Well, my tail is coming due and I can't afford it. Unable to get a loan, and no room on credit cards, etc. Can't be on the leave of absence status if I do locums, which is what I need to do because I need some sort of income.

Have you or anyone you have known gone without the tail? I would be doing this for financial reasons, not necessarily to decline it on principle.

I have heard groups/employers will not hire you without a tail from the previous job (I think it was mentioned in my previous thread and elsewhere) because that is risky to them if something came up from the past while in a new practice.

This is a little scary for me, but I also look at it this way- what could someone take from me if I have basically nothing (or I'm in the red). Believe me, my finances are embarrassing to me but I cant do anything right now but try to make it better.

Any advice appreciated!

I realize there are several good threads on tail already, but I guess I wanted to hear some updates on those of you who have been through this, and hear any suggestions about my situation where I would like to pay a tail but can't afford it, would like to be working but haven't found anything yet, and would like to do locums but would violate leave of absence. Thanks!

becco, could you spend $100 (or so) with a sitdown session with a financial advisor? Several departments at our hospital have one or two who visit with the graduating residents; maybe your old hospital or any other teaching institution in town could give you a rec for a financial advisor who deals with OBs. (note: not a lawyer, not your insurer... someone informed and unbiased :-) )
good luck.

I'm considering the same thing, becco, so it'll be interesting to see what others say. I'm at the point of just closing my practice, not paying a tail, filing bankruptcy and just letting the chips fall where they may. My malpractice insurer will give a free tail if I retire from practice after being with them for at least 5 years (which I have) and the exceptions instead of retirement are if I work in clinical practice for the federal gov't, a state university, the military, and I can volunteer. I'm looking to move back to my home area which has a lot of military bases, so looking into one of them, but if I have to do locums or whatever to make money, I guess I just won't have the tail.

Thanks for your reply! And your others in the past. You have been a very helpful voice on MomMD! I see you have a similar catch22 situation. Free tail but no work, vs. tail and ability to work (with more debt)...

Since my post I have done some more internet searching about this. What I have gathered is that the only situation where it makes sense to not pay the tail is if one is totally leaving clinical practice. Apparently lots of employers will not consider hiring someone if they have a period of time that is not covered with a tail. I guess if a case is put forth later the new practice is put at risk.

I have read that some people have kept policies and paid for a part time policy while not working, but this apparently isn't available to me because I was on a group policy and not individual. I spoke to the malpractice insurance guy about this sort of thing and he seemed confused and did not consider this an option.

I could probably afford my first installment of what is due (in two weeks, yikes!) but I can't pay the whole thing over the next 9 months (which is their longest payment plan) even if I get a great full time job!

Under all of this is my debate about whether to even continue in my specialty or go for another. Switching to another would be a long road, and I don't quite know where to start.

Thanks for your update and maybe some more folks will add to the discussion!

becco,
wow I am so sorry you have to go through this. Not even locums will hire you without a tail? I am sorry I have no good advice or experience to help you. Did you have any luck speaking with your malpractice carrier in extending the time you have to pay the tail if indeed you want to do this?

Of course, as you mentioned, starting over in another specialty is an option. You could contact programs in the field(s) are you considering switching too to see if they have any jobs to offer outside the match (which did just open up--you can check it out on the NRMP website--I know this because I have been considering the same thing, career switch out of ob/gyn to something else!). Or you could just consider going through the match. It's scary but when you consider practicing some form of medicine for 20 or 30 years you should be happy with it (for the most part); it makes the extra time needed to complete a different residency seem like a very small investment.

I really hope you can get closure with this one way or another and I feel so badly you have to deal with this garbage. Keep us posted about what you decide to do.

I am trying again for a loan now that our house sale is all settled, so we will see about that. They extended the time it will be due but that is fast approaching. The locums doesn't care about the tail, but groups might (see below). My plan is to pay it, and the only option is a loan.

I am in the process of getting a locums job, all my stuff is in and I hope to hear from them soon!

My dilemma for now: my husband wants me to wait to consider another residency until we can sell the house or our oldest is in school in 2 years (daycare is rather expensive compared to free...). That would mean applying for next year's cycle rather than this year (to start in 2012). For me it is delaying what I think is the inevitable and I reminded him that that means even longer until I can make a "doctor's salary" again.

The dilemma for ME is if I can't make enough with locums until then, should I consider a full time job?! I have had an interview with one group and might have one coming up. This feels odd to me because I am not sure about even continuing in the specialty, so making a commitment to a group feels a little off. However, money-wise with the debt and all it seems to make sense to accept a full time, traditional job to make ends meet plus work on debt. This would have to have a tail, so an exit would be possible.

I am wondering when I should talk to program directors about another residency. I would like to get some experience in the day to day life of the other specialty, and start making some connections. The other money problem solver might be to do locums and work in a lab or something at the residency program in my town...

What specialty are you considering? As you may have seen, I switched to IM after 1 year. Its not as exciting, but the options and potential flexibility are certainly more. Will locums give you benifits? Are there any gyn only jobs out there for you? Do you have ANY interest in a ob/gyn fellowship? Good luck!

Becco,
It seems like you have already decided that you are going to swtich out of ob/gyn--I agree with you about 'delaying what is inevitable' and you are wise to check out some of the other residency programs in your area. If you are considering IM or FP you may even get a spot outside the match.

I have also thought about joining a group for a little while, just to get my old salary back (although the opportunity costs of that salary were much higher than the monetary payments were worth!) but every place I've talked to wants at least a 2-3 year contract (at least the ones that pay the malpractice tail). You can earn nearly as much with full-time locums work (in terms of gross pay) but they don't cover any benefits and don't take out any taxes so as far as net pay you probably won't make as much. BUT--there are no tails to pay and once your job is over, you can leave!

Anyway, maybe you could talk to your husband again regarding your decision to start a residency in 2011 vs. 2012--you'd be getting benefits that you don't with a locums job, and you will be one year closer to getting back to the salary you were accustomed to prior to starting another residency. Plus you will probably be a lot happier and less stressed out (who can put a price on THAT?!)

"am wondering when I should talk to program directors about another residency. I would like to get some experience in the day to day life of the other specialty, and start making some connections. The other money problem solver might be to do locums and work in a lab or something at the residency program in my town..."

becco, aren't you interested possibly in pathology? It sounds like if you can swing it financially, you might enjoy a year in a lab just to be more sure you want to pursue pathology as a residency switch. and of course, hanging out in the program is a great way to get in :-)

thank you for sharing all your insurance troubles and questions. Psych is certainly MUCH lower than OB, but the conversation is really informative.....