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msc545

Clinical Psychologist & Neuropsychologist
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Kaiser will pay up to $49 million to settle a lawsuit brought by the state Department of Justice and prosecutors in six counties, including San Bernardino, that accused California’s largest health care provider of disposing of syringes, medicine, bodily fluids, and potentially body parts in dumpsters bound for local landfills.

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I wasn't considering it, and if I ever have to, something drastic (and likely horrible) has happened to my career.
 
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Not particularly surprising, but I am very familiar with the ins and outs of corporate healthcare.
 
I understand. Kaiser offered me an obscene amount of money last year to "come on board" during the 3+ month strike by all of their mental health workers in NorCal over their policy of overbooking patients to the point that people had to wait months for a second appointment, and providers had individual caseloads of 200 and 300 patients.

I turned them down because I won't cross any picket line (and they had plenty), and I don't trust Kaiser to do the right thing or follow the law at all.

The California Dept of Managed Care has a rule that HMOs like Kaiser must schedule a follow-up psychotherapy visit with a date within 10 days of the first visit. Kaiser has been ignoring that rule for many years with no repercussions because they are a huge healthcare provider in California, and the DMC is afraid to enforce the law against them.
 
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I understand. Kaiser offered me an obscene amount of money last year to "come on board" during the 3+ month strike by all of their mental health workers in NorCal over their policy of overbooking patients to the point that people had to wait months for a second appointment, and providers had individual caseloads of 200 and 300 patients.

I turned them down because I won't cross any picket line (and they had plenty), and I don't trust Kaiser to do the right thing or follow the law at all.

The California Dept of Managed Care has a rule that HMOs like Kaiser must schedule a follow-up psychotherapy visit with a date within 10 days of the first visit. Kaiser has been ignoring that rule for many years with no repercussions because they are a huge healthcare provider in California, and the DMC is afraid to enforce the law against them.
Every recruiter email I've received from them is a joke. I'm surprised you got a seemingly good offer.
 
I think they were getting desperate. Nobody would work for them and they had a lot of patients not getting services. That being said they ALSO couldn't help trying to tell me how to practice but wanted me to also be an independent contractor. Those things don't go together legally I am told.
 
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Dozens of healthcare workers were arrested in Los Angeles on Monday after sitting in the street outside of a Kaiser Permanente facility to demand that providers address dangerously low staffing levels at hospitals in California and across the country.

The civil disobedience came as the workers prepared for what could be the largest healthcare strike in U.S. history. Late last month, 85,000 Kaiser Permanente employees represented by the Coalition of Kaiser Permanente Unions began voting on whether to authorize a strike over the nonprofit hospital system's alleged unfair labor practices during ongoing contract negotiations.

"We are burnt out, stretched thin, and fed up after years of the pandemic and chronic short staffing," Datosha Williams, a service representative at Kaiser Permanente South Bay, said Monday. "Healthcare providers are failing workers and patients, and we are at crisis levels in our hospitals and medical centers."

"Our employers take in billions of dollars in profits, yet they refuse to safely staff their facilities or pay many of their workers a living wage," Williams added. "We are prepared to do whatever it takes, even get arrested in an act of civil disobedience, to stand up for our patients."
 
If you're a CA diploma mill grad, I honestly don't understand why you would work here. Get in with a govt agency, there's enough out there in that part of the country I would imagine, make base payments for 10 years, and call it a day/move on. Do these guys really pay that much? I can't imagine it be worth it to work at a job where you have a social work level caseload and no way to provide actual psychotherapy.
 
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If you're a CA diploma mill grad, I honestly don't understand why you would work here. Get in with a govt agency, there's enough out there in that part of the country I would imagine, make base payments for 10 years, and call it a day/move on. Do these guys really pay that much? I can't imagine it be worth it to work at a job where you have a social work level caseload and no way to provide actual psychotherapy.
Depends if they did real accredited internships, which CA does not require, but most govt jobs do. We have a couple exploitative larger practices here, 90%+ staffed by millers.
 
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If you're a CA diploma mill grad, I honestly don't understand why you would work here. Get in with a govt agency, there's enough out there in that part of the country I would imagine, make base payments for 10 years, and call it a day/move on. Do these guys really pay that much? I can't imagine it be worth it to work at a job where you have a social work level caseload and no way to provide actual psychotherapy.

They pay garbage and work people to death almost, from what I understand.

I am NOT a diploma mill grad by any measure.
 
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They pay garbage and work people to death almost, from what I understand.

That is true of most corporate healthcare entities, some private group practices, and certainly anything owned by private equity. Outside of the VA, I don't know of many large healthcare employers that are good to their employees and employee psychologists.
 
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That is true of most corporate healthcare entities, some private group practices, and certainly anything owned by private equity. Outside of the VA, I don't know of many large healthcare employers that are good to their employees and employee psychologists.

I would say it's the same for my area. If I absolutely had to go back to the healthcare org world, there's only one system I'd consider working for in this area.
 
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That is true of most corporate healthcare entities, some private group practices, and certainly anything owned by private equity. Outside of the VA, I don't know of many large healthcare employers that are good to their employees and employee psychologists.
I think private practice is still the way to go although marketing is very difficult.
 
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I think private practice is still the way to go although marketing is very difficult.

I think the field really lends itself to private practice. The older I get, the less I see the benefit of psychologists holding a w-2 job or the "advancements" in training over the last few decades. We just are not valued in the hospital system the way we should be.
 
I think the field really lends itself to private practice. The older I get, the less I see the benefit of psychologists holding a w-2 job or the "advancements" in training over the last few decades. We just are not valued in the hospital system the way we should be.
I do some hospital work as a consultant. This is a good position as I simply evaluate patients and testify in court, and I don't have to worry about hospital politics, inadequate support, or predatory scheduling...
 
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As it stands now, my state system isn't horrible. Pay isn't as high as some other spots (but still solid), and I have zero productivity requirements, amazing benefits, union protections, and can come and go as I please to do private eval work (or really anything). State govt work isn't for everyone, but if you can deal with a little bureaucracy and not let it get to you (code for not being too sensitive and/or not caring too much), definitely worth it IMHO. This definitely depends on the state though. The other two I've trained in i wouldn't ever consider working in those systems.
 
I do some hospital work as a consultant. This is a good position as I simply evaluate patients and testify in court, and I don't have to worry about hospital politics, inadequate support, or predatory scheduling...

Is this a W-2 position? I assume it is 1099 if you are referring to yourself as a consultant. 1099 gives you a lot more freedom as you are essentially working for yourself.
 
As it stands now, my state system isn't horrible. Pay isn't as high as some other spots (but still solid), and I have zero productivity requirements, amazing benefits, union protections, and can come and go as I please to do private eval work (or really anything). State govt work isn't for everyone, but if you can deal with a little bureaucracy and not let it get to you (code for not being too sensitive and/or not caring too much), definitely worth it IMHO. This definitely depends on the state though. The other two I've trained in i wouldn't ever consider working in those systems.

Same can be said for certain positions in the VA system. However, this is not all or even most positions.
 
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The challenge for any HMO right now is that there are not enough therapists (or doctors) to meet demand. Private practices can just stop taking new patients when they're comfortably full and make access an insurance company problem. No value judgements about any of this--it's all just tradeoffs and perspectives. Single payer systems would/do run into the same problem--or carve out/limit therapy.
 
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The challenge for any HMO right now is that there are not enough therapists (or doctors) to meet demand. Private practices can just stop taking new patients when they're comfortably full and make access an insurance company problem. No value judgements about any of this--it's all just tradeoffs and perspectives. Single payer systems would/do run into the same problem--or carve out/limit therapy.

Certainly, the question then becomes how do you handle this shortage? This varies by system and even individual hospitals. Kaiser has a second set of issues in that they are their own insurer, so hiring more people and simply billing more services is not an option. They make their money on limiting/ capping services. Remember, access is not necessarily an insurance company issue as long as patients are making their premium payments. Then access issues do the job of limiting services.
 
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Certainly, the question then becomes how do you handle this shortage? This varies by system and even individual hospitals. Kaiser has a second set of issues in that they are their own insurer, so hiring more people and simply billing more services is not an option. They make their money on limiting/ capping services. Remember, access is not necessarily an insurance company issue as long as patients are making their premium payments. Then access issues do the job of limiting services.
In most/all states access is a huge insurance company issue and insufficient access will lead to DOI fines/sanctions/etc. There's extra focus on this with KP since they provide their own services but the lever is DOI and that patients (or their employers) who can't access desired/needed services will change insurers.
 
In most/all states access is a huge insurance company issue and insufficient access will lead to DOI fines/sanctions/etc. There's extra focus on this with KP since they provide their own services but the lever is DOI and that patients (or their employers) who can't access desired/needed services will change insurers.

Access issues with regard to mental health and therapists are rarely fined. Most insurance networks have outdated/shadow provider lists. They may get dinged for not auditing in the list, but that is a drop in the bucket. DOI has not even dinged all the insurance companies that have carve outs for substance abuse and mental health.
 
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In most/all states access is a huge insurance company issue and insufficient access will lead to DOI fines/sanctions/etc. There's extra focus on this with KP since they provide their own services but the lever is DOI and that patients (or their employers) who can't access desired/needed services will change insurers.
The insurance companies pay the annoyance fines and keep on truckin' to billion dollar profits. That's not a consequence to them, it is a FEATURE. They did the math and would rather pay the fines than actually change to add more staffing and address their toxic policies that are meant to delay and deny care.
 
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IME, most state insurance laws (including California) require the insurer to have enough providers to meet demands. If you have read the state laws regarding insurance, then you can cite the laws to the insurer, and offer them the opportunity to give you out of network pre-authorization (which is billed at your cash rate), or you can report them to the state department of insurance for sanctions.

Insurers HATE complaints to the department of insurance, because that department can restrict the insurance’s ability to sell insurance in that state.
 
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Is this a W-2 position? I assume it is 1099 if you are referring to yourself as a consultant. 1099 gives you a lot more freedom as you are essentially working for yourself.
Yes 1099. I won't work in a W2 position as I am in California and with W2 I lose 50% of what I make before I ever see it...
 
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Yet another reason to love California.
Actually aside from that it's great. California or Hawaii are the only places I would consider living in the US.
 
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Yet another reason to love California.

Meh, probably closer to 30-40% in CA given progressive tax rates and obvious reductions in taxable income. I still will never live there, but not because of taxes. Also, you're still paying taxes on 1099 income, you just have more ways to work deductions depending on how your business is set up.
 
Actually aside from that it's great. California or Hawaii are the only places I would consider living in the US.

Meh, probably closer to 30-40% in CA given progressive tax rates and obvious reductions in taxable income. I still will never live there, but not because of taxes. Also, you're still paying taxes on 1099 income, you just have more ways to work deductions depending on how your business is set up.


Aside from that, the wild fires, the cost of real estate, the rolling blackouts. There are many things to like about CA, but that state is really hitting critical mass in terms of population and infrastructure. It is also a huge drag on wealth.
 
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Aside from that, the wild fires, the cost of real estate, the rolling blackouts. There are many things to like about CA, but that state is really hitting critical mass in terms of population and infrastructure. It is also a huge drag on wealth.
Do you live in California?
 
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I loved California and would move back in a heartbeat if I could afford a house there.
 
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Do you live in California?

Nope, I'm from that East Coast bastion of unaffordability (otherwise known as the best city on earth). A lot of similar problems minus the wildfires. Hence why I relocated to a more affordable area. CA has the added problem that you can't find a decent bagel.
 
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Nope, I'm from that East Coast bastion of unaffordability (otherwise known as the best city on earth). A lot of similar problems minus the wildfires. Hence why I relocated to a more affordable area. CA has the added problem that you can't find a decent bagel.
This hate for CA is pitiful. East coast was covered in smoke not too long ago. Come for the weather, culture, food, and topography. Actually don't, and keep pretending you live somewhere better.
 
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This hate for CA is pitiful. East coast was covered in smoke not too long ago. Come for the weather, culture, food, and topography. Actually don't, and keep pretending you live somewhere better.

Frankie says Relax, dude. Everyone has places they dislike and places they prefer. It's normal.
 
This hate for CA is pitiful. East coast was covered in smoke not too long ago. Come for the weather, culture, food, and topography. Actually don't, and keep pretending you live somewhere better.

I never said I won't vacation there. I just don't want to be a resident. As for living somewhere better, I like where I live just fine. I also like that I can afford a home and realistically comtemplate purchasing a second property.
 
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Had an offer to do a forensic fellowship at patton state hospital. Legit turned it down due to CoL (as i wasnt going to live in san bernardino and the closest nice spot was redlands and yikes the prices in 2014 even). dont understand how people survive out there.
 
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Nope, I'm from that East Coast bastion of unaffordability (otherwise known as the best city on earth). A lot of similar problems minus the wildfires. Hence why I relocated to a more affordable area. CA has the added problem that you can't find a decent bagel.
But you would be able to easily find a decent burrito. I think that's a fair trade.
 
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But you would be able to easily find a decent burrito. I think that's a fair trade.

It is a balmy 80 degrees by me with a mild breeze today. I also have a really good local burrito place by my house that also has excellent pupusas. When it gets cold in a few months, plane tickets to CA are cheap...especially when my wife gets to charge a portion of the trip on the corporate credit card. ;)
 
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It is a balmy 80 degrees by me with a mild breeze today. I also have a really good local burrito place by my house that also has excellent pupusas. When it gets cold in a few months, plane tickets to CA are cheap...especially when my wife gets to charge a portion of the trip on the corporate credit card. ;)

I'm sorry, but I'm calling BS on your having a good burrito place near your house in the city I am assuming you live in.
 
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I'm sorry, but I'm calling BS on your having a good burrito place near your house in the city I am assuming you live in.

:rofl:

Not sure where you think I live, but there are a lot of Latin immigrants that know how to cook a good meal if you know where to look.
 
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