Private Practice post-doc interview

[GoPokes]

Hi all,

Current intern here that has a post-doc interview with a group private practice. I've read up on some previous threads about this, but was curious about questions I should be asking during this interview. I'm not very familiar with PP (in a UCC currently) and am unsure what I should be expecting in terms of pay, health insurance, etc. The post-doc is almost exclusively assessment in 3 areas: school settings, doing disability evaluations, and forensic evaluations. Any therapy clients we take are private-pay, as I can't bill insurance.

tl;dr: what questions should I be asking to ensure I don't get in a bad situation?

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[erg923]

Hi all,

Current intern here that has a post-doc interview with a group private practice. I've read up on some previous threads about this, but was curious about questions I should be asking during this interview. I'm not very familiar with PP (in a UCC currently) and am unsure what I should be expecting in terms of pay, health insurance, etc. The post-doc is almost exclusively assessment in 3 areas: school settings, doing disability evaluations, and forensic evaluations. Any therapy clients we take are private-pay, as I can't bill insurance.

tl;dr: what questions should I be asking to ensure I don't get in a bad situation?

What are the previous 5 years worth of post-docs doing now? If they don't know, that's a problem. If they aren't doing any of the 3 activities you described, that would likely indicate problem. If none of them work at the practice now, that might indicate a problem too.

Is the stipend/salary above NIH guidelines (36k?), as it sounds like the practice is designed to make money from your labor, thus you should be compensated accordingly.

 

[PsyDr]

If salaried:

1) What is the productivity expectation (e.g., how many patients per day? or reports per week. If testing, if techs are used and how that affects productivity).
2) benefits (e.g., health insurance, retirement, PTO, sick days, CE stipend, etc).
3) What is the expectation for non-producing hours/days? If you are just writing reports, are you expected to be dressed in office wear from 9-5pm? If you last psychotherapy appointment ends at 4pm, is it okay to go home?
4) Is there potential to come aboard permanently, depending on how things work out?

If productivity:

1) is this a draw or split?
2) what happens when there is no work? Does marketing count for anything if you do it? How so?
3) 1099 or w2? "If I am a contractor, it is my understanding that the IRS says I must be able to set my own schedule, is this your understanding?"

 

[GoPokes]

Sorry I didn't mention this before -- it's pay per assessment, not salaried.


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[erg923]

Sorry I didn't mention this before -- it's pay per assessment, not salaried.


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Then you will want show/no show rate data made available to you.

Set/flat rate or % split based on whats billed?

 

[PsyDr]

Sorry I didn't mention this before -- it's pay per assessment, not salaried.


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IME, most psychologists who offer this crap are trying to bull**** you into a contractor position.

1) They have already announced themselves as pretty bad in business by doing this. Most set ups will require the owner to provide similar benefits to their employees nuder the law. This includes retirement matching, health insurance, etc. It is an incredible pain in the ass to set up, and its expensive.

2) The problem with post docs and 1099 status is that the IRS guidelines for how to determine if someone is a contractor includes such gems as "setting your own schedule" and "providing your own tools". Go ahead and call Pearson, WPS, or PAR and try to order your own tools. Shouldn't take more than 8 minutes because they won't sell to you. So..... you're not a contractor. Can't be.

 

[GoPokes]

IME, most psychologists who offer this crap are trying to bull**** you into a contractor position.

1) They have already announced themselves as pretty bad in business by doing this. Most set ups will require the owner to provide similar benefits to their employees nuder the law. This includes retirement matching, health insurance, etc. It is an incredible pain in the ass to set up, and its expensive.

2) The problem with post docs and 1099 status is that the IRS guidelines for how to determine if someone is a contractor includes such gems as "setting your own schedule" and "providing your own tools". Go ahead and call Pearson, WPS, or PAR and try to order your own tools. Shouldn't take more than 8 minutes because they won't sell to you. So..... you're not a contractor. Can't be.

Thanks for all of your responses.

I actually just got off the phone with a previous post-doc who overall enjoyed their experience.

Points I took away that seem relevant to what you mentioned above:

I would be considered a contractor.

50/50 split

Office provided

Pay my own taxes/health insurance

Supply my own protocols, provided with testing equipment


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[WisNeuro]

Pay your own taxes/health insurance, supply your own protocols, 50% split?!? Will you have any actual money at the end of the month.

 

[PsyDr]

Thanks for all of your responses.

I actually just got off the phone with a previous post-doc who overall enjoyed their experience.

Points I took away that seem relevant to what you mentioned above:

I would be considered a contractor.

50/50 split

Office provided

Pay my own taxes/health insurance

Supply my own protocols, provided with testing equipment


Sent from my iPhone using SDN mobile

You cannot purchse your own protocols. All you can do is purchase stuff from your employer (aka, "the company store"). There's a few songs about how that works for the employees.

I would argue this is financial exploitation.

 

[WisNeuro]

Pearson would sell to him if he was licensed, probably even if he just confirmed his doctorate. But yeah, sounds like something of a raw deal on the financial front. I'm more appreciative of my postdoc all the time.

 

[erg923]

Thanks for all of your responses.

I actually just got off the phone with a previous post-doc who overall enjoyed their experience.

Points I took away that seem relevant to what you mentioned above:

I would be considered a contractor.

50/50 split

Office provided

Pay my own taxes/health insurance

Supply my own protocols, provided with testing equipment


Sent from my iPhone using SDN mobile

So...they give you a WAIS kit, but you not the testing record form? That's just douchebag.

What is your estimated earning after health insurance?

Keep in mind that private practice post-docs can suck for a variety of reasons, the biggest one being financial. Health insurance, vacation/sick days and not having the pressure to produce for your own livelihood when you really want to be learning seem important. I wouldn't do it unless this was some kind of "foot in the door" to a booming lucrative practice/potential partner, etc.

 

[bmedclinic]

GoPokes, I 'm a little concerned for you that you're gonna get screwed.

I like math. Let's do some math. You're assessment oriented. Provided you're going to get on insurance panels, here's how the financials go:

You do testing. 96101 code used for X # of hours. Usually this is less than therapy, btw. It's dependent on the contract, though.
So let's say its 90 bucks x 5 hours. 450 bucks, not bad. But your cut of that is not 225. It's 225 *.7 = $157. And that's for 5-6 hours of your actual time doing testing.
So after taxes, 26- 30 bucks. And that's without paying for protocols, report writing time, etc. Whew. Maybe my math is bad, but I dont think I'm too far off.

 

[LETSGONYR]

Keep in mind that private practice post-docs can suck for a variety of reasons, the biggest one being financial. Health insurance, vacation/sick days and not having the pressure to produce for your own livelihood when you really want to be learning seem important. I wouldn't do it unless this was some kind of "foot in the door" to lucrative practice/potential partner, etc.

Good points... to add to this, I'd also ask about didactic opportunities (even if they're off-site or in collaboration with another practice/institution). I think it's an important part of the fellowship experience, and in some fields, they may be required for eventual board-certification.

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[PhDToBe]

Similar question: I have an upcoming interview with a busy/active private practice. What kind of starting salary should I request or expect (I will have completed a postdoc by the time I would begin)? I know salaries vary a lot depending on location; this one is in a large city. Thanks!

 

[smalltownpsych]

Similar question: I have an upcoming interview with a busy/active private practice. What kind of starting salary should I request or expect (I will have completed a postdoc by the time I would begin)? I know salaries vary a lot depending on location; this one is in a large city. Thanks!

If it's a private practice, then I wouldn't think that they would pay a salary. Typically they would offer a percentage of what you bill or what you collect. Ask about the referral sources and what they are billing and collecting from the various insurances they take. What kind of no show policy do they have? How far out are the clinicians booked? Does the office staff fill cancellations for you efficiently? If you are going to be doing a lot of psychotherapy,then you need to be aware of your skills with various populations and what the need is at this agency for that. If everyone is competing for the same niche, it might be hard to keep schedule filled. As far as the split goes, I would aim for 70%. I get 60 right now but that is because it is based on what is billed as opposed to what is collected. If you are going to be scheduling 40 hours, then expect to bill about 30 and make calculations based on that number. If you aren't really good, then you will burn through referrals and have a tough time keeping schedule filled at which point you would be at about 20 out of 40 per week and frustrating the other practitioners since you would be draining their potential business by wasting leads.

 

[PsyDr]

When they bring up overhead, I'd point out that this concept includes THEIR health insurance, not yours.

 

[PhDToBe]

If it's a private practice, then I wouldn't think that they would pay a salary. Typically they would offer a percentage of what you bill or what you collect. Ask about the referral sources and what they are billing and collecting from the various insurances they take. What kind of no show policy do they have? How far out are the clinicians booked? Does the office staff fill cancellations for you efficiently? If you are going to be doing a lot of psychotherapy,then you need to be aware of your skills with various populations and what the need is at this agency for that. If everyone is competing for the same niche, it might be hard to keep schedule filled. As far as the split goes, I would aim for 70%. I get 60 right now but that is because it is based on what is billed as opposed to what is collected. If you are going to be scheduling 40 hours, then expect to bill about 30 and make calculations based on that number. If you aren't really good, then you will burn through referrals and have a tough time keeping schedule filled at which point you would be at about 20 out of 40 per week and frustrating the other practitioners since you would be draining their potential business by wasting leads.

Thanks so much for your response!

I should have clarified- they told me the pay is salary and the work is in a unique niche that is in demand. I have experience in the particular niche, but they do other type of work with which I am less familiar. However, they don't expect the applicant to have ANY experience, so in that way I am already "ahead" so to speak. That being said, what should I expect/request in terms of salary and vacation? Is it okay to ask for both more salary and vacation or does that come across as greedy? lol. I'm not sure what the norm is for salary or vacation days in PP. Thanks!

 

[smalltownpsych]

Thanks so much for your response!

I should have clarified- they told me the pay is salary and the work is in a unique niche that is in demand. I have experience in the particular niche, but they do other type of work with which I am less familiar. However, they don't expect the applicant to have ANY experience, so in that way I am already "ahead" so to speak. That being said, what should I expect/request in terms of salary and vacation? Is it okay to ask for both more salary and vacation or does that come across as greedy? lol. I'm not sure what the norm is for salary or vacation days in PP. Thanks!

Interesting. My first job as a licensed psychologist I set my target at 80k. I don't know if I would worry too much about vacation. I would ask for more money as opposed to more vacation. Better to come across as greedy than lazy. Hopefully they are offering a scaled type of vacation plan where you can get more time off later. That seems to work best because the first year or so at many jobs, you probably shouldn't be taking too much time off. This is dependent on the type of work you are doing, of course.
Questions that you have to ask yourself is if this is a stepping stone for a few years or is it longer term. If you see long term potential, then build that into the negotiation. Also, will there be markers for success that you can hit and get rewarded for. If you are developing a niche that is demand, then what happens when you have your practice up and running and are making them lots of money? You can also ask about reimbursement for professional expenses such as licensing and education. What about health insurance and 401k? Remember, you could potentially get a solid job at a VA, so long as you did an APA internship, that will provide great benefits and a salary that is likely higher than what they will offer. I was comparing my first job to a position with county mental health that would have paid at least 85k to start and had solid benefits, but I chose a better working environment for a little less, but it was at my minimum target and offered potential for growth. I also was still working at my postdoc and they gave me a small bump after I got licensed so I wasn't desperate and I was willing to relocate.

 

[foreverbull]

Interesting. My first job as a licensed psychologist I set my target at 80k.

Wow! Not sure what state you live in, but psychologists in CA start out at $55k-$70k depending on what setting you're in. During one of my postdoc interviews, I said I wanted my ideal salary (as a licensed psychologist in the future, not during postdoc) to be around $80K and my interviewers flat out laughed at me and told me that that was too high. Anyway, $80K for your first licensed year seems a bit high to me given the salaries I've seen come up for early career psychologists outside of neuropsych/forensic/VA systems.

 

[smalltownpsych]

Wow! Not sure what state you live in, but psychologists in CA start out at $55k-$70k depending on what setting you're in. During one of my postdoc interviews, I said I wanted my ideal salary (as a licensed psychologist in the future, not during postdoc) to be around $80K and my interviewers flat out laughed at me and told me that that was too high. Anyway, $80K for your first licensed year seems a bit high to me given the salaries I've seen come up for early career psychologists outside of neuropsych/forensic/VA systems.

I left California ten years ago because the market was saturated and it has only gotten worse I see. When I first started undergrad with the dream of becoming a psychologist, the going rate for a starting psychologist in California was 80k. That was 20 years ago. Now I see get why the average pay for a psychologist is so low nationwide. Even better for California they are going to flood the market with LPCs now. So the median home price is 400k and the compensation for a psychologist is so low they can't afford that at all. The state I am in now, the median home price is half that and my salary is probably double the median California psychologist salary. I won't say the state because we don't need a 1000 psychologists to move here from California and begin driving salaries down, although the cold weather might keep them out for a bit.

Now that my rant is over. It could be that you are looking at UCCs and CMHs which are notorious for underpaying psychologists. At least the UCCs have a nine month year and fairly light hours from what I understand. My first job as a licensed psychologist was as a clinical director of a therapeutic boarding school and paid 80k with great benefits and it was not in California.

 

[Sanman]

Wow! Not sure what state you live in, but psychologists in CA start out at $55k-$70k depending on what setting you're in. During one of my postdoc interviews, I said I wanted my ideal salary (as a licensed psychologist in the future, not during postdoc) to be around $80K and my interviewers flat out laughed at me and told me that that was too high. Anyway, $80K for your first licensed year seems a bit high to me given the salaries I've seen come up for early career psychologists outside of neuropsych/forensic/VA systems.

Confirming all thoughts I had about never moving to California. I guess it is my inner economist, but I figured out early on that the advantage of healthcare is that salaries are fairly consistent throughout the country. This means the advantage is having to not live in a major metro/ high cost area in order to command a decent salary and is the reason I left the metro I grew up in. That thinking has served me well and hopefully this post will enlighten all the people contemplating expensive for-profit schools in CA.

 

[foreverbull]

I left California ten years ago because the market was saturated and it has only gotten worse I see. When I first started undergrad with the dream of becoming a psychologist, the going rate for a starting psychologist in California was 80k. That was 20 years ago. Now I see get why the average pay for a psychologist is so low nationwide. Even better for California they are going to flood the market with LPCs now. So the median home price is 400k and the compensation for a psychologist is so low they can't afford that at all. The state I am in now, the median home price is half that and my salary is probably double the median California psychologist salary. I won't say the state because we don't need a 1000 psychologists to move here from California and begin driving salaries down, although the cold weather might keep them out for a bit.

Now that my rant is over. It could be that you are looking at UCCs and CMHs which are notorious for underpaying psychologists. At least the UCCs have a nine month year and fairly light hours from what I understand. My first job as a licensed psychologist was as a clinical director of a therapeutic boarding school and paid 80k with great benefits and it was not in California.

Yeah, I hear you. I am from a midwestern state where the beginning salaries for psychologists are the same as California but with a much lower cost of living, so the money goes much farther. There are trade-offs, given the accessibility to a lot of cultural and natural activities on the coasts vs. inland, and more progressive politics in CA vs. the state I grew up in. I knew I wanted to live in California for all of those reasons and am willing to sacrifice some things to have that experience. I haven't regretted it. It just depends on personal preference, of course.

The salaries I was quoting were from job postings of community agencies, private agencies, professor jobs, UCCS, etc. The only jobs that paid over $70k were administrative/clinical director positions, prisons, forensic, neuropsych, or VAs. Also surprising is the high need for school psychologists out here with good pay...too bad it requires different training.

 

[jmiah717]

Yeah, I hear you. I am from a midwestern state where the beginning salaries for psychologists are the same as California but with a much lower cost of living, so the money goes much farther. There are trade-offs, given the accessibility to a lot of cultural and natural activities on the coasts vs. inland, and more progressive politics in CA vs. the state I grew up in. I knew I wanted to live in California for all of those reasons and am willing to sacrifice some things to have that experience. I haven't regretted it. It just depends on personal preference, of course.

The salaries I was quoting were from job postings of community agencies, private agencies, professor jobs, UCCS, etc. The only jobs that paid over $70k were administrative/clinical director positions, prisons, forensic, neuropsych, or VAs. Also surprising is the high need for school psychologists out here with good pay...too bad it requires different training.

LCSW's can make that in 5 years of working at the VA. That seems awfully low to me. But I guess each market is different.


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[deleted760483]

Wow! Not sure what state you live in, but psychologists in CA start out at $55k-$70k depending on what setting you're in. During one of my postdoc interviews, I said I wanted my ideal salary (as a licensed psychologist in the future, not during postdoc) to be around $80K and my interviewers flat out laughed at me and told me that that was too high. Anyway, $80K for your first licensed year seems a bit high to me given the salaries I've seen come up for early career psychologists outside of neuropsych/forensic/VA systems.

80k is a very reasonable number in a lot of non-saturated areas. My starting salary was quite a bit more than 80k at my first licensed job not even including bonus productivity incentives

 

[WisNeuro]

80k was too high!?! I think my first job out of postdoc was 88, and had several increases the first couple years. And that's not just neuro, many of my gen psych colleagues started out in the high 80s, low 90s. And now, after several years of experience, I wouldn't even consider anything out of six figures, unless they had absolutely phenomenal benefits.

 

[AppsAintNoThang]

Wow! Not sure what state you live in, but psychologists in CA start out at $55k-$70k depending on what setting you're in. During one of my postdoc interviews, I said I wanted my ideal salary (as a licensed psychologist in the future, not during postdoc) to be around $80K and my interviewers flat out laughed at me and told me that that was too high. Anyway, $80K for your first licensed year seems a bit high to me given the salaries I've seen come up for early career psychologists outside of neuropsych/forensic/VA systems.

I have no idea where you are in CA, but it's a very big state. I do nothing specialized but have received offers for my first licensed job ranging from 85-95k to start. Remember you are an N Of 1, as am I. But at least there's flexibility out there beyond your experience.

 

[foreverbull]

I have no idea where you are in CA, but it's a very big state. I do nothing specialized but have received offers for my first licensed job ranging from 85-95k to start. Remember you are an N Of 1, as am I. But at least there's flexibility out there beyond your experience.

Indeed.