WELCOME TO THE CLINICAL CENTER GRAND ROUNDS,
A WEEKLY SERIES OF EDUCATIONAL LECTURES FOR PHYSICIANS AND
HEALTH CARE PROFESSIONALS BROADCAST FROM THE CLINICAL
CENTER AT THE NATIONAL INSTITUTES OF HEALTH IN
BETHESDA, MD.
THE NIH CLINICAL CENTER IS THE WORLD'S LARGEST HOSPITAL TOTALLY
DEDICATED TO INVESTIGATIONAL RESEARCH AND LEADS THE GLOBAL
EFFORT IN TRAINING TODAY'S INVESTIGATORS AND DISCOVERING
TOMORROW'S CURES.
LEARN MORE BY VISITING US ONLINE AT HTTP://CLINICALCENTER.NIH.GOV
WELCOME TO TODAY'S CLINICAL
CENTER GRAND ROUNDS.
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ROUND TOPICS.
FOLLOWING THE PRESENTATION,
QUESTIONS FOR THE SPEAKER WILL
BE TAKEN FROM THE MICROPHONES IN
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AT THE CONCLUSION OF THE
PRESENTATIONS, BOTH QUESTIONS
WILL BE ANSWERED AS TIME PERMITS
AND IN ADDITION, THERE WILL BE A
STAFF CLINICIAN COUNSEL
SPONSORED COFFEE MEET AND GREET
WITH OUR SPEAKER IN THE ATRIUM
JUST OUTSIDE THE
LIPSETT AUDITORIUM.
NOW IT IS MY GREAT PLEASURE TO
WELCOME BACK HOME TO THE NIH
CENTER THE SPEAKER, TYSON BELL,
ALSO XOAN AS THE MASTER OF FLOW.
THIS PRESENTATION IS THE SECOND
IN WHAT WE HOPE WILL BE A LONG
TRADITION OF THE NIH STAFF
COMMISSION COUNCIL ANNUALLY
SPONSORED CLINICAL CENTER DPRAND
ROUNDS.
THE STAFF CLINICIAN COUNCIL
SPONSORED PRESENTATIONS ARE
INTENDED TO SPOTLIGHT TALKS
IMPORTANT TO THE PERSONAL AND
PROFESSIONAL DEVELOPMENT OF OUR
CLINICAL FACULTY.
THE DOCTOR IS THE WITH THE
DIVISION OF PULMONARY AND
INFECTIOUS DISEASES AT THE
UNIVERSITY OF VIRGINIA WHERE HE
ALSO SERVES AS VICE CHAIR FOR
FACULTY AFFAIRS FOR THE
UNIVERSITY OF VIRGINIA
DEPARTMENT OF MEDICINE, DR. BELL
IS BOARD CERTIFIED IN INTERNAL
MEDICINE, INFECTIOUS DISEASES
AND CRITICAL CARE MEDICINE.
TYSON EARNED HIS BACHELOR'S OF
ARTS DEGREE IN AFRICAN AMERICAN,
AND AFRICAN STUDIES AT THE
UNIVERSITY OF VIRGINIA IN 2005
AND HIS MEDICAL DEGREE AT
COLUMBIA UNIVERSITY DEGREE OF
SURGEONS IN 2009.
HE COMPLETED HIS RESIDENCY AND
CHIEF RESIDENCY IN INTERNAL
MEDICINE AT THE MASS MATIONZ
GENERAL HOSPITAL AND A
FELLOWSHIP IN INFECTIOUS DISEASE
AT MASS GENERAL BRIGHAM.
HE THEN TRAINED HERE AT THE NIH
CLINICAL CENTER IN CLINICAL CARE
MEDICINE, HE SUBSEQUENTLY JOINED
THE FACULTY OF THE UNIVERSITY OF
VIRGINIA IN 2033 WHERE HE SERVES
AS AN ASSOCIATE PROFESSOR OF
MEDICINE INFECTIOUS DISEASES AND
INTERNATIONAL HEALTH AND THE
DIVISION OF PULL MONITORAR EXPE
CRITICAL CARE MEDICINE, IN 2020
HE EARNED HIS MBA FROM THE
UNIVERSITY OF VIRGINIA DARTEN
SCHOOL OF BUSINESS.
DR. BELL HAS BEEN WIDELY
RECOGNIZED FOR HIS TEACHING AND
LEADERSHIP IN THE STUDY OF
HEALTH DISPARITIES, IN 2022 HE
WAS NAMED 1 OF THE TOP 40 UNDER
40 LEADERS IN MINORITY HEALTH BY
THE NATIONAL MINORITY QUALITY
FORUM THE STAIM YEAR HE RECEIVED
EXCELLENCE OF TEACHING AWARD
FROM THE UNIVERSITY DEPARTMENT
OF MEDICINE AND KEY NOTE SPEAKER
AT THE UNIVERSITY OF
COMMENCEMENT EXERCISES.
AT THIS TIME HE SPOKE ELOQUENTLY
ABOUT ACHIEVING FLOW, BY
NEGOTIATING BOTH PRESSURE AND
RESISTANCE FROM DETERMINATION
AND GRACE.
HE IS A PASSIONATE CLINICAL
EDUCATOR WHO HOSTS A PODCAST FOR
PHYSICIANS IN ACADEMIC MEDICINE.
HE IS AN ENTREPRENEUR WHO
CONFOUNDED A COMPANY DEDICATED
TO DELIVERING BREAK THROUGH
CANCER DETECTION, HE'S A FRONT
LINE LEADER WHO WORKS TIRELESSLY
FOR HIS PATIENTS, COLLEAGUES AND
COMMUNITY.
HE IS AN ALTRUISTIC HUMAN BEING
WHO CHANGES THE STATUS QUO AND
NOT AFRAID TO SHARE HIS JOWRN
TOW HELP YOU BELIEVE IN
YOURSELF.
PLEASE JOIN ME IN WELCOMING
TODAY, GRAND ROUNDS SPEAKER
DR. TYSON BELL WHO WILL PRESENT
THE FACULTY AFFAIRS FILES OF
UNRALPHING THE MYSTERY OF
ACADEMEC MEDICINE, DR. BELL.
[ APPLAUSE ]
>> WELL THAT IMPOSSIBLE TO BUILD
ROW MAKES ME REALIZE I'M DOING
TOO MANY THINGS AT 1 TIME.
THANK YOU SO MUCH FOR INVITING
ME BACK, THIS PLACE IS REALLY
SPECIAL TO ME, I FEEL LIKE A LOT
OF MY ACADEMIC CAREER, I WAS
KIND OF STRUGGLING ALONG, TRYING
TO FIGURE OUT WHAT MY CALLING
WAS GOING TO BE, WHAT I WANTED
TO DO BECAUSE I DIDN'T QUITE FIT
IN ANYONE'S BOX AND AT THE IN,
IH WAS THE FIRST PLACE WHERE I
FELT LIKE I DID FIT IN THE BOX
AND THAT BOX REALLY WAS A BOX
THAT HAD NO WALLS BECAUSE,
PEOPLE ARE DOING ALL KINDS OF
THINGS, BUT YOU REALIZE THEY WAS
AN OUTLIER SO THIS IS WHERE I
HIT MY INFLECTION POINT IN MY
CAREER AND I OWE A LOT OF MY
SUCCESS TO THE PEOPLE HERE,
DR. MASUR, FUNCTIONS IN HOST
DEFENSEN, BERKELEY WHO I CRAFTED
MY COMMENCEMENT SPEECH ON YOUR
LECTURES, A LOT OF MY SUCCESS
TRACES RIGHT BACK TO THIS PLACE
SO IT'S SO SPECIAL TO ME AND I
ENJOYED THE WALK FROM THE
GATEWAY CENTER ALL THE WAY UP TO
THE CLINICAL CENTER EVEN THOUGH
IT'S STARTING TO GET A LITTLE
WARM.
ALL RIGHT, SO, THE FACULTY FILES
SO I'VE BEEN DOING FACULTY
AFFAIRS AT THE DEPARTMENT OF
MEDICINE WHERE BASICALLY WHAT
I'VE BEEN DOING IS TALKING WITH
FACULTY ABOUT THE THINGS THAT
THEY'RE GOING THROUGH WHETHER IT
BE WORK, LIFE, CAREER AND I
ALWAYS COMMIT MYSELF TO JUST
LISTENING FIRST, SO LIKE THE
FIRST YEAR, FIRST YEAR AND A
HALF OR SO, AND I'VE DONE A LOT
OF LISTENING AND NOW THIS IS MY
FIRST TIME, I WILL DO TALKING
AND PUT SOME THOUGHTS OUT ABOUT
SOME OF THE ISSUES I SEE WITHIN
ACADEMIC MEDICINE, AND REALLY
IT'S GOING TO BREAK DOWN INTO
THE PEOPLE, SO, [INDISCERNIBLE]
PAYS ME TO TELL THEM THAT NOBODY
CARES ABOUT COVID ANYMORE, SO I
NEED TO DISCLOSE THAT.
OBJECTIVES, 3 THINGS, I WANT TO
DISCUSS CAREER, LIFE, MONEY, AND
FAMILY ALL IN THE CONTEXT OF
ACADEMIC MEDICINE, I WILL SAY
THINGS THAT MAY BE YOU DON'T
AGREE WITH BUT THE HOPE IS TO
PROVOKE A DISCUSSION HERE.
I WANT TO GIVE YOU A STARTING
POINT FOR FURTHER DEVELOPING
YOUR CAREER REGARD OF WHAT STAGE
YOU'RE IN BECAUSE CAREERS
CONTINUE TO EVOLVE AT EVERY
POINT AND THEN HOPEFULLY
GENERATE A LASTING DISCUSSION
AMONGST FACULTY HERE ABOUT
MAKING A ROBUST CULTURE OF
FACULTY DEVELOPMENT HERE.
ALL RIGHT, SO I HAVE CASES, ALL
RIGHT, THESE ARE ALL FACULTY
MEMBERS AT UVA, THAT SOME POINT
OR ANOTHER HAVE FOLKEN WITH THEM
ABOUT SOME OF WHAT THEY'RE GOING
THROUGH, SO CASE NUMBER 1 I WILL
CALL SQUARE PEG ROUND LOOP HOLE,
THIS IS A FAC ULTIMATELYY
MEMBER, IN YEAR 5 OF THEIR
APPOINTMENT, THEY WANT TO GO UP
FOR PROMOTION, THEY'RE
MD-Ph.D., THEY'RE ON TENURED
INVESTIGATOR TRACK AND I WILL
TALK ABOUT THE TRACKS AT UVA,
BUT THIS IS THE TENURE TRACK,
INDEPENDENT FUNDING TRACK, IT'S
ENTRY LEVEL AT ASSISTANT
PROFESSOR, HAS A GOOD
PUBLICATION RECORD, GOOD
REASONABLE REPUTATION, RUNNING A
BASIC SCIENCES LAB WITH 7-9
PEOPLE AND APPROXIMATE HE DOES
HAVE SUBSTANTIAL ROLES IN
CLINICAL DUTY EXPE EDUCATION AND
FOR FUNDING HE USED A
COMBINATION OF THE START UP
FUNDS, HE HAS STATE FUNDING
INITIATIVE THAT'S BEEN GREAT FOR
US AND HE HAS A K-AWARD AND HE
JUST SUBMITTED AN RO-1 TO HE
FEEL SYSTEM OKAY TO SHIP OUT, HE
HASN'T HEARD BACK ON THE SCORING
YET.
HE MET WITH OUR P& T HEAD AND
ADVISED TO WAIT ANOTHER YEAR
BECAUSE HE'S NOT QUITE READY SO
WHAT DOES THAT MEAN, IF YOU LOOK
AT HIS BREAK DOUBLE PATENTS OF
HIS FTE OR CLINICAL COMMITMENTS
YOU SEE HE REALLY IS A TRIFECTA
LIKE THIS CLINICIAN, EDUCATOR,
RESEARCHER, HE SPENTS 30% IN
CLINICAL CARE AND 15% IN
EDUCATION AND HE DOES HAVE
LEADERSHIP ROLES BOTH WITHIN
EDUCATION AND CLINICAL CARE SO
HE REALLY DOES HAVE HIS FINGERS
IN EVERYTHING.
NOW I WANT TO BREAK DOWN JUST
FOR BACKGROUND HERE, THE
DIFFERENT TRACKS AT UVA, AND
OVERLAY WITH THEM, WHAT I THINK
AN EQUIVALENT WILL BE HERE AT
THE NE H, SO THE CLINICIAN
INVESTIGATOR TRACK IS TENURE
ELIGIBLE, TENURE AT UVA IS
UNCLEAR EXACTLY WHAT IT MEANS
BECAUSE THERE'S A LOT OF JOB
SECURITY EITHER WAY BUT TENURE
FOR NOW DOES COME WITH A SMALL
SALARY IPT GREATER CREASE, SO
THERE'S THAT, NOW HIS CLINICIAN
INVESTIGATOR TRACK, IS DESIGNED
FOR POSITION RESEARCHERS AND
SOME EXPECTATION OF CLINICAL
CARE AND EVERYBODY'S IS, BUT
THIS 1'S ALL ABOUT THE RESEARCH.
NOW THAT ARE 2 OTHER TRACKS,
CLINICAL EDUCATOR THAT'S ALSO
TENURE ELIGIBLE, AND THIS 1
SUGGIEST THAD HAVE YOU 80% OF
YOUR TIME DEVOTED TO PATIENT
CARE OR MEDICAL EDUCATION, SO
THAT'S WHAT'S SUGGESTED BY IT
AND THEN CLINICAL FACULTY ARE
SEEING PATES FOR THE MOST PART,
THIS IS A NON10 IRBED TRACK AND
THE MAJORITY OF YOUR TIME IS
SUPPOSED TO BE DEDICATED TO
CLINICAL ACTIVITY.
SO BETWEEN THE 2 DIFFERENT
TRACKS THAT HE WOULD BE
POTENTIALLY CONSIDERING, CI, AND
CE, ARE THE 2 THAT I'M GOING TO
FOCUS ON, HE'S ESTABLISHED THAT
HE'S NOT GOING TO BE A CLINICAL
FACULTY MEMBER.
SO THE REQUIREMENTS FOR
PROMOTION TO ASSOCIATE, NOW THIS
WILL BE DIFFERENT FOR EVERY
INSTITUTION, IF YOU'VE SEEN 1
ACADEMIC INSTITUTION, YOU'VE
SEEN 1 ACADEMIC CENTER, AND SO
THIS WAS JUST AT UVA, SO FOR
CLINICIAN INVESTIGATOR, YOU ARE
REQUIRED TO HAVE 3 THINGS, 1 IS
EXCELLENCE IN RESEARCH, AND THAT
IS MEASURED BY INDEPENDENT AND
ORIGINAL INVESTIGATION AND
EXTERNAL FUNDING.
THIS IS NOT WRITTEN IN THE LAW,
BUT IT EFFECTIVELY, IT'S UNIQUE
TO RO-1 OR EQUIVALENT GRANT
WHICH IS THE GOLD STANDARD FOR
INDEPENDENT INVESTIGATIVE
FUNDING AND YOU HAVE TO HAVE A
RECORD OF SCHOLARSHIP AND LOCAL
AND REASONABLE REPUTATION, AND
THEN AS YOU PROMOTE FURTHER, AS
PROFESSOR YOU HAVE TO DEVELOP
ANOTHER CORE OF EXCELLENCE
WITHIN EDUCATION OR CLENICAL
CARE.
ALL RIGHT, CLINICAL EDUCATOR ON
THE RIGHT HERE, YOU HAVE TO
DEMONSTRATE EXCELLENCE IN EITHER
OF THE 3 CORE MISSIONS OF THE
ACADEMIC CENTER, PATIENT CARE,
EDUCATION AND RESEARCH, AND THEY
HIGHLIGHT SOME EXTERNAL FUNDING
AS NOT A REQUIREMENT, BUT
SOMETHING THAT COUNTS AS
EXTERNAL AS RESEARCH EXCELLENCE,
AND THEN YOU ALSO HAVE TO HAVE
SCHOLARSHIP AND REASONABLE
REPUTATION, SO THE MAIN DRVESS
HERE IS THAT FOR THE CI TRACK,
YOU HAVE TO HAVE EXTERNAL
FUNDING AT THIS RO-1 LEVEL
FUNDING OR HIGHER AND FOR CE
IT'S MORE FLEXIBLE HOW THEY
DEFINE RESEARCH EXCELLENCE AND
IT'S 1 OF 2 OTHER PATHWAYS THAT
YOU COULD CHOOSE, ALL RIGHT AND
THEN SIMILAR TO THE CI TRACK IN
ORDER TO GET FURTHER PROMOTION,
YOU HAVE TO 22 AREAS OF
EXCELLENCE, NOT JUST 1.
ALL RIGHT.
NOW HERE'S THE PROBLEM, IT'S
DIFFERENT HERE OF COURSE, BUT
OUTSIDE OF THE NIH, A LOT OF
SUCCESS IN INVESTIGATIVE FUNDING
DEPENDS ON RO-1 GRANTS
EVENTUALLY AND AS CAN YOU SEE
HERE, OUR RATE OF RO-1 FUNDING
AND IT WAS IN THE 90S BUT EVEN
LOWER NOW, IT'S 22%, SO THIS IS
FIRST TIME SUCCESS AMONG FIRST
TIME APPLICANTS AND I THINK
THAT'S TOO LOW TO COUNT ON FOR
PROMOTION, EESSENTIALLY, SO IF
YOU ARE COUNTING ON A GRANT THAT
HAS 20% AND THAT'S YOUR
REQUIREMENT TO GET PROMOTED, I
THINK THATEE OVERLY RESTRICTIVE.
NOW IF YOU ARE REAPPLYING, YOU
SEE THE RATE HERE, IT'S NOT
FANTASTIC, RIGHT, BUT IT IS
BETTER THAN 20%, AND THIS IS WHY
I THINK THERE IS--WE ARE
EXSEATED ABOUT BRINGING IN
PEOPLE WHO HAVE MULTIPLE RO-1
GRANTS FOR UVA BECAUSE THEY'RE
MORE LIKELY TO GET REFUNDED BUT
IT IS DIFFICULT TO GET THAT
FIRST 1 WHICH IS WHY A LOT OF
OUR YOUNG FACULTY FEEL LIKE THEY
ARE ASKED TO DO PROJECTS THAT
THEY FEEL WILL BE HIGHER CHANCE
OF GETTING FUNDED, RATHER THAN
THE INDEPENDENT INVESTIGATIVE
WORK THEY WANT TO DO AND
SOMETIMES ARE NOT ANSWERING THE
QUESTIONS THAT THEY WANT TO
ANSWER BUT THE QUESTIONS THEY
THINK WILL GET MONITOR THAT'S
HOPEFULLY WILL DEVELOP INTO MORE
CAREER SUCCESS.
SO THAT'S 1 ISSUE I'VE OUTLINED
HERE AND I'VE BASIC LEAVE TAKEN
A STANCE THAT AT THE UNIVERSITY
OF VIRGINIA, I DON'T THINK
ANYONE WHO'S TARTING OUT ON
FACULTY SHOULD BE ON THE CI
TRACK, EVEN IF THEY ARE DOING
THAT SORT OF WORK.
I THINK IT'S NOT A REALISTIC
PATHWAY.
ALL RIGHT, SO, NOW, AS AN ID
FELLOW, I WAS ASKED AND TRAINED
WHY AND GET DOWN TO THE ROOT
CAUSE AND FIND THE ABSCESS, SO
ALWAYS ASK, WHY THIS, WHY THIS,
WHY THIS?
SO WHY PROMOTION NOW?
WELL IT COMES WITH A 10% PAY
INCREASE WHICH IN HIS CASE WOULD
CORRESPOND TO $23,000, THAT'S A
LOT OF MONEY, NOW HE CAN MAKE
HIS ENDS MEET, BUT HE'S NOT
QUITE COMFORTABLE, HE'S SAVING
FOR RETIREMENT, COLLEGE, AND THE
KIDS, 1 OUT OF 3 KID SYSTEM IN
PRIVATE KIDS MIDDLE SCHOOL
THAT'S HIGHLY RATE INDEED OUR
AREA, HE TRAVELS OUT OF STATE
FREQUENTLY FOR SWIM MEET ANDS
THERE'S A BIG COST ASSOCIATE
WIDE THAT SO HE MOONLIGHTS 3-4
TIMES A MONTH FOR EXTRA INCOME
AND THAT'S A COMMON THING THAT
UPON HAS AMONGST OUR FACULTY AND
I KNOW HAPPENS A LOT HERE AND
OUR FACULTY.
SO I WILL COME BACK TO THAT
EMPLOY SO LESSON 1, ANTICIPATE
YOUR CAREER EVOLUTION, I WAS
VERY CAUTIOUS IN SAYING NOT
WHERE ARE YOU NOW, BUT WHERE YOU
ANTICIPATE THAT YOU'RE GOING TO
BE, SO HE WAS HIRED AS AN
INVESTIGATOR BUT HIS JOB IS
ACTUALLY A MIX, HE DOES
EDUCATION, HE DOES RESEARCH, HE
DOES CLINICAL CARE, IN MY VIEW
ISSUES THE CLINICIAN EDUCATOR
TRACK ALLOWS FOR MORE
FLEXIBILITY AND AN EASIER
PROMOTION PATHWAY AND HIS GOAL
IS TO GET PROMOTED AND HAVE THAT
PAY RAISE, IT'S EASIER IF HE'S
ON A CLIN ED, PATHWAY, HE
DOESN'T HAVE TO GIVE UP HIS LAB,
HE CAN GET JUST AS MANY GRANTS
AS HE WANTS TO BUT THERE'S NO
FINANCIAL REPUTATIONAL DOWN
SIDE, HE DON'T PUT ON OUR BADGES
WHAT TRACK YOU'RE ON, IT'S JUST
ASSOCIATE OR DISTINGUISHED
PROFESSOR, SO NO 1 REALLY CARES
WHAT PATHWAY YOU'RE ON.
SO IN THIS CASE, EVEN THOUGH THE
POLICY WAS CLEARLY WRITTEN FOR
INVESTIGATIVE FUNDED PEOPLE TO
GO IN THIS SPECIFIC PATHWAY, THE
LETTER OF THE LAW ALLOWS YOU TO
GO TO A CLINICIAN EDUCATOR
PATHWAY, SO IN MY VIEW, IF HE
CAN FOLLOW THE LETTER OF THE
POLICY, IT'S OKAY TO VIOLATE THE
SPIRIT OF THAT POLICY.
SO FOR HIM, I ADVISE HIM, GO TO
CLINICIAN EDUCATOR PATHWAY, GET
YOUR PROMOTION NOW AND JUST
CONTINUE YOUR CAREER AS THE SAME
WAY THAT YOU WOULD OTHERWISE.
ALL RIGHT, BUT THERE'S SOMETHING
ELSE THAT I WANT TO ADDRESS
HERE, AND THAT'S THAT HE WAS
REALLY STRETCHING HIMSELF TO
MAKE THE ENDS MEET AND HE WAS
MEETING A LOT OF OBLIGATIONS FOR
IT THAT HIS CHILDREN WANTED TO
DO, SO RAISE YOUR HAND IF YOU
BELIEVE THAT WE SHOULD ALL
STRIVE TO PROVIDE OUR KIDS WITH
THE BEST OPPORTUNITIES THAT WE
CAN.
ALL RIGHT, I DISAGREE WITH YOU.
ALL RIGHT, WE SHOULD NOT WANT TO
PROVIDE OUR KIDS WITH THE BEST
OPPORTUNITIES WE CAN.
THAT'S A ROUGH STATEMENT, RIGHT?
BUT LET ME SAY IT ANOTHER WAY
THAT'S A LITTLE EASIER TO
DIGEST.
WE SHOULD PROVIDE OUR KIDS WITH
THE BEST OPPORTUNITIES THAT ARE
REASONABLE FOR OUR MEANS AND OUR
LIFESTYLE, MEANING, IT'S NOT THE
ULTIMATE GOAL, BUT IT'S A PART
OF OUR LIVES, OUR KIDS FIT INTO
OUR LIVES, WE DON'T FIT INTO OUR
KIDS LIVES, RIGHT?
SO I KNOW IN OF THESE THINGS
BRING YOU JOY, BACK BREAKING
EXTRA CURRICULAR ACTIVITIES,
OVERSCHEDDULES, TRAVELING ALL
ACROSS THE COUNTRY TO DO TRAVEL
TEAMS, NOW IF THAT BRINGS YOU
JOY, AND YOU LOVE DOING THESE
THINGS, THEN CONTINUE DOING
THEM, BUT IN MY EXPERIENCE, A
LOT OF FACULTY WHEN I ASK THEM,
HEY, WHAT ARE DOING THIS
WEEKEND, I WILL BE THERE ALL
WEEKEND AND I WILL BE THERE FOR
A SWIM MEET AND YOU CAN SEE THE
JOY LEAK FROM THEIR FACE.
THAT'S A SITUATION WHERE MAYBE
YOU SHOULD CONSIDER JUST NOT
DOING THAT.
NOW I'VE TOLD MY KID, THEY'RE 6
AND 10 YEARS OLD AND I'VE
ALREADY TOLD THEM, THEY'RE NOT
DOING TRAVEL TEAMS, WE'RE NOT
DOING IT.
THERE'S A LIMIT TO WHAT WE'RE
GOING TO DO TO SUSTAIN THEIR
LEVEL OF ENJOYMENT BECAUSE WE
HAVE LOTS OF COMPETITIVE TEAMS
IN CHARLOTTESVILLE, NOW
HOPEFULLY I STICK WITH THAT, BUT
WE AT LEAST SET THAT
EXPECTATION, WE DON'T ORBIT
AROUND OUR KIDS, YOU ORBIT ARK
ROUND US AND THAT'S A STEP THAT
WE'RE NOT GOING TO GO.
NOW, THIS IS TOUCHY PUBLIC
SCHOOL VERSUS PRIEF SCHOOL AND I
THINK THIS COMES UP IN THE
CONTEXT OF PROVIDING THE BEST
FOR OUR KID ANDS THINGS LIKE
THAT SO I WILL BE HONORS
EMPLOYEES TOAST TELL YOU WHAT I
DO, SO MY KIDS ARE IN PUBLIC
SCHOOL, IN [INDISCERNIBLE]
COUNTY, THEY'RE DOING WELL, MY
DAUGHTER IS STARTING TO READ, MY
SON IS DOING QUITE WELL IN HIS
CLASS, I KNOW FOR A FACT THAT IF
THEY WERE IN OUR PRIVATE SCHOOL
SYSTEM, THAT MY DAUGHTER WOULD
PROBABLY BE READING RIGHT NOW
AND THAT MY SON WOULD BE FURTHER
ALONG IN HIS ACADEMIC
ADVANCEMENT, I KNOW THAT BECAUSE
I'VE SEEN WHAT'S HAPPENING IN
THE PRIVATE SCHOOLS AND PUBLIC
SCHOOLS, BUT I THINK IT'S GOOD
ENOUGH WHAT THEY'RE GETTING IN
PUBLIC SCHOOL AND THE BEST
PREDICTOR OF YOUR CHILD'S
SUCCESS IS THE FACT THAT YOU'RE
SUCCESSFUL.
SO IN MY HOUSEHOLD OUR FEELING
IS, WE WILL DO WHAT'S BEST FOR
US FINANCIALLY.
WE COULD AFFORD TO PUT OUR KIDS
IN PRIVATE COOL BUT WE'RE
CHOOSING NOT TO MAKE IT MORE
FINANCIAL BENEFICIAL FOR US, AND
THEN THAT MAY BECOME A
CONVERSATION LATER, MY SON HAS
ALREADY ASKED ME, SOME OF HIS
FRIENDS ARE IN PRIVATE SCHOOL, I
TOLD HIM NO, BUT MAYBE AT SOME
POINT WHEN IT MAKES SENSE, HIGH
COOL LEVEL, SOMETHING LIKE THAT
BUT WHAT I DON'T WANT TO DO IS
COMMIT THEM BOTH TO BEING IN AT
THE ELEMENTARY COOL ALL THE WAY
UP BECAUSE THATIA JUST GOING TO
PUT A STRAIN ON US THAT I'M NOT
TELLING TO TAKE BO
CONSIDERATION, NOW I DO KNOW
THERE ARE SOME SPECIAL
SITUATIONS, LIKE SOME CHILDREN
NEED, YOU KNOW SPECIAL--SPECIAL
NEEDS, THERE'S SOMETHING UNIQUE
ABOUT THE SCHOOL, MAYBE YOU WENT
THERE AND THERE'S SOMETHING THAT
MAKES YOU FEEL GOOD ABOUT IT SO
OUTSIDE OF THOSE SPECIAL
SITUATIONS WHERE IT DOES
OBJECTIVELY MAKE SENSE, THIS IS
REALLY JUST DOWN TO THE
FINANCES, I THINK THAT'S
SOMETHING TO CONSIDER, AND AT
THE LATER FACULTY LEVEL WHEN I
WAS A FELLOW, YOU KNOW, I'M A
NODEY --NOSY PERSON, I ASK
PEOPLE, WHO ARE YOU DOING, WHAT
ARE YOUR KIDS DOING.
AND A LOT OF WHAT CAME UP, MY
KID GOT INTO UNIVERSITY OF
MARYLAND, VIRGINIA TECH OR
GEORGE TOWN OR GW, LIKE WHAT DO
I DO IN AND THERE WAS A 1
FACULTY, I IT WASN'T HERE BUT IT
WAS SOME OTHER INSTITUTION CLOSE
TO HERE WHO SAID I'M GOING TO
HAVE TO MOONLIGHT LIKE 4 OR 5
TIMES A MONTH TO AFFORD THIS AND
THEY GOT INTO UVA, AND THEY
WANTED TO GO TO GEORGE TOWN, I
KIND OF WHAT WANTED TO TELL THEM
YOU CAN BE THE GO TO GEORGE
TOWN, I KNOW THERE ARE GEORGE
TOWN GRADS HERE, THERE'S NO SLAM
AGAINST THAT BUT ECONOMICALLY,
IT WAS WAY MORE BENEFICIAL TO GO
TO THE STATE SCHOOL, NOW YOU
COULD ALSO INSTEAD OF JUST
SAYING NO, BECAUSE WE DON'T WANT
TO TELL OUR KIDS NO, RIGHT?
BUT YOU COULD ALSO A I'LL
SUPPORT YOU UP TO THE LEVEL THAT
I WAS PLANNING ON AT UNIVERSITY
OF VIRGINIA, AND THEN THE REST
IS ON YOU, THAT'S PERFECTLY
FINE, TOO, BUT MY POINT HERE IS
THAT THESE ARE THINGS WE SHOULD
THINK ABOUT, AND WE SHOULDN'T
JUST LEAN TOWARDS DOING AND
DOING MORE JUST BECAUSE WE CAN
OR EVEN TO THAT PEOPLE AROUND US
ARE DOING THE SAME.
ALL RIGHT.
I HOPE THAT WASN'T TOO
CONTROVERSIAL.
ALL RIGHT, CASE NUMBER 2.
A DAY EARLY AND A DOLLAR SHOT.
THIS IS A FACULTY MEMBER WHO IS
IN YEAR 9 OF THEIR APPOINTMENT
AND THEY WERE DENIED PROMOTION
ON AN CLINICIAN INVESTIGATOR
TRACK.
REMEMBER I ALREADY HATE THIS
TRACK, I DON'T THINK ANYONE
SHOULD BE ON THIS.
HERE'S ANOTHER REASON WHY, THEY
TARTED TO THIS TRACK WITH A
SMALL LAB AND A K-GRANT.
THEY WERE UNABLE TO SECURE RO-1
FUBDING OR THE EQUIVALENT.
AND THEN WE HAVE AN OPTION, YOU
HAVE TO GO UP ON THIS TRACK BY
YEAR 6 AND YOU CAN DEFER IT, AND
SO, THEY GOT 1 YEAR DEFERRAL AND
THEY WERE SUPPOSED TO GO UP ON
YEAR 7 AND THEN COVID HAPPENED
AND WE HAD THESE OPTIONAL
DEFERRALS THAT SHE ELECTED TO
TAKE SO SHE HAD 2 AND THEN WERE
DELAYED BY 3 YEARS, THE DIVISION
CHIEF AND CONCERNED THAT THEIR
HIGH CLINICAL BURDEN PREVENTS
THEM FROM PROMOTING THEIR
RESEARCH, GOES UP FOR PROMOTION,
DENIED AND IN OUR SYSTEM IF
YOU'RE DENIED PROMOTION, THEN
YOU GO TO THE CLINICAL FACULTY
TRACK.
SO THIS IS WHAT HAPPENED.
NOW, WHY SO MUCH CLINICAL DUTY.
REMEMBER, WE ALWAYS WANT TO ASK
WHY, IN-PATIENT DUTY IS ABOUT 20
WEEKS PER YEAR, SO .70 FTE IS
WHAT THAT EQUATES TOO BUT THEN
THEY MOONLIGHT ABOUT 6 TIMES FOR
EXTRA INCOME SO EVEN MORE THAN
THE OTHER PERSON AND THEN 1 OF
THEIR MAJOR FINANCIAL GOAL
SYSTEM TO PAY OFF THEIR HOME
EARLY, THEIR MORTGAGE IS AT
2.6%, I KNOW THEY'RE MUCH HIGHER
THAN THAT NOW, SO I'M SORRY IF
YOU WERE NOT ABLE TO LOCK IN A
RATE LIKE THIS BUT THIS IS THEIR
SITUATION.
THE SAVINGS FOR RETIREMENT AND
COLLEGE ARE OKAY BUT THEY COULD
BE BETTER, AND THEY'RE ON TRACK
TO PAYOFF THEIR MORTGAGE 10
YEARS EARLY.
ALL RIGHT, SO THE ISSUES
IDENTIFIED HERE ARE THAT THE CI
TRACK WAS NO LONGER THE
APPROPRIATE TRACK, I DON'T THINK
IT'S APPROPRIATE FOR ANYONE,
REALLY, THERE'S FAILURE TO
CHANGE TRACKS WHEN IT WAS CLEAR
THAT THAT INITIAL PLAN WAS BT
WORKING SO INSTEAD OF DOING
THESE DEFERRALS, MAYBE WE KREBS
CYCLE SWITCHING TO ANOTHER TRACK
THAT MAY BE EASIER AND DOESN'T
DEPEND ON THIS, THIS EXTERNAL
FUNDING THAT WE KNOW HAS GONE
DOWN AND THEN THERE'S AN
OVERSTRETCHED CLINICAL BURDEN
SIMILAR TO THE OTHER PERSON,
CASE 1, BUT THIS IS WORSE, AND
FINANCIAL GOALS IN MY OPINION
ARE NOT OPTIMIZED SO LET'S TALK
ABOUT THIS.
IF YOU HAVE A FINANCIAL PLANNER,
AT LEAST A GOOD 1, AND YOU WORK
THROUGH WHAT THE FINANCIAL
PRIORITIES ARE, THEY GO IN THIS
SORT OF ORDER, FIRST IF YOU HAVE
A DEBT PAYMENT, YOU SHOULD MAKE
YOUR DEBT PAYMENT, YOU SHOULDN'T
NOT PAY YOUR MORTGAGE OR CAR,
AND YOU GET A BAD CREDIT SCORE
AND EVERYTHING'S MORE EXPENSIVE
SO PAY YOUR DEBT.
THAT'S NUMBER 1.
NUMBER 2 YOU WANT AN EMERGENCY
FUND, NOW MOST SOURCES SAY YOU
WANT 6 TO 9 MONTHS OF FUNDING,
IF YOU WERE AT OF A JOB FOR THAT
AMOUNT OF TIME YOU COULD PAY FOR
YOUR BILLS AND ALL THAT.
I THINK FOR PHYSICIANS IT
DOESN'T NEED TO BE THAT LARGE,
BECAUSE THE PHYSICIAN SECURITY
IS 3.4%, I DON'T THINK WE HAVE
TO WORRY ABOUT THAT BUT YOU
SHOULD HAVE EMERGENCY FUND
SAVINGS, AND AFTER THAT, IT CAN
BE OTHER GOALS WHETHER IT BE
COLLEGE, VACATION HOME, BOAT,
ANYTHING THAT IS NOT FOR
RETIREMENT.
SO THIS FACULTY MEMBER, REMEMBER
I SAID THERE ARE SAVINGS WERE
OKAY FOR RETIREMENT BUT IT COULD
BE BETTER AND SAME FOR COLLEGE,
IT COULD BE BETTER AND THEY'RE
PUTTING A LOT OF MONEY INTO
PAYING OFF THE HOUSE EARLY, SO
LET'S TALK ABOUT THAT.
THIS GETS TO THE NOTION OF
ECONOMIC OPPORTUNITY COST.
NOW THIS IS A PORTION WHERE I'M
GOING TO IMPART TO YOU, THE
$168,000, 675 THAT I PAY FOR MY
MBA, I WILL GIVE YOU THE LESSONS
IN 3 SLIDES, ALL RIGHT, SO
ECONOMIC OPPORTUNITY COSTS,
BASICALLY ASKED THE QUESTION,
WHAT DO YOU SACRIFICE BY
CHOOSING 1 OPTION OVER THE
OTHER, IF YOU'RE USING THE MONEY
IN THIS WAY, WHAT ARE THE OTHER
THINGS CAN YOU DO WITH YOUR
MONEY AND WHAT BENEFIT WOULD
THAT GIVE YOU OR WHAT WOULD THE
COST BE.
SO YOU GUYS UNDERSTAND THE
CONCEPT VERY WELL, BECAUSE
THERE'S TIME OPPORTUNITY COST.
I REMEMBER WHEN I WAS A FELLOW
HERE, I LIVED IN NORTHERN
VIRGINIA TO SAVE MONEY, I LIVED
WITH MY WIFE'S PARENT NEAR
DULLES AIRPORT AND I KNEW IF I
TRIED TO LEAVE AT 8:00 TO GET TO
WORK, THAT WAS GOING TO BE A
DISASTER.
IF I LEFT AT 6:00, IT'S A
PREDICTABLE DISASTER THAT I WAKE
UP EARLY BUT I AT LEAST GET TO
WORK WITHIN HOUR BUT IF I LEAVE
AT 3:00 IN THE AFTERNOON, IT
WON'T BE PERFECT, I CAN GET HOME
AT A REASONABLE TIME, BUT IF I
LEAVE AT 4 OR CLOCK, BETS ARE
OFF, THERE'S PRECIOUS HOURS, SO
THERE'S TIME OPPORTUNITY COST TO
GETTING HERE EARLIER AND LEAVING
HER EARLIER NOW THE SAME CONCEPT
APPLIES IN ECONOMICS.
SO I WILL PUT FORTH THE ARGUMENT
THAT WAS PUT IN THE MILLIONAIRE
NEXT DOOR, 1 OF THE FIRST
PERSONAL FINANCE BOOKS I READ, I
AGREE WITH ABOUT 65% OF WHAT
THEY SAY IN HERE, YOU KNOW IT'S
LIKE LIVING WITHIN YOUR MEANS
AND THINGS LIKE THAT, BUT THEY
ALSO SAY THINGS LIKE YOU SHOULD
DRIVE A HONDA CIVIC FOR THE REST
OF YOUR LIFE, THAT I DON'T AGREE
WITH BUT THEY MAKE THE ARGUMENT
THAT PHYSICIANS TEND TO BE
UNDERACCUMULATORS OF EXPWELGT
WHAT THAT MEANS IS FOR A SIMILAR
PROFESSIONAL WITH A SIMILAR
INCOME AT THE END OF THAT OTHER
PROFESSIONAL CAREER, THEY TEND
TO HAVE MY HIGHER NETWORK THAN A
PHYSICIAN DOES AT THAT SAME
INCOME LEVEL.
SO MEANING A PHYSICIAN MIGHT
STILL BE WEALTHY BUT THEY'RE
LESS WEALTHY THAN THEIR INCOME
WOULD PREDICT EMPLOY NOW THERE
ARE SOME REASONS FOR THIS THAT
SOME OF THEM ARE NOT
CONTROLLABLE, WE TEND TO START
LATER IN LIFE, SO RESIDENCY,
TRAINING, FELPS OSHIP, I THINK I
WAS 32 OR 33 WHEN I GOT MY,A
DULT JOB.
SO, YOU KNOW WHEN YOU LEAVE
CLENG --COLLEGE AT 22, OR LEAVE
GRAD SCHOOL AT 26, THERE'S OTHER
YEARS THAT OTHERS ARE AX
KIEWMULATING WEALTH SO THAT'S A
FACTOR, BUT WE'VE HEARD THAT A
LOT BUT WE'VE ALSO HEARD, I'M
TOO BUSY, CLINIC BURDEN IS
INCREASING, THESE GRANTS ARE
AREN'T ANYTHING TO WRITE
THEMSELVES.
I DON'T HAVE TIME FOR THIS CRAP.
I'VE HEARD THAT.
A LOT OF US HAVE BEEN REWARDED
AND WE'VE GOTTEN WHERE WE ARE
BECAUSE WE GET THROUGH THE WORK
THAT WE NEED TO DO, STARTING
FROM COLLEGE AND ALL THE WAY UP,
WE'RE NOT USED TO ASKING FOR
HELP WITH THINGS THAT WE'RE NOT
ENTIRELY COMFORTABLE ASKING FOR
HELP WITH AND THEN THERE IS A
SOCIAL EXPECTATION OF SEEING A
DOCTOR, AND IF YOU SEE AN
ORTHOPEDIC SURGEON AND THEY'RE
DRIVING 1987 HONDA ACCORD, YOU
ARE GOING TO HAVE QUESTIONS
ABOUT THAT, ESPECIALLY IF THEY
WORK AT GEORGE WASHINGTON.
NOW WHAT HAPPENS UNFORTUNATELY
IS THAT I THINK THAT POOR
FINANCIAL DECISIONS BY
PHYSICIANS ARE COMPENSATED FOR
BY GENERATING EXTRA INCOME.
SO, IN OTHER WORDS, IF FIND
YOURSELF BEHIND AND NOT QUITE
MEETING YOUR GOALS YOU STRETCH
YOURSELF BY DOING MORE CLINICAL
SHIFTS, TAKING ON MORE CLINICAL
ACTIVITIES THAT SORT OF THING,
INSTEAD OF HAVING MORE SOUND
FINANCIAL HABITS, YOU FIX IT
YOURSELF BY JUST WORKING MORE.
ALL RIGHT?
NOW LET'S RUN THROUGH THIS
ECONOMIC OPPORTUNITY COST FOR
THEIR DECISION, SO THEY HAVE A
30 YEAR MORTGAGE, IT'S AT 3%,
AND IT'S A 500,000 DLTS
MORTGAGE, I KNOW THERE ARE SOME
PLACES WHERE YOU CAN BUY HOUSES
FOR 500,000, SO I KNOW, THIS IS
NOT THIS AREA, I KNOW, DON'T
ATTACK MAY, THE REGULAR MORTGAGE
PAYMENT HERE WOULD BE $2663,
TOTAL INTEREST AT THE END OF
THIRD YEARS WOULD BE $220, SO
YOU WOULD SAY $720,000 TOTAL AND
LOAN PAID OFF IN 30 YEARS IF DO
YOU DO IT IN 30 YEARINGS AND
DON'T PAY ANY ADDITION MONEY IN
ANY WAY.
WHAT ABOUT IF YOU PAY AN EXTRA
THOUSAND DOLLARS, YOUR PAYMENT
GOES UP, YOUR TOTAL INTEREST
GOES DOWN FROM $220,000 TO
$188,000, AND YOUR LOAN IS PAID
OFF IN 20 NOT 30 YEARS.
SO YOUR BENEFIT, YOUR ECONOMIC
BENEFIT YOU SAVE IS $92,000 IN
INTEREST BY PAYING AN EXTRA
THOUSAND DOLLARS A MONTH.
NOW LET'S COMPARE THAT IF YOU
TOOK THAT AMOUNT OF MONEY AND
INVEST IT AND SAY LOW COST S&P
500, SINCE THE BEGINNING OF THE
S&P 500, IT'S RETURNED ABOUT 8%,
PER YEAR, 8-10% PER YEAR OVER
TIME SO IT GOES UP AND DOWN I
KNOW, BUT OVERTIME IT TENDS TO
RISE 8%, SO 8%, YOU INVEST THAT
$1000 OVER THE 30 YEARS BECAUSE
YOU'RE NOT PAYING EXTRA NOW,
THAT $1000 PER MONTH GENERATES
$1.4 MILLION AND SO IF YOU
SUBTRACT 92,000 HERE FROM 1.4
GENERATED THERE, YOU'RE
$1.3 MILLION WEALTHIER BY NOT
PAYING OFF YOUR DEBT SOONER THAN
YOU NEED TO.
NOW YOU GUYS ARE HERE BECAUSE
YOU PAY EXQUISITE ATTENTION TO
DETAIL.
SO I KNOW SOME OF YOU PICKED UP
ON THE FACT THAT LIF YOU PAY OFF
YOUR MORTGAGE 20 YEARS EARLIER,
THEN YOUR BILL'S GONE, THEN I
WILL HAVE EXTRA MONEY TO INVEST
AT THAT POINT, RIGHT?
SO WHAT HAPPENS THERE, LET'S SAY
YOU TAKE THAT EXTRA MONEY FOR 10
YEARS, THIS WAS YOUR PAYMENT
THAT YOU WERE PAYING, AND NOW 20
YEARS YOU INVEST THAT FOR 10
YEARS, AND IT'S AT 8%, YOU
GENERATE 660,000 THERE IS OF
NETWORTH, AND IF YOU COMPARE IT
TO THE 1.3 GENERATED HERE,
YOU'RE STILL $548,000 RICHER BY
NOT PAYING YOUR DEBT OFF SOONER,
NOW THE REASON THIS IS, IS A
TIME VALUE OF MONEY.
THAT IF YOU HAVE A MORTGAGE THAT
IS AT A LOW PERCENTAGE RATE, THE
PACE OF INFLATION MAKES THAT
MORTGAGE CHEAPER OVER TIME AND
IF YOU CAN DO SOMETHING THAT
GENERATES MORE RETURN THAN THE
INTEREST THAT YOU'RE PAYING,
THEN YOU MAKE MORE MONEY AND
THAT'S WHY COMPANIES LIKE APPLE
THAT WORTH LIKE A TRILLION
DOLLARS, THEY HAVE 17 BILLION
DOLLARS WORTH OF LOANS AND YOU
COULD EASILY JUST PAY THAT OFF
WITH A STROKE OF A PEN BUT THEY
REALIZE THAT THAT MONEY THEY'RE
PAYING DEBT ON CAN GENERATE MORE
INCOME FOR THEM DOWN THE ROAD SO
I WANT TO YOU THINK LIKE THAT,
TOO, BUT IT'S NOT THAT SIMPLE.
THERE ARE MORE QUESTIONS HERE
THAN JUST, SHOULD YOU DO THIS OR
SHOULD YOU DO THAT.
SO 1 OBVIOUS QUESTION IS PAYING
OFF YOUR DEBT SOONER WORTH IT TO
YOU.
RIGHT?
SO IT MIGHT MEAN THAT THAT 548,
THAT WOULD BE GOOD BUT YOU JUST
WANT THAT, YOU JUST WANT YOUR
MORTGAGE PAID OFF SOONER, YOU
WANT THAT FEELING.
THATYA VALID.
THAT'S A VALID FEELING BUT JUST
REALIZE THAT THAT'S THE COST,
THE ECONOMIC OPPORTUNITY COST
FOR THAT.
IS PAYING YOUR DEBT OFF SOONER
WORTH THE TIME SPENT FOR DOING
THAT, THE EXTRA MOONLIGHTING
SHIFTS AND ALL THE EXTRA
CLINICAL DUTIES YOU'RE DOING,
WOULD IT BE BETTER SPENT DOING
SOMETHING ELSE AND THE QUESTION
I ULTIMATELY ASK MYSELF BECAUSE
I--ONCE I HAVE MY PROMOTION FROM
ASSIST ABT TO ASSOCIATE, I STOP
MOONLIGHTING, THERE WASN'T A
FIRM DECISION, BUT MY WIFE
STARTED--SHE'S A PERFORMER AND
DOES BROADWAY AND SINGING AND
THERE'S A PERFORMANCE THE
BEGINNING OF THE YEAR AND SO SHE
HAD A LOT OF NIGHT DUTY AND
REHEARSALS AND THINGS AND I
REALIZED WE'RE FINE, WE'RE
MAKING ENDS MEET AND I CAN
GENERATE EXTRA MONEY AND INVEST
IT AND HAVE ALL THIS EXTRA MONEY
ABOUT YOU IT'S NOT WORTH IT FOR
ME AT THAT POINT.
SO IS IT WORTH DPENERATING EXTRA
INCOME ALTOGETHER, WHICH IS ALSO
A QUESTION YOU SHOULD ASK EMPLOY
NOW I KNOW THAT PEOPLE MOONLIGHT
AND DO EXTRA SHIFTS FOR MANY
DIFFERENT REASONS SO SOMETIMES
IT MIGHT BE SKILLS ACQUISITION,
KEEPING YOUR SKILLS BASE UP AND
THINGS LIKE THAT, VERY VALID AND
SOMETIMES IT'S GENERATING EXTRA
INCOME TO MAKE THE POINTS MEET
BUT MAKE SURE THAT YOU'RE
MANAGING YOUR FINANCES
APPROPRIATELY SO YOU'RE NOT
DOING ANYMORE THAN YOU HAVE TO
BECAUSE A LOT OF UNHAPPINESS
COMES FROM BEING STRETCHED AND
FEEL LIKE YOU'RE DOING THINGS
THAT YOU DON'T REALLY WANT TO DO
TO MAKE ENDS MEET.
SO LESSON 3 IS TO ORGANIZE YOUR
FINE ARMANI LIFE, I HAVE A CHECK
LIST FOR YOU.
IF YOU ARE NOT TRACKING YOUR
FINANCIAL TRANSACTIONS AND,A
COUNTS, I THINK YOU SHOULD DO
THAT, THERE ARE MANY DIFFERENT
WAYS, THESE ARE ALL SOFTWARE
SERVICES, EMPOWER, QUICKEN, I
USE MONARCH MONEY BUT I'M NOT
RECOMMENDING THAT AND CREDIT
KARMA, IT'S PAINFUL BECAUSE IT
TAKE ACE LOT OF TIME TO PUT ALL
YOUR INFORMATION IN THERE,
YOU'RE TRACKING IT, YOU HAVE TO
FIGURE OUT LIKE WAS THIS
ACTUALLY AFRONS COFFEE OR WAS A
SNACK OR SOMETHING LIKE THAT,
AND I DO THIS FOR 1 OR 2 MONTHS
OUT OF THE YEAR WHERE I CLOSELY
TRACK IT CAREFULLY AND THEN THE
REST OF THE YEAR I GO ON BECAUSE
I HAVE BETTER THINGS TO DO WITH
MY LIFE BUT AT LEAST I KNOW WHAT
I'M SPENDING MONEY ON, SO
SOMETIMES YOU WILL FIND
SURPRISES LIKE I FOUND THAT MY
WIFE AND I BOTH HAD AMAZON PRIME
MEMBERSHIPS, ASK HER MEMBERSHIP
WAS A 1 YEAR ANNUAL FEE THAT YOU
SAVE MONEY ON AND 1 YEAR WE SAID
LET'S DO THAT TO SAVE MONEY AND
THEN I'M DOING THE MONTHLY
SUBSCRIPTION AND WE NEVER PICKED
UP ON IT AND YOU WOULDN'T UNLESS
YOU WERE TRACKING YOUR FINE
FINANCES CLOSELY AND THERE'S
PROBABLY 7 OR 8 STREAMING
SERVICES THAT WE'RE PAYING IF
ARE THAT WE DON'T ACTUALLY USE,
SO THINGS LIKE THAT, IT'S NOT
LIKE--I'M NOT GOING TO BECOME
SUPER WEALTHY BECAUSE I TOPPED
MY AMAZON PRIME SUBSCRIPTION BUT
IT'S THINGS THAT YOU'RE
RECAPTURING YOUR POWER OF YOUR
FINANCES, NOW THE NEXT THING IS
TO LEARN ABOUT CAREER AND
PERSONAL FINANCE BECAUSE THIS IS
NOT SOMETHING WE TALK ABOUT
COMFORTABLE ONABLY WITH OUR
COLLEAGUES AND EVEN FOR ME, I
STRUGGLE WITH BEING OPEN ABOUT
THIS, SO I DO HAVE A COLLEAGUE
THAT--WHO'S IN A SIMILAR STAGE
IN MY LIFE AND CAREER, WE SHARE
ALL OUR INFORMATION WITH EACH
OTHER, SHE KNOWS WHAT I MAKE,
WHAT I'M WORTH, I KNOW HERS AND
WE TALK THROUGH OUR DIFFERENT
FINANCIAL SITUATIONS AND THEN
THERE'S A BOOK CLUB, WE'RE NOT
READING LIKE A BOOK A MONTH OR
ANYTHING, IT MIGHT BE LIKE 1
BOOK A YEAR, ON BASIC PERSON
FINANCE AND OUR REFLECTIONS ON
IT, AND ALSO IT MIGHT BE ABOUT
CAREER DEVELOPMENT.
NOW A FINANCIAL ADVISOR IS A
GREAT IDEA, A CONSULT FOR
SOMETHING THAT'S VERY IMPORTANT,
FINANCIAL ADVISOR IS SOMEONE WHO
KNOWS THINGS LIKE THIS SO YOU
DON'T HAVE TO KNOW THINGS LIKE
THIS.
NOW THERE ARE 2 DIFFERENT KINDS,
THERE ARE 1S WHO ASSESS A 1 TIME
FEE, YOU JUST PAY A BURCH OF
MONEY.
--BUNCH OF MONEY, IT'S PAINFUL
TO GIVE THEM THAT MONEY BUT THEY
GIVE YOU GOOD ADVICE.
FIRST TIME I DID IT I PAID $750
AND THE FINANCIAL ADVISOR SAID I
SHOULD REFINANCE MY MORTGAGE,
NEVER OCCURRED TO ME TO DO IT
BUT I DID IT AND IT WAS PAINFUL
BUT I SAVED $820 BY REFINANCING
MY MORTGAGE.
SO HE MADE UP WITH HIS FEE JUST
WITH THIS FIRST MONTH AFTER
DOING THAT, NOW THAT'S 1 WAY TO
DO IT, THE OTHER WAY IT TO HAVE
SOMEONE WHO MANAGES YOUR ASSETS
SO IF YOU DON'T WANT TO MANAGE
YOUR INVESTMENTS THAT'S ALSO
FINE.
THEY WILL TAKE A CHUNK OF YOUR
MONITOR THAT'S' GENERATED AND IS
USUALLY 1 TO 1.5%, SOME PEOPLE
SAY DON'T EVER DO THAT.
I THINK IT'S FINE IF YOU DON'T
WANT TO TOUCH IT AND YOU WANT
SOMEONE ELSE WHO IS PROFESSIONAL
AND MANAGE IT, BUT DO THAT, THE
POINT IS HAVE SOMEONE WHO IS
LOOKING OUT FOR YOUR FINANCIAL
INTEREST, AND THEN CRAFT AN
ESTATE PLAN, ANYONE WHO'S BEEN
WITH A PATIENT END OF WELL,
KNOWS IT'S IMPORTANT TO HAVE
POWER OF ATTORNEY AND WILL
ENTRUST PREPARATION, SO THOSE
ARE ALL THINGS I SUGGIEST FOR
YOU GUYS TO DO.
ALL RIGHT.
NOW I WANT TO GET TO THE
QUESTION, DOES MONEY BUY
HAPPINESS ISSUES WHO HAS BEEN
TOLD THAT MONEY BUYS YOU
HAPPINESS?
THERE'S A SONG, MONEY CAN WEIGH
YOU HAPPINESS.
I I'VE ALWAYS BEEN OF THE MIND
SET WHERE PEOPLE WHO SAY THIS
DON'T HAVE ANY MONEY BECAUSE
MONEY ABSOLUTELY DOES BUY YOU
HAPPINESS.
THESE ARE 2 DIFFERENT STUDIES,
THEY FOUND 2 DIFFERENT THINGS,
THIS 1 WAS BY KAHNEMAN AND
ASSOCIATES AT PRINCETON
UNIVERSITY AND THEY'RE LOOKING
AT ABOUT A THOUSAND PEOPLE IN
DIFFERENT PROFESSIONS AND THEY
ASK THEM ARE YOU HAPPY OR SAD?
OR ARE YOU HAPPY OR AT LEAST NOT
SAD?
AND WHAT THEY FOUND WAS THAT
YOUR HAPPINESS DEFINITELY
INCREASED UP AND TO A CERTAIN
POINT AND THAT PERSON POINT WAS
SOMEWHERE BETWEEN CYST THOUSAND
AND $90,000 OF HOUSEHOLD INCOME
PER YEAR, AND THEN PEOPLE WHO
REPORTED AT LEAST I WAS NOT SAD,
THEN THEY FOUND THE SAME RIGHT
HERE.
NOW WE HAVE TO ADJUST FOR
CERTAIN THINGS, THESE PEOPLE
WERE NOT LIVING IN BETHESDA, SO
YOU HAVE TO,A JUST FOR THAT,
RIGHT?
BUT THEY FOUND THAT THERE IS A
LIMIT, THE CONCEPT HERE IS THAT
THERE'S A LIMIT TO HOW MUCH
HAPPINESS WILL BUY YOU PAST A
SYRUP POINT OF HOUSEHOLD INCOME.
NOW THAT DIRECTLY CONFLICTS WITH
THIS STUDY, WHICH WAS PUT OUT BY
KILLINGSWORTH OUT OF UNIVERSITY
OF PENNSYLVANIA, AND THEY FOUND
THAT THIS WAS COMPLETELY LINEAR
RELATIONSHIP, THAT MORE MONEY,
MORE HAPPINESS, RIGHT THERE.
SO WHAT WOULD EXPLAIN AND THIS
WAS ABOUT 10 OR 30,000
RESPONDENTS, SO A LARGER SAMPLE
SIZE.
NOW WHAT WOULD EXPLAIN SUCH
DISPARATE FINDINGS THERE IN WHAT
WAS REALLY COOL IS THAT THESE 2
GROUPS CAME TOGETHER TO DO A
RESEARCH STUDY TOGETHER TO
RECONCILE WHY THEY FOUND SUCH
DRNT RESULTS AND WHAT THEY FOUND
WAS THAT IT'S MORE OR LESS A
LINEAR RELATIONSHIP BUT IT'S A
CAVEAT HERE, THESE PERCENTILES
ARE YOUR PERCENT OF BASE LINE
HAPPINESS, SO IN OTHER WORDS IF
YOU'RE HAPPIER THAN 85% OF THE
PEOPLE IN THE SURVEY RESPONSE,
YOU GOT MORE MONEY, YOU'RE MORE
HAPPY.
THAT LEADS TO MORE HAPPINESS.
AND THEN ONCE YOU GET DOWN TO
THE 15th PERCENTILE, IT
FLATTENING OFF AND THIS LEVEL IS
AROUND $120,000 OF HOUSEHOLD
INCOME, IF YOU WERE UNHAPPY,
STRESSED OUT, BURNT OUT, ALL
THOSE SORTS OF THINGS AND YOU
HAD MORE MONEY, YOU JUST ADDED
MORE MONEY TO BURN AND STRESS
YOU OUT.
ALL RIGHT?
SO IT KIND OF RECONCILED HOW YOU
FEEL BEFORE MONEY MATTERS.
I WANT TO SEE WHAT THIS LOOKS
LIKE IN PHYSICIANS SPECIFICALLY
BECAUSE GENERATING MORE INCOME
AS A PHYSICIAN OFTEN IS
DIFFERENT THAN GENERATING MORE
INCOME IF YOU WORK FOR AMAZON,
YOU MIGHT BE DOING MORE OR LESS
THE SAME WORK, AND A LOT OF
RESPONSIBILITY, A LOT OF
PHYSICIANS GENERATE MORE INCOME,
YOU ARE IN A SPECIALTY WHERE
THERE'S A LOT OF NIGHT CALL,
OVERNIGHT, OR DOOR TO DOOR, OR
AND YOU DO THAT TO MAKE MORE
INCOME AND THIS IS ABSOLUTELY MY
ANECDOTA EXPERIENCE, IS THAT
FACULTY WHO FEEL LIKE THEY'RE
STRETCHING THEMSELVES TO SUSTAIN
A INCOME THRESHOLD TO SUSTAIN A
LIFESTYLE WHO ARE BURNT OUT AND
UNHAPPY, THAT IS A TREND IN OUR
PROFESSION,A THAT LEADS TO NOT
MUCH MORE HAPPINESS GAIN.
SO MY POINT HERE IS NOT YOU
SHOULDN'T THINK THAT MONEY IS
IMPORTANT HERE, IS ALSO NOT AN
ARGUMENT THAT PEOPLE SHOULD BE
UNDERPAID BECAUSE I THINK PEOPLE
SHOULD BE PAID FAIRLY BUT MY
POINT HERE IS THAT IF YOU'RE
UNHAPPY AND YOU THINK MORE MONEY
WILL BE THE SOLUTIONS PROBABLY
NOT GOING TO WORK, OKAY?
AND THAT'S ANOTHER REASON WHY
YOU WANT TO MAKE SURE THAT YOUR
FINANCIAL HOUSE IS IN ORDER.
ALL RIGHT, MOVING ON.
WE'RE DONE WITH MONEY, MAYBE.
NO MEANS YES, CASE NUMBER 32.
THIS IS A FACULTY MEMBER FEELING
OVERWHELMED AND BURNT OUT MOVING
ACROSS THE COUNTRY FROM
WASHINGTON, THEY STARTED ON
FACULTY 3 YEARS AGO AS A
CLINICAL EDUCATOR AND THEY
DEVELOPED A STELLAR REPUTATION,
THEY ARE EXCELLENT IN TEACHING,
CLINICAL CARE, MULTIPLE TEACHING
AWARDS, CLINIC DUTY RIGHT THERE,
4 HALF DAYS A WEEK, 8 WEEKS PER
YEAR OF INPATIENT DUTY.
MULTIPLE COMMITTEES, BALANCES
MULTIPLE MEETING, INCLUDING WHEN
ON SERVICE, THEY DON'T ENJOY
CLINIC THAT MUCH ANYMORE AND
THEY'RE INTERESTED IN DEVELOPING
A MENTORSHIP AND EDUCATE ORROLE
AT THE MEDICAL SCHOOL LEVEL.
SO THEY CAME TO ME AND THINKING
BURN OUT, WHAT SHOULD I DO?
NOW BURN OUT IS HIGH, AND 1
THING TO POINT OUT IS THAT BURN
OUT IS HIGHER AMONGST FEMALE
FACULTY SOPHISTICATEDY THIS IS A
AAMC SURVEY, THEY NEED TO UPDATE
IT, THIS IS FROM 2019, I WOULD
LIKE TO SEE WHAT POST COVID
NUMBERS LOOK LIKE.
BUT WHAT'S TRIKING HERE IS THAT
IF YOU LOOK OVER HERE, THE LEVEL
OF TRESES IS PRETTY CONSISTENT
ACROSS DIFFERENT KINDS OF
FACULTY.
BUT IF YOU LOOK AT AND IT'S THE
SAME OVER HERE AND IF YOU LOOK
AT RACE AND GENDER, YOU SEE
THERE'S MORE FEELINGS OF BURNING
OUT OR BURNT OUT AMONG ALL WOMEN
AND THEN WOMEN OF COLOR.
AND SO, THERE'S AND WE'VE LOOKED
AT OUR OWN DATA AT THE
UNIVERSITY OF VIRGINIA AND WE
EXACTLY MIRROR ALMOST TO A T
THIS EXACT DATA.
THERE IS MORE BURN OUT AMONGST
OUR FEMALE COLLEAGUES AND I
THINK 1 IN 5 IS STILL TOO HIGH.
SO THIS IS SOMETHING THAT WE
SHOULD TALK MORE ABOUT AND THAT
WE SHOULD MAKE SURE THAT PEOPLE
HAVE GOOD SUPPORT TO GET THROUGH
BURN OUT AND WITH THEIR FIELD
AND WORK, I THINK WHAT'S ALSO
IMPORTANT IS THAT WE NEED TO
MAKE SURE THAT THE WORK WE DO
WITH SELF-IS NOT STUPID AND THAT
WE ARE DOING WHAT WE CAN TO
DECREASE THE NONVALUE ADDED
THINGS THAT WE HAVE TO DO
BECAUSE ADMINISTRATIVE BURDEN
INCREASE IN HEALTHCARE NOT GOING
DOWN, 1 THING I WANT TO
SPECIFICALLY POINT OUT IS THE
TERM CALLED THE MINORITY TAX,
THIS WAS COINED MANY YEARS AGO
BUT ADDRESSED HERE IN THE BMC
MEDICAL EDUCATION JOURNAL WHERE
RODRIGUEZ AND COLLEAGUES SAID
THAT THE MINOR TAX HAS BEEN
DEFINED AS THE TAX OF EXTRA
SPBTS ONITY FACULTY IN THE NAME
OF EFFORTS TO, ACHIEVE DIVERSIT.
SO THIS IS--THEY FOUND OUT THERE
WERE ON 2 DIFFERENT SEARCH
COMMITTEES BECAUSE THEY JOANED
WOKNOW SEARCH COMMITTEE THINKING
THEY WERE REVIEWING 1 GROUP OF
CANDIDATES AND FOUND THEY WERE
ACTUALLY ON IA DIFFERENT SYRUP
COMMITTEE AND THEY WERE ON 2 AT
THE SAME TIME BUT THOUGHT THEY
WERE ON 1.
THEY ARE ON A HOSPITAL CULTURE
IMPROVEMENT WORKING GROUP, STAFF
REPRESENTATIVE FOR THE CLINICAL
STAFF IN THE HOSPITAL, PRESSURE,
SO IT JUST GAZ ON AND ON AND ON.
AND THE GREEN THING RIGHT HERE
ACCIDENT THIS IS THE 1 THING
THAT'S ACTUALLY WRITTEN INTO HER
JOB DESCRIPTION SO THIS IS
PERSON WHO JUST SAYS YES, HAVE A
REPUTATION FOR BEING GREAT AND
PRODUCING EXCELLENT WORK, NO
GOOD GOOD DEED GOES UNPUNNISHED
SO THEY KEEP GETTING ASKED TO DO
THINGS, AND IT'S LIKE DEATH BI A
THOUSAND CUTS THAT EVENTUALLY
YOU REACH A BREAKING POINT, SO
LESSON 4, IS TO HARNESS THE
POWER OF NO, WHO REMEMBERS THE
DARE, DARE TO KEEP YOU OFF DRUGS
IN I WILL DARE YOU TO SAY NO.
PREFACULTY SUCCESS SO BEFORE YOU
GET TO THE FACULTY LEVEL, YOU
HAVE BECOME SUCCESSFUL BECAUSE
YOU SAID YES TO THINGS, I TOOK
ON THE EXTRA PROJECT, YOU'VE
DONE THE EXTRA COURSE, THE EXTRA
OPPORTUNITY BUT ONCE YOU'RE
FACULTY, I THINK YOUR
SUGASSESSES REQUIRES TO YOU SAY
NO TO THINGS AND YOU MAKE AN
EFFORT TO PROTECT YOUR TIME,
THIS IS A FUNNY TWEET THAT MY
FRIENDS AND I CIRCULATE EVERY
NOW AND THEN, THIS IS DENNIS
BRITON Ph.D. FACULTY BUT HE
SAID I WAS ASKED TO SERVE ON A
DIVERSITY COMMITTEE AND I SAID
NO, PLEASE CONGRATULATE ME.
AND IT FEELS WRONG TO TURN
PEOPLE DOWN BUT ONCE YOU TART TO
DO IT, IT FEELS GOOD.
RIGHT?
SO I CHALLENGE PEOPLE TO MAKE A
CHECK LIST OF LIKE 10 BLANK
CHECKINGS AND THEN THESE ARE ALL
THINGS THAT YOU SAY NO TO, AND
SO SOMEONE ASKS YOU TO DO
SOMETHING, YOU SAY NO, AND YOU
CHECK AND YOU WRITE DOWN WHAT IT
IS TO YOU SAID NO TOO AND IT
FEELS SO WRONG TO START DOING
THIS BECAUSE YOU ALWAYS SAID YES
TO PEOPLE BUT ONCE YOU STAY NO
AND RESTRICT YOUR OPPORTUNITIES
TO THE THINGS YOU WANT ON DO, 2
THINGS HAPPEN, YOU FEEL BETTER
ABOUT THE TIME YOU'RE COMMITTING
TO THE JOB THAT YOU WANT TO DO,
AND THE SECOND IS THAT PEOPLE
REALIZE THAT THEY SHOULDN'T COME
TO YOU UNLESS IT'S SOMETHING
THAT'S WORTH WHILE AND WORTH
YOUR TIME.
SO ONCE I STARTED SAYING NO TO
OPPORTUNITIES, I DON'T SAY NO TO
THE NIH, I WILL COME AND SPEAK
WITH YOU GUYS, BUT I HAVE TURNED
DOWN SIMILAR OPPORTUNITIES TO
OTHER PLACES BECAUSE IT JUST
DIDN'T--IT DIDN'T FIT.
NOW, IT'S EASY TO TELL PEOPLE
JUST START SAYING SNOW, JUST
START SAYING NO, BUT I WANT TO
GIVE YOU A FRAMEWORK FOR HOW TO
THINK THROUGH. THIS I WILL GIVE
YOU EXAMPLES.
SO GETTING READY FOR THIS TALK,
HERE'S PARKER'S E-MAIL, THIS WAS
THE PREP MEETING WE WERE GOING
TO HAVE BEFORE COMING ON, I KNOW
YOU'RE FREE, YOU'RE ALL SET, YOU
DON'T NEED ME BUT A HAVE A
CONFLICT WITH MY SON'S
PRESENTATION, IF THERE'S
ANYTHING I CAN DO FOR HELP, I
CAN YOIN FOR 5 MINUTES, EVEN IF
YOU DON'T NEED ME, I CAN JOIN
FOR 5 MINUTES.
AND ID, I KNOW OF COURSE, MY
CHILD FRACTURED HER WRIST, I'M
CATCHING UP, I'M ON SERVICE, SO
SHOULD HAVE BEEN A VERY EASY
DECISION TO JUST SAY I'M NOT
GOING TO BE HERE, I HAVE SO MANY
THINGS TO DO, I WILL SAY NO BUT
THAT'S THE CULTURE WE NEED DO
DEVELOP, THAT WE ARE HERE FOR
EACH OTHER, THAT ARE FOCUS ON
THE JUST HERE AS OUR ROLE IN
CLINICIANS OR RESEARCHERS HERE
AND THERE'S OTHER THINGS GOING
ON AND WE DON'T EXPECT PEOPLE TO
BE PLACES JUST BECAUSE THEY CAN
BE PLACES, NOW, THE FRAMEWORK I
WANT TO GIVE YOU IS FROM A GOOD
FRIEND OF MINE,
DR. [INDISCERNIBLE] AT UCLA AND
SHE HAS THIS APPROACH WHERE SHE
THINKS ABOUT HER LIFE IN CAREER
BUCKETS.
SO EVERYTHING SHE DOES OUTSIDE
OF HER DIRECT RESPONSIBILITY,
NEED TO FULFILL 1 OF THESE
BUCKETS SO RESEARCH, SHE'S A
COLORECTAL CANCER RESEARCHER OR
IT CAN CONTRIBUTE TO HER WEALTH,
CONSULTING FEE, SPEAKER FEE, IT
NEEDS TO CONTRIBUTE TO HER
ADVOCACY, A LOT OF ADVOCACY WORK
FOR UNDERREPRESENTED MINORITIES
AND COLORECTAL CANCER SCREENING,
IT CAN FULFILL THE OBLIGATIONS
LIAISON FAIGZ, SO A CONFERENCE
THAT INVITES YOUR FAMILY TO GO
TO FOR INSTANCE, OR RAISE HER
NATIONAL PROFILE BECAUSE IF HER
NATIONAL PROFILE IS RAISED THEN
THAT'S BEATER FOR HER CAREER,
NOW THERE'S 1 THING, SO SHE TOLD
ME THIS, I WAS LIKE, COOL, SO
YOU DO SOMETHING ONLY IF IT
FILLS YOUR BUCKET, SHE SAID NO,
IT NEEDS TO FULFILL AT LEAST 2
BUCKETS AT 1 TIME, ALL RIGHT IN
SO, IT'S NOT JUST, JUST 1-OFF
THING, BUT IF IT CAN FULFILL 2
DIFFERENT ROLES AT 1 TIME, THEN
THAT'S SOMETHING THAT'S WORTH
GOING TO.
SO WHEN I GO TO CONFERENCES, I
TRY TO SEE IF I CAN BRING MY
FAMILY ALONG AND THEY HAVE THAT
EXPERIENCE WITH ME, AND I CAN
FULFILL 2 ROLESSA THE ONCE.
BACK WHEN I WAS DOING A LOT OF
COVID WORK IT WAS RAISING MY
PUBLIC PROFILE, AND DESTROYED MY
FAMILY LIFE BECAUSE I WAS AT
WORK DOING ZOOM AND THINGS LIKE
THAT BUT IT LED TO MORE
OPPORTUNITIES TO SPEAK AND
ULTIMATELY GENERATE IT AND MORE
WEALTH AND CONSULTING FEES AND
THAT HELPED WITH THAT ASPECT OF
FAMILY LIFE, SO, 2 BUCKETS AT
ONCE BUT SHE MADE THE POINT, I
SPOKE WITH HER YESTERDAY,
BECAUSE I WANTED TO MAKE SURE I
DIDN'T MISREMETABOLISM RESENT
HER, SHE SAID YOU NEED TO
REMEMBER THAT YOUR PRIORITIES
MIGHT CHANGE OVER TIME SO ALWAYS
REEVALUATE WHAT YOUR BUCKETS ARE
BECAUSE YOU MIGHT HAVE
COMPLETELY DIFFERENT 1S, SOME
MAY NOT MEAN AS MUCH AS THEY DID
BEFORE, BUT THIS NOTION THAT YOU
SHOULDN'T JUST COMMIT TO
SOMETHING BECAUSE IT FULFILLS 1
ASPECT OF THIS THAT WE NEED TO
TART DOING DOUBLE DUTY SO I'VE
TAKEN THAT LESSON TO HEART FROM
HER.
ALL RIGHT, NOW I WANT TO GET
BACK TO THIS, THE MINORITY TAX,
THEY HAD A LIST OF ACTIONS TO
TAKE TO TRY TO DECREASE THE
CHANCE THAT YOUR INFACULTY,
YOU'RE NOT OVER TAXED
RESPONSIBILITIES THAT ARE
RELATED TO ACHIEVING DIVERSITY.
SO 1 WAS TO VALUE DIVERSITY
EFFORT LEERILY ACROSS THE
-FAIRLY ACROSS THE
INSTITUTE, WE DON'T WANT TO BE
ON COMMITTEES THAT HAVE EXTRA
TIME OR STIPEND NOT ATTACHED TO
IT.
FUND STATED INSTITUTIONAL
DIVERSITY EFFORTS, EXPECTATIONS
EMILYINATE ALL FORMS OF
DISCRAMINATION, ENSURE FRANK AD
HONEST COMMUNICATION BETWEEN
ADMINISTRATION AND FACULTY AND
DEVELOP AN EMPLOYEE RETENTION
STRATEGY, AND DEVELOP BROAD
KAWOF THURE CHANGE ACTIVITIES
WITH WIDE SPREAD PARTICIPATION.
NOW IT USUALLY BREAKS DOWN THIS
3 DIFFERENT NOTIONS RIGHT HERE,
SO 1 IS YOUR SENSE OF VALUE TO
THE INSTITUTION, DOES THE PLACE
I WORK, DID THE LAB I WORK IN,
DOES THE WORK THAT I WORK WITH,
DO THEY VALUE ME AS A PERSON, AS
AN INDIVIDUAL, AS A PARENT,
SECOND IS YOUR SENSE OF AGENCY,
THERE IS SOMETHING THAT'S
HAPPENING THAT DOESN'T MAKE
SENSE WITH YOUR WORK FLOW OR
SOMETHING IN YOUR CAREER, DO
HAVE YOU THE ABILITY TO CHANGE
THAT.
OR AT LEAST MAKE AN EXPOSURE TO
--EFFORT TO
MAKE THAT BETTER, THAT GETS TO
YOUR SENSE OF DO YOU HAVE POWER
OR FEEL POWERLESS AND YOUR SENSE
OF COMMUNITY.
DO YOU HAVE PEOPLE ARK ROUND YOU
WHO HAVE SIMILAR INTERESTS SO
CAN YOU CONFIDE IN FOR YOUR
CAREER AND YOUR PERSONAL LIVE.
NOW I WILL GIVE YOU AN EXAMPLE
HOW THIS WORKS OUT, I THINK A
LOT OF FOLKS RELY ON 1 OVER THE
OTHER, SO RESIDENCY, HAVE YOU A
STRONG SENSE OF COMMUNITY, I
NEVER FELT LEAK I HAD A LOT OF
POWER AS A RESIDENT.
I DIDN'T FEEL LIKE I WAS VALUE
AS A RESIDENT, BUT I HAD A LOT
OF PEOPLE WHO I WAS WITH ALL THE
TIME AND THEY VALIDATED ME EVERY
SINGLE DAY AND A GREAT
EXPERIENCE AND THAT'S WHY A LOT
OF PEOPLE REMEMBER THEIR
RESIDENCY FONDLY AND SAY THIS IS
WAS A GREAT EXPERIENCE, WOULD BT
DO IT AGAIN BUT IT WAS A GREAT
EXPERIENCE, NOW WHEN YOU
INTROFACULTY, THIS SENSE OF
COMMUNITY IS NOT AUTOMATICALLY
THERE ANYMORE, YOU'RE NOT AROUND
PEOPLE WHO ARE OF THE SAME AGE
OR SAME EXPERIENCES, THEY'RE
KIND OF ON YOUR OWN SOMETIMES
AND SO YOU'RE DEVELOPING YOUR
SENSE OF VALUE.
YOU HAVE YOUR ATTENDING SALARY
BUT THEN YOU REALIZE, MAYBE
YOU'RE UNDERPAID AND THEN YOU
HAVE ALL THESE CLINIC EXECATIONS
THAT DON'T REALLY MAKE SENSE TO
YOU, YOU DON'T KNOW WHY THE
ADMINITRATION IS MAKING THIS
CHANGE WHEN YOU'RE CLINIC IS NOT
REALLY A PROBLEM BUT THEY'RE
TRYING TO STANDARDIZE THINGS
ACROSS THE INSTITUTION, FOR
EFFICIENCY AND ROLL OVER AND ALL
THAT SORT OF STUFF AND YOU FEEL
POWERLESS AND A LOT OF OUR
FACULTY ARE STRUGGLING WITH THE
INCREASING SENSE OF LOSS OF
POWER AND SELF-DETERMINATION,
THAT THEY FEEL UPDATER VALUED BY
THEIR INSTITUTION AND @ THE SAME
TIME THERE'S NOT A LOT OF
COMMUNITY TO CONFIDE IN.
SO I TEND TO THINK IN TERPS OF
THESE 3 TEARMS AND IN USUALLY
WHEN SOMEONE IS VERY UNHAPPY OR
BURNT OUT SOME OF THESE MIGHT BE
OUT OF WHAT BEING AND THAT'S
WHAT I WANT US TO FOCUS ON
MOVING FORWARD.
NOW 1 THING THAT I THINK REALLY
HELPS, IS EXECUTIVE COACHING, SO
HERE'S AN EXAMPLE, WHO IS THIS
PERSON, SO I KNOW THERE'S WISARD
FANS IN A ROOM, THIS IS SOMEONE
WHO PLAYS BASKETBALL WELL, YOU
MAY NOT BE USED TO THAT.
SO HE IS THE BEST HIM AND
CAITLIN CLARK ARE THE BEST
SHOOTERS THAT WE'VE EVER SEEN IN
THE HISTORY OF BASKETBALL AS A
SPORT ON OUR EARTH.
WHO ARE THESE PEOPLE?
THEY'RE SHOOTING COACHED
BRAPPEDON PAIP AND BRUCE
PHASIER, WOULD YOU LOOK AT THESE
GUYS CAN THINK SHOOTING COACH.
STEF CURRY HAS 2 SHOOTING
COACHES WHO HELPS HIM WORK ON
HIS SHOT.
THE GREATEST 3-POINT SHOOTER IN
THE HISTORY OF THE WORLD HAS
SHOOTING COACHES, WHAT IN THE
WORLD CAN THEY TELL HIM ABOUT
HIS SHOT?
RIGHT, NOW SURE, I BET BRANDON
AND BRUCE ARE BETTER 3-POINT
SHOOTERS THAN YOU ARE BUT
THEY'RE NOT BETTER THAN STEF
CURRY, I CAN,A SURE YOU THAT.
SO SOMEONE LIKE STEF CURRY HAS
COACHES, SHOULDN'T YOU HAVE A
COACH?
ALL RIGHT?
SO THINK ABOUT IT THIS WAY, YOU
GUYS ARE THE STEPH CURRY OF
ACADEMIC MEDICINE, IT'S NOT
NORMALIZED TO YOU BECAUSE YOU
BATHE IN MEDICINE ALL THE TIME
BUT LET'S THINK ABOUT THIS WAY,
3% OF THE PHYSICIANS ARE NIH
SPECIALIZATIONS AND THE NIH IS
THE STIP OF THE SPHERE WHEN IT
AM CANS TO TGF BETA ADVANCE WANT
SO WHEN I WORKED HERE AND I
WOULD ASK A PHARMACIST, HEY HA
DOES THAT MEDICINE DO, IT WAS
NORMAL TO SAY, WE DON'T KNOW,
WE'VE NEVER TRIED IT BEFORE.
WHEN I ASK QUESTIONS OF MY
PHARMACIST NOW, THERE'S USUALLY
SOMETHING WORKED OUT BECAUSE YOU
GUYS HAVE DONE THAT WORK SO YOU
GUYS REALLY ARE THE TIP OF THE
SPHEER WHEN IT COMES TO
ADVANCING KNOWLEDGE, IT CAN BE A
LONELY SPACE, CHALLENGING AND
STRESSFUL SPACE TO TRY TO
DEVELOP YOUR CAREER AS LYOU GUYS
ARE AT THE APEX OF THIS, YOU'RE
THE STEPh CURRYS AND IF HE HAS
AN EXECUTIVE SHOOTING COACH AND
AN EXECUTIVE COACH, RIGHT?
NOW THE NIH DOES HAVE THIS
RESOURCE, I LOOKED AT THEIR
EXECUTIVE COACHING WEBSITE HERE
AND THEY DO HAVE THESE AVAILABLE
FOR PROFESSIONALS AT THE NIH AND
THESE ARE MANY DIFFERENT NAMES
THAT THEY WORK ON THAT WILL IMET
TO BUT THAT RESOURCE IS THERE
AND IF I WORKED HERE THAT IS
SOMETHING I WOULD LOOK AT, AND
UNIVERSITY OF VIRGINIA WE HAD A
SIMILAR THING AND I MET WITH AN
EXECUTIVE COACH, I FELT LIKE MY
CAREER IS ANYTHING FINE BUT THEY
HAD GOOD POINTERS IN WEAKNESSES
I HAD AND HOW I APREACH
LEADERSHIP AND THINGS I NEED TO
WORK ON TO BE A BETTER LEADER.
NOW YOU ALSO HAVE A GREAT
RESOURCE HERE, DR. HASHIMOTO, HE
IS INDEPENDENT RESOURCE FOR
FACULTY TOW LOOK AT THEIR WORK
AND LIFE AS NIERK H SCIENTIST,
HE'S BEEN A--HE WAS AT YALE F 26
YEARS BEFORE COMING HERE IN 2017
AND I E-MAILED HIM YESTERDAY AND
HE WANTED TO STRESS WITH YOU
THAT HE WORKS WITH THE STAFF
CLINICIAN COUNCIL TO ORGANIZE
PROFESSIONAL ACTIVITIES AND
SUPPORT FOR CLINICAL FACULTY, HE
IS PILOTING A MENTORING PROGRAM
TO ASSIST WITH THAT FIRST MAJOR
TRANSITION FROM ASSISTANT TO
ASSOCIATE WERE POSITION, AND
THIS MODEL OF THE EXISTING
TENURED TRACK PI FACULTY MIDTERM
PROGRAM TO ESTABLISH, AND THE
OVERALL GOAL IS TO ESTABLISH THE
MENTORING, ON THE PAPER ON THE
MINORITY TAX TO ESTABLISH MENTOR
AND CULTURING, SO THAT'S THE
IDEA HERE TO ESTABLISH THAT
CULTURE.
SO I WANT TO MAKE CLEAR THE
COACH AND THE MENTOR, THIS WAS
ON THE NIRE H WEBSITE HERE, A
COACH IS THERE TO PROVIDE IN THE
OUTSIDE OPINION AND FOCUS ON
YOUR SUCCESS, THEY PROVIDE
OPPORTUNITIES FOR YOU TO EXPLORE
YOUR OWN MOTIVATIONS AND HELP
FIND ANSWERS FOR YOURSELF AND
IDENTIFY BARRIER ANDS SOLUTIONS
TO FIND OPPORTUNITIES THAT YOU
MAY NOT HAVE SEEN BEFORE, A
MENTOR TYPICALLY COME FROM
WITHIN YOUR ORGANIZATION, THEY
ARE FOCUSED ON YOUR SUCCESS, BUT
THEY ALSO HAVE OTHER PRIORITIES
AND THAT'S NOT ALWAYS A BAD
THING BUT REALIZE THAT YOUR
DEPARTMENT CHAIR OR THE PERSON
YOU REPORT TO MAY HAVE OTHER
INTERESTS IN ADDITION TO YOUR
SUCCESS, DOESN'T MEAN THEY DON'T
WANT YOU TO BE SUCCESSFUL BUT
THERE ARE OTHER THINGS THERE AND
THEY PROVIDE POLICY TO THE
ORGANIZATION THEY CAN HELP THE
MENTEE GET BETTER ACCESS TO
BETTER OPPORTUNITYS.
SO I MAKE IT A POINT TO HAVE A
COACH, A MENTOR WITHIN MY
IMMEDIATE ORGANIZATION AND
SOMEONE OUTSIDE MY DEPARTMENT
DIVISION, WHO I TALK WITH AS
WELL WHO ARE PEOPLE WHO I KIND
OF HAVE A BOARD OF FOLKS WHO I
LEAN ON FOR ADVICE
[INDISCERNIBLE] BEING A COUPLE
OF THEM.
NOW LESSON 5 HERE, CAREER
SOLUTION ERS US EVOLUTION AND
DESTINATION, SO I'VE SPOKEN WITH
THE FELLOWS AND SOME OF THE
FACULTY ALREADY AND WE'VE SEEN
THIS NOTION THAT CAREERS ARE
NONLINEAR AND YOU CAN'T PREDICT
WHAT YOU'RE GOING TO BE DOING IN
5 YEARS VERSUS NOW, BLAH, BLAH,
BLAH AND I'VE SEEN GRAPHICS
LOAMACYIC THIS THAT HAVE ALWAYS
NEVER BEEN QUITE COMFORTABLE
WITH THEM AND I THINK I FIGURE
THE OUT WHY, THAT THIS ASSUMES
THAT IT'S ALL WIGGLE, DIGLE, YOU
HAVE NO CONTROL, YOU DON'T KNOW
WHAT'S ANYTHING ON AND THEN YOU
GET TO THE PROMISED LAND UP HERE
IN THE SKY, THAT'S WHERE IT IS,
THAT'S THE MECCA, RIGHT IN I
LOOK AT IT MORE AS LEAK A TREE,
THIS IS A RED BUD THAT'S IN MY
BACKYARD AND IT'S A LITTLE MORE
TABLE, RIGHT?
YOU KNOW IT'S A TREE, YOU KNOW
IT'S GOING TO GROW, IT NEEDS
LIGHT, WATER AND NUTRIENTS BUT
IT'S GOING TO LOOK A LITTLE
DIFFERENT FROM YEAR TO YEAR AS
IT GROWS, RIGHT IN AND THE
BRANCHES MIGHT HAVE A DIFFERENT
COMPOSITION, WE HAVE 1 OF THE
BRANCHES WAS TAKEN DOWN BY A
LAWN MOWER GUY WHO RAN INTO THE
BRANCH, SO THAT'S GONE, SO
THERE'S 0 ALONG THE WAY AND IF
YOU CUT THE TREE DOWN AND LOOK
AT THE RINGS TO STUDY, YOU KNOW
WHAT WILL HAPPEN.
SO I FEEL LIKE CAREER
DEVELOPMENT IS LIKE THIS, SO IF
ANYONE'S A GARDENER, YOU KNOW
THERE'S A LOT OF WORK THAT GOES
INTO GARDENING AND THAT YOUR
GARDEN WILL CHANGE NATURE
OVERTIME BUT THERE'S SOME
PREDICTABILITY TO IT, SO, I
THINK YOUR CAREER HAS DIFFERENT
BRANCHES, IN THESE DIFFERENT
THINGS AT DIFFERENT TIMES AND IT
RESPONDS DIFFERENTLY TO
DIFFERENT STIMULI, BUT AT THE
END WE KIND OF KNOW YOU'RE GOING
TO BE SUCCESSFUL BUT BE
COMFORTABLE KNOWING IT MIGHT
LOOK DIFFERENT YEAR TO YEAR IN
THAT JOURNEY.
SO IN SUMMARY, THESE ARE MY 5
LESSONS MAKE SURE THE PATH
YOU'RE ON IS THE CORRECT 1, JUST
BECAUSE YOU CAN DO THINGS
DOESN'T MEAN YOU SHOULD DO
THINGS, PLEASE ORGANIZE YOUR
FINANCIAL LIFE, PARTNER ESES THE
POWER OF THE UNAPOLOGETIC NO AND
EXPECT TO EVOLVE OVER TIME AND
THAT YOU'RE CAREER WILL EVOLVE
WITH YOU AND I WILL END WITH
THIS QUOTE RIGHT HERE.
AND HAPPY TO TAKE ANY QUESTIONS
OR COMMENTS.
[ APPLAUSE ]
.
>> WE HAVE A FEW MINUTES LEFT
FOR QUESTIONS FOR DR. BELL, THE
MICROPHONES ON EITHER SIDE IF
ANY HAS ANY QUESTIONS STEP UP TO
THE MICROPHONE, AND I KNOW THERE
ARE QUESTIONS ON THE VIDEOCAST,
TYPE THEM IN THERE AND WE WILL
ASK THEM FOR YOU.
IN THE MEAN TIME I WILL TALK
ABOUT WHAT YOU SAID, YOU TALKED
ABOUT CAREER DEVELOPMENT AND
WHAT GOES ON IN YOUR OWN
INSTITUTION, AND IS CAREER
DEVELOPMENT LEAVING THE
INSTITUTION AND IT'S TIME TO
MAKE A MOVE AND AFFECT YOUR
CLEAR DEVELOPMENT, SO, I
STRUGGLE WITH THIS, LIKE
ACTIVELY RIGHT MOW, BECAUSE
WE'RE COMFORTABLE IN
CHARLOTTESVILLE, I LOVE UVA, AND
I TALK TO SOME OF THEM AT THE
NEXT NATURAL STEP AM I STAYING
HERE BECAUSE I'M COMFORTABLE OR
AM I STAYING HERE BECAUSE OF
TAKING THAT STEP AND I'M BEING
PASSIVE AND I DECIDED TO FOCUS
ON, AND MY EXTENT IS SKILL
DEVELOPMENT RATHER THAN THE JOB
TITLE AND SO, IF I'M LEARNING
AND GAINING SKILLS, AND KIND OF
DOING THE KIND OF WORK I WANT TO
DO AND ESPECIALLY IF MY FAMILY
IS COMFORTABLE, THEN THAT'S A
FACTOR IN MY STAYING AND EVEN
THOUGH I MIGHT BE GAIN MORE
INCOME AND HAVE A LARGER JOB
PROFILE BY MOVING SOMEWHERE
ELSE, I'VE CHOSEN TO STAY.
NOW A DIRECT EFFECT OF HAVING A
CULTURE OF MENTORSHIP AND
EXECUTIVE COACHING, IS THAT YOU
CAN EXPECT THAT THERE WILL BE
SOME PEOPLE WHO WILL LEAVE
BECAUSE YOU WILL REALIZE, THE
THEY WILL REALIZE THAT MAYBE
THEY'RE NOT GETTING THE SENSE OF
VALUE AND A SENSE OF AGENCY THAT
THEY HAVE THEIR HOME INSTITUTION
AND IT'S BETTER FOR THEM TO
LEAVE, I THINK THAT IN THOSE
CIRCUMSTANCES, THAT'S A GOOD
THING, BECAUSE YOU WANT PEOPLE
TO AT A AT INSTITUTION THAT WANT
TO BE THERE, THEY DON'T FEEL
LIKE THEY'RE TRAPPED THERE, A
LOT OF INSTITUTIONS, I WORKED
AUGHT BEFORE, PEOPLE ARE THERE
BECAUSE THEY FEEL TRAPPED BUT
NOT NECESSARILY THEY WANT TO BE
THERE, IT'S LIKE AN ATTACK,
EVERY TIME THEY WALK INTO WORK
ALL THE TIME AND THOSE
SITUATIONS, THAT IS WHERE YOU
SHOULD CONSIDER LEAVING, BUT
IT'S A COMBINATION OF MANY
DIFFERENT FACTORS, ISSUE YOUR
FAMILY, YOUR CAREER DEVELOP AM,
WHERE YOU THINK YOU WILL GO BUT
AS LONG AS YOU DO THAT, CAREFUL
EVALUATION, I THINK CAN YOU COME
TO THE RIGHT DECISION AS LONG AS
YOU DON'T HOLD YOURSELF TO AN
UNREALISTIC STANDARD.
>> YEAH, TYSON THANK YOU
FANTASTIC TALK BUT A GREAT
PERSPECTIVE.
THE THING ABOUT SAYING NO IS I
THINK IS A CRITICAL POINT, I
LOVE HOW YOU FRAME THAT E
SPECIALLY AS FACULTY.
I WONDER THOUGH ABOUT THE
PROTECTED TIME OR STIPULATIONS
PEPPED FOR COMMITTEE WORK
DOESN'T EXIST, HAVE YOU BEEN
ABLE TO OPERATIONALIZE ANYTHING
FOR U VA?
>> I HAVE NOT BUT I HAVE FOR
MYSELF, SO EVERY TIME SOMEONE
ASKED ME TO DO SOMETHING THAT IS
NOT DIRECTLY MY JOB
RESPONSIBILITY I ASK FOR
PROTECTED TIME O I ASK FOR MORE
INCOME, AND IT HAS ACTUALLY, YOU
HELP MEDE WITH THIS WHEN I--WHEN
I NEGOTIATED MY FIRST JOB, I GOT
MORE MONEY BECAUSE YOU TOLD ME,
THEY HAVE MORE MONEY TO GIVE
YOU, AND YOU GOT THEM TO PAY FOR
NDA, SO I OWE YOU ABOUT
$220,000, SO THANK YOU.
BUT IT FELT SO UNCOMFORTABLE TO
EVEN ASK AND ADVOCATE FOR MYSELF
AND JUST, YOU KNOW FOR
INSTITUTION FOR WHEN WHICH I OWE
SO MUCH, RIGHT IN WHY AM I
ASKING FOR MORE, BUT IT WAS--IT
WAS A SIGNAL, THAT I VALUE MY
TIME AND MY EXPERTISE AND YOU
SHOULD, TOO, AND IF YOU DON'T
THEN I WILL DO SOMETHING ELSE,
NOW WHAT HAPPENED OVER TIME IS
NOW PEOPLE KNOW, THEY ARE COMING
TO ME TO DO THINGS THAT THEY
NEED TO COME WITH SOMETHING,
BECAUSE IF IT'S NOT DIRECTLY
RELATED TO WHAT I DO, THEN
THERE'S GOING TO BE A PRICE TO
PAY.
NOW I WOULD LOVE TO
OPERATIONALIZE THAT, AND WHAT
I'M WORKING ON WITH OUR
COMPENSATION REDESIGN PLAN IS TO
TAKE INTO,A COUNT THE ACTUAL
WORK THAT BEAM ARE DOING IN
DESIGN AND SENSES INTO THAT, WO,
SO RIGHT NOW, OUR PLAN IS JUST
FOCUSED ON CLINICAL REVENUE
GENERATION AND THAT'S AN
IMPORTANT PART OF AN ACADEMIC
INSTITUTION AND A LOT OF QUALITY
WORK AND EDUCATION WORK TO GO ON
AND BUILD OUR MECHANISMS TO
REWARD THAT ACTIVITY AS WELL,
TOO.
NTHANK YOU.
>> VERY SIMPLE QUESTION, REALLY
WONDERFUL TALK, GREAT, I MEAN
YOU TALK ABOUT THINGS THAT WE
SHOULD BE TALKING ABOUT AND WE
NEVER HAD SO I CONGRATULATE YOU.
BUT THE QUESTION, I'M ALWAYS
INTRIGGED WHEN YOU PUT UP THE
PERCENTAGE OF TIME DEVOTED TO 1
EFFORT BECAUSE YOU DON'T SHOW
THE NUMERATOR AND DENOMINATOR.
HOW MANY HOURS A WEEK SHOULD WE
BE WORKING?
NOOH, THAT'S A LOADED QUESTION.
SO, OH, MAN, SO TIME ALLOCATION
IS SUCH A TRICKY TOPIC BECAUSE
DIFFERENT SPECIALTIES HAVE
DIFFERENT EXPECTATIONS OF WHAT
THE WORK SHOULD LOOK LIKE, AND
IF YOU TAKE INTO ACCOUNT
POLITICAL CARE WHERE THERE'S
NIGHT DUTY EXPE THINGS LIKE
THAT, I DON'T HAVE-SUCCINCT
ANSWER, AND I'VE BEEN ASKED TO
ANSWER THIS QUESTION, HOW MUCH
TIME SHOULD WE BE SPENDING
BECAUSE WE HAVE TO COMSAIT FOR
THAT TIME, I DECIDED I DON'T
WANT TO PUT A SPECIFIC NUMBER
INTO WHAT GOES INTO HOW MUCH
WORK YOU SHOULD BE DOING
BECAUSE, THE WORK THAT WE DO IS
NOT ON THE CLOCK, IN A SENSE,
RIGHT?
I DO ANSWER E-MAILS AFTER WORK,
I DO ANSWER E-MAILS BEFORE LIKE
I PUT THE KIDSOT BUS TO SCHOOL,
I WORK OVER NIGHT SOMETIMES NOT
THAT AWNCH AND I DON'T TRACK HOW
MUCH I'M WORKING.
I THINK THERE'S A LEVEL OF WHICH
PEOPLE ARE OVEREXTENDED, THE
OTHER ASPECT OF THIS IS THAT
SOME PEOPLE MIGHT DO THE SAME
YOB BUT THEY WORKENTIOUS
FICIENCY LEVELS SO FOR THE SAME
AMOUNT OF WORK, THERE MIGHT BE
MORE AFTER CLINIC WORK THAT
SOMEONE DOES COMPARED TO SOMEONE
ELSE, I THINK WHAT'S MOST
IMPORTANT WE HAVE A REASONABLE
EXPECTATION ABOUT THAT'S
TRANSPARENT ABOUT WHAT THE WORK
SHOULD LOOK LIKE IN TERMS OF
CLINICAL COMMITMENTS AND THE
HOURS SPENT THERE, AND THAT
OUTSIDE OF THAT, THAT YOU HAVE A
REASONABLE AMOUNT OF TIME TO DO
THE NONCLINICAL WORK THAT
FULFILLS YOU AND THAT YOU'RE
COMSATED APPROPRIATELY FOR THAT
AND I THINK IF FACULTY FEEL LIKE
THEY'RE WORK EXPECTATIONS ARE
TRANSPARENT, THEY'RE FAIR FOR
THEIR PROFESSION AND FOR THEIR
COLLEAGUES AND COMSATED
APPROPRIATELY AND THEY HAVE
OPPORTUNITY TO GROW, THEN THE
AMOUNT OF HOURS THAT YOU SPEND
DOING THIS VERSUS THAT, DOESN'T
MATTER AS MUCH, SO I'M KIND OF
DODGING YOU A LITTLE BIT BECAUSE
I DON'T HAVE A FIRM ANSWER.
>> WITH THAT I WOULD LIKE TO
THANK EVERYONE FOR COMING AND
WONDERFUL TALK FROM DR. BELL AND
I WANT TO ENCOURAGE EVERYONE
OUTSIDE WE HAVE A SPONSORED MEET
AND GREET AND COFFEE AND
DR. BELL WILL HANG AROUND AND IF
YOU HAVE MORE QUESTIONS OR SAY
HELLO AND TALK INFORMALLY AND
WITH THAT THAT CONCLUDES GRAND
ROUNDS. 2051 01:05:17,513 THANK YOU ALL FOR COMING.