The ten year plan...

I'm a big fan of the 10 year plan. I wrote my last one let's see...about 10 years ago! I've been carrying it with me in my work bag and it's funny because just putting it down on paper without really referring to it, I managed to achieve nearly everything that was important to 38 year old me. For some reason, I divided it into sections: "Lifestyle", "Money", and "Personal Fulfillment." Let's take a look...

Lifestyle:
Travel: check (England, Canada, Iceland, Vietnam, Cambodia, Dubai)
Music: check (founded and played in Boeufcake which sparked the Wallingford Dad-Rock punk scene)
Children: check
4 day work week: check
minimum 4 weeks vacation, 6 better: check and check
out of office by 6 pm: ha! 

Money:
mostly achieved salary goals, mostly achieved retirement planning and student loan repayment. 

Personal Fulfillment:
Spend less time dealing with insurance paperwork: actually, until the ACA, this was true
Serving the underserved: check
Ability to affect community health through public policy and organizational policy: up until 3 years ago, yes.
Responsive staff that balances working with physicians versus working with organization: up until 3 years ago, yes.
Be a leader in medicine, not in the business of medicine: yes.
Teaching: yes.

So this ten year plan had run its course and some of the things I had achieved were clearly slipping away which is why I needed to return to school and why I needed to make a career change. I had a lot of great career advice in the last couple months and what came up consistently is that the 10 year plan as you approach 50 is the one where you go for broke. You write your own job description. You shoot for the stars and throw in everything you hope to accomplish in life and don't worry about how crazy it sounds. So without further ado, here it is 10 year plan 2.0:

1

Finish MHA program – better understand the financial principles and language behind health care delivery, learn how to plan and execute projects and obtain a credential that positions me as a leader in health care.

2

Continue to focus on health care disparities and the needs of the medically complex, socially chaotic whom the current system serves poorly and at great cost.

3

Explore alternative models of primary care delivery which place the provider-patient relationship front and center, and leverage that relationship and continuity of care for long term improved health outcomes and cost savings.

4

Place a high value on a humane, sustainable, and personally satisfying work schedule where employees feel valued and value each other and come to work with enthusiasm and emotional connection.

5

As a mid-career physician leader, I have much expertise and experience and it is important that I have some degree of control over the work I choose to do at this stage in my career.

6

As a family physician who has chosen to work among people with unmet health care needs, I have a unique perspective on the Social Determinants of Health, which are the real source of health care disparities, and my perspective is informed by personal experience. My goal is to improve the health of populations; as such, I have a responsibility to advocate for political change that addresses these social determinants.

7

It is becoming increasingly clear that providing primary care through a competitive private insurance system is antagonistic to points 2-6 and my plan is to achieve these goals while minimizing my engagement with the insurance industry.

I agree that this is all pretty crazy stuff and no one is hiring for this exact position right now (If you are let me know, I am ready to start immediately!). I am fortunately in the position to take some time to plan all this out, finish school, spend some time with the boys and figure it all out. I will be doing some part time work or short term jobs as interesting opportunities come my way and I am interested in exchanging ideas with people along the way. And hopefully writing a lot more.