Here's an article about doctors from my residency alma-mater who provide free care to the homeless in Salinas, CA. I did a rotation at the free clinic when I was a second-year resident, and reading this article makes me homesick for those days.
I haven't been in a blogging frame of mind lately, and I blame it on professional chaos. In a recent post I mentioned that my hospitalist colleague came very close to resigning from Xpress Hospitalists, the name I choose to use for the staffing agency who took over our hospitalist program when we could no longer staff it ourselves. Well, things have evolved since then. Here's a precis:
Now that Noo is solidly on the path to melanoma wellness, I find myself with more time for my annual midlife crisis. The past several years, around the time of my birthday, I find myself succumbing to a certain disillusionment and generalized ennui. I do a lot of ass-dragging and complaining, find fault with my colleagues, bemoan the decline and fall of human civilization, read too many books and articles about crime/financial collapse/political instability/ovarian failure, and generally take stock of the daily tedium of Real Life:
I spent most of the last 48 hours lying around my house in a goopy puddle of depression. Not clinical depression, just everyday "what's the point?" anhedonia. Here's a few reasons why:
As of tonight I am rural doctoring once again. I've been off work for six weeks, taking a mini-retirement to catch up on rest and uncommitted time. Of course I had a million plans for my time off, including:
I've been writing this post series in an effort to unpack my mixed feelings about leaving primary care to become a full-time hospitalist. Part One described the original Dream of Family Practice which inspired me to enter primary care in the first place. Part Two described how reality fell short of the dream. In this post I want to examine how I feel about my decision and revise the dream to propose specific changes that might lead me--and other doctors in similar situations--to return to primary care.
King City is a very small agricultural town in central California. I've never been there but the residents in my program used to take care of King City's patients when their own rural hospital, Mee Memorial, couldn't provide needed services. The people of King City and surrounding environs don't have many options for obtaining health care except for a publicly-funded FQHC and Dr. Harrison's private practice.
In the last post in this series about becoming a rural physician, I'm going to discuss joining your new community. By this point in your training, you've already explored the rural experience in medical school and residency, and you've also found a job in a rural community you like. But once you get there, how do you start life and medical practice?
A young professional can find dozens of how-to guides on how to hire movers and pack boxes, how and when to cancel utilities at your old home and install them in your new one, and how to forward your mail. But there's more to moving than relocating your coffee maker, your garden gnomes and your lava lamp collection. You have to become a part of a new community, and for a new doctor, there are some special tasks to complete and considerations to make.
So far 2008 has been a professional roller-coaster for me. I gave up primary care at my FQHC late in 2007, thinking I'd be helping to lead our grassroots hospitalist program. The program folded, but I'm going to be continuing as a staff physician for the agency who is taking over hospitalist services at our hospital.
The summary of events fails to capture the disappointment, the uncertainty and terror of choosing the wrong job. It's been exhausting and I'm glad its over.
In this series addressing the training of the rural physician, we've covered education, residency, procedures, rural problems and the type of intellect--the generalist's mind--suitable for people providing health care in remote locations. But once young doctors have completed medical training, how should they go about finding a job in a rural location? This post will discuss job-seeking and job choice for rural doctors.
A while ago I wrote about the ending of my hospitalist program and my options to join another group. Here's a brief recap of the choices, and a discussion of the factors influencing my decision:
Join whatever solution Gimbels--the small hospital where I've worked for four years--put in place after our hospitalist group dissolved.
Join Revenue-Keepers, an extension of a private practice wishing to retain the income generated by following their patients in the other local hospital, Macys.
Join Hospitals-R-Us, a national staffing company specializing in ER and hospitalist programs.
Lately my body has been sending me messages. These arrive in units equivalent to somatic emails or text messages: isolated aches in the sacroiliac joint, shooting plantar fascia pains, tension-type headaches. Furthermore, I've been noticing a distressing increase in facial blotchiness after a long night on call. The first bloom of youth, which masks the mundane ugliness of fatigue, is fast disappearing, leaving behind baggy eyes and big pores.
Both of these posts make reference to the many woes facing doctors, which is a shame when these young docs should be celebrating their accomplishments. In honor of them, I offer the following Top 7 reasons why it's great to be a doctor:
I received an email from a prospective medical student last week, asking about how I manage work/life balance and see my family and friends. This is one of those excellent questions that has no easy answers. Ask five doctors, you'll get five different answers. So here's my $.02.
In Part Three of this ongoing series about my personal financial journey as a working doctor, I present a few scenarios of how I earn my income. (Yes, I do feel like a gerbil on an exercise wheel sometimes). In Part Two of this Series, I detailed how I accumulated medical school debt, and next week's edition will discuss my spending patterns and cost of living issues.
I want to emphasize the purpose of this series: to provide a real scenario of a doctor's earning/spending/work patterns so that people can understand concerns about the current state of physician compensation. I am not whining about how little I earn, especially in comparison to average U.S. workers. I consider myself very fortunate and I have a good life, thanks to my earning potential as a physician. However, I would like to disabuse the notion that doctors are all filthy rich and motivated entirely by money. I hope that providing a complete picture of one woman's financial profile--mine--will help ground the dialogue about physician compensation in reality.
