Dear Margo,
I need advice. My husband is a Family Physician. In 2014 he decided he wanted to open his own practice. I was hesitant, but still worked my butt off to make it happen, acting as the business manager. Well, it didn't go well and in May 2018 he had to get a second job at another clinic to pay off bills from the failed venture. We almost went bankrupt. Times got very hard and still are, but we at least kept the house. He now has an opportunity to take a job in Australia that pays more than here, offers furnished housing, and transportation. (Paid vacation. Too. He has never had a paid vacation in his career, as US docs just don't get paid if they don't work.) ? I want to go. We have three girls who would be able to experience a new country for two years, not to mention the many short plane rides to experience places such as Fiji, New Zealand, Bali, and Thailand. ?He says absolutely not. He still has a core patient base of about 200 patients from his private practice that he sees as a concierge-style doc, and says he cannot leave them. He won't even discuss this with me without blowing up. I'm pissed off, thinking he is putting those patients ahead of me, his children, his family. I am quite bitter thinking about what we went through for his failed business venture, and how he won't even consider this opportunity. We have been married 25 years.??Advice, please? Mrs. X

Dear Mrs. X,
Where to begin? Family physicians are first cousins to internists, which are becoming increasingly hard to find. Because FPs also need to be versed in pediatric medicine, I would guess they are harder to find. This makes me wonder why the practice failed. Being married to a doc, myself, I was surprised by your remark about there being "no paid vacations." Before your husband went out on his own, he had to have been in some kind of practice, hospital or private ... and those docs do get paid vacations. As for Australia, it is one of my favorite countries and reminds me of the US forty years ago - in the good way. (And Fiji and Thailand, oh my.) It would be a wonderful family experience, would broaden your husband's medical knowledge, and would replenish your bank account. As for 200 concierge patients, that should be bringing in a decent amount of money, so I would think he could disperse these people to other practices without much difficulty - with the understanding that he would return in two years. It is admirable that he doesn't want to leave his patients, but in the big picture this argument doesn't hold much water. My opinion, to put it bluntly, is that he owes the Australian experience to you and the children. It's a once in a lifetime chance, and because he is so resistant, the only thing I can think of that might change his mind is a couples' therapist where you lay your cards on the table. I do hope you get to go and enjoy a refreshing and wonderful change. Let me know, Margo