It dawned on me one day, when I went into CHASE to ask about a home loan about twenty years ago, that pretty much everyone in a commercial bank who isn’t a teller is called “Vice President.” It was an impressive sounding title when you saw it on a business card (who has those anymore?) or heard it casually mentioned at a speed-dating event. The name implies a singular position. Second in command (or maybe third in the case of Al “I am in control here” Haig). I think the gig is up on that now and the title isn’t budging the needle anymore. But a recent article in the New York Times exposed the trend of employers giving more workers the title of “manager” or “assistant manager” (they listed absurd examples of “food cart manager” and “lead reservationist”) who are near the cut-off for the federal requirement of overtime pay beyond 40 hours/week (the current cut off is a salary of $35,500/year). So it’s a fancy title in lieu of a pay increase, or, in their case, pay that is justly due but withheld. And also don’t tell it to academic radiology departments. As in most every field, doctors are working harder for the same money or less. And with burn-out at an all-time high, they have to think of clever inducements. One very cheap perk is a phat-ass title like VICE-CHAIR! That sounds really important, right? Well, for starters it never really was, even in the days when only one sucker filled the thankless job. But in the last 5-10 years, there has been a slo-mo explosion of new titles in medicine with the first wave looking something like this:
Vice Chair of Research
Vice Chair of Operations
Vice Chair of Quality and Safety
To be clear, some of these are necessary and were already in place, it’s just that they weren’t at the level of “Vice Chair.” As hospital systems have grown, their management has become unwieldy and complex tasks have to be spread around. I get that. More work for everyone, both clinical and administrative. But with reimbursement under constant siege (something that never seems to happen with C-suite compensation or marketing/advertising budgets), there is limited room to advance pay. So whether consciously or not, the powers-that-be landed on a solution that shoves almost everything and everyone to the level of VICE!! We humans do LOVE our titles, and many will endure whatever humiliation necessary to receive them. You see them awkwardly brandished on white coats and in e-mail salutations, like stackables from the The Container Store. And let’s just face facts — most doctors are total fucking dorks. My own professional society, the ASNR, could officially change its name to the American Society of Nerdoradiology and no one would miss a beat (our national meeting makes Comic-Con look like the free concert at Altamont and should be sponsored by Rockport and whoever makes pocket protectors). So then there came a second wave:
Vice Chair of Education (we also see a rise of the tack-on title or “ampersandwich”….. such as VC of Education & Diversity or, given the burgeoning numbers of MD-MBA’s who are secretly hoping to evade clinical responsibilities while drawing a higher salary, VC of Operations & Finance)
Vice Chair of IT (medical informatics tends to run about 15 years behind finance and about 5 years ahead of government, so we informally call it hospital “shitformatics” or “ShIT”)
Vice Chair of Wellness & Mindfulness & Gratitude & Work-Life Balance. Their main role is to send you platitudinal quotes and reminder e-mails about mid-morning group yoga that you cannot attend due to the clinical work-load (if you were to go, you would find mostly vice chairs from various departments doing light stretching and shooting the shit).
But work titles, like hospital administrators, are an ever-expanding phenomenon. It’s simple physics. Soon the only ones in the department who are beneath the Vice Chair level will be the “tellers.” And below are some proposed new/improved titles for the coming third/turd wave:
Vice Chair of Parking
Vice Chair of Ergonomics
Vice Chair of Box Lunches
Vice Chair of Marketing Strategies and Social Media
Vice Chair of Bathrooms (includes hand-washing stations)
Vice Chair of Fashion, Hair and Make-up
Vice Chair of Music (Yanni led a recent national survey of departmental playlists; some departments combine with Vice Chair of Wall Art)
Vice Chair of Modules, Credentialing Forms, and Surveys (remote from Guantanamo Bay, Cuba)
Vice Chair of Foreign Bodies (VCFB, hee-hee!)
ADDENDA:
- One friend (JS) read the post and would like to be Vice Chair of Proofreading for my tendency to make numerous spelling and syntax errors in my initial posts, though he realizes that a blog, like life itself, is a work in progress.
- Another friend (BR) requested that he become Vice Chair of Vice-Chairs (VCVC). And to that I say, “There’s always room for one more near the top-middle!”
Great Exudations 