I’m baaaaaack…..?

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Happy New Year!  Nothing says a fresh start to 2013 like a closeup photo from The Shining.  🙂

But I am back.  Part of me wants to hedge and say “well, I am back….but sort of”, or “well I’m just part-time.”  Until I quickly realize that those are old, familiar, ridiculous cultural scripts that I have been purging from my life for the past three years.  That crappy mantra that you spend a good chunk of your life training for a profession that you truly have no idea what will look like over the course of your life, and then you get a job and stay in it for the remainder of your career come hell or high water.

What a crock.

For those of you who regularly read my blog (and a very special Happy New Year to all 33 of you!), you know that roughly three years ago I essentially walked away from more than a decade in clinical medicine to reclaim control over my life and happiness as a consultant.  It’s been a wonderful and powerful growth experience, and a great exercise in trimming the b.s. out of my life.

So I was understandably surprised at myself when I decided last year to get back into clinical practice.  (For the gory details, feel free to visit my post “Dipping a Toe Back in the Pool“).  I’ve now been back in academic clinical medicine for roughly 3 months, and a few of you have asked me for an update on how things have been going.  So here it is:

Keeping in mind that I am still in my honeymoon phase and I have yet to experience all of the crazy politics and administrative pressure of being back in clinical practice……I am over the moon, deliriously, spectacularly happy.

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I don’t think this is an accident.  I think this is an amazing combination of right people, place, and time.  Specifically speaking:

1. My chairman is a god.  Ok, well that’s exaggerating.  Mostly he’s a simply fabulous guy who has managed to become a very skilled administrator while maintaining his coolness as a human being.  He hired me for a very specific role, and since my arrival has not for one minute started piling on “other duties as assigned”.  In fact, there is no such clause in my contract (this being my second time around at this particular rodeo).  In fact, the person who is putting the most pressure on me to be productive is me.  As far as he’s concerned, my first year of salary was a line item in his budget, and he is constantly reminding me not to put too much pressure on myself in my “ramp-up” period.  He also tends to hire lovely, energetic, passionate physicians, so I am surrounded by a department full of (mostly) amazing and happy colleagues.  Yes, I think he is part alien.  He also had a charming accent and likes to put “eh?” on the ends of his sentences, even when they aren’t questions.  Lovely.

2. I am protected from the aspects of clinical medicine I found most damaging in my previous existence.  Really this boils down to three things.  First, I don’t take any overnight call.  NONE whatsoever.  Some docs don’t really mind overnight call.  For me, it made me beyond miserable.  To be fair, my last incarnation of overnight call was in the most dysfunctional model you could ever imagine: in an outpatient practice that received 35,000 patient visits a year, we had NO nurse triage to screen overnight calls.  ANY parent https://www.neon-das.com/cgi-local/store/commerce.cgi?product=EFOthat called into the clinic was routed directly to the on-call physician.  Which meant we were answering parents calling us at 2 in the morning to let us know that their child has had a mild cough for the PAST THREE WEEKS and what should they do about it right that instant?  My favorite was a parent who called me at 4 am to tell me they had run out of baby formula.  Clearly, I went to medical school so I could direct people to look up their local all-night drugstore.

Second, since I don’t have any call, I HAVE NO PAGER.  For those of you who have never carried a pager so long it has actually melded with the flesh near your right hip, you won’t totally get how important this is.  I nearly broke out into a little dance in my chairman’s office my first day at work when he looked at me in his thoughtful way and said, “No, I don’t think you need a pager….not at all, eh?”  My colleagues and my administrative staff all know how to get hold of me through email or my cell if it’s urgent (which it rarely is).  Getting rid of that piercing electronic tumor at my waist has been a very liberating experience.

Third, I have SUPPORT.  A LOT of it.  I have an administrative assistant who handles all the scheduling and paperwork nightmare that I used to have to do for myself.  I have a coordinator who schedules all my patients, takes care of all the insurance approval, and vets me through the right offices for any need I have.  I have a dedicated nurse in clinic who knows exactly how I like to see patients.  And most importantly, all of them are HAPPY to do their jobs.  It’s a miracle.

3. I am part time.  I cannot stress enough how this has been the cornerstone of my happy return to clinical care.  I spent the last three years developing a thriving and satisfying consulting practice, and there was no way I was going to walk away from that.  I’ve started back clinically working one day a week.  Realistically, I work a little more than that in that sometimes I have to take care of some occasional communication or patient followup a different day of the week.  Which, when you love your job, is not a resentful situation at all – it’s part of building a practice.  But it allows me to grow at a unhurried pace and not have any anxiety about justifying my salary.  Plus we have already planned for adding in a second day if (when?) my practice gets too big for one day a week.  Mostly though, being part time protects me from the institutional and administrative politics that I found so damaging in the past.  Working once a week, there is no expectation that I will sit on multiple committees, attend numerous staff meetings, or get sucked into university service I have no interest in doing.  The things I get involved in I do by choice, and make sure they are projects I want to be part of.

4. I am valued.  In this disposable day and age, it is simply miraculous to work in a place where you get to provide a unique service that no one else does, and people actually tell you how grateful they are that you are there.  The fact that I view this as miraculous is sad, but it’s just a fact.

I know how fortunate I am to wake up pretty much every day of my work week now and look forward to what the day has in store for me.  I also know it’s not luck – a lot of work went into making this happen, and still does.

In the spirit of moving forward in a new year, I’m including a link to Kathy Caprino’s most recent article, “The 8 Most Damaging Excuses People Make for Their Unhappiness.”  I have always found her insights to be spot-on when it comes to getting unstuck and allowing yourself the opportunity to have a happy and healthy career.

As always, thanks for reading.

~lumi

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