Dear Anita,

Good morning. Freezing cold morning over here! I hope you enjoyed your walk yesterday, and beware of the ice! I don’t want you having any falls like last year!!!

To your last point yesterday evening, the changes do seem abrupt – of course.  Here my husband is worried about this SD job, and all of a sudden seeing his current job in a new light.  It is a combination of fear for the other option, as well as perspective.

There is the concept of medicine being difficult everywhere at this moment (Your husband stated it perfectly months ago – when you spoke to him, he mentioned many points – medicine is ruled by administrators and insurance companies that just care about the bottom line, money — therefore doctors are treated like metric items to be pushed around often).  So knowing this, and learning to accept it is key.  Yes, it isn’t ideal – but it is the state of affairs at present.  10-20 years ago was different.  This is the case in all of the US, east coast or west coast.

The only difference being that many things in the east coast can be more grueling simply because of the “hustle” and the aggressive nature, and often a difficult patient population.

That isn’t to say the West is any better.  As you mentioned if he is in sunny SD in a nice building with great colleagues – what if he has 1 patient that day – the stress of that far supercedes a clinic full of inner city patients in nyc!

So there we have that.

My husband is pleased with his chairman’s response to him, and his openness.  He has noticed recently that things are changing, and that he will have to be much more patient in this sort of setting (as in, IF I am going to work here I just have to know change happens slowly – and with that, know that at the end of the day it is a predictable/stable job that you come to daily).

So here’s something more, interesting timing.  Yesterday I had a phone call with a physician in SD.  I connected with him through our network somehow (long story) he works at one of the local hospitals and is pretty entrenched in the community.  He was one of the leaders at this hospital over the last year.

Anyway, he mentioned how the SD orthopedic community is “cut-throat” as in there is the perfect storm of “too many great physicians, and too little volume” which makes it difficult for many.

He also mentioned that he knows the group that my husband would be joining, and the other surgeon.  (the one I mentioned that may be approaching retiring/going on his own).  Let’s call him Dr. T.

Well, he stated that he knows Dr. T quite well, and he is a great honest person.  He feels that Dr. T was thinking the over head (costs you have to pay when you’re in the private “eat what you kill” model) were getting too high.  And so he may be branching out on his own (he is in his 50s and already has experience out there for years by now).

So we spoke about this, and why would my husband want to join a practice, where the current surgeon in his specialty is trying to phase out, perhaps because high costs! Moreover, if the climate is that cut-throat and perhaps difficult to get patients – well that says something.

He recommended we speak to Dr. T again and be more direct.  And say to him, “will you be leaving” and what his thoughts were on the overhead.  Be direct.

I agree this is a great idea.  Dr. T mentioned that his dad had a stroke recently and he is not doing well, so he is going to spend more time away from the practice, and that my husband could have the volume of patients he would be unable to see.  But what is the real story..

It isn’t a good idea to join a practice without knowing the full story of course.  My husband will be talking to Dr. T this week.

All in all, more and more fingers are pointing to NYC – aren’t they…

• This reply was modified 4 years, 11 months ago by Cali Chica.