Saturday, August 16, 2008

what's up with rich's job?

that has been the $64,000 question at our house (and if that question was only to cost us $64,000, we would have been very happy people) over the past several months, and now i think there is an answer.

to recap: rich has worked like a dog for the Corporation ever since we got here; two years prior to that he was doing his second fellowship which also required an insane amount of hours (like 80+ regularly, but it was expected and we knew it would end). so we have had four years of him working 60 to 80 and beyond hours a week continuously with few breaks save those for medical conferences. then, on my 40th birthday, he formally quit his most hated (by me) job with the Corporation. it was an outstanding gift. we spent about a week trying on the idea of him staying home for a year, because he has a wicked evil noncompete clause, and while i would have loved that he clearly would not have been comfortable. so we spent another week trying to figure out if we could withstand a half-million dollar judgment against us if he were to work and violate his noncompete. that didn't sit well with either of us--basically we would have had to leave the state for him to go into private practice for the rest of his life somewhere else to afford the payments, so that wasn't a solution. then, we spent a week trying to find a solution in another state, which also didn't pan out. finally, i think i developed clinical depression and became absolutely of no use whatsoever to anyone so rich had to work directly with the attorneys and the Corporation and he worked out a deal.

rich is still with the Corporation, and he is still there all the time. he signed another contract. but over the course of the year he will be transitioning from Corporate medicine back into Academic medicine, which is really where he should have been all along. he was trained as a medical scientist and the Corporation has no use for that--so a rather large part of rich's skills, and i hate to say it but his identity as well, were being disregarded. he really had few options at the end of the day to leave--we couldn't afford the fee, which was of course the whole point of the noncompete, thus he has to stick it out for another year.

i'm not terribly happy with the compromise, but my understanding is that the Corporation isn't happy either so i guess it's all good. however my reasons for dissatisfaction are completely different than Theirs--i'm not looking forward to the continued domestic absence of rich and the Corporation isn't looking forward to the multi-million dollar annual loss they will endure in rich's impending void. rich, however, is perfectly happy--he wanted to leave slowly so he could treat his patients that need more immediate care and he wanted to start slowly at his new job so he wasn't overwhelmed (again). we have learned too much about how Corporate medicine works over the past few months, and i have to say, it is an ugly beast.

stay healthy, compa├▒eros.

one thing that kills me in all this is that there is absolutely no ethical consideration in any of this. ethically, it is right for rich to practice his particular super-subspecialty to the best of his ability, regardless of the wants of a Corporation. he should be allowed to leave a private practice if he so chooses to go into a public practice that would allow him to treat any patients he wants--particularly those without insurance or who are otherwise not going to receive any medical care at all. this is one exceedingly rare instance where i believe the state should legislate ethics--it is in the state's best interest for rich to switch from private to public if he so chooses (and he would be taking a pay cut to do so, so this isn't a money thing), so why not afford him some protection against a noncompete judgment? if you have a physician practicing anything--primary care, tertiary care, super-subspecialty, etc.--and they are grossly underrepresented in the state (as rich is--he has a patient base of around 2 million people, which is almost 10 times what the average oculoplastic surgeon needs), then i truly believe there should be legislation to protect these doctors from leaving the state just because they are done with private practice and want to go into primary indigent care. but that is just my opinion, and we all know what opinions are like...

so that is the very long version of what is up with rich's job.

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