Are you happy?

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pinipig523

I like my job!
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You know, we get a lot of threads and questions on our forum ranging from board scores, will I match, how were interviews, salary, contracts... But I've never seen a thread on happiness.

So, the question of the day or decade:

Are YOU happy with your career in Emergency Medicine?

For me, I can truly say that I am happy so far. I enjoy being a resident in the field. I enjoy the job prospects and the thought of becoming an attending shortly. I am glad I chose this field. I am a happy Emergency Medicine resident.

You?
 
Yep.. I love it. Great setup. Great hours, challenging, interesting and lastly, the compensation is fair.
 
Yeah it has it's moments but I think theres been an overwhelming amount of pressure from the parents for me to do well that doing a paramedic course is out of the question.
 
Yeah it has it's moments but I think theres been an overwhelming amount of pressure from the parents for me to do well that doing a paramedic course is out of the question.


You've already been told by other people not to give advice about things you really have no knowledge with. You were just accepted to MED SCHOOL a week ago, and you are now giving advice about if you love your career in emergency medicine. Please leave this to people that are actually in the position to give an opinion
 
Yeah it has it's moments but I think theres been an overwhelming amount of pressure from the parents for me to do well that doing a paramedic course is out of the question.

:smack: You are not in Emergency Medicine, you aren't even in medicine yet. Quit misrepresenting yourself.
 
I would appreciate more detailed responses from residents and attendings. Thanks.
 
:smack: You are not in Emergency Medicine, you aren't even in medicine yet. Quit misrepresenting yourself.


*Sizzzzzle*.

PGY-3 here, starting electricattendingland in the spring/summer. Love it. Plenty of time to be a 'real person' outside of the hospital, unlike so very many consultant-subspecialists. Sometimes I'm jealous that I'm not the end-all/be-all of management... but at the end of the day, I get to go home and I am *never* "on-call".
 
Yeah it has it's moments but I think theres been an overwhelming amount of pressure from the parents for me to do well that doing a paramedic course is out of the question.

You just got into med school and you're in ER already? 😕😕
 
I'm a newly minted attending. This last year has been hard, with burnout, with the death of a sibling, etc. I found myself being short and impatient, and dreading going to work. With the advent of a more reasonable schedule, and with the written boards out of the way (fingers crossed), I feel much better about things. For the first time in a while, I was looking forward to my next shift the other day. I just went out with some co-workers for a ladies' night. Things are looking up.

I think in the scheme of things, we're very lucky. I'm one of those people who works to live and not lives to work. Even though I am working three nights over the Thanksgiving holiday, I have my time off. And it's a lot of time off. When I'm done with the Seattle marathon on Sunday I don't know what I'm going to do with my time! I'm well compensated, my job is intellectually stimulating, and I know that what I do is meaningful and has a positive impact on people.
 
EM residents/attendings: thanks for posting here. Halfway through my third year, and EM is #1 on the list. Appreciate your thoughts on this.

@Pinner Doc: any thoughts in general on living/working in the PNW?
 
I am only a year older than the op, but for any youngers...

I am extremely happy with my decisions this far... I work 12 - 12 hour shifts a month; I've done some occasional moonlighting at a sleepy spot 'in my hometown' which is 3 hours from where I live now (I visit the parents, make some money, and have a tax write off)... I am at what I call a 'psuedo-academic' program.. we are a level 1 trauma center with residents in all the primary specialties and a few subs, plus a full four year medical school... but NO EM residency.... So I interact with residents/med students daily and they 'rotate through out department'... VERY different than a true EM residency program, but it does help keep me interest in some teaching..

I am far from burned out... maybe it will happen one day, I dunno? What I stress to people about EM is that it seems to make logical sense that its tough to 'burn out' in something that you can literally work a day a week and still have your 'needs met'....

I could work ~6 days a month and MORE than pay our bills (well into a six figure income; even if you are in an area that is lower on the pay scale)..... I have no clue how someone could not be happy working that little?

The people that are unhappy simply work too much or let some of the patients 'get to them'....

I just got a companion pass on Southwest Airlines. I just booked my wife and I 4 days in Nashville over New Years. As soon as I see my Jan schedule, we will be making a 3-4 day trip to Vegas.... We recently were in California, Baltimore before that; just spent Thanksgiving at my parents and did a quick hunting trip where I killed a nice buck... We are headed to my wifes hometown (Houston) on Monday for the week. We have a four month old at home who I get to spend more than adequate time with.

Emergency Medicine is awesome...
 
finished a pgy 1-4 residency june 30th, started working as an attending july 1st.

i work twelve shifts/month. shift lengths are 8, 9, 10, and (rarely) 12 hours.

the hospital i work at is busy (76K visits/year, 26% admit rate, strokes/stemis/level 2 trauma) and some days i feel like jesse spano during the caffeine pill freakout episode of saved by the bell, but most days i love what i do. being an attending is both scarier and more awesome/fun than being a resident, and is orders of magnitude better than being a med student. a lot of the older guys tell me that they started feeling totally comfortable about 4-5 years out.

my quality of life is awesome. i have a ton of free time, have been paying off my student loans, saving money, and am slowly starting to crawl out of the >$300K hole i dug myself into during school/residency. in fact, i'm going to start moonlighting at another hospital next month because i have so much free time that i could easily work 4 more shifts/month and still have a high quality of life.

so, to answer the OP's question, i am very happy with my decision. wouldn't change a thing.

--sp
 
Great thread.. It seems that mostly new attending are posting their experiences (which is great) and in fact, most of the people I've spoken with are new-ish attendings.. the few older attendings on this board (whose posts I've read) seem much less enthusiastic.. can any older attendings comment on this? Is it just a sampling bias?

Hoping to hear from some older attendings who still very much enjoy it (or vice versa)
 
finished a pgy 1-4 residency june 30th, started working as an attending july 1st.

i work twelve shifts/month. shift lengths are 8, 9, 10, and (rarely) 12 hours.

the hospital i work at is busy (76K visits/year, 26% admit rate, strokes/stemis/level 2 trauma) and some days i feel like jesse spano during the caffeine pill freakout episode of saved by the bell, but most days i love what i do. being an attending is both scarier and more awesome/fun than being a resident, and is orders of magnitude better than being a med student. a lot of the older guys tell me that they started feeling totally comfortable about 4-5 years out.

my quality of life is awesome. i have a ton of free time, have been paying off my student loans, saving money, and am slowly starting to crawl out of the >$300K hole i dug myself into during school/residency. in fact, i'm going to start moonlighting at another hospital next month because i have so much free time that i could easily work 4 more shifts/month and still have a high quality of life.

so, to answer the OP's question, i am very happy with my decision. wouldn't change a thing.

--sp

SP,

Great to hear!

If you don't mind, which geographic region do you work at (so as to not give out to much info)?
 
I'm very happy where I am. So much so I recently turned down a dream offer to work at a less likeable place.

3 1/2 years out from residency, work 12-14 12 hr shifts/month (my choice), assistant medical director/vice chair of a very large ED (105,000 visits/year).
 
I've just graduated, so I've only been an attending for almost 6 months now. I love my job, hospital, coworkers. I've had lots of challenging cases but residency definitely prepared me well. There are days that have moments of frustration, but overall I'm very happy with my first job choice and how my career is starting out. The pay is great too.
 
@Pinner Doc: any thoughts in general on living/working in the PNW?

I'm originally from the northeast, so it's a fairly big change. Grew up in upstate NY, college in NH, med school in NYC, and residency in UT. In terms of working in the PNW, I haven't appreciated any huge differences from elsewhere I've lived. There was that state mandate that medicaid patients are only financially covered for 3 ER visits a year, but a guy in my group (who's also a JD) just got that knocked down... so, glad that's over. I'm also surprised at how lax WA state is about psychiatric admissions - there are good outpatient resources, but getting a patient admitted is hard.

In terms of living: it more than satisfies my love of the outdoors, and I love being in a semi big city again.
 
I'm five years out of training and have been very fortunate to this point in my career. I am a medical director of two departments and a self-admitted workaholic, so for me, this has absolutely been the right career choice. I will agree that, for the most part, patients are the same everywhere, even down here in sunny Florida. Ironically, the clinical aspect of my job is by far the easiest, and at times I actually find myself hiding in my patient care. It is a good balance for me, in that I can combat the at times gritty politics of modern medicine with what I like to do best - treat patients.

My work hours are probably much higher than the average ED physician, given the administrative duties added to my full-time schedule, but I also make the schedule, so it could be MUCH worse than it is. I rarely (if ever) do night shifts, I get weekends off, and I am able to get away from it all on a fairly regular basis. The pay is outstanding.

Not to paint too rosy of a picture - being a director is very difficult at times, and the interpersonal skills required to do an effective job don't come without a price. I am somewhat disappointed in my colleagues from decades past who have managed to give away our medical system to the nurses and government agencies who now control us (and have for the past 20 years or so), but I still feel as though our specialty is able to make a difference in the overall practice of medicine.

As I see it, there is no other specialty in modern American medicine that is more aligned with and prepared for the coming healthcare changes, and I see great potential for our mindset and angle on the world to shape how we as physicians practice in the future.

For what it's worth - I never pegged myself as a political physician, a medical director, or even a leader, but it kind of fell in my lap and I ran with it. After all, that's what all of us in Emergency Medicine do better than anyone else - make it work.

Am I happy? absolutely. We all have our good and our bad days, but overall, I feel like my bad days are outnumbered greatly by the good. There will always be lawsuits, angry patients, satisfaction scores, and "the man" looking down upon us, but it's who we are that makes or breaks our experience.

Will I do this forever? Who knows. Does anyone really know? I do know one thing - I would do everything over again without changing a thing.

To those of you who are thinking about this field (or any field in medicine for that matter), don't focus too much on the medicine, the politics, or the "lifestyle." Focus on who you become as you mature in your field, and always find ways to apply what you have learned until you find your niche. I found mine...
 
Been out 5.5 years now.

I am in nirvana. Not only because of my job, but because:
I bought my dream house
My wife and I have three healthy amazing loving children
I make more than enough money
I am respected at work
I don't have to fight for an admission
I have no traffic to deal with
I have bought 3 cars (two fancy german ones that start with P) since I've been out (which admittedly is probably nto the best financial move but I really had to)
I'm assistant medical director, and actually don't mind it
Night shifts I actually get to sleep and get paid
My wife doesn't have to work, and she's relatively happy staying home with the kids
I am able to help out family financially

I have told my wife many times over the past 2-3 years if I died today, I would die a very happy man. I couldn't have said this during residency, or even during my first EM job, but I can say it now.

Oh, I work about 110-120 hours a month clinically. Do abou 20 hours a month as an assistant director.

Q
 
Been out 5.5 years now.

I am in nirvana. Not only because of my job, but because:
I bought my dream house
My wife and I have three healthy amazing loving children
I make more than enough money
I am respected at work
I don't have to fight for an admission
I have no traffic to deal with
I have bought 3 cars (two fancy german ones that start with P) since I've been out (which admittedly is probably nto the best financial move but I really had to)
I'm assistant medical director, and actually don't mind it
Night shifts I actually get to sleep and get paid
My wife doesn't have to work, and she's relatively happy staying home with the kids
I am able to help out family financially

I have told my wife many times over the past 2-3 years if I died today, I would die a very happy man. I couldn't have said this during residency, or even during my first EM job, but I can say it now.

Oh, I work about 110-120 hours a month clinically. Do abou 20 hours a month as an assistant director.

Q

Quinn, that is awesome. I'm happy for you and I don't even know you.

Here's to hoping I have your good fortune. 👍
 
Quinn, that is awesome. I'm happy for you and I don't even know you.

Here's to hoping I have your good fortune. 👍

Just to add one thing to this thread. I like 9er, and Quinn found my dream job. I know quinn has spoken some about his job and I remember a few years back 9er talking about his.

With regard to finding that "dream" job here is what I think matters.

Find a true democratic job, find it in a good location to live (for you). Bust your ass during residency because that is what will line you up for those jobs no advertises.

I am 3 years about and this year will make about 70% more than I EVER thought I would make in EM. my income will go up (based on how our partnership works).

No one fights me when I admit, my concerns are heard and the way my group is set up as a partner our directors are my employees since 1) they are elected and 2) I pay their salary. In the future I too hope to move into some admin just to broaden my horizons and challenge myself.

Avoid jobs where the decision makers are 2 states away or doesnt work where you work.

Money is there to be made. Find the right job and be the best you can be there.
 
There is happiness to be found in academics as well.

I think an important lesson to learn from the likes of Quinn and myself is that if you don't like your current job, LEAVE IT. As a BCEP you have a multitude of job opportunities. "Grow where you're planted" is sage advice, but one shouldn't be so afraid to uproot that one puts in a whole career at a job s/he can't stand and then retires prematurely from burnout.
 
There is happiness to be found in academics as well.

I think an important lesson to learn from the likes of Quinn and myself is that if you don't like your current job, LEAVE IT. As a BCEP you have a multitude of job opportunities. "Grow where you're planted" is sage advice, but one shouldn't be so afraid to uproot that one puts in a whole career at a job s/he can't stand and then retires prematurely from burnout.

Yes there is definite happiness in academics but the chairman better be right for what you are looking for. I have friends who are both very happy and very sad in academics.
 
There is happiness to be found in academics as well.

I think an important lesson to learn from the likes of Quinn and myself is that if you don't like your current job, LEAVE IT. As a BCEP you have a multitude of job opportunities. "Grow where you're planted" is sage advice, but one shouldn't be so afraid to uproot that one puts in a whole career at a job s/he can't stand and then retires prematurely from burnout.

Yeah. I'd like to reiterate this point.

Leaving my previous job was the BEST CAREER DECISION I HAVE EVER MADE. Not only financially, but professionally, as well as personally.

They say the grass is always greener, and I don't know if I necessarily believe that, but the job I had before, wasn't bad. it wasn't great, but it wasn't bad. but damn, my job now is the best on earth, for multiple reasons. After 2+ years under your belt and you're board certified and not a jack-weed, you can find those jobs that are unadvertised. Like I did.

BTW I cold-called my current job. I'm pretty lucky man...
Q
 
As someone getting ready to start residency next year, it's nice to see some positive viewpoints.

It's easy to get into all the negatives, and it probably has better entertainment value.
 
I worked 16 years in community EM with some part time academic. Transitioned to full time academic about 5 years ago. I still work a pretty hefty schedule ( my own choice). It has its moments but I really like my job. At 53 years old I look forward to going to work. I could not imagine doing anything else.

And yes, I have a very active life outside EM
 
Sometimes I'm a little in awe that I actually get paid to do this.

Shifts can be rough and systems can be frustrating, but I still love that I get to take the first bite out of the apple and take care of patients on the day that they most need a doctor. I spend a ton of time with my kid and husband and still pay the bills.

There's a lot of retrospectroscopy when it comes lifestyle and specialty choice (e.g., they-knew-what-they-were-getting-into-when-they-signed-on-for-general surgery/OB/cardiology/etc), but in reality, I don't know that many of us REALLY knew what we were getting into. I am SO GLAD I fell in love with emergency medicine, because life on the other side of residency is awesome.
 
Just to add a little. Yesterday an old college buddy came into town. He works for medtronic and went to Biz school. we were talking about whats doing in our lives and it is just amazing. I told him I work 12 days a month and his eyes were just bugging. It is great to gain the perspective of others with "real jobs" and see how luck we are.

No traveling for work (which gets old after a little while), great salary, and entertainment at work. Every once in a while you even feel good about making some people better.
 
I think EM is a really really tough field for the long term. Erratic schedules, stressful shifts, minimal autonomy or positive reinforcement, extremely challenging patients and no opportunity for ongoing relationships with the good ones, little collegiality or respect from colleagues. I would really encourage any interested student to immerse themselves in the ER, talk to as many attendings as possible (especially those who have been out longer than 5 years), and think long and hard about their decision to go into EM. In my opinion there are much better clinical career choices for longevity and long term professional fulfullment - it just depends on what you want out of your career.
 
I think EM is a really really tough field for the long term. Erratic schedules, stressful shifts, minimal autonomy or positive reinforcement, extremely challenging patients and no opportunity for ongoing relationships with the good ones, little collegiality or respect from colleagues. I would really encourage any interested student to immerse themselves in the ER, talk to as many attendings as possible (especially those who have been out longer than 5 years), and think long and hard about their decision to go into EM. In my opinion there are much better clinical career choices for longevity and long term professional fulfullment - it just depends on what you want out of your career.

EM def isnt for everyone.However, to counter the points above. If you find the right job you can minimize the tough parts. Erratic schedules, my group of 40 or so people we only have about 8 of us who work at night, i know that 365 days a week I am off from 2pm until 530 pm. Other than that I can get any 9 days off every month.

Regarding stressful shifts I think this too depends. My group sees about 1.8 patients per hour which isnt bad. Is it easy? no but few jobs in medicine are "easy".

The prior poster must have had a bad experience. My group is well respected within the hospital. We are very involved in everything from P&T, Cardiology, hospitalist, surgery and Critical care committees. The only group I ever get gruff from are a few of the urologists. plastics - no prob, OMFS - no prob, ortho - no prob.

I think your practice environment makes a big difference and due to this I have an inherent dislike and distrust of the Emcares, teamhealths etc. Now I know it is great for some people, it just isnt for me.

My job is special. I truly feel that way. So do the guys who have been here for 20+ years. No one leaves, getting in is hard.

Work hard find the right job where they just dont abuse you and kick you out. Find a place where you are respected and can contribute your unique skills and you can get what you want out of your job. This leads to fulfillment for me.
 
Thanks for the posts.

I'm definitely in a grumpy phase about our specialty, and I am starting to wonder if its the company after reading your posts. Or maybe its me.

I like the hospital and staff, and most of my colleagues including the scribes who are wonderful. The patients are the patients, the work is the work which i tolerate.....

I am contracted for only 120hrs/mo 9,10,12's end up working 2 weekends a month and taking call for part of a third including 2-3 other calls/mo. The path to partnership is very nebulous and at minimum 6yrs with no set guidelines- though I am only a year and a half out, I definitely feel resentful thinking about how much they are making off of me and the 8wks of vacation the partners get. I am in a "desirable area"(due to some social connections) so the pay is already just ok and I have an hour commute each way(no i would not be happy living there).

My group is large >150 docs but my core hospital team is more like 8 docs, which makes scheduling at times very inflexible.

The job and company are by no means bad(our pt/hr demands are not bad, we have scribes, full time is only 120hr/mo), and I'm not sure if I'm being unreasonable in my frustrations, because I certainly don't want to get into a grass is always greener situation.

I think what I have boiled it down to is:

1. Feel like life is passing me by with weekend/evening work. as a single person its hard to give my schedule requests >2months ahead of time. I'm sitting at home alone on random tues/weds and missing spending time with family and friends, let alone the missed holidays which come with the territory. This issue may change as I settle with a family.

2. I think I may need to be either a very well paid employee where I feel well taken care of even if the big wigs are making money, or find a smaller true democratic group where the path to partnership is laid out from the start, or find two part time jobs which give me more flexibility.

Sorry for rambling, just needed to get it out of my system. Thoughts?
 
It seems like you know why you are unhappy. One of the saddest aspects of our specialty is the belief that we can just use people for an unknown amount of time.

Here is my 2 cents

1) If you work 120 hours a month and feel that life is passing you by it probably isnt related to your job. It seems like you are covering a lot of weekends and this is prime family/friend time. Seems like you are working a disproportionate amount of those. Perhaps you should consider moving to a more fixed schedule. As a night person in my group I get the hours I want. Perhaps you could work it out where you worked Mon-Thurs only and if you worked all nights those guys would pay you a differential and allow you to make your own schedule.

2) If you are annoyed about the partners vacation and just how much money they make off of you what makes you think working for a big corporate group would make you feel different? If it is flexibility you desire get on staff at 3 or 4 places and pick up shifts when they need it. This usually works well when the places you work are chronically short staffed. You can also get 2x or 3x pay for picking up these shifts last minute.

Hope you find the pot of gold at the end of your rainbow.
 
boo2 -

i just left a job that sounds like the one you describe... will get back to you later on whether my new situation is better. i'm also single and totally feel you on the social life aspect. what IS better about new job:
1. fewer hrs - 32 vs 36 per week, will take less if given opportunity once i'm more established
2. larger ED = more shifts = more flexibility for trades and not getting stuck in a certain shift for 3-4 days in a row at times
3. 8-9 hr shifts = can always have a life even on a day i'm working. no more 12 hr weekend shifts. that's not a weekend at all....
4. set partnership path = if i like it, i know when i'll make x and y levels.
5. smaller city = less traffic, lower cost of living, less time required to take care of life's business.

i start in early 2012.

and to answer the OP - i am a poor example to follow. don't do what i did, which is get injured in residency, have the problem misdiagnosed, then end up on medical leave and leaving your first job for medical reasons. don't incur huge amounts of personal debt - it affects my decisions in ways i really hate. still trying to figure out what "life" was teaching me for all of that... and god help my future patients w/ the same problem. i worked through it, didn't get off on the substance abuse tilt, and found a way out.
 
EM def isnt for everyone.However, to counter the points above. If you find the right job you can minimize the tough parts. Erratic schedules, my group of 40 or so people we only have about 8 of us who work at night, i know that 365 days a week I am off from 2pm until 530 pm. Other than that I can get any 9 days off every month.

Regarding stressful shifts I think this too depends. My group sees about 1.8 patients per hour which isnt bad. Is it easy? no but few jobs in medicine are "easy".

The prior poster must have had a bad experience. My group is well respected within the hospital. We are very involved in everything from P&T, Cardiology, hospitalist, surgery and Critical care committees. The only group I ever get gruff from are a few of the urologists. plastics - no prob, OMFS - no prob, ortho - no prob.

I think your practice environment makes a big difference and due to this I have an inherent dislike and distrust of the Emcares, teamhealths etc. Now I know it is great for some people, it just isnt for me.

My job is special. I truly feel that way. So do the guys who have been here for 20+ years. No one leaves, getting in is hard.

Work hard find the right job where they just dont abuse you and kick you out. Find a place where you are respected and can contribute your unique skills and you can get what you want out of your job. This leads to fulfillment for me.
Not a bad experience - just my observations from decades of experience and interactions with colleagues in my work at both major academic programs and large community practices. The experience you describe is great but quite uncommon in the current era of emergency care - even the great private group set-ups are only a CEO's decision away from something remarkably different. That's why I encourage prospective students to really do their homework about the current state of our field.
 
I am only a year older than the op, but for any youngers...

I am extremely happy with my decisions this far... I work 12 - 12 hour shifts a month; I've done some occasional moonlighting at a sleepy spot 'in my hometown' which is 3 hours from where I live now (I visit the parents, make some money, and have a tax write off)... I am at what I call a 'psuedo-academic' program.. we are a level 1 trauma center with residents in all the primary specialties and a few subs, plus a full four year medical school... but NO EM residency.... So I interact with residents/med students daily and they 'rotate through out department'... VERY different than a true EM residency program, but it does help keep me interest in some teaching..

I am far from burned out... maybe it will happen one day, I dunno? What I stress to people about EM is that it seems to make logical sense that its tough to 'burn out' in something that you can literally work a day a week and still have your 'needs met'....

I could work ~6 days a month and MORE than pay our bills (well into a six figure income; even if you are in an area that is lower on the pay scale)..... I have no clue how someone could not be happy working that little?

The people that are unhappy simply work too much or let some of the patients 'get to them'....

I just got a companion pass on Southwest Airlines. I just booked my wife and I 4 days in Nashville over New Years. As soon as I see my Jan schedule, we will be making a 3-4 day trip to Vegas.... We recently were in California, Baltimore before that; just spent Thanksgiving at my parents and did a quick hunting trip where I killed a nice buck... We are headed to my wifes hometown (Houston) on Monday for the week. We have a four month old at home who I get to spend more than adequate time with.

Emergency Medicine is awesome...

Wow this sounds so nice

Can I really do something like this? I will have in excess of 200K in debt by the time i graduate
 
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So, the question of the day or decade:

Are YOU happy with your career in Emergency Medicine?

We're doctors. Of course we're unhappy. We're just less unhappy than the poor unfortunates in other fields who have less days off than we do.
 
Very Happy here.


I have been out 5.5 years. Academics and then community.

Yup. very happy.
 
Not a bad experience - just my observations from decades of experience and interactions with colleagues in my work at both major academic programs and large community practices. The experience you describe is great but quite uncommon in the current era of emergency care - even the great private group set-ups are only a CEO's decision away from something remarkably different. That's why I encourage prospective students to really do their homework about the current state of our field.

Yep. Learning the business side is key. FWIW my group has owned our contract for over 30 years. The key is to be good to the CEO's the boards, the VPs etc. Be involved. Prove your worth.. if you do they wont want to get rid of you.
 
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