Weekend Blues

So, now it's official. I am unemployed.

On vacation, with internet access problems, a market melt-down and the intense heat... oh the heat. Well, I'm the guy who wanted to live in the desert!

This is the summer of our discontent.

I was having a discussion with a colleague about the option of going into practice for myself versus being an administrator at a larger organization. This is probably a good time to evaluate what I've been doing.

I spent over a decade in medical education, got the admin bug and realized that primary care and universities had such disparately aligned incentives that university-based residencies did not represent a fruitful future. In fact, university-supported, community-based affiliations appeared to be the best compromise for a primary care training program.

Armed with an MPH and a desire to develop my management skills, I found an FQHC and had a great 3-year ride where I helped stabilize and grow an organization that served 10,000 of a potential population of over 100,000. I started yearning for greater growth, a larger organization and most definitely a smaller town without any beltway-style traffic.

Unfortunately I did not heed the words of an adviser who made the point that the majority of organizations in this country make medical practice and medical management particularly unpleasant. The last six months must be characterized as a failure, although the challenge was huge and clearly evident at the start.

So, in this context, my colleague was asking why I wanted to continue working in management. It is a good question, given that I believe that good management is invaluable to physicians. Perhaps I can be forgiven for having a bad taste in my mouth for the people I have worked with and for generalizing to the world of medical management. The sad part part is that "good medical management" is awfully hard to find and I am nobody's cavalry. The good organizations don't need me and the bad ones will chew me up.

But it's due to be a beautiful and hot weekend here in the desert and remember, it's not the heat... it's the humidity! Have a great 4th of July.