We're up the creek...

[Nickarolaberry]

Hi Mamas,

I guess I just need some good old fashioned encouragement. You all are probably going to think we're nuts or I"m just b****ing.

My dh is a surgeon. He finished residency 2 years ago, and we moved to our current location for him to start a job where partnership was in the offing.

It didn't happen, and now he's out of a job. HE's trying to start his own practice, but it's slow going, and meanwhile, we have no income. He has to come up with his own malpractice insurance...to the tune of over $100K a year. Without it, he can't practice.

We also have to now pay our own medical insurance. Funny, huh? Doctor's family without medical insurance.

The first premium of the malpractice we will cover by dipping into an inheritance that was left for our daughters' college educations by a relative of dh's. We feel terrible about doing it, but it's either that, or no career. It will cover him for a few months, and the mortgage for 2 months.

We have the house on the market. IT's slow right now, and we can't sell for less than we paid or we'll have to pay back on the mortgage even after selling, as we only bought 2 years ago and haven't really dented the principal.

I have 3 little kids, and I was a professor before. The best adjunct job I could get at this point (because now tenure track is fairly out of the question, due to my being out of my career for 6 years and the dearth of potential jobs here) would not pay enough to cover daycare.

We're looking at moving for a different job, but we have to sell the house first, and anyway, getting licensed and up and running in another place is very expensive too.

I'm hoping we won't lose the car. I owe about what it's worth (Ford minivan); if I sell it, I won't have anything left over to buy something else and I need to be able to get around; with 3 kids in carseats it has to be something that can accommodate all of us and be reliable enough not to need constant repair work.

I've accepted a teaching job (middle school English and Social Studies) for next fall and also one for the summer (day camp); the camp job provides for childcare (girls get to be at "camp" for free; baby gets a mother's helper to himself and is available for me to nurse, etc. and I do get a small salary) but the pay isn't so great.

Sigh. We've cut wayyyy down on our expenses but dh is still not to the point of wanting to apply for WIC etc. (can you imagine the pride issue? an MD and a Ph.D. and no job security and no income -- I'm not meaning to sound snobby at all; I realize these things do happen to everyone but we never thought after all our planning and struggling to get to this point that we would be in this situation). We recently paid off all our credit card debt (thank you, tax refund) but now face going back into it for lack of anything else to live on...

Gah. Sorry. Just venting.

[Mama Dragon]

Dude. Something is seriously screwed up in a society where 2 highly educated people can't get a job or start a career. I understand why you'd be hesitant to post, but you've got as much right to complain as any of us!

Can your DH get a partnership with anyone else? Can you tutor at all? Would moving to a better area help? I hope things work out for you soon, to work so hard just to have to deal with all this is a load of crap!

[1growingsprout]

all i can say is HUGE HUGS to you... DH is an attorney/broker... i am a broker... i chose to stay home...if i had to go back to work it would take a long time to get the correct papers filed etc.. while everyone thinks atty jobs are easy to come by.. they arent... fortuanetly DH works in the legal dept of a large financial corporation... hanging out our own shingle isnt such a good idea... again we would be faced with the same issues... health benefits... malpractice insurance... etc etc....


is it possible for your DH to sign on with an HMO... aetna/blue cross/kaiser permante? or how about an urgent care type thing for a while... starting yoru own practice is no fun.... teaching is a great career.. not the best $$ wise unless you are at the college level but its a great career... how about working at a tutoring company (sylvan) or something like that?

[LeBoof]

Just a thought....have you thought about teaching at an online academy? A lot of legitimate colleges are offering classes online now (where the prof's may be anywhere in the world). You might find that your job market opens up a little bit if you don't have to focus on just your part of the world. This way you could also stay at home with the kids. I'm not sure if they pay any better, but it might be worth looking into.

I'm afraid I don't have any better suggestions than the others that have been made here for your husbands situation. You said that your husband is too proud to want to use WIC and some of the other programs available. I have a question though...has he talked to your Human Services Dept. about if they know of any job openings? If they don't know of any, they might be able to point him towards someplace that would.I know it's not much of a help, but it might be worth a think or two.

LeBoof

[Nickarolaberry]

Ugh, I just lost a whole post.

Thank you mamas for the encouragement. :

DH is looking into locum tenens, which is like temping for doctors. It's a good gig, because they pay your malpractice and all related travel expenses and the salary isn't bad.

However, it means being gone for chunks of time. Since he's starting to build a referral base among primary care docs for them to send him surgical patients, being gone when they call is not a good idea. They'll call once and if he's not around, move on to someone else, then word will get out that he's not so available. KWIM?

Taking a job with another group is a possibility but unlikely. Medicine in our area seems to be very political (maybe it is everywhere but we've only been here since he's left residency) and other docs do the "hire someone for two years then cut them loose instead of offering partnership" bit a lot. It's very discouraging.

Also, in addition to general surgery (hernia, thyroid, appendix, abdomen, etc...basically anything not neuro, cardio, plastic, or orthopedic) dh is trained and practices a highly specialized kind of surgery that only a few people in our area do. It's very competitive between those people; even though there are enough patients that want it for everyone, these surgeons tend to view it as a "zero sum game" and don't want to take on a partner who might compete with them (which is dumb...partners who bring in more patients, make more money!).

Our area doesn't really have large HMO kind of places which hire their own docs. Insurance might be HMO, but the docs participate from their own practices, if that makes sense.


I am trying to look into online work, but honestly haven't gotten very far. I just don't know how to proceed or where to find it. The only source I've gotten is wahm.com and they don't pay enough for me to afford a babysitter (they cost over $10/hr. here). I thought about taking kids in for daycare, but since we're selling the house that's problematic plus I don't think I have the temperament for it.

I taught political science as a professor and I also worked at a major Washington think tank that specialized in Middle East policy, but a lot of the online universities I've checked into want someone who does more business-related stuff. I could do English grammar and composition type of courses, but don't see many of those either.

Any ideas would be welcome. Thanks mamas! It just seems so ridiculous, as a pp said, that two highly educated and trained people who literally spent over 10 years working toward our career goals would be in this position.

[Ruthiegirl]

Ouch. My sympathies to you and your family. Dh is a professor and we have been going through some painful, lean years here, too. I wait tables a couple of nights a week. I chose a high-end restaurant that I like a lot and I make decent money. I average $200 a night, work 2 nights a week and take home enough pay to keep up with the mortgage. Dh has taken on some addition editing work ($20 and hour) as well. He gets up at 4:30am and does 2.5 hours each day.

We each chose this kind of work to help supplement, because we can do it without paying daycare costs for our 2 children. It is hard, but is working. Our house is also for sale, but the market is flooded here with too many houses for the small number of buyers.

Your situation sounds difficult, but I imagine that over time it will improve dramatically. I kow the pain you are feeling. We lived a long time accruing credit card debt that is only now getting paid off. I should say this loudly though -- it is getting paid off. We are turning things around. Over time, things have gotten much better and each year gets easier. Dh is up for tenure in 2 years and then he gets a big bump in pay.

I would imagine your dh will go through a similar rite of passage. This forum is an excellent place to find tips on further ways to cut costs. Small things really help. Line dry your clothes, track your expenses very carefully and account for every penny. And hold tight, you can make it though.

[Eman'smom]

It's hard isn't it, you think we've worked hard, life will get easier when x is over (for us it was the phD) but the thing is it hasn't gotten easier.

[McFeelings]

I remember living VERY lean when my mom (also an MD) started her practice. Can you help him with setting up the practice? Design slides and brochures for him so he can give talks to civic groups? I know my mother did a lot of talks at nursing homes, schools, large businesses, physical therapy places, etc. to generate a name for herself in the community without advertising. People like to go see doctors they know.

On weekends we worked at the office. Setting up files, decorating the waiting area, etc. It was hard work for all of us.

Also, is there a nearby medical school where your husband can work as a member of the clinical faculty? The pay is usually next to nothing but the credential can help boost a new practice.

After 30 years, my mom is THE doc in her specialty in the community. She has a 3-month wait and doesn't even have to deal with insurance companies.

[betsu63]

Come to Canada!!!!!!!!!!!! I don't know how much malpractice insurance is but I'm sure that it wouldn't be anywhere near that. He would have no problem getting a job and probably you too.

[kwarwick]

Hugs to you....not much support to offer, just an ear and a shoulder, and while it doesn't make it better, there are others of us out there in the exact same situation as you.

DH has been in practice for over 10 years, and in the last 4, we've watched his malpractice rates skyrocket (with no claims against him) and insurance reimbursement rates crash. Really crash. He's getting paid less than ever before, and our family has gone from living a very comfortable lifestyle to thinking of selling our house, putting his student loans in forbearance (OMG, I shudder at the interest accruing), living on half of what we used to, laying staff off, etc, etc.

We have barebones health insurance, a $5000 deductible (the only thing that helps with the premiums when you're self employed!), and pay cash for our health care (thank goodness we're a healthy family!).

Some things we did to cut expenses, maybe some of these will help?.......raised our insurance deductibles (health ins, car ins, homeowner's ins), started checking out DVDs from the library vs. Blockbuster, started getting books from the library, did a price list at the grocery stores, started buying bulk, really paid attention to where we were driving for things to conserve gas, using coupons, trying to find free or inexpensive entertainment to do as a family to not feel deprived. They sound simple, but we weren't paying attention to those things before. (plz don't slam this anyone if these things seem like second nature to you! just trying to help and relate)

I don't have any other suggestions other than check this forum for great ideas (this has been a great resource since we've been in this situation), check out the Tightwad Gazette from your library (outdated a bit but great ideas), and stay committed to your children, as we can tell you are.

It sounds like you're doing great things, and remember to breathe. Any time I get anxious or angry about it, I breathe and refocus on the present, the most important things....our health, our family, my DD, my DH.

And, I know no one wants to hear this, but healthcare in this country is going downhill fast. The insurance companies and big business / hospitals are getting richer, and the great independent doctors are being forced out. Scary for the patient is what it is. Not even going to get started on this soapbox..... I could rant for days, but that doesn't help you. My DH is actually in school 3 nights per week right now, going for a new profession. It's crazy, a blow to his ego, his dream, his committment to seving his patients, but he just doesn't want to practice this way anymore. We know so many doctors in our area that have left for other states or left healthcare entirely. It's terrible, because they were really great doctors who helped their patients greatly.

I hope you find some good solutions, and again, hugs to you. PM me if you'd like some more support or to vent.

Remember to breathe,
Karen

[Nickarolaberry]

Wow, Karen, thanks so much for posting. Sometimes it seems like I live in the twilight zone. People who know my dh is a doctor -- a surgeon, no less -- look at me as if I've grown an extra head when I say we're in dire straits. The truth is we weren't doing fabulously well when he was employed, but that was mostly our own fault ( we let ourselves get suckered into too big a
mortgage, and between that and the med school loans which are over $2K a month, consolidated, we were barely making ends meet).

But now? Seriously dire.

I don't think we can go to Canada for a whole lot of reasons. In the past couple days we have looked into moving out of state, but the realities of getting licensed and hospital privileges somewhere else make it a better bet to stay put and try things out here, at least for the moment. :

You're not the only one who can go ranting and raving for days about the medical business and how it really hurts patients when docs are basically forced out of business by the hospitals and insurace companies...

My dh will get a reimbursement from medicare for a surgical consult...$18. No joke. A hernia repair? From medicare...$250. Similarly with other "bread and butter" surgeries like appendix, gall bladder, etc. Ridiculous. He'd make more money charging people for the kind of home repairs he does on our house. What does that say about all that training? I dunno, but the one specialized surgery he does do will be the money maker, if we can get things going. The other stuff will be supportive and for patients' benefit, but definitely not for making a living. When you have to make more than $150K out of the gate JUST to cover malpractice and health insurance, never mind pay living expenses or med school loans, something is seriously awry with the system.

Sigh. I have already done a lot of frugal things in the past (6 years of residency training will teach a mama how to push the frugal envelope, : ).
We do a price book, cloth diaper, don't do disposible products really at all, make our own cleaning supplies, go mostly meat-less (we eat chicken once a week, on Shabbat), clip coupons, redeem cans, buy used clothes and goods as much as possible, etc. I'm not sure how much farther I can go with it, although I'm sure there's always room. I do like to buy my family organic milk and dairy products if possible; there's no way they'd go vegan, and I would be really loathe to do conventional dairy, but I may have to. :

Anyway. Thanks for the hugs. I need them, keep 'em coming.

[skueppers]

I don't know how it is for surgeons, but my father has always worked for a hospital, where his malpractice insurance is paid for.

It's true that he's never made the big bucks, but we always had a comfortable middle-class lifestyle when I was growing up.

Is something like that possible for your husband?

[swimswamswum]

Has he looked into getting his loans repayed through the NIH? There is a program where health professionals' loans are repayed when they sign on to work with populations with major health disparities. I know someone who had something like $200k forgiven from this program. This was last year, but I think he should look into it.

I am sorry you're all going through so much.

[Mizelenius]

Originally Posted by Synthea™

Dude. Something is seriously screwed up in a society where 2 highly educated people can't get a job or start a career.

No kidding!!!!

[AdoptChina]

A few years ago DHs company decided they wouldnt cover health insurance anymore so we had to get insurance ourselves...and for a family of 10 that isnt cheap lol. We found the best "deal" (for lack of a better word) by joining a local chamber of commerce...that enabled us to get a group rate rather than an individual one. Still insanely expensive but better than other options

Just wanted to post in case it might help you

[Nickarolaberry]

The Chamber of Commerce idea is a good one. It doesn't come out much less expensive than the COBRA option we have now through dh's old job.

It's also possible that through my part time teaching job I might be able to buy into a health care coverage option that is less expensive.


However, things are up in the air again with my fall job. Because of the hours, it's possible I won't even be able to afford babysitting (I need to be there more hours than I'm teaching, but won't get paid more...I just get paid by the class period I teach).

I may be looking into homeschooling again and trying to find more online work. I have about 20 resumes out for online stuff that I've found but so far, no dice.

DH is out shmoozing primary care docs to build a referral base. Sigh.

I have another question, about cars, but I'll ask it in another thread. Thanks!

[LeBoof]

I know you said you'd seen the site for WAHM. Have you checked out http://www.moneymakingmommies.com She has job listings and support for mom's wanting to work at home.

Oh, and you can also try looking at some of these other websites. They all offer free online joblists for telecommuters. Some seem to have more listings for IT work than others but they're all worth looking at.
http://www.telecommuting.cjb.net
http://www.tjobs.com
http://www.workaholics4hire.com
http://www.sohojobs.org

As far as the university level jobs, don't just look for strictly online universities. I know the University of Maryland has an entire section that's online, so does the University of Texas and I believe the University of Denver as well as several of the colleges around here. They may be willing to hire a prof who's in another state and it should work the same as any other job application. Just specify ahead of time what you are looking for.Some colleges may even have a separate job listing for telecommuting jobs under the online dept. heading.

I sure do hope this helps you out some.

LeBoof

[lenore80]

Has he looked into working for the state as a surgeon or doctor? I would check out your state's website for job openings.

[smudge]

I am so sorry you guys are dealing with this! People are still in the old school mindset of doctor=rich. NOT THE CASE.
He should check into Public Health Dept. He may (like a PP said) be able to get his loans dealt with. There is also the military. The Army paid for nursing school for me. I know they have programs that will take care of the loans once you join, basic training for a doctor would be a breeze compared to what I did, as he would be an officer going in (Capt) and not a Private like I was.
In the military, your housing, health and dental would be taken care of, as well as the malpractice and patient referral base.
Anyway, just a thought.

[Nickarolaberry]

We will look into the Public Health Service. My dad did the "Berry Plan" during the Vietnam War and we were posted to Jacksonville, FL for a few years. His best friend from residency did the same thing and went to the southwest and worked on a NA reservation.

The thing about the military is complicated. We looked into it when he was in medical school and it was somewhat convoluted as a surgeon. Worth exploring, but unlikely.

Surgeons also don't make great "order followers"