And I said yes I’m given these opportunities and where I where I think I can make a difference in this phase of career. I was ready but Rick kind of asked that question. Point Blank like you understand this is what this means? And are you ready? And so that was an important part of that conversation that this really could be life altering and I’ve got to really think about all those things. So that was a conversation nobody else had. Others said “Well, you know you’d have to continue seeing patients in some capacity. That’s really important.”

That wasn’t really the question. The question was in terms of what you see yourself. Are you willing to go down a different road which closes the door on the other road?

No one is framed it that way.

You’re in front of a group of mid-career doctors and they’re all considering a leadership or management role. You have a chance to change their lives and affect them in a positive way. What are five things you’d say to them?

1. Making that decision is not a fork in the road choice. It’s as if you’re somewhere on a rainbow, between two colors. You don’t wake up one morning and say “I’ve been an orthopedic surgeon for the last 20 years and now I want to be red.” Start stepping into roles and taking on projects. Become involved in hospital activities and start to take on a leadership role and get in front of people. Explain what you’re doing and then ultimately having some process or some procedure or some division or have something tangible that you have affected change the business.
2. Demonstrate some aptitude for the executive world, in team building, project development, project management. Have some responsibility for the budget for a team. And maybe hiring and firing decisions or at least decisions about increasing or decreasing services and going through some of the complexities. You’ve got to be interested in people. You’ve got to be ensuring the organization. You have to have some of that some of that leadership aptitude
3. Be comfortable with the pace of change. Understand that being an executive is going to take time away from some of your clinical responsibilities. Every quantum of time that goes to your management responsibilities is going to take away a little bit of that experience of a physician and ultimately will take away some of your expertise. The fewer swings a golfer takes the more errant the shots he has. Are you ready at this stage to dial down a little bit?
4. The last is there could be financial consequences, especially for the more lucrative specialties. They’re lucrative for a reason, but they’re also incredibly difficult to sustain over a long period of time. Understand that while there may be other opportunities there may be erosion of income for some for some folks, or maybe augmentation income for others.

Balance and understanding of what makes you tick is critical.

You asked me a question before that I didn’t answer and I want to answer. You asked me about anything that I screwed up. There’s one of the things that I screwed up very early in my time here and I’m very aware of it and I’ve probably messed it up a few other times. It has to do with power dynamics.

It was Christmas Eve 2014, and everyone was leaving early. We’re closing the office and I was leaving, and it was right around noon. I was working on a report. I was going to be gone for the next week and I just wanted to finish a report and I needed a piece of data that our quality director had, a nurse and she’s fantastic.