Monday, February 18, 2008

OB-Gyn in trouble

I love being an Ob-Gyn. It was the only rotation in med school that I really truly could see myself doing as a job. Having said that, as time passes, I see more and more the dark things are going to get bad before they get better (sorta like residency, if you think about it).

Solo Ob-Gyns are a dying breed. It's not the call - it's the overhead! Even my practice (3 docs, a CNM, and 2 PAs), the numbers are now starting not to work. We've been looking at the numbers, and there's little to pare. I practice in a "red alert" state, so our malpractice insurance is a large expense. We docs actually pay ourselves less than the mean and median, so cutting there (although possible) is not a viable option for long. We have a great staff, but they're running close to maximum output. We're considering eliminating the match on the 401K, but that won't help a lot. I do make a profit, albeit barely.

I could add more hours. I value time with my kids and husband. I could squeeze in more patients. But I like my schedule as is - 30 minutes with a new patient is not a luxury with EMR, it's a necessity (especially those who come in with a long list of meds). (EMR is a whole 'nother rant)

So I'm at an impasse. I'm technically not a partner in the practice, I'm employed. My contract will be up in the summer. They would like to keep me but the writing is on the wall. Do I go to the hospital and become employed? Do I move back to where I trained, as they are looking (I've seen the ads in the Green Journal)? I talked to one of my former attendings, he said they would love to have me back on faculty. I haven't burned any bridges anywhere. I've talked to the Chief of Staff here, they would be interested.

Lots to think about. And I need to get moving, so I have a contract in place and a plan.


dr. whoo? said...

Ah, no advice, as I find myself in a similar bind in the coming year-and-a-half. You say that the "writing is on the wall," but have you asked directly? What do you *want* to do? I'm asking myself the same questions; it is definitely not easy. All I can offer is best wishes on your upcoming decision. :)

ER's Mom said...

Yes, I have asked directly. The docs I work with are wonderful and have kept me in the loop (not like yours, from reading your blog). Our office manager sat me down a few weeks ago and told me that things are going down.

rlbates said...

Good luck to you.