Anxiety and Anticipation.

As I move forward discussing a new position with a new institution, the practicalities of it become more and more probable. I’ve been where I am now for four and a half years, and I’ve been largely happy. But the last year and a half or so have been more difficult from a professional perspective. The department has a new focus on economics and the dollar value ROI of our work. I find this really depressing. It’s one thing to say, “this institution needs to remain economically viable.” It’s another to say, “every project we do needs to have a specific fiscal return, and that’s the most important part of your work.”

We haven’t transitioned all the way to that second sentence yet, but the senior leadership has been telegraphing that that’s where we’re headed. I loathe the concept of billable hours and justifying my salary with my own specific returns. That needs to be done at the department level.

I also have personal issues about the person I now report to. My boss is overall a pretty good boss, but she’s got me pigeonholed as a middle manager. And not a particularly well-performing one. I’ve gotten the worst performance reviews of my professional career under her. In fact, I’ve gotten the only reviews that aren’t pretty exceptional. It’s ego-bruising, but also it’s dispiriting.

We’re now in a situation where my boss has decided to insert an interstitial layer between herself and the people at my level. So I’m effectively being downgraded. This new person is going to come in, read my last couple of reviews, and perceive me as a mediocre asset. That’s inevitably going to be career limiting.

The truth is I can basically do what I want to do where I am. But I have a ceiling over my head. I have a shifting institutional culture that I’m not fond of. And I may have a real opportunity to step up: to do larger scale institutional efforts, with a larger team reporting to me, and without the pressure to make specific financial contributions, but rather to be a partner with clinical and administrative assets to improve care.

I want to be in a place where the things I’m best at are the things I’m valued for. Where I can design and manage the contribution I make. And increasingly, that looks like it might need to be somewhere else.