PracticalDermatology

“I am out here for you. You don’t know what it’s like to be ME out here for YOU. It is an up-at-dawn, pride-swallowing siege that I will never fully tell you about, ok? Help me….help you. Help me, help you.”

—Jerry Maguire to Rod Tidwell

Now that the torpedoes have been launched and collateral damage has been assessed, we can get to the business at hand…yet to be determined, of course.

It’s been interesting watching the spring playoff season for both basketball and hockey (despite Milwaukee choking again). To some degree, in hockey, the old guard continues to dominate as the seasoned veterans take their teams to higher levels, relying on experience and leadership to prevail and get better with each round. By contrast the young guns of professional basketball have helped teams known for futility rise from ashes to give the establishment fits, using speed and streaky shooting to advance while the old guard watches the clock (and their chances for one more legacy salute) slowly run out. Such as in sports, such as in life…

It has become the new paradigm in society, in corporate America, and in medicine, that the new young guns are identified as the new leaders while the old ones are overdue for pasture, and their ideas are not only antiquated, but are borderline inappropriate. The “old way” of thinking, speaking, and even writing (sorry…not sorry) are too raw, too brutally honest, and therefore too late for this current climate, so the search for the new young guns who can play with speed and energy, and within bounds, is always on.

The most ironic element of this search is that the old guard is constantly being queried about who the next “rising star” or “up-and-comer” is, making the job easier for the seeker but even easier for accelerating the exodus of the aged veteran who allegedly can’t hit as many shots as the competitors for the stat sheet, but yet can still score the winning goal or make the crucial assist with the game on the line. Ironically, the search for the rising star is often meant not to add to the team, but to rebuild it.

Dermatologists have long been complicit in and also long been recipients of this phenomenon. There were decades of the associate period before partnerships in clinics were offered, or not offered, usually as part of a succession plan. There were the days when “nobody could find a decent associate” or “this arrangement isn’t working out,” which meant the young guns had to take things into their own hands. And just like The Association sang “Along Comes Mary,” so the specialty says along comes consolidation…and suddenly the script is flipped, the old guard has to sell and adjust to systems while the new guard finds long-term security. 

The same movement is definitely on steroids when it comes to our own education and the recruitment of the next generation of hall-of-famers. Our own societies, training programs, leadership platforms, speaker bureaus, and steering committees have identified many young, vibrant leaders that represent the future…most likely mentored by the previous leaders of the future. Ideally, the transition of leadership comes in the spirit of collaboration, and the team emerges stronger.

Many of us in the home stretch of our careers want to make sure the future is bright, and that the leadership can lead the team to many winning seasons. But it’s always entertaining when requests for advice often involve the question: “who are the next rising stars/up-and-comers/ young leaders?” One always wonders, is that a search for collaboration or for succession? In other words, are you asking me to help you replace me? One would hope that isn’t the case, that mentorship and partnership should always be valued over obsolescence, but it may in fact be either the inexperience or even the agenda of those asking the question that hastens our fragmentation. Maybe that’s the piece of the blueprint that makes for losing seasons, while balancing young speed and veteran leadership often wins championships.

So to all the rising and falling stars alike, be ever on the hunt for the next generation while always bringing your A-game at any age, and the next time you’re asked who should replace you, go ahead and instead replace the ones who ask that question and let them be replaced so we can keep the winning tradition intact.