Wednesday, December 23, 2009


Hopefully I’m not the only NP that can’t fathom how 2 weeks can flash by so quickly. I can’t say that anything has changed dramatically since I resolved to more seriously pursue professional change. Concrete steps I have taken: Contacted a coworker about trading work schedules come February (switching down to 32 hours and working a Wednesday-Saturday rotation). I’ve also taken on a slightly greater leadership role at my current job by heading up a group that will try to integrate different educational initiatives within the building (i.e. Grand Rounds, Journal Club, Inservices, Evening CEU courses, ‘Travelling’ CEU courses, and a group I started last year to discuss practice innovations.)

Ideally, I would like to work less and study more in 2010. I love my clinical work but feel that my calling is in areas with a more macro focus. So to the end of working less, going down to 32 hours in February and leaving my employer in June seems to strike the nicest balance between responsibility and innovation. [Note to self: Tell no one at work about this blog.] The next 6 months would give me the opportunity to save more money, complete more projects at work, and prepare to begin down another path. June would mark 4 years of traditional clinical work before “branching out”. I just wish I new what that was going to look like! More to come on that later. Now for a beer and, hopefully, back to back wins at trivia night!


Tuesday, December 8, 2009

A modest agenda

So, for no particular reason beyond having not much to do tonight, I'll continue my blog-athon with a list of options/opportunities/ideas worth developing in my life right now.

>Start my own LLC: Disruptive Physical Therapy (DPT, get it, ehn? ehn?)
>Develop follow up on PASS with a cross-discipline collaboration builder
>Work on a blog/online presence for NPs: promote the 'Move It' brand (if you can label it as such)
>Develop an app for new professional collaboration and consensus building
>Quit working and get an MPH
>Quit working and get an MBA
{Continue working and do either of the above}
>Enroll in next year's MIT New Media masters class (starting 2011)
>Develop an open source component for John Moore's project at MIT's New Media lab (technology enabled remote rehab program compliance monitoring)
>Promote the development of Fellowships in Prevention (within Ortho/Cardiopulm)
>Pursue a nationwide practice analysis (part of a PhD?) to form a Prevention specialty

Do none of these things, live like a hermit until my loans are gone (2012 if I commit to serfdom), and then start innovating...

My favorite way to look at this list is as a 'surplus' of opportunities. How could I do all of these if they weren't partially combined or integrated? Could starting DPT, LLC enable me to pursue an MPH or even MPH-MBA while building Or would that be overloading myself by taking on too much? I'd like to think not, but need to be rational.

My loans are at low interest rates (sub 5% fortunately enough). How much of my saving would a start up company take? Could I expect any return on invest? If so, how soon?

Enough for one night. More musing to come. ~ben

Pizza and cogitation

As I sit in a pizza shop trying to organize my thoughts, I'm not quite sure where to begin. This blog may ramble on. It's been a crazy 5 months and I'm trying, as I imagine many New Professionals are, to appreciate what I've accomplished in my time since PT school as well as to assess what I can still do with my remaining year and half of 'newbie' status.

Many salient quotes come to mind:

"What we have to remember is that we are really, very young. We have time to recreate ourselves as professionals many times over at this point." ~James Spencer

"You have 30 days to make this website happen." ~Steve Wolf, regarding a project I proposed in February [note: it hasn't happened yet]

"I'm pushing really hard to get approval for another Level 3 position to open up. If it does, I think you should be one of several people to interview for it. [read: You want a carrot? Who's a good boy? Carrot? Carrot? Roll over. Roll over.]" ~my boss

"Systems are rarely disrupted from within the silo. Generally, innovation happens at the intersections of multiple disciplines by upstarts with novel ideas." ~paraphrased from Clayton Christensen in pretty much everything he's ever written about Disruptive Innovation

I guess a part of what I'm struggling with here is the desire to step out of the mainstream. The fear, of course, is getting swept in the wrong direction or being a failure. Escalators aside, it's not in my nature to be a risk taker, so getting swept away looms large in my list of activities to avoid. There is a point in life, however, when I think someone has to decide to risk sinking, abysmally, or 'stay in line' in perpetuity.
For most New Professionals it's just not in the cards to take significant risks. This problem will only get worse as PT school continues to become more expensive and as available health care reimbursement dollars decline. While it makes leaving the mainstream more difficult, this may be the best thing that's ever happened for Physical Therapy. Back in February, I listed as an 'inspirational thought' the idea that payment is a "shrinking pie" (fewer available dollars, smaller pieces to go around, etcetera). I ask, what could be better for an evidence-based, articulate group of Professionals than a resource war?
But I digress, this Blog is about..., ..., knowing when to change directions in your first 5 years. In keeping with my quote theme, it's immediately apparent that I'm not meting Ghandi's call to "Be the change you want to see in the world." (Darn Indian philosophers and their tall orders!) We are on the receiving end of so much information and subject to so many masters, decision making can be very difficult. Stepping back to survey the situation, and, even more intimidating, stepping out on our own is daunting.
I hope that my next few blogs will reflect the thought process of one new professional trying to do just that. Come what may, I plan to document the thoughts, discussions, negotiations, and possibly a resignation that follow. I hope you guys will read along!


Friday, December 4, 2009

Books read and blogs to come

Hello all,

I've just finished a really interesting book on Health care "The Innovator's Prescription". I highly recommend it. I have note cards full of potential blogs! (Exciting for me anyway) I want to finish my other book, which I've been reading in parallel, "Predictably Irrational" by a behavioral economist, before I write the blogs. Some really interesting perspectives between and across these books. I look forward to getting some ideas out there and hopefully firing Move It back up.

Ciao for now ~ben