Want to get as many letters after my name

[Tim]

@Rogue Dad, M.D.,
“If I was actually good at getting funding my tweet would probably be “Who else loves academic medicine as much as me?” Once (if) I get that big grant I’ll change my tune as I rise to the top, forgetting all the pain that it took to get there”

Time will tell. If the next meeting about that promotion starts out with the Dept Chair starts with “Have you given any thoughts about where you would like to work next?”
Either the grant didn’t come through or your social media presence was very effective.
Most likely the promo will come with a smile, “Congratulations, more grant applications. You are making great progress. Maybe next year.”

[Anne]

Yes, speech has consequences. Not speaking up has consequences too. Have you ever not spoken up about something because of fear of consequences and later regretted it? I have. Would I have regretted the consequences more? I'll never know.

Hopefully we all have things we care about more than a job or promotion and can decide when to speak up and bring attention to a matter that we think needs it. I've said it before and I'll say it again, one of the great things about financial independence is that it gives you much more freedom to be the squeaky wheel when you think the situation warrants it..

As a general rule, if you wouldn't be comfortable saying something in face to face conversation, don't say it behind a veil of supposed anonymity. I don't think any of us who share any degree of personal info can truly be anonymous, unless I guess we lie to muck up the details . It would be difficult for someone across the country to ID us but not a coworker.

I would encourage everyone with children to have a regular conversation with them about these issues, especially as the comments and pics they post or pictures/video they take without the benefit of a fully developed prefrontal cortex can really harm them. Someone on another thread made a comment about wishing it was still the 1990s, pre-social media. I don't want to go back to the 90s--the fashion trends were truly hideous--but I'm glad there was no social media, internet access, or constantly available cameras/video when I was a teenager.

[Dreamgiver]

Comparing yourself with people who have it worse off might be a good coping strategy I guess. However, I think that comparing yourself to people better off than you leads to overall better conditions for everybody. I do think physicians' environment has gotten worse in general. Yes, salaries are good and that's what keeps a lot of people around. There are a lot of people out there with a lot less education who make more than most physicians with fewer work hours, fewer regulations, and a lot less liability. Yes, these are smart people who took some risks, not any different from many physicians.

As far as the original question, MBA would be the best way to go. Think about this though. What is that you are after? Money? For several specialties it would take a lot of ladder climbing for many years before you'd break even financially. Is it power? Is it the ability to shape things? What is it? I have an MBA. Started sitting in some admin meetings and wanted to poke my eyes out. Quickly shifted course after that and sticking with clinical medicine which is what I love and employing my MBA skills for non-medical endeavors. Financially I'd have to become a VP level admin to break even. And I would not care much for the job to be honest as a lot of (not all) admin work is meaningless. My clinical work is not meaningless. There are some good administrators, few and far in-between. New leadership comes and heads fall no matter how good you are.

[RogueDadMD]

Lol -- one thing I've learned from successful researchers is that there is an inherent randomness in the process, and also that success begets success.  The amount of failures it takes to succeed is enormous, and that's what the most successful researchers tell me.  That is probably similar to many other fields, such as entrepreneurship.

I don't think the system is rigged similar to an MLM, but I do think it is hard to decipher, and I do think it is not always logical why some  fail and some succeed.  I've had numerous researchers tell me that (both successful and unsuccessful).

My direct boss knows my active interest in research and my ongoing efforts despite some failures (and some successes).  My department chair doesn't know me as well.  However I have numerous papers in progress, am actively participating in grants (also PI on a grant), and planned grants.  So at least I can fall back on the fact that I have no trouble showing I am putting forth significant effort (which I am), despite potentially being viewed as a malcontent on Twitter. I don't view my Twitter account as purely anonymous -- my division head knows about my blog and has known about it for 2 years.  Lots of my co workers know about it, though I have no idea who looks at Twitter, I always assume my boss could see it.  I think it's unlikely my bosses give retribution over a tweet that was not disparaging towards any individual or institution in particular, but I can't predict.

If I'm being completely honest and trying to give myself credit, I don't think I am a failure at research.  I've not hit the milestones I wanted, but I am progressing and have hit some good milestones.  However I just had a grant with a hard rejection that is coloring my thoughts.  That's the danger of social media... using it to vent publicly when in the past it would be done privately.  Many highly successful researchers have far stronger words to use -- what I said feels rather tame compared to what I hear others say (albeit in private, which is the difference).  I agree the safest thing would be to just delete the tweet -- it's just 280 characters of throwaway text.  Perhaps I'll do that soon.

[Tim]

@Anne,
“As a general rule, if you wouldn’t be comfortable saying something in face to face conversation, don’t say it behind a veil of supposed anonymity. “

Face to face adds a tremendous dimension of communication, non-verbal. How one delivers the words are sometimes as significant as the words themselves. Tone, setting, facial expression are a really big deal.

[ENT Doc]

I am all for speaking up when it is an ethical imperative because you’ll always win that argument, especially if framed well and not as an attack on someone. But there are issues between the brand of coffee in the lounge and protesting egregious behavior that simply are not worth dying on that hill for. Some are. Free speech is great. But it does require knowing how and when to exercise it for strategic purposes.

[CM]

hightower wrote:

Lordosis wrote:

Click to expand…

I agree. I think people need to chill out and come back to reality.

I would love to be a fly on the wall in a blue collar bar where a physician was complaining about his job to roofers and mechanics.

 

“Now we have to check this box to show that we asked everyone if they have had any falls in the past year.  I swear if they add any more clicks I am going to quit!”

Click to expand…

This line of thinking is literally the only thing keeping me employed as a physician.  I’m thankful for my blue collar upbringing for this reason.

Click to expand...

I've been a dishwasher and a cook. I've collected scrap lead and melted it in a closet a foot from a 1200 degree furnace. I've delivered papers in darkness at 3-4 a.m., sold ice cream from a truck, and mopped urine off the floor in a nursing home. I've mowed lawns, done landscaping work for a convent, and been a pool boy at a country club. I've done boilermaking work in July when it was 97-98 degrees just about every day, and I've even been a bellhop. So I've got plenty of experience with blue collar work.

Every one of those jobs was easier and less stressful than what I do now, and I'd switch to any of them now (but one) if they paid 1/4-1/3 (maybe 1/5) of my current compensation. (I'm no longer capable of doing the boilermaking work at this age.)

Given our compensation and autonomy, the intellectual nature of the work and the meaning, I think it beats most comparable white-collar professional jobs, e.g., investment banker, equity analyst, portfolio manager, lawyer, consultant, or MegaCorp executive. But I start sprinting every day as soon as my alarm rings, and the day is very stressful. My blue collar jobs were a breeze, very relaxed -- even though I was invariably the hardest working guy on every job. There was little responsibility, no liability, and no pressure.

I've tended the grass on both sides of the fence, and it is greener over there -- except for the compensation.

[Anne]

Lol good coffee is worth fighting for.

I'm not arguing with you ENT doc and I don't doubt you believe in free speech.   Nor am I naive.  I know people can get themselves in trouble just by offending someone who has power over them, I've seen it happen plenty of times.  It's just troubling to me when people have to worry so much about voicing their thoughts and opinions.

 

[Tim]

@CM,
I was greatly impressed with variety of experience. It struck a chord, although a few different experiences.
High strung, high motor, high achiever. Is it possible to adjust the speed? You are running at 110%. By your words, you were outstanding in the other occupations as well.and most likely would have assumed more responsibility and still been striving to get better.

CM at 90% is still pretty darn good. You get the point, some of the pressure is most likely internal and can be cut out. Never did the boiler work. So what would I know.

[CM]

Tim wrote:

@cm,
I was greatly impressed with variety of experience. It struck a chord, although a few different experiences.
High strung, high motor, high achiever. Is it possible to adjust the speed? You are running at 110%. By your words, you were outstanding in the other occupations as well.and most likely would have assumed more responsibility and still been striving to get better.

CM at 90% is still pretty darn good. You get the point, some of the pressure is most likely internal and can be cut out. Never did the boiler work. So what would I know.

Click to expand...

Thanks, but I wouldn't say I was outstanding at mopping urine, mowing grass, or washing dishes. :-)

Some of the pressure may be unnecessary. I write more comprehensive notes than 90% of colleagues, which is time-consuming, but I'm not comfortable doing less. Also, I can't stand to be late for appointments, something most of my colleagues don't seem to struggle with, but I blame my hyper-punctual father. Because I don't want to be late for appointments and don't want any surprises that I'm not prepared for, I study all of tomorrow's charts today and take notes and make a preliminary plan. I'm the only sap that does this, but so far I don't feel comfortable unless this work is done. However, it's patient care that causes this; I didn't create extra burdens for myself as an equity analyst.

The boilermaker work is the one job I wouldn't want to repeat. It was about an hour and 45 minute commute to the job site so I was up before 5 a.m. for the 7 a.m. start. The heat was oppressive in hard hat, goggles, gloves, long-sleeved shirt, jeans, and boots hanging off the side of a hook ladder by one leg and one arm 30 feet in the air grinding off spot welds. The regular guys just paced themselves. Still, there was no pressure.

 

[Tim]

@CM,
There is a method to my madness. Guilt. You mentioned your father and your compulsion for performance as a physician. I recognize the symptoms. At some point it is actually healthy to lower the speed to maybe 80 or 90?

Running at 110 % seems to produce diminishing returns in terms of career satisfaction in medicine.
SHS had some thoughts, it’s difficult for physician to find balance running over redline in the name of perfection.
https://www.kevinmd.com/blog/post-author/side-hustle-scrubs

So when you figure it out, let me know. Sometimes it’s best to ease back on the throttle. Letters behind a name is one example, your performance is another.

Burnout and over commitment are real issues. Minimizing self inflicted sacrifices seems prudent. Looking for the key to turn off the engine. It shouldn’t be a 24 hr race.

[hightower]

CM wrote:

hightower wrote:

Lordosis wrote:

Click to expand…

I agree. I think people need to chill out and come back to reality.

I would love to be a fly on the wall in a blue collar bar where a physician was complaining about his job to roofers and mechanics.

 

“Now we have to check this box to show that we asked everyone if they have had any falls in the past year.  I swear if they add any more clicks I am going to quit!”

Click to expand…

This line of thinking is literally the only thing keeping me employed as a physician.  I’m thankful for my blue collar upbringing for this reason.

Click to expand…

I’ve been a dishwasher and a cook. I’ve collected scrap lead and melted it in a closet a foot from a 1200 degree furnace. I’ve delivered papers in darkness at 3-4 a.m., sold ice cream from a truck, and mopped urine off the floor in a nursing home. I’ve mowed lawns, done landscaping work for a convent, and been a pool boy at a country club. I’ve done boilermaking work in July when it was 97-98 degrees just about every day, and I’ve even been a bellhop. So I’ve got plenty of experience with blue collar work.

Every one of those jobs was easier and less stressful than what I do now, and I’d switch to any of them now (but one) if they paid 1/4-1/3 (maybe 1/5) of my current compensation. (I’m no longer capable of doing the boilermaking work at this age.)

Given our compensation and autonomy, the intellectual nature of the work and the meaning, I think it beats most comparable white-collar professional jobs, e.g., investment banker, equity analyst, portfolio manager, lawyer, consultant, or MegaCorp executive. But I start sprinting every day as soon as my alarm rings, and the day is very stressful. My blue collar jobs were a breeze, very relaxed — even though I was invariably the hardest working guy on every job. There was little responsibility, no liability, and no pressure.

I’ve tended the grass on both sides of the fence, and it is greener over there — except for the compensation.

Click to expand...

I agree with you completely.  I used to work in a greenhouse where my job was to water and move around roses all day long.  No kidding, I used to stand there with a hose sniffing roses all day.  I often fantasize about how easy my life would be in a less stressful job, but it's that enormous pay cut that's preventing me from doing it.  We could afford for me to work a job making only $50-60k/yr and we'd still be able to make ends meet, but we wouldn't be able to save much of anything or afford to go on vacations anywhere other than local campgrounds.  It would be tough from a money standpoint.  So, if we wanted to live frugally and save, we'd have to sell our house and really down size quite a bit to keep our expenses low.  We're okay with doing that if we have to, but we haven't felt the need...yet, lol.

[Lordosis]

My first job was in a sewer plant. It was hot and stinky. I will stick with medicine.

[Tim]

Sometimes we don’t take the time to express gratitude.
To all colorectal surgeons, thank you for your service.

Lordosis’s comment reminded me of Mike Rowe’s Dirty Jobs program. Please blame him.

[Lordosis]

Tim wrote:

Sometimes we don’t take the time to express gratitude.
To all colorectal surgeons, thank you for your service.

Lordosis’s comment reminded me of Mike Rowe’s Dirty Jobs program. Please blame him.

Click to expand...

Blame me or Mike Rowe?