Is this feasible...

[worriedwell]

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I'm thinking about my future and my options...anybody who has some thoughts that are based on more than mere conjecture, please chime in.

Could I set up my career as follows...

work in the mornings in some capacity (haven't figured it out yet) at a hospital and receive benefits and health insurance from them. lets say from 8-12am daily. then take private patients from 1pm to 4pm daily that pay me out of pocket, lets say 200/hour. i'd probably have to set up and rent office space in a nearby area, i'm assuming, rather than let them come to the hospital so that the hospital doesn't take a cut.

financially speaking...this amounts to maybe $60-75K from the hospital annually. in addition, if you add 200x15 hours weekly, which is $3,000 weekly for lets say 50 weeks. That means that you are making $150K just from that 15 hours weekly in gross salary.

so does this mean i could work from 8 to 4 everyday and if you factor in office rent and some vacation...be making $200K per year?


it also means that if one can just scrape up a consistent 20 patients per week to do psychotherapy with for $200 a pop, that amounts to $4,000 per week which amounts to $200,000 per year for a 20 hour work week plus 2 weeks vacation (prior to insurance and office rent).

forget about altruism and helping the indigent for a second (hell, you could devote 10hours a week to free psychotherapy or to a homeless shelter and still only be working a 30 hour week), doesn't this just seem like too easy of a way to make boatloads of money? what am i missing? it has to be harder than this? do people just not pay out of pocket? do people get that bored with hour long psychotherapy sessions? and why aren't clinical psychologists just doing this without any medicine management and making tons of cash?

chime in capitalists, as i just started paying off my debts and my western roots of consumption and indulgence are taking over...

 

[fiatslug]

What you're talking about sounds a lot like what attendings at the VA do (though the ones I'm thinking of work closer to full-time at the VA and then do private in addition), so you can throw in some retirement gravy on top of all that! What you're proposing sounds pretty common, in fact... Lots of local new grads here in SF work at city clinics (sweet benefits, baby) part time and set up private practices in the evenings. They start off paneling for insurance, then change to private pay as things get going in their practices and they can cherry-pick the pts. Some new grads from our program are going into private practice, and have been working on our inpt unit until their practice fills--I'll let you know in a few months how it goes for them.

 

[MBK2003]

The only things I see here are logistical issues, which can probably be worked out. Private pay patients who can give you $200/wk usually are working, so will want to see you early mornings or evenings/weekends (aside from the unemployed personality d/o patients supported financially by their families - how many of those do you want to carry?). Most new inpatient attendings (in my area, at least), end up having to work some afternoons to take new admissions because the older attendings have cherry-picked the mornings and get preferentially the patients admitted o/n by the resident/moonlighter.

The reality is, most people I know who are private pay only, work a lot of early mornings, evenings, and weekends to accommodate the patients' need to maintain employment.

MBK2003

 

[Anasazi23]

I'm thinking about my future and my options...anybody who has some thoughts that are based on more than mere conjecture, please chime in.

Could I set up my career as follows...

work in the mornings in some capacity (haven't figured it out yet) at a hospital and receive benefits and health insurance from them. lets say from 8-12am daily. then take private patients from 1pm to 4pm daily that pay me out of pocket, lets say 200/hour. i'd probably have to set up and rent office space in a nearby area, i'm assuming, rather than let them come to the hospital so that the hospital doesn't take a cut.

financially speaking...this amounts to maybe $60-75K from the hospital annually. in addition, if you add 200x15 hours weekly, which is $3,000 weekly for lets say 50 weeks. That means that you are making $150K just from that 15 hours weekly in gross salary.

so does this mean i could work from 8 to 4 everyday and if you factor in office rent and some vacation...be making $200K per year?


it also means that if one can just scrape up a consistent 20 patients per week to do psychotherapy with for $200 a pop, that amounts to $4,000 per week which amounts to $200,000 per year for a 20 hour work week plus 2 weeks vacation (prior to insurance and office rent).

forget about altruism and helping the indigent for a second (hell, you could devote 10hours a week to free psychotherapy or to a homeless shelter and still only be working a 30 hour week), doesn't this just seem like too easy of a way to make boatloads of money? what am i missing? it has to be harder than this? do people just not pay out of pocket? do people get that bored with hour long psychotherapy sessions? and why aren't clinical psychologists just doing this without any medicine management and making tons of cash?

chime in capitalists, as i just started paying off my debts and my western roots of consumption and indulgence are taking over...

What you're talking about is very common. Every attending at my hospital has a similar setup, but it's even better due to 'faculty practice.' They work in the respective service (inpatient/CL, etc) and have private practice in the hospital office, to which they give the hospital a percentage. Remember, this way they gain close to 100k for part time hospital work, have benefits and insurance, have an office and phone system, etc. This still comes out to less than 40hrs/week.

They moonlight on weekends as they see fit, and most of the attendings pull >200k, without working crazy hours.

If you substitute this for more private practice, you charge double to triple for intakes, and fit in more med management visits, and make even more. Want to moonlight for a night at the local non-resident staffed hospital or prison? Add another 600-1k per month.

Choose to do a nursing home rounds one saturday a month, bill out for 30 patients by noon...add another 1-2k, depending.

Why don't psychologists do this? Some do. Others try try. Vast majority have no medical knowledge, and can't prescribe, so they're competing with Master's level (i.e. cheaper) therapists. They're not physicians, so they have limited options and privilages.