It's now three and a half years since I left clinical medicine and leapt at the opportunity to put my population health hat on for an administrative position within the hospital system that I'd devoted my clinical career to.
What does my life today look like? How have I navigated going from what was 6 shifts per month to a 5 day a week job with meetings that occur as early as 7pm and run as late as 7:30pm?
When I started this position, despite it being a hybrid job with up to two days of remote work, I went into the office 5 days a week for 3 months. I knew that, despite my pedigree and professional relationships, I was technically under-qualified for the job, so I wanted to let the people who took a chance on me know that I was worth the risk.
I sought to get to know the personalities on my team; to understand the privileges and headaches associated with the administrative role; and to become a familiar face to the 60-odd employees. In service of that goal, I arrived early every day and worked through every lunch.
How'd that work out? Imperfectly - the COVID pandemic was still in full swing when I joined, so with the exception of a few small executive gatherings, I remained in my office and all meetings were done on computer via videoconferencing.
As a father of school age kids still living at home, I made it a point to stay no later than half an hour past end of day (every other executive on the team was routinely staying 30-60 minutes after) to make it home in time to eat dinner with my family. That helped level-set with my team. While there were inevitably some scheduled meetings that ran through dinner,
My colleagues on the executive team expressed appreciation for my commitment and work ethic. If there was unfinished business to attend to, I logged on after dinner to ensure I responded to queries and put out fires.
I loved those first three months: the crash course in medical leadership, the ability to serve as the physician voice at the policy-making table, the ability to advocate for patients when meeting with health plans.
It's hard to disentangle the novelty of the job with the novelty of getting to use the restroom when I needed to (in the ER I'd held it for hours on end), getting anchor sleep on a regular basis, feeling an order of magnitude less stress than I'd experienced in the ER, and being suddenly available to socialize with friends and family every weekend.
I can't believe the rest of the world isn't shouting from the rooftops how lucky they are to pee as needed (pee PRN? see what I did there?).
To this day, I consume copious amounts of fluid on the job and take gratuitous trips to the restroom, simply because I can. It feels magical to do that.
My third year into the job overlapped with my father's long farewell and eventual death, and the experience reinforced two messages for me. First, that time with those we love is fleeting. Second, that the job was only to going to consume more time going forward.
A couple of months after my father died, I let my boss know that I was not going to be available in the way the job required, and thanked him for the opportunity over the past several years. I went in thinking this was the end of my time in this role.
After a lot of back and forth, my boss graciously asked me how available I thought I might be. I told him I could work half-time, which I happened to be aware was the minimum required to maintain employee benefits. We agreed to a trial period to see if I could continue to add value in a half-time capacity.
I am now approaching one and a half years in my half-time role. I am grateful that the leadership team still sees me as adding sufficient value to justify my continued role. They have also communicated that they will eventually be adding another MD to the leadership mix, because they require a full-time physician leader's availability (something, despite their repeated kind offers to return to my prior full-time role, I do not wish to give at the expense of being available for my family).
This puts me in a precarious position, which I have come to accept. Their new hire will be my superior. I am uncertain if I will work as well with that individual as I have with the senior management team. It is possible that they will be threatened by my presence, or will decide I am superfluous.
Here's the thing: my work-life balance has never been better. I am often around my kids when they are willing to talk, right after school. My wife and I get to enjoy date night as a regular feature we prioritize in our lives. I just zipped up to visit my mom and newborn nephew last week, and it was a joy to have time to do that on a whim. I rode my bike, lifted weights, and walked with a friend in the past week. I attended a dear friend's film debut. I have a book club scheduled for an evening in the coming week.
I don't want to give up these small joys, each of which provides me pleasure out of proportion. For decades, work has always had to come first. Thanks to financial literacy plus a couple of decades, it can finally be a secondary factor in my decision-making.
That's a wonderful position of strength to be coming from. Do I feel uneasy with the job uncertainty? Of course. But not enough to breach my professional boundaries.