He is the physician assistant (PA) to a spinal surgeon, Dr. Stouffer, but is training with several neurosurgeons as well. They have clinics in St. George and Cedar City, and do surgeries in hospitals in both cities.
It took a verrrryyyyyy long time to get this job. Mark's brother asked him, "Why didn't you get the ball rolling a little sooner?"
OH BUT WE DID.
Okay, let's start back nearly a year ago, around June 2014. Mark was contemplating finding a second job for financial reasons. Having Isabelle cost a fortune, we couldn't afford health insurance (we have been completely without it for 7 months), we didn't have a drop in savings, let alone retirement, and things we needed to replace couldn't be replaced. We are up to our eyeballs in debt from PA school and things just weren't getting any better.
We got a call from my brother Tyler, who is friends with a spinal surgeon, Dr. Major. He pulled him aside at church and asked if Mark was looking for a job. (Mark had shadowed Dr. Major several years ago and was offered a job then, but couldn't take it because of his new contract with the National Health Service Corps.) Mark talked with Dr. Major and he said that in August, a couple new neurosurgeons were coming to the practice and they needed more mid-levels part time. He would get back to us when he knew more.
In August, Dr. Major called Mark again and offered for him to join the practice, and it would be full time instead of part time. Mark told him that his NHSC contract wasn't up till January 25, 2015, and Dr. Major said they would be willing to wait for him. Mark accepted and we were very excited! At the time, the IHC job listing was for a nurse practitioner, and it needed to be switched to a PA position. (Both are mid-levels that do essentially the same things, it was just a minor detail.) "The listing will be up in 2-3 weeks."
Mark's office at Premier, as he had started to empty it out.
So then Mark and I had to meet with the whole management team at Premier Pediatrics, where he worked for 6 years. He was meeting to negotiate a few things with them, but the new job offer came at the same time, so we decided to tell them that he would be leaving in January. (I had to sit there during the whole thing and it was so very awkward. But it turned out fine.) We were not allowed to talk about him leaving for a few months, though.
Since this all happened 5 months before he was supposed to start his new job, they had plenty of time to hire some new providers to replace Mark. It was agreed that his last day would be January 23rd and his first day at the Neurosciences Institute would be January 26th, 2015.
Fast forward 5 months......
IHC never posted the job listing, so Mark could never apply for it, so the job wasn't official. We have no idea why, but there was one particular person who was supposed to be in charge of making it happen, and they refused to return phone calls or keep us updated on anything. Every few weeks, Mark would try and make contact, and the few times he managed to get through, they'd always say, "Wait another 2-3 weeks." We gathered from the listing (that was still up as a nurse practitioner
position) that Mark would need current certifications in BLS and ACLS
(basic and advanced cardiac life support) in order to apply. So a few
weeks and several hundred dollars later, he got those certifications so
he'd be ready to go.
At one point in November, we actually just drove down to the office and he tried to just pop in to meet with someone. They kept him waiting for an hour and no one ever came out to meet with him.
We gave up and went to lunch and then went back over, and this time we were able to meet with the office manager and one of the neurosurgeons. They assured us that the job listing would be up by Thanksgiving and we'd have everything squared away by the end of the year.
November came and went.
December came and went.
Most of January came and went.
STILL NO JOB LISTING.
We were at our wit's end, and Dr. Major, despite being the senior surgeon, had no power over this. He did manage to get someone to START on the process of getting the job listed, but then we were told that it had to be approved through like 6 different channels of people. The office manager, upon realizing that Mark was supposed to start in two weeks, said, "Oh! That's not possible! I hope you've made arrangements with your current employer to keep working there." WHAT THE @$%@#$Q%@#$?!
But Mark's replacements at Premier Pediatrics had already arrived--he couldn't keep working there. January 20th rolled around. Finally:
The job listing!! I had been checking like 10x a day for months. I hurriedly applied for Mark. (Or so I thought...)
Three days later, Mark's last day at Premier arrived. He had really loved working with kids, and he was an extremely popular provider. Every day, a mother would be brought to tears when he told them he wouldn't be back for their next appointment. (True story.)
This also marked the end of his time with the NHSC, which saved our behinds by paying back 2/3 of our $150k PA school loans over 4 years. (If you are a doctor, PA/nurse practitioner, nurse, mental/behavioral health professional, dentist or hygienist and can work in primary care in a rural or medically under-served area, look into this program!)
We still hadn't heard anything from IHC, but Dr. Major said to just plan on showing up on Monday. Until we found out that that wasn't allowed...he wasn't an official employee yet. Sigh.
At some point during his first week of unemployment, someone finally called, only to tell us that Mark's application was never received! WHAT THE )@*#$%($#@*^$%?!
So then we had to apply all over again, and this time there were several more pages to fill out. When I'd done it before, after I filled out a bunch of pages, I uploaded his resume, and it brought me back to the home page and I thought I was done. Nope.
About a week after we submitted his application for the second time and he was interviewed: The official job offer and contract arrived!! We had been told that once his contract was in hand, he could start shadowing at the clinic and operating room.
NOPE.
At this point, we were contacted by corporate IHC, who said in no uncertain terms that he was not allowed to set foot anywhere until his credentialing was done, which typically took "about 12 weeks" and "Official start date is June 8." (WHAT THE #*Q$%^(@&#%^?!) But we were going to be sent a large packet of paperwork to get things started, and the sooner we got it done and sent back, the faster the process would go.
TWO WEEKS GO BY.
We never received the packet. We finally called and figured out that they had sent it to Mark's old work address!! The manager there at the time didn't know what to do with it, and so stuck it in a corner and didn't bother to inform us. When we called, a new manager had taken over, and she couldn't find the packet. Mark offered to drive the 300 miles to SLC to get it from headquarters. So then the corporate lady says, "That is a long way to drive! I can just email it to you."
WHAT THE *(&#%$(&%^#$(&%?!
So we got all that #*^#%$(@# paperwork done in like 3 hours flat, and submitted it.
We finally got a welcome letter from corporate. Welcome, you're hired, we're glad to have you, "You aren't allowed to work until credentialing is done, and on our end you need to allow 4-6 MONTHS." WHAT THE @!%^@#$*#*#%)&*#$_@%^*_(&%)*^?!
At this point, nervous breakdowns were occurring all around. We were just so frustrated and upset and angry, especially because the people at his new clinic KNEW that this would be a long process and yet totally ignored us for 5 months, when they could have, SHOULD have been working on all this.
Mark tried to stay busy (I put him to work on a lot of projects) and he took temp jobs with my dad, with a local hotel changing beds and with a cabinet shop in Hurricane. The only way we were surviving was thanks to a big tax return that we got. We were supposed to use that money for other things, but survival came first. About a month and a half in, I applied for WIC, food stamps and Medicaid to help keep us afloat.
We were able to spend a lot of time as a family (in Zion on President's Day, which happened to be a free day) and that was nice. But still there was a lot of frustration at our circumstances. It was hard because the both of us would get stopped wherever we went and asked how the new job was going, and he hadn't been able to start yet.
Our friends and family were very supportive during this time. My brother-in-law's mom, who is a nurse in St. George, put us in contact with the Medical Staff Coordinator for the hospital there, and she immediately got to work getting us temporary privileges set up. If we had met her sooner, we might not have been in this mess!
Oh, I forgot to mention that Mark has been an affiliate at the hospital in Cedar for 6 years, and had worked in the labor & delivery department with all the new babies. It is an IHC facility....they had credentialed him 6 years ago. It is in the SAME corporation. WHYYYYYYYY they couldn't just give him immediate clearance for the other facilities as well is beyond me. (A few times, corporate would come across his IHC work records and remark, "You're already in our system! Huh!") Ugh. Anyway.
Mark had to be approved by three different Boards of Trustees (one of which only meets quarterly) so that he'd be allowed to work in the two hospitals and two clinics. As a matter of fact, he still hasn't been approved by them all yet. But we were able to work on getting him temporary privileges in the meantime.
So we've spent the last two months waiting, doing paperwork, waiting, MORE paperwork! Phone calls, emails and faxes and yes, more paperwork. Blood tests. Drug screenings. References. College diploma and medical license checking. They were waiting on a reference from Mark's previous attending physician, Dr. Dowse. He faxed it over, but all they got was a blank fax. So that was another bump in the road.
At some point, it finally did dawn upon corporate (a.k.a. "Medical Group") that this guy they were getting 10 emails about per day needed temporary privileges! He had already been granted them by Dixie Regional (hospital in St. George) and Valley View (hospital in Cedar City) but Medical Group needed to grant them too in order for him to be allowed to see any patients in the clinic or the OR setting.
Finally....FINALLY....they said he could attend New Employee Orientation on March 16th, one week ago.
We were so excited that we hung out on the lawn to greet him as he came home from orientation.
Mark is going to be in training for the next 6 months. He is having to learn spine surgery/orthopedics as well as neurology and neurosurgery, what to do in the clinic, how to do rounds in the ICU, etc.
He had two days of orientation last week, and then three days of surgery and clinic. They meet at 6:30 am, and Mark has an hour drive to get there, so he has to get up at 5:00 and leave at 5:30 am. So far, he has been working about 12 hours, plus driving 2 hours, getting home around 7:15 pm. It has been exhausting for him and exhausting for me to be alone with the kids all day! I've had a low grade headache ever since he started.
This job is a big change for us, but we know that it will be good in the long run. Mark has always wanted to work in surgery and is very excited about that aspect of it. Standing for 4-5 hours at a time is tough, especially since sometimes he has to wear 3 lead aprons the whole time (because multiple x-rays are taken during certain procedures).
Most of what he's doing is assisting with spinal fusion surgeries, which is where they fix compressed vertebrae. They have to stick wedges in between, do bone grafts and put in titanium rods and screws. He has assisted in a couple other procedures, too. The other day, he had to stand and hold a guy's spinal cord while the surgeon was drilling around it. "Don't move or you'll paralyze this guy for life." No pressure, haha.
Practicing sutures on pigs feet last night.
While the hours are long, we are hoping that eventually he will be able to spend 2-3 days a week in Cedar City, so he won't have to commute. We will be getting family medical/dental/vision coverage, a 401k and a pension plan, all of which we have never had before. He will get paid per mile for his travel, they will cover testing and licensing and continuing education fees, and once his training period is done, he'll get paid overtime (everyone seems to work at least 60 hours a week). Not to mention, his salary is higher overall.
It's a good thing we don't believe in fate or bad omens, otherwise we would have given up on this job a long time ago! It has been 7 days since he started, which was 7 weeks after the date we THOUGHT he would start, and 7 months since the offer from Dr. Major.
Now we just need to get that first paycheck on April 3rd. Then I'll really be able to heave a sigh of relief.
