STEPPING OUTSIDE YOUR COMFORT ZONE
brief moments of discussion . I chose to do a deeper dive on the personal side . I wanted to serve at a higher level that impacts many more people and our larger community .
Starting in the mid-90s , I began working relationships and was appointed in 1993 by then Governor Evan Bayh to the Indiana Medical Licensing Board where I served for eight years . Additional appointments came to the Medicaid Drug Utilization Review board and various state committees . I volunteered and led legislative committees with our national and state medical societies . I served our county medical society as Board Chair and President , and our State Medical Association as delegate , House Speaker and was elected President in 2014 . I was also selected to chair the PAC of the American Psychiatric Association ( APA ) for 12 years and was elected to the APA Board of Trustees . For over 20 years I met with and nurtured relationships with Indiana ’ s federal elected officials , state legislators and local politicians . Some referred family , some became patients and many became friends . Even though my partners sometimes rolled their eyes , I was given appreciated latitude in taking time to lobby and attend legislative meetings .
I really had to step out of my comfort zone in order to gain the experience and knowledge about safety net systems , Medicaid policy , medication utilization and health plan administration . After I completed my MHA , I helped run a Medicaid health plan and worked with transitioning our county hospital in with a new system . My friends asked me why , but I felt these experiences broadened my expertise and set me up for a bigger role . When the door opened in 2013 for a cabinet level leadership position with Governor Mike Pence ’ s administration , I was ready . I was appointed in early 2014 as the Secretary of the Indiana Family and Social Services Administration ( FSSA ), the Hoosier equivalent of our Kentucky Cabinet for Health and Family Services ( CHFS ).
I was the first physician appointed to this position , and had five major agencies in my office including Indiana Medicaid , Mental Health , Department of Disabilities , Division on Aging and children ’ s education including pre-K . The annual budget was above $ 17 billion , and represented almost 40 % of the state budget . I assembled a great team , many from the private world , and we had a busy threeplus years running this mega-agency until Mr . Pence left for Washington in 2017 . We accomplished many initiatives important to our medical world . We designed and built the Indiana Neurodiagnostic Institute , a 150-bed rapid throughput state facility attached to a tertiary care hospital for the care of the medically challenged and psychiatrically impaired of Indiana . We were the first conservative state to expand Medicaid ( with eventual approval of the Obama Administration ) with consumer-driven provisions including a medical savings account and dental benefits . We expanded pre-K , shortened wait times for SNAP and disability determinations , provided extra funding for NFP hospitals and expanded our ambulatory physician access for all Hoosiers . In short , we accomplished so much more in “ leading ” the political process than our usual advocacy could have stimulated .
Stepping outside your comfort zone will come with many costs . State and government salaries are about 50 % of your clinical compensation . There are no perks , free dinners or social events – at least not legal ones . You never wear your white coat and your name badge does not have an “ MD ” designation . You can ’ t run late for meetings and staff tend to exit the office precisely at quitting time . So , you are often the first to get to the office and the last to leave . But the positives can more than balance the contrary : no EMR or late-night phone calls from the ER ; no double booking , skipped lunches nor sleepless nights . Of course , both workplaces get mired in bureaucracy and administrative rules that stall progress and compound headaches . But like any divergent enterprise , it ’ s the friendships and work relationships that strengthen the sense of accomplishment and achievement .
As young trainees and professionals , we had dreams and career aspirations that hopefully have been mostly fulfilled . Rejoice in these good feelings . But if your enthusiasm has waned or you find yourself considering other work options , remember to challenge yourself to step outside what feels comfortable and normal .
Remember the wise advice of George Eliot ! “ It is never too late to be what you might have been .”
Dr . Wernert is the Executive Medical Director of Norton Medical Group and practices with Norton Behavioral Medicine .
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