The costs, challenges, and rewards of management

Until recent years, the designation of physicians as managers in medical complexes generally followed three criteria, professionally known as "SAG Factors"--Seniority, Accountability, and Gullibility. Within the scope of these salient features, little room for creative career design or targeting was possible. Given the unprogrammed and largely unprepared conscription of many physicians into early management roles, it is worth noting with pride the frequency with which these early, however "sagging," pioneers rose to the occasion. There is also competent support for the idea that good managers are born, not made, as the plethora of maximally degreed and minimally talented MBAs running loose in corporate ranks today attests.