I'm a lousy blogger . It's been a couple of months since I posted so here's an update.
My original plan to leave my private practice and work part time plus per diem hours at urgent care wasn't going to work. After discussing it with the medical director, he felt that the days of nearly unlimited per diem shift availability were going to start drying up. So I decided to switch to full time (36 hours/week) to guarantee my hours and income. I will officially be full time as of 11/5.
My last day in my practice was 9/28 so this month I've still been part time. It worked out well as we were on vacation from 11/7-11/16. The last 2 weeks of the month I kept my schedule kind of light, 28 and 32 hours.
We did open our HELOC and immediately drew out $14,700 for the malpractice policy I needed to take out when I left my practice. Right now, I'm just making small payments on that (I paid $250 last month and will do the same this month). Once the last college tuition payment is made in December, I'll start attacking the HELOC more aggressively.
As for college, we do have one more payment of $15,135 due in December. Right now, I've got about $9,000 set aside plus some surplus in our checking account. I'm not quite sure if we'll have the full 15K by December, but if we need to draw a couple thousand from the HELOC, I'm fine with that.
Once I'm full time, my income will increase and our health insurance costs will drop by over $300/month so there will be additional money to throw at the HELOC. We'll have it paid off within a year.
So everything is on track and doing well financially speaking.
Viewing the 'Health Care/Insurance' Category
I'm a lousy blogger . It's been a couple of months since I posted so here's an update.
I realized I never posted anything after my first day at the new job.
To give a quick review, I'm a family practice doctor. I've been in private practice for 23 years, 16 at my current job. For various reasons, I decided it was time to start exploring other options and Urgent Care centers are popping up like weeds and in desperate need of doctors to staff them all. I interviewed with a couple and signed on to work per diem with one chain of centers connected to a big local hospital group. They currently have 5 centers, a 6th one not far from my house will open next month, and 1 or 2 more should open by the end of the year. So they are expanding rapidly and that just means more and more shifts to fill.
I did my first shift a week ago Thursday evening 5-9pm. It actually went pretty well I think. It got a bit hectic in the last hour or so and I was still muddling my way through the computer system but I managed (with the help of my one-on-one IT support person who was with me the whole time).
My next shift wasn't scheduled until 6/16 but I decided I needed to work before that to keep up on the learning curve so I picked up an open shift last night, also 5-9pm. That went much more smoothly than last week. I felt a lot more comfortable and confident in what I was doing. My IT guy was with me again and I made sure to work with him to clarify some specific workflow routines on the computer and I took good notes of the processes so that on future shifts when he isn't there anymore, I'll be able to know what I'm doing.
Right now, the 6/16 shift is the next one I've got booked. I was going to possibly pick up more but we got some bad news this morning as a very close relative was just diagnosed with colon cancer. He's in the hospital now getting worked up and will likely have surgery in the next few days. My wife and mother plan to fly down to Florida to be with him. My daughter and I will stay home. I don't want to commit to any more shifts until I have a better idea of what's going on with him. If not for that, I'm all set to jump into the new position on a regular basis.
The question now becomes what to do with my existing job. I'm still working full time there. My partner and I have already talked about me possibly reducing my office hours so that I can split my time more with the Urgent Care. Part of me really hates to leave the practice as I like what I do for the most part, but personally, professionally, and financially for sure, the new job has a lot of advantages. I don't think I'm going to make any decision for at least a couple of months but I've got a lot to think about. So for now, it's just a side gig and some nice extra money.
We got a nice surprise today. Before my wife's first surgery on 10/23, the office required us to make an upfront payment of $316 which I assume represented the percentage of the bill they anticipated wouldn't be covered by insurance.
Today, my wife got the mail and saw what she thought was another bill from the practice and wondered why because she thought we had paid everything. It turned out to be a check refunding the $316 because insurance had covered everything.
Today is her birthday so that was a nice little bonus gift.
And things were rolling along so well this year...
My wife has been having some gynecological issues which her doctor has been trying to correct with medication without success. So she is going in on Tuesday for a D&C/Hysteroscopy. Once that is done, they will be scheduling her for a total hysterectomy in the near future.
Obviously, my first concern is that she get better soon as she really has been miserable lately, but there will be a significant financial impact to her surgery, too. We have insurance but there is a deductible and co-insurance to deal with. Her gallbladder surgery a few years back cost us about $3,000 as I recall. I suspect this ordeal will run more than that between the 2 procedures. I'm guessing about $5,000. She is supposed to get a discount of some sort because she works for the hospital but I don't know what that will amount to.
Then there are lost wages. I'll probably lose about $1,500 in income from taking off. She will probably lose another $1,000-$1,500 depending on how long she has to be out of work.
So all together, we're probably looking at about $8,000 in unexpected costs. We have the money, fortunately, but it is still a lot, not that you can put a price on your health.
Even though I'm pretty good at giving financial advice and talking about what we all "should" be doing, I'm often as guilty as the next guy about not actually taking action and doing those things we talk about.
This has been on my mind a lot recently. DW isn't thrilled with her job and may decide to go back to SAHM status at some point. Even though most of her income goes to savings, some of it still comes home and gets spent. We already took a big cut when she went from her last job to this one without really changing much but losing the current income will eventually have some impact.
A year or so ago, I met with my insurance broker and he ran quotes for me and showed that we could lower our life insurance premiums by switching companies, but I never followed through so have maintained the more expensive policies.
Then a couple of months ago, I got an online quote from another auto insurance company that would have saved us about $36/month, but never did anything with that either.
Now, we've had the discussions in the forum about mortgage rates falling and we will probably benefit from refinancing again if rates fall a bit more in the coming months. Maybe by summertime, it will make sense and save us somewhere around $50/month.
Add to that the fact that the last payment on DD's braces is in May and we'll have an extra $150/month free from that.
So if I get off my butt and redo the life and auto insurance, refi the mortgage and add in the braces money, we could see over $200/month extra in our budget. So I guess that's my goal for this year.
DW and I agree that we haven't been eating all that healthy lately and need to get back on track with diet and exercise. I decided to take a trip to Whole Foods today and spend some time exploring some different options, particularly looking for some healthier snack options since that is often our downfall.
I picked up a number of new things to try, a couple of which we already sampled tonight and liked. I was mainly focused on items with little to no saturated fat, no trans fat and no high fructose corn syrup.
The one problem with those things is, of course, that they are more expensive than the crappy versions, but I'm willing to spend a little more for good health. Also, we are working to get back to cooking at home more and eating out less which will save a lot of money. I'd rather spend it on better quality groceries than on high calorie meals out.
Top 10 Reasons for an Annual Physical
“I feel fine.”
“I only go to the doctor when I’m sick.”
“Doctors only recommend physicals to make more money.”
People have all kinds of excuses for not getting regular check-ups. Here are 10 reasons why you should. For the record, I’m a board certified family practice physician in practice for 14 years.
1. High blood pressure: Often called “the silent killer”, high blood pressure usually causes no symptoms at all but greatly increases your risk of having a heart attack, a stroke, kidney damage and other serious health problems. Millions of people have high blood pressure and don’t know it until something bad happens. Seeing your doctor annually and getting your BP checked can identify the problem before it harms you.
2. Diabetes: Like high blood pressure, high blood sugar can have no symptoms until it is severe, but will still be damaging your body even though you can’t feel it. An annual sugar test can identify this hidden disease. This is especially important if you have a family history of diabetes or you are overweight. Women who had elevated sugar during pregnancy are also at higher risk of developing diabetes later in life and should be regularly screened.
3. Cholesterol: Same story. No symptoms. Unless you get a simple blood test, you don’t know your cholesterol is high and hard at work clogging your arteries and setting you up for a heart attack or stroke.
4. Cancer screening: Many common cancers can be checked for with simple tests as part of your annual physical. In the office, we can screen for breast, colon, skin, cervical and prostate cancers by exam, blood test, Pap smear and sending you for a mammogram. Patients 50 and older should also get a colonoscopy.
5. Vision: It never fails to amaze me how many patients come for physicals and can barely read the eye chart. I wonder how many auto accidents are due to drivers who just can’t see what is happening around them.
6. Vaccines: You aren’t all done with shots once you turn 5 years old. Adults need shots, too. Tetanus boosters, flu shots, pneumonia vaccines, pertussis boosters, hepatitis B, etc. This is particularly important if you are planning any foreign travel, but even if you aren’t. Speaking of travel, you should always check with your doctor well in advance of a trip to see if any special vaccines are needed (typhoid, yellow fever, malaria medication, etc.).
7. Obesity: Many people never step on a scale outside of their doctor’s office. As a result, a lot of folks seem truly surprised when they come in, get weighed, and see how many pounds they’ve gained. Often, just seeing that number motivates them to make some changes, start eating better and get back to their exercise routine. Plus, it gives me an opportunity to discuss their weight and make suggestions about how to address it.
8. Smoking: Studies have shown that patients whose doctors counsel them to quit are more likely to quit. If you smoke, hopefully your doctor will raise the subject during your annual exam and talk to you about quitting. There are various methods to help you quit that your doctor can prescribe if you are ready and willing to make a quitting attempt.
9. Thyroid disease: This is a common problem, particularly in women. There are symptoms, but many of them are very general and people attribute them to other things: fatigue, weight gain, dry skin, changes in the menstrual cycle. This is another case where a simple blood test can identify the true cause of those symptoms and your doctor can prescribe medication to correct the problem.
10. Anemia: Again, something like thyroid disease that has symptoms that people often attribute to something else. Fatigue, decreased exercise endurance, headaches – all things that many of us feel from time to time. That annual blood test can determine if the underlying cause is a low blood count. If so, your doctor can work with you to find out why you are anemic. The cause could be something simple and benign or something much more serious. Catching it early could make a big difference in the outcome.