Thursday, August 02, 2007

bringing home the bacon

So even though on paper, Joe is getting paid more now as an attending than as a resident, we have done the math and it seems that in the end, our total household income is going to be about the same this year as last. True, an attending ophthalmologist with a private office practice could potentially make a buttload (I believe this is the financial term used in the Wall Street Journal), but Joe's stint as an attending ophthalmologist is more of a patchwork solution that he cobbled together to give him something to do while I finish my last year of residency and while he works on Plan B. He is working as an attending supervising residents at two academic medical centers in the city, and is the "consult attending" supervising residents seeing inpatient ophtho consults on the wards at [Downtown Hospital]. He can also staff surgical cases generated by these consults, and sometimes he can even get paid for doing these surgeries, but it's not consistent, and since he's not in solo practice with his own solid patient base, it's not like he's generating a constant stream of high-paying surgical cases or anything.

In addition, now that he's not a resident anymore, he has to start paying back his student loans. (You can defer paying back your loans while you're a resident, pleading "financial hardship," but after you graduate, you're fair game.) So that takes a huge bite out of his pay. And sadly, despite this, at the current rate of loan-paying-back (there must be an actual word for this), I don't think we're set to square away his tab with Uncle Sam until the year 2026. No, I'm not kidding. Hopefully, when I finish and get a real-ass job, we can step up this payment schedule and we can pay it all back sooner, maybe in five or ten years instead of twenty, but man, that's a big bill. Marry the man, marry his student loans.

But despite all this, Joe and I would still be making a net income approximately equivalent to what we made last year, when we were both residents. Except for one thing. Joe has been working for a month, and he still hasn't gotten paid yet. Apparently, [Downtown Hospital] only pays its clinic attendings once a month. I don't know how this is possible, but I guess for most attendings, who actually have private offices, their clinic salary is probably only, like, 10% of their total income, not 75% as Joe's case. It can easily be changed over to a once-every-two-week pay schedule, but Joe has encountered considerable resistance to this change from the administrative staff, as that would involve them actually having to expend energy above their basal metabolic rate. Also, there's all the paperwork and bureaucracy of starting a new position at a new hospital, each office blaming the other office for the delays in getting the proper information processed. So it has now been a full month, and my little resident paycheck is the only thing that is keeping our family afloat. And let's not forget that 95% of my paycheck goes to pay our nanny. (The remaining $50 a week is for buying crack. Or food. But mostly crack.)

I was almost inclined to be understanding towards the staff of the administrative offices at [Downtown Hospital], who insisted that it was out of their hands, and that there was nothing to do but wait for some mysterious higher-up office to process what they needed to process, but then this administrative assistant said to Joe yesterday, during his umpteenth query with regards to getting paid for his work, "Well, I was on unemployment for two years, and I was fine, so you will be too."

OK, so HOW DOES THIS MAKE ANY SENSE?

  1. When you're on unemployment, you get a check every week. Or every two weeks, whatever. But the whole point of this is that Joe has not gotten paid at all. How are we going to feed our kid, woman? He can't eat stolen hospital Jello cups and reconstituted beef flavored bullion forever, you know.
  2. Forgive me if I'm getting unecessarily insulted by this point, but Joe is not unemployed. He is an attending physician at an academic medical center who is, frankly, getting underpaid for his work. I mean, theoretically, if he ever got paid.
  3. Is there any more complacent answer that indicates, I know it's my job to help you, but I would rather not because it would involve moving more that saying, "Don't worry, you'll be fine"? I thought not.

Joe has talked to her supervisor and to everyone he can think of to talk to, but everyone so far is pleading ignorance. And I would be shocked, when the paycheck finally materializes, if it were actually in the correct amount, as this piecemeal system of picking up clinic shifts does not seem conducive to the administrative office actually keeping track of all his activity. Joe himself is obviously keeping track, but we frankly cannot afford to have him fighting for pennies every single month because these administrators are allergic to doing their damn work.

For someone whose job it is--whose whole reputation hinges on being efficient and diligent and accountable for her work, this kind of bureaucratic inertia is beyond maddening.

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