Salary inequity/variability within the market

[erg923]

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We have talked ad naseum on here about how mediocre salaries are given the level (and amount) of training we are forced to go through, as well and the relative expertise we can bring to the table. How cost efficient/beneficial that is the larger healthcare system is up for debate, I know, but whatev. What I haven't heard so much outcry about is the HUGE variability in salaries within the same area (city). Maybe its worse in my area, but its seems really ridiculous. Let me explain:

I recently accepted a new full time position outside of small time academia. I will start in August. Its both clinical and administrative, although, fairly non traditional clinical work. I could no longer justify my poor academic salary when there is so much more potential out there, especially when I have a growing family and have found students to be equally as much a pain the ass as they are enjoyable. I dabbled in some paid clinical stuff this year (UR and doing some presurg evals in a local pp), as my states provisional license allows me to do clinical work so long as someone signs off on it, but I really didn't like sacrificing my evenings and having to take my laptop into the bedroom every night. Thus, I took this position. No, its not my dream job and I wont be retiring from it, but here comes the kicker, ready. I will be starting and making more than the fully tenured faculty at my current college. Being that its a private college, I looked up online and I will still be making significantly more than associate ranked professors at my city's large state school. I interviewed for a largely clinical administrative job in a state prison that pay HALF of what I will be make. I interviewed for another job that will be about 6k less than the job I accepted. I investigated another place where I would start about 20k less than my current job and never would be given a raise.

THE POINT OF ALL THIS IS THAT THE SALARIES WERE ALL OVER THE PLACE[/I] FOR JOBS THAT ALL REQUIRE THE SAME DEGREE, SAME SKILL LEVEL, SAME LEVEL OF EXPERIENCE, SIMILAR RESPONSIBILITIES AND SIMILAR HOURS (37.5-40 hours/week).

I just couldn't reconcile the huge variability out there for essentially equivalent positions. Anybody hear me here, or am I just being weird.

 

[MBellows]

I will be starting and making more than the fully tenured faculty at my current college. Being that its a private college, I looked up online and I will still be making significantly more than associate ranked professors at my city's large state school.

Did those salaries include grant-linked funding?

 

[erg923]

Did those salaries include grant-linked funding?

I dont know, probably not. Although my current college does not have any substantial grant funding in our department, so i know those salaries are accurate.

 

[PHD12]

THE POINT OF ALL THIS IS THAT THE SALARIES WERE ALL OVER THE PLACE[/I] FOR JOBS THAT ALL REQUIRE THE SAME DEGREE, SAME SKILL LEVEL, SAME LEVEL OF EXPERIENCE, SIMILAR RESPONSIBILITIES AND SIMILAR HOURS (37.5-40 hours/week).

I just couldn't reconcile the huge variability out there for essentially equivalent positions. Anybody hear me here, or am I just being weird.

I am not surprised that salaries are extremely variable in our field. Nice job landing a nice salary so soon after graduating! That's why it's important to interview in multiple places and negotiate. I think the only clinical positions that pay decently are the ones with administrative duties (aside from VA and some medical schools). I would imagine that your salary is higher because it is not a strictly clinical position and has admin duties. I don't think most psychologists are willing (or maybe able) to take on administrative roles.

Although I will say that the advantage of a professor position is that you can have multiple sources of income. Everyone I know who is a faculty (med school and psychology departments) has at least a PT private practice, some consulting work, and lead workshops/trainings. You cannot leverage your "professor title" in a 100% clinical role. The money does come later after you are tenured through connections with private ventures.

Did you negotiate salary? How much were they willing to increase it via negotiation?

 

[erg923]

I am not surprised that salaries are extremely variable in our field. Nice job landing a nice salary so soon after graduating! That's why it's important to interview in multiple places and negotiate. I think the only clinical positions that pay decently are the ones with administrative duties (aside from VA and some medical schools). I would imagine that your salary is higher because it is not a strictly clinical position and has admin duties. I don't think most psychologists are willing (or maybe able) to take on administrative roles.

Did you negotiate salary? How much were they willing to increase it via negotiation?

I am not really sure that that is the reason, as others psychologist work for this company that have almost strictly clinical duties and are paid handsomely as well. I negotiated for a slightly higher than the initial offering and got it no problem.

But again, I wasnt trying to make the focus on the fact that I am making more than most early career folks in this area. I really just wanted to get a feel for how people feel about the variability out there? I mean, I had no idea I would be interviewing for jobs where one pays 45K, another 60, another 80k, and another 100k...with no significant difference between duties and hours worked. And all in the same city! Literally, a position working with a more dangerous population doing essentially the same kind of thing i will be doing now (and required a doctorate) paid half of what I was offered by this company.

How exactly does this happen? What factors influence it? What maintain the disparities amongst different settings and companies?

 

[PHD12]

I am not really sure that that is the reason, as others psychologist work for this company that have almost strictly clinical duties and are paid handsomely as well. I negotiated for a slightly higher than the initial offering and got it no problem.

But again, I wasnt trying to make the focus on the fact that I am making more than most early career folks in this area. I really just wanted to get a feel for how people feel about the variability out there? I mean, I had no idea I would be interviewing for jobs where one pays 45K, another 60, another 80k, and another 100k...with no significant difference between duties and hours worked. And all in the same city! Literally, a position working with a more dangerous population doing essentially the same kind of thing i will be doing now (and required a doctorate) paid half of what I was offered by this company.

How exactly does this happen? What factors influence it? What maintain the disparities amongst different settings and companies?

Good questions. I know kaiser pays "generously" as well. A few kaiser psychologists informed me that this is because they have strong unions and value psychologists. They also have a high face to face quota for psychologists even though the hours are not lengthy per se. They are compensated for working in a very high stress, fast-paced setting and being able to juggle an enormous case load (200+) even though the hours may not be so different than other settings. I don't know if your new job is similar.

Was there variability among the qualifications of the psychologists in the 45K position compared to the ones in a 100K position when you interviewed at different places?

 

[irish80122]

One factor worth considering is whether a position is 9 or 12 months. Many academic positions are 9 month positions, so you are only being paid for 3/4 of the year. However, you can make significantly more if you teach over the summers or you receive a grant that will pay you summer salary. For instance, without getting into my salary, I am an young assistant professor. I just recently wrote a grant that, if I receive it, would fund my almost my entire summer, which would amount to a 20k+ pay raise. I would still make significantly more doing clinical work, but it at least gets me closer to the ballpark.

 

[Pragma]

Congrats, erg! Sounds like you found something you are happy about and will be well compensated for! You deserve it.

The variability probably is even worse in other places. It definitely will vary by locale to some extent. But salaries will probably be higher in industry, less popular cities, etc. In academia, the range is huge. Some new faculty will start at or close to 100K and some will start at 40-45K depending on where you live and the nature of the job. Other factors (e.g., 9 month contract vs. 12 month, summer salary (grant funding) on top of 9 month salary, etc) influence those numbers. I have a friend that started at 90K at an AMC last year in a big city, and another that started at 65K.

The field is extremely variable. Recognizing that and seizing a better opportunity is very smart. But every position does have its drawbacks. Going outside of academia generally means less job security and a less flexibile schedule - but not all the time.

 

[Sanman]

I think it depends on a few things. The first is payor mix, largely uninsured or Medicaid people or those that cannot be billed for traditionally (college students) wil pay the least. Private pay will be the most and insurance can be good or bad. The second thing is cost of overhead. Being able to split overhead makes groups more profitable generally. The third thing is saturation. Lack of saturation gives you more power to negotiate. I have been looking around a bit and have yet to receive an offer under 70k. Friends in other specialties and other areas have salaries starting at 45k (cmhc) and up.

 

[Therapist4Chnge]

I have a friend that started at 90K at an AMC last year in a big city, and another that started at 65K.

The field is extremely variable. Recognizing that and seizing a better opportunity is very smart.

The vast majority of it is billing (actual collected v. overhead/set cost). The vast majority of salaries are set by administrators who don't know what we do, but they know exactly what we cost. Our positions are often subsidized bc of some of our non-billable duties, though this is harder and harder to justify if we can't cover our base costs to our hospitals/universities/etc.

I spent two years golfing with a bunch of hospital administrators and 95% of what they talked about involved productivity and RVUs. You can only really negotiate if you know your cost, billings, collections, non-billable contributions, etc. your boss may be a psychologist, but somewhere up the food chain is an accountant...and s/he will impact your salary more than any kind of "extra" thing you do.

 

[edieb]

The vast majority of it is billing (actual collected v. overhead/set cost). The vast majority of salaries are set by administrators who don't know what we do, but they know exactly what we cost. Our positions are often subsidized bc of some of our non-billable duties, though this is harder and harder to justify if we can't cover our base costs to our hospitals/universities/etc.

I spent two years golfing with a bunch of hospital administrators and 95% of what they talked about involved productivity and RVUs. You can only really negotiate if you know your cost, billings, collections, non-billable contributions, etc. your boss may be a psychologist, but somewhere up the food chain is an accountant...and s/he will impact your salary more than any kind of "extra" thing you do.

Billing is the key. One hospital in New Mexico offered me $65K licensed when I was a standard PhD Clinical Psychologist. When I attained prescriptive authority, the same hospital offered me $170K for the same 40 hour workweek. The difference: RVUs. The DoD, although less tied to RVUs, is the same thing. As a federal governtment GS 13 psychologist, I was earning $40 an hour (approx) and I was recently offered a DoD position for over $100 an hour. THe difference again in RVUs (and supply : Demand). This is why we need to get listed as physicians under Medicare

 

[Therapist4Chnge]

I get monthly reports from our billing company that breaks down billed, paid, pending, sent to collections, written off, dx's paid, % collected from each payor, etc. i will need at least 12mon of billing to have a decent idea of the $'s, but I know I'm in the minority for actually looking at this data.

I currently work ~32hr/wk and make more than most mid-career psychologists bc my actual "hourly rate" is much better bc I minimize low/non-payors. Pre-cert all neuropsych referrals and cherry pick the worker's comp, private pay, and surprisingly....Medicare. I have plenty of room to build my NP private practice, but prefer having flexibility in my schedule.

 

[DynamicDidactic]

its not just psychology. lawyers have a very bimodal distribution.
http://www.nalp.org/salarycurve_classof2011

 

[PsySeeker]

Erg, looks like your about to become the statistical outlier you chided me about becoming in another thread... 😉

All kidding aside, a big congrats! I wish you the best, keep on representing psychologists well.

 

[Pragma]

The vast majority of it is billing (actual collected v. overhead/set cost). The vast majority of salaries are set by administrators who don't know what we do, but they know exactly what we cost. Our positions are often subsidized bc of some of our non-billable duties, though this is harder and harder to justify if we can't cover our base costs to our hospitals/universities/etc.

I spent two years golfing with a bunch of hospital administrators and 95% of what they talked about involved productivity and RVUs. You can only really negotiate if you know your cost, billings, collections, non-billable contributions, etc. your boss may be a psychologist, but somewhere up the food chain is an accountant...and s/he will impact your salary more than any kind of "extra" thing you do.

This seems to be the most important area for advocacy for clinicians.

I'm fairly certain that the RVU talk is going to dominate that conversation further and further. If you cost more than you make, then you aren't an asset. Declining reimbursement is not helpful there.

 

[Pragma]

I get monthly reports from our billing company that breaks down billed, paid, pending, sent to collections, written off, dx's paid, % collected from each payor, etc. i will need at least 12mon of billing to have a decent idea of the $'s, but I know I'm in the minority for actually looking at this data.

I currently work ~32hr/wk and make more than most mid-career psychologists bc my actual "hourly rate" is much better bc I minimize low/non-payors. Pre-cert all neuropsych referrals and cherry pick the worker's comp, private pay, and surprisingly....Medicare. I have plenty of room to build my NP private practice, but prefer having flexibility in my schedule.

The word "minimize" is a dirty word in some circles. It means good business sense but it also means minimizing access. I noticed the "charity" or "pro bono" cases getting thrown around my institution like a hot potato when I was a postdoc. Salaries were tied to billing, and as such, people avoided treating those who had lower paying third-party insurance/Medicare (or no insurance) clients/patients, and a charity/financial need case reduced their numbers and therefore impacted their salaries.

I think it places providers in a tough spot here, because usually there is an institutional mission/professional ethics reason to see all cases, but that goes against you financially. So if an institution is going to tell providers that they need to account for as much billing as possible, but also expects them to see cases where there is less optimal coverage (or no coverage), then you'll see this dynamic. Within hospitals, you may even see individual departments make policies (e.g., we don't accept ____ funding cases), which makes it easier on providers. But otherwise, providers may create their own individual ways of avoiding cases that pay less (e.g., scheduling them further out and giving them referrals), which may or may not be very fair/objective if you want to treat patients the same way.

 

[vistaril]

Billing is the key. One hospital in New Mexico offered me $65K licensed when I was a standard PhD Clinical Psychologist. When I attained prescriptive authority, the same hospital offered me $170K for the same 40 hour workweek.

nice!

 

[xyzpsych]

Billing is the key. One hospital in New Mexico offered me $65K licensed when I was a standard PhD Clinical Psychologist. When I attained prescriptive authority, the same hospital offered me $170K for the same 40 hour workweek. The difference: RVUs. The DoD, although less tied to RVUs, is the same thing. As a federal governtment GS 13 psychologist, I was earning $40 an hour (approx) and I was recently offered a DoD position for over $100 an hour. THe difference again in RVUs (and supply : Demand). This is why we need to get listed as physicians under Medicare

What did you do to be able to prescribe? What kind of psychology was your background in if you don't mind me asking?

 

[edieb]

Ph.D. from Louisiana State University, a very, very research-based clinical psychology program and then a post-dcotral master's in clinical psychopharmacology from New Mexico State University for psychologists wanting to prescribe, order labs, etc in New Mexico and Louisiana, the DoD and the IHS

 

[cara susanna]

For people talking about low academic salaries, can I ask what the range was? I mean, we are talking as low as 20k to 40k here?

 

[DynamicDidactic]

my school, large Midwest state school, the starting salary is about 65k for tenured position.

very low cost of living around here though.

 

[erg923]

For people talking about low academic salaries, can I ask what the range was? I mean, we are talking as low as 20k to 40k here?

small private college, mind you.

And not that bad, but I think the kicker was 1.) the ceiling. 2). one could make almost double my salary (starting) in multiple others jobs and still have plenty of time for PP on the side (if so desired) and have more room for growth and salary negotiation.

 

[PsyDr]

why in the hell would anyone take 20k or 40k as a salary?

It's hard to advocate for the profession when people willing take wages that are less than that of a college graduate. It's no wonder we have no respect. We don't respect ourselves.

 

[erg923]

why in the hell would anyone take 20k or 40k as a salary?

It's hard to advocate for the profession when people willing take wages that are less than that of a college graduate. It's no wonder we have no respect. We don't respect ourselves.

I have no idea, and that's not what my university salary starts. That said, functionally, its not that far from the 40k mark, AND, as I said before, state prison jobs here will start someone who is up to 3 years post degree/license at 45k. Obviously, that's insulting...but plenty of people take these jobs (which max out in the high 60s).


This is the eastern midwest and salary suppression is bad for all kinds of jobs in my particular city (which makes little sense since its such a great town otherwise). 100k is probably close to a kings ransom here.

 

[Pragma]

For people talking about low academic salaries, can I ask what the range was? I mean, we are talking as low as 20k to 40k here?

If we are talking non-clinical positions (more traditional 9-month contract University jobs), then the range I saw was from about 45K (SLAC) to in the 80s (R1) in a larger market.

I took one making in the mid 60's on a 9 month contract, but one that also allowed me to do a PP on the side and earn more money via summer teaching or summer grant salaries.

There isn't really a ceiling necessarily, but your raises are based on your initial salary. At least at my institution, there are opportunities for merit increases both pre and post tenure (based on scholarly productivity).

 

[Doctor Eliza]

why in the hell would anyone take 20k or 40k as a salary?

It's hard to advocate for the profession when people willing take wages that are less than that of a college graduate. It's no wonder we have no respect. We don't respect ourselves.

40k is a hell of a lot more than 0k. I don't think it is about self-respect, it is about practicality. Sometimes you need to pay the rent and put food on the table even if the salary is insulting. Having principles and living in a homeless shelter because you think you are too good for a low paying job isn't going to get anyone anywhere either.

Dr. E

 

[PsyDr]

Market forces are still at work.

For employers, the desired outcome is highest possible revenue production.

There are two ways to increase revenue: increased production/sales or decreased overhead.

In a service based industry in which the hourly rate is essentially set, the easiest way to increase revenue is to decrease labor costs.

The easiest way to find the cheapest labor is to low ball offers, until the labor force will no longer accept those conditions.

And then offer lower salaries.

But if people keep taking the positions that pay nothing because they are afraid, then employers will keep lowering salaries for everyone.

Those that actually stand up and say that they are worth more, and demonstrate it by using the most fundamental of maths to demonstrate their worth are the ones who are saving our profession.

 

[erg923]

Market forces are still at work.

For employers, the desired outcome is highest possible revenue production.

There are two ways to increase revenue: increased production/sales or decreased overhead.

In a service based industry in which the hourly rate is essentially set, the easiest way to increase revenue is to decrease labor costs.

The easiest way to find the cheapest labor is to low ball offers, until the labor force will no longer accept those conditions.

And then offer lower salaries.

But if people keep taking the positions that pay nothing because they are afraid, then employers will keep lowering salaries for everyone.

Those that actually stand up and say that they are worth more, and demonstrate it by using the most fundamental of maths to demonstrate their worth are the ones who are saving our profession.

Dr. Eliza has been candid numerous time about feeling stuck in her current PP. I empathize with that and the earning that comes along with it. You cant just sa no to everything when you need to pay the rent..much less save for home, children, etc. I cant blame her, but yet cant help but think there are better things out there that she is not finding/aware of. I think a dangerous part of allowing oneself to "stay stuck" is that skill atrophy can set in (I'm just recently been discovering all things that I have to offer besides traditional therapy and testing) and people can get pigeon holed (by employers) and then passed over (due to the competition for positions) because they have been doing that one thing for so long.

One of the comments on get on my CV is the diversity of professional experiences I have had.... even being just one year out of internship. I have taught undergrad and grad classes, held an academic appointment, published my dissertation, been active in the state psych association, supervised graduate student clinical work (individual at the university CC and lead group supervision as an clinical adjunct at the school), served as a supervisor and training consultant on a interdisciplinary training program at the city's med school, done therapy in my university's cc and done some assessment work in a local PP. A large part of why I was favored for my upcoming position was a very non-traditional prac experience I had in grad school (similar to where Ill be now) and the various experiences I have obtained in teaching, supervision, and clinical work. They are wanting to get back into research (although that's not really part of the job description), so my academic ties and very mild, although very existent record of scholarly output put me above the rest as wel (so I've heard).

 

[Doctor Eliza]

Recently, I've been actively talking to a colleague about starting our own PP's in a shared office space and some creative strategies for getting our names out there, etc. (I'm creative if lacking business sense.) You really can't get ahead in the PP world (especially around here) working for someone else.

The scariest part is the money required to start up such a venture and the time it will take to start generating a reasonable income. I cannot go without some amount of income. Really, I think if I could do it all over (and I stayed a psychologist) I would find a marketable specialty which would be attractive to employers like the VA and medical centers. PP is not a dream career.

Congrats on your new gig!

Dr. E

Dr. Eliza has been candid numerous time about feeling stuck in her current PP. I empathize with that and the earning that comes along with it. You cant just sa no to everything when you need to pay the rent..much less save for home, children, etc. I cant blame her, but yet cant help but think there are better things out there that she is not finding/aware of. I think a dangerous part of allowing oneself to "stay stuck" is that skill atrophy can set in (I'm just recently been discovering all things that I have to offer besides traditional therapy and testing) and people can get pigeon holed (by employers) and then passed over (due to the competition for positions) because they have been doing that one thing for so long.

One of the comments on get on my CV is the diversity of professional experiences I have had.... even being just one year out of internship. I have taught undergrad and grad classes, held an academic appointment, published my dissertation, been active in the state psych association, supervised graduate student clinical work (individual at the university CC and lead group supervision as an clinical adjunct at the school), served as a supervisor and training consultant on a interdisciplinary training program at the city's med school, done therapy in my university's cc and done some assessment work in a local PP. A large part of why I was favored for my upcoming position was a very non-traditional prac experience I had in grad school (similar to where Ill be now) and the various experiences I have obtained in teaching, supervision, and clinical work. They are wanting to get back into research (although that's not really part of the job description), so my academic ties and very mild, although very existent record of scholarly output put me above the rest as wel (so I've heard).

 

[erg923]

Recently, I've been actively talking to a colleague about starting our own PP's in a shared office space and some creative strategies for getting our names out there, etc. (I'm creative if lacking business sense.) You really can't get ahead in the PP world (especially around here) working for someone else.

The scariest part is the money required to start up such a venture and the time it will take to start generating a reasonable income. I cannot go without some amount of income. Really, I think if I could do it all over (and I stayed a psychologist) I would find a marketable specialty which would be attractive to employers like the VA and medical centers. PP is not a dream career.

Congrats on your new gig!

Dr. E

I think that's kind of my point. You seem to think you are not marketable? Why? You have a Ph;D. (more versatile than a Psy.D...sorry but its true) from a top school. And presumably, competency and experience with other aspects of clinical psychology other than pure traditional psychotherapy. Why do you think your training and experiences are not appealing or valuable to employers? Its only if you keep yourself stuck in the PP market too much longer that I can see this happening. I would urge you to diversify your CV if you want to want to be more appealing...and make some side money. Get involved in the state psych association, teach, adjunct faculty and serve on diss committees or supervise students, do UR or serve as psychologist reviewer, consult with nursing homes, etc.

 

[PsyDr]

E,

I would think that the people who have stated that they make between 170k and 300k would very much disagree with your statement. They at least had the courtesy of stating their opinions were their opinions and not general facts.

I very much have a problem with this treatment seeking treatment rejecting type behavior. it's very much like the group member who refuses to try anything new, only validates his/her own opinions while invalidating others, and tries to drag everyone else down with him/her.

There are people who are doing very well for themselves, myself included. There are other people who do less well for their own reasons.

I have no problem with you having your own perspective. I do have a problem with your general statements about how awful pp is in every thread about pp, without acknowledging that your is only one opinion of many.

 

[Doctor Eliza]

I'm glad you have been so fortunate in your career. I acknowledge that this is my opinion and you have yours. However, it isn't like I am in a cave and never talk to others in PP. I'm not the only person who feels this way. I think you are very much in the minority.

Let's agree to disagree.

Dr. E

E,

I would think that the people who have stated that they make between 170k and 300k would very much disagree with your statement. They at least had the courtesy of stating their opinions were their opinions and not general facts.

I very much have a problem with this treatment seeking treatment rejecting type behavior. it's very much like the group member who refuses to try anything new, only validates his/her own opinions while invalidating others, and tries to drag everyone else down with him/her.

There are people who are doing very well for themselves, myself included. There are other people who do less well for their own reasons.

I have no problem with you having your own perspective. I do have a problem with your general statements about how awful pp is in every thread about pp, without acknowledging that your is only one opinion of many.

 

[Sanman]

I'm glad you have been so fortunate in your career. I acknowledge that this is my opinion and you have yours. However, it isn't like I am in a cave and never talk to others in PP. I'm not the only person who feels this way. I think you are very much in the minority.

Let's agree to disagree.

Dr. E

I think the bigger issue here is that PP is a business. I think we can all agree that you will not become wealthy working for someone else. That said, you can make a lot more than Dr.E is making. Hell, I am making the same as her unlicensed with a considerable bump to a salaried position upon licensure and have taken interviews offering me even more than my current position. There will always be upsides and downsides to any business. While Dr. E is unhappy, I am sure her boss will say that PP is the golden path. I do believe there is more than one way to build a private practice rather than being a fee-for-service employee or just jumping out on your own. I have managed to find decent opportunities with established practices or new practices with experienced clinicians/managers that need my particular specialty skill set. It really depends on how you plan things. ERG built up more non-traditional skills, I have chosen to keep myself in clinical specialty areas with growing needs and develop a skill set that allows me to move beyond just clinical work into more management oriented positions. Actually, I completely agree about skill set atrophy and brought up that point at my most recent interview to highlight my interest in more than just traditional clinical duties. EdieB managed to make psychopharm work for her. The bottom line ends up being that just sitting in an office and doing (even really good) therapy is not enough to make one successful in this career.

 

[Doctor Eliza]

I apologize if I contributed to derailing this thread. Erg wanted to talk about market variability, so we should get back to that...

 

[Therapist4Chnge]

I think the three largest contributors (in my opinion) are geography, supply/demand, and speciality. It is no secret that large cities tend to have some of the highest paying jobs, though they also have a much higher concentration of providers AND they typically more senior-level providers. Early career psychologists are at a disadvantage and often only have "being cheaper" as a selling point. If you do not have a good way to differentiate yourself from the 50-100+ other people who applied, even if you get the job...you probably won't get the salary or the work/life balance you want.

People will be best served to not expect to live in a big city, make a high salary, AND have a good work-life balance if they are still an early career psychologist. There are too many clinicians in most markets to make that a viable option for all but the outliers. You can still be a Big Fish in a Big Pool...but it isn't easy without putting in some significant time, effort, and networking.

As for $40k faculty gigs....take at your own risk. Employers will pay what someone is willing to take, and they have little incentive to raise a salary unless they cannot fill the position. I looked at a job in a smaller city where I would have been one of TWO neuropsychologists in the community (who weren't military/VA/retired/academics) in a 300mi+ radius. Those jobs exist and they can pay VERY WELL....if you are willing to live in a smaller community and cherry pick your caseload.

 

[MBellows]

Early career psychologists are at a disadvantage and often only have "being cheaper" as a selling point.

I wouldn't necessarily knock "being cheaper" as a valid selling point. For some service areas that can certainly be advantageous (e.g. working with homeless population). Besides, depending on the level of specialization and area, there isn't too much difference in performance based on practice experience. They can also market as being the most up to date, whereas experienced providers may be stuck in 1975.

 

[Therapist4Chnge]

I wouldn't necessarily knock "being cheaper" as a valid selling point. For some service areas that can certainly be advantageous (e.g. working with homeless population). Besides, depending on the level of specialization and area, there isn't too much difference in performance based on practice experience. They can also market as being the most up to date, whereas experienced providers may be stuck in 1975.

I'm not saying "cheaper" is a good thing, but many early career people are not expecting to make a certain dollar amount because of more experience. Reimbursement via insurance is based on licensure level and not experience, so it actually behooves a employer to go cheaper w. labor cost and take the margin profit as a buffer against declining reimbursements. Sadly, I didn't even consider "performance"/quality in the equation, as there is an assumed level of competence. Making a case for being EBT-based or similar is a good one. My proposal to possible employers was primarily based on billing $'s and some additional skillsets that are valued outside of a clinical position. Now I need to think of reasons why I shouldn't move to LA or NM once I get licensed as a prescribing provider like edieb.

 

[Therapist4Chnge]

I made more than what she reports as a postdoc. I like her idea of starting a new practice with some like-minded practitioners. I'm tempted to do the prescriber training as a stopgap. What's the cheapest way to do that?

I think The Winter has finally come and hell has frozen over.

I know a couple of the profs in the New Mexico State program (who formerly taught in the NSU program) and was impressed by their knowledge and teaching of the material. Supposedly Fairleigh Dickinson has a decent program too, but I'm hesitant to recommend any program that isn't fully residentially-based.

 

[erg923]

I made more than what she reports as a postdoc. I like her idea of starting a new practice with some like-minded practitioners. I'm tempted to do the prescriber training as a stopgap. What's the cheapest way to do that?

Getting way off topic here, but could someone explain the concrete benefits to doing this if you live in a state (and don't plan on moving) that doesn't have Rx for psychs? I have a student now is asking about this.

Someone once mentioned that you could get consulting contracts/gigs with local med practices, but I not sure I understand how that would work? If you just have the post-doc masters in phram, you are not fully trained/prepared to Rx...and my cousin, who is an fam med doc has NO problem handing out SSRIs, benzos, and anxiolytics. Why would he pay me handsomely to give him my two cents?!

 

[Therapist4Chnge]

Getting way off topic here, but could someone explain the concrete benefits to doing this if you live in a state (and don't plan on moving) that doesn't have Rx for psychs? I have a student now is asking about this.

Someone once mentioned that you could get consulting contracts/gigs with local med practices, but I not sure I understand how that would work? If you just have the post-doc masters in phram, you are not fully trained/prepared to Rx...and my cousin, who is an fam med doc has NO problem handing out SSRIs, benzos, and anxiolytics. Why would he pay me handsomely to give him my two cents?!

I think the value is pretty limited if you don't plan on using the training in a direct way (e.g. prescribing, doing research involving pharma stuff, teach pharmacology, etc). I did the training because it was local, I thought it'd be useful in my day-to-day clinical practice, and it'd help if/when I got more involved with medication trials/treatment research. I'm actually getting more involved on the research end now, and I do find the knowledge very useful, but in retrospect the training was a PITA to complete and it has not translated in direct $'s of earnings.

I'm conflicted in regard to recommending the training because I don't really support online training (I completed a residential only training program that has since ended) and being RxP trained has limited use when compared to NP training. If someone wants to prescribe....an NP program is the far more flexible option because of the ability to independently prescribe in most states. I wasn't particularly impressed by the NP curriculums I saw, but the pathway is much easier and more lucrative. Like JS, I view prescribing as a distant 2nd or 3rd option because I would much rather practice as a neuropsychologist, but it's not a bad thing to have available if reimbursements continue to decline.

*edit to add*

As for the GP/FP/PCP consulting stuff....i have only seen this with actual prescribing psychologists, and they worked in conjunction with a GP/FP/PCP office. Currently I am not a prescriber, nor do I offer any consultative services in this area, though I have been able to develop a good reputation in my medical system that has resulted in some more referrals. I don't think that is a good enough reason for someone to do the training, as I could cultivate a similar reputation through other avenues and save the $15k in tuition.

 

[vistaril]

I think the value is pretty limited if you don't plan on using the training in a direct way (e.g. prescribing, doing research involving pharma stuff, teach pharmacology, etc). I did the training because it was local, I thought it'd be useful in my day-to-day clinical practice, and it'd help if/when I got more involved with medication trials/treatment research. I'm actually getting more involved on the research end now, and I do find the knowledge very useful, but in retrospect the training was a PITA to complete and it has not translated in direct $'s of earnings.

I'm conflicted in regard to recommending the training because I don't really support online training (I completed a residential only training program that has since ended) and being RxP trained has limited use when compared to NP training. If someone wants to prescribe....an NP program is the far more flexible option because of the ability to independently prescribe in most states. I wasn't particularly impressed by the NP curriculums I saw, but the pathway is much easier and more lucrative. Like JS, I view prescribing as a distant 2nd or 3rd option because I would much rather practice as a neuropsychologist, but it's not a bad thing to have available if reimbursements continue to decline.

*edit to add*

As for the GP/FP/PCP consulting stuff....i have only seen this with actual prescribing psychologists, and they worked in conjunction with a GP/FP/PCP office. Currently I am not a prescriber, nor do I offer any consultative services in this area, though I have been able to develop a good reputation in my medical system that has resulted in some more referrals. I don't think that is a good enough reason for someone to do the training, as I could cultivate a similar reputation through other avenues and save the $15k in tuition.

how feasible is becoming an NP for most psychologists though? I mean you guys don't have any nursing training? Even in the accelerated rn programs(before the np), you'd probably still need some prerequs to even get into nursing school(which would have to be a bsn)....and then spend all that time rotating on med-surg floors as an rn student...blech.....I can't imagine that is a good route for someone who is already a psychologist.

 

[vistaril]

40k is a hell of a lot more than 0k. I don't think it is about self-respect, it is about practicality. Sometimes you need to pay the rent and put food on the table even if the salary is insulting. Having principles and living in a homeless shelter because you think you are too good for a low paying job isn't going to get anyone anywhere either.

Dr. E

40k? sheeeesh.....I'll tell you what dr E....I'd hire you for 50k as a contract employee, schedule you 8 1 hr patients per day back to back I would get from my med mgt clinic, have you bill blue cross, and you'd make me a decent bit of money.....

 

[undecidedman]

It wouldn't take very long. Someone posted an 18 month route a while back and it's not like it would be much of a challenge. Wouldn't want to take that route though, I agree.

what about for someone who isn't a psychologist yet but considering it. What would be the best route for them to take if they wanted prescriptive authority and clinical psychologist.

 

[mcvcm92]

what about for someone who isn't a psychologist yet but considering it. What would be the best route for them to take if they wanted prescriptive authority and clinical psychologist.

By what I've read, it seems like the smartest financial choice to make if you want to prescribe is to become a psychiatrist. But if you don't have the pre-medical requirements or don't want to go to medical school (or can't get in), probably doing a LCSW program and then a NP program is best. Doing your doctorate in clinical psych and then doing a NP program would take quite longer than the LCSW & NP combination.

 

[erg923]

what about for someone who isn't a psychologist yet but considering it. What would be the best route for them to take if they wanted prescriptive authority and clinical psychologist.

Psychiatrists can do therapy if they are in PP. They just choose not to...

Contrary to what people believe, you are trained in therapy during residency...although quality is variable and its easy to half ass it and still get out, from what I'm told.

 

[edieb]

what about for someone who isn't a psychologist yet but considering it. What would be the best route for them to take if they wanted prescriptive authority and clinical psychologist.

If you are committed to living in a state with prescriptive authority for applied psychologists, then earning your post-doctoral master's degree in psychopharmacology is more lucrative than earning an NP degree and prescribing. Otherwise, just go get your NP degree

 

[AnnoyedByFreud]

By what I've read, it seems like the smartest financial choice to make if you want to prescribe is to become a psychiatrist. But if you don't have the pre-medical requirements or don't want to go to medical school (or can't get in), probably doing a LCSW program and then a NP program is best. Doing your doctorate in clinical psych and then doing a NP program would take quite longer than the LCSW & NP combination.

The LCSW + NP idea doesn't make sense to me. Just do the NP. Psych NPs are licensed to do therapy and if you want to get better at it, you can do more therapy trainings after you graduate. That is far cheaper than adding in a whole other degree (LCSW). Also, some psych NP programs include more therapy training than others (like Penn), so shop around.

 

[mcvcm92]

The LCSW + NP idea doesn't make sense to me. Just do the NP. Psych NPs are licensed to do therapy and if you want to get better at it, you can do more therapy trainings after you graduate. That is far cheaper than adding in a whole other degree (LCSW). Also, some psych NP programs include more therapy training than others (like Penn), so shop around.

Whoops, my mistake... I didn't know that psych NP programs allow its graduates to be able to conduct therapy (I thought it was more so prescribing medication).

 

[Hoop Jumper]

The LCSW + NP idea doesn't make sense to me. Just do the NP. Psych NPs are licensed to do therapy and if you want to get better at it, you can do more therapy trainings after you graduate. That is far cheaper than adding in a whole other degree (LCSW). Also, some psych NP programs include more therapy training than others (like Penn), so shop around.

Wait, NPs are licensed to do therapy???

 

[AnnoyedByFreud]

Psych NPs are, yes. Not all NPs.