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My Journey to Power

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Another important info that I learned from my supervisor:

At some point, one of the two current chiefs of the rotations (Bob and Antonia: him 63 years old seasoned politician and her 40ish ambitious tough woman, both with ego problems), Bob gave his demission. It was not accepted by the now retired head of the paediatrics departments because "they did not have any one else to replace him with". The retired head of the paediatrics department is gone now in august. Nobody liked him because he was actually just doing research and not doing his management/leadership job which led to a power vacuum filled by the heads of units (cardiology, etc.). And also left the department without a vision nor a direction, leading to even more dysfunctions.

We have 3 people who are at key functions and decide our careers: Bob and Antonia for the resident physicians and Juanita for the attending physicians. They are gatekeepers. The problem is that all of them have ego problems, are power hungry and workaholics, so you guess what kind of people they select or not select.

That's the current situation.

Lucio Buffalmano has reacted to this post.
Lucio Buffalmano

Yesterday I had a phone call with a colleague who gave me some advice on this situation. She thinks that it's already set in stone and that I can mention it a last time in an email.

However I got a great info from her

Another head physician who's actually a much better person than Bob has been interested in doing Bob's work since 7 years. I know this guy and I think he would be a much better fit of course. He respects resident physicians much more. The problem is that the current situation is based on how much Bob likes you to give you what you want. And he's known to be racist, xenophobic and

So here it comes:

My strategy

I'm going to be as bold as pushing Bob out of his job. He's done too much harm. He's broken too many careers. It's justice time.

Phase 1

We're going to meet the big boss and I'm going to tell him 2 abuses I've been subjected to: unpaid overwork (had to work during my holidays) and this rotation situation. The big boss was the one to tell us that he's interested in this topic.

Phase 2

As head of the resident physician committee we're going to do a survey towards the 60 resident physicians regarding the rotation transparency (what do you like? what you don't like? what would you change? What problems have you encountered? How are you satisfied?).

Phase 3

I'm going to summon a meeting with the committee (the 5 of us) and the 2 of them (Bob, Antonia). Or even 3 of us and 2 of them. The importance is that we're in majority to display superiority. We're going to present ourselves (we meet the big boss 4 times per year and keep him informed of our progress), tell them we officially represent the 60 resident physicians (they don't), present them the results and ask them to answer the questions. So we're going to reverse the power dynamics completely here. We're going to judge them and see if they're the right fit for this position (I'll slip: "what type of specific training did you have for this position?"). We're going to collect their answers and thank them.

Phase 4

After the meeting, I'm going to contact the head physician interested by Bob's job. I'm going to make an ally out of him in this. I'm going to tell him that we had this meeting and that soon we will meet the big boss. I'm going to ask him: "Do you want us to tell the big boss that you're interested by this role?"

Phase 5

We're going to transmit the answers to the resident physicians by email. This will also increase transparency.

Phase 6

We're going to talk with the big boss about this meeting and look for solutions with him. We're going to plant the seed that the other head physician would be a better fit.

So basically we will take the problem and make it in the open. They will also have to have accountability, which they don't have yet. The goal is to design a fair system of rotation attribution. Also we will propose a plausible alternative to Bob. So all the forces will go in the direction of Bob going away. With more pressure on him, Bob is going to feel uneasy. Knowing he already wanted to resign is a key information. Antonia will start to smell that this position is not as good as she thought it was (she works on it 1 day a week). So they will smell that they're soon toast. There will be more control over them as the system I imagined allow more transparency.

I'm also going to read: "How to deal with tyrans" from Epictetus. This is going to be good. I also decided to apply to another city with a university hospital as I'm tired of their Shehanigans. I was going to tell Bob just to imply: "look what you're losing" but this immature and personal. I will keep it a secret until I have an answer.

Also, I have empathy for Bob as if he wanted to leave this job, it also sucks to do a job you did not want to do anymore. Also there was a new system to hire resident physicians put in place 3 years ago because he was already doing what he wanted in the hiring process (not the rotation attribution). People complained.

So the only answer to too much personal power in an organization is: systems of control. I'm an engineer, I will design such a system.

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Lucio Buffalmanoleaderoffun

Great John, go for it and keep us updated.

Just keep in mind this is a great plan, with an ambitious goal, and it requires lot of skills.
And as any ambitious goal, it may carry some risks along the way for you, and you may get some pushback or not everything may align.

But you can learn from all the hiccups along the way.

Some notes:

Quote from John Freeman on August 14, 2022, 9:02 am

Phase 1

We're going to meet the big boss and I'm going to tell him 2 abuses I've been subjected to: unpaid overwork (had to work during my holidays) and this rotation situation. The big boss was the one to tell us that he's interested in this topic.

Some notes I'd make here:

  1. Frame it as 2 bad things he did, but not as abuses on you. High power people short on time want to side with strong parties who drive things forward and carry them to victory, not with the abused ones they need to rescue at their cost of time and (emotional) resources
  2. Frame the overwork as something Bob fails to appreciate and (emotionally) reward for, not something that you were forced to do. The high bosses always want to get as much as possible from the employees, so the frame of "he gets us to do overwork" is not good enough for your objective
    1. Say you'd have done the overwork anyway, you don't want to run the risk of people rethinking bad of you because you "gave too much". Bosses want employees with a self-sacrificing spirit. Say you'd have done it anyway, but his attitude make you feel bad for giving, instead of happy to be a giver as any good boss should
    2. The frame must you'd have done even more with someone else, not that's a wining frame that serves your goals
  3. Frame the rotation as a black box that is not based on any objective measure, rather than something you were wronged for

Overall, the biggest risk is to make it seem like a personal thing. So the best frame must be not so much on "this person is bad", but on the improvement you can gain -ie. "we can do better replacing this guy with a better one"-

Ali Scarlett, John Freeman and 2 other users have reacted to this post.
Ali ScarlettJohn FreemanKavalierBel
Have you read the forum guidelines for effective communication already?

Thank you very much Lucio for these golden nuggets!

Quote from Lucio Buffalmano on August 14, 2022, 2:09 pm

Just keep in mind this is a great plan, with an ambitious goal, and it requires lot of skills.
And as any ambitious goal, it may carry some risks along the way for you, and you may get some pushback or not everything may align.

Thanks to your feed-back, I now could weigh the risks and benefits. Regarding the risks, he's a well-seasoned politician and has 30 years of experience ahead of me. So the goal of removing him is actually not realistic and not the best goal. Since a few days have passed I have more perspective on this and let go the personal part/revenge. I will focus on improving the system. The old man retires in 2-3 years, so it might be more beneficial to replace him after he leaves.

Some notes:

Quote from John Freeman on August 14, 2022, 9:02 am

Some notes I'd make here:

  1. Frame it as 2 bad things he did, but not as abuses on you. High power people short on time want to side with strong parties who drive things forward and carry them to victory, not with the abused ones they need to rescue at their cost of time and (emotional) resources

Very true.

  1. Frame the overwork as something Bob fails to appreciate and (emotionally) reward for, not something that you were forced to do. The high bosses always want to get as much as possible from the employees, so the frame of "he gets us to do overwork" is not good enough for your objective
    1. Say you'd have done the overwork anyway, you don't want to run the risk of people rethinking bad of you because you "gave too much". Bosses want employees with a self-sacrificing spirit. Say you'd have done it anyway, but his attitude make you feel bad for giving, instead of happy to be a giver as any good boss should
    2. The frame must you'd have done even more with someone else, not that's a wining frame that serves your goals

Golden again. A precision: the overwork was with another boss Harry in my previous rotation. He kind of rewarded me with a good evaluation BUT this evaluation did not get me the rotation I wanted and it's underpaid anyway. I took 2 weeks of holidays to work on my reports and much more overtime. So in the light of what you said, this is not a topic I'm going to advance now. When I'll do it, I'll first make the inventory of the overtime that resident physicians do and insist that the problem is that it is not paid, according to the law.

  1. Frame the rotation as a black box that is not based on any objective measure, rather than something you were wronged for

Overall, the biggest risk is to make it seem like a personal thing. So the best frame must be not so much on "this person is bad", but on the improvement you can gain -ie. "we can do better replacing this guy with a better one"-

Definitely, that is why I changed my strategy. I now realise that I'm a small fish, not in terms of power (which it is) but in skills and network. So I will go the collaboration/win-win route with Bob. I will try to find what is in there for him in this change.

This event prompted me to listen to "Secrets of Power negotiating". I decided to become a master at negotiation.

I also realized today that salesmanship = people skills + negotiation skills + persuasion skills + listening skills.

So I will work on my negotiation skills first and then persuasion.

Lucio Buffalmano and leaderoffun have reacted to this post.
Lucio Buffalmanoleaderoffun

I didn't want to dissuade, you John.

In the worst-case scenario, you can only learn the most when aiming the highest -including with the most spectacular of failures, also because a "failure" here wouldn't be the end of the world for any of your life goals and objectives-.

John Freeman and Kavalier have reacted to this post.
John FreemanKavalier
Have you read the forum guidelines for effective communication already?

You did not dissuade me. You helped me see the gap in skills. Because I lost to him during the negotiation and I know he’s a great manipulator and liar, it’s something to take into account. He’s still someone who can damage my career.

What I mean is that I don’t want to make an enemy out of him.

That means: adjusting the action steps and goals.

Also regarding the overtime, you helped me to realize that the angle of overwork is not the right one. The right one is that the law says that overtime should be paid in time and/or money. So they have legal obligations towards it.

Lucio Buffalmano has reacted to this post.
Lucio Buffalmano

Update: so my mentor/supervisor sent Bob (I'll call him Sauron from now on) an email and he got a call from Sauron.

He said that he would see what he can do and did not change his mind in the final draft. That's his specialty: false promises, lies and just doing what he wants.

So I'll be working in a private pediatrics office. This is great news as I will have more time for me. Today I realized that I don't care if I don't do intensive care. It would have been a great experience, but I'm totally fine. I don't need it. I'll find my way either way as I'm smart enough to figure it out (self-belief, new mindset, not boasting).

I also found what kind of career I want: I want to work with migrants. This is something that is exciting to me and makes me want to be an expert at it. It has this intercultural element that I love (I love cultures). Working with migrants is like travelling, it's very enriching.

I'm going to apply for jobs aligned with this goal (almost done with the first application): adolescent medicine, child and adolescent psychiatry, child abuse medicine.

So I'm very excited as I see a path now as before I felt like I was hitting a wall mentally: I could not project myself in the future but I can now.

Since I changed my priorities from my career/job/mission to my life, I also feel much lighter. I don't have pressure now as I'm free to choose what I want to do next. If I get it fine, if I don't, fine as well.

If I have great friends, great hobbies, beautiful women, a healthy and strong body AND an average career, who cares? (But I don't think I'll have an average career, knowing that I always push the envelope). I'm not too old to find a great and beautiful woman.

But that's how I view it now. What I reached in life is enough for my standards. I am both an engineer and a physician, so I almost completed my dream of being a engineer-physician-entrepreneur. I did not know what shape it would take, but now I see that it can take another shape than building a high-tech startup.

I also have many ideas for online products around pediatrics, teaching especially. In my current organization I feel stifled as they don't believe in me so much (apart from my supervisor and a few other people) because of their closed minds. When I'll be out of it, I'll be able to network freely with people who have a bigger vision than writing papers in an academic center.

I said 5 years ago that in 10 years I see myself as pediatrician doing innovation. They literally laughed at me and rejected me. I got accepted later though.

I was depressed a year ago because I was surrounded by toxic people and could not see a way out. I knew I would find it and kept pushing.

What I realized recently is that I can still make my dream of revolutionizing Pediatrics real. I'll just have to find another route.

Maybe it won't be with cell culture and tissue engineering. Maybe it will be with migrants. Maybe it will be in the way pediatrics is taught. I don't know.

What I know is that I love to improve and make new things, have new ideas. I just haven't find the right environment yet.

In 2 words, here is summarized my current feeling:

I believe.

Lucio Buffalmano has reacted to this post.
Lucio Buffalmano

Rock on, John.

I was indeed surprised you had decided for intensive care since the other one, from the outside, seemed at least an equally good option -and, to me personally, a better one-.

John Freeman has reacted to this post.
John Freeman
Have you read the forum guidelines for effective communication already?

Thanks! Yeah it is a bitf ego and I like to challenge myself so it's attracting to me. Also the idea to learn better how to save the life of a critically ill child. However, for my professional project it's not strictly necessary. I love to explore: I did legal medicine in the past and I learned a lot. So the idea was a lot to explore, live an experience, partly-ego, partly because my peers could do it and not me, challenge myself, and have it on my CV as a strong argument of being a "good doctor".

However, for my professional project it's more consistent with learning to be good in ambulatory medicine (no tubes and IV in ambulatory medicine).

Lucio Buffalmano has reacted to this post.
Lucio Buffalmano

Hello everyone,

this morning I asked my supervisor who talked with Sauron on the phone:

Me: "Is this indiscreet or can I ask you if Sauron has something against me?"

Him: "Nothing, he just finds that you're enthusiastic and that you love everything and you don't have a plan"

Me: "Until now!" (with a smile, referring to migrant people)

So I could gather good intel: it's because they cannot see in what box they can put me. Also, that he's more pragmatic and unemotional as me. He already told me that during the interview, so it confirms that what he said was true: that I did not have a goal/plan until now.

Just like when we talked with Sauron, I said: "every day I'm grateful to have chosen pediatrics". He said (taken aback, like he is not): "Good"

Then he said something for which I'm going to create a new thread.

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