Monday, September 18, 2017

Ambition, rejection and leadership

Most readers are aware that it was my work as a medical officer in the U.S. Preventive Services Task Force program at the Agency for Healthcare Research and Quality that catapulted me from a little-known junior faculty member to a recognized authority on preventive medicine and guidelines. What you probably didn't know is that AHRQ turned me down the first time I applied for the job, fresh out of my medical editing fellowship at Georgetown. In retrospect, they absolutely made the right decision. Not only was the physician they selected considerably more qualified, she is still working there, while I left four years after being hired (2006-2010). But that initial rejection, painful as it was, put me in excellent position to seize the next opportunity to join the program one year later.

I've been reflecting on this and other early-career disappointments to put my more recent leadership setbacks into perspective. Even though I won't take the helm at American Family Physician (the medical journal with the third highest print circulation in the world, behind the New England Journal of Medicine and JAMA), I will continue to contribute behind the scenes and support the new Editor in a variety of ways. And although I won't have the opportunity to Chair the AAFP's Commission on the Health of the Public and Science (and my 4-year term as a member ends in December), I will continue to work on evidence-based clinical practice guidelines and other projects in family medicine, such as this position paper on incarceration and health and last week's presentation at FMX on the challenges of providing preventive services to adolescents and young adults. Finally, I remain a go-to source for reporters looking for a skeptical perspective on overused screening tests, especially the prostate-specific antigen test; I was recently quoted in the New York Times and STAT about a modeling study that in my estimation didn't live up to the hype surrounding its conclusion that PSA screening "saves lives."

In short, I'm down but certainly not out. Although I have again fallen slightly short of my high ambitions, I will find other avenues to demonstrate leadership in medical publishing, evidence-based medicine, and population health. At least one silver lining is that I should have more time to devote to blogging about subjects that need the context that a Common Sense Family Doctor can bring.


  1. Thanks for sharing, Kenny. Ambition and rejection is something many of us struggle with, and I'm glad you had the courage to give all of us a little perspective on the matter.

  2. Thank you for your genuine contribution to medical education in this post. This is so true. It reminded me a little of this:

    1. Thank you, May. My senior year of college my roommates and I had a "Wall of Shame" where we'd post all of our rejection letters. Won't name all of mine but one was from the Admissions Office at Georgetown University School of Medicine - where I will be a full Professor soon.

  3. Kenny! Big love to you, cousin, for posting such a vulnerable topic. -- Teresa

  4. Loved this post ... as always you make me so proud!
    Setbacks are certainly disappointing, but they may also serve as stepping stones to even greater accomplishments or personal joy.

    Just look at Abraham Lincoln, who may have never been president if he won his earlier elections, or my life if I had been accepted to medical school, when I first applied. Chances are, we may have never met then and I would not have you by my side. Love you!

  5. And bear in mind that you have many more years ahead of you to contribute in many more ways. Thanks for sharing this excellent post and being willing to make yourself vulnerable so that others may benefit from your reflection and insight. Congrats on being YOU!

  6. Kenny, I appreciate knowing how things turned out, and that you are OK ! You are a young "up and comer", my friend, and I have no doubt that the best is yet to come !