Entitlement or naïveté?

I make it a practice of saying, "Yes," to any student or young professional person who wants career advice.  This serves two purposes.  One is to provide (hopefully) helpful assistance to someone starting his or her career.  The other is for me to be rejuvenated by the energy and idealism of the next generation of community leaders.

This week, a person who is involved in health care consulting at one of the big firms sought advice about how to move from that environment to a job "somewhere in the provider-payer space."  (By the way, I hate the term "space" when it is used in this manner, but I have learned to expect it from consultants and venture capitalists.)

The person thought that the ideal job would be to join the internal strategic planning group in a large academic medical center.

I advised against this.  I pointed out that such groups are often marginalized in AMCs.  They tend not to be respected by the doctors and nurses, because they are viewed as not understanding the obligations, work flows, and other issues associated with delivering clinical care.

I suggested, instead, that this person seek a "line" job in a hospital, helping to run an ambulatory clinic or some other operational role.  "Learn what it is like," I said, "to organize how care is delivered, dealing with nervous patients, stressed out nurses, and doctors with strongly held views.  Over time, you will demonstrate good work and initiative and how make changes.  Based on that, you may be asked to participate in task forces that help set the strategic direction for the hospital.  By then, too, you will be known and respected by clinicians and therefore less likely to be marginalized."

The response was firm and immediate: "No, I don't want to do that.  My salary would take a cut, plus I want to be involved at a higher level in the institution."

I was struck by this.  Just a short time out of MBA school, followed by a stint as a consultant, this person was confident s/he would provide value in the corporate planning function of the most complicated type of business in the world.  Whatever happened to the idea of starting low, learning what life is like on the front lines, demonstrating ability, and working one's way up the ladder?

Instead of being rejuvenated by the energy and idealism of someone in the next generation, I felt like I was facing an overabundance of entitlement.  Perhaps, though, I took it the wrong way.  Maybe it was just naïveté.