Path to Private Practice

[West Wing]

So here's my hypothetical future career path:

1. BA in Psychology
2. MA in Sports Psychology
3. PsyD Clinical Psychology
4. Join/Make a private practice
5. Make $75,000 for the rest of my life

So, could someone please point out the holes in my plan? I feel like the transition between #3 and #5 is more difficult than I currently understand,

Thanks!

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[Sanman]

Alright, My first question is why are going to complete a masters in sports psychology? My second question is where are you in your education now? My third question is what type of psychology, patiet population, etc do you want to work with? Answer these questions and we can begin to answer yours.

 

[West Wing]

1. I was thinking about going to JFKU and they offer a program that links the MA with the PsyD with only 1 extra year. I love sports and I think it would be nice to have the option to do either sports psychology or private practice.

2. Right now I am working on my BA.

3. I want to do something like working with depression/anxiety disorders, maybe specializing in adolescant depression. As for patient population, I guess the first part of my answer gets at that. Also, I plan on living in either in Northern California or Southern California. (Not sure if that fully answers the question.)

Hope that is clarifying and thanks in advance for the help!

Alright, My first question is why are going to complete a masters in sports psychology? My second question is where are you in your education now? My third question is what type of psychology, patiet population, etc do you want to work with? Answer these questions and we can begin to answer yours.

 

[NRAI2001]

1. I was thinking about going to JFKU and they offer a program that links the MA with the PsyD with only 1 extra year. I love sports and I think it would be nice to have the option to do either sports psychology or private practice.

2. Right now I am working on my BA.

3. I want to do something like working with depression/anxiety disorders, maybe specializing in adolescant depression. As for patient population, I guess the first part of my answer gets at that. Also, I plan on living in either in Northern California or Southern California. (Not sure if that fully answers the question.)

Hope that is clarifying and thanks in advance for the help!

Why not go to med school and do psychiatry?

 

[Sanman]

Why not go to med school and do psychiatry?

Why not go to carpentry school and become a carpenter?

 

[Sanman]

Alright, I have a few comments:

First, I have never heard of JFKU. I took a look at their website and it says that they are APA-accredited, which is always good. However, I would look into their internship/post-doc match rate.

Second, I am guessing that they are charging you tuition. If it is high and you have a lot of debt, You are going to need a much higher salary than 75k to pay off six figure debt and live in southern california comfortably. Be care ful of that.

Third, if you do the sports psych combined program, you will be somewhat limiting what you can do. The reason for this is that most of your experience will in sports psych and it will be difficult to match into internships and post-docs in unrelated specialties since you won't have enough clinical hours in your other chosen specialty to be competitive. If you want to specialize in child psych, you must be aware that it is very competitive and you will be fighting for a spot against people in specialized child psych programs. If you want to work in sports than do it, otherwise think about it. Ther really isn't ny "double majoring" in grad school.

If you want to do primarily therapy, you are looking at starting at 40-50k and then earning and average income of 65-75k. If you prefer to do neuropsych/assessment then the pay will go up. However, 75K is definitely doable at this point in psych. Generally, you will make more in areas like Ca to compensate for the standard of living. I have heard that the average income for psychologists in the L.A. area is ~80k.

Let me know if you have any other questions.

 

[50960]

JFK U is well known in Ca. APA accreditation is nothing but BS.

 

[Sanman]

Hey,
I agree that its standards are BS, but it can make it hell to get internships, post-docs, or licensure i some states without it. I'm dealing with enough pain to add to my headaches.

 

[NRAI2001]

JFK U is well known in Ca. APA accreditation is nothing but BS.

JFK is known as a ****ty school, its near SF, they have a law school also.

 

[NRAI2001]

Why not go to carpentry school and become a carpenter?

I want to do something like working with depression/anxiety disorders, maybe specializing in adolescant depression. As for patient population.......

Sounds like the realm of psychiatry to me.

Can clinical psychologist prescribe meds?

 

[West Wing]

The program at JFKU is sports psychology stuff for the first year, then you take the regular, 4 year Clinical Psychology PsyD program. I didn't really think of it as something that would limit by opportunities, but exapnd them.

I am not at all set in stone about where I want to go, just floating ideas.

About med school...I am a psychology soph. and I really have no idea what I would have to do to become pre-med, and also the requirements and difficulty of med schools. I really haven't thought about it that much, but what are the pitfalls in going to med school for psychiatry instead of pursuing a PsyD?

"Why not go to carpentry school and become a carpenter?" ... That's a good line.

Psisci: you seem to know a lot about the programs in CA. I am definately going to grad school in CA...do you think you could post the best regarded schools in PsyD and clinical PhD?

As a side note, this is a great, great site because I have a million questions and a lot of them are getting answer from the other posts.

 

[NRAI2001]

The program at JFKU is sports psychology stuff for the first year, then you take the regular, 4 year Clinical Psychology PsyD program. I didn't really think of it as something that would limit by opportunities, but exapnd them.

I am not at all set in stone about where I want to go, just floating ideas.

About med school...I am a psychology soph. and I really have no idea what I would have to do to become pre-med, and also the requirements and difficulty of med schools. I really haven't thought about it that much, but what are the pitfalls in going to med school for psychiatry instead of pursuing a PsyD?

"Why not go to carpentry school and become a carpenter?" ... That's a good line.

Psisci: you seem to know a lot about the programs in CA. I am definately going to grad school in CA...do you think you could post the best regarded schools in PsyD and clinical PhD?

As a side note, this is a great, great site because I have a million questions and a lot of them are getting answer from the other posts.

Well i think the biggest difference between clinical PHD and going to med school is that with med school you are a fully licensed and independent MD. You have knowledge of the entire body. You can prescribe medications with out anyones supervision or authority. I m not 100% sure about clinical pyschologists, but I dont' think they can do this at all or they may need supervision from an MD/DO when prescribing medications.

Med school takes 4 years to complete, while most phd programs take 5 to 7 years to complete. Then there is post doc work afterwards...etcPsychiatry isn't a competitive residency to get and there are many fellowship options afterwards. I think in the end the time needed to be in school will come out to be the same.

The prereqs for med school are:
1 year of general bio
1 year of general chem
1 year of o chem
1 year of physics
some schools require a year of math and a year of english.

If you are a sophmore you have plenty of time to complete these.

 

[NRAI2001]

I guess it comes down to if you want to be able to prescribe medications on your own.

So what is the main role/job of a clinical psychologist?

 

[PsychEval]

I would love to see a one sentence answer. As a group, psychologist are horrible at providing a targeted description of what they do.

 

[Sanman]

Well, I'll give it a try. Psychologists assess, research, and treat a variety of behavioral and cognitive disorders through numerous, generally non-pharmacological means.

 

[PsychEval]

Not bad, I would drop the linguistically negative though.

A while back there was a write up in psychotherapy finances on the 30 second elevator conversation. The article suggested psychologists need to have a packaged response ready at a moments notice. Being an ethical promoter might just land you a corporate client.

Wow, that’s great. I am a ceo of a small company, I have 50 employees who could benefit from an employee assistance program focused on…..

Dr. Ivory Tower did not teach us that one.

 

[West Wing]

So, if I want to see patients suffering from anxiety, depression and stress disorders in a private practice setting, is there any reason I should choose PsyD over med school?

I should also mention I am bad at science. There is no way my grades would be very good if I had to take a bunch on science classes.

Also, I've heard after you finish med school you have to do some more training for four more years. Is this true and what happens during those 4 year?

Thanks

 

[50960]

JFKU has an OK reputation in Ca, but that can be said of most professional schools. The doctor is made in the clinical training, not the degree although many students and postdocs disagree with this as they have suffered to be in the program they are in so they expect to be honored for it....they will not for the most part get that honor in the real world. Get your degree where you wish, but focus on getting GREAT clinical experience, or research experience...this will make you successful. A great PhD grad who has no skills will fail 90% of the time.

 

[Sanman]

PsychEval, I definitely agree that we desperately need some business training in psychology, since private practice all boils down to running a business. One of the problems that I am having with my classmates is that they are going into their education with the expectation of low pay when they get out. They aren't trained to efficiently run a business and expect not to be paid well, no wonder they end up with low salaries. I sincerely believe that this is part of the problem in psychology. You are only worth what you decide you are worth. I, personally, haven't decided in what setting I would like to practice, but I will definitely supplement my education with some business courses in the future.

West wing, How do you want to treat your patients? Psychiatrists dole out meds for the most part, Psychologists do more assessment and therapy. Knowing the population isn't enough, you need to decide how you want to treat them and in what philosophy you believe. Don't go either way thinking you will be able to do it all. It really doesn't work that way anymore.

 

[50960]

The Bell Curve...some people have to.

 

[psych101]

I agree about the business training issue. Those that accept low salaries hurt the field. Anecdotally, I think much of this has to do with gender. I've observed many women psychologists who have husbands that make big money and don't seem to care about making $45,000 a year as a professional. That's not good. Yeah, you can make $75,000 a year for your entire career, but why would you want to?

I wish there was an easy solution to this observation that you make. Though I don't take offense to your statement, I don't think you can make any legitimate inferences about gender here (your observation could easily be attributed to the fact that there are so many more women than men in the field anyway) -- but I don't doubt it's what you have observed. I WISH I could make even $75,000 -- unfortunately even attaining that mark is at least a few years away. Although it may not be true in all parts of the country or in all subspecialties in psychology, I think many will find themselves (at least at the outset and until attaining full licensure) in an overloaded job market where many of the "generic" clinician positions (even supervisory positions) are posted in the classifieds as seeking PhD/LCSW/LPC. It's ridiculous. It took me 4 months after internship to secure a low-paying (not even $40,000) job that essentially discredited all my training simply so I could be employed somewhere in order to accrue hours toward licensure. I think psychology needs to do a better job protecting the field, advocating for those in practice, and preventing the already-existing and worsening dilemma of the glut of psychologists turned out of training programs each year. Since the APA has done little thus far to address these issues, I'm afraid I don't hold out much hope for positive change in the very near future.

 

[RobinA]

It's ridiculous. It took me 4 months after internship to secure a low-paying (not even $40,000) job that essentially discredited all my training simply so I could be employed somewhere in order to accrue hours toward licensure

Hell, I'll be going for LPC licensure and I'm anticipating this problem. I may wind up with a job that pays less than the one I had when I only had a Bachelors. I've pretty much resigned myself to the fact that I'm not in this for the money.

 

[Sanman]

I have also heard it is quite difficult to find good positions to accrue supervision hours if you aren't doing a formalized post-doc. Ironically, it is bottlenecks like these that, while difficult to deal with for those who can't obtain a position, do something to control the number of psychologists practicing and at least give us a decent income. I really don't know why we don't follow medicine is this aspect, as they have clearly excelled at controlling their numbers. The other problem being that if you are at a program that doen't grant you a masters degree, internships and post-docs become difficult to find because the agency can't bill for your work.

 

[NRAI2001]

Can a psychiatrist practice clinical psychology? If so you could have the benefit of higher pay and more job opportunies.

 

[Sanman]

Can a psychiatrist practice clinical psychology? Well he could perform some the same activities (psychotherapy), however his/her income would drop accordingly. Medical professionals are paid according to the procedure they perform. Med checks pay better than psychotherapy/assessment, hence psychiatrists are paid better. All doing only psychotherapy with an MD would get you would be a psychologist's salary with way more debt.

Jon, I certainly agree with you about being able to do well in psychology. That is why it drives me nuts when fellow students/ supervisors speak about not being in it for the money. In the medical profession, you would never hear that out of a doctor. That is a pre-med notion. A doctor will tell you that s/he provides and valuable service and helps many people, thus s/he should paid accordingly. Why shouldn't psychologists expect the same?

 

[PsychEval]

Can a psychiatrist practice clinical psychology? Well he could perform some the same activities (psychotherapy), however his/her income would drop accordingly. Medical professionals are paid according to the procedure they perform. Med checks pay better than psychotherapy/assessment, hence psychiatrists are paid better. All doing only psychotherapy with an MD would get you would be a psychologist's salary with way more debt.

Jon, I certainly agree with you about being able to do well in psychology. That is why it drives me nuts when fellow students/ supervisors speak about not being in it for the money. In the medical profession, you would never hear that out of a doctor. That is a pre-med notion. A doctor will tell you that s/he provides and valuable service and helps many people, thus s/he should paid accordingly. Why shouldn't psychologists expect the same?

Language becomes reality. The negative folks tend to have negative outcomes, avoid them. I would recommend surrounding yourself with strong clinicians that are positive, energetic, hard working, ethical and entrepreneurial.

 

[PublicHealth]

The thought never entered my head going into the field that I wouldn't make a six figure income.

And what exactly are you making, Dr. Snow?

 

[PublicHealth]

$950,000/year. You?

-$50K/year (I'm in med school).

I was simply interested in the kind of money available to psychologists. If you don't want to share, that's fine. Have a great day!

 

[PublicHealth]

What, you don't believe me?

If it's true, then please share your success story!

 

[PsychEval]

Can a psychiatrist practice clinical psychology? Well he could perform some the same activities (psychotherapy), however his/her income would drop accordingly. Medical professionals are paid according to the procedure they perform. Med checks pay better than psychotherapy/assessment, hence psychiatrists are paid better. All doing only psychotherapy with an MD would get you would be a psychologist's salary with way more debt.

Jon, I certainly agree with you about being able to do well in psychology. That is why it drives me nuts when fellow students/ supervisors speak about not being in it for the money. In the medical profession, you would never hear that out of a doctor. That is a pre-med notion. A doctor will tell you that s/he provides and valuable service and helps many people, thus s/he should paid accordingly. Why shouldn't psychologists expect the same?

Psychiatrists often utilize the 90862 CPT code for billing. Medication management. There is NO time limit for the 90862. If a psychiatrist works 10 minutes or 60 minutes the reimbursement is the same for this CPT code. Consequently, what is typical is around 3 – 4 90862’s in an hour with insurance reimbursing around $75 / 90862 (there is a wide distribution in reimbursement with different insurance plans). In this example the psychiatrist makes around $300 a hour.

God bless Yalom! One fantastic way of assisting several people while making a nice living is group therapy. Insurance reimbursement for group therapy is around $50 / person. Facilitate a group with 12 patients. In this example the psychologist makes around $600 a hour. Having a practice with 2-3 groups per week would be obtainable with a little work.

 

[RobinA]

Jon, I certainly agree with you about being able to do well in psychology. That is why it drives me nuts when fellow students/ supervisors speak about not being in it for the money. In the medical profession, you would never hear that out of a doctor. That is a pre-med notion. A doctor will tell you that s/he provides and valuable service and helps many people, thus s/he should paid accordingly. Why shouldn't psychologists expect the same?

Just because an MD has a notion, doesn't make it right. There ARE MDs out there who don't do it for the money and who work at least part of the time not making much money at all. Not everybody who is in need of a basic service has the ability to pay for it. Some lawyers work for peanuts, some MDs work for peanuts and some psychologists are willing to work for peanuts to serve an underserved population. Values differ.

 

[LM02]

Just because an MD has a notion, doesn't make it right. There ARE MDs out there who don't do it for the money and who work at least part of the time not making much money at all. Not everybody who is in need of a basic service has the ability to pay for it. Some lawyers work for peanuts, some MDs work for peanuts and some psychologists are willing to work for peanuts to serve an underserved population. Values differ.

I think we're getting back into the realm of false dichotomies (which often appear on these boards).

For example, if I chose to become a lawyer, I would be "doing it for the money." Why? Because I have no interest in what lawyers do, and if I pursued that option it would be because I was motivated by a six-figure starting salary alone.

So does that mean that, because I happen to be passionate about psychology, that I'm necessarily "not in it for the money" ?? Of course not. I am passionate and motivated by the scientific method, research, and how these things can inform assessment, treatment, and prevention. But I certainly plan to market myself accordingly, and find a way to make a solid living. Passion can only take you so far - when you're on the brink of burn-out, and making $38K/year as a therapist in an overburdened community mental health center, where is the motivation to continue??

 

[RobinA]

True, but if you're insinuating that expecting to profit is wrong, I beg to differ..

Expecting to make a profit is not wrong and not what I am insinuating. What is wrong is insinuating that someone's willingness to work for LESS of a profit than you are is somehow wrong.

In reference to my comment that not everyone in need of a service can afford it you say "As a professional making my living through providing services, that is not my problem." OK, you and I are on on galaxies far, far apart, there is no point in continuing this conversation. Peace.

 

[Sanman]

Originally Posted by RobinA
Just because an MD has a notion, doesn't make it right. There ARE MDs out there who don't do it for the money and who work at least part of the time not making much money at all. Not everybody who is in need of a basic service has the ability to pay for it. Some lawyers work for peanuts, some MDs work for peanuts and some psychologists are willing to work for peanuts to serve an underserved population. Values differ.

I never suggested that every person had to be in it for the money. I said that we should be compensated appropriately for the services we provide. Those working for little wages part time are doing so by CHOICE. However, it is becoming hard to make a decent living the field if that is your choice. I don't feel that it is neccessary for me to suffer to help insurance companies and medicare make a larger profit. If you are worried about those who are not able to afford services for themselves, my suggestion is that you fight immediately for higher wages and when they are at the appropriate level, cut your practice down to 30, 20, or how many hours a week you would need to equal your past income and spend the rest of your time doing pro bono work. That would help more people than wanting to help them, but not being able to because you can't afford to and make ends meat. The bottom line is that we should be able to choose to reduce our fees, not have the reductions forced on us. And for every person you treat who can't afford it there is a person who can, but his insurance won't pay you your fee and is cheating you! I can't go to the grocery store and tell the clerk I am only paying $1 for a gallon of milk, I be arrested for theft if I left with it.

 

[NRAI2001]

I never suggested that every person had to be in it for the money. I said that we should be compensated appropriately for the services we provide. Those working for little wages part time are doing so by CHOICE. However, it is becoming hard to make a decent living the field if that is your choice. I don't feel that it is neccessary for me to suffer to help insurance companies and medicare make a larger profit. If you are worried about those who are not able to afford services for themselves, my suggestion is that you fight immediately for higher wages and when they are at the appropriate level, cut your practice down to 30, 20, or how many hours a week you would need to equal your past income and spend the rest of your time doing pro bono work. That would help more people than wanting to help them, but not being able to because you can't afford to and make ends meat. The bottom line is that we should be able to choose to reduce our fees, not have the reductions forced on us. And for every person you treat who can't afford it there is a person who can, but his insurance won't pay you your fee and is cheating you! I can't go to the grocery store and tell the clerk I am only paying $1 for a gallon of milk, I be arrested for theft if I left with it.

 

[mole2]

. . . = Government healthcare

Are you kidding?!!! Some perspective, please

 

[PsychEval]

What do folks think about Fee - for - Service?

 

[PsychEval]

I have been focused on primary care. Perhaps I need to be co located with a plastic surgeon.

 

[Sanman]

That brought up an interesting thought. How would a pre-surgery screening for something liek BBD be billed if you were working with a plastic surgeon?

 

[PsychEval]

Bbd?

 

[Sanman]

I meant BDD, body dysmorphic disorder. Sorry, long day.

 

[Allotheria]

I meant BDD, body dysmorphic disorder. Sorry, long day.

It gets billed as pre-op clearance eval. I do the screenings for bariatric surgery.

 

[PsychEval]

I meant BDD, body dysmorphic disorder. Sorry, long day.

Thanks.

 

[PsychEval]

It gets billed as pre-op clearance eval. I do the screenings for bariatric surgery.

1 90801, and 2-3 hours of 96100?

What assessments do you utilize? Is there a standard battery?

 

[PublicHealth]

1 90801, and 2-3 hours of 96100?

What assessments do you utilize? Is there a standard battery?

What do these assessments involve? What are you getting paid to conduct them?

 

[50960]

Usually a clinical interview, some testing etc... Pay depends on time spent, but most people get over 500$ a pop easily.

 

[Sanman]

How many patients a week generally run through a surgical center like that? Is it possible to make that a full time position or is that more of a consultation, part-time only deal?