How do I deal with doing skilled work my title and pay ignore?

You hold the clinical side of the practice together, and the title on your badge and the number on your check do not say so. That gap between what you do and what you are recognized for is genuinely tiring. Your frustration is earned, not petty. Two things are true at once. Your worth is real whether or not the system names it, and you are allowed to ask the system to name it better. Feeling unseen does not mean you must stay quiet. It means the recognition has to be pursued, because it rarely arrives on its own. Start building the case. Keep a plain record of what you actually do, especially what would break without you, and bring it to your next review or a conversation about your role. Advocating for yourself with evidence is not complaining. It is refusing to let work this real stay invisible.