Well, this is my very first entry in my very first blog. I better not set the expectations too high - posts will be few and far between, as I'm busy, busy, busy. . . .

If any of you have read my story, The New Job, you know that I moved here after my department was consolidated into another. A colleague of mine, a "friend", or should we say former friend, offered me a position as more of a lifeline than anything else. Unfortunately, the thing is that if anyone should never have become a department chair, he's the one. Saying he has ADD is putting it mildly. :nuke: He can't resist micromanaging things and he doesn't give anything a chance to succeed before he makes changes. Further, we are an academic medical center and there are bound to be fluctuations in activity. Grants come and go and the patient census can be expected to rise and fall - that is the nature of things.

I was here for scarcely a half-a-year when he removed me from my position as a division chief because I "reduced the efficiency of the division." Let's look at that for a minute. When I arrived, the inpatient census on the division was fifteen and the one physician caring for those patients was reaching a state of burnout. At the same time we had three physicians seeing outpatients, none of whom was particularly busy. It only made sense to split the inpatient service in half and rotate the outpatient physicians through the second inpatient service, while at the same time having the former inpatient physician also see some outpatients, too. This had the advantage of improving continuity of care for the patients, while making the inpatient service less "stagnant." Our residents also benefited from having a wider variety of teaching experiences. It was a win-win situation and a resounding success, and the inpatient census skyrocketed even higher, reaching a high of nearly thirty.

But then the natural cycle asserted itself, temperatures cooled, fewer kids shot each other or for whatever reason and the census fell to around eight. Seeing this happen, I was prepared to do what obviously needed to be done - to temporarily suspend the second inpatient service until the census picked up again as it inevitably would (and did), but I was never given the opportunity. I was removed from the directorship person, my salary was cut by 25% and I was removed from the service, with most of my protected research time being eliminated as well. Now as to my having made the service more inefficient - the only way I did that was by the addition of my position - adding a fourth salary to the division budget. I thought I was brought in to create change, but they didn't want change. I later found out that I was brought in expressly to fire one of my colleagues in my division - it was assumed I would recognize the need to fire him right away. Although he certainly was not and is not pulling anything close to his weight, he has been here forever and knows how to use every provision of his union contract to protect himself, and I wasn't about to fire him without cause.

So anyway, the long and short of it is that my lifeline of a job has turned into a bit of a nightmare. I've been shuttled into one situation after another without any regard to what I want to do or to what my strengths and abilities are. I also walked right into the middle of one of the worst political messes in any academic medical center that I've ever witnessed, in which the medical center and the medical school are literally at war with each other. The dean and the CEO hate each other's guts, and the fight has become very personal, without regard to the thousands of lives affected.

A couple of weeks ago, I was called into my boss's office to be told that layoffs were being discussed. The CEO is withholding $1 million per month of money he claims the medical school is now getting from the state and no longer needs from him. That's total BS, and it's total BS that the medical school can't manage with $1 million less in a budget of billions if it has to. Of course the budget has to be balanced at the end of the day, but the dean has to do something to fight back and so he's grandstanding in the media. "If you don't give me my money, I'm going to have to fire some doctors and we won't be able to take care of the poor." Well, as the last hired in the department, I would be the first to be laid off. Never mind that I have a distinguished career spanning more than two decades. Never mind that I've been a department chair and a division chief. I've been unhappy in this job, practically since arriving here, and I've been looking, but everywhere I've interviewed, people have wanted to know why I want to change jobs so soon. At least now I have a reason.

So I guess what I'm getting at is that my writing may have to slow down for a while. I plan to introduce Out on a Limb on schedule, but it may slide, particularly if I find myself involved in a move. I'm interviewing for a job next week. It's in a private practice setting with an academic affiliation - definitely not the sort of thing I envisioned myself doing when I finished school, but after having been burned in academia twice now, being away from the center of the firestorm doesn't seem like a bad idea.