Written with love by Lacey Andrews, Psychologist and Science Writer 

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Let’s start with an anecdote. I was early in my career when I realised that I would need to be located  overseas for at least a year. I was excited about this opportunity – my friends were able to afford gap years and Uni exchanges however I had not had opportunities to travel.

However, a part of me was deeply worried. The Psychology profession, from my perspective at the time, had been deeply inaccessible and inflexible. And even though we had all learnt that practising remotely with clients was possible due to Covid – practising outside the borders of Australia seemed downright radical.

But, I had no choice. My husband had gotten a job overseas and I was determined to go with him. What followed was half a year of intense research and barrier upon barrier, and another month plus of no income upon relocating ironing out administrational kinks.

And I did it! I successfully worked overseas with Australian based clients!

I am writing this blog for those of you who are like me – who need to keep working to travel, and want our highly regulated profession to work more flexibly for them in a safe and ethical way.

AND! If you are thinking of taking the leap, you probably have the same worries I did. So, I have put together a breakdown of the some of my bigger “pain points”, the financial and logistical hurdles that initially tripped me up, to help you prepare.

In this blog:

• The Medicare Gap
• The Cost of Living Equation: Why earning “less” might mean saving “more”
• The Hidden Costs: Wi-Fi, Visas, and Insurance, oh my
• The Lifestyle Reality Check (It isn’t a holiday 100% of the time)
• So, is it worth it?
• Discount offer!

1. The Medicare Gap

The rules around Medicare are pretty black and white, but misunderstanding them could have serious repercussions for your practice.

Under current legislation, Medicare benefits are generally not payable for services if the provider is located outside of Australia at the time of the service. It doesn’t matter if your client is sitting in their lounge room in Melbourne with a valid Mental Health Care Plan. If you are in Bali, a rebate cannot be claimed.

For a lot of us who trained in a system where MHCP referrals make up the bulk of our caseload it can be difficult to imagine building a viable income stream without them.

I was able to work overseas without these referral types. However, I did have to pivot and have realistic expectations.

Medicare does not often have to be the be all and end all. There are other referral types without the overseas restriction, and do not forget that people do not even need a referral to see you.

You may also be moving from a Volume Model (relying on rebates and high turnover) to a Value Model (private billing). Yes, clients who are price sensitive may reduce how often they see you, and at the same time you will keep clients who value you as their clinician.

2. The Cost of Living Equation: Why earning “less” might mean saving “more”

This is where we need to do some maths. I know how much you all love it, why else would our degrees include so many statistics courses? Depending on where you want to travel, your budget may not be as impacted as you think, even with no MHCP referrals!

Finance people call it Geo-Arbitage. I’ll walk you through a thought experiment.

Let’s look at the cost of living in Australia. You could be paying several hundreds of dollars of week for private rental, and depending on where you live, even a share house. If you have a mortgage you are likely paying thousands a month. You’re also paying for transport, utilities, and if you’re anything like me, $6 coffees. How many clients do you need to see a week to keep your head above water?

Now, compare that to the cost of living in another country. Pick one you want to go to and look it up, or you can use a tool like this Numbeo’s Cost of Living Index.

The magic is in the margin. Even if your income drops because you lose the rebate-driven referrals, depending on where you are travelling to, your cost of living could drop more.

How many clients would you have to see to live comfortably in your destination of choice? How many clients would you have to see to not only meet your cost of living, but save money? Play around with some figures, you may be surprised with what you come up with.

But for an accurate cost of living comparison don’t forget to factor in all of your costs!

3. The Hidden Costs: Wi-Fi, Visas, and Insurance, oh my.

While overall cost of living could be cheaper, working from the road comes with its own price tag.

As a Psychologist, I believe concepts like reliability and safety are integral to my work. What about your work? Would you call these concepts important?

So how do we protect these concepts, our relationships with clients, and our income from things like Wi-Fi dropping out and other tech problems? And what about other business necessities like insurance?

I found considering the below a big part of my success regarding sustainable practise.

• Tech Redundancy: I didn’t just rely on one way of connecting to the internet – I had 2 different phones I could rely on for hotspot backups. There are many options around connecting to the internet now – wireless routers, satellite internet and mobile phones being considerations.
• Insurance: This was the biggest sticking point for me. I found my standard Professional Indemnity insurance covered me for work within Australia only. If you are physically located overseas, you may not be covered unless you have a specific extension, assuming that this is an option at all (for me it was not).
• Visas & Tax: I am not a migration agent or immigration lawyer, so I cannot offer advice around this, however I can say that working this out could be a potentially significant cost.

4. The Lifestyle Reality Check (It isn’t a holiday 100% of the time)

This is the part that you may not see on social media.

When you move overseas, you could be transitioning into a new role – the role of a “Traveller”. However, you are also still a Psychologist. You could be a “Traveller” in the mornings and a “Clinician” in the evenings (or vice versa, depending on your time zone!).

The financial trade-off we talked about earlier? It buys you freedom, yes. But it also requires a level of discipline.

I have been in situations where I have had to wake up at 3am to attend an urgent session with my Supervisor.

You might be in a beautiful city where everyone else is at a 5 PM happy hour, but you are in your room with the curtains drawn, noise-cancelling headphones on, holding space for a client in crisis back in Sydney. You aren’t “on holiday.” You are working. And because you don’t have a physical office to leave at the end of the day, the boundaries between “Work” and “Life” can get very blurry, very quickly.

To make this lifestyle sustainable it is very helpful to think of your work and life boundaries and how you will manage any tension between them.

Don’t get me wrong, overall I found the lifestyle incredible. I had days where I have spent the morning seeing clients and the afternoons looking at Da Vincis and Goyas, and if the mood struck I could go to France on Saturday and Germany on Sunday.

I could go on, but I will leave it here – you are not just travelling for fun, you cannot forget about work. There was many a time I was trying to switch to holiday mode but I was till thinking about clients.

5. So, is it worth it?

Taking my practice overseas was one of the best things I have done in my whole life.

But, if I’m being honest, it was incredibly challenging to even figure out if it was possible, let alone financially viable. I spent months navigating the maze of insurance and legislation, wishing someone had just written a manual.

So, I decided to write one.

I am currently building my online course: Working With Australian-Based Clients While Overseas.

It is designed specifically for Australian-trained Psychologists to take the confusion out of the process. We cover everything from insurance and data security, to things like risk management.

Want to be the first to know when it launches?

Join the my mailing list if you haven’t already (enter your details in the pop up form that you see when you first enter my website, or simply click “stay up to date” as you navigate around my site). Not only will you get updates, but early subscribers will receive a discount code when the course goes live.

References

Department of Health, Diability and Ageing – Medicare, provider numbers and overseas travel

Numbeo – Cost of Living Index.

Images sourced from Unsplash and Pexels with minor edits applied. Finger icons created by Pixel perfect – Flaticon with edits.