From the Private Sector to the Corporate World

Thought I would give an update on Jared’s NEW job.

Monday morning, on 8/11, at the New Hire Orientation, Jared was met by a three-woman entourage. They marched out to welcome Jared specifically to the St. Joseph team and shared how thrilled they were to have him there. He spent all day in hospital training. Even Sister Penny (the nun that interviewed him) spoke and told all about the history of St. Joseph and the order of St. Francis. He had some HIPAA training. He was the only Physician Assistant (PA) there. Most of them were paramedics or Medical Assistants. He did find out that while he’s accruing his Paid Time Off (PTO) he cannot use it until 90 days have passed (that’s about the middle of November). This put a big damper on me flying back to Oregon for Elissa McCullough’s wedding reception and Jared’s plans to go to a Dallas Cowboy game when his parents come for Cooper’s ordination to the Priesthood the end of October. [When he mentioned he was hoping to go to a Dallas game, the three women exclaimed in their southern accents: “Oh yah gat ta goh to tha Stadium!” They said they’d make it work so he could get the time off for that and pull whatever strings they needed to because it's worth it go to "the Stadium!", which cracked him up. He said if they could swing anything, it would be so I could go to Utah for Elissa’s wedding, which was very touching to me. I guess it’s true that the Dallas Stadium isn’t going anywhere any time soon J]

Later that day he spoke with his entourage who informed him they got approval to have eClinical Works up at his rural site in Madisonville. This is the electronic medical records system Jared’s been using in Oregon for the last 7 ½ years. Because he’s so familiar with it, Tina, the director of Occ Med, fought the administration to get it put in place for him. It would make the occ med portion of documenting SO MUCH EASIER—otherwise it would all be by hand and paper charting—he hasn’t done that since his college days! In addition, his supervising physician can easily access files and charts remotely. It was an exciting announcement and I’m so grateful they pushed to get this system up in Madisonville!

On Tuesday, he met with the supervisor over mid-levels (they are called advance practitioners her or AP, so Jared is technically a PA and an AP) Kim, who was the first person from St. Joe’s who Jared spoke to back in March. She is very laid back and open to suggestions and ideas. There was another PA there (also named Kim) and the three of them chatted about nuances and the clinics in the areas and they had a very enjoyable lunch meeting J

On Wednesday 8/13, he was supposed to do billing/coding training but occupational med (occ med) is different with pre-employment forms for physicals that are billed to the companies as well as the work injuries and all the paperwork associated with those.  Apparently, there are people at the hospital who do all the referrals and coding for him. So that’s REALLY nice!! Because of this, he stayed in Bryan (where the hospital is located) and shadowed his supervising physician, Dr. Howard at his office. Jared was actually able to see patients and do physicals. **As a side note to our Oregon friends…Dr. Howard’s son lives in Portland and is a chef at the restaurant “Screen Door” where southern cuisine is celebrated. We’ve never been there, but talk about a small, small world!

On Thursday, the slated training was for the electronic medical records system (eclinical works). We got a laugh out of that, but Jared did learn a few things that he didn’t already know. Jared mentioned to the trainers that I had actually flown to San Antonio last October for the eClinical Works National Users Conference. Their eyes got big and they quickly asked, “So what’s your wife up to these days?” Kim, the other PA Jared had lunch with earlier in the week, spoke for him, “She’s raising five babies!” J Before the training started, there was a super early meeting, like at 6:30 or 7:00am. Jared went dutifully. It wasn’t long before I got a text from him which read, “So I’m the only one here.” Thinking back to a time when I was the ONLY patron at a session in the temple (which was on my birthday so I thought it was actually really cool!), I texted back, “Is that a little awkward, being the only person for the speakers to address?” He texted back, “No, I mean I am the ONLY person here.” What? Not even the presenters showed up? Later he texted me and said that a corporate guy had showed up and talked to Jared a little bit. He asked Jared if he had taken any ICD-10 training (ALLLLL the medical codes are changing by October of next year and it’s seriously going to be a nightmare…for everyone…so don’t be surprised when none of your medical claims don’t get paid because the providers have to be SOOOO atrociously detailed. It’s insanity). Jared said no and the man gave him a paper with some information and told him that if he took a 2-3 hour training online, Jared would get a $600 stipend. SWEET!!! We can use that money to replace the iPad that JJ dropped and shattered on the front walkway, the day we moved in while we were unloading the moving trailer. [The hardest part of moving in to a new place…not having anyone to watch your kids while you direct box and furniture traffic].  Jared shadowed Dr. Howard some more and even though he’s not quite payer credentialed yet, he learned the ins and outs of occ med and got paid to do it! However, as luck would have it, Jared started working right after a pay period ended so we had to make our last Oregon paycheck stretch THREE weeks instead of two. But tithing works every time! We were blessed to have more than enough AND the paycheck was direct deposited into our new bank account…something we thought would take a few more pay periods. We also get paid on Thursdays here, instead of Fridays. Which you wouldn’t think would be a big deal, but for some reason, not having to wait until the very last day of the work week to get paid, makes a huge difference!

Thursday afternoon, Jared had a lunch meeting with Reed, the regional administrator of the Madisonville Hospital. Reed echoed the sentiment that they are SO excited to have Jared here because they’ve tried several times to get this occ med clinic up and running but it’s been touch and go for a long time. They just couldn’t “lure” someone there who was willing to stay at that location. With 30,000 annual, tax free reasons, we took the bait! And with the influx of the oil and gas companies moving into that region, they are tired of sending their employees all the way down to Bryan for their injuries or pre-employment physicals, etc. Jared does feel some pressure to at least get this program up and running during his two year contract for loan repayment (maybe longer if approved). But graciously, Reed did tell Jared not to worry though if the program can’t get off the ground. If it doesn’t work out, they would find another place for Jared to work. Which is nice…but this is the spot for the loan repayment! They actually mentioned this at the New Hire Orientation too. That St. Joseph doesn’t like turn over and they would rather move people around to different spots within the system than let them go. I’m not worried. They think they know Jared, but they haven’t seen what he can do or how great he is with patients and people. That’s why I wish they would have taken a chance on him and added him to the clinic in Navasota where apparently they had too many providers and not enough patient volume. He could have helped build the business there. But, I know there are bigger forces at play here, so I won’t complain.

Jared spoke with the marketing director, Celeste, shortly after his lunch meeting with Reed. She said Reed called her immediately after he and Jared had lunch and said emphatically, “Oh yeah! Jared’s great. We definitely have the right guy for the job.”

On Friday, 8/15, Jared drove north to Madisonville (to the critical access hospital) and he saw his new  space—which is attached to the itty bitty hospital. There are two exam rooms, 1 small area for vision testing and at that point they were still trying to create an office space for him. It helps to know this is only temporary. The geriatric/psych group will be moving out  of their current space and Occ Med will be moving in sometime next summer. They share the same campus as the hospital, it’s just a different building. Across the small parking lot from the future space will be rehab so Jared will be able to send his patients to PT right from there, which is nice and convenient.

Jared spoke with Reed again and despite Reed’s initial “no worries, we’ll make your employment with us work no matter what happens with Madisonville,” he told Jared, “Sooo, we’re kind of running a deficit here. We need to get things going as soon as possible.” I guess once Reed realized how good Jared would be, he felt he could be more forthcoming about the situation. Tina, the director of Occ Med, told Jared, “Don’t you worry about that. You just see the patients.” J

Jared learned that Dr. Howard is over all the Express Care facilities (urgent care), which is awesome, because a) Jared can get a foot in the door for picking up an extra shift every once in a while and b) Jared is already linked to Dr. Howard. If there was another doc over these facilities, Jared would have to go through more corporate/state hoops (a pain and time-consuming load of paperwork more than anything) to add himself under another supervising physician. The only problem, is that Jared found out his payer credentialing won’t be in effect until October 1^st, which was later pushed back to October 15^th. Whoa! That means he can’t see any work related injuries (a good 90% of what makes up occ med) until after that date. Nor can he work at an express care.

The mega commute and solo flight in Madisonville began about 10 days ago. He started on his own in Madisonville on September 8^th. There will be about five weeks where he’ll just be doing physicals. Not ideal, but at least he’s working. I’m so grateful for that! The EMR is set to go in the second week of October so that will hopefully be in place right around the time he can start on the work related injuries.

During his first week of employment, Jared also learned that St. Joseph is about to become part of the Catholic Health Initiative which is a huge umbrella for health systems. Once that happens, we will be the 3^rd or 4^th largest hospital system in the country. Typically that also expands more coverage for employee benefits too. So we’ll see.

Additionally, there’s a rumor of a PA program being started at Texas A & M in the future. If so, that could possibly provide some teaching opportunities for Jared down the road. Jared had been offered a faculty teaching position at Pacific University the week before we found out we were moving, that he sadly had to decline.

One of Jared’s apprehensions about this occ med venture was put to rest. He won’t have to schmooze the oil and gas companies by himself. He’ll go with Celeste (marketing) during his regular scheduled office hours to do that.

On Saturday, 8/16, Jared had to take his DOT certification exam. He started the online training in July when we were apart. It was brutal...so many details to remember. He was worried about taking the test because even the physicians had trouble with it. The average passing score for the docs is 70%. Jared passed at 79%!

Before we got our first paycheck on 8/28, Jared got his very own business cards! In case anyone wants to call or email him J

Since his first day in Madisonville, Jared had one or two patients here or there the first few days. On Thursday last week…no one. On Friday last week….no one. He and his temporary nurse/receptionist, Jana, spent their days moving their limited furniture around, finding other furniture in the storage area, and setting up the space and exam rooms. He got a tour of the hospital. This Monday, he saw…no one. Tuesday…Jana was going to be gone with no patient prospects. He had a Meet and Greet Breakfast at the hospital Tuesday morning and before it was over, around 8am, some of the supervisors he works with said, “Oh, hey, do you need to get going up to Madisonville?” He said, “My nurse isn’t going to be there today. It will only be me and we have NO ONE scheduled. Is there any filing I can do while I’m here?” He was trying to avoid the inevitable. BRUTALLY long days for someone who is used to seeing upwards of 25 patients a day! Yesterday, however, he saw A patient. I told him not to keep the patient too long. That he’d have to eventually let them get back to their life J

He does however, have a desk and a little office space in his little clinic. It's very nice and convenient that he has an attached bathroom :) Too bad his desk sits in a wifi blackhole!

 

The picture on the right is of Jared and his "best girl." The picture on the left is of his girls...Dawn, Shirley, Lisa and Elizabeth from Dr. Hicken's office. He misses them and they miss him like crazy! It's such a great picture! I was sad when he took it to the office because it made me smile every time I saw it. 

Today, Jared has one patient, right at the end of the day. Tomorrow, he wraps up his second week with a “To-Date” total of 5 whopping patients altogether...unless , of course, someone happens to call the office in the next 24 hours. Jared says he and Celeste may be going out to talk to some of the businesses tomorrow so that will help shake things up a bit for him. Getting started is sometimes the hardest part of anything we do! But we’re grateful and still happy and at peace with our choice to come here.

As far as the commute goes…Jared has calculated that he is actually driving 100 miles a day, not 80…making his weekly mileage…100 miles MORE a week than we thought. Craziness. Thank goodness gas is cheaper here.

Though I think Jared’s having some buyer’s remorse for not getting the hybrid Civic back in March. I appreciated though, that he was trying to keep our monthly payment down. Who knows…we might have to re-evaluate that after a month or two of commuting. Love the Civic though. It’s a great car. In case you missed it on Facebook...Jared sent this sunrise picture to me Monday morning while driving to Madisonville.

 

And one last funny thing…all the employees have been asked by St. Joseph hospital to take a survey to provide honest, anonymous feedback of their services and how they do business. The invitation Jared received in the mail to do this survey reminded the employees not to forget to pick up their participation gift, because they value the time the employees would spend doing so. Jared  happened to find out what that gift was. The most irrelevant gift you could give someone living in Texas.

An ice scraper.

A squeegee however--(the dew is SO heavy in the mornings!)—now there’s something to get excited about! Maybe he should mention that on the survey!