My Thoughtful Spot

job hunt

Here's the next installment in the saga for me to find work that pays money.

Two weeks ago, I went on an interview in northern California. The city is two hours away from the Sacramento airport, up a winding, twisty, two lane road. In other words, quite inaccessible to Daniel, who would be frequently traveling to see me from southern California. Other than the location, everything was wonderful: the hospital facilities were excellent, the other physicians (surgeons and otherwise) were young, friendly, and welcoming, and they were very excited at the prospect of having a young female surgeon join their ranks. In a few weeks, they will be sending me an offer letter. But I have to keep looking because it's just too far away. If nothing else turns up, I'll take it, but I'm afraid that I'll feel stranded. It's truly a rural setting; the town has no stoplights, one stop sign and a Walmart as the biggest shopping experience.

I have another interview this week in the Central Valley of California, which is where I grew up. The benefits of this job are immediately obvious; if Daniel can visit or I can't get away for a bigger trip, my family is close. My mom is ecstatic about the possibility that I could be an hour away from them. And that doesn't bother me; they understand that I have to work very hard sometimes. I'm keeping my fingers crossed and, even if they offer me less money than the other opportunity, I'm going to take it.

You might be wondering... why is it so hard for a surgeon just out of training to find a job in California? The answer isn't simple, but a big part of it is that the California legislature, in it's infinite wisdom (insert sarcasm here), decided that it should be illegal for hospitals to employ physicians directly. So that means that I either need to find a large group of surgeons to join and they are going to pay me money, or the hospital has to give that group some money to help support me in the beginning. But this latter arrangement is how I got into the mess I'm currently in. The hospital just doesn't give away free money. They sort of make you an indentured servant for the "gift" of a salary. You agree to take this money, then you have to stay in the area for 2-3 years to pay it off. The problem is, if the situation is bad, and the year is over and you can't make money any more, you're stuck, or have to pay it back.

While I'm not looking forward to having to pay back a year's worth of salary, it makes sense in the long run to leave. Here's an example: I wouldn't stay in one place, making no money for three years, just to forgive a debt of $20 when I could go somewhere else, make $100 in the same three years and have to pay the $20 back.

These two jobs are unique in California in that they do not have the repayment part to working there. I get a salary and a W-2, just like most other people. In fact, I won't be agreeing to any more repayment options ever again.

where to begin

My career. I'm not even sure where I should start. I could start at the very beginning, in which case it would be helpful if I had a time machine and I could tell myself not to begin this whole persuit of medicine and helping to heal others because it's not worth it.

At the end of last month (on vacation, actually) Daniel and I came to a realization. To be more precise, he already had the realization, I needed to catch up, did so, and then we came to a mutual understanding. My practice is going nowhere. Treading water. Sure it's not sucking any money out of our personal finances, but all my marketing efforts have yielded no increase in patients, resulting in me not bringing home any money in six months. This is a hobby. I could make more money working at Sephora.

This leaves two options: 1) If the hospital administration is very interested in seeing me as the new generation of surgeons here, they can step up and provide me with a base salary for a few years or 2) it's time to move on.

"Moving on" can mean so many things. Move to another hospital in the same area. Move to a place that is an hour or so away. Move hundreds of miles away. Move to another state. I'm considering the latter two. Not because I want to, but because I have to. There just are not any jobs for bread and butter general surgeons out here, the hospital recruited me prematurely and there isn't enough work. Southern California is blessed and cursed with so much: sunny days, beautiful people, traffic, smog, lots of hospitals and lots of doctors. So I need to go to where the work is.

Lots of people have to do this in their careers and I'm not spoiled enough to think that the perfect job will fall out of the sky into my lap exactly where I want it to be. But usually, when someone has to do a large move for a job, they get to go with their family. I, however, would not. Daniel was just made partner. And while he can do more remotely than he could when he was an associate, I would be naive if I thought he would be around for a majority of the time. It's just not realistic. Medicine doesn't lend itself to telecommuting, so I'd be relatively stuck.

Back when we were planning our lives, there was one important piece of information we overlooked. In order for Daniel to have a successful career, he needs to work in a metropolitan area. In order for me to have a successful career, I can't.

I have an interview this Friday in northern California that is one hour and 45 minutes away from the nearest airport. While it's not my first choice, it's my only interview so far. One of the other opportunities I'm hoping will work out has a small airport and is within 3 hours driving of home. Bonus here: it's about 40 minutes to my family. So when Daniel couldn't visit, I could potentially hang out with my family.

I don't know what is going to happen, but things are in motion. Sometimes I'm excited. Mostly I'm scared. But I'm trying to be brave.

missing: motivation

Right, so I've obviously been not posting. It's just been a tough week for me personally. My business continues to lie squarely in the "failing" column. I'm having body image/fat issues. Both of which combine to make ME feel like an utter failure and a complete drain on my small family.

I'm going on vacation on Saturday, which I'm excited about, of course. But I'm also kind of stressed about it. Whenever I go on vacation, I very easily gain at least five pounds. In a WEEK. That is just not an option this time. It can't happen. And if I'm not at work, I'm actually making less money, if that is even possible. So the vacation is a mixed blessing. I hope that I will be able to let some of these feelings go; I really will feel worse if I ruin an entire vacation.

I've got to get it together. Somehow.

decking the office

Since I just opened my doors a few short months ago and am still having some cash flow issues, I wasn't able to get any festive decorations this year for my new office. Not that I would have gone all out, but I at least wanted a small tree with some lights. But I haven't brought home any money since August, so even a $5 decoration seems like an extravagance. (That's right, my assistant makes more money than I do at this point.)

If I could, though, I would want to start with this; it's $10 at our local grocery store. It fits me in my office well...

It was a rough day of non-operating (= no revenue) and bookkeeping today.

new office

Two out of six rooms are painted and I still need new flooring, but since I don't know when the rest of the work is going to get done I thought I'd post some pictures of my new office! The captions go with the picture above it.

This is my only set up exam room. Bought the exam table for $150 (new ones go for about $1,400) out of a guy's garage, courtesy of Craig's List.

This is the exam room with a view from the corner by the cabinet. Chairs from Ikea, $50 each.

Here's the reception area, as viewed from the front desk. Chairs from Ikea ($99 ea), tables from Ikea ($8 each), and flowers from Restoration Hardware (gimme a break, they were 50% off!).

The reception area with a view of the front door/window.

This water fountain is on one of the reception tables. Fountain $20, tray $15 (Pier One).

Here's a close up of the fountain.

I also have relaxing, spa-type music that can be heard in the reception area. I basically want people to feel relaxed. Well, as relaxed as one can feel before they meet a surgeon. I also realize that many of them will have to pee, but at least they'll be at ease.

Once I operate more (i.e., earn more money), I can put stuff on the walls. I'm not sure what exactly yet, but I do know it will involve some flameless candles.

final office move

• All my stuff was out of his office on Friday morning, with the exception of the phone, since my new phone line was supposed to be installed Friday morning. If I wanted the medical assistant to answer the phone for half a day, he wanted me to pay a full day's rent. I told her to forward the phones to the answering service and that I would not be paying an extra day's rent. The douchebaggery persisted until the bitter end.

• During a move, when having friends share the same physical space as you is helpful if not imperative, I realize how many of my friends are remote. Normally making such a distinction would never enter in my mind, but I can't carry a desk down stairs and across a parking lot by myself. Fortunately, I had one friend who could help me for a few hours on Thursday. Aside from that? Just me.

• For years now, Daniel and Steven (brother), have successfully convinced me that I can make computers explode with a simple touch of the mouse. So I was actually really worried about setting up my brand new, all-in-one printer/fax/copier/scanner. But I did it. Well, almost all of it. I can't get the fax to save directly to a file instead of printing out on paper. But my brother couldn't either, so THERE.

• To fix aforementioned (I love that word) problem, my computer/network guy told me to go to Fry's and get an external fax modem, whatever that is. I had never been there, and going on a Saturday night is even more of an interesting experience than normal. Now I know where the non-gang Asians spend their Saturday nights.

• Changing cabinet hardware on 63 doors and drawers without a drill takes a very long time.

• Is there a special trick to changing a toilet seat? There's a handicapped one on right now, which is horrid; I must change it. But I see no screw head or anything. If I figure it out, I'll let ya'll know. Cuz I know you're dying to find out the answer.

• You can't keep a wireless modem on the floor or next to the computer. You get a less reliable signal and there needs to be at least three feet of space between the modem and the computer. At least that's what the guy from AT&T said after my internet cut out for about 10 minutes. Who knew?

• I have one eyelash growing from the upper, outer part of the lid. There is no natrual curve and it slopes down. Then it grabs onto the lower lid's lashes, creating a very odd sensation and getting in my field of vision. In my dominant eye. Couldn't this wait til next week, ladies? sheesh.

• The hospital is working on getting bids from contractors to re-do my floors. The carpet is really nasty and who knows when it was last changed. I want hardwood throughout, but especially in the exam rooms. Where I do procedures. With exposure to body fluids. Enough of a picture? Right. When they finally do get a bid, I am really not looking forward to moving all that stuff out again. Likely by myself.

• It's been a ton of work, and I know the hard work isn't over. But I honestly don't mind. And now I have a new outlook on why Walt Disney would bend down and pick up trash in Disneyland -- because he was proud of what he created, he worked hard to make his vision come true, and he didn't mind getting his hands dirty to keep things nice.

new office

Last Friday I signed the lease for my own suite. That's right. My. Very. Own. Don't have to share with assholes others anymore. This is the big news to which I alluded earlier! There was a huge hang up, first with the legal department of the hospital and then with the current owner of the building. They wanted more rent, the hospital wanted to give me a break, etc., etc, which I why I didn't want to say anything, lest the whole thing fall apart. Keep in mind, the absolute last day I can be in my current office is 10/31. If it fell through, I fully intended on pitching a big tent in the parking lot and practicing medicine out there until they could figure shit out.

But I don't have to! I signed my lease. I spent the weekend going over finances, walking miles upon miles in Ikea and Home Depot, and trying to move a >400lb exam table without a furniture dolly. (Won't be doing that again. Thank goodness there was another man in the medical building who was nice enough to help us.)

I have an allowance for "tenant improvments," which I would like to spend on new flooring and paint. I wanted a hardwood type vinyl (is it called pergo?) but the facilities person said that it would likely be over my allowance. How much can new flooring for 800 sq. ft. really be? I'll even paint myself, I told her. We'll see. I just can't have carpet in the exam rooms. I do procedures in there. Blood. Pus. Body fluids. 'Nuff said.

If I have my head on straight in the mornings, I'll remember to bring my camera so I can show some before and afters. I'm excited!

new chapters

I don't want to jinx anything, but I think that I'll be starting on yet another new chapter in my work life. I won't talk about it until it actually happens, though. Sound a wee bit superstitious? Not only am I a surgeon, but I'm also a baseball fan. It's pretty common knowledge that baseball fans are highly superstitious, but surgeons are pretty high up on that scale, too. Combine the two? Woah.

I've been having a lot of new chapters in my career lately. Might seem unstable, but I think it'll all work out fine in the end. (Unless, of course, you consider the health care bill that passed the Senate Finance Committee today. Thanks, Olympia Snowe, for selling out Republicans and doctors across the country.)

Stay tuned  for some good news... hopefully very soon. The suspense is killing me!

cute or smart?

When Daniel and I were visiting my family a few weeks ago, I had the chance to have the ultimate girly moment with my sister: we put our make-up on together. So we're there.. chatting, laughing, painting... and she pulls something out of her bag that caught my eye with a sparkle. Glitter eyeliner. I simply had to try it. And decided as soon as I was going to get home, I was going to get some for myself.

I've seen the sparkle make-up trend before and actually participated by buying glitter mascara to go on top of regular mascara. But this? This was COOL.

But then I started thinking. Glitter make-up is pretty casual. And I experience enough age discrimination at work. ("HOW old are you, exactly?" "How long have you been a doctor?" "You look so YOUNG!") So I decided not to wear the glitter eyeliner when I see patients in the office to discuss surgeries. But the other days, including days in the OR, I thought could be glitter optional. I didn't want it to destroy any credibility as I described how I was proposing to cut into someone; I get it.

One morning, all giddy from the glitter on a non-office day, I posted my sparkled-out status on facebook. Most people were supportive and loved the idea of a diva doctor. But then one comment really struck me: "The sad part is that the first impression of cute will make people think ditsy and then you have to prove yourself. I would recommend a white lab coat, hair in a bun, and glasses."

I always wear a white coat because I get tired of being mistaken for a nurse. Not that there is anything wrong with being a nurse, but that is not my degree. That comment goes way beyond glitter eyeliner and implies that someone who is pretty cannot be taken seriously and should "ugly" herself up if she wants people to think she is smart. I resolutely refuse to play the school marm role. If the Fox News babes have done anything for we women, it's shown that you can be both hot and smart.

friendly surgeon seeking office. works well with others. really.

Needless to say, after I found out that I was being kicked out, again, I was not in a good place. I was so relieved to get out of the situation with the older surgeon; things had gotten really bad there. So bad that I don't really feel comfortable going into gory details here, but trust me, it sucked. When I finally got everything set up with the younger surgeon I was happy. I felt safe. Sure, it was hectic, but I knew that the work I was doing was going into my business. My practice. Even if I was sharing space.

So when I was asked to leave because the younger surgeon didn't want to share, I was really angry. REALLY angry. I would fluctuate between wanting to hit a wall and crying for about 36 hours.

I immediately told the hospital administration. Not that I'm running to tattle on him or anything; he can do what he wants with his practice. But I needed their help. I needed to know what my options were. Where could I go?

There was no way I could coherently discuss the situation the day I found out. And I had surgeries the next morning; I needed to focus. As I was waiting for my patient to get into the OR, the hospital administrator called me. There was an opening in one of the medical office buildings -- a small suite at a very reasonable rate. I instantly felt better, even though I had agreed to nothing. At least there would be a place for me to go.

During the next few days, Daniel and I discussed our options. There was no other general surgeon in the area I could share space with. I would have to start asking some nice, friendly primary docs who might have space. And there was the option of just opening my own office in that recently vacated space.

The benefits of sharing space are obvious: I don't have to buy exam tables and furniture and I might be able to share an employee and avoid becoming an employer with all the horrible regulations my lovely state puts on employers. But at some point, I would have to move out. And moving sucks. That's one of the main benefits of opening in my own space. But I don't have enough furniture for a whole office, which would mean we would need to tap into our savings for opening expenses. But no moving again if I chose not to. My space. MINE.

I'm taking the office. I'll be getting a moving allowance for renovations, since I signed a three year lease. It needs new flooring and paint (badly) and I'm hoping I'll have enough of an allowance for hardwood flooring.

I'm hoping to sign the lease some time this week for a move-in date around 10/1. Even though I have 60 days technically to move out of my current situation, I have NO desire to stay where I'm not wanted. Come on October!

P.S. The best part? The office I'm taking is right next to the older surgeon. It's just going to burn them up knowing that I'm running a successful practice on the other side of their wall. Bwahahahahahahaaa.