Office Politics/Leadership Development – Dr. Plastic Picker

Category: Office Politics/Leadership Development


July 29, 2021

by drplasticpicker

I had more middle-management nonsense yesterday to deal with. I usually don’t let minor personality issues bother me, as I can usually work with most people. But we heard a set of data yesterday and I tried to peel back the layers of things and figure out what went wrong and is going wrong. The set of data basically said that poor babies are not getting their vaccines. The issue is a set of people have not been hired, and another set of people who have been hired and recruited by me can’t work unless the first set are in the system. That is it. That’s the entire point. I know it’s a systemic issue and there are always excuses, but I needed to know the why. My questions may have bothered people, and sometimes it seems like we are asked to do impossible tasks in middle management. I was asked to do a seemingly impossible task almost five years ago, but I did it. This I felt was a safe meeting (at least I feel safe) but I guess I’m somehow intimidating. I had a long and exhausting conversation about middle-management nonsense afterwards and we moved forward somewhat. I’m still frustrated because in the end poor babies still aren’t getting their vaccines and my hands are tied in terms of pulling levers to fix that issue, and even if the team works well together and I somehow stop appearing intiminidating to folks – in the end we didn’t move forward.


Seagull’s footprint pointing to my bag. Reused a tyson breaded frozen chicken bag from Costco. Lots of shoes that day.

July 22, 2021

by drplasticpicker

A lot of people lose their shoes at the beach. Two days ago when I was able to get to the beach early in the morning, I found a lot of single shoes buried in the sand. I know these become bits and pieces of plastic because further north near Tourmaline, the plastic that washes back from the Pacific are often plastic bits of shoes. People really should remember their shoes at the beach. Is it really that hard?


July 16, 2021

by drplasticpicker

There are 21 months and approximately 630 days left of my Assistant Boss term. Yes, I’ve decided in my melancholy and frustration regarding middle-managment to have a countdown. Yes I have. This is the beautiful United States of America and I have freedom of speech and freedom to count. If other MDs can have a retirement countdown and not suffer any professional repercussions, than I have an Assistant Boss countdown. I used to sometimes think about how many years to retirement, but I no longer even consider that thought – as the practice of actual patient care brings me so much fulfillment and joy again. Or maybe it never was as fulfilling and meaningful as it has been the last two years. But the Assistant Boss and middle-management time? I am doing a countdown. Yes I am. And no one can stop me.

I am also going to buy a rooster and I’m going to name him Louie. There is a special person named Louie and I talked to him recently. We caught up on life and I asked him how his retirement is going and he said with true happiness in his voice, “I’m good. I’m really content.” And rather than asking him to work shifts or talk about our middle-management needs, we just chatted about life. He really cared about the farm and wished me luck in Oregon. And I decided at that moment that when we start raising chickens (which the plan is relatively soon) that I will name one of the roosters after him. He laughed.

And that laugh, and that conversation made up for so much. His happiness and contentment gave me joy. During my time as Assistant Boss I was able to do certain projects that eased his transition. It eased the pain of what middle-management did to him at the end of his career. I remember the ignoble way the HMO machinery tossed aside one of it’s best leaders. As I think to my countdown the 21 months left, I don’t know where life will take me. But I always think to Louie when I have doubts. I call him sometimes when I have moral quandries. But it’s time to let him go too. He is living his life in retriement with joy, but I will have a chicken and name it after him so I can remember the Chief Boss and I’ll sing to that chicken/rooster that oh so fitting song.

“Louie Louie. oh no. said we gotta go. yeah yeah yeah.”

Bags I’ve especially noted and haven’t deleted from my phone.

July 9, 2021

by drplasticpicker

I’ve been asked to pass on a huge part of my Assistant Boss portfoilio. It’s access and per diem physician management. It’s the right thing to do, because I have too much on my middle-managment plate (hence the frequent cursing silently and sometimes not to silently in my office – Dr. Dear Friend knows – at departmental emails). Given that there are so many meetings I have to attend, I get paid precisely 2 hours to do about 10 hours of work. Other people are getting paid the same amount, and the work should be shared.

This is absolutely the right thing to do for the department and for my family. I can now concentrate on new projects and helping move vaccination and other quality metrics forward. I can now work on physician leadership development within our department, and trying to figure out more ways to insert pediatricians into our HMO upper management leadership structure.


Plans for the 34 foot bridge for our Oregon farm.

July 7, 2021

by drplasticpicker

Hopefully yesterday was the last root canal. I felt literally “beat up” again. My dentist reminds me of my former co-chief resident in Pediatrics at Mans Greatest Hospital Dr. T. He. She is a really kind person. My dentist was very young, and she was very skilled with her nerve blocks and I hardly felt anything when she was doing things. She had a brusque manner of speaking but she was gentle in her care of me. I appreciated that.

I woke up irritable today. I watched too much Dawson’s Creek, as I was recovering from my hopefully last root canal. I must not be the only one getting root canals, the dentist office seemed busy. My mortgage broker also said that her family member needed a root canal too. It must be a trend post COVID. Too much snacking.

But on reflecting upon yesterday, it had been a good day. I made it through 3 hours at the dentist, handling appointment access problem without bothering anyone. I also led my first Immunization Task Force meeting and it went really well. I’m really proud of myself for helping to reorganize that meeting and stream-line that entire committee. It’s a huge accomplishment, saving the organization time which is saving money. Yet that committee is now more effective because I made it project focused. We also decided it would be completely virtual, and save on travel time. We no longer take minutes, and only do action items.

And today I’ll just be a doctor today. I’ll show up at clinic and see my patients. I miss seeing my patients. I’ve been either in medical school or a doctor 22 years now. That is a long time. I’ve been studying medicine or practicing medicine longer than the before. It’s why I call myself Dr. Plastic Picker. That Doctor was something I had wanted so much, and to lose that – would be not the ending I wanted.

I’ll send some work emails and deal with some scheduling issues, and send an email about the mentoring award. Did you know about the department mentoring award? That was months in planning and thinking and a labour of love for me years ago. It meant a lot because the person the mentoring award is named after gave me a professional home when he took a chance and hired me. I have felt throughout my career sincere gratitude for his support. I have to remind myself that I’m at that stage in my career that there are some people who care about my opinion. It’s hard for me to make that adjustment. I tend to view my premedical students with clear eyes and I mentor them with my whole heart. My colleagues, it’s harder. To be a true departmental leader, is truly about building future leaders. If one does not hold that as your north star (a phrase our HMO holds up constantly) than one better leave your position and let someone else in it. Physician wellness is about effective physician leaders as well. That is why physician wellness and burn-out is so complicated. It’s not an easy problem to fix. Neither is climate change.

But through the last two years as I’ve gotten better, I realized that I have to keep on trying. I have to keep on plugging along. Why would I leave the rest of my colleagues behind? We all need to do this together. We need to bring back meaning to medicine. We need to save the earth for our children. For me, these two tasks go hand in hand. Physician wellness. Climate and health activism. It motivates me and gives me urgency.

But today I’ll take a breather. The root canal did me in again. It’s my kryptonite. 22 years in medicine. That’s a long time.

The picture of the bridge? I just wanted to show it to you – that is all. Architectural or technical drawings are works of art.

Dreaming of this. Mr. Plastic Picker is on board.

July 2, 2021

by drplasticpicker

I’ve let middle-management worry me (it is 18.75% of my job description – literally) the last two days. It is a complex system and it’s easy to become a creature of said system. I’m definitely strong enough to manuever within it and still stay effective and impactful. But it is so annoying. That’s all I can say about it. So many committees, office politics, minutiae. In the end, it’s the children that get the better care at the end that make it worthwhile. It’s my colleagues and trying to improve their lives, which give me strength. I know I have been a transformational leader and have given the HMO monolith bang for their MD Middle Management buck. But I had an epiphany this morning, just sitting here at 4AM and typing away. I finished watching a NetFlix series which was really heart-warming and touching, and should have slept more – but I didn’t because I have to help a student with an abstract for the upcoming AAP meeting. My epiphany as I roused myself to do something that was important for a student and the earth, is that if I “fail” at this Middle Management or I chose to “opt out” it is 100% the system.


Mommy win

July 1, 2021

by drplasticpicker

Yesterday I felt literally and metaphorically “beat up.” I had a root canal and then I had to correctly address a middle-managment issue that required me to apologize. It was the right thing to do, but the circumstances that led up to that apology to a very wonderful person are so complex that it is mind-boggling. Sometimes I get so frustrated. If I was a man, I would not have to deal with many of the issues that make middle-management difficult. It’s still a man’s world, and as a technically part-time woman physician (supposedly 80%) leader – there is still so much unpaid work and responsibilities that I have to bear. It’s difficult for me because I’m the second income, and there is no financial or ego-motive for me. We are financially free, and it would be more cost-effective for me to return to clinic and just have the joy of seeing patients. I fundamentally love patient care. I since long got-over the ego-motives for being in physician leadership. We are glorified bean-counters and more like HOA-association heads. No real power, trying to get everyone to keep their front lawns up to made-up HOA specifications.

But I apologized and it was the right thing for the team, and my words were sincere. It wasn’t me, my actual person apologizing, it was Middle-Management Me apologizing. But in the back of the mind, I think of all the male leaders before me that never apologized. The Chief Boss a few chief bosses ago that made certain hiring decisions. The men that did untoward things to people that never fully had to own up to their moral transgressions. The men that sat there in the same position and essentially made a mess of the schedule that affected my life and the life of many working pediatrician mothers, and not many people said anything. The ones in leadership that formed a hiring system that is so stacked against BIPOC physicians, that it’s literally contributing to structural racism and health inequities. But it’s water under the bridge, and the current leadership team has no idea and they don’t need to know – because they weren’t even in our organization at that time. New team. It’s time to restart. It’s new relationships now. We have to build new connections and get to know eachother. But in my more vulnerable self, I feel hurt. I feel hurt not because of the actual situation that happened that required me to apolgize, but that I remember my journey to get to where I am. I see the accoloades that we are receiving for different metrics and how well run things are, and it was just assumed it was always like that. And I remember the past and how far it took us to get here, and no one remembers the steps and the efforts and the late nights trying to fix a system that seemed unfixable.


May be an image of outdoors
Cloest place to buy sundries. Say hi to Phillip, nice gentleman there.

May 27, 2021

by drplasticpicker

I’m still processing it all. It was a whirlwind 48 hours. Someone mentioned to me on a work committee call that I was able to make because I was at the airport on a layover flying home, “I hope you enjoy your vacation.” I’m not sure why, but that kind of took me aback. Vacation? This trip was not a vacation. There is never a vacation from being Dr. Plastic Picker. This particular person didn’t mean anything by it and we have a complicated history between us, but it just shows no one knows your journey as well as you know your journey and I certainly do not know this colleagues – and the challenge is how and if to articulate it to folks. I’m not particularly close with the person who made this innocuous comment and it was meant as a pleasantry, so I didn’t feel the need to explain it further. I just said it was not a vacation and moved on to the next topic of the committee meeting.


You can’t make this stuff up. I saw this yesterday on my beach plog on the way to Tourmaline.
Left the motorcycle but recycled the cans.

May 17, 2021

by drplasticpicker

Sometimes life is stranger than fiction, or even my trashart. I gathered bag #455 yestserday and it was a reused pita bread bag that was filled with wet plastic bags mostly washed up on Tourmaline Beach. I hadn’t really meant to head to the beach but I’m glad I did. It’s always an adventure. I wanted to start jogging more, so naturally ended up in my spot and did a beach cleaning amongst the rocky shore. I saw a beautiful snowy egret. They are a rare sight and only come feed where the kelp is left in it’s natural state. Where there is kelp, there are insect and remnants of crabs and other crustaceans. The “beach” of the white sand is really not natural. There is supposed to be kelp. The surf-rake removes it for us humans so we can recreate (and I mean to use that word in a new way). If it was up to me, we’d leave the kelp and the beach would be for the beautiful birds like the snowy egret.


Mantilija Poppy

May 4, 2021

It’s someone’s birthday this week. Mr. Plastic Picker and I have two teenagers now in the house. One about to drive and another living in a world of dreaming about volleyball spikes and playing varsity. They both have such conventional lives with conventional concerns. For someone who grew up in a refugee household, I realize how unusual that is. Mr. Plastic Picker and I are who we are because of the way we were raised, within loving households that faced more struggles but anchored in a country that had opportunities for us. We are not trying to recreate ourselves in our children or recreate the circumstances that molded us. We are happy that the children have volleyball, and some of the biggest concerns is who is going to be taller than whom. Which SAT prep course to take? Summer house vacation with friend or go with your parents camping? I concentrate on them and also concentrate on the society surrounding them.

Did you hear about Bill and Melinda Gates divorce? Do you think money had anything to do with it? No money in the world is worth the dissolution of a marriage. I remember when Al and Tipper Gore annoucned their divorce. Because I had rewatched the Inconvenient Truth so many times, I was shocked. My own parents are still married. Mr. Plastic Picker’s parents are still married. And indeed when I was a young doctor mulling over the divorce of Al and Tipper Gore, a Dr. KJ who was older worked beside me and she came out and said “I’m still married.” That reminded me not to borrow the concerns of others.

Bill and Melinda Gates mentioned in their press release about their three children, and successfully raising them. Mr. Plastic Picker and I are in the midst of raising our two tweens. For me, our marriage and the family we’ve created which is an extension of our two families merged into these two teens – is the most important thing in my life. Maybe this is something a liberal feminist would disagree, but its more important than my career and more important than money. I don’t talk about my marriage and my family as much about plastic, but I wonder if my friends truly understand.

But that’s the wonderful thing about the new world. I can do it all. I can be married, have two teens, and be Assistant Boss and be an Eco-Avatar Dr. Plastic Picker. I can do it all and also be head of vaccine quality measures. It’s funny one truly understands who is supportive of your career, or those who gently push you along and help you along the way. Beware of those who subtly leave professional land-mines. Dr. Plastic Picker is all my years of being a mentor and Assistant Boss, I never told anyone to quit. I never told anyone that you could not do anything. I hope that I encouraged people along their career path and their family. There is no race. You can have children, a successful marriage, and be in leadership. I’ll clear the professional land-mines for you. Other people don’t see them, but as a litter-picker now I notice them all.