juggling

Last year at this time, I was looking forward to graduation and a new job that started in September. That new job carried with it an excellent guaranteed salary and a one year contract. The salary is there for me to live on while I build my practice, get my name out there, and get known by the community. Any money that I earned by seeing patients and operating would be deducted from the amount given by the hospital, all while keeping my salary level the same. I had high hopes that by this point in that first year, I would no longer need to draw any money from the hospital.

But then the economy turned to crap, people lost their jobs and their insurance, and those who still did have insurance didn't want to have non-urgent surgeries because they would need to take time off work. I'm still drawing a large amount of my monthly salary from the hospital and am trying to figure out what I'm supposed to do when my contract is up in September.

If I stay in the area (not necessarily with the same surgeon) for three years, I don't have to repay the hospital. They decided to invest in me and my business. But if I leave, I need to pay back what they gave me to supplement my measly earnings. Sounds fair. Here's the thing. My receivables are not enough for a salary, let alone sharing expenses with another surgeon or starting up my own practice.

The surgeon I'm with now wanted me to pay half of his expenses. (Which, by the way, is exorbitant, according to several knowledgeable sources, considering where I am in my practice development.) That would be $10,000/mo. Most previous months, I haven't even made that. So that option is out.

Another seasoned surgeon is in the area. But he's solo and has been for quite some time. He was recently sharing space with another younger surgeon, who just recently moved out. He's not ready or willing to share space with another new person quite so soon. (There are also some very crazy personal dynamics going on between him and the surgeon I currently work with, but there's no need to explain all that.) Bottom line: that option is out, too.

There is one other surgeon I could share space with. But he's got space in the brand new medical office building, which has very high rent. I'm not even sure if I could afford to work there. Besides, he's unhappy with his experience at this hospital and is actively seeking employment at a nearby hospital. So he might not even be there for much longer. This option is questionable.

And that's it. No other surgeons to share space with. I'd need to leave. But to make leaving doable with the salary repayment I'm going to have to do would mean that I would have to get a nearly impossibly high salary somewhere else.

I'd have to move. By myself. Because Daniel is nearly a partner at his firm; he can't move now. There are a couple of surgeons in my hometown that would love to share space with me, but they can't offer me a salary. (They wouldn't even charge me expenses to begin with!) I'm waiting to hear back from a couple of hospitals about what they can do for me. But I doubt it will be high enough to offset the "cost" of leaving my area. The only plus about being in my hometown is that my mom, sister, and some old friends are still there. I wouldn't be completely alone.

The other (less desirable) option, is to do work that is called locum tenens. Which basically means I travel around the country and fill in for a month, three months, six months... while another surgeon is recovering from an illness, traveling, or whatever. The biggest thing there is that I would be completely isolated. And not building a practice. And not having a guaranteed income once a job was done.

I have no idea where I'm going to end up and all these possibilities need to be kept open... all the balls need to be in the air simultaneously. Needless to say, the whole thing has got me stressed to the max. Not sleeping well, nightmares, waking up early freaking out (and, I hate to admit it, crying more)... all that.

I've been told I have good hands, but I'm not sure how many more balls I can juggle at once.