Professional practices, beliefs, and incomes of U.S. neuropsychologists: The AACN, NAN, SCN 2020 practice and “salary survey”

Abstract

Objective: This portion of the 2020 survey updates practice information, beliefs, and income data of clinical neuropsychologists who practice within the United States. Methods: Doctoral-level neuropsychology practitioners were invited via numerous methods, with multiple reminders, to participate in a web-based survey from January 17 through April 2, 2020. The useable U.S. sample of 1677 doctoral-level practitioners was 6.2% larger than the comparable group in the prior 2015 practice survey. Results: Whereas women practitioners predominate, which continues a steeply increasing trend across time, increases in overall ethnic/racial diversity continue at a slow pace. Median age has remained very similar over the last 30 years, reflecting a continuous influx of young practitioners. A relatively small minority of neuropsychologists work part time. The proportion of board-certified neuropsychologists continues to show meaningful increase; interest in subspecialization certification is relatively high. Reliance on technicians remains popular, especially for neuropsychologists who work in institutions or are board certified. Although implementation of new CPT codes in 2019 and related payor policies appear to have had more negative than positive effects, psychologyrelated annual incomes of neuropsychologists have again increased compared to prior surveys. Variables such as specific work setting, state, region, years in practice, forensic practice hours, board certification, and basis for determining income (e.g. hours billed, revenue collected, relative value units) have an impact on income. More than half of practitioners engage in forensic neuropsychology, with the number of related practice hours per week again increasing. There is very high agreement regarding the use of response validity measures in clinical practice and forensic practice. Neurologists remain the number one referral source whether working in an institution, private practice, or a combination of both, and regardless of maintaining a pediatric, adult, or lifespan practice. Career satisfaction ratings for income, job, and work-life balance remain high, with the majority of ratings regarding the future of the specialty in the positive range. Additional data summaries related to a wide range of professional ARTICLE HISTORY

American Academy of Clinical Neuropsychology (AACN) 2021 consensus statement on validity assessment: Update of the 2009 AACN consensus conference statement on neuropsychological assessment of effort, response bias, and malingering

“…MMPI-2-RF/MMPI-3), are recommended for forensic examinations (Sherman et al, 2020). Such guidance is consistent with the vast majority of current practices of neuropsychologists when conducting clinical and forensic evaluations (Sweet et al, 2021b).…”

“…Specifically, with 1684 respondents answering relevant items pertaining to PVTs, Sweet, Benson, Nelson, and Moberg (2015) found that 91.2% of postdoctoral trainees, 88.5% of practitioners with no forensic experience, and 95.1% of practitioners with at least some forensic experience either "agree" or "strongly agree" that there is sufficient empirical research and knowledge to support the use of PVTs in practice. In a similarly-sized sample of 1699 respondents five years later (data collected in 2020), "agree" and "strongly agree" endorsements among these same three groups were 93%, 93.2%, and 95.3%, respectively (Sweet et al, 2021b). Interestingly, in the category of "strongly agree," non-forensic practitioners increased from 45.9% to 62.2% and forensic practitioners increased from 64.5% to 75% relative to 2015.…”

“…Related to forensic practice, approximately only 1% of practitioners in 2015 and in 2020 did not use either PVTs or SVTs. In this regard, beliefs are generally comparable between those who engage in forensic practices and those who do not, with respondents who are engaged in forensic practice more often reporting that they rely on multiple standalone PVTs and multiple embedded PVTs in clinical and forensic cases (Sweet et al, 2021b;Schroeder et al, 2016).…”

“…In this regard, the NAN position paper on the 'medical necessity' of validity assessment (Bush et al, 2005) and AACN Practice Guidelines (2007) continue to offer sound guidance supporting the evaluation of validity in all neuropsychological evaluations. And, without question, in 2020, postdoctoral trainees and practitioners in clinical neuropsychology are adhering to this guidance (Sweet et al, 2021a(Sweet et al, , 2021b.…”

“…Use of single versus multiple indicators. The 2009 consensus conference statement recommended that practitioners use multiple indicators of performance and symptom validity, and in the intervening years this has, in fact, happened Sweet et al, 2021b). Such recommendations, in conjunction with the explosion in PVT and SVT research over the past 10þ years, raised subsequent concerns regarding the best approach for combining multiple PVTs and SVTs in an individual assessment.…”