The other day, LinkedIn informed me that I was a strong match for a developmental-behavioral pediatrics section chief position at an academic medical center in the Midwest.
The irony was hard to miss. Years ago, I held essentially the same leadership position. It nearly killed me.
The recommendation arrived complete with all the reassuring language modern recruiting systems like to use. My qualifications matched the position well. My experience aligned with the requirements. My leadership background made me an attractive candidate. In fairness, the algorithm was not entirely wrong. It saw what most employers would see:
- Developmental-behavioral pediatrician
- Academic faculty member
- Section chief experience
- Leadership of federally funded programs
- Clinical research
- Teaching and mentoring
- Years of experience in a shortage specialty
On paper, I looked like an excellent fit. Yet the recommendation exposed an interesting limitation. My curriculum vitae, which is readily available on LinkedIn, reflects not only my qualifications but also the fact that I previously held essentially the same leadership position. The algorithm appeared to recognize the credentials that made me eligible for the job while overlooking a more complicated reality.
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I no longer held that position. Years ago, funding disappeared and I lost the role. The algorithm treated that experience as a qualification. It never considered the possibility that the experience itself might contain an important lesson.
What the algorithm could not see was the human cost associated with acquiring those credentials. A résumé tells employers what you have accomplished. A biography tells them what it cost. There is a profound difference.
The experience brought me dangerously close to suicide. The algorithm had no way of knowing that. It recognized my accomplishments. It could not recognize my scars.
Years ago, I accepted leadership responsibilities because I believed I could help improve systems, advocate for patients, train future physicians, support interdisciplinary teams, and build programs that would endure beyond my own career. Like many physicians, I entered leadership with a mixture of optimism and naïveté. I assumed competence would matter. I assumed hard work would matter. I assumed patient care would remain the central mission.
What I underestimated were the forces that gradually consume many physician leaders:
- Administrative burden
- Budget pressures
- Productivity demands
- Personnel conflicts
- Institutional politics
- Financial constraints
- The endless accumulation of meetings, committees, compliance requirements, and reporting structures that slowly displace the work physicians actually trained to do
That blind spot is not unique to recruiting software. Health care systems often make exactly the same mistake. We are very good at measuring outputs. We count RVUs. We count publications. We count grants. We count committee memberships. We count leadership titles. We count quality metrics. We count clinical encounters. We count virtually everything except whether the physician is still enjoying life.
No one asks whether the physician sleeps well. No one asks whether administrative responsibilities have replaced meaningful clinical work. No one asks whether the physician still looks forward to Monday morning. No one asks whether the position has become emotionally unsustainable.
The result is predictable. A physician can be productive, respected, admired, and outwardly successful while privately approaching burnout. Or worse.
The recommendation became even more ironic when I looked at the salary range. What caught my attention was not simply the position itself but the compensation. Years ago, I earned approximately $170,000 in a similar leadership role. The advertised salary was dramatically higher: $232,700 to $310,000. When I held a similar position, funding limitations ultimately ended my employment. Years later, the same specialty was advertising substantially higher compensation while an algorithm enthusiastically suggested I return.
Perhaps the market has finally recognized the severe shortage of developmental-behavioral pediatricians. Perhaps institutions have discovered that replacing experienced physicians is expensive. Perhaps inflation has simply changed the landscape. Or perhaps enough physicians have learned what such positions actually require that fewer are willing to take them.
Whatever the explanation, I found myself looking at the posting and feeling something unexpected. Not temptation. Relief. Relief that I no longer needed to say yes. Relief that I could look at the opportunity and decline it without regret. Relief that I had survived long enough to acquire perspective.
That perspective came into even sharper focus later the same day. I was cleaning my office. Like many retirees, I have spent years accumulating papers, plaques, books, photographs, and professional memorabilia. I was actually looking for an old award plaque that had disappeared somewhere into the organizational black hole of closets and storage boxes. Instead, I found something much more important. A letter written by my father to my mother on September 3, 1970.
My father was an Air Force navigator. In the letter, he discussed relatively ordinary matters. He needed a few more hours to requalify in the C-130. He expected to complete the process within a couple of weeks. He mentioned upcoming training in the Philippines before an assignment in Taiwan. Nothing dramatic. Nothing prophetic. Just the routine concerns of a military officer planning next month’s work.
Less than a month later, on October 2, 1970, he was killed in an aircraft accident.
I sat in my office and cried. Not because the letter contained some profound revelation. Quite the opposite. The letter reminded me that life is largely composed of ordinary moments that only become precious later.
I also found an old piece of parachute cord. My father and I used parachute cord constantly when I was growing up. Long before Velcro became commonplace, parachute cord solved countless problems. Finding that small piece of cord instantly transported me back decades. The letter and the cord are now resting safely together.
Neither object would improve my LinkedIn profile. Neither object would increase my salary. Neither object would strengthen my résumé. Yet both were more valuable to me than the job recommendation.
That realization forced me to confront a question that modern medicine rarely asks. How do we define success? For years, my definition looked much like everyone else’s:
- Promotion
- Leadership
- Recognition
- Professional advancement
- Larger responsibilities
- Greater influence
In medicine, we are often taught that success follows a linear path:
- Medical school
- Residency
- Fellowship
- Faculty appointment
- Leadership role
- Larger leadership role
- Bigger title
- Bigger office
- Bigger salary
The next opportunity is always assumed to be better than the last. Age and experience have taught me otherwise. Sometimes wisdom consists not in accepting opportunities but in declining them. Sometimes success consists of knowing when enough is enough.
Today I spend part of my time writing, working on book projects, publishing articles, enjoying retirement, and spending time with family. I watch turtles climb the embankment of the retention pond behind my home. I appreciate simple moments that I once rushed past while pursuing professional goals. No algorithm would identify those activities as career advancement. Yet they have improved my life immeasurably.
The recruiter saw a perfect match. The algorithm saw qualifications. The job description saw leadership potential. All of them were looking at my résumé. None of them were looking at my life.
For perhaps the first time in my career, I was completely comfortable with the difference.
The recruiter offered me the job I once thought I wanted. A letter from my father reminded me of what matters more.
Ronald L. Lindsay is a retired developmental-behavioral pediatrician whose career spanned military medicine, academic leadership, and national advocacy for dignity-centered neurodevelopmental care. His NIH-funded work with the RUPP Autism Network helped define evidence-based approaches to autism and related developmental disorders.
He directed the LEND Program at The Ohio State University and founded JBLM CARES, a $10 million autism resource center for military families. His writing spans clinical scholarship and long-form fiction. He is the author of The Mercy Directive and the six-novel Cassandra series, a completed political and medical fiction saga tracing the rise of the Cassandra system from its origins to its national and international legacy. His forthcoming memoir, The Quiet Architect, examines how conscience and structure collide in modern medicine.
He shares updates on LinkedIn.
