When you're looking for the perfect job, it's natural to shoot for a competitive salary, a prestigious hospital, or an interesting patient population. But it's also important to look deeper.
To thrive in medicine, you need to be excited about more than just your job. Because honestly, the job will sometimes go badly. And during those times, you'll need something bigger to hold on to.
More than anything, you need a practice culture that lifts you up, values you, challenges you, and ultimately makes you a better version of yourself.
I was lucky to find the right fit early. I've spent the past 20 years as a Vituity physician assistant (PA) — most of it at the same emergency department (ED).
At this point, Vituity is so much a part of my life that I can't imagine who I'd be if I'd taken a different path. So to illustrate the importance of finding the right "fit," here are some of the ways my job has changed me for the better.
Between you and me, I wasn't an academic star in undergrad, though I did excel in PA school. And when recruiting time rolled around, I had to convince a site that already had a PA with five-plus years of experience that I was worth taking a chance on.
Vituity saw that spark and did just that. My first Medical Director's attitude toward all of the new hires was, "Here's a rope. You might use it to hang yourself. But we really hope you take it and build something wonderful." He told me that if I could make it in his department, I could work anywhere and in any specialty.
We all face a lot of challenges during our early years of practice. But whenever despair started to creep in, I would remember that my team had chosen me, and that they believed in me. The mentoring of physicians like Dr. David Tito, Dr. Piera Assaf, David Dehass, and many others inspired and motivated me to prove them right.
When I was fresh out of PA school, I was pretty excited to finally be making some bank. But about ten years into my career, I realized that money alone wasn't making me happy, and something seemed to be missing.
That's when I started thinking about my purpose. Was I doing what I was put here to do?
Fortunately, my former Regional Director Michael Sequeira, MD, and CEO Mark Spiro, MD, encouraged me to think of medicine as a higher calling. Their mindset was, "Yeah, we know you're really productive. And you're sharp clinically. But what else have you got? How are you going to make a difference at the site and in the organization that touches these patients' lives and creates a better experience for them?
With their encouragement to find new and better ways to practice, I recognized that medicine is a unique experience for each patient. Sometimes what a patient and/or their family needs is a kind word, a hand to hold, or just some reassuring words. To be a great PA, it’s necessary to find your own unique approach and use that to connect with patients, colleagues, and everyone you have an opportunity to influence throughout your shift.
The truth is, we're all kind and helpful when it's easy. To experience selflessness and the satisfaction that comes with it, you must help not only your patients but also your colleagues and other staff members when it is a sacrifice and inconvenience. In the ED, we get that chance every day.
Who influences me and makes me who I am? My family certainly does. And I'm lucky that my work family does too.
When you choose a job, you also choose a second family, so make sure it's a happy one. These days, I actually spend more time with my work family than my wife and kids. And when I head home for the day, my colleagues' voices, triumphs, struggles, and stories always follow me.
In our department, we've had tragedy, birth, marriages, divorces, career successes, and failures. I personally experienced many of those things, but I experienced many more through my work family. How could that not shape the person I am today?
When you're feeling out a job opportunity, look carefully at how long people stick around. Working with the same people year in and year out is incredibly rewarding. And I know from experience that it's made me a better PA and a better person for knowing them.
I remember when Cameron Nouri, MD, one of my current medical directors, joined Vituity over 10 years ago. It was his first job out of residency, so I've spent half my career with him.
Over the years, he's shared many stories from his life. He emigrated from Iran and has talked openly about the struggles he faced in both countries.
Today he's an exceptional leader who's incredibly dedicated and loyal to his team. He considers others first and epitomizes the servant-leadership role. When I work with him, I always feel that no matter what the day brings, we got this!
A few years back, I was in one of those career phases where I was cruising along — doing good work, but not exactly setting the ED on fire. Then we hired a young physician who had been our resident and who was incredibly hungry to learn.
He asked questions for the purpose of learning and understanding. He wanted to know: How did I succeed with my advanced provider peers? What did advanced providers need from physicians?
He didn't care about titles. He cared instead about relationships, what was important to individuals, and what motivated our team to work so hard and efficiently. He inserted himself into our advanced provider world by working alongside us and openly recognizing the quality work that was done.
He, like his mentor Dr. Nouri, did not seek recognition for himself. Instead, he wanted his team of colleagues for that day to be recognized.
His curiosity and commitment to patient care and his staff’s wellbeing was infectious and really energized me to step up my own game. And it also served him well, because Mike Mesisca, MD, has now been a successful ED Medical Director for several sites.
That's another benefit of longevity with the same organization. It's incredibly uplifting to watch the people around you grow and succeed over the years.
One day, about 12 years into my career, I looked around my ED and realized that many of the PAs working with me had once been my students. It was a very tangible reminder that we're all moving forward — even when change is so slow, we sometimes feel like we're standing still.
Vituity has an amazing professional resilience program. For years, I enthusiastically recommended it to others. But me? I was convinced that I didn't need it. Showing my emotions at work seemed like a weakness.
But when I finally attended the resiliency workshop, I realized that I wasn't an island. Every provider struggles sometimes. Because let's face it, what we do for a living, and what we see day in and day out, is not normal to most of the population.
Our jobs are emotional. Medicine is emotional. It's important to join the family emotionally as well as professionally.
The program helped me realize that when I experience my feelings, I have so much more to give to my patients and colleagues. So I no longer shove negative feelings down like trash in a compactor. (Well, not most of the time.)
My colleagues taught me that when I accept my flaws as well as my successes, I show up more powerfully in all areas of my life. And I also free others to do the same.
Remember how Vituity took a chance on me when I was a new PA? Well, that experience really stuck with me. Here's how I know.
Five years ago, my family and I met a young man through our godson. This teen was aging out of foster care, which meant he was graduating from high school and would no longer have support from the foster system.
I've cared for many kids in the ED who were foster kids or from broken homes. In most cases, they're incredibly vulnerable with limited support and resources. And as I described above, my ED career also taught me the joy of selfless service to others.
Once we realized that there was no family for this young man and that he would be left to navigate society and life on his own, we opened our home to him. And last year, after earning a scholarship two-years prior, he graduated from the University of California, Berkeley. He’s about to enter a master’s program while pursuing his dream of playing professional football.
It's funny how life comes full circle. Twenty years ago, Vituity took a chance on a kid with very little medical experience but a huge work ethic and lots of heart. And now I'm happy to be paying that opportunity forward.
So in closing, don't choose a job just for the money or the location. Choose the job that's going to make you a better person. That’s going to present opportunities for greatness where you can exceed your own expectations.
And when evaluating offers, don't be afraid to ask hard questions and get a little personal. Because in all the years to come, it's your relationships that will bring meaning and joy to your career.
Originally published August 2, 2018.