Saturday, February 2, 2008


I apologize for not posting much of late. A lot's been going on. I've been waiting patiently for my provisional license paperwork to go through since early December. It finally came in last week. The state board will even allow me to sit for my final oral examination for full licensure while I'm finishing my postdoc year. Since they're only conducted in January and July, I've sent in the money (while I still have some) to sit in July . That way come December 4, I'm ready to practice on my own. I even got to pick my specialty area - neuropsychology. That's the good part.

The bad part is that I can't do a damn thing with a provisional psychology license, even though it's supposed to be a step up from the Associate's license I've held since 2004. Despite the fact that I've been doing neuropsychological and psychological assessment for the last six years and have somewhere in the area of six thousand hours in practicum, specialized clinical training, research practicum, internship and doctoral research, without that last piece of paper apparently I still don't have enough experience to do anything without having my hand held. Part of what my postdoc is supposed to entail is testing geriatric patients (my area of expertise, by the way). These people inevitably have Medicare. After wading through the national Medicare website and the state Medicare website for what feels like months and not finding information relevant to the questions I had, I was randomly picked to participate in a survey. Several of the survey questions dealt with the type and relevance of information that came up in the search results (1 search term = 10,000 irrelevant hits, 2 search terms = 20,000 irrelevant hits), the availability of customer support (nonexistent) and how satisfied I was with the service overall (yeah right). I posted my unvarnished opinions - in polite language, no less, gave them my contact information, and hit "submit."

The next morning a customer care representative named Jennifer called me from the state Medicare servicer. She was very sweet and polite and not at all the typical government drone. She actually wanted to help. I explained to her that the information I was finding was inconsistent and confusing and that I was frustrated with the process. She apologized and said that unfortunately, my complaints were not at all uncommon, in fact they were the norm and she knew what a joke it all is. She didn't know the answers to my questions, and didn't know where to find them, but wrote them down to go ask her supervisor and called me back within ten minutes.

Turns out that of the 3 separate sets of Medicare Part B paperwork, that I have to fill out all 3 and my boss/business partners also have to fill out all 3. That's 9 iterations of the same information. Yes, they'll be submitted in triplicate to the Department of the Office of the Division of Redundancy Department. That's irrelevant right now anyway, because with my license I can't bill Medicare. I have to be fully licensed to bill Medicare, or anyone else, despite the fact that had I pursued an MD which is a lower degree, and easier and faster to obtain, I would be able to bill Medicare with my provisional license. Stupidheads.

Why did the great bloated and lumbering government bureaucracy cross the road? Who knows? Why the hell do they do anything?

Now I can still do the testing, as long as my boss is actually in the next room (nevermind that I've done it for six years already - mostly in a public hospital, so I've Seen. It. All.), but I can't bill for my time. He can bill for me at half the rate, noting that the testing was done by a "technician," then turn around and pay me an as yet to be determined flat hourly rate as an employee. Granted, this frees up some of his time to test other patients, but we were planning for me to go out and do rural geriatric outreach. He can't be two places at once so that's out and now I have to come up with a Plan B so that I can get some money coming in. I can't wait until December to start getting paid. I like my car and want to keep it. That old Merle Haggard song, "If We Make It Through December," keeps running through my head. Most of the work I've done in the last six years has been unpaid but now that I've gotten the PhD, the student loan fairy doesn't come here anymore.

The Man, who is officially retired now and also has no foreseeable income, was great about it though. When I told him, I was really expecting much grumbling, bitching and blaming along the lines of, "Spent all that money and worked your ass off for ten years working for free and now you have the doctorate and you can't get paid? Why couldn't you just stop with a bachelor's degree like normal people?" et cetera. Instead, he shocked the hell out of me by putting his arms around me and saying, "Sorry about that, Babe. We'll make it. We always do." This is true. I've soldiered on through far worse than this - and for longer than 10 months. I'm trying to be pissed off about not this latest wave of bullshit to slog through, but after blasting through four degrees and nearly a quarter million dollars in ten years, more than anything I just feel empty and frustrated and hobbled. I've already let the student loan companies know that when my payments start coming due in late May, that I'll be needing those deferment papers immediately because I can't pay what I don't have. Sigh.

So this is where I explain my blogging silence of late, dear readers. I've been busy looking for a job that I can get paid for doing. I've put in applications to teach psychology at every possible online university I can think of, and some more that I'd never heard of. I even put in an application at the university where I earned my BS degree to teach there, which I wasn't planning to do for several more years - like after I'd gotten my student loans paid off and was getting ready to retire from clinical work. It was the only one that really looked promising. University policy is to throw away incomplete applications. There were 17 applicants and of the 17, only one other person besides me submitted all of the requisite application materials. The other person only has a Master's and is ABD in a PsyD program. That position doesn't begin until August. I've also called one of the docs I worked under during my internship. My friends who still work for her say she's begging for people to do testing for the neverending parade of people applying for social security disability and Texas Rehabilitation Commission benefits. She has 14 therapists sharing 4 offices Monday through Thursday, but I'm going to see about going in on Fridays and Saturdays when the office is officially closed to do the evals. We'll see. Cross your fingers that the "get paid for working" fairy pays me a visit.


Kate said...

Oh, I hear you. I do, I do. I'm one of those ABD PsyD's, but I have 3 master's degrees under my belt and it's enough for now... and as much as I love my job (see Friday's post) (no, really, I do love it), it never leaves me as revved as a good Rorschach/WCST/WAIS combination. Gawd, I miss that stuff sometimes.

But it weren't to be, at least not now. So I'll be living vicariously, once you get in and start testing, and if you ever need a technician... I kick ASS at the MMPI.


Loving Annie said...

Good Tuesday morning Dr. Brainiac. Totally understand about where your focius is and needs to be.

I will cross my fingers for you that a decent paying job comes across that'll pay the bills between now and Decmeber.

The Man IS being wonderful about it all.

I can't believe how many years you have put in and how much money it has cost and they are being stupid not to have you out there practicing at a decent rate !

Hmmmmm, maybe Brittany Spears could use your help ???

Left 'special blessings' for you today on my blog :)

Romulus Crowe said...

Beurocracy, vast paperwork and officials who think they work for the Gestapo. You guys think you're free of British influence but that British genetic heritage keeps coming back!

Sorry about that.

If it's any consolation, it's even worse here, in the land of the pointless official. Our empty-suits won't cross the road without ten-page risk assessments signed in triplicate, health and safety approval and a stamp from the ethics committee.

Even self-employed, I have to fill out risk assessment forms and then sign to say I've read them. I also have to detail what action I will take against myself if I breach the assessment. One day I'll have to fire myself.

Brunhilda said...

What a nightmare. I hope you find a job to pay the bills soon. Medicare is wonderful, huh. The little sis has applied for a social services position in a nursing home - I hope she knows what she is in for dealing with medicare.

Dr. Brainiac said...

Thanks for the support, y'all. Oddly enough, I'm still happy, albeit frustrated.