Oct 26, 2022
Answers to the questions I get most often at meetup Q&As
https://astralcodexten.substack.com/p/from-the-mailbag
DEAR SCOTT: When are you going to publish Unsong? — Erik from Uruk
Dear Erik,
Aaargh. I have an offer from a publisher to publish it if I run it by their editor who will ask me to edit lots of things, and I’ve been so stressed about this that I’ve spent a year putting it off. I could self-publish, but that also sounds like work and what if this is the only book I ever write and I lose the opportunity to say I have a real published book because I was too lazy?
The only answer I can give you is that you’re not missing anything and this is nobody’s fault but my own. Maybe at some point I will make up my mind and something will happen here, sorry.
DEAR SCOTT: How is your Lorien Psychiatry business going? — Letitia from Lutetia
Dear Letitia,
As far as I can tell, patients are getting the treatments they need and are generally happy with the service. In terms of financials, it’s going okay, but I’m not scaling it enough to be sure.
I originally calculated that if I charged patients $35/month and worked forty hours a week, I could make a normal psychiatrist’s salary of about $200K.
I must have underestimated something, because I was only making about two-thirds what I expected, so I increased the price to $50/month. But also, it turns out I don’t want to work forty hours a week on psychiatry! Psychiatry pays much less per hour than blogging and is much more stressful! So in the end, I found that I was only doing psychiatry work ten hours a week, and spending the rest of the time doing blogging or blogging-related activities.
Seeing patients about ten hours a week, three patients per hour, at $50/patient/month, multiplies out to $75,000/year. I’m actually making more like $40,000/year. Why? Partly because the 10 hours of work includes some unpaid documentation, arguing with insurance companies, and answering patient emails. Partly because patients keep missing appointments and I don’t have the heart to charge them no-show fees. And partly because some people pay less than $50/month, either because I gave them a discount for financial need, or because they signed up at the original $35/month rate and I grandfathered them in.
At my current workload, if I worked 40 hours a week at Lorien I could make $160,000. But if I worked 40 hours/week and was stricter about making patients pay me, I could probably get that up to $200,000.
But also, if I quadrupled my patient load, that would mean a lot more documention, arguing with insurance companies, emergencies, and stress. So I can’t say for sure that I could actually handle that. Plus forcing patients to pay me is some extra work and could make some patients leave or make the model harder somehow. So I can’t say for sure that I could do that either.