Section 5 -- Factors Influencing Employment and Salary

Tables 10-13 address factors that influence employment and earnings such as "soft money" income arrangements, supplementary income, overhead rates, and changes in the health care system.

Psychologists within medical school settings are often expected to generate their own income through clinical work and/or research grants, unlike psychologists in other settings where such demands are less common. This arrangement is commonly known as "soft money." The majority (57.5%) of respondents with full-time positions in medical schools reported that they were required to earn a portion of their salary through clinical work, research grants, or both. The sources of these mandatory salary contributions were distributed about equally, with 19% deriving part of their salary through clinical work, 18.5% through research grants, and 19.5% through both. Less than half (42.5%) reported that they had no such requirement--that their salary was fixed and fully funded by their employer. The requirements varied by type of department. That is, some departments placed more emphasis on deriving salary through research grants, other departments placed more importance on clinical work, while still other departments required both clinical work and research grants as sources of mandatory salary contributions. About a third of those psychologists in departments of traditional medical specialties (32%) reported that part of their salary was drawn from research grants. Of those psychologists in Family/Prevention/Health departments, 27.5% had to generate clinical income. And about a third of psychologists in Rehabilitation and Pain Management departments had to earn income from both sources. "Soft money" constituted respondents' salaries in varying proportions, and as seen in Table 10, the levels differed by department type. Collectively, however, psychologists who were expected to supply part of their salary through clinical work had to contribute a median of 55%. Those required to generate research grants had to fund 90% of their salaries. And those who had to generate both types of income funded themselves fully at 100%.

An additional factor that indirectly influenced salary was overhead rates for clinical work and/or grant income. Overhead rates differed markedly depending on whether clinical work or research was involved. The median overhead rate for clinical work was 28%, compared to a 48% overhead rate for grant income (see Table 12).

Perhaps the most talked about concern influencing employment and earnings of medical school psychologists is the proliferation of changes in the health care system in the last decade (e.g., managed care, provider panels) (see Table 13). Across all departments, almost 39% of psychologists claimed that their clinical income or salary was affected by these changes. Thirty-two percent reported that their hospital underwent a merger with another organization within the past five years, and of those, 22% claimed that psychology positions were lost as a result of the merger. The impact of the merger as a result of changes in the health care system reportedly caused 19% of these psychologists to undergo an increase in required clinical hours, 17% to experience less time for professional development, 15% to receive less support for teaching, and 13% to experience less research support. Still, the majority of psychologists (61%) working in hospitals that experienced a merger reported no impact on their daily work activities.

Table 10: Sources of "Soft Money" Income of Medical School Psychologists by Department Type

Table 11: Supplementary Income of Medical School Psychologists by Department Type

Table 12: Overhead Rates for Clinical Work and Research Grants by Department Type

Table 13: Impacts of Changes in the Health Care System on Employment of Medical School Psychologists by Department Type

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