7 good things

Yesterday I was having a conversation with Luca about regrets.

I think in many ways, my stint at The Industrial Supply Company From Hell (TISCFH) was a total and utter waste of my time. I keep in touch with practically nobody from the company. Working there raised my blood pressure and gave me an anxiety disorder. I have completely abandoned a lot of the things I learned there.

In some ways, I regret that I did not have the balls to quit the consulting firm and to go to a post-bac program or other research job right away. I already knew that I wanted to go to grad school, and I knew it wasn't going to be an MBA that I sought. I think how much farther along in my career I might have been. This happens most often when I talk to friends from my cohort who are attendings already.

On the flip side, I probably wasn't actually ready. I didn't know how to go about getting the research experience I needed to apply to grad school. I didn't know how to get the letters of recommendation, or what the other requirements were. I didn't know anything, and I was afraid to jump, or even to try and find out.

I was afraid of failing.

So I ended up at TISCFH in a job I hated with a boat-anchor boyfriend.

Can you say, "Wasted three years," boys and girls?

On the other hand, I probably wouldn't have gotten into THIS MD-PhD program had I applied straight away. I probably wouldn't have met my husband.

So I thought about it, and I came up with 7 things I learned from working at TISCFH that have helped me in the long run.

1) Know when to keep your mouth shut when you're getting BS constructive criticism. This is a completely invaluable skill that is worth mastering in any field.

In fact, I got so good at eating s*** at that company that when one of my not-favorite OB-Gyn residents gave me constructive criticism that was just as BS, I managed a sincere sounding, "I really appreciate the time you took to alert me to these problems. I will do my best to prevent that from happening again in the future." I was so sincere sounding that they even mentioned how gracious I was on my eval.

And sometimes when you think about constructive criticism in retrospect that you thought was BS, you realize there might have been something to it. And now you haven't burned that bridge with the person who gave it to you. Isn't that nice?

2) You can run a very effective and efficient organization without the aid of gadgets and the latest expensive technologies. I alluded to this in a previous post, and in many ways I think TISCFH was a little draconian with this philosophy. On the other hand, I have seen first hand how effective processes are completely vital to an organization, and also how idiotic technologies can screw even the best process up.

For this reason, I am skeptical any time someone touts an Electronic Medical Record as the panacea of health care quality improvement. An EMR won't fix a thing if the underlying processes are crap. It may even make things worse.

3) I learned how bad it can be. Granted, I never (and still have never) pulled an all-nighter at TISCFH, but as a receiving supervisor, I had to be at work by 5AM 5 days a week, and was there until 5PM or later most days. Add this to two hours in the car every day and a hostile work environment that at times made me want to vomit all over the warehouse floor.

All I can say is that my rotations were not the shock they might have been otherwise. And I felt really grateful that I no longer had to spend my days watching my employees unpack boxes.

4) I got to manage my first group of employees. I cannot tell you how helpful this has been in the hospital. I began to learn something about what makes a "good" employee versus what makes an "ok" employee, and that it's not just a matter of a boss liking one person better than another.

When I'm in the hospital, every time I am at a loss for what to do, I think to myself, "If there were nobody here to ask, and I had to figure this out by myself, what would I do?" I also think actively about the following question: If I were a resident, what would I want my med student to do. Looking back, my ability to stay consistent with these internal reminders has been directly associated with my performance.

5) I learned how a business runs. What accounting sheets look like, and how an accounting database might be organized. How to measure productivity. How to improve processes. How to figure out if your company is being screwed by an outside organization. How decisions get made.

Doctors often think it's offensive when I say that patients in the hospital are not unlike packages moving through the warehouse. It's true though. They are.

6) The real world is like high school. It's important to work in an environment with people whom you respect, and with at least a few that you like personally. After that though, it's all about how well you do the job.

When entering a new work environment, rather than worrying about whether everyone likes you, worry first about learning what constitutes a good job. If you do that, the people who matter will notice. Some people will dislike you no matter what you do, so it's best to not let it get to you if you can help it. And if it turns out your company culture is toxic to you, don't be afraid to get a new job.

7) How to run a meeting and manage your boss. Some people are easier to work with/for than others. Looking back at some of my not-so-fantastic relationships with some bosses, I can see how things could have been better had I managed the relationship more effectively.

Always come with an agenda, and stick to it. Don't be afraid to ask questions or to ask for clarification when you don't understand -- even if your colleagues tell you to stop asking questions. It's shocking how often that happens -- and in my case at least, the colleagues were always wrong. Don't giggle. Make sure you leave the meeting with a clear understanding of next steps. Speak and act decisively and with authority and people will respect you and give you more responsibility. Take ownership of your work and your mistakes.

It also helps if you are right from time to time, but that gets better with practice.

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So maybe it's good I spent those three years in hell afterall. I'll let you know again how I feel about that when I'm 43 and still slogging through residency or fellowship.