Perhaps you are old enough to remember when the goal for most of us was to graduate and get a “real job”. You know, the whole enchilada: secure (and decent) salary; health, disability, and life insurance; holidays and sick days; and a retirement package that included benefits for life. Wow… are those days long gone! Colleges and universities are hiring more adjunct faculty and decreasing their tenure-track lines. Agencies are hiring counseling interns and recent grads for less money, and with new benefit plans that are “bare-bones” or highly employee funded.
The most recent shift I’ve seen in our area is with agencies and private –for-profit counseling centers who are dropping the “bomb” on their counselors (many of whom have been employed by them for many years) that they will soon become independent contractors if they choose to stay with the organization.
This “independent contractor” status usually means that the organization will continue to let you use your office, do your billing for you, provide scheduling and administrative support, and fill your book with clients. Doesn’t sound too bad, right?
The other side of that coin isn’t as rosy, however. Some organizations find a way to allow the independent contractors to pay them for their benefits. In many cases though, health, disability, and life benefits are eliminated or the independent contractor is able to pursue their benefits under the COBRA laws. No more paid vacations or sick time under this plan either! Independent contractors are paid only for the clients they see. Depending on the arrangement with the organization, they may be paid an administrative fee for no-shows or late cancellations that cannot be billed to the insurance companies. More often however, you are paid only for clients seen.
So much for a steady paycheck… And when the independent contractor does get paid, it is a fraction of what the organization will bill and collect from the insurance company. For example, a masters-level clinician who might have an average compensation (directly from the insurance company) of $75 per session, might be paid anywhere between $25 and $45 per session under this type of arrangement. That means you will leave anywhere between $30 and $50 PER SESSION on the table! If you are seeing 25 clients a week, that adds up to $750 - $1250 per week that you are essentially paying for “overhead”. You could be donating as much as $5000 per month under this new arrangement.
Is this just a sign of the times? Maybe it is. But, if we can look for the opportunity in the crisis perhaps we can find new options that are also a sign of the times. We’ll talk more next time…
Deborah Legge is a counselor in private practice and an assistant professor at Medaille College. She specializes in coaching counselors in private practice and is the founder of InfluentialTherapist.com