Greetings (Dr Wife is Stresssssssed)

Hi all, I was just directed to this website from another location. It's nice to see that there are support groups for the spouses out there

My wife is the doctor in our family (I'm the computer guy). We threw in a lot of stressful situations all at the start of our marriage (Moved in August, started her job in august, married in september, started my job in october...).

I do need some advice and help on a situation here...I'll just copy and paste what I posted on another site:

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My wife is a Family Practice Doctor, I'm not (I work with computers, most MD stuff confuses me). She suffers from OCD and stresses out very easily. Residency was not an easy time for her but she made it through. Now she's 5 months into her first job in the 'real world'. It is a position at a clinic (outpatient I guess you'd call it) working for a larger hospital.

She is absolutly stressed out and hates this position. When I say stressed out I mean exactly that. She has actually missed several days of work because she can not stand to return to work, this morning she was finding every reason possible to delay going in. At the moment this is a new clinic, she's seeing 10-15 patients a day, but the upper management wants them to see even more 20-30, with 30 being the 'best number'. She panics at handling just a few patients right now.

She does have OCD, and is taking medicine for that and depression. She has even told her shrink of thoughts of 'more drastic actions' that have us a just a tad bit worried there. At the present time it would be a miracle if she managed to finish out her one year contract.

I have no doubt in my mind that its imperative that we get her out of this position and into something less stressful and more suited for her. The problem is, I don't have a clue what this would be. She is too stressed out to give any serious effort to finding new options, so it's fallen upon me.

Not being a doctor, I don't know what options there are. She has eight years of schooling and over 100K in loans. Working in a clinic like this is not going to work. She has done some urgent care work, but the jury is still out on weather that's better or not. She's investigated some insurance work, but they keep stating theyd like 3-5 years of clinical experience.

Can anyone give me suggestions or direction on a search here? Career consuling (who?), alternative jobs? I've heard of several case reviewal things, but I dont know anything further on those.

While we're on it...are there any Physician specific support groups? I dont believe there are any in our town, so I suppose online groups would have to do.

I am truely desperate for any advice and direction here. This has been going on for two months and has not gotten any better, and at this point my own health is being affected.

Thanks.

H

[rainbabies]

[fluffhead]

Hi H, welcome.
Sorry to hear about your predicament - it sounds like a very stressful situation for you, and of course for her.
I have a friend who is a FP doc who got sick of the whole clinic scene, and went to do locum tenens. He got a gig with one company (several locations within an hour of each other) which keeps rehiring him, and he ends up working about two-thirds of the year.
I don't know if this would work for you guys - it's pretty spotty work, and you might be more geographically restricted.
There's also moonlighting at hospitals? Maybe she'd be more inclined to have less commitment to a job at this point?

I hope things get better.

[Sheherezade]

I'm so sorry to hear that you got through training only to end up in a *more* stressful situation! I know that there are physician support groups available, although I don't think they necessarily lean towards OCD. I can't recall them at the moment, but I will check in to it and post as soon as I find a link or two.

I agree that you need to help your wife out of this job situation. Clearly, this is not her gig. Can she get any advice from her medical school alumni office? You might also try your national organization (AAFP? just guessing!). They might have resources for job alternatives. I know some docs have gone the insurance/HMO route but you've already checked in to that. You might also consider legal offices that deal with med malpractice and biotech/pharm research positions. (Just some ideas.)

As for you....hang in there. It's only a year. Hopefully, the two of you will escape your current circumstances. Sometimes just planning that escape can help you cope with the day to day stress.

Thanks for the suggestions all, I'm scribbling down a few of these to give to her this evening. (Happy VDay honey, here's some alternatives :b). I know she has checked into an urgent care thing that her company does, which may be an alternative, but she needs to look into it some more.

I've worked in a corporate environment quite a bit, but my most recent experience was with a bankrupt company, so things are a lil twisted. Her company is constantly on them about numbers and other policies (See 20-30 patients a day each, try not to treat everyone and refrain from refering people if possible, if you have to refer, do it to an insystem/related doctor).
Right now their biz is slow (3 docs, one nurse prac) as they are a new clinic in a new city (Another hospital has the majority of the business there). Only a few months ago did they finally start advertising.

Is this sort of thing common amongst medical practices (namely the see lots of patients and don't refer people bit)?

Her residency didn't make them see tons of patients, but 15 in a day wouldn't have been a stretch. I was (fortuantly?) living eight hours away from her at the time she was doing residency because of the job situation. Right now it seems like I have to get her OCD thing under control, cause it just makes the situation worse :/

[DCJenn]

You know, it's not uncommon for the docs to not find the 'right' match with the first job out. We've had quite a few people here whose spouses have broken contracts to get out from under the insanity. Or had countdowns until they could renegotiate or LEAVE.

If she's medicated for her OCD, is it time for a small uptick? at least for the short term?

Would research appeal more to her or would she miss the patient contact? A smaller clinic setting or a private practice vs. a hospital setting?

What's the penalty for her leaving? If it's not so bad- then run like the wind, as her sanity and yours are in the mix here.

Jenn

I know I hated my first job out of college and swore I'd never go back to computer consulting....and I've tried to get that across to her. Takes a bit :/

I have been considering making a count down calender for her, to give her something to look forward to. Might just have to get to work on that today.

As for her meds, I do think they are upping it, just slightly. It helps a tad bit.

I know research is an option...i'm not sure if it'd fit her or not, we need to give some of that a serious thought for a bit.

Lastly...I don't know the penalty if she gets out of her contract early. I know we'd hate to move, having just bought a house, and I just got settled into my job. :/

I think locum tenens or a "house officer" gig would be a good option to research. The house officer people basically cover services that are not covered by resident, so do shift work on the floor, rather than a clinic setting. That could be something she's more comfortable with.

It may end up being that she needs a slower practice -- small town kind of thing. Larger corporations are always going to be focused on the numbers.

Good luck to you.

[Sheherezade]

Is work as a hospitalist out of the question for a FP?

I know her group has hospitalists, but I'm not sure if it's something she's into. I guess she has some bad memories of hospital work in residency

Another question, sorta on the same topic: I can't remember the last time she sat down and read a book just for fun. Everytime I see her reading it's a book related to work, or a journal, or some other article. She has a book she received for Xmas in 2004, but it's still sitting there unread (heck, I read it first).
Is this a common thing? Do MDs find they can't sit down and read just for fun?

[DCJenn]

Re: the fun factor-

My husband has an computer game that he plays when he needs to destress, but as for reading an actual book for pleasure? He's reading the Chronicles of Narnia now, but only AFTER he's studied and completed a chapter in a Board review book per night. So, I'd guess he's getting about one page at a time completed.

The last time I remember himm reading a book for pleasure, other than on an airplane was at the beach in 2001. Seriously.

He does exercise but I"m not sure that counts as fun since the Army expects him to pass the physical every six months.

Jenn

SO reads books, but also doesn't own a television. We also read the local paper and NY Times over coffee on weekends when he's off and when it's warm enough to sit outside (so, figure about a dozen times a year). Mostly he reads journal articles related to whatever resarch he's involved with.

Thanks folks...at least I know she's not the only one struggling to find free time
Of course, now she has a fever of about 100, so it's a lil easier at the moment (lots of sleep )

[Laker]

I don't know how those of you with a spouse with significant call can do it. DW is on IM now and is miserable. No sleep, working on morning report presentations when not working, jerky attendings. I rarely see her. Totally sucks. We are counting down the days until this internship year is over.

I have so much respect for those of you dealing with med/surg/family/ob/gyn significant others. It takes tons of sacrifice and determination.

Keep it up.

[smiley]

Sorry to hear about your struggles, but hopefully together you two can find a solution. If they can work out a her medication it will probably put her in a better frame of mind.

Do you know anything about the rural FP practices, usually they actually repay student loans and tend to allow for smaller patient loads. The ones I worked with usually saw 15 per day. Another thing to think about could be the doc-in-a-box, I would think since they have such a high percentage of cash paying (vs. reimbursement) population there would be less reason to force an increased pt load.
Good luck with everything.