Will anyone actually discuss salary? Let's see...

[JeyRo]

Interesting. Did you have another sort of foot in the door?

Well, yes. Personal relationships - I exploited those a little too. I'll be honest.

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[deleted176373]

Interesting. Did you have another sort of foot in the door?

Ya, good question. Although former military psychs (who are not VA interned typically) are also often competitive for these positions for obvious reasons. While the VA system is a lucrative employment setting so are most of the major military medical centers, any of the GS positions in federal service (including really interesting jobs at places like the FBI or USMC) are equal to the VA generally in benefits. It certainly does help to have personal relationships to get these jobs, people typically go with known performers!

M

 

[stevenjw]

Question: when many of you talk about salaries and the va, hospitals, etc., I don't see anyone making a distinction between phd and psyd graduates.
How big of a difference do the degrees make in future earning potential?

 

[Pragma]

Question: when many of you talk about salaries and the va, hospitals, etc., I don't see anyone making a distinction between phd and psyd graduates.
How big of a difference do the degrees make in future earning potential?

Other people may be more familiar with this than me, but I don't think you encounter differences in salaries per se, but differences in job opportunities. The VA, for example, has standard salary rates depending on your experience/training level and I believe location. The degree shouldn't matter.

An AMC that hires a clinical psychologist probably isn't going to differentiate between degrees when it comes to salary negotiation. For example, T4C had noted a very high starting salary and I believe he has a Psy.D. However, I'd imagine that most AMC positions (particularly ones involving research) will be hiring Ph.D.s more often.

So I'd consider it a difference in probability of being selected for certain types of positions rather than a difference in salary, although I haven't looked at data exploring this.

You will find differences between salaries for men and women with the same training background when it comes to academic and hospital positions. There are a number of issues contributing to that trend that aren't unique to psychology, although some have surmised that more reluctance to negotiate starting salaries among women might partially contribute to the trend in recent years. Does this salary gap exist in the VA?

 

[psychRA]

Like Pragma, I actually have found CMHC settings to be much more frustrating and stressful than VA work...although it's also going to depend on what is stress-inducing for you.

This has been my experience as well. I could never go back to a CMHC. I've worked in east coast, west coast, and southwest VA hospitals - never been in a CBOC, which is substantially less appealing to me.

 

[Sanman]

Question: when many of you talk about salaries and the va, hospitals, etc., I don't see anyone making a distinction between phd and psyd graduates.
How big of a difference do the degrees make in future earning potential?

In general I have to agree with Pragma. Positions do not pay based on PhD/PsyD, but rather on the title of Licensed clinical psychologist. For the VA and many other desirable positions, APA accreditation for both your program and internship is generally a requirement. Having completed a post-doc may bump your pay/ make you competitive for more academic positions (or let you start GS-13 a yr earlier at the VA I believe), and board certification may give you a pay bump as well. That said, the number of job options open to you increases (generally), the more of these things you accomplish. PhD grads are likely to have an easier time obtaining a job with a research/teaching component. They may also have more access to internships and post-docs that require a research component. Thus, they may have an advantage in obtaining positions that may be more closed off to PsyDs. While I am sure it might happen, I have yet to see anyone for give a PhD a clinical interview for having too much research experience.

 

[JeyRo]

There are a number of issues contributing to that trend that aren't unique to psychology, although some have surmised that more reluctance to negotiate starting salaries among women might partially contribute to the trend in recent years. Does this salary gap exist in the VA?

You can't offer someone less than what the General Schedule offers for psychologists - I suppose service chiefs could theoretically dole out less bonuses for women, or hiring boards could potentially discount pre-hire experience for women over men (for the purposes of started people at GS-12 rather than 13) but I think the rules are pretty inflexible for that kind of monkeying around in the federal government.

 

[Sanman]

You can't offer someone less than what the General Schedule offers for psychologists - I suppose service chiefs could theoretically dole out less bonuses for women, or hiring boards could potentially discount pre-hire experience for women over men (for the purposes of started people at GS-12 rather than 13) but I think the rules are pretty inflexible for that kind of monkeying around in the federal government.

Not sure how true this is, but I have hear salaries are slightly negotiable within the range of your step and you can negotiate benefits and flexibility of schedule as well. I wonder if women I more inclined to toward the flexibility and men the money.

 

[Therapist4Chnge]

Question: when many of you talk about salaries and the va, hospitals, etc., I don't see anyone making a distinction between phd and psyd graduates.
How big of a difference do the degrees make in future earning potential?

Some of this was covered by recent posts...but I'll just leave it how I wrote it.

It doesn't matter for the VA (in most instances) because everything is based off of the the GS-Scale, a standard gov't pay scale. However, there are some things that psychologists can do to come in at a higher level and/or maximize their salary. Pre-licensure jobs tends to be GS-11, with many VA jobs "promoting" the person to GS-12 once they are licensed. Some VA post-docs/fellowships will have a set stipend not established using the GS levels, instead it will be based off of grant funding and/or "the going rate". I have seen post-docs go for $41-$46k-ish in the past few years, which isn't bad in most locations. Once on a pay scale, the way to move up is by yearly "step" increases (not much more than a cost of living increase each year) or take a new job w. a higher pay scale.

To maximize your salary in the VA, it is best to go get speciality training via a fellowship, and then come in at the GS-13 level instead of coming in as a GS-11 or GS-12. Not all jobs will allow for a GS-13 grading, so people can get stuck fighting for a posting that starts out significant less than another posting that is graded higher. Each GS level requires certain experience, so you can't "jump" to a higher level without meeting the minimum requirements of that level. Your want to come in at the highest level possible because the difference can be significant: GS-12, step 1 in Cleveland is $71.5k. GS-13, step 1 there is $85k. There are "local" adjustments for each city, so I picked Cleveland bc I thought it'd be right around the national average. There are little things you can tweak (protected time, pet projects, etc), but the salary is basically the salary.

If you can get a joint appointment within the VA and another hospital/university, then you can have more flexibility with negotiating your salary You can get a % paid by the VA, a % by the hospital/university (that may be at a higher/lower rate), and then buy out some time via a research grant. This path is usually very competitive and lends itself to more senior level people, but it can provide a very competitive salary and the most flexibility for you to do what you want. There are other ways to cut the pie in the VA system, but those are the most common.

An AMC that hires a clinical psychologist probably isn't going to differentiate between degrees when it comes to salary negotiation. For example, T4C had noted a very high starting salary and I believe he has a Psy.D. However, I'd imagine that most AMC positions (particularly ones involving research) will be hiring Ph.D.s more often.

The pay and opportunities will vary greatly at an AMC. My base faculty salary was actually set by the university (though it is competitive w. other salaries out there). If I was a senior level prof and/or I had a big grant in hand, then I'd have more leverage to negotiate a higher starting faculty salary. The base faculty salary at a university/AMC could be well north of $150k+ for established researchers, but working primarily as a clinician makes my value tied directly to my clinic's productivity/billing. I have a great setup bc I have psych techs handle all of my testing and I have favorable rates for other work I do during the week. This is definitely doable in other places, but it is a very very competitive process to get to this position. I'm a clinician who happens to enjoy doing research and I have some unique programming and related skills, so it was a bit of a perfect storm. I always provide the caveat that I'm a bit of an outlier, so people need to look at the reported numbers and go with them and not my N=1.

Ok...lunch done, back to work!

 

[JeyRo]

Not sure how true this is, but I have hear salaries are slightly negotiable within the range of your step and you can negotiate benefits and flexibility of schedule as well. I wonder if women I more inclined to toward the flexibility and men the money.

I would be very surprised if there was any ability for hiring boards to negotiate salaries beyond what's directly called for in the GS system, or benefits - it's all baked into the collective bargaining cake, more or less, for federal public employees. However, flexibility of schedule, yes, I think there's potentially a lot of leeway, particularly as an informal arrangement between the psychologist and their assigned site.

I understand if you're a psychiatrist there's a lot more potential for hiring boards to roll out the red carpet in terms of signing bonuses and the like - but that's a whole different matter.

 

[AcronymAllergy]

Not sure how true this is, but I have hear salaries are slightly negotiable within the range of your step and you can negotiate benefits and flexibility of schedule as well. I wonder if women I more inclined to toward the flexibility and men the money.

I was going to mention this same point--while the salaries are fixed at each grade and step, I believe you can negotiate somewhat as to your initial step; then again, as JeyRo mentioned above, psychologists aren't always in a spot where they can successfully perform these types of negotiations. Other contributing factors could be part-time vs. full-time status, supervisory vs. non-supervisory role, and geographic location.

 

[VAneurodoc]

Once on a pay scale, the way to move up is by yearly "step" increases (not much more than a cost of living increase each year) or take a new job w. a higher pay scale.

Not entirely correct. The first few steps are yearly, then every other year for steps 5, 6, and 7. Steps 8, 9, and 10 are every three years. They are more than cost of living increases which we also get, although they were frozen several years ago so there has not been one since I think 2010.

 

[JeyRo]

Not entirely correct. The first few steps are yearly, then every other year for steps 5, 6, and 7. Steps 8, 9, and 10 are every three years. They are more than cost of living increases which we also get, although they were frozen several years ago so there has not been one since I think 2010.

Supposedly Papa Obama has promised us a 1% cost of living increase but at best that will happen months from now, and depends entirely on the outcome of the so-called fiscal cliff negotiations. Although that's a laughable cost of living adjustment for anyone, it's something and still, the step increases continue.

 

[clinpsych]

I hope people don't mind my reviving this topic.

Do you think that working as an independent contractor for a group practice is a financially viable option if the practice is in network with insurance companies with favorable reimbursement rates (~$115 per session), and the contractor keeps 60-70%. I'd primarily be doing individual therapy and have specialized knowledge of a common diagnostic category. The practice primarily serves an upper middle class population. I'd have to do some of my own marketing, but apparently there are surplus referrals in the practice.

To operationalize financially viable, I would hope to earn close to $100,000, would aim to see ~35 clients per week and would be willing to work ~12 hours on evenings and weekends.

$115 per session x 35 individual clients - 20% (no shows, unpaid fees) x 60% cut = $1,932 per week or $94,668 for 49 weeks worked per year

Does anyone see any problems with this math? Is there anything important that I'm forgetting? (I am also considering the cost of the benefits that would be included at many other jobs.)

My dream has always been to work private practice, and this seems like a fantastic opportunity, but I want to be realistic.

The other option I'm exploring is working for the VA. (I should be fairly competitive for these jobs - I have VA experience and knowledge of in-demand EBPs.) I would enjoy the clinical work considerably more within the group practice, but also want to be financially secure.

Your thoughts and feedback would be appreciated!

 

[Pragma]

$115 per session x 35 individual clients - 20% (no shows, unpaid fees) x 60% cut = $1,932 per week or $94,668 for 49 weeks worked per year

The math is fine assuming that every client gives you this reimbursement rate and that you are always able to maintain a 35 client caseload.

I wouldn't count on either of those things - in fact, I would count on reimbursement declining most likely. If it were me, I'd go for the VA.

 

[AcronymAllergy]

The math is fine assuming that every client gives you this reimbursement rate and that you are always able to maintain a 35 client caseload.

I wouldn't count on either of those things - in fact, I would count on reimbursement declining most likely. If it were me, I'd go for the VA.

The VA also has the advantage of its benefits, although I'm not sure how the salary compares in the poster's area.

That being said, I wonder if it'd be possible to take the spot at the VA while possibly still working as an independent contractor at the PP? You obviously wouldn't be full-time, but even just one day/week (or maybe a couple nights per week) would boost your income.

 

[Pragma]

The VA also has the advantage of its benefits, although I'm not sure how the salary compares in the poster's area.

That being said, I wonder if it'd be possible to take the spot at the VA while possibly still working as an independent contractor at the PP? You obviously wouldn't be full-time, but even just one day/week (or maybe a couple nights per week) would boost your income.

Ooooooh good suggestion! I am very much a promoter of the "stable job/benefits + side work to boost" model of employment.

 

[KillerDiller]

I hope people don't mind my reviving this topic.

Do you think that working as an independent contractor for a group practice is a financially viable option if the practice is in network with insurance companies with favorable reimbursement rates (~$115 per session), and the contractor keeps 60-70%. I'd primarily be doing individual therapy and have specialized knowledge of a common diagnostic category. The practice primarily serves an upper middle class population. I'd have to do some of my own marketing, but apparently there are surplus referrals in the practice.

To operationalize financially viable, I would hope to earn close to $100,000, would aim to see ~35 clients per week and would be willing to work ~12 hours on evenings and weekends.

$115 per session x 35 individual clients - 20% (no shows, unpaid fees) x 60% cut = $1,932 per week or $94,668 for 49 weeks worked per year

Does anyone see any problems with this math? Is there anything important that I'm forgetting? (I am also considering the cost of the benefits that would be included at many other jobs.)

My dream has always been to work private practice, and this seems like a fantastic opportunity, but I want to be realistic.

The other option I'm exploring is working for the VA. (I should be fairly competitive for these jobs - I have VA experience and knowledge of in-demand EBPs.) I would enjoy the clinical work considerably more within the group practice, but also want to be financially secure.

Your thoughts and feedback would be appreciated!

I just attended a seminar on the viability of private practice. Based on what I gleaned, I think the mark you are aiming for is realistic, but probably only about 3 years down the road. Even if you get clients who trickle down from others in the practice, it will take a while to build your own reputation among main referral sources in your area. Also, the trickle down clients may not be the ones you personally want to work with or fit your areas of expertise. Any hours you do see clients the first few years will take away from time spent marketing and networking to build for the future. It's a delicate balance and tends to be yet another deferral of gratification in this field.

 

[PHD12]

I just attended a seminar on the viability of private practice. Based on what I gleaned, I think the mark you are aiming for is realistic, but probably only about 3 years down the road. Even if you get clients who trickle down from others in the practice, it will take a while to build your own reputation among main referral sources in your area. Also, the trickle down clients may not be the ones you personally want to work with or fit your areas of expertise. Any hours you do see clients the first few years will take away from time spent marketing and networking to build for the future. It's a delicate balance and tends to be yet another deferral of gratification in this field.

Yep. It's going to take you a while to build to 35 patients.

94K is not that great if you are working 60 hours per week and evenings/weekends. 35 patients per week can easily lead to burnout. You can start at around that salary at the VA (depending on location) and max out at over 100K. The benefits and pension are worth at least 35K per year. Plus, you won't be working evenings and weekends.

 

[Pragma]

Yep. It's going to take you a while to build to 35 patients.

94K is not that great if you are working 60 hours per week and evenings/weekends. 35 patients per week can easily lead to burnout. You can start at around that salary at the VA (depending on location) and max out at over 100K. The benefits and pension are worth at least 35K per year. Plus, you won't be working evenings and weekends.

Yeah - estimate how many hours per week those 35 clients will take you. Then assume you only have to work 35-40 hours per week at the VA.

If you really really absolutely think this private practice thing is important to try, why not just do it on Saturdays or something, or a couple of evenings per week in addition to the other job? I think AA had a good idea, and this would probably maximize your income for the amount of time you are going to spend each week. I personally have a setup like this (although my primary job is nonclinical). I am also making an assumption that you won't have a non-compete agreement (those are more common at AMCs I think - I haven't heard of them at the VA).

This would give you a chance to try it out without depending on it, boost your income, etc. If you find it is more rewarding and lucrative, you can quit the other job. But it is harder to go the other way around...

 

[clinpsych]

That being said, I wonder if it'd be possible to take the spot at the VA while possibly still working as an independent contractor at the PP? You obviously wouldn't be full-time, but even just one day/week (or maybe a couple nights per week) would boost your income.

I absolutely would do this if it would work out geographically! However, that seems unlikely at this point as the VAs in that area aren't posting openings.

If I take a VA job, I'll definitely be on the look out for PP opportunities.

 

[Doctor Eliza]

1. Talk to people already contacting at this practice--is it as good as it sounds (to you) or are they unhappy after actually working there? This happens a lot with the practice I work for. Sounds much better than it is.

2. How sure are you of the $115 figure? Most insurances pay me $70 in my area.

3. How long term are the clients in the practice? A healthy middle class population is a double edged sword. While they are easier in some ways, many if them only need/want like 4 sessions. This makes it harder to maintain a weekly caseload of 35

4. Read the contract and make sure you can take clients with you when you go out on your own some day.

5. How much office, billing, and secretarial support is there for your 40%? Do you have to provide any of your own supplies or furniture?

6. Are you eligible for private health insurance or do you have a spouse who could get you on their plan. You would be surprised about how hard it can be to qualify and how expensive it can be.

7. The biggest concern I would have would be the vague promise of lots of referrals and the need to do your own marketing. Find out (by talking to people in the practice) how that pans out. I have had a few friends run into trouble with that set up.

8. Will you get a better split if you stay with the practice for a number of yrs? Remember in PP, you will essentially never get a raise (and often a cut) from insurance companies. The VA would offer raises and room for advancement, right?

9. Do you care about being home for dinner with a partner and/or children? Evenings are by far the easiest to fill in PP, but I has been hard for me and many of my colleagues to miss out on family time. And it sucks to eat dinner at 9pm.

I'm sure I have more thoughts, but this is what i can think of off of the top of my head. I work in a PP with a 50-50 split. While I like the work, the poor money and long hrs are a big source of stress. Honestly I (and most of my coworkers) would take a VA job in a heartbeat. Many of us apply when they have an opening, but they can be hard to break into. (Additionally, my own skills are a poor fit for the VA.) My advice would be to look for a VA job now and if you hate it, PP will always be there.

Best,
Dr. E

 

[AcronymAllergy]

I absolutely would do this if it would work out geographically! However, that seems unlikely at this point as the VAs in that area aren't posting openings.

If I take a VA job, I'll definitely be on the look out for PP opportunities.

If your specialty is one that requires boarding, I've heard from my (VA) supervisors that once they completed that process, they began regularly receiving requests for independent contracting-type work with various area PP's and other organizations. Even if it's not an area that's currently pushing boarding, it sounds as though it's an in-demand specialty, so once you begin networking in the area, the job offers may start coming to you to some extent.

 

[neuroal]

I'm a Master's level clincian at this point (deferred PhD acceptance for a year) so ignore if not relevant to the OP's question.

I'm currently at a PP w/2 psychiatrists, an MD, 3 psychologists (I'm under the owner's license), several master's level clinicians like me, and of course, the office staff. I started at $42K plus bonuses every 3 months depending upon productivity (avg for counterparts ranges 1-2K per quarter). I can get full medical benefits at a low cost (am on husband's plan so do not need them), 2 weeks paid vacation, paid holidays, 1K per year in training/CE funds, paid travel to conferences, and paid opportunity to certify as a psychometrist (not sure if that's needed professionally?), and malpractice insurance.

It's 15 minutes from my front door and I love the range of activities I engage in (individual therapy, NP testing for alzheimer's, some forensic assessment, IOP program development and group therapist, and training PhD candidates from area university).

The PP focuses on forensic, psychological assessment, DBT IOP groups (Adult MH, Dual, Pain Mgmt, Adolescent MH - all CARF certified), and we may be starting a PHP, and individual. I think a main revenue for the PP is the assessment of AD inpatients at nursing homes that specialize in AD that we've partnered with recently and the IOPs. It's very busy but I love the work and am not overwhelmed. The people are incredible.

I also used to be a business analyst and project manager and was recently asked to consult for an area company to design training that promoted learning effectively as memory and learning were the focus of much of my psychology training. This is a little more I/O and builds on my prior experience. But it pays $50/hr and is extremely lucrative for me. Will likely only do it 8-10 hrs per week. So I guess I'm making $60-70ish from both positions.

 

[PsychevalIII]

Its good that your hearing different points of view. No risk, no reward. I would learn everything you can from the group, then go and build your own empire. Everyone is talking about the "benefits" that go along with working at the VA. If you are successful at private practice, your benefits could far outweigh anything the VA could ever consider, i.e. european made company car that you own, company condo that you own, company building (s) that you own, etc. At the end of one's VA Career, who owns the hospital? I live in a cheap part of the country, and will own about one million in real estate (in todays dollars) free and clear from my private practice at the time of my early retirement. Not to be confused with my personal real estate. I can either sell the offices, rent them out, or continue to have the company generate me a pay check every two weeks even after I am no longer working. Think big picture.

 

[clinpsych]

Thanks to everyone for their feedback - you've given me a lot of food for thought!