What (More) Do You Want From Me? Reflections on Mentorship, Dermatology, and Moving Forward

“What do you want from me? 

You can have anything you want

You can drift, you can dream, even walk on water

Anything you want, You can own everything you see

Sell your soul for complete control, 

Is that really what you need?

What do you want from me?”

— Pink Floyd, The Division Bell

Professionally and personally, it’s hard to avoid the “what if” and “if only” scenarios. But when those thoughts outweigh the pride in where we’ve landed or who we’ve become, maybe it’s time to pause and appreciate the labor and sacrifices that got us here.

More importantly, we must remember that while we all started somewhere, many of us had people who opened doors or quietly watched our backs, even without being asked. All the more reason to reflect on how we respond when someone asks us for help now, whether they be patients, colleagues, or family alike.

This month, I could’ve quoted the Adam Lambert song with the same title (which is a good tune!), but it’s more about bad relationships and blame. And it’s spelled “Whataya Want From Me?” Pink co-wrote the original version, and I don’t need her coming after me.

The Pink Floyd version? A bit more cryptic. Some think it’s about David Gilmour’s divorce. AI says it explores “alienation and the human desire to connect,” a theme they revisit often. Like much of their music, the meaning isn’t clear-cut. But that lyric—“What do you want from me?”—can strike a nerve. It captures helplessness, frustration, vulnerability, even persistence. It’s what you might hear in your head after a long day, facing endless questions, helping everyone else while feeling like the walls are closing in. And yes, you might be thinking, “Here he goes again.” But stay with me.

We’ve talked in the past about mentorship, leadership, burnout, and even an exit strategy when the time was right. This issue includes perspectives on consolidation versus a return to solo practice. Having worn many of those hats (and been lucky to have mentors who opened doors), I try to answer the call when others are navigating the same waters. I hear from young dermatologists contemplating career change, pharma folks between roles, and others who “find me” when they need advice. That’s a compliment, even when it’s time-consuming. One day, the same people might be the ones I need help from. I try to pay it forward because when I needed help, people showed up for me.

Starting or selling a practice isn’t just a business question, because its ripple effects hit every part of your professional and personal life. Each market, each moment, requires its own SWOT analysis. And while a dermatologist isn’t easily replaced, not everyone is cut out to be an employer. On the other hand, many who sold to private equity or got absorbed by larger systems found the employee life miserable and could not wait for their handcuffs to be removed after the buyout.

Advice and the crystal ball don’t always align. Like helping your kid with homework, you don’t just hand over the answer. You teach the process, and hopefully offer a few cautionary tales. When the issue of how much we as physicians are actually worth (meaning us, not just our practices or our assets), the question “what do you want from me?” often comes to mind. What more could one possibly do or give when the sweat, creativity, and final product of what was created from the ground up gets measured in a spreadsheet? At the same time, when you price out what it takes to start again, that sticker shock can shatter the solo-practice dream before it gets off the ground.

As we collectively continue to lobby for better Medicare reimbursements, to fight for identity as scope of practice erodes, and as the looming threats from AI remind us that the matrix is real, we as colleagues and friends must stick together and help each other out. Yes, the matrix is real. Now more than ever, we need to help each other out. We need to make sure that opinions stay opinions, and as Michael Corleone once taught us, business isn’t personal. When you have the chance to open a door, don’t slam it shut. Remembering when to hit delete instead of the send button should not be a challenge, especially when the aftermath is not worth the rant.

And again, the stanza returns:

“You can have anything you want, 

you can own everything you see…

Sell your soul for complete control

Is that really what you need?

What do you want from me?”