Relief.

I arrived at work this morning to find an email awaiting me from my hospital’s new Chief of Staff. He wants to include me on the patient flow team, and to develop what he termed: “a rational, effective, efficient and sustainable system.” Well, that sounds like some goddamned engineering. Finally. And if he wants me on that team, that means he’ll have to provide hard money to have me there. I don’t have to worry about the financing of it, that’s the administration’s job. When I do work for the hospital, the hospital pays me.

So, I wrote back telling him I’m excited, I have some ideas, oh and by the way here’s a paper I just published in your sub-specialty relating to patient flow. I’m excited by the opportunity to go prove myself to a new person. I’m good at that. And this is an opportunity to go back and shift some of my focus to the real world, local-impact engineering that I was originally hired to do. I love fighting for grants, don’t get me wrong. It’s heavenly to have your job depend on the vagaries of three randomly selected MDs who can’t understand your field. But I’m excited to go and get paid by people whom I can present my work to face to face and explain my methods in dynamic, interactive plain language.

When I graduated, I didn’t think I wanted to be an academic at all. Well, because I didn’t care about doing anything because all I cared about was drinking a bottle of whiskey a day. After I got sober, I still didn’t think I wanted to do academic work, and I said so when I was hired for my position by the big hero PI who hired me. Which he accepted at face value, and then gently guided me into academic work because that was where he saw me. He was an interesting mentor. But he was right: I have something to contribute to the academic world.

Luckily, part of what I can contribute to the academic world is publishing reports of quality work. The literature for the use of engineering tools in optimizing delivery of care is thin, light, often badly done by people who aren’t engineers. In fact, when reading simulation or operations research papers in the medical literature, if the first or last author isn’t a PhD Systems or Industrial engineer (or a business school prof in operations management – that’s a hard math discipline), it’s probably awful. There are a huge number of simulation papers, especially, written by physicians playing with cool computer toys who have no fucking clue what they’re doing. The result is bad work that discredits the industry.

Ok. Rant over. My point is, I think I’m going to get to do some really cool engineering work directly for my hospital again, and it will be publishable and interesting, and actually directly improve patient lives. And I may just be able to keep the job that I have and love, without having to flee to Canada for a lousy prestigious tenure-track position at a world-renowned university. I complain about my job a lot, but it’s a great job, with good pay and great benefits. I’m happy when I’m not stressed about keeping it.

So, the plan: I’ll prepare to meet my new Chief of Staff. I’ll join the patient flow team. I’ll keep writing grants and papers. And I’ll make a difference in our patients’ lives. That sounds good. I hope it works out that way.