To recap: Back in November 2017, I was living in Korea as a new father and was desperate to get back into medicine. I thought my best bet would be to get back into residency but that didn't fan out. In September 2018, I began working for a corporation that provides wound care services to patients in nursing homes. In June of 2019, I started my own private practice. Things were going well, then COVID happened. For more detail, I would refer you to the following posts:
First post on 11/30/17: CA license, but no board cert. How to get life back on track with a baby?
Second post on 7/15/19: Re: CA license, but no board cert. How to get life back on track with a baby?
Third post on 8/2/19: Re: CA license, but no board cert. How to get life back on track with a baby?
Fourth post on 2/21/20: Second update to "CA license, but no board cert. How to get life back on track with a baby?
Fifth post on 8/4/21: 3rd update: "CA license, but no board cert. How to get life back on track with a baby?"
Sixth post on 11/25/2022: 2022 Update: "CA license, but no board cert. How to get life back on track with a baby?"
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How time flies. These threads have become a semi-annual tradition for me to look back and see how far I've come from the day when I was writing the first thread in my little cafe in Seoul.
1. Practice is still going well.
Things got a little to busy for me to visit and talk with nursing home administrators and nurses, so I hired a salesperson to go around nursing home to represent me. We had a lot of figuring out to do, including setting up a website and having marketing materials. The pecan pies have become a huge hit amongst nursing homes. I just hired two more nurse practitioners in preparation for the additional work coming our way... well I'm already drowning in work, so I can't wait for them to be caught up with our practice standards.
2. I began taking care of homeless patients on the street and at outreach programs.
This was around Thanksgiving last year when I began reaching out to street medicine people in my town. I began seeing homeless patients around Christmas time and now have an active volunteer practice taking care of homeless patients in a children's library at a local church where they have soup kitchen every Sunday. I remember in my younger years telling myself that I'd never step foot back in any church for the rest of my life, and here I am willingly going to church every Sunday. That's a trip.
I am going to attend the Street Medicine conference in LA in August. I'm hoping maybe I can run into some folks from SDN, if there are any.
3. I work at a hospital now.
In January, a doctor I knew from one of the nursing homes reached out to me to see if I would consider working at a LTACH where he's the medical director. If you've been following along, I am not board certified in anything, and that's how I ended up starting this whole saga. As such, I didn't think I would be given privileges at a hospital. However, I was told that the hospital was willing to make an exception for my credentialing process as it was that I had enough doctors in the community who can vouch for me.
The credentialing took two weeks, and I got fast tracked to become one of the two wound care doctors at the hospital. The other wound care person is a board certified plastic surgeon. Working at the hospital took some getting used to, but there was a great team of wound care nurses waiting to make things happen.
It's been about three months, and we are doing some biblical work at the hospital. There's a patient with failed 3way VY advancement flap that initially looked like a hopeless situation. Now, the wound is granulating and contracting well, and I think with some wound vac and further debridement, everything might close under secondary intention. That was surprising to observe.
Nurses are happy. The primary teams are happy. The ID docs are super happy, lol. And the administration is happy as well.
Now I can see myself working at other hospitals in town as well. Not the university hospitals or the PPO networks but I can see other LTACHs and smaller hospitals wanting to partner up down the road. It feels so good to know I bring something valuable to big institutions.
4. I'm continuing to go to Mexico when I can.
I have some very interesting cases down in Mexico. A lot of motor vehicle accidents in lower extremity leading to osteo/wounds in the foot. I really need to get a modified van for my Baja trips so it's easy for me to setup a procedure area. Lol. Pipedreams. We all have to have one, right?
------
Today, I take care of patients with wounds in all kinds of settings - across the border, in the streets, patient homes, SNFs, and at a hospital. We don't let our patients fall through the crack - the discontinuity of care. I really think we have a strong alternative model for taking care of wound patients. Not all of these activities are financially helpful for the practice, but I know there is a tremendous amount of value in keeping a homeless patient from having to go to the hospital for a bad paronychia or a cellulitis whether we get paid for it or not.
I'm going to keep working on this model and continue to build the practice. I believe in the good that we're doing, and I'm excited for the difference we'll be making.
ps. I'm no longer scared of the Moloch. lol.
First post on 11/30/17: CA license, but no board cert. How to get life back on track with a baby?
Second post on 7/15/19: Re: CA license, but no board cert. How to get life back on track with a baby?
Third post on 8/2/19: Re: CA license, but no board cert. How to get life back on track with a baby?
Fourth post on 2/21/20: Second update to "CA license, but no board cert. How to get life back on track with a baby?
Fifth post on 8/4/21: 3rd update: "CA license, but no board cert. How to get life back on track with a baby?"
Sixth post on 11/25/2022: 2022 Update: "CA license, but no board cert. How to get life back on track with a baby?"
----
How time flies. These threads have become a semi-annual tradition for me to look back and see how far I've come from the day when I was writing the first thread in my little cafe in Seoul.
1. Practice is still going well.
Things got a little to busy for me to visit and talk with nursing home administrators and nurses, so I hired a salesperson to go around nursing home to represent me. We had a lot of figuring out to do, including setting up a website and having marketing materials. The pecan pies have become a huge hit amongst nursing homes. I just hired two more nurse practitioners in preparation for the additional work coming our way... well I'm already drowning in work, so I can't wait for them to be caught up with our practice standards.
2. I began taking care of homeless patients on the street and at outreach programs.
This was around Thanksgiving last year when I began reaching out to street medicine people in my town. I began seeing homeless patients around Christmas time and now have an active volunteer practice taking care of homeless patients in a children's library at a local church where they have soup kitchen every Sunday. I remember in my younger years telling myself that I'd never step foot back in any church for the rest of my life, and here I am willingly going to church every Sunday. That's a trip.
I am going to attend the Street Medicine conference in LA in August. I'm hoping maybe I can run into some folks from SDN, if there are any.
3. I work at a hospital now.
In January, a doctor I knew from one of the nursing homes reached out to me to see if I would consider working at a LTACH where he's the medical director. If you've been following along, I am not board certified in anything, and that's how I ended up starting this whole saga. As such, I didn't think I would be given privileges at a hospital. However, I was told that the hospital was willing to make an exception for my credentialing process as it was that I had enough doctors in the community who can vouch for me.
The credentialing took two weeks, and I got fast tracked to become one of the two wound care doctors at the hospital. The other wound care person is a board certified plastic surgeon. Working at the hospital took some getting used to, but there was a great team of wound care nurses waiting to make things happen.
It's been about three months, and we are doing some biblical work at the hospital. There's a patient with failed 3way VY advancement flap that initially looked like a hopeless situation. Now, the wound is granulating and contracting well, and I think with some wound vac and further debridement, everything might close under secondary intention. That was surprising to observe.
Nurses are happy. The primary teams are happy. The ID docs are super happy, lol. And the administration is happy as well.
Now I can see myself working at other hospitals in town as well. Not the university hospitals or the PPO networks but I can see other LTACHs and smaller hospitals wanting to partner up down the road. It feels so good to know I bring something valuable to big institutions.
4. I'm continuing to go to Mexico when I can.
I have some very interesting cases down in Mexico. A lot of motor vehicle accidents in lower extremity leading to osteo/wounds in the foot. I really need to get a modified van for my Baja trips so it's easy for me to setup a procedure area. Lol. Pipedreams. We all have to have one, right?
------
Today, I take care of patients with wounds in all kinds of settings - across the border, in the streets, patient homes, SNFs, and at a hospital. We don't let our patients fall through the crack - the discontinuity of care. I really think we have a strong alternative model for taking care of wound patients. Not all of these activities are financially helpful for the practice, but I know there is a tremendous amount of value in keeping a homeless patient from having to go to the hospital for a bad paronychia or a cellulitis whether we get paid for it or not.
I'm going to keep working on this model and continue to build the practice. I believe in the good that we're doing, and I'm excited for the difference we'll be making.
ps. I'm no longer scared of the Moloch. lol.
