Remind me tomorrow
 

of that dream, that golden ring I reached for. That laughable ideal. The big idea, the fulfillment of a professional and personal goal. Today it was made crystal clear that's not going to happen. The ship is going in another direction and I don't have a ticket. I've been played for a fool, so sorry, you've been outsourced, we're not picking up your option, we're going in another direction ... but in the meantime, kindly carry on picking up our shit. Until we find someone cheaper, then we won't need you at all.

Yeah, my employer just funded the assholes who fired me in 2011 so they could hire cheaper, incompetent labor - just completely funded them and used MY staff to train their employees - to directly compete with my practice. My employer has funded the setup of three fucking urgent care centers to compete with me for Occ Med, so they can be open 84 hours/week as opposed to my 48, and MY budget is paying for THEIR radiology techs and half their office expenses. I have begged and pleaded for more staff and funding to meet the need, and this is my answer.

Oh but wait - before I flip them the bird, I have to remember that I need the health insurance that comes with this job. No one will insure me with a recent history of cancer and expensive treatment, not unless I'm in a big employee group. And if the RepubASSHOLES get their way and repeal the ACA, no one will ever insure me again, God forbid I cost the insurance companies anything. Taking a big leap of faith in the next year or so is likely to land me in a pile of 'So sorry you aren't related to a rich RepubASSHOLE family; you'll just have to go die somewhere, preferably quietly'.

And, I have no other immediate source of income. I am three months from qualifying for long-term disability (could be key if/when I get sick again). I am three months from qualifying for FMLA (ditto re getting sick again). If I leave a job after less than a year, it looks like shit on my CV, which looks like shit already due to taking time to raise my children and look out for their needs through autism, bipolar disorder, schizophrenia/schizoaffective disorder, and GAD/ADHD. You'd think that shepherding children through those minefields would be considered respectable on a CV, but it isn't.

So. Dream's defunct. What next? I'll be right with you ... vision's a little blurry. Fuck it.

I'm sorry they cut you off at the knees, it sucks, but don't take it personally, it's business.

It sounds like providing more hours in more locations would be a plus for the customers, while incompetent care providers is certainly a minus. It's likely the people calling the shots are not concerned with quality of care, they're bean counters looking at the bottom line. Finding ways of Meeting corporate obligations cheaper, is SOP these days.

Yes, that's it. Just business to them, and quality has no role to play. But to me it's something I've invested in. Now I have to decide whether to continue being a part of it, whether to hang on and garner them more business (and continue to have health insurance and an income for a time) or cut myself loose before they do it for me. They've planned some great office space in their new building strictly for Occ Med, I planned it for them actually - for free, duh. It's the carrot they dangle. Now I suspect they've planned it for mid-levels.

I know a great doc at OSHA in DC who developed a wonderful Occ Med practice at University Hospitals in Cleveland, and once she'd gotten it busy, tons of clients, working with mid-levels, the bean-counters decided to go strictly with the mid-levels and let her go without notice. She warned me about working for medical centers, as did others.

Shit Ortho that does suck but as I've said before. "I'm shocked to discover gambling in this establishment."

If you look at that wealth income disparity graph I posted and flip it over you'll see how I recently realized it should be viewed, as a funnel showing where all the money flows. It's hard to imagine that the medical field, once a bastion of stability and guaranteed income safety has also fallen prey to the MBA idea of profit is the only thing that matters. Basically we have become a country of people run by sociopaths. I'm still in the job market, going to Voc Rehab now to try to be trained for a new profession. 20+ years training and experience as a photographer and the industry has pretty much vanished. One of the stupid jobs I applied to (CVS shelf stocker) required an hour long, pver the internet assessment just to submit an application. IT was essentially a meyers briggs sort of test with something like nine parts, each of which had been tweaked to be reflective of stocking shelves at a CVS. After all that I didn't even get an auto-reply. FFS

The rate at which everything is changing and the rate at which the money in the economy is getting sucked down that funnel makes it nearly impossible to anticipate what sector isn't at risk for outsourcing. I just heard a story on Vermont Public Radio about the restructuring of the 911 dispatchers to reduce the number of centers from 7 to 2 and have them serve a dozen counties with a fraction of the staff. The reason was "it would save a lot of money."

First, the obvious. Who the actual fuck thinks a dispatcher who is unfamiliar with the area being served is going to be helpful at all? Not any of the cops or firefighters who called in. At that rate they might as well outsource it to India,

"Yes, good evening. I would like to thank you for calling 911 emergency services tonight, My name is Karen, how may I provide you with excellent customer service today?"

"Hello? 911?"

"Yes. This is Karen, at 911. May I ask you what is your first name, please?"

"John."

"I would like to thank you again for your patience, John, could you please tell me what is the nature of your emergency today, please?"

"I'm bleeding very heavily, I've cut my arm, everything is going black."

"I see. I am so sorry to hear that John. Could I please get some information from you about where you are calling from at this moment?"

"East Cupcake, Vermont."

"Thank you for that information, John. So you are in East Cupcake, on what street?"

"Elysium Boulevard, just off the Brachial artery... Hurry."

"I don't see Elysium Boulevard in East Cupcake, what other towns are nearby? John? Hello? This is East Cupcake in Hew Hampshire, correct? John? Hello?

In a few minutes you will receive a follow up phone call from my supervisor asking you to rate the quality of this call. I hope I have given you superior customer service today. Please call us anytime at 911 whenever you have a life threatening emergency. Thank you once again."


Then there's the issue of "saving money" WTF does that mean? It means spending less money in your own fucking town. With 50 people out of work that's a lot of groceries and hardware store visits, fewer haircuts, renters, you name it. The money isn't "saved" it's being taken from the town and flushed down that funnel.

As always, I continue to hate everything.

911 op reminds me of the HAL 9000 (or 5000, whatever the fuck it was).

Would you be eligible to continue your current health insurance at your own expense under COBRA?

Yes, but only for 18 months. At that point any insurance company that can ditch me, will.