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Posted Aug 23 2008 10:37pm
I was hell-bent on coming out West, knowing that coming to a turn-around could be dangerous. I recently discovered that my 6-month tenure as Chief Medical Officer was beaten on the short side in recent company history. So the worst-case scenario of living here for six months to decide if it would finally become a long-term living decision has come to pass. The cost was living through some emotional turmoil for a few short months, rather than wild success at a company that was ready for the things I am passionate about (quality improvement and care for the under-served).

Interviewing is always a fun activity, and one which I am getting good at, with some mixed feelings. Physician groups with a strong professional streak talk about independence and the lack of managed care in their practice, important people in town who come through their doors and unlimited compensation based on how hard one is willing to work. We never hear about the price on one's family and loved ones of giving up nearly all leisure time to "properly" take care of people. Sometimes medicine can have a strange culture.

Service organizations, especially with public governance tell you their civil service salaries up-front and proceed to tell you about their wonderful government benefits. Intangibles count, I guess.

Teaching groups always talk with pride about full-spectrum family medicine, including ward service for children and adults, maternity care, nursing home, etc etc etc. It's a bit like an extension of professional pride with a service twist, but this is a rural area and family docs can get away with being "stem-cell" physicians. Any city worth its salt has enough specialists to prohibit the practice of being a true generalist. It seems vaguely unfair, but the other concern is that physicians are now guarding their lifestyles a little better than they did a couple of generations ago. Why would anyone want to be an internist, a pediatrician, a hospitalist, an obstetrician, a teacher, a manager and a business-man at the same time, even if they may be capable of doing some of those things on some occasions?

All I want is to sip wine from my deck at home on top of a desert river gorge with snow capped mountains off in the distance at the end of a reasonable day's work with some challenge but a minimum of heart-ache!

I know, I'm nuts!
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