I find many things fascinating, not the least of which is the incredible noise that rises from various media about health care. The cacophony is hardly intelligible, characterized by an incredibly naïve and the kindest warm-heartedness (albeit potentially counter-productive) on one-hand and selfish market-centered arguments on the other.

Although learning about and expounding on policy, ideology and philosophy can be enormous fun, any physician turned manager is ruled by a pragmatism dictated by where the rubber hits the road.

I am a radical, affirmative centrist and a pragmatist who manages to upset ideologues of either stripe, right or left. I really don’t like ideology taking precedence over truth or right.

The mission of medicine as a calling is equally as valid as the business of medicine. When the rubber meets the road, we must absolutely set aside our political and ideological differences and focus on achieving fundamental goals. But we can have fun arguing!

Apart from the dialectic, I hope this blog will bring to bear the unique perspectives of a practicing physician and health care manager to the worlds of management and policy. I have accumulated anecdotes and stories over years of journaling. Some of these stories shed light on the world of medicine that hopefully will add to the worldwide debate on health care.

I am the medical director of mid-sized, multi-facility, primary-care based, multi-specialty safety net Community Health Center on the East Coast of the US. I am not (yet) a US citizen and have graduated from a global top 10 or 20 medical school depending on which magazine you read. I have a management degree from a top-5 School of Public Health. I also have a background in residency education, having served in various roles over more than a decade at two different University based family medicine programs.

I will write this blog pseudonymously due to controversies associated with health care for the underserved (Medicaid, minority and immigrants) since I would like to avoid adverse consequences for my job, my patients or the community. As an anonymous blog, it is difficult – if not impossible – to provide additional reassurances that no other conflicts of interest exist. All I can do is promise full disclosure as we proceed and hope the frequent disclaimers will not be overly distracting.