Saturday, February 23, 2008

Wake Me Up Before You Go, Go

In my younger years, when this song first came out, I sang the next line, "...don't leave me hanging on a lively yo-yo." Hee. What exactly a "lively" yo-yo is, I cannot describe. What can I say? I wasn't the champion lyric interpreter that I am today. This song got stuck in my brain because, you guessed it, someone woke me up before he went (went). Mr. Whoo had an early morning service commitment that required him to be up and out of the house before 5:30 am, and CindyLou took that as a clue that she needed to be awake, too. Telling a 3 year old that it's too early to be awake just doesn't fly when Daddy is already up, showered, and out of the house, so no sleeping in for me! I am soooo sleepy, but Mr. Whoo and CindyLou are napping, and the Bean is happily awake. No rest for the wicked! He and I are hanging out, watching Tivo'd Ameri.can Id.ol. (We are just at the end of the group sing, and....Jazz Hands! Hee. The Bean seems to favor Michael J.ohns, maybe he has an ear for this sort of thing?)

It has been a harrowing week. I have had a couple of really sick patients. One patient had HELLP with platelets dropping into the teens before she finally turned the corner. The other patient got a high spinal instead of an epidural (!) and we were *this close* to having to intubate her. Luckily, the worst of it was that she felt particularly crappy and was incredibly numb from the chest down for nearly 3 hours. Basically she labored right down to the perineum before she could feel too push. She had a happy, healthy baby, didn't feel a thing for another 2 hours, and, thankfully, has no residual effects from the misplaced anesthetic. Yikes. I feel like I have worried enough this week to sprout several gray hairs. It also seems like all of my March babies are preferring to be born in February instead! I am on call this weekend, so I am hoping the next couple of days are more low key.

I've been thinking of what my ideal practice would look like, as my contract is coming due in the next year. Something like a true group practice (shared OB patients, but individual GYN pts), with 4 or 5 docs, each with one 24 hour "labor deck" call during the week (which would include all labors/inductions/rounding for the entire group for that day, with no office duties), the day post call off, maybe doing surgery during your call day, and doing office the other days of the week, taking weekend call every 4-5 weekends. Sounds nice, but I am unsure if it exists in a workable form. We love just about everything about where we are now except for the call coverage (or lack thereof) and the office manager, of course. I am going to initiate some discussion now, so that we don't have to scramble at the end of the contract for a new place to go, should it come to that. Hopefully it won't, and we can work out an acceptable deal. On that note, Bean just filled his pants...during Paul.a's new video. Another sign of his ear for talent? I think, yes. Have a great week!


Margaret Polaneczky, MD (aka TBTAM) said...

What youa re describing is a typical group practice these days, not unusual. What you are doing is unusual, and I imagine, untenable for much longer....

C said...

Delurking to tell you it does exist! I live on the east coast (Boston area) and work in a 9-member practice. I'm taking call once a week and in the office the other days (unless I'm post call). We don't do majors when we're on call (it's busy enough) but other than that, I think we're meeting all your criteria. And....we're looking for new docs! :)

I probably earn less than you, and that can matter a lot on the East Coast where housing is expensive, but the lifestyle is great. Reading your blog has taught me to appreciate my great deal. (You seem to do a wonderful job, but gosh, you work harder than I do).

Taking Heart said...

Our hospital is searching et interviewing OBGYNs right now. We have two small community hospitals, and Dr.s that all have their own practices, but work together for call. It's nice. I hope you get what you are searching for.

Daf said...

I haven't ventured into the world of Docs with Blogs yet but am loving yours so far (really dig the name, too)! I've kept mine completely off-limits for work-related posts but would like to add you to my blogroll, if that's aiight with you.

I'm out shopping for a new gig myself, and have a shopping list very similar to yours. Group of four minimum (taking OB call at least - I wouldn't mind a larger group at all if more senior docs chose to do just Gyn), love the dedicated day for OR and covering the board, etc. Fingers crossed that we both get what we want!

Anonymous said...

Please, can someone help me understand life as an Ob/Gyn? I'm a 3rd year med student at a big university hospital and I've mostly only been exposed to academic Ob/Gyn, where the attendings really seem to have it relatively easy, but only in comparison to the residents. I couldn't go into OB if it's like obgynkenobi. I'm trying to decide between obgyn, family and peds. I want the 'ideal' job that obgynkenobi is describing, and it sounds like it does exist... but how hard is it to find, and what kind of money would you be making? i really appreciate your help.

dr. whoo? said...

tbtam~ You are right. Something has gotta give. My CV is back in circulation, just to see what may be out there. It is a shame, we were led to believe things were different here than than they are in actuality. Better to move now than when the kids are in school, I imagine. Sigh.

chavale~ Wow, that sounds dream like! Unfortunately, the area is too far away from family for us to consider, or you'd be getting an unsolicited copy of my CV ;)

Money is important, but not the most important, for certain. And, if I do have to leave this area, I leave this job with $200,000 of my student loans paid. That alone is worth some of the rough lifestyle I've endured over the last few years. After residency, I can do *anything* for 4 years, you know!

Thanks for de-lurking and for letting me know that such opportunities exist. It gives me hope!

the nurse~ It was supposed to work that way here, sharing call, etc. Except it just didn't happen. The OBs in this area are all very competitive with one another (strange, because there really is a lot of business to be had). I feel like I sort of got sold down the river, so to speak. We shall see. Thanks for the good wishes...I hope so too! :)

daf~ Hello and welcome, glad you are enjoying this corner of the blogosphere so far! Please feel free to link away. I will put in a reciprocal link, if you would like, as well!

Yes, it seems that they are out there, now it is just a matter of finding them. I wish you the very best with your search as well!

hi 3rd year student~ Don't panic, my life is not necessarily typical of the profession. More or less I am a solo practitioner with call coverage (sort of) sharing office space with another solo practitioner, both employed by a community hospital. It wasn't what I signed up for, either.

As you can read above, there are better lifestyles out there, with call schedules and salaries running the gamut, I am sure. Do what you will love to do, even when you are working like a dog. If you love the work, it makes even the worst days bearable. Good luck!