As leadership changed, the culture around performance and advancement shifted. Over time I felt that institutional memory, specialty expertise and long‑term contributions were not valued consistently. Promotion practices seemed opaque, and I saw clinicians with substantially less experience and questionable communication acumen move into roles without clear explanations. Most importantly, I experienced increasing friction between high performers and leaders whose roles felt more performative than grounded in clinical or operational expertise. That tension appeared to be tolerated by the institution. Questions about decisions were discouraged, and requests for discussion went unanswered—even when they came from people with decades of service and a record of strong outcomes. After years of above‑average performance reviews, the feedback I received near the end of my tenure seemed inconsistent with my record and, in my view, hypocritical. This sudden shift in narrative felt like a mechanism to justify decisions already made rather than an honest assessment. For clinicians who invest deeply in their programs and relationships, contradictory or last‑minute feedback is demoralizing and undermines trust in the review process. Although department leaders appear to view themselves as emotionally intelligent, my experience was quite different: they delivered polished, stoic performances but did not exhibit the empathy, listening, or unbiased 360 assessment skills that clinicians need from leadership. That disconnect was another source of friction between high performers and management.
