> Don't adjust fees on a regular schedule and have no idea whether their fees are really covering their costs. (Does "I'm just going to increase my fees by 8 percent across the board" sound familiar?)

> Don't market their practices.

> Don't attempt something unless they're absolutely positive it will work. (In business management—unlike clinical skills—competence does not equal flawless performance. Running a business is all about taking risks.)

> Are codependent, constantly putting the needs of others ahead of their own.

> Live in financial chaos and are often financially stressed.

> Have inadequate record-keeping systems or don't understand the systems they have.

> Are vague about their financial situation—they don't know how much they have, how much they earn, how much they owe, or how much they need.

> Cannot articulate what financial success would look like to them.

> Incur late fees or other financial penalties.

> Live month to month, are unable to pre-plan financial expenditures or income, and have little or no savings.

> Are confused by the concepts of net and gross. Your practice may gross $1 million, but that doesn't mean you have $1 million in the bank—in fact, it doesn't mean you have anything in the bank.

> Have an unsteady work rhythm. An underearner may work in damaging cycles of energy and exhaustion.

> Know that things must change but feel powerless to make it happen. Underearners tend to blame others for their circumstances—for example, making comments such as "If I raise my fees I'll lose clients" or "There's no growth potential in this area unless I take clients from another practice."

> Depend on a future rescue.

Underearners believe they'll be bailed out of their financial condition by some future event such as a lottery win, an inheritance, a spouse's income, or retirement.