Making Money as A Psychologist

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whiteelephant

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I know this question has been posed and answered before. But I wanted to see if perhaps there are ways to be resourceful and pull in enough money to be comfortable given realities of psychology reimbursement.

Right now, I am interested in being a counseling/clinical or school psychologist. My mom is a neuropsychologist that tells me the field of psychology is changing. She feels psychologists with a phd graduate degree put in a lot of time and don't get proportional reimbursement.

I don't want or need to make the most money in my career. But I want enough to be comfortable, to make at least 65k. This is especially true given that I already have a master's in public health where I could, if I tried, surpass the amount of money that I would make for awhile in psychology. Given that private practice is fading out, how and where would it be possible to make money as a psychologist? Is there enough of a need for consulting in certain areas?

Also, this is part of a larger conversation, but I had some questions as to the changing role of psychology for disorders that are partially biological, partially behavioral. My mom feels psychology will take a back seat in certain disorders because the emphasis will be on prevention and this will examine the biological underpinnings or biological mechanisms. More money will go to this biological research and intervention. If this is the case with even aggression or maladaptive behavior in youth, what role will social/behavioral interventions play?

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Are you limiting yourself to practice-oriented careers? Starting salary for many research gigs is at or above 65k (not counting post-doc of course). With an MPH, there are also a host of organizations that you might be a good fit for, though it wouldn't be a traditional path.

There's no doubt we are seeing a boom in the biological basis for disorders right now. Interesting, we're seeing the opposite pattern in traditional medicine where there seems to be increasing recognition of the role that behavior plays in tx outcomes for many things. Moreover, there are two major flaws with the thinking that biological basis for disorders poses a threat to psychology: 1) It assumes that therapy/behavioral interventions DON'T impact biology (they do). Its not neat or easily understood, but that's what makes it exciting to study:) and 2) It assumes that psychologists don't or can't learn the biological basis for disorders. Its true folks who are completely opposed to learning anything about biology/chemistry,/etc. are likely going to have a rough time of it in the coming years. It isn't by chance that neuroscience is within the department of psychology at many schools. Psychologists can and do get training in these areas. Heck, I just wrote a fellowship application that included training in the neurobiology of nicotine withdrawal in animals for this very reason. I actually think psychology training is fantastic for those pursuing this area. As much as it pains me to say it given my interests, a lot of the classic "biological basis of mental disorders" work out there right now is absolute junk. Our genetic studies rarely replicate and account for extremely small amounts of the variance in most disorders. As much as it pains me to say it given my interests, a fair portion of the neuroimaging work seems to be done by people who need to go back and take an undergrad research methods course....much of it is smoke & mirrors, "look at our pretty pictures...they make up for our craptastic methodology" with minimal scientific validity. I think we're starting to see some realization of this and improvement in the quality recently, but I do think it speaks to the importance of a balance between the two.
 
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Right now, I am interested in being a counseling/clinical or school psychologist. My mom is a neuropsychologist that tells me the field of psychology is changing. She feels psychologists with a phd graduate degree put in a lot of time and don't get proportional reimbursement.

Very true.

Given that private practice is fading out, how and where would it be possible to make money as a psychologist? Is there enough of a need for consulting in certain areas?

Not true, at least for niche practices. Clinicians who work with eating disorders (and/or bariatric eval), forensic (more assessment than not), health psych, rehab psych, and similar areas are all doing quite well. The trick is being very picky with what insurance you take (if you take any at all). If you are a generalist...good luck with that because your competition is fierce with people willing to work faster/cheaper.

I know clinicians who have entire practices built around EAPs and privately negotiated fee-for-service contracts, which are different than taking insurance. If you do quality work and are willing to do the leg work in the beginning...private practice can still be a nice place to practice...comfortably. If you take insurance....outside of some niche areas and/or being able to negotiate your own fees, it will be a harder deal going forward. I made a business decision that I will not join any insurance panel, but that is easier said than done for a lot of clinicians.

My mom feels psychology will take a back seat in certain disorders because the emphasis will be on prevention and this will examine the biological underpinnings or biological mechanisms. More money will go to this biological research and intervention.

Ollie's post is spot on. You'll need to go to a legit training program and build up your research skills, but there are definitely options in this line of work.
 
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Have you considered psychiatry? They get reimbursed at a rate approximately 3x that of psychologists. They obviously have different training and treatment approaches, but they get the satisfaction of "helping people" with mental health problems.

If I could do it all again, I would have been a psychiatrist.

Dr. E
 
If you are a generalist...good luck with that because your competition is fierce with people willing to work faster/cheaper.

Do you mean for private practice or in general as well?
 
There are numerous ways of making money as a psychologist. However, what I do believe is that the landscape is changing quicker than ever and being adaptable to that will make or break your practice. Mental health is simply experiencing what is happening in the healthcare industry in general at an accelerated rate. Traditional private practice is starting to seriously suffer in this country. Recently, my personal physician went from a completely solo practice to a group practice reduce overhead, billing and administrative costs, etc. Part of the reason for this is that very few medical professionals know how to run a business effectively. Poor business management is no longer a viable option in this market. Those who are better at running businesses and reducing costs, those that specialize in areas of high need, and those that are open to a changing landscape will do well and those that cling to older ways will likely continue to suffer in this economy. While a lot is made of salaries both in private practice and in other areas, what is not stated is the total lack of business acumen of most healthcare professionals. Most of the my colleagues did not even do a thorough job search before accepting their first full-time position (usually at the place they did their internship/post-doc). That type of thinking is not acceptable if you want to make it in this field.
 
Right now, I am interested in being a counseling/clinical or school psychologist. My mom is a neuropsychologist that tells me the field of psychology is changing. She feels psychologists with a phd graduate degree put in a lot of time and don't get proportional reimbursement.

I don't want or need to make the most money in my career. But I want enough to be comfortable, to make at least 65k.

Depends, what are you willing to do?

There are plenty of venues where a counseling/clinical psychologist can make $65k or more. (Prisons, VA, Military, etc) There are also venues where you can make less. If I had the desire to go the private practice route, I would want the ability to prescribe as needed, which would mean either Psychiatry or having a provider who could prescribe allied with my practice (or in some states the appropriate post-doctoral training). I think that you need to carefully examine what career paths are available and how they fit in with your ideal work environment. Personally, I would not want to pursue private practice until I was retired from my current career and then only a part-time small practice.
 
Thanks everyone for your replies. There are some very perceptive things said about the changing role of psychology. That's why I was careful to say fading/changing and not disappearing. Certainly new research and new healthcare structures change the role of psychologist.

Given the observations made about some of the more lucrative niches, I was wondering if someone might suggest how to locate/research these further. I know my interests, but have yet to match them with a viable career path.

I am interested in actually interacting with people. Thus, I thought private practice. I am particularly interested in helping youth with adjustment disorders that overlap with depression, LD and ADHD.

I am also interested in some kinds of research. I am more interested in applied research and program development. Research isn't entirely my forte since I have problems organizing, but I can do some forms well in the right context. So, I thought maybe there's some consulting niche to look into.

Lastly, apart from health psychology are there any emerging areas that allow a psychologist to gain some additional background in biology and legitimately find some role?

Also, Dr. E., wouldn't you say that psychiatrists have a lot of additional training to go through in order to make that money? My mom always makes the same comment about wanting to go into psychiatry. But training involves years of learning indirectly related material before the real focus on mental disorders and the brain comes into play.
 
Yes, psychiatrists have to study lots of things that don't directly relate to what they practice. However, that is probably the case with every profession. It certainly is with psychology. How often do I use what I learned about brain anatomy or history of psychology as a practicing clinical psychologist? I used it to pass the licensing exam and that was it. Honestly, how much do I use the in-depth knowledge of statistics or research that is required to obtain a Ph.D.? Very little. What I learned in grad school is such a small portion of the real-life practice of a psychotherapist. True, psychiatrists may have proportionally more info that they have to learn that they won't apply when they practice. However, at the same time, becoming a licensed psychologist is really not a shorter path than becoming an MD (many people think it is).

Personally, the major reason (aside from financial stability) that I wish I would have been a psychiatrist is that I feel I could help people more than I can as a psychologist. Getting out in the real world of private practice, I have been stunned by the realization that so many people need appropriate medication before anything I say or do will have an impact. And getting that medication can be so difficult. There is a shortage of (quality) psychiatrists in my major city, It is not uncommon for new patients to wait 3 months to be seen. Instead people go to their GP's who have no freakin' idea what they are doing. It is disheartening.

Dr. E.
 
It is no coincidence that the two least matched residency programs in the medical system are Psychiatry and Family Medicine. (at least in Canada) People always want to match to the top programs, they want a flexible life, they want more money, more prestige, etc Not only that but lots of people are not willing to budge from their very particular/specific interests. They want derm or radiology and they won't budge. So now we have a situation where quite a few people are not matching and generally don't seem to be happy if they don't get their top choice. There is a belief that you should def be able to match after you spend so much time in school but it doesn't work that way. The system is designed for there to be access to all specialities based on demand.

I bring this up because Psychology students can't think the same way. I know most of us know exactly what we want to specialize in, if we want to be in private practice or work in a hospital, we imagine the way our life will be, the pay we will get,etc So if we want to be succesful I don't think you can simply put your head down and do what you intended from the start without considering all the factors above. Otherwise, you really have only yourself to blame.

You might have to pick what is most important: money, prestige, work hours, flexibility in your life, speciality. If you want it all, the odds are you'll pay for it.
 
... psychology will take a back seat in certain disorders because the emphasis will be on prevention and this will examine the biological underpinnings or biological mechanisms.

On the contrary- prevention of any medical/mental health syndromes or disorders will almost always involve some major form of behavior change (including change in private verbal behavior). A well trained clinical/counseling/behavioral psychologist has a lot to offer in this domain. Due to limitations in training, time, problems with the medical model, etc, physicians may only be able to tell patients to do something differently (e.g. take a pill, exercise). A psychologist may be better trained/positioned to actually design and implement individual- and systems level interventions that will actually increase the future probability of the patient actually doing something differently.

If you think of the practice of professional psychology as a series of 50 minute, one-on-one meeting with patients, students, teachers, etc., than it can get a bit discouraging when you look a the financial ramifications of the training, career prospects, mid-level encroachment, etc. If you think of the practice of professional psychology as as the application of the principles of a science of human behavior (yes- including private verbal behavior!) in applied, "real-world" settings, then the extent (and potential!) of the training makes more sense. If all you need to make is 65K, there really are a lot of very cool things you could do with a Ph.D. in psychology. You'll have to work hard to (a) get the opportunity to learn all these things in a good, funded, program; (b) position yourself for a pre-doctoral internship that will refine/expand your abilities (and subject yourself to the crap-shoot of the match process); (c) work your way up the career ladder, spending 5-10 years doing very good work at what might not always be your dream job at what won't be your dream salary (but will NOT, despite what others might say, put you below poverty level and will). Being at the beginning of your training can be daunting, but very exciting with all the possibilities out there if you are willing to work hard, be creative, and, initially be humble and humbled.
 
I don't see why there is so much negativity though.

I mean the concentration on mental health issues is growing and growing. More and more people are being open about their problems, more people are getting diagnosed, etcThe situation should get better for Psychologists, Psychiatrists, and anybody who works in the mental health field.
 
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I don't see why there is so much negativity though.

I mean the concentration on mental health issues is growing and growing. More and more people are being open about their problems, more people are getting diagnosed, etcThe situation should get better for Psychologists, Psychiatrists, and anybody who works in the mental health field.

Whats "the situation" you are referring to? Gross numbers of those seeking "mental heath services doesn't translate to anything in and of itself for psychologists.
 
Does it make it worse?

I would think more people seeking mental health services would be a clearly positive thing. I know there is no certain data to prove that but just as a general rule.

Ie You are telling me if we heard that there was LESS people seeking mental health services you wouldn't come out and say that it is bad for psychologists?

Whats "the situation" you are referring to? Gross numbers of those seeking "mental heath services doesn't translate to anything in and of itself for psychologists.
 
Does it make it worse?

I would think more people seeking mental health services would be a clearly positive thing. I know there is no certain data to prove that but just as a general rule.

Ie You are telling me if we heard that there was LESS people seeking mental health services you wouldn't come out and say that it is bad for psychologists?

Again, it all depends on what the need is and where the need is coming from. If all of the increased need is from individuals without health insurance or any way to pay for mental health services (say an increase in depression among the unemployed) then the fact that there is increased need is of little consequence without access. If the demand is coming from a group whose payor will not pay out enough per session to make seeing a client worthwhile, it is also of little consequence to a given professional (medicaid patients perhaps). An increase in demand from a group with good health coverage/ a generous payor might be a boon if it leads to increased clientele for a psychologist (Veterans if the VA hires psychologists and not other mental health professionals). An increase in one of the other groups will just tax the limited resources available to deal with them (CMHC and government services).
 
On the flip side of this, from my perspective at the hospital where I work, there is a DESPERATE need for competent therapists. So many therapists out there have poor training, and a lot of clients mention that the thing that helped them the most in their recovery was a good relationship with a therapist that they trusted. I see this a lot with anxiety disorders/trauma in particular.
Maybe, but even in that case, i would like to stress that the need is for therapists, not necessarily psychologists. As is often said on this board, there is no need to become a psychologist to do therapy.

Dr. E
A psychologist who does mostly therapy. ;)
 
Maybe, but even in that case, i would like to stress that the need is for therapists, not necessarily psychologists. As is often said on this board, there is no need to become a psychologist to do therapy.

Dr. E
A psychologist who does mostly therapy. ;)

Why do you mostly do therapy, then? Did you set out with that intention and get 'over'educated? Do you not have the additional skills or experience? Did you not know that a doctorate was overkill to do therapy? I know from your posts here that you seem very dissatisfied with the current state of your career, so I'm wondering how it got to be that way?

I have a licensable masters, and I never, ever want to do therapy full-time, so I'm looking forward to filling my future career as a psychologist with several different activities besides therapy--because it is not an option for me to just do that (I could do it now and I know I wouldn't be satisfied). I get confused when psychologists just do therapy, particularly when it ends in a state of disappointment.
 
Why do you mostly do therapy, then? Did you set out with that intention and get 'over'educated? Do you not have the additional skills or experience? Did you not know that a doctorate was overkill to do therapy? I know from your posts here that you seem very dissatisfied with the current state of your career, so I'm wondering how it got to be that way?

I have a licensable masters, and I never, ever want to do therapy full-time, so I'm looking forward to filling my future career as a psychologist with several different activities besides therapy--because it is not an option for me to just do that (I could do it now and I know I wouldn't be satisfied). I get confused when psychologists just do therapy, particularly when it ends in a state of disappointment.

I decided to do a PhD because I wanted to be a university professor. My undergrad profs were good about informing me that if I wanted to be a therapist a PhD was overkill. However, through grad school I learned that I did not want the life of a university professor. When I got to grad school, I learned that our professors were miserable, unhappy human beings and I did not want that for myself. Also, my priorities shifted and I was more interested in having a family than being a superstar publisher. Further, I learned that I liked doing therapy (and psychoed assessments) and was pretty skilled at it.

I have thought about doing some adjunct teaching, but unfortunately, the pay for that would be less than I make as a therapist. I may still do some at some point for variety's sake.

It should be said, that some of my bitterness comes from what can only be described as an exploitive business arrangement witht the owner of my practice. If I got out on my own, I might be a little less bitter (but would still rather be an MD).

Dr. E
 
It should be said, that some of my bitterness comes from what can only be described as an exploitive business arrangement witht the owner of my practice. If I got out on my own, I might be a little less bitter (but would still rather be an MD).

Dr. E

I have seen a bit of this in our field, unfortunately. The whole "I'll take 60%, you keep the rest" kind of thing.
 
When I got to grad school, I learned that our professors were miserable, unhappy human beings and I did not want that for myself.

Funny, because I've experienced just the opposite--my therapy supervisors have been miserable, unhappy people who are utterly uninspiring professionals, while my experience with mentors/professors in grad school have been the kind of people I aspire to be. Oh well!
 
Yeah, it was pretty disheartening when I realized that my nail tech takes home about what I do per hour ($35 before taxes)

Dr. E

A general rule of thumb.....you will rarely build wealth if you work for someone else. The value of owning a multi-practitioner office is being able to keep more (%-wise v. invested time), and rarely can you have this if someone else is employing you because they are by definition looking to keep more and pay less. A large difference is that the owner "gets paid" whether they work or not, while the employee in this model only gets paid when they work. This approach pads the overall margin because the owner can double dip their hours (get paid for their hour and a % of each of their employees' hour). Obviously there are other costs that eat at the margin, but a halfway decent model can produce a more comfortable bottom line. If I ran a practice and could get away with paying $35/hr (and not offer benefits or rent space in a place like NYC), I'd cookie-cutter that out and retire in 10-15 years because my net margin (profit) would be at least 30%+ after taxes.
 
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A general rule of thumb.....you will rarely build wealth if you work for someone else. The value of owning a multi-practitioner office is being able to keep more (%-wise v. invested time), and rarely can you have this if someone else is employing you because they are by definition looking to keep more and pay less. A large difference is that the owner "gets paid" whether they work or not, while the employee in this model only gets paid when they work. This approach pads the overall margin because the owner can double dip their hours (get paid for their hour and a % of each of their employees' hour). Obviously there are other costs that eat at the margin, but a halfway decent model can produce a more comfortable bottom line. If I ran a practice and could get away with paying $35/hr (and not offer benefits or rent space in a place like NYC), I'd cookie-cutter that out and retire in 10-15 years because my net margin (profit) would be at least 30%+ after taxes.

I think the above has to be kept in mind. A large part of whether someone is unhappy or happy also depends on where they are rather than what they are doing. For example, I am unlicensed and in the part-time private practice I work at $35 is my minimum net per therapeutic hour after I pay for overhead, supervision, etc. After I am licensed, that rate jumps to $60-$90/hr after overhead. So, doing the same job in the same setting as Dr. E, I would be clearing double what she might be in a given week were I licensed. Also, my clients pay up front and then file for reimbursement from insurance, so my pay is never delayed. Pay attention to your work contracts and find out what is competitive.
 
Hey folks,

I thought I would post a reply here, as it seemed something was missing on this particular thread in regards to a way in which Psychologists with a PhD could generate extra income: third party / insurer requested assessments. I believe these pay quite well.

However:

1. Some people may find them boring or objectionable for a variety of reasons.
2. It may be quite competitive to break into this field, although not as competitive as one might think. Simply attending a few conferences may be sufficient to increase your marketability.

As a chronic pain doc in canada, I have been performing these assessments for about 4 - 5 years now. Doing so has protected me from downswings in patient attendance / no shows, stock market fluctations, etc.

Just a thought.
 
I think the above has to be kept in mind. A large part of whether someone is unhappy or happy also depends on where they are rather than what they are doing. For example, I am unlicensed and in the part-time private practice I work at $35 is my minimum net per therapeutic hour after I pay for overhead, supervision, etc. After I am licensed, that rate jumps to $60-$90/hr after overhead. So, doing the same job in the same setting as Dr. E, I would be clearing double what she might be in a given week were I licensed. Also, my clients pay up front and then file for reimbursement from insurance, so my pay is never delayed. Pay attention to your work contracts and find out what is competitive.

Sanman- Just Curious- If you don't mind saying, is this a fee-for-service arrangement? How many hours per week can you bill out on average?
 
Sanman is not taking into account no-shows, etc. You may net $x amount per billable hour; however, a sizable number of hours per day will not be billable because of no shows, etc. Furthermore, if your figures were correct, the average clinical psychologist would not be making $65K a year.

One problem is that when you conduct psychotherapy or assessment, your scope of practice is not protected by law. Thus, any profession, including ones that are much cheaper, can easily mimic what you do (there are a thousand people saying they are proficient at transplant evaluations, cognitive therapy, psychological testing etc.) and undercut your price. Mental health sciences predicated in the social sciences have literally become a race to the bottom in terms of reimbursement. Thus, unless you are a Marsha Linehan or Judith Beck, you are likely fighting a losing battle because nothing we do as psychologists is protected by law.

On another note, I think it is so sad when I hear people say "I would be happy earning $65K" For all the education we receive, we should be earning much more. Furthermore, when you get out in the real world, you will see $65K will only be ok if you are single and plan on staying that way. In addition, you will never know true job security as a Ph.D. because anybody (MSW, etc) can replace you.


Being recently licensed as a clinical psychologist (2010) and being almost finished with my post-doctoral master's in clinical psychopharmacology, I think I have a good perspective on the whole "making money" thing as both an assessment/therapy provider and a person who can manage medications.

It is quite strange to receive 2-3 phone calls a day from recruiters wanting me to work at their institution and receiving offers of $200K/year rather to work as a prescribing psychologist in a big city like New Orleans rather than me having to think about moving to Wyoming or Montana to take a $65K/year job. It will be strange to actually have job security and be in demand for once. You will find that unless you are either very lucky or willing to work 24-7 for a long time, the emotional cost of becoming a psychologist is simply not worth it. On an honest day, I think most psychologists would agree
 
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Sanman- Just Curious- If you don't mind saying, is this a fee-for-service arrangement? How many hours per week can you bill out on average?

It is fee-for-service. It a group practice, but I am only contracted for 20/hrs wk there (by choice) and have left some of those hours free as part of the agreement when hiring me was for me to help develop a behavioral medicine/cbt program for the group as they have had calls, but no one has as much of a background as I do. Right now, as I am the only male, the only minority, and the only post-doc there I could likely fill up most of my schedule with unrelated cases.
 
I normally don't respond any more, but I just can't help it. The future can be great, even if your not a psychiatrist. I have seen negativistic, self defeating, stinking thinking among psychologist for years. Misery loves company. Even while working toward my Ph.D. I would see other students who would say Ï didn't get into this field for the money." As if they were planning for a life of poverty. (be careful of your automatic thoughts) I never understood it and still don't. I went to a public school, APA approved, received good training, got licensed, paid my dues for 2-3 years, worked very, very hard, went into private practice, got busy, hired another, then another, then another, and another, blaw, blaw, etc. Now, I'm finally not classified as early career, but am looking at early retirement in the next 5 to 8 years. Dream big, then implement.
 
I normally don't respond any more, but I just can't help it. The future can be great, even if your not a psychiatrist. I have seen negativistic, self defeating, stinking thinking among psychologist for years. Misery loves company. Even while working toward my Ph.D. I would see other students who would say Ï didn't get into this field for the money." As if they were planning for a life of poverty. (be careful of your automatic thoughts) I never understood it and still don't. I went to a public school, APA approved, received good training, got licensed, paid my dues for 2-3 years, worked very, very hard, went into private practice, got busy, hired another, then another, then another, and another, blaw, blaw, etc. Now, I'm finally not classified as early career, but am looking at early retirement in the next 5 to 8 years. Dream big, then implement.

How many of the people that you hired will be retiring early? What rate have you negotiated with those folks?
 
Sanman is not taking into account no-shows, etc. You may net $x amount per billable hour; however, a sizable number of hours per day will not be billable because of no shows, etc. Furthermore, if your figures were correct, the average clinical psychologist would not be making $65K a year.

I did not speak about no shows or paper work, I spoke about how much I get paid per therapeutic hour. My point was that fee arrangements and work atmosphere differs with every practice. I know, for example, that my fee split is better than Dr. Eliza's fee split because she has mentioned hers here before. Sure there is unpaid paperwork, no shows, etc. Just part of the game.

I would disagree with your $65k/yr average as well. I have seen the BLS/APA numbers and don't want argue about that though. And let's not get too sad sack on the profession edieb, you are already work at a VAMC and make $80k. So, I am guessing moving to Wyoming for $65k would be silly. I am not saying that the field is perfect and I will not likely ever see $200k doing therapy (nor do I plan to be doing so in a few years anyway), but we are not all struggling to make ends meet. You make more than that figure licensed and reading the other thread at least a couple of people here clear six figures. I have a job offer in the 70's plus benefits once licensed. Let us at least be honest about where things stand.
 
How many of the individuals that I have hired will be retiring early, I have no clue. I know a radiologist who makes 500 K and lives pay check to pay check because he wants to live in a 6,000 square foot house and likes to spend money. Those at my office receive a salary, productivity pay, malpractice, holiday, sick, professional leave, etc. They average about the 80th to 90th percentile and I'm always hiring.
 
How many of the individuals that I have hired will be retiring early, I have no clue. I know a radiologist who makes 500 K and lives pay check to pay check because he wants to live in a 6,000 square foot house and likes to spend money. Those at my office receive a salary, productivity pay, malpractice, holiday, sick, professional leave, etc. They average about the 80th to 90th percentile and I'm always hiring.

Of what?

I am just curious. Private practice sounds like nothing I would personally ever enjoy. However, I am curious about how these practices are structured.

I also am somewhat wary, knowing that the model does involve getting others to do the work for you, so you make money when you are not working. Yes, all well-deserved after establishing a practice, overhead, etc, etc... but this model cannot be feasible for all entering psychologists because of the very fact that it is a zero-sum game to a large extent. You could not be as well off without the people working for you.

So when I hear people suggest "If you work hard, you can make tons of money" I question their ethics given the current economic climate, the nature of the issues facing our field, and the limited amount of cash-paying clients out there.

Edit: I forgot to re-ask - what percentage do the folks you hire take home out of what they bill? What percentage do you keep?
 
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Sorry for not being clear. When I refer to the 80th to 90th percentile I am refering to the national average. Yes, I'm talking about a passive income model. But, if you believe the only way to do well in this field is to be unethical, are you suggesting successful people are crooks? I saw Dr. Ellis one time make 15 K at a 2 hour presentation, Dr. Phill has a net worth of something like 300 million. Maybe bad examples, but anyway.
 
Sorry for not being clear. When I refer to the 80th to 90th percentile I am refering to the national average. Yes, I'm talking about a passive income model. But, if you believe the only way to do well in this field is to be unethical, are you suggesting successful people are crooks? I saw Dr. Ellis one time make 15 K at a 2 hour presentation, Dr. Phill has a net worth of something like 300 million. Maybe bad examples, but anyway.

No, but I am suggesting that some people do well because not everyone can do as well, which is why I think it is prudent to be conservative when describing what kind of earnings to expect to new, young, 20-something folks considering making an investment in this field. It is private practice owners who benefit from the cheap services of recent graduates who need to make enough money to start paying their loans. I am not saying that it shouldn't be that way necessarily, but there is more "paying your dues" in this line of work than many others, and many folks will never be done paying their dues because there is just not enough to go around with our rising numbers.

You didn't answer my questions, but that's okay. I think I get the picture.
 
How is it structured, you mean LLC, S-Corp, C-Corp? Each have pros and cons. In this case, 1 owner. And PS. anyone who is not professional, ethical, competent, etc. would not be with my group. I do understand how things can seem out of reach sometimes considering community mental health centers want to pay us less than a plumber makes / year.
 
How is it structured, you mean LLC, S-Corp, C-Corp? Each have pros and cons. In this case, 1 owner. And PS. anyone who is not professional, ethical, competent, etc. would not be with my group. I do understand how things can seem out of reach sometimes considering community mental health centers want to pay us less than a plumber makes / year.

All I asked is what percentage of billing do your hired psychologists keep, and what percentage goes to you.I am not suggesting anyone is unethical in your practice.

I did make a statement about questioning ethics when it comes to advising young students about how much money they can make in the profession. I think saying "sky is the limit" without adequate qualification, base rate data, etc., would be misleading.
 
Very fair. Approximately 60-70 percent goes to the clinician. The rest goes to the company which involves considerable overhead (own a building, support staff, accounting, utilities, advertising, desks, furnature, computers, cleaning crew, billing costs, etc.). About future young students, well, thats complicated. I don't want to mislead anyone. What I am trying to suggest is that I am no one special at all and have done pretty good. I think my model applied to radiology would be about 3 million a year. So if I had to do it all over again, thats another story. For anyone with a bachelor's degree in psychology, I would recommend the nurse practitioner license. Fee schedules equal something like 65 / unit, which could lead to 350K a year with a great office manager. I know what I'm talking about.
 
Very fair. Approximately 60-70 percent goes to the clinician. The rest goes to the company which involves considerable overhead (own a building, support staff, accounting, utilities, advertising, desks, furnature, computers, cleaning crew, billing costs, etc.). About future young students, well, thats complicated. I don't want to mislead anyone. What I am trying to suggest is that I am no one special at all and have done pretty good. I think my model applied to radiology would be about 3 million a year. So if I had to do it all over again, thats another story. For anyone with a bachelor's degree in psychology, I would recommend the nurse practitioner license. Fee schedules equal something like 65 / unit, which could lead to 350K a year with a great office manager. I know what I'm talking about.

Sounds like a much more fair contract than anything I have heard of in my locale. Clinicians are often asked to take 40%.
 
Very fair. Approximately 60-70 percent goes to the clinician. The rest goes to the company which involves considerable overhead (own a building, support staff, accounting, utilities, advertising, desks, furnature, computers, cleaning crew, billing costs, etc.). About future young students, well, thats complicated. I don't want to mislead anyone. What I am trying to suggest is that I am no one special at all and have done pretty good. I think my model applied to radiology would be about 3 million a year. So if I had to do it all over again, thats another story. For anyone with a bachelor's degree in psychology, I would recommend the nurse practitioner license. Fee schedules equal something like 65 / unit, which could lead to 350K a year with a great office manager. I know what I'm talking about.


I'm curious, are these licensed or unlicensed people? Masters or doctoral level? Do you need to be on-site at all times or is this something that could allow you to hold another position? I have played with the idea of doing something similar in a few years while, perhaps, having part-time or consulting position as well. As I have an interest in real estate investment, the office overhead might be there anyway.
 
Sounds like a much more fair contract than anything I have heard of in my locale. Clinicians are often asked to take 40%.

I have never heard of an offer for that little money with the exception of unlicensed clinicians. My contract is much more in line with Psychevallll's rates. The bottom line is that your business determines the rate you make and too many people are willing to lower their rate below their worth.
 
All are independently licensed, both masters level and doctoral level. I have not figured out a way to make a 96102 (psych tech code for testing) viable. Maybe some have. I have thought about hiring those who want a post doc to get licensed if I could get a 1 year pay back after licensure to cover the time, cost of record forms, lost revenure in regards to billable hour time to supervise, and potential loss (office space being used on an intern who will likely create less deposits). Also, all the goverment agencies and CMHC's around my area hire those without a license as they are able to do so and bill insurance and I am not. Life's not fair. I don't have to be on site considering everyone is independently licensed to practice. If we ever get telemedicine, I see intakes while in the islands in my future. JK.
 
I have never heard of an offer for that little money with the exception of unlicensed clinicians. My contract is much more in line with Psychevallll's rates. The bottom line is that your business determines the rate you make and too many people are willing to lower their rate below their worth.

Well I haven't looked into it much because I am not planning to go into private practice unless I really need to make extra money for some reason. But I have heard that some places look to give only 40-50% of the billing directly to clinicians. I know taht there are better contracts out there, but I am guessing that in many locales folks who have established practices have plenty of willing clinicians available to see their patients at a lower contract rate. I also know some practices vary regarding when people are paid - some larger practices pay you outright. Other practices do not pay you until after collections (so if the patient or their insurance take too long, you will be waiting).
 
A general rule of thumb.....you will rarely build wealth if you work for someone else. The value of owning a multi-practitioner office is being able to keep more (%-wise v. invested time), and rarely can you have this if someone else is employing you because they are by definition looking to keep more and pay less. A large difference is that the owner "gets paid" whether they work or not, while the employee in this model only gets paid when they work. This approach pads the overall margin because the owner can double dip their hours (get paid for their hour and a % of each of their employees' hour). Obviously there are other costs that eat at the margin, but a halfway decent model can produce a more comfortable bottom line. If I ran a practice and could get away with paying $35/hr (and not offer benefits or rent space in a place like NYC), I'd cookie-cutter that out and retire in 10-15 years because my net margin (profit) would be at least 30%+ after taxes.

I normally don't respond any more, but I just can't help it. The future can be great, even if your not a psychiatrist. I have seen negativistic, self defeating, stinking thinking among psychologist for years. Misery loves company. Even while working toward my Ph.D. I would see other students who would say Ï didn't get into this field for the money." As if they were planning for a life of poverty. (be careful of your automatic thoughts) I never understood it and still don't. I went to a public school, APA approved, received good training, got licensed, paid my dues for 2-3 years, worked very, very hard, went into private practice, got busy, hired another, then another, then another, and another, blaw, blaw, etc. Now, I'm finally not classified as early career, but am looking at early retirement in the next 5 to 8 years. Dream big, then implement.

Win!
 
Very fair. Approximately 60-70 percent goes to the clinician. The rest goes to the company which involves considerable overhead (own a building, support staff, accounting, utilities, advertising, desks, furnature, computers, cleaning crew, billing costs, etc.). About future young students, well, thats complicated. I don't want to mislead anyone. What I am trying to suggest is that I am no one special at all and have done pretty good. I think my model applied to radiology would be about 3 million a year. So if I had to do it all over again, thats another story. For anyone with a bachelor's degree in psychology, I would recommend the nurse practitioner license. Fee schedules equal something like 65 / unit, which could lead to 350K a year with a great office manager. I know what I'm talking about.

I'd love to hear more about this... PMing you...
 
This is a great thread. Thanks for all the input everyone!
 
Yep. Very tempting.

At the end of the day it is knowing how to run a business and make the needed adjustments to maximize $$ within whatever industry you work. You can employ wholy mediocre therapists and be very successful. I'd prefer to employ people who are great at their jobs, but that (sadly) isn't a pre-requisite for being successful.
 
At the end of the day it is knowing how to run a business and make the needed adjustments to maximize $$ within whatever industry you work. You can employ wholy mediocre therapists and be very successful. I'd prefer to employ people who are great at their jobs, but that (sadly) isn't a pre-requisite for being successful.

I suppose that would depend on how you define "successful" with regard to running a private practice. If it is solely about money, then sure, employ whomever. Some might argue that with all of this education we receive, we also should choose to make decisions about how we run a practice based on more than just about our own profit margin and practice what we preach in terms of being good stewards of the field.
 
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Well it makes sense. If I invested into marketing, buying a building, insurance, and could gurantee others an independent practice, with guranteed clients, with nothing to worry about on the business side, the catch being that i get a percentage of their earnings..that be a great deal for them and myself.
 
I suppose that would depend on how you define "successful" with regard to running a private practice. If it is solely about money, then sure, employ whomever. Some might argue that with all of this education we receive, we also should choose to make decisions about how we run a practice based on more than just about our own profit margin.

I am not advocating a 'bottom line' approach to practice, and not just because that approach has proven to come with some significant threats to long-term viability. I am just trying to balance the, "I want to help people!!" haze that tends to pervade private practice work and lead people to make wholy bad decisions about how to run their practice. Running a successful practice will allow for clinicians to eat a couple of extra hours in a case that needs it, but not have that decision take food off of your own table at night.

We are highly educated professionals who provide a value service to our patients, but we often treat ourselves like 2nd class professionals. Plumbers, lawyers, accountants, and the like all provide valuable service to their customers, but because we are in a helping profession we are treated differently. We allow ourselves to be treated differently. I swear I am not a heartless guy, if I were I would have opened up a Cash-For-Gold/Cash Advance storefront and called it a day. Those things are goldmines, if you can look past the predatory practices. I am not advocating that approach. I am just trying to remind people that private practice is a business.
 
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