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Big changes on the horizon

February 6th, 2016 at 10:01 pm

I haven't posted a blog for quite a while. I'm on the forums all the time but not here. I wanted to share some news and I thought this was the better place for it.

Before I do, let me just mention that for 2015, I earned $12,163 from surveys. That's by far the most I've ever made. See what happens when I really stay committed to doing it?

Anyway, on to the news.

I've been at my current job for almost 16 years. Overall, I've been happy there. Certainly, there have been issues but nothing that was enough to make me consider leaving.

One thing has been a growing problem, though. The doctor I work for is a lousy businessman. Unfortunately, medicine is very much a business today and you need to be very financially savvy to succeed, no matter how good of a doctor you may be - and he just isn't.

The most troublesome effect of that is that I haven't had a raise for years. I'm embarrassed to admit how many years. I feel kind of awkward complaining since I still make far above median income and I don't want to come off sounding ungrateful to folks who would kill to make what I make, but the simple reality is that what was fantastic money 10 years ago and still pretty decent money 5 years ago is barely covering things today. Pretty much everything is more costly than it used to be - food, clothing, taxes, cars, etc. I'm sure very few of you would like to have your incomes cut back to what you made 10 years ago.

So I finally started looking into other opportunities. I do family practice currently (always have) but I started exploring the growing field of urgent care. There are 2 big hospital-based urgent care systems in my area. One of them is paying 28% more than I currently make. The other is paying 71% more. I'd be stupid to not at least look into making a change for a 71% increase in my income (or even a 28% increase).

I've taken the first steps in the process. I've already met with, and gotten an offer from, the higher paying place. I'm going to sign on on a per diem basis for now and hope to pick up a couple of weekend shifts each month to see if I like it, remaining at my regular job as well. I'm also going to meet with the other place and may sign on as a per diem with them too. Being signed up with both will give me more opportunities to find open shifts when I'm looking to work.

If, and this is the big question, I find that I enjoy the urgent care work, the ultimate goal would be to transition into doing that as my full-time gig. I only need to work 21 hours/week at the higher rate to match my current weekly income, which wouldn't be hard at all, especially as they are opening a new center next month and have a few more planned over the next couple of years. The demand for doctors is only increasing. Now is a great time to be getting involved.

Sorry for rambling but I haven't really been able to share this with too many people just yet. It will probably be a few months before all of the paperwork and credentialing is done and I can actually start working but I feel good knowing I've gotten the process started.

13 Responses to “Big changes on the horizon”

  1. PatientSaver Says:

    Wow...you only need to work 21 hours a week at the urgent care place to match your current weekly income..that's great.

    But I'm surprised you haven't approached your boss for a raise. I don't think you even need to make a case for it given how many years it's been. He very well might just cave and give you a great raise and wouldn't that be so much easier than changing jobs?

  2. Ima saver Says:

    It is so good to hear from you. I think what you are doing is a very smart idea and I hope that you find that you enjoy the new job. I wish you all the best and please keep us informed. I feel like you are family!!

  3. disneysteve Says:

    PatientSaver, we've discussed it numerous times. He's just said that he can't afford to pay me more. I think it is largely due to his lack of business skills. What worked for him 10 or 15 years ago when times in medicine were much different just doesn't work any more. He hasn't kept up with the times and made the changes needed to maximize the profitability of the practice. It's very tough to run a medical practice today.

    Ima saver, thank you so much. I hope you are doing well. We haven't chatted for a long time.

  4. MonkeyMama Says:

    Sounds smart to me! Good luck with the changes.

  5. My English Castle Says:

    Very exciting--and sounds like a great lifestyle change.

  6. creditcardfree Says:

    Smart move!! I hope that you like it well enough to make it your new career. Many of us would love such a significant raise, but knowing you have been without a raise for so long I'm super happy for you!

  7. livingalmostlarge Says:

    Good luck and awesome job taking the pay raise. Will you work 40 hours or cutback?

  8. VS_ozgirl Says:

    As somebody who is paid with a CPI raise at the start of every financial year, I don't know how you have stuck it out for so long, but good for you in taking steps to earn a salary you are clearly entitled to. It sounds like your boss will have to make some massive changes also, and he should have given you the raise as it is the going rate and he will probably have to pay it to your replacement. Which makes it sad that he could not pay it to you in the first place! The fact is you stuck it out for so long because you are financially savvy and are able to live on less, but really why should you have to? It's like you are being punished for being smart and able to live within your means. Good luck with your upcoming changes, all the best.

  9. snafu Says:

    From a patient's point of view, I'm sad. Our GP abruptly closed his practice last year and we were rocked to our soles as he was t excellent and we had a 15 year relationship. From a career point it sounds smart. What does DW say? Does the new guy get ugly shifts? Urgent care is a hugely stressful environment. Every patient is overwrought and the adrenalin is nearly tangible in the air.

  10. disneysteve Says:

    I really want to thank everyone for the comments. I appreciate it and it is helping me think through things. Let me respond to a couple of items.

    I am not considering this change solely for monetary reasons. Medicine has changed tremendously over the past 23 years since I started, and the nature and pace of change over the past 5 years has been the worst. I spend an increasing amount of my time doing BS work that serves absolutely no purpose and has nothing at all to do with patient care. It is also work that we get zero reimbursement for doing. I'd be happy to go into more detail about what I mean if anyone is interested.

    I fully realize that urgent care (uc) will have it's own set of issues to deal with but most of the things that annoy me the worst now won't exist because they are tasks and issues that uc doesn't deal with.

    I work in a very small office which results in me doing a lot of tasks that in the uc setting will be handled by ancillary staff, giving me more time to devote to the patients.

    snafu suggested that uc is "hugely stressful" but I'm not so sure that's true. The centers I'm looking at have a daily patient volume that is similar or even less than what I currently see in my office. Even if the volume grows to be somewhat higher, there won't be all of the other tasks to be done. I have a friend, actually a patient of mine, who is an urgent care physician with one of the groups I'm looking at. I've had many discussions with her to learn more about what her days look like and she has spent time with me in my office and has said repeatedly she doesn't understand how I manage it all. She says her job is so much less stressful than mine.

    Example: This past Monday in my office, I saw 26 patients in an 8-hour day. UC is seeing 20-25, so pretty similar. However, in addition to seeing those 26 patients, I also did approximately 50 prescription refills, handled about 30 sick messages by phone, filled out 2 or 3 disability forms, signed off on about 2 dozen reports from specialists, reviewed and addressed lab and x-ray reports for 10-15 patients, and met with a couple of sales reps. Almost all of those non-patient tasks don't exist in UC. There is a little of it, but it is minimal. I can't deny that seeing the stacks of charts that need my attention while I'm trying to keep up the pace seeing patients is already pretty darn stressful.

    VS_ozgirl makes an excellent point about my boss having to pay more to replace me. I've already thought of that and I haven't come out and said it to him but I will in the course of discussing this. I have told him outright that I can't keep doing this for what he's paying me, so I planted that idea in his head. I'm sure he knows he can't replace me for the current salary.

    snafu asked if the new guy gets the bad shifts. Not really. First off, there really are no bad shifts. The one group is open 9-9 M-F and 9-5 on Sa-Su. The other is 9-9 every day. No night work. Also the former has more flexible scheduling so shifts are not necessarily 12 hours or 8 hours long. They could need someone for 4 hours on Tuesday or 6 hours on Friday. They showed me the actual work schedule for the next month and I could see where open shifts are and where per diems are working. It's pretty evenly distributed.

    The last thing I'd say right now is to emphasize that I haven't made any firm decision about the future. I'm purposely doing this in such a way that lets me dip my toes in to see how I like it. Doing per diem a couple of days per month will get me some extra money and let me see if I enjoy working in the uc environment, while still maintaining my normal schedule in my office. If I find that I don't like uc, I'll be no worse off than I already was. If I do like it, then I can sit down with my boss and discuss options. Leaving the practice entirely is not the only choice. We could work something out where I just trim back my hours and split my time between the office and uc. I think I'd be okay with earning less for the family practice time and more for the uc time (which is as it should be to some extent). I just don't want to end up working 50+ hours/week at this point in my life. If the overall work hours stay about the same but the total income climbs, I'd be okay with that. It's not all about the money.

  11. LivingAlmostLarge Says:

    Steve good analysis. Sometimes it's not about the money. We're pretty sure my DH is taking a paycut partially due to the nature of moving to a Lower Cost of living. Potentially because it'll be entry level versus where he was, senior level. So we could be looking at around 25% or more paycut. But his long term job prospect and happiness (and ours was at stake). So it's not about the money. You know you can live on $120k. So what's to lose?

  12. Kiki Says:

    I think all of the above make ms sense. I hope it is a good fit but if not you still have the regular job until something else cones along.

  13. FrugalTexan75 Says:

    Sounds like you are thinking this through and taking steps to make sure this is what you really want. Good luck however you go!

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