Okay,
so here’s the long and the short of it. This is REALLY hard to put in a
nutshell, or two or three or nine. Actually, Jared could probably do it in one sentence, but that would be completely unsatisfying to me, leaving waaaay too
many questions unanswered. And now you know the secret to why I cannot keep a
journal. You've been warned.
Starting
any kind of business or service from the ground up takes time. Jared knows
that. He owned and operated his own
massage therapy business sixteen years ago and it took time and patience to
build up his clientele.
When
Jared accepted the job in Madisonville, TX it was the complete opposite of what
we were hoping for. #1) It was occupational medicine (occ med) entailing
basically DOT/employment physicals, drug screenings, and on-the-job injuries. #2)
Working in Madisonville would require a 100 mile daily commute for Jared
because we live in south College Station.
*sigh* BUT—to soften the blow of
the less desirable things, we had 60,000 tax-free reasons to make that
sacrifice for 2-3 years. So we hunkered down and hoped for the best.
Even
with a 50 mile drive each way, Jared would leave at 6:30am to drop Jake off at
seminary and had plenty of time before the office opened at 8am. He usually
wrapped up around 4:30pm and was able to back in our area around 5:30pm and
could pick up kids from piano or other school activities. So even though his
commute “stunk,” he was home earlier than when he worked a regular day in
Oregon and it worked out well. For me.
For
Jared, it was a different story. He and Celeste, the St. Joseph (STJ) marketing
director, reached out on several occasions to the surrounding businesses to
generate a working relationship with the local employers in the area. On
December 5, 2014, Jared was interviewed by a local news station and appeared on
the 10 o’clock news to announce the services his clinic would offer. However, by
the end of December, Jared was seeing no more than 8 patients…a week!! It was
more than he had been seeing in September, but not the 30 a week the hospital
had been dreaming of. It was painful mentally and professionally to Jared as a
medical provider who is used to seeing 25-30 patients in an 8 hour day. But he
continued to hang on because loan repayment was tied to this job.
Speaking
of loan repayment--before the holidays, we had discovered that though this job
was advertised to offer $60,000 (tax free) toward our student loans for a
two-year commitment, the information from the National Health Service Corps web
site (the organization that awards the repayment) showed the maximum pay out
amount as $50,000. We tried not to quibble over $10K. $50,000 is still a lot of
money!
Then
things really started to shift in January with two major catalysts. #1) The
Madison hospital administrator, wanting to generate more income for his small
hospital, decided to bring in two specialists--an orthopedic surgeon for a half
day every other week and an OB/GYN 1 day a week to offer more services to the
small town of Madisonville. Definitely a good idea, if it weren’t for the fact
that the office space they’d be using was the occ med clinic office. Right. So
that means that when the specialists are “in town,” Jared, the occ med
provider, would have to relocate himself to another part of the hospital or
just not work, while the other doctors used his space. Jared’s not a
territorial guy. But the question he felt he needed to ask was this: “Are we
going to build up the occ med clinic, or not?” I think it goes without saying
that, professionally, this wouldn’t be good for his clinic. They had just
advertised on the news where they would be and when and just as they were
starting to gain a tiny bit of momentum, they were not going to be as
accessible. It would only take one
patient to walk-in with an injury and not be able to find Jared, for it to get
back to the employer that going to the new occ med clinic was a waste of time.
This was very frustrating to Jared, who just.wanted.to.work. And felt like this
was so many steps backwards. But he didn’t want to be viewed as inflexible or
difficult to work with. He said he was willing to share the space (that he was
in first) but that very specific guidelines and protocols needed to be in place
so that all parties involved were on the same page.
While
they were thus hashing out the aforementioned details of the occupancy of the
occ med clinic, the second catalyst happened when Jared’s medical assistant
(MA) gave her two weeks notice. It had nothing to do with Jared--in fact, he’s
the reason she stayed as long as she did. He was basically her only
cheerleader. She had a very difficult job to do and it wasn’t a big surprise
that she was leaving. She worked a couple days into her two weeks and then
Jared got a text one evening from the MA saying she was not coming back.
So
Jared was now without anyone to help in the occ med clinic. Jared found himself
registering and rooming his few patients, which there was plenty of time for,
but that’s beside the point. Jared is not trained to do this nor was he hired
to do it. In a pinch, he’s roomed patients in Oregon by taking their weight,
temperature and blood pressure. But that was family practice and this is
occupational medicine which is wrapped up tight in papers, forms, documentation
and hoops in which to jump through. Tina, the staffing/hiring gal, said she had
someone who could fill in for a few weeks while they looked for a replacement
MA and Tina even had some candidates already lined up—which was encouraging
because it’s beyond difficult to staff those rural clinics. Jared was able to
sit in on a few of the interviews. He had a patient he was seeing during one
particular interview with a candidate Tina felt would be the best. Because time
was of the essence, Tina went ahead with the interview and decided she was the
one. Tina was all set to hire her and was just waiting for the upper-deck
formality approval. Except it never came. The woman in charge of approving new
hires said that when she looked at the occ med clinic, she decided there needed
to be an increase in patient volume
before approving the cost of hiring another MA. WHAT?????? She does realize
that the MA being requested does not make two in the office, right? Jared needs
AN
MA. ONE. UNO. SINGULAR. Jared would love nothing more than to have more patient
volume as well, but how does one do that when there isn’t even someone to run
the office? Oi. Seriously. I get that prudence is needed—especially with a
non-profit organization such as STJ. But, with all due respect, they kind of
have it backwards. I don’t know much about business, but I’ve worked in a
successful family practice clinic that Jared helped build and if there’s one
thing I’ve learned, it’s that not staffing a clinic appropriately will hurt
your business financially, more than help it. Not allowing an MA to be hired
for the occ med clinic because of the cost is pretty ironic since you can’t
grow a clinic without the necessary staff.
This
was actually SO ridiculous, we laughed and were speechless for a bit. Even the
cheapest doc I know from Oregon, had ONE medical assistant. She could never
keep them because she was so cheap, but the doc at least knew she couldn’t run
her office without one.
This
move, or lack of it, sent Jared a pretty powerful message. If STJ wasn’t
invested in the occ med clinic—denying appropriate staff to help generate more
volume—then why should he be? It made him feel like he was on a sinking ship—50
miles from home—that he had to drive to every day, then sit on every day, by
himself, doing nothing but sink a little lower with each painfully passing day.
I
felt terrible sending Jared off to that sinking ship, alone, with no one to see
or interact with. He’d have a string of 3 or 4 days where he saw no patients.
To be brutally honest, for a non-profit organization so concerned about
spending money on one MA, I am shocked they would continuously pay Jared’s
salary when, based on his circumstances, was doing a whole lot of nothing. It
almost felt dishonest. But Jared reminded me that someone up at the top really
wanted an occ med clinic in Madisonville. Clearly it’s not the woman in charge
of approving new hires—which also makes me wonder…don’t these two people talk?
For the first time in eight years, Jared’s job satisfaction reached an all-time
low.
Remember
how I felt this underlying current of peace about our decision to take this job
and move our family here? Well, despite the circumstances Jared found himself
in, I still felt it. Somehow, it would be okay.
During
the turmoil of no MA and with his loan repayment application already submitted,
a position in another rural clinic in Brenham (Family practice/Express Care)
opened up internally. Jared’s actually filled in there a couple times and had
just been there on Valentine’s Day. Jared felt that his PA liaison, Kim, and
Tina would ask him if he wanted to shift over there. I asked him if he would.
He said no. He didn’t want to drive another 100 miles a day (in the opposite,
southwest direction) without loan repayment. I didn’t blame him.
But
a few days later, at the end of February, Jared had another meeting with all of
his immediate bosses and supervisors (about 6 of them) who are involved with
him, the occ med clinic, and outlying rural clinics. They talked about many
things. To their credit, they knew how much Jared wanted loan repayment and
that he’d have to stay in Madisonville to get it. But Jared had shared with them
before that this full-time occ med clinic isn’t viable on its own due to the
lack of need in the area. Jared said they would need to combine it with a
primary care or express care model to supplement volume in order for it to be
sustainable. Jared had already submitted his loan repayment application though
and if awarded, he would HAVE to work up there 40 hours a week to honor his
contract and Jared agreed with the Madison hospital administrator, that there
isn’t even part-time work up there right now, let alone full-time work. With
that said, the group of bosses said they’d find a way to keep him in
Madisonville if he received the loan repayment award.
Jared
shared the events of that meeting with me on our way to get some camping
supplies for Cooper one evening. For the past couple months, especially, I’d
mostly just been a cheerleader, telling Jared “You’re awesome!” “Thanks for
making that long drive to and from Madisonville every day!” “We’re so blessed
to have a job—thanks for being a great provider for our family!” etc. and
letting him share his frustrations. But it became clear that I needed to speak
up.
At
that point, we had been doubling our fast offerings for a whole year. The first
six months, it was for extra help in selling our home, securing a job, finding
new and temporary housing, the move, etc. But since September, we’ve been
doubling our fast offerings to help us secure that much desired loan repayment
award. Jared almost didn’t go to PA school because he didn’t want to accrue
that much debt. But I’m so glad we did. We’re better off financially even with
the student loans and he’s been able to bless so many people because of these
skills. The Lord knows our deep desire to get out from under these loans as
fast as possible. We want to serve a mission together some day and all of our
savings is wrapped up in our monthly “summer home” payment. So surely these
desires qualify as righteous ones and I know that with God all things are
possible. We’ve been fasting for this purpose for months and our children have even
joined us a couple times. The occ med clinic Jared works at has a high score
rating and the chances of receiving loan repayment are much better than most.
But we knew it wasn’t a 100% guarantee. In the meantime, I’ve been pleading
with the Lord. We’ve done everything we could think of,
in our power, to do our part in securing the blessing of loan repayment. We
uprooted our comfortable family after a decade of living in Oregon and drug
them halfway across the country and further south. Jared took a $30,000 annual
pay cut for a job in medicine he was not interested in with a commute he was
not looking forward to. We attend the temple regularly. We serve as best we can
in our church callings. We strive to teach our children righteous principles.
We pay our tithing and for added measure, to show we would rather put others’
temporal needs before our own, we’ve doubled our fast offerings.
I
won’t lie—I’ve thought about that extra money we’ve used for fast offerings a
few times. It would have been so very handy, in so many instances with a big
move and new home. But we want the Lord to know we mean serious business about
the loan repayment and that we were willing to consecrate money we could have
used for something better (for us and others). Additionally, we know the
blessings of doubling your fast offerings far outweigh whatever sacrifice was
required. So, really, it’s a win-win on our end. Choosing to double our fast
offerings was also important to us because if the loan repayment didn’t
come through, we could stand strong and say—at least we did everything we could
and we have no regrets. The loan repayment was SO important to us. It was the
reason we came to Texas.
But
sitting in the car, that particular evening, with my sweet husband who just
wanted to work and not feel like he was wasting away professionally, I decided
I needed to tell him something. Something I never would have dreamed would come
from my frugal, CFO mouth.
“Honey,
forget the loan repayment. You just need to get out of there. It’s not worth
the frustration, the time, the gas to drive and losing your skills.” It was
professional atrophy for Jared to be in Madisonville doing nothing. Sure it was
maddening mentally, but losing his skills would be professional torture. I
tried to assure Jared that the loan repayment money was just that—money. Furthermore,
with the recent events of the past six to eight weeks, it was at a cost I
didn’t feel was worth the price.
I
told Jared my biggest fear wasn’t
that he’d NOT get the loan repayment. It was that he would and then he’d
have to stay in Madisonville. What if, six, nine or twelve months down the
road, STJ finally realized that there really wasn’t enough full-time work for
him in relation to his salary and they moved him out of Madisonville before his
two-year contract was up?? If that happened, one of two things would take
place. #1) Jared would have to leave his job with STJ and Texas (without us)
and work at another rural clinic somewhere in the United States with the same
score as his clinic until his contract was up. That would require a family
separation and having to support Jared financially on top of our regular monthly
obligations here. #2) Jared would have to pay the $50,000 back (that would have
already been sent to the financial institutions holding the loans) AND we would
be required to pay a $7500 monthly penalty fee
until the term of his contract had been fulfilled. Either option would crush us
financially to say the least. If Jared was given the repayment award and
accepted it, I’d be a major stress-fest for two years! Jared expressed this
perfectly earlier in the month when he said, “I can’t plan my future on a bunch
of ifs and maybes.”
It’s
so interesting to me that, at the end of February, the $50,000 didn’t have the
pull on me like it did just a couple months before. I know every job has its
ups and downs, but Jared was stuck in the middle of the hospital administrator
where he worked and the hospital organization he was employed by. He had to put
out fires when he had an MA, he had been yanked in one direction after another
and every time he thought the clinic took a step forward, it seemed like they
took several back. This was more than just a bump in the road—this was more
like fork in the road. Jared didn’t want to leave St. Joseph and find work
somewhere else. He likes the organization and what they stand for. He likes the
long-term stability it offers. If nothing else, he’s loyal. Jared’s immediate
supervisors had already told him in their recent meeting that having him in
Madisonville was like having their All-Star player on the bench. They know how
good and dependable he is. He’s on the high end of their top experienced
mid-level providers in the organization. When doctors started dropping like
flies this past fall due to influenza, they were calling Jared, asking him to
leave Madisonville (which was a treat for him!) and fill in for other
providers. He always jumped in to help, even on the weekends, when they needed
coverage. And every time he’s there, the girls at the office ask, hopefully,
“Can we keep him??” Jared is efficient and personable. With his experience in
family practice and urgent care, he knows how to stay on schedule. He’s faster
than several of their new doctors. Everybody loves Jared!
They’re
lucky Jared is so laid back because if they had anyone else to work the occ med
clinic, they would have quit a long time ago. But Jared stuck with it for six
months. Half a year. Long enough to do all the marketing that can be done, to
be available five days a week, all day, for patients needing his services.
There just isn’t the demand for occ med right now. So Jared needed to make a
choice.
Jared
was concerned about walking away from the full-loan repayment opportunity, even
though it wasn’t guaranteed. He wanted to make sure it was the right thing to
do—especially after all we did to get here. But he said he had crunched some
numbers and shared with me that if he worked at an urgent care [they are called
urgent cares in Oregon and they are express cares here, but I can’t seem to break the habit of saying
“urgent care”] and could work an additional 15 hours a month, it would bring in
an extra $11,000 for us every year! And those providers working in express care
get the first jump at extra shifts. Jared’s kind of been the back-up, back-up
guy for those available shifts. I was floored! So we were still losing money by
being in Madisonville and I was convinced even more that we needed to let the
loan repayment go.
Jared’s
other hesitation stemmed from not wanting to quit something he started. I was
so touched by this. But I told him it’s not quitting when the other player
walks away. It is impossible for you to grow Madisonville when you aren’t
properly equipped or supported. They changed the game so it doesn’t count.
After
our discussion that night, Jared decided he would propose to his bosses that he
could bounce around to the different express care clinics and fill in where
there’s a need. Ultimately, he wants to be in urgent care with primary care as
his second choice. Of course, it only added to his stress when after a few days
and into the weekend no one returned his email or call.
Over
that same weekend, Jared started to ponder more about Brenham. STJ has an
immediate need to fill. It had been advertised for two weeks internally with no
takers. If he took that job, it would save STJ time and money. They wouldn’t
have to screen candidates or spend money to fly them out for on-site
interviews. Nor would they have to wait for out-of-state candidates to get
credentialed and certified, etc. He could start working there immediately. Yes,
it’s still about 40 miles (45 minutes) each way. BUT…he’d be working the
Express side of the clinic and those providers don’t work every day. So that
would save US gas, time and money. And the best part, when he drives to work,
he’d be driving to actually WORK…not just sit for a brutal eight hour day,
alone. He had pretty much convinced himself to pursue the job in Brenham.
He
finally called Tina and proposed this option to her early that next week. Kim
called Jared a couple days later and told him to apply for the Brenham
position. A couple days after that in the middle of March, Jared had an
interview with one of the head hauncho guys. He told Jared that the doctor in
Brenham was so impressed with Jared when he was there on Valentine’s day (whom
he only saw for about 10 minutes) that she wrote a letter to Jared’s superiors,
telling STJ how great Jared was and what an incredible asset he’d be at their
clinic. This administrator wanted to make sure it was Jared’s idea to go to
Brenham. Jared assured him it was and repeated that while occ med could work within a family
practice or express care model, it wasn’t currently sustainable for full-time
and he just wanted to work.
The
man was fine with that and said they would need a time commitment from Jared.
It’s no secret Jared is vying to be in the Navasota clinic which is only 20
minutes from our home where he interviewed last March. Jared understood and
respects that they need more than short-term coverage in these rural clinics.
Jared told him he would commit for two years—the same amount of time he would
have been in Madisonville anyway.
So
the job change was approved. He starts Monday, April 6th. His last
day in Madisonville was Friday, March 27th. A letter has already
been sent out stating Madisonville no longer has full-time occ med available as
they had hoped. They do want someone up there one day a month though. They
asked Jared of course. It would be an extra shift and possibly include mileage reimbursement,
as well, but they would need Jared on a Monday and he works Mondays, so it
appears Jared no longer has ties to Madisonville.
The
gal doing Jared’s paperwork for the job change wanted to verify Jared’s time
commitment in Brenham. He said he’d give two years. She said with that kind of
a commitment, she’d put in a request for a “retention bonus” of $10,000.
WHAT???? We had no idea there was such a thing and of THAT amount! We were flabbergasted!
It’s certainly not $50,000 tax free, but “ironically” enough, that money fills
one of our first short-term financial goals that we can now “check!” off our
list. It is a huge, totally unexpected blessing!
The
new job isn’t perfect but it’s much better than it was. First of all, Jared will
actually work!! He will work on the urgent (express) care side. His schedule is
opposite the other PA. He works EVERY Monday and Wednesday (which means FHE
will move to Tuesday and I’m going to need help transporting my boys to and
from Young Men on Wednesdays…) He has EVERY Tuesday and Thursday OFF. Holy
Schnikey!! I can’t even begin to imagine the glorious options that will come
with that. And he works EVERY OTHER weekend (F, Sa, Su). So—the worst part of
the job is that he has to work every other Sunday. It’s super stinky on many levels. We’ve been blessed to avoid
working on Sundays ever since he started as a PA, but we just can’t avoid the
fact that he’s in a profession where working on Sundays is sometimes required.
We’re hopeful this could change in the future.
So
looking at the schedule—at the most, he will work 4 days in a row (F, Sa, Su,
M) but on the flip side, at the most he’ll have 4 days OFF in a row (Th, F, Sa,
Su). Mondays through Fridays are 12 hour shifts. But Saturday and Sunday he
only works til 4pm so he’ll be home around 5 or 5:30, keeping those evenings
free for date night or Sunday meetings/firesides/home teaching. Those days off
will be SO awesome in the summer! All told, he only works 14 days out of 28.
Not a bad little gig. This new schedule will save us money and gas because
he’ll be driving to Brenham less and it also opens up some really great
opportunities for our family. And no, there’s no loan repayment in
Brenham. But because of his schedule,
Jared is now free to work a T/Th or F that he has off, which will help us reach
that goal of 15 extra hours (or more) a month as a way to increase our savings.
We’ve
already decided that any extra income is mostly going into retirement. We had
been married almost 10 years before Jared was employed as a PA. So we’re a
little behind people our age and have some ground to make up when it comes to
retirement savings. [Although I just heard on the O’Reilly Factor on Fox News
that in 2013, 47% of Americans saved NOTHING out of their paychecks. That’s
just CRAZY talk!! What are these people THINKING???]
Someone
may argue we should put all that extra money we make into our student loan
debt. The only problem is—there is about $110,000. There is very little
interest on these loans and we can pay our monthly obligation. Trying to pay
them off early on our own would
basically take forever and would use up every last penny of our savings. The
extra income would work for us better, if we used it to max out our ROTH IRAs
each year because time is our friend when it comes to savings. Even IF we got
the $50,000 in loan repayment, we’d still have around $60,000 left to pay off
ourselves, which would take 6-7 more years, perhaps.
That’s
when I realized that the Lord had still provided a way for us to fulfill our
righteous desire to be able to save money for a mission when we retire. We had just
figured the only way for us to start saving would be to pay off our debt as
fast as we could and then start
saving—making the loan repayment a big part of that plan. But building up our
retirement with Jared generating more income with “extra” work days, works even
better!! In the long run, we’ll be able to save more and a whole lot sooner!
This
has been a very enlightening process for us. I have to wonder if, when we
announced to our friends in Oregon that we were moving to take a loan repayment
job because we felt peace with our decision to do so, the Lord looked down on
us and smiled saying, “Not really, but you’ll see…”
Our
faith isn’t in outcomes. We doubled our fast offerings hoping for loan
repayment, “but if not…” (Daniel 3:17-18), we would still be faithful and
accept what is. We trust the Lord’s plan, which is usually way better than our
original play anyway, so it’s all good!
**If
Jared had blogged about this experience he would have said:
Things
didn’t work out in Madisonville, so I took a job in Brenham.