I dedicate part of my time over the next few years to honing my skills and building up a strong forensic practice, what are the possibilities I’m looking at for compensation?

Thanks for reading all of this, it’s been on my mind for a while hence the rambling.

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[lobstar]

I think your summary is the reality of the situation. There's unfortunately no guaranteed path like we're used to with med school, residency, get job that pays X based on MGMA or whatever. You commit to it you may not get clients you may get a lot. Try billing 700 and they may or may not pay it. I'm not forensic trained but have gotten 400 for random patients who call in and I have time to do something I'm comfortable with. It's kind of like asking if I open an interventional clinic what will I make. It all depends on your marketing and local factors. But yeah you can make a ton of money potentially.

 

[romanticscience]

Forensics is a specialty that, if you want the money, you cannot consider it the same way as other medical specialties (e.g., neurosurgery), where the money is guaranteed and often comes in the form of a salary.

The good money associated with forensics comes through privately contracting with a 3rd party (attorney, insurance company, government agency, or court) who pays you your rate. It is highly variable because these contacts are sometimes feast or famine. You can't create a steady stream of them (usually, although I do court work, which eats what you kill at a lower rate) like you can a bunch of cataract surgeries.

Many forensic people are in academia, where they get paid a crappy salary and get paid a premium for their forensic work. On the other side of the spectrum are the big names (Dietz?) who probably can schedule 40 hours per week of high-rate forensic work.

Your income opportunity is not guaranteed in this field. A fellowship doesn't do it. Many with the board certification are just essentially jail psychiatrists. I didn't do the fellowship. It comes more down to performance quality, networking, business acumen, and seniority/experience in the field.

 

[TexasPhysician]

I know multiple forensic trained psychiatrists. One does essentially jail/inpatient work that doesn’t need the fellowship, but it kind of uses it (no extra pay). The others aren’t using it at all. I know a couple doing forensics work with a significant amount of their time. Neither did a fellowship. They networked significantly getting to know attorneys and judges. They get paid quite well, but these aren’t salaried jobs. You don’t apply and “get it”. These “in” psychiatrists also don’t plan to give it up until they die. One essentially admitted that he is the next one up with a certain judge and he is waiting for another psychiatrist to die (his words). In my limited experience, it is a long road to get “in” and then it’s great.

 

[Merovinge]

To summarize, much smaller N, much larger standard deviation, harder to make anything from the data.

 

[Bartelby]

If a lawyer will not pay $300/hr you should walk away. $750/hr is on the high end and would more likely be a sought-after expert, such as someone who is late-career or very well known (probably for a specific niche). Depending on the cost of living / local market, I think in between those numbers is realistic for an experienced forensic psychiatrist.

As others mentioned, a fellowship cannot guarantee you forensic work after. For those who do a fellowship and want to build a significant forensic practice, the general estimate I have heard is around five years of ramp-up to get to consistent work (usually to fill a part-time practice). I think that is about right. Attorneys value you for your skills as a doctor, so continuing to practice clinically is important. It is quite rare to see someone doing full-time expert witness work, and when you do that person usually is mid- or late-career with a track record of having provided many years of clinical care before they dropped it.

As above, forensic work can really be feast or famine. It is relatively easy to schedule consistent outpatient clinical schedules as you build a panel. It can be hard to get just the right amount of forensic work. Cases come as they do. They get delayed. You spend weeks or months sitting around with nothing to do on a case, and then suddenly a new bolus of work kicks in. It's the nature of the work, so you have to be flexible about twiddling your thumbs some of the time and then putting in extra hours at other times. The hourly rate is high, but the consistency is likely to be an issue for most.

You can do forensic work without a fellowship, and I think this is especially true outside of expert witness work (with good mentoring a competent psychiatrist can get up to speed in corrections or the state hospital system without a fellowship). If you want expert witness work to be a significant part of your practice the fellowship is worth it. Keep in mind forensic fellowship training has only existed for ~30 years, so yes, there are plenty of current practitioners who didn't do fellowship. These days, a fresh graduate will have a harder time breaking in without the forensic board certification. You also don't know what you don't know, and some of the non-fellowship trained experts out there are doing pretty low-quality work. If you do expert work without the fellowship, I recommend at least getting some supervision from someone experienced for the first few of any given type of case.

 

[splik]

1. very few people are doing mostly forensic work especially when it comes to civil work. Your expertise is based on being a clinician (or researcher) so you need to be doing that. The exception is for criminal work which usually doesn't pay as well. There are people in retirement who just do expert witness work and people like Park Dietz who never really did clinical work but the overwhelming majority will be doing at least 50% clinical/research etc
2. Depending on the kind of work the compensation can vary wildly. I do some cases for $275/hr (court appointed criminal work - I only accept very interesting or high profile cases at low rates) and others at over $1000/hr (civil depositions).
3. It can be difficult to break into because you need experience and reputation or to work with someone who has that and refers you cases. I frequently turn down cases.
4. Overall, doing forensic work is more of a hassle and can pay similarly to doing private pay clinical work.
5. Bread and butter cases like competency evals or worker's compensation are plentiful but the pay is usually much less
6. The work can be very interesting. I am quite selective and usually pass on boring cases (most cases are dull)
7. Overall I make the same or less from my forensic work as I do from my clinical work
8. While the pay for clinical and forensic work can be similar (some of my clinical colleagues charge way more than my forensic rates), you can usually do more billable hours with forensic when you account for record review and report preparation.
9. The average forensic psychiatrist is probably making similar to an average clinical psychiatrist. There are probably more clinical psychiatrists charging over 1000/hr than there are forensic psychiatrists

 

[psych1234567]

Thank you all for your very thorough and detailed responses. It gives me a lot to think about and I appreciate your perspectives.

 

[FatherPsychiatry]

Agreed with the above replies. I did forensic fellowship but do not do any "forensic" work (aside from working in corrections, where most of the psychiatrists here have not done fellowship). One additional consideration to the direct pay from forensic work is, leveraging time during your other (usually clinical) work to do your forensic work. Lets be honest - when you work in a place like a State Hospital, certain correctional settings or inpatient, you have, lets say, quite a bit of down time. Well a big part of forensic work is report review/writing, so instead of using the downtime to rant about the Lakers with the social workers (if you're cool) or appreciate some newly discovered work of Proust (if you're a nerd), you can read and write forensic reports. I know many people that do that, and you can consider it like increasing your compensation per hour you spend at the office from like the typical $200-250 to $400+.

 

[ridethecliche]

I'll add that a lot of forensic fellowships don't teach that much civil stuff.

My biggest reason to do the training was because I'm interested in it and because I'm planning to stay on in the area and plan to continue to work and learn from my attendings after I graduate.

 

[Geraltofrivia]

I did a forensics fellowship. Tbh I enjoyed it, I made a lifelong friend (my cofellow with whom I am still close). I learned psychiatry differently from my home institution (where I did my training). I learned how to be more informed about committing people and how the law evolved.

Forensics (corrections, expert witness work, etc) without fellowship is like having a set of tools and not knowing what to do with it. Eg figuring it out on your own
Forensics with fellowship is like having the tools and instructions organized so you have a general idea of what to do but you still have to do a lot of the work and figure it out from there.

Would I do it again? It's hard to answer. Probably not, I don't really use much of my forensics training in my general practice. I do appreciate the knowledge I gained though and more importantly the connections I made. I learned wisdom from my mentor (a brilliant man whom I still look up to) and as I said, made a lifelong friend. But it's hard to answer. I would advise to look deep within yourself to determine if you're genuinely passionate about Due Process and understanding Commitment and stuff. That's what drove me into it

 

[Ellomate]

9. The average forensic psychiatrist is probably making similar to an average clinical psychiatrist. There are probably more clinical psychiatrists charging over 1000/hr than there are forensic psychiatrists

General Psychiatrist doing civil expert witness charge around $1000/hr?
If this is the case, why aren't all psychiatrist jumping on-board?

If mainly interested in civil cases, is there a point on pursuing forensic fellowship?
Would forensic fellowship give me an edge on documentation, billing, networking, etc?

Thank you!

 

[romanticscience]

General Psychiatrist doing civil expert witness charge around $1000/hr?
If this is the case, why aren't all psychiatrist jumping on-board?

If mainly interested in civil cases, is there a point on pursuing forensic fellowship?
Would forensic fellowship give me an edge on documentation, billing, networking, etc?

Thank you!

The fellowship trains you in "Forensic" Psychiatry, of which expert witnessing (the good money) is only a part. If you look at the training, it includes a lot of study in correctional and academic forensics (e.g., landmark cases and policy).

I didn't do a fellowship. However, I like independent study.

Lawyers want EXPERTS in X, not necessarily experts in forensic psychiatry. Would you hire the Harvard MD PHD general psychiatrist with 100 publications on PTSD or the community guy who works at Big Box Psych who is board-certified in forensic psychiatry?

I heard somewhere that the fellowship might accelerate your timeline to get expert cases. Though, it is only one year. How much expert witnessing experience can you get in that timeframe for anyone who did the fellowship?

 

[Bartelby]

General Psychiatrist doing civil expert witness charge around $1000/hr?
If this is the case, why aren't all psychiatrist jumping on-board?

If mainly interested in civil cases, is there a point on pursuing forensic fellowship?
Would forensic fellowship give me an edge on documentation, billing, networking, etc?

Thank you!

$1000/hour is a very rare rate for forensic psychiatric work whether you are board certified or not. Some forensic psychiatrists charge more for testimony than for other tasks, for example double, which could mean that a $500/hour practice is charging $1000/hour when testimony is needed.

Many psychiatrists don't want to have anything to do with the courts, getting deposed, or getting dragged out of clinic for lengthy testimony at trial. The approach to these cases is also different, and if you don't learn the relevant standards in civil evaluations you will run into trouble when cross-examination starts. Also as mentioned elsewhere in this thread, it takes quite a bit of time and concentrated effort to build up a referral stream of civil forensic cases. Lawyers are certainly not routinely contacting general psychiatrists to ask them to take $1000/hour cases.

If you are mainly interested in doing civil expert witness work I think the fellowship is very much worth it. Not surprisingly, the cases that pay the best (often civil personal injury, employment law, etc.) seek out the most impressive experts. If you are a new entrant to the field without much forensic experience, then unless you are the national-level MD/PhD PTSD expert romanticscience mentions above you will need something compelling to reassure attorneys that you will be a solid/competent expert.

 

[FatherPsychiatry]

General Psychiatrist doing civil expert witness charge around $1000/hr?
If this is the case, why aren't all psychiatrist jumping on-board?

If mainly interested in civil cases, is there a point on pursuing forensic fellowship?
Would forensic fellowship give me an edge on documentation, billing, networking, etc?

Thank you!

Agreed with the others that replied above.

Also this might be a helpful resource in terms of $

How Much Physician Expert Witnesses Charge or Get Paid by Specialty, with Average Fees and Rates

Statistics from our database on how much physician expert witnesses charge and get paid by specialty, on average, and how to determine your rates

www.physiciansidegigs.com

Psychiatrist average there is $485. This reflects my experience as well (seems to be $300-600 an hour, maybe $500 to $1000 for depositions/trial testimony).

Highest expert witness I know is a hand surgeon who charges $1500. I don't know any psychiatrists personally who come close to that. Curious what Park Dietz et al command.

 

[splik]

General Psychiatrist doing civil expert witness charge around $1000/hr?
If this is the case, why aren't all psychiatrist jumping on-board?

If mainly interested in civil cases, is there a point on pursuing forensic fellowship?
Would forensic fellowship give me an edge on documentation, billing, networking, etc?

Thank you!

NO. Read. You totally missed my point which is that on average forensic work doesn't come out better than clinical private practice. I said there are more clinical psychiatrists charging over 1000/hr than there are forensic psychiatrists that do. Clinical psychiatrists see patients. Forensic psychiatrists serve as expert witnesses. More people are charging 1000/hr+ to see patients than they are for expert witness work.

Most psychiatrists don't do expert witness work because they don't have what it takes or find it too much of a hassle. Not a lot of people want to go through grueling depositions or testifying in court, want to do the travel, or have the flexibility or willingness to read through potentially large volumes of records or prepare a report. Cream rises to the top. If you are charging at the higher end of the spectrum you are going to produce an outstanding work product, be at the top of your field, or have extensive deposition and testimony experience which usually means many years of experience.

If you have dollar signs in your eyes, you may well be disappointed with forensic psychiatry. If you have a strong interest in the interface of psychiatry and the law, and enjoy applying your psychiatric expertise outside of the clinic, and don't mind sparring with attorneys and holding your own when under attack then this could be a great option. Not all fellowships are equal. Most forensic fellowship graduates don't appear to do a ton of forensic work.

Doing forensic work is absolutely a nuisance. It is not worth the money alone. I do it because I love it and for many cases I get paid a lot less than I could for seeing patients. It can be very stressful dealing with attorneys, and you might not get paid for your work if you don't protect yourself enough. There are of course cases where I get paid a lot more. Because of my niche, I tend to get more complex cases which involve more extensive record review which means more billable hours. The work is not necessarily steady so there can be times where you get a lot of cases and other times where you might not have much. At this point in my career, I have a constant stream of cases but the workflow is still very uneven and things often get pushed out on the legal calendar. I put in nights and weekends to get work done (this is partly because I'm disorganized but also because cases often require tight deadlines and I have patients most days).

I do find it pretty exciting. To give you some example of my current case load, I'm helping to depose witnesses in a multi-billion dollar multi-plaintiff litigation, doing a mitigation eval for a serial killer on death row, doing an insanity evaluation of a multiple murderer who shot up a well known chain, doing a fitness for duty evaluation for an older physician who was reported to the medical board as impaired, and have several cases involving different kinds of sex offenses including assessing for autism in one case, complex trauma in another, and the impact of the adolescent brain in another. It is a nuisance but I would be bored just doing clinical work even though I do love my patients and get some very fascinating clinical cases too.

 

[Stagg737]

Highest expert witness I know is a hand surgeon who charges $1500. I don't know any psychiatrists personally who come close to that. Curious what Park Dietz et al command.

Probably close to that surgeon. Back in 1993 he charged $300/hr or $3k/day for his testimony in the Dahmer trial but apparently also got paid $50k from an insurance company for his testimony in a separate case. In 2022 his rate was $1,200/hr as noted from the second article below:

"His curriculum vitae as of July 15 was 104 pages, he told the jury. His going rate is $1,200 an hour, but government cases, including this one, get a discounted rate of $800 an hour because it involves the public’s money, Dietz testified."

COLUMN ONE : Probing the Dark Side of the Mind : Psychiatrist Park Dietz helps catch and convict criminals by unraveling twists of human behavior. Stalkers and serial killers are among his specialties.

It is a dark world that Dr.

www.latimes.com

Mass murder expert takes stand to rebut Scott Kologi insanity claim in family massacre

Dr. Park Dietz, a forensic psychiatrist who specializes in mass murder, took the stand in the Scott Kologi family massacre trial.

www.app.com

 

[Cath Up]

Can general psychiatrists conduct contemporaneous testamentary capacity evaluations? It is fairly straightforward and I would think with baby boomer generation's wealth transfer it is needed and important.

 

[nexus73]

Can general psychiatrists conduct contemporaneous testamentary capacity evaluations? It is fairly straightforward and I would think with baby boomer generation's wealth transfer it is needed and important.

It surprises me, but In my experience it’s extremely rare that anyone wants a capacity eval before making/updating a will. It happens but obviously much more common psychiatry is brought in posthumously when there is a dispute. Maybe people don’t want to shell out the thousands of dollars for a front end capacity eval on the off chance the will is challenged.

 

[Geraltofrivia]

Can general psychiatrists conduct contemporaneous testamentary capacity evaluations? It is fairly straightforward and I would think with baby boomer generation's wealth transfer it is needed and important.

I would argue yes, but you have to know what you're doing and be thorough about it. This can be self-taught with careful study. You cannot as an example, and I've seen this a lot, base your entire evaluation on what the family wants. I don't mean to belittle you, but just remember, the family is not your patient, the patient is your patient.

NO. Read. You totally missed my point which is that on average forensic work doesn't come out better than clinical private practice. I said there are more clinical psychiatrists charging over 1000/hr than there are forensic psychiatrists that do. Clinical psychiatrists see patients. Forensic psychiatrists serve as expert witnesses. More people are charging 1000/hr+ to see patients than they are for expert witness work.

Most psychiatrists don't do expert witness work because they don't have what it takes or find it too much of a hassle. Not a lot of people want to go through grueling depositions or testifying in court, want to do the travel, or have the flexibility or willingness to read through potentially large volumes of records or prepare a report. Cream rises to the top. If you are charging at the higher end of the spectrum you are going to produce an outstanding work product, be at the top of your field, or have extensive deposition and testimony experience which usually means many years of experience.

If you have dollar signs in your eyes, you may well be disappointed with forensic psychiatry. If you have a strong interest in the interface of psychiatry and the law, and enjoy applying your psychiatric expertise outside of the clinic, and don't mind sparring with attorneys and holding your own when under attack then this could be a great option. Not all fellowships are equal. Most forensic fellowship graduates don't appear to do a ton of forensic work.

Doing forensic work is absolutely a nuisance. It is not worth the money alone. I do it because I love it and for many cases I get paid a lot less than I could for seeing patients. It can be very stressful dealing with attorneys, and you might not get paid for your work if you don't protect yourself enough. There are of course cases where I get paid a lot more. Because of my niche, I tend to get more complex cases which involve more extensive record review which means more billable hours. The work is not necessarily steady so there can be times where you get a lot of cases and other times where you might not have much. At this point in my career, I have a constant stream of cases but the workflow is still very uneven and things often get pushed out on the legal calendar. I put in nights and weekends to get work done (this is partly because I'm disorganized but also because cases often require tight deadlines and I have patients most days).

I do find it pretty exciting. To give you some example of my current case load, I'm helping to depose witnesses in a multi-billion dollar multi-plaintiff litigation, doing a mitigation eval for a serial killer on death row, doing an insanity evaluation of a multiple murderer who shot up a well known chain, doing a fitness for duty evaluation for an older physician who was reported to the medical board as impaired, and have several cases involving different kinds of sex offenses including assessing for autism in one case, complex trauma in another, and the impact of the adolescent brain in another. It is a nuisance but I would be bored just doing clinical work even though I do love my patients and get some very fascinating clinical cases too.

I'm having a really hard time getting forensic work. I did a few CSTs but that was about it. I want to do forensics cases because I find it fun and intellectually challenging. What pointers if any could you give me? Thank you Splik

 

[sloop]

Agreed with the above replies. I did forensic fellowship but do not do any "forensic" work (aside from working in corrections, where most of the psychiatrists here have not done fellowship). One additional consideration to the direct pay from forensic work is, leveraging time during your other (usually clinical) work to do your forensic work. Lets be honest - when you work in a place like a State Hospital, certain correctional settings or inpatient, you have, lets say, quite a bit of down time. Well a big part of forensic work is report review/writing, so instead of using the downtime to rant about the Lakers with the social workers (if you're cool) or appreciate some newly discovered work of Proust (if you're a nerd), you can read and write forensic reports. I know many people that do that, and you can consider it like increasing your compensation per hour you spend at the office from like the typical $200-250 to $400+.

I work at a state forensic hospital. While what you say about down time is generally true, I will also say that a lot of the places I have experience with will try to rope forensically trained doctors into doing reports of varying complexity for little or no extra pay, whether this is part of their explicit duties or not. Where I trained, the forensic psychiatrists were regularly doing court-ordered criminal responsibility and competency evaluations for the Department of Mental Hygiene on top of running their ward and taking call. They were busy. Where I am now, I don’t take call and the reports are a less formal obligation, but I still get voluntold to do them fairly regularly. I have set pretty clear boundaries, though, that I will do competency and Jackson evaluations as well as more clinical evaluations like second opinions for treatment over objection, but I will not do retention/transfer evaluations for insanity acquittees. There is a limit to what extra work I am willing to do for whatever our forensic differential is (something like $12K per year).

The other thing to consider with state work is that some places will forbid you to do certain kinds of work because they see it as some sort of conflict of interest, but this is variable. Where I trained, the staff forensic psychiatrists were forbidden from doing private criminal work within the state, but were allowed to do criminal evaluations in other states as well as civil evaluations within the state.

OP, I think you have gotten good information and advice about the pay in forensics (and how it is highly variable depending on practice environment, location, types of evaluations, etc.). One thing I would add, though, is that you should not underestimate the extent to which purely forensic practice can be difficult on a personal level even if you can achieve it. For some people, all they want to do is evaluation-based forensics, but others need some clinical practice in their routine to feel fulfilled. My forensic fellowship was almost entirely evaluation-based with practically no clinical time. It was an absolute blast and extremely interesting, but by the end of the year I couldn’t help feeling that something important was missing from my life. When I first started, I also thought I could be totally content doing evals all the time, but I ultimately realized that I need to feel that I am sometimes working to actually help and advocate for patients.

 

[ladysmanfelpz]

I did a forensics fellowship. Tbh I enjoyed it, I made a lifelong friend (my cofellow with whom I am still close). I learned psychiatry differently from my home institution (where I did my training). I learned how to be more informed about committing people and how the law evolved.

Forensics (corrections, expert witness work, etc) without fellowship is like having a set of tools and not knowing what to do with it. Eg figuring it out on your own
Forensics with fellowship is like having the tools and instructions organized so you have a general idea of what to do but you still have to do a lot of the work and figure it out from there.

Would I do it again? It's hard to answer. Probably not, I don't really use much of my forensics training in my general practice. I do appreciate the knowledge I gained though and more importantly the connections I made. I learned wisdom from my mentor (a brilliant man whom I still look up to) and as I said, made a lifelong friend. But it's hard to answer. I would advise to look deep within yourself to determine if you're genuinely passionate about Due Process and understanding Commitment and stuff. That's what drove me into it

This is good to hear. I honestly don't know how much I will use it in my practice, but one attending said she loved it and although does not practice it currently the knowledge in learning the law is very beneficial. I am moving to a new city to live with fiance and we plan to stay for only a year and thought why not for the fellowship.

It does have me second guessing as I still don't plan to practice it much at this point and don't know if a year of fellow income is worth it when I'm somewhat non-traditional. I'm fine with public speaking, but writing reports all day and lots of weekend/night work as @splik mentioned does have me a bit worried.

 

[Geraltofrivia]

The fellowship will probably change the way you practice for the better and possibly help make you a future leader for psychiatry. Laws are rapidly changing and in my opinion, not in a good way.

 

[sloop]

Lawyers want EXPERTS in X, not necessarily experts in forensic psychiatry. Would you hire the Harvard MD PHD general psychiatrist with 100 publications on PTSD or the community guy who works at Big Box Psych who is board-certified in forensic psychiatry?

I think this depends on the evaluation. You might be right if you’re talking about trauma-related psychiatric damages in a civil case, supposed lack of responsibility due to dissociation (which is often BS hired gun stuff IMO, but that’s a different topic), or battered woman syndrome. If you’re talking about a typical psychosis-related criminal responsibility case, the forensic psychiatrist may be preferred.

As an aside, I think you are seriously undervaluing forensic fellowship. As you say, the fellowship is not primarily about testimony but, rather, about the process of coming to and supporting a forensic opinion (among some other skills). I have seen some seriously hot takes by well-respected experts who lack forensic training. Stuff like determining people are not responsible despite concealing a body, cleaning the crime scene, and running from the police, arguing that people meet the ALI test due to a paraphilia alone, speculatively opining that psychosis will definitely resolve once medical issues are treated, saying people are not responsible due to PTSD when supposed dissociation during the offense is the only symptom, etc. Certainly some of this is willful hired gun BS, but I also think that forensic fellowship teaches you to think about information in a different way than is natural for purely clinical psychiatrists. In general, my experience is that forensic psychiatrists tend to rely more on more objective forms of information/evidence and do more thorough investigations, while clinically trained psychiatrists are more likely to believe and rely on the reports of the defendant or their family (possibly because this is the type of information they are used to relying on in clinical practice).

 

[ridethecliche]

Tldr

Current forensic psych fellow. Highly recommend doing it if you're interested in the work. If not, then at a minimum you should take the AAPL course at least once and attend as often as possible (read yearly).

Have attendings that charge 500/hr for private cases. They have no shortage of work.

People like getting a good deal. They like winning more. If you work well with attorneys and are judicious with what you take on then you can do pretty well. If your reports stand up to scrutiny and you have trial experience... Have at it.

Re @sloop point re kind of work and fulfillment. We do a fair amount of treating work during half the year at a state hospital and corrections. I liked it enough that I'll be doing some part corrections at the same shop. It's out of state so shouldn't affect local practice much. It just means I won't accept criminal cases in that state. Nbd.

 

[Merovinge]

Tldr

Current forensic psych fellow. Highly recommend doing it if you're interested in the work. If not, then at a minimum you should take the AAPL course at least once and attend as often as possible (read yearly).

Have attendings that charge 500/hr for private cases. They have no shortage of work.

People like getting a good deal. They like winning more. If you work well with attorneys and are judicious with what you take on then you can do pretty well. If your reports stand up to scrutiny and you have trial experience... Have at it.

Re @sloop point re kind of work and fulfillment. We do a fair amount of treating work during half the year at a state hospital and corrections. I liked it enough that I'll be doing some part corrections at the same shop. It's out of state so shouldn't affect local practice much. It just means I won't accept criminal cases in that state. Nbd.

I mean that hourly is the same or less than what all the CAP folks in cash PP around me make just seeing patients. I am not sure if that was meant as a flex for forensic pay, and bless anyone who objectively does the work for the right reasons, but if you are just looking to make bank, I would not be looking at doing forensics.

 

[ridethecliche]

I mean that hourly is the same or less than what all the CAP folks in cash PP around me make just seeing patients. I am not sure if that was meant as a flex for forensic pay, and bless anyone who objectively does the work for the right reasons, but if you are just looking to make bank, I would not be looking at doing forensics.

Flexing on behalf of someone else is a weird flex. This particular person works full time elsewhere and this was for a criminal case working for the DAs office so I'm guessing there are additional stipulations/benefits/limits. As brilliant as this person is, they're not the most business savvy. Given that I'm sure they could charge much more for these cases. I'm sure the other folks in the program that do mostly private cases end up charging more.

PP child sounds awful to me though. I'd much rather do forensic work at that fee lmao. I say this as someone who has made 400+/hr for some moonlighting shifts as a fellow.

 

[splik]

Have attendings that charge 500/hr for private cases. They have no shortage of work.

This sounds low for private cases. I charged more than that years ago c. 2018 early out of training and my rates have gone up since then. My clinical rate is higher than that too. Some people in academics undercharge from what I've seen although I charged more than that when I was in academics too. I do a lot of cases for less than that if they are government cases. I'm selective and only take super interesting cases for that usually criminal. From bitter experience I've learned that if attorneys are too price conscious, you run the risk of not being paid. Forensic rates haven't quite kept apace of clinical private practice rates imo.

I'm having a really hard time getting forensic work. I did a few CSTs but that was about it. I want to do forensics cases because I find it fun and intellectually challenging. What pointers if any could you give me? Thank you Splik

This is not a question that can be meaningfully answered here as it is somewhat individualized. I provide consultation to psychiatrists and psychologists on doing expert witness work. It's usually non-forensic trained folks, but also forensically-trained people who aren't getting the guidance they need from their mentors. This includes things like retainer agreements, fee schedules, marketing, working with attorneys, reports, and depo and testimony preparation. Most people do have to invest some time and effort into running a successful forensic practice. Otherwise, you need to join a forensic group practice or if in academics be part of of the forensic program that gets cases.

 

[BetaBlocked_1]

Here is some salary data on forensic psych. The 50th percentile is around $450k, which is much higher than general psych, which is around $320k.

 

[Bartelby]

Interesting! I have never seen that website / those numbers before. Do you know what that $450k median is supposed to mean? For example, is that the self-reported income of forensic psychiatrists who responded to a survey, the average salary advertised or reported for correctional / state hospital jobs, or something else?

 

[BetaBlocked_1]

Interesting! I have never seen that website / those numbers before. Do you know what that $450k median is supposed to mean? For example, is that the self-reported income of forensic psychiatrists who responded to a survey, the average salary advertised or reported for correctional / state hospital jobs, or something else?

Yes, it's self reported income by practicing forensic psychiatrists. The data can be broken down by practice setting although this is forensic psych, CAP plus general psych. The dashboards are interactive.

 

[Justice1071]

I've seen this before, but is the data for the median in Forensics based on only 5 people reporting their salary for that subspecialty?

 

[BetaBlocked_1]

I've seen this before, but is the data for the median in Forensics based on only 5 people reporting their salary for that subspecialty?

Yes. The total sample size is close to 200, but it's still small for forensic psych. Here is another look at forensic psych (you can find it under the 'Other' tab). 7 reported that their practice is predominantly forensic psych, and the median is at $430k.

 

[FlowRate]

Forensic rates haven't quite kept apace of clinical private practice rates imo.

If you feel comfortable sharing, are people paying >>$500/hr to you for relatively B&B psych stuff, or is it almost all patients who specifically benefit from some of your niche subspecialty expertise?

 

[splik]

If you feel comfortable sharing, are people paying >>$500/hr to you for relatively B&B psych stuff, or is it almost all patients who specifically benefit from some of your niche subspecialty expertise?

my practice does focus on niche stuff but I definitely have some pts who are paying that for problems of living therapy only that could probably be managed by a non-MD for much less. I suspect it is much harder for psychiatrists to have a practice focusing on milder problems nowadays though given significant competition from others. It wasn't that long ago that MFTs couldn't even bill insurance for therapy and in the 1980s the APA lobbied to stop insurance paying for therapy from psychologists! Now most psychiatrists don't do psychotherapy proper at all.

I think it also depends what you mean by B&B stuff. A lot of psychiatrists seem to only want to treat anxiety and depression (and possibly ADHD). I've noticed a trend where a lot people think they can just hang up a shingle and have a telehealth practice charging outrageous fees and they don't want to see patients in person, and won't see patients in crisis, with SI, recently hospitalized, bipolar, schizophrenia, addiction, personality disorders, medically complex patients, pregnant patients, geriatric patients, or prescribe controlled substances. They then struggle to fill and wonder why. We can all exclude what we want but you cannot limit yourself to a very narrow high functioning population or build a practice only around your convenience rather than filling a need.

If you consider issues like OCD, bipolar disorder, higher functioning psychosis, SUDs within B&B psych issues, it is very possibly in many markets to attract and fill a cash practice. You don't need to have a subspecialty niche but you do need to provide value by providing patient with access to services or a level of care they cannot easily get through their insurance. Having a niche (which doesn't have to be some subspecialty) does help with marketing whether that is focusing on bipolar, addictions, LGBTQ+, executive health, physicians, TMS, specific psychotherapies (e.g. ACT, psychoanalytic, MBT, CBT etc).

 

[ridethecliche]

Seeing only anxiety and depression everyday forever would make me very Le Bored.

Re forensic psych salary.

I'm curious what folks are seeing for hourly rate based on their geography. I'm also not sure if the numbers quoted above are full time or supplemented work.

I'm not sure how and when I want to start building up a forensics practice. I'm interested in it for sure but don't know if I'd want to do just that full time.

I certainly have some ideas of other things I could do at the same time though.

 

[NicholasPavona]

Yes, it's self reported income by practicing forensic psychiatrists. The data can be broken down by practice setting although this is forensic psych, CAP plus general psych. The dashboards are interactive.

View attachment 399778

No offense but this salary blows.