Sunday, August 12, 2012

In the meantime...

I wasn't thinking Spacehog, as much I as was thinking about how to describe what I haven't done in the past 11 months.  When last I left off, I was jobless and depressed.  Now I'm just depressed.  I'm not really the type to mope in melancholy, though.  Think of a brightly burning torch -- that's me usually.  Now recall a glimmering candle, and you get the picture.

I took a job with the Low T Center in November 2011, a business venture capitalizing on the rejuvenation potential of the baby boomers using testosterone replacement therapy.  The arena was relatively foreign to me, but a physician assistant friend who had taken a job with them, and whom I respect hugely, encouraged me to sign on.  I like the business model which is tightly efficient, and I have grown to like the owners a great deal, as I understand how they think, and work.  Basically, we try to identify men in their 40s through 60s who are symptomatic for low testosterone (medical term:  hypogonadism) through onsite testing, and then offer supplementation therapy, predominantly injectable testosterone cypionate (e.g. brand name Depo-Testosterone).  Apparently variations of this model have been working for years, but none have focused on on-site testing, low waiting times, a "man-centered" clinic atmosphere, and billing insurance for the patients.  Many clinics to date have been poorly managed, often with suspect care patterns, long waits in the office and/or for labs (days typically), and subjected the patients to self-filing, if they wanted the insurance to cover the visit.  We've obviated all that.  Perhaps the thing that I enjoy most about the place is that we are constantly working on our care patterns to make them efficient, effective, and, above all, helpful for the patient.  I feel like we are "legitimizing" the business, in a manner of speaking.

I tried in the interim, briefly, to go back to residency, to do some more and different training.  I only succeeded in hurting my image, however, and I think that that was all a big mistake.

Additionally, I looked into taking the directorship of an area indigent "gap" clinic, which was enthusiastically offered me, but then withdrawn (as it was suddenly and inexplicably offered to someone that was not even in the running to my knowledge) after the board met to consider my application.  I have no idea why, and no one is talking.  Echoes of my termination from my last job here.  Since the winds of favor so suddenly changed after the board meeting, it must be that someone on the board did not support my application.  I suspect the administrator at Memorial Hermann, Steve Sanders, but I really don't know.  It could be that someone from my last job was contacted and volunteered some negative press, or something.  It is weird how oddly paranoid -- not my typical self really -- one gets when one's life is so plagued with uncertainty.  My personal goal for the directorship was to keep me in a more broad clinical environment, and thus stimulated.  I hoped that it would not be to the exclusion of the Low T Center, but as an adjunct.  Anyway, it is said, "No guts, no glory," but I would say that these job attempts are eviscerating me nicely with nothing to show for it.

A bright note, however, is that my wife became pregnant in mid-November 2011, and delivered our first child together, a son, Ethan Scott, on 16 July 2012.  However, being 46 and having a newborn is a lot harder than I recall, compared to having my first two, in my 30s.  Still and all, he is a blessing and a reminder that miracles really do happen.  More has happened of course, but I'll try to write about that later.