Office Politics/Leadership Development – Dr. Plastic Picker

Category: Office Politics/Leadership Development

Saved $5 and carbon emissions by figuring out the ChargePoint app problem at the work electric charging station. I 끝 (kkeut) that problem as well.

March 19, 2022

by Dr. Plastic Picker

My mind is filled with Korean these days. Between living with my in-laws for the last 16-17 years to binge-watching K-dramas to having my Korean New York City sister-in-law visit this weekend and being in the center of our essentailly Korean household, I’m an observeror and participant in this life we have. My Vietnamese parents are close by but I don’t see them as much and I don’t speak to them as much, so my mind turns toward Korean words these days. Every morning I have a quick breakfast and it’s a bit of kimchi and some side dishes with rice. Plant based because most cultures were plant-based before that word was a thing. What does 끝 (kkeut) mean in Korean? To Finish. To End. And I’m at a beautiful ending in my career.


Blooming succulent, so happy.

February 26, 2022

by Dr. Plastic Picker

I worked last night the staggered shift. 25 patients evenly spaced out in 20minute appointment slots. No longer the triple booked patients at 6pm and leaving at 930pm and overeating at night at 10pm. Pneumonias and bilateral ear infections. I had to order a fair number of antibiotic prescriptions yesterday. It almost felt normal, pre-COVID pandemic like. One of my work colleagues reminded me that I had come up with the idea of the “Happy Hour Shift” and indeed that was what started it all. Fixing a broken scheduling template that would garner so many complaints and predisposed doctors and nurses to make errors. There was no conceivable way to see three patients in the same appointment slot.

But people forget, and as life improves – they often forget what was the catalyst. Indeed, I had forgotten – but then this work friend who is not in our department, reminded me.

This change was good for me as well, and I fought for the sane scheduling system with my own family’s well-being in mind. It was a long day, but I had time to walk up to the #guerillagardening project at my “lunch” hour which was at 2pm. I walked and looked at the plants I had planted there almost 2 years ago.

Blooming now.

It’s all growing and thriving now. I had to put in effort at the beginning. But now, the natural rainfall and once or twice a month watering from saved bathwater from my own house – is enough. It took me courage to fight for those changes in the schedule. It took creativity. It took rationality and a mind that thinks clearly. There are some minds that are so chaotic that threatened to make all of our lives intolerable.

But rather than dwell on the those forces I had to counter, I focus on the growth I see. I focus on what is beautiful and what has worked. And this plant was the first one that proved to me that in the desolate area of the upper parking garage planters that had been abandoned for decades – something beautiful could grow.

It’s os happy and chaotic.
#2 upcypcled reburbished planter stand from a chair I found in the alley

February 23, 2022

by Dr. Plastic Picker

Life is meandering. RG, our premed advocacy intern working on leaded aviation pollution, and I were supposed to make verbal comments at the EPA meeting last night. We both submitted written comments. It was nothing that was asked of us, just somewhere we thought we should be. But RG had to work last minute (all this environmental health work is volunteer) and I logged in once on my phone, and afterwards when I tried to log in again on my computer – the link did not work. Mr. Plastic Picker is a witness that I tried to log into the EPA “EPA’s Draft Strategy to Reduce Lead Exposure and Disparities in US Communities” and the it was unsuccessful. I really really tried. But since RG wasn’t there and part of advocacy is fun for me, if I get to do it with the premed interns, I didn’t really mind that much. Instead of being attached to the EPA meeting until 9pm, I ceased by Zoom logging in efforts at 710PM. And then I watched Kdramas! Well, the current show I just finished is more artsy so not really a drama. But I learned something that was very profound from the close-captioning translations. I love the Kdramas because I actually do have a decent grasp of Korean, and it’s this weird world where I’m learning all this Korean but I get to read too. Anyway, the translation was the best part of this show about a family of three women and the percussions of domestic violence.


Just a gift from the HMO for Mr. Plastic Picker.

December 19, 2021

by drplasticpicker

I’m not sure why I am sad this morning. I had a very nice and easy Friday staggered evening pediatric urgent care shift, and got home by 8pm. I used to get in by 10pm with the schedule from the old days. I had the morning to live my life, and got to see the kids and Mr. Plastic Picker off on Friday morning then start work at 1030am. I appreciate that time for whatever you call it, work-life balance, having breakfast, being able to think, self-care. This weekend I’ve been watching Korean dramas still, but I’m done with the last series which was really good. I’m kind of an intense person at times and when I really get into something, I really get into it. Case in point, my 19 year marriage 24 year relationship with my husband, almost at 600 bags of trash collected, acculumating accolades for a resume I don’t need. That intensity I think is important and a reflection of mental health and a soul that is strong.

And I’m not sure why but those intense feelings I’m having are intense saddness still at the middle management meeting we had last week as we were discussing schedules and mundane things. I’ve chosen to be true to myself, and to seek self-awareness and in that awareness I realize how scarred we all are. Senior physicians at meetings saying “we are getting through it, “it’s okay” and platitudes upon platitudes – when all of us know our back stories. A family that was deferred. Relationships and marriages shattered. Meals that were missed. Time. We loss time with family. Many of us didn’t get to see key moments when are children were growing up. And in that loss we all suffered from a medical staffing system that was broken, we weren’t able to be aware of the answers. We weren’t able to see beneath the source of all this scheduling cr@p that was one rogue idea that should have never left the gate. Another true manager that is not a physician or someone with power over our lives that is not one of us, telling us what to do. Why are physicians so scared? Why do people not listen to eachother at meetings? Am I guilty of that too? Did you hear people’s pain? Did you hear the replies that essentially were non-replies?

And most of my saddness were a few phrases that keep on playing back in my mind. I wish this particular meeting was recorded and the replies could be replayed and we could listen again to our back and forth. Perhaps meeting transcripts should be analyzed like Shakpearean verses or passages in hallowed tomes. I think if we dissected our phrases and replies, we’d understand more about why physician burn-out is still a real problem. Why physicians disproportionately get divorced and commit suicide, and why our own children sometimes don’t do well in life because we sometimes work in unbearable conditions. Words make such a difference.

Thank you for continuing to hear my ramblings about life. Here is the beautiful roots of a beautiful gift a neighbor gave to my in-laws. During my now two year foray into gardening, I’ve learned one important fact. The roots of any plant/system have to be healthy. You have to regenerate the soil to grow the roots, and only then will you get beautiful fragrant flowers. That’s the management metaphor I’ll leave you with today. Still at it. So fundamentally well and joyous. Wishing for everyoen the same, and hoping we can heal our profession and the earth at the same time.


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.