Leading to a New Start
I wrote earlier as an intro to a different blog topic that my spouse had lost her job. Her entire clinic had closed, the second one in the last year in our town and one of thousands all around the nation. Back in 2010 when the Affordable Care Act passed over 60% of physicians worked in private practices. Fifteen years later that number is under 40% and falling according to latest estimates. I'm not surprised, not because I dislike the ACA. It fixed some serious issues in our healthcare system. But whenever we change something quickly and without much discussion from those in the know, i.e. doctors, there are likely to be side effects that happen that no one saw coming. This was one of those things. It is what it is.
Fortunately, though this clinic was by far the largest in our town and likely a 20 mile radius in every direction, there are still some left. When news broke, my wife and I talked it over and after refusing to retire, we decided we didn't want to move with one kid still in school for a few more years. We identified some other clinics in town and within easy commuting distance if need be that would likely offer her a job and as it turned out, we were wrong. There were over a half dozen clinics that were interested in signing her up. It doesn't hurt that she is the highest ranked physician in town.
Unfortunately, my wife has never really had to negotiate for a job before. While in residency, word got out and she had a job lined up before she graduated in a nearby town where we now live. It was in a small private clinic that lasted about 2 years after the ACA passed and then was bought out by a larger company. It has since been sold, traded, spun off, combined over a half dozen times until it was closed here a couple months ago. Fortunately with all the offers and my guidance on the negotiations, she was able to get another job lined up and at the first of last week, and will be signing a contract shortly. Though it wasn't really a doubt that she would get offers, it is still a relief to have that chapter behind us.
Part of the negotiations though was to start after a long vacation. We had already planned a short vacation to the Philippines this summer but hadn't bought tickets. After finding out she would be unemployed shortly, and luckily before all this business in Iran drove up gas and thus ticket prices, we decided that it was an opportune time to take a longer trip this time around. So we bought round trip tickets with departure and arrival flights nearly a month apart, encompassing most of June, to really spend some time at our other home away from home on the far side of the globe.
All her potential suitors, especially the one that she signed with, were more than willing to work around that. Although she hasn't had to go into the office, she has still been on contract and doing work via her office computer at home until last week when she officially had her last day. So my wife now has the entire next month off which she will use to relax, really for the first time since she decided to go back to school and become a doctor instead of her previous path of physician researcher which was the year before our eldest was born who is now 20. That is a long time. After the month off we will go on nearly a month long vacation before she starts again.

Second post this morning about finding a way forward in the health care maze, this one from the provider context.
ReplyDeleteI wish there was a perfect system that could be modeled from but I have yet to see it. There are good and bad aspects of all of them it seems. To me, the best solution seems to be to just be healthy so that they aren't necessary.
DeleteGlad she already has her next opportunity online. And what a welcome break before the next chapter starts.
ReplyDeleteI'm sure she will enjoy the time off and I know I'm looking forward to an extended stay on the other side of the planet.
DeleteIt sounds like everything is falling into place perfectly! I hope she likes the new job and also gets the chance to relax and recharge on vacation.
ReplyDeleteThus far anyway. The real proof will be a couple weeks into her new job and hopefully having proof that it is was what we thought it would be.
DeleteIt's great that she has so many opportunities readily available, and can work in that nice long break as well. I'm not sure I understand the link between ACA and the consolidation of practice ownership. (I assume that's what you mean -- private practices being bought by chains or corporate owners.) I remember when I was a medical reporter back in the late '90s that was a trend even then, and that was long before ACA. Did ACA accelerate it somehow?
ReplyDeleteI do think it has accelerated this last decade and healthcare is quickly becoming a top/down enterprise as these huge corporations gobble up everything around them. Although I won't pin it all entirely on the passage of the ACA and like you said, it maybe would have happened anyway eventually, I think the ACA did accelerate it. I personally saw my choice in insurance package options dwindle from more than a dozen in 2010 to only a single option by 2015. After that, prices dramatically rose quickly. By the time we stopped our ACA plan, it had risen about 450%. Although not entirely clear to me since it is such a complex subject, I suspect the medical companies offering healthcare adjusted with the changing insurance landscape in some sort of positive feedback loop that involved expanding dramatically. There is no longer any competition to slow things down. We have seen time again throughout history that huge corporations that form virtual monopolies rarely are in our best interest which is why I have always felt a single payer healthcare system likely would not be either. I think our system prior to the ACA was a horrible system but I think we jumped from one frying pan to another, both over the same fire when we passed the ACA. It made improvements that were greatly welcome but has problems of its own. I've said it before many times on here and other blog comment sections, we keep arguing over who is going to pay for healthcare and haven't done much of anything to fix what is broken about it.
DeleteMy primary care physician has changed his practice. I now pay $200 a month to his office and all visits are free, but referrals out and lab tests, etc. are charged to the insurance company. Insurance companies are money machines in cahoots with Big Pharma and Big medicine and good independent doctors are getting squeezed out and put under more controls. I am more than happy to support my doctor and hope he makes it even though others who were his patients think his pricing is too high. Good luck to them finding another good doctor in this town.
ReplyDeleteConcierge medical practices seem to be expanding from what I have seen though I haven't seen one that appears to be highly profitable. Mostly it seems like a way for doctors who still want to practice medicine but without the headaches of dealing with employers or insurance providers. I think it will likely never grow too big once since many can't afford to go that route.
DeleteI'm glad that's a done deal and you'll be able to take off on your travels without that hanging over you. I'm already getting excited about travel stories (and photos!) when you return.
ReplyDeleteI am excited too! Every time I go over there I am constantly bombarded with ideas from experiences that I feel would be good to blog about when I get home.
DeleteYou're living through tense times. I hope it works out for you.
ReplyDeleteI don't feel tense about it. Everything is always changing, sometimes for the good and sometimes for the worse. I don't think this situation fits into either of the extremes. But those who study metrics do seem to agree the quality of our healthcare is decreasing and the expense getting higher so we definitely aren't trending towards the good side of it.
DeleteCongratulations on the new gig for Mrs. Ed and the upcoming travels! It’s a shame about the state of private practice clinics, but at least the market knows your wife’s value. Two months of total freedom—one at home and one in the Philippines—is exactly what the doctor (yes, it was intended) ordered. Have a fantastic trip!
ReplyDeleteThanks Mr. Shife!
DeleteHawaii desperately need more doctors. Your wife is going to be in demand forever. You're so lucky to have a doctor in your family to keep you healthy too.
ReplyDeleteThat is also a curse because as long as she is in demand, she feels the need to help and thus her retirement isn't looking to be anytime soon.
DeleteI am so glad she has employment and can still have some time off and a vacation! Seems we have lots of Clinics around here...the only one that had a problem was the Dialysis Center they were open for about two years and then closed up so people have to drive 40 miles or 60 miles. Health care is so needed!
ReplyDeleteMy guess would be the dialysis isn't a huge profit driver for whomever owns it and so they, like many, decide to shift resources to more profitable clinics, at our expense unfortunately.
DeleteWell, that turned out really well. I haven't heard of medical clinics closing around here, but I periodically remind myself to take nothing for granted. Living near a big city, it's easy to think there will always be plenty of doctors, but with the business model of physicians offices changing (and seeing the change in my own GP's office), I know in my head nothing can be counted on. I'm reading backwards, and now thinking about your post on AI, I've been recently wondering how that technology may adversely affect all manner of medical services. Okay... sorry - enough of that. Congratulations to your wife on her new job! :)
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