Psychiatrist vs. Psychologist - Salary Questions

[positivepsych]

Hi there,
I have several questions about psychiatrist vs. psychologist salaries. I've had several advisors lately tell me to go to medical school instead, since psychiatrists make 3x as much for doing similar work. However, I'm not interested in taking hard life science classes post-bacc or being a medication manager as a career, so I don't like this option.

Though making a ton of money is not a priority for me, I feel its somehow unfair if someone is making that much more for the same work by virtue of their degree. So here are my questions:

1) From my research, it seems that clinical psychologists make $60-80K, while psychiatrists make $160-180K (based on salary.com data for a So. Cal. city). Why do psychiatrists make that much more? I understand that they perscribe medication, but I wanted to know if this discrepancy exists if both have their own private practices and see patients primarily to do Cognitive-Behavioral Therapy?

In other words, do/can Psychiatrists charge a higher billing rate for the same CBT by virtue of their MD degree?

2) I've heard that this discrepancy is somewhat offset by the high malpractice insurance that psychiatrists must pay. Is this true? Do psychologists in private practice need to have malpractice insurance as well?

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[PsychMode]

Hi there,
I have several questions about psychiatrist vs. psychologist salaries. I've had several advisors lately tell me to go to medical school instead, since psychiatrists make 3x as much for doing similar work. However, I'm not interested in taking hard life science classes post-bacc or being a medication manager as a career, so I don't like this option.

Though making a ton of money is not a priority for me, I feel its somehow unfair if someone is making that much more for the same work by virtue of their degree. So here are my questions:

1) From my research, it seems that clinical psychologists make $60-80K, while psychiatrists make $160-180K (based on salary.com data for a So. Cal. city). Why do psychiatrists make that much more? I understand that they perscribe medication, but I wanted to know if this discrepancy exists if both have their own private practices and see patients primarily to do Cognitive-Behavioral Therapy?

In other words, do/can Psychiatrists charge a higher billing rate for the same CBT by virtue of their MD degree?

2) I've heard that this discrepancy is somewhat offset by the high malpractice insurance that psychiatrists must pay. Is this true? Do psychologists in private practice need to have malpractice insurance as well?

It's my understanding that psychiatrist often act primarily as psychopharmacologists rather than therapists. Furthermore, I believe that psychiatrists always make more money than psychologists when it comes to salary. I am not sure about whether they charge higher prices for the same nonpharmacological therapy, but I wouldn't be suprised. They have medical degrees and could potentially prescribe meds to their clients even if they don't. Keep in mind that psychologists who are primarily interested in clinical practice are competing with master's degree practitioner these days. Even with regards to psychologists having prescription privileges, some master's level social workers believe for some reason that anyone with an MSW should be able to pursue prescription privileges. If you are concerned that psychiatrists make 3x more than psychologists, then medical school is the best option. A medical doctor is going to make more than a nonmedical doctor.

I am strongly interested in psychology. I would pursue social work (at the doctoral level) if I couldn't get into psychology at the doctoral level. My professional interests lean more toward clinical research, but I would like to combine clinical research with clinical practice. Even if I had planned on going to medical school, I am very sure that I would not pursue psychiatry.

 

[PublicHealth]

It's my understanding that psychiatrist often act primarily as psychopharmacologists rather than therapists. Furthermore, I believe that psychiatrists always make more money than psychologists when it comes to salary. I am not sure about whether they charge higher prices for the same nonpharmacological therapy, but I wouldn't be suprised. They have medical degrees and could potentially prescribe meds to their clients even if they don't. Keep in mind that psychologists who are primarily interested in clinical practice are competing with master's degree practitioner these days. Even with regards to psychologists having prescription privileges, some master's level social workers believe for some reason that anyone with an MSW should be able to pursue prescription privileges. If you are concerned that psychiatrists make 3x more than psychologists, then medical school is the best option. A medical doctor is going to make more than a nonmedical doctor.

I am strongly interested in psychology. I would pursue social work (at the doctoral level) if I couldn't get into psychology at the doctoral level. My professional interests lean more toward clinical research, but I would like to combine clinical research with clinical practice. Even if I had planned on going to medical school, I am very sure that I would not pursue psychiatry.

Psychologists with prescriptive authority in Louisiana use the same CPT codes to bill for pharmacotherapy services as psychiatrists. They are currently in the process of educating insurers about medical psychologists. Incomes of psychologists in this state (and NM) are expected to rival those of psychiatrists.

 

[Poety]

Hey everyone, just wanted to chime in on what my assumption is. I would guess that psychiatrists make more because of the medical degree - as they're medical doctors. Historically, the MD's make more than the PhD's in almost any field (as unfortunate as that is!!!) I have no idea as to WHY, but I know it does hold true.

If you want to get into psych, but love medicine as well, then I say go to medical school (as an iatrist, you'll also be responsible for knowing about your patients medical conditions, interactions with their other meds, etc etc, and you will probably manage these to some degree) as a psychologist, you can prescribe in some states, and if you were interested in pursuing that, you could go that way too if you wanted to focus more on just the "psych" aspect.

Good luck with your choice! Either way, you'll be successful

 

[LM02]

A lot of it also has to do with health insurance reimbursement issues.

As a psychologist, you will need to buy malpractice insurance - but it is significantly cheaper than MD malpractice rates.

 

[PublicHealth]

Hey everyone, just wanted to chime in on what my assumption is. I would guess that psychiatrists make more because of the medical degree - as they're medical doctors. Historically, the MD's make more than the PhD's in almost any field (as unfortunate as that is!!!) I have no idea as to WHY, but I know it does hold true.

If you want to get into psych, but love medicine as well, then I say go to medical school (as an iatrist, you'll also be responsible for knowing about your patients medical conditions, interactions with their other meds, etc etc, and you will probably manage these to some degree) as a psychologist, you can prescribe in some states, and if you were interested in pursuing that, you could go that way too if you wanted to focus more on just the "psych" aspect.

Good luck with your choice! Either way, you'll be successful

Medical school is also a hell of a lot more expensive than clinical psychology PhD programs! Private medical school is easily $150K-200K in loans. The majority of PhD programs in clinical psychology are free and you get a stipend to cover living costs. Internship in clinical psychology also pays enough to survive, as do post-docs. Most psychologists with specialty training (e.g., neuropsychology) will start at $70-100K. VA system = $80-100K. Not bad considering minimal to no debt for doctoral training. Academic jobs for psychiatrists start in the $70-100K range as well. Some psychologists also supplement their income by conducting fee-for-service forensic evaluations, so they can make a "psychiatrist salary" if they're savvy enough and develop a reputation in the field. Prescriptive authority will also boost salaries for psychologists who pursue psychopharmacology training and who practice in states that permit psychologists to prescribe.

 

[Harmony]

Medical school is also a hell of a lot more expensive than clinical psychology PhD programs! Private medical school is easily $150K-200K in loans. The majority of PhD programs in clinical psychology are free and you get a stipend to cover living costs. Internship in clinical psychology also pays enough to survive, as do post-docs. Most psychologists with specialty training (e.g., neuropsychology) will start at $70-100K. VA system = $80-100K. Not bad considering minimal to no debt for doctoral training. Academic jobs for psychiatrists start in the $70-100K range as well. Some psychologists also supplement their income by conducting fee-for-service forensic evaluations, so they can make a "psychiatrist salary" if they're savvy enough and develop a reputation in the field. Prescriptive authority will also boost salaries for psychologists who pursue psychopharmacology training and who practice in states that permit psychologists to prescribe.

One of the major drivers for prescribing medication is higher reimbursement rates for a shorter cycle time (15-20 mins med checks). Hence, logically it makes sense that prescribing psychologist will enhance their earnings. But there are some interesting unknowns at this time, such as, reimbursement rates and amount of prescribing to be done by psychologist. Psychologist will do an admirable job if they can convince insurance companies to reimburse them at the same level of psychiatrist considering the ease that prescribing authority can be obtained specially in LA. I don't think PA/NP/Pharmacist have been able to do this. The other aspect is whether prescribing psychologist will totally go to the medical model in order to enhance their earnings. Medicare and Medicaid is another story all together. I think one thing that will be closely monitored is the "Quality of care", is it at par with the pyschiatrist? As mentioned by someone in this forum earlier, their may be a huge supply of prescribing psychologist that may lead to increased competition and decreased reimbursement rates similar to what is happening in traditional psychology services. Although, Public Health's passion for prescribing is well taken but more data needs to be available to the draw the conclusion that psychologist and psychiatrist will make similar earnings in states allowing prescribing. Until then, it is any one's guess!

 

[Poety]

Medical school is also a hell of a lot more expensive than clinical psychology PhD programs! Private medical school is easily $150K-200K in loans. The majority of PhD programs in clinical psychology are free and you get a stipend to cover living costs. Internship in clinical psychology also pays enough to survive, as do post-docs. Most psychologists with specialty training (e.g., neuropsychology) will start at $70-100K. VA system = $80-100K. Not bad considering minimal to no debt for doctoral training. Academic jobs for psychiatrists start in the $70-100K range as well. Some psychologists also supplement their income by conducting fee-for-service forensic evaluations, so they can make a "psychiatrist salary" if they're savvy enough and develop a reputation in the field. Prescriptive authority will also boost salaries for psychologists who pursue psychopharmacology training and who practice in states that permit psychologists to prescribe.

Hi PH, actually, I just wanted to clarify on the academic position - a starting psychiatrist in academia will not make 70K, that would be a residents salary with moonlighting - my friend just got on faculty and hes making 125K plus benefits package to start - just wanted to point that out Most academic positions start at a bit over 100K, even for new psychs.

woops, and one other thing, average debt for psychiatrist is 175K, mine is 250K at a state school (transferred from outta state) but thats because I took out max loans each year, since I just CANNNOT live like a starving student after making 70K as a nurse pfftt

 

[edieb]

Presently there is only one prescribing psychologist in NM; thus, I do not think that there will be a glut of medical psychologists in the near future

One of the major drivers for prescribing medication is higher reimbursement rates for a shorter cycle time (15-20 mins med checks). Hence, logically it makes sense that prescribing psychologist will enhance their earnings. But there are some interesting unknowns at this time, such as, reimbursement rates and amount of prescribing to be done by psychologist. Psychologist will do an admirable job if they can convince insurance companies to reimburse them at the same level of psychiatrist considering the ease that prescribing authority can be obtained specially in LA. I don't think PA/NP/Pharmacist have been able to do this. The other aspect is whether prescribing psychologist will totally go to the medical model in order to enhance their earnings. Medicare and Medicaid is another story all together. I think one thing that will be closely monitored is the "Quality of care", is it at par with the pyschiatrist? As mentioned by someone in this forum earlier, their may be a huge supply of prescribing psychologist that may lead to increased competition and decreased reimbursement rates similar to what is happening in traditional psychology services. Although, Public Health's passion for prescribing is well taken but more data needs to be available to the draw the conclusion that psychologist and psychiatrist will make similar earnings in states allowing prescribing. Until then, it is any one's guess!

 

[edieb]

http://www.nmpa.com/displaycommon.cfm?an=1&subarticlenbr=13

 

[PsychEval]

The data on average income for prescribing psychologists will be somewhat skewed, considering many of the psychologists who have the money/time/and flexibility to pursue the training will likely be in private practice and financially successful before the training. Generally, private practice psychologists tend to make more than most other psychologists anyway. Consequently, to better understand the financial impact of prescriptive authority, one would need to compare the income of a psychologist before he/she obtained prescriptive authority, to their income after they have prescriptive authority. Other factors to consider would be inflation, changes in total billable hours, malpractice insurance increases (no changes at this time, but perhaps a small jump in the future according to APA's insurance carrier) etc. A psychologist who is excellent at therapy, testing, and psychopharm and has strong referral base will easily make $140,000 in private practice, without the $150,000 to $250,000 debt of medical school.

 

[50960]

There are much more than 1 prescribing psychologists in NM. There were about 10 people who were ready on the day the law was put into effect, but you are correct the number is low everywhere.

 

[PublicHealth]

There are much more than 1 prescribing psychologists in NM. There were about 10 people who were ready on the day the law was put into effect, but you are correct the number is low everywhere.

Any idea what the CA Psychological Association is doing to pursue RxP this year? I heard that they're one of the "sleeper" states.