Hand to Hand Combat

My life, at the moment, is divided into three spheres. Namely, being someone's wife, some people's mother, and on the side, trying to make some money. The balance between the three seems all the more elusive with each passing day, and thus, Hubby and I talk a lot about these three issues. I have also been trying all sorts of permutations with the three spheres. Sometimes, I rent out my children as a solution, managing spheres 2 and 3 simultaneously... just kidding.

Mainly, I have been messing with my work schedule. In the two years since I left residency, I feel like I have done it all: Inpatient for the insured, Inpatient for the indigent, Outpatient with the indigent, Outpatient with the insured. Of all these things, they all have their pros and cons. As much as I love inpatient work, and as good as I am at it, life style wise, it is just too hard for us. To be on call, being woken up at night, rounding on weekends... Not for me. I understand most of the physicians out there routinely do this, but not me. As much as I like working for the indigent population, the craziness of an ailing public health system can make it very unpleasant at times. Sometimes, like yesterday, I seriously was considering yelling during a staff meeting... But that is another story for another time.

Both of these options, while difficult for me, are both really important. There is a shortage of psychiatrists for inpatient services and community mental health services, precisely because the schedules are hectic and the work envrionments are nutty. (At the agency I am with right now, there are four vacancies!) Besides, I chose medicine not because I wanted to fully serve myself, but because God calls me to serve others. But where do I draw the line?!

I really like my private practice, simply because people actually GET BETTER. I like it so much so that I actually joined a network, and now, my schedule is getting filled up (which brings another issue of: What am I going to do when it is so full that I am going to need more time for this endeavor?), and I am discovering the joys and the pains of being a contracted physician.

For instance, this morning, I was engaged in Hand to Hand Combat on the phone and the internet. I spent about two hours trying to figure out the difference between certification # vs. authorization #. Then enrollee # vs. subscriber #. I thought I was going to need a sedative! Of course, I could have hired a billing service for this, which I did when I was doing inpatient work. However, as the goal is to work fewer hours and make more $, I figured I should be the billing service, if not forever, at least to figure out the system and know what actually happens (or not happen.)

What else is weird, is that insurance plans sometimes outsource the mental health portion to others. For instance, even if you have Blue Shield, your mental health coverage may actually come from United Behavioral Health. Also, these health care plans are merging all the time! Life PacifiCare is now going to join United Behavioral Health, and they are going to be called Optum.

I can't keep up with this, but I am going to try.