Morgan Housel, “Little Ways the World Works”:
Chamath Palihapitiya once noted that however fast your business grows, that’s the half-life for how quickly it can be destroyed. So many companies, flush with cheap money from previous years, are learning this right now. Every business and every industry has a natural growth rate – push beyond it and short-term growth comes at the cost of long-term quality, and eventually survival.
Another year of the NRMP match results, and Family Medicine continues to be a relentless slow-moving disaster within the house of medicine. 805 unfilled postions, only 28% filled by US MDs. Just 1,501 US MDs in the whole country matched to one of the most critical jobs in all of healthcare (1739 applied, but the discrepency is probably a reflection of FM being a back up option for several hundred people).
I think people see this and point out several obvious deficiencies:
All true. All essentially impossible to easily fix within medicine and our training paradigms. Some people discuss the possiblity of special loan reimbursement, and that I suppose is obliquely helpful, but the reality is that PSLF already exists and there are already programs for working in underserved areas. Debt is a problem, but I don’t think tackling that head-on is going to solve the decline of primary care in the US.
Another suggested solution I often hear is to make family medicine sexier by allowing for different fellowships, creating more training options and allowing family docs to broaden their skills into things like dermatology.
There may be something to this, though I suspect in most cases, there probably isn’t. Even if such broadening were successful, it is probably counterproductive to the actual goals of primary care. A backdoor into dermatology is probably not going to solve a shortage of qualified practitioners. Nor do I think additional training is going to improve perceptions of prestige or respect.
The thing the ACGME can do to make things better are to change the training composition/requirements and especially length. Family Medicine should probably be a shorter, outpatient-focused course of training for general practitioners in the US.
In the era of massive midlevel expansion, it simply can’t be three years long. Anything else isn’t going to work to get people interested again.
In a world where many institutions struggle to attract aspiring family practitioners, I suspect the only solution is to fight fire with fire. I think we need more efficient training. We need to acknowledge that while more training is always good, it isn’t always necessary. And if we can’t get the job done in less time (though Canada is two years), then we need to seriously consider the efficiency of our process and the ability of our tools to assess competence.
We have, for too long, resorted to a proxy metric of time to tell us that somebody is skilled. This crude tool shouldn’t be the best we can hope for going forward. Nor will it help us address a possible post-AI world where physician retraining may become a more pressing concern.
So, I think the answer is just to start by shaving off a year and getting it done in two years.
(In a fantasy world, training duration would be as long as it needs to be. Strict training lengths are important to hospitals using residents for predictable labor, not because every doctor needs the exact same amount of training time to reach competency. The ebb and flow of patients in a resident clinic is probably slightly easier to accommodate than hospital service coverage.)
Given the current reality that many people in family medicine do not want to practice a significant amount of inpatient medicine, potentially refocusing a portion of that to an optional third year instead of making it a core part of the residency is likely one way to offer flexibility without fundamentally changing the field. Offering different paths for those who want to work in rural areas doing procedures and those who want to do OB are great ideas, but some serious introspection to figure out what the core of a PCP/GP should be in the US is overdue. I won’t claim to know the answer, but the match results tell us some stakeholders need to figure it out.
I also want to preempt anyone who wants to argue that doctors are already poorly trained and that shortening training will worsen that problem. The answer is, of course, all things being equal, that shorter training will be worse training. Many older physicians indeed believe that younger physicians are graduating “less well-trained” than previous generations. Part of that is a manifestation of reduced training volume. Part of it may be related to the increasing complexity of medicine. And part of it may be related to cultural shifts, such as decreased studying after work, and other such factors.
But that assumption also implies that there is no fat to trim, that all months of training are essentially equally useful, and that a shorter process should look the same as the longer process, just worse. All training is useful, but some is clearly necessary. The reality is that we cannot afford to ignore training quality. We need to provide better, more effective training. We need better measures. We need to reward hard work and variable skill so that the most competent people can graduate when they’re ready and not just when they’re older.
And ultimately, we need to rethink our fixation on time as the defining measure of competency. It’s not. It’s a crutch.
It’s job-hunting season, and I’ve received a variation of the following question several times this week alone: “How do I figure out if a practice I interview at might sell to private equity?”
I appreciate the fear of joining a private practice only to have the rug pulled during the workup in a sale to private equity. It’s what I was worried about when looking for jobs in 2017, what I was scared of when I entered practice in 2018, and what happened to some of my friends in 2018-2019.
My group was and is fiercely independent, and I was fortunate that the Dallas area was not ripe pickings for Radiology Partners, unlike Houston and Austin markets. But I had many of my friends end up on the wrong end of a sale and eventually change practices.
I have also certainly spilled enough digital ink on this topic over the years myself, so I am probably not entirely free from blame for increasing the collective anxiety about this issue.
But I do think that at this juncture, it’s relatively low risk.
The era of PE expansion in radiology through debt-fueled acquisitions of individual practices is essentially over, as far as I can tell. This is a model almost entirely dependent on the zero interest rate environment of the twenty-teens. The costs of borrowing money now are too high to enable these shenanigans, and the degree of leverage these companies have is already so high that there really isn’t any excess capital to deploy in acquiring individual practices when they also need to service their debt, pay for operations, and invest in AI and other magic.
Furthermore, the PR is not great at this point, and I doubt most practices that are actually healthy would want to sell. No one is buying the initial magic & sparkles pitches, so I don’t think either party wins in 2025, and everyone knows it. A struggling practice wanting to hitch their ride to a larger organization and/or extract some value before implosion would be a different story—but those would be less desirable for a purchase. RP, USRS, and LucidHealth may not be that good at actually running a radiology business, but they are very good at their real business, which is a primarily finance game that happens to involve healthcare.
So, investing tens of millions of dollars (even if you had them to burn) in an individual practice acquisition is very risky in 2025. Since these companies have reached scale, there are better ways for them to grow.
Private equity is more likely to grow their workforce through hiring individual radiologists than they are through group purchases, and they’re more likely to grow their imaging volume through organic growth or contract sniping than they are through the outright purchase of a practice. They can also grow by picking up the pieces when someone else fails, like RP did when Envision “transitioned” the corpse of its radiology business.
The “hostile takeover” is still somewhat possible, in the sense that an RP or similar could swoop in and try to steal a contract from a local group, have that local group dissolve because that contract represented a large fraction of their business, and then hope to hire up some of those radiologists for free on the back end to essentially keep the jobs they already had but have since lost (as in, keep staffing the hospitals they were already staffing before the contract change).
This has happened before, but even this, I think, is relatively unlikely to happen now or happen at scale, because these PE companies are not immune from the challenges in the market and have a hard time staffing as well (and also because many hospitals aren’t particularly happy with their level of service).
The reality is that private equity hasn’t gone away and won’t go away, but the greater fear for an individual practice is to implode under the weight of unsustainable image volume growth or be unable to provide the right lifestyle and compensation balance that are required to hire and retain radiologists in this increasingly nationwide market in the era of teleradiology.
A group failing because they can’t be competitive in the job market because their hospital won’t pay for the stipends to make their job competitive, for example, is a real concern. Could a PE-entity swoop in and hoover up some work there? Absolutely, but that’s not the same thing as your new practice screwing you over.
This is to say: If the job sounds good enough that you want to do it, then I personally wouldn’t worry much about it at this point. A healthy group probably doesn’t have much to fear from private equity in the short term given the radiologist shortage. The market itself is enough of a challenge.
When I was a fellow, my key metric when choosing my job was variety, not so much in terms of pathology or the pictures themselves but in the day-to-day. Variety helps me do one overarching critical thing for my professional satisfaction: optimize for enthusiasm.
There are a lot of things I like about radiology and some that I don’t, but one thing that makes everything go down smoother is a nice balance to the week—with different kinds of work on different kinds of days that demand different kinds of things from you.
I always thought I would be in typical academic practice because I generally like being “involved,” and I like the community. I enjoy teaching and mentorship, and I always have. I’ve been a peer mentor of one variety or another since high school. It’s just something that I find meaningful. I don’t didn’t even mind committee work and other kinds of bureaucracy, even if how the sausage gets made is off-putting. (If we’re being honest, I also probably felt I’d stay in academia because of comfort with the only system I’d ever known, willingness to buy into the lie that the best work gets done there, and a general failure of imagination.)
One thing I didn’t like was the rigid hierarchy, the prevailing pay-your-dues to get a better job attitude, the unfair treatment and distribution of different kinds of work among different kinds of people, especially when such treatment is a preference for seniority or clout that is sometimes unearned and often counterproductive for actual department functioning.
Another was that I don’t particularly enjoy the research game, which is the only meaningful academic currency in many departments, even when most research we do as a field—and certainly all the research I’ve done—has been trash. Someone should do it, but it doesn’t need to be me.
A bit of research here and there is fine, but a job with a “clinician educator” focus (and where that is valued) is what spoke to me.
Academia providing less vacation and money, while often true, wasn’t actually that much of a consideration at the time.
As those who have read the relevant posts on this site, I wanted nothing to do with private equity when I found my first job. Thankfully, that wasn’t an issue in Dallas. I don’t regret that outlook, and my peers who joined PE or joined practices that sold to PE have all left without exception.
With regards to university or hospital employment, it doesn’t take much exposure to the layers of management or dubiously useful hierarchy to find a representative democracy with physicians in control to be refreshing. Obviously, the hospital is still the hospital and is dysfunctional in all the ways large organizations so often are, but a true private practice is one-step insulated and removed, able to advocate for ourselves and control our own workflows.
Speaking to hierarchy, I liked that new associates could be involved in everything and do anything in the group except serve on the board of directors. I was an associate program director for the residency before I was a partner.
My schedule is a combination of teaching at the hospital, working from home, and sometimes working solo at an imaging center in a strip mall somewhere.
Ultimately, I’m a better teacher when teaching is part of my job that I get to look forward to and not something I do every single day. Trust me, even I sometimes get tired of hearing myself speak and saying the same things over and over again.
I also like the fact that I get to spend some of my days working with residents and students, and some of my days working by myself—reading my own cases at my own pace, sometimes doing my own procedures and talking (briefly) to my own patients.
(I did just take over the program director role this month, and that also means regular admin time as well.)
Having a hybrid schedule was especially important for me, because while I have no interest in being a teleradiologist, I very much have an interest in working from home on at least a weekly basis (I’m about 50% remote).
My wife has her own solo psychiatry practice and makes her own schedule. So as the parents of two young children, the ability to have lunch together or take a walk around the neighborhood during the week is an incredible boon to our marriage. We’ve had more mini dates and spent more quality time together during the day than we could ever hope to carve out from our busy evenings with the family or over-scheduled weekends.
Some flexibility is seriously valuable.
I also really appreciated my group’s goal of a four-day workweek. I didn’t really need an academic day—which can get filled by meetings and duties and other administrative tasks—what I really wanted was a day off to pursue my hobbies/interests, to be a good partner and parent, take my kids to school, pick them up, make sure the house is in order, and yes, recharge my battery at least just a little.
Some groups have lots of week-long vacation blocks because it is by far the easiest way to do scheduling, but the reality is that I don’t need week-long blocks in huge numbers. In my current life, I’m not going on lots of trips when my kids are in school. I also don’t need large blocks of time off because I’m not diligent enough in my time management to take advantage of them for creative pursuits—I need regular time off.
So a four-day workweek combined with healthy vacation is a great mix. When you combine my eight weeks of PTO and my four-day workweek, you end up with the equivalent of like 17 weeks off, which is, of course, phenomenal.
From a partnership perspective, this is also a strong way to handle staffing in that the fifth day off is not a guarantee depending on who’s on vacation and how the lists are, but it allows for our division to be flexible accomodating shifting workloads, scheduling PTO even one day at a time, and staffing/recruiting.
This is to say, I don’t always get that fifth day off—but I do most of the time. And when I don’t, I just get paid extra for working.
But when people ask how I have time to write, that’s certainly part of the answer. 1
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My situation is, of course, mine. My wife became an attending when I was a senior resident, and we’d already returned to be near our families for residency. We weren’t going anywhere. I wasn’t canvassing the country looking for the most magical of all possible jobs. I was looking for the best job for me in the Dallas area, and I was trying to achieve that combination of work variety, location variety, and schedule flexibility.
There’s nothing wrong with different kinds of radiology practice. Different strokes and all that. But I will admit that when I was a trainee deciding between staying in academics at my home institution and joining a traditional, typical private practice, I couldn’t shake the feeling that I wasn’t excited about either choice/extreme. I feel very fortunate that the chance to do something in the middle was available where I was looking.
(And yes, we’re hiring.)
In his 2023 book Decisions about Decisions, Harvard Law School professor Cass Sunstein offers this advice: Rather than concentrating on the probability of being right or wrong in a decision—which is often impossible to determine due to the intrinsic uncertainty and the unpredictability of the future—focus instead on comparing the cost of being wrong with the benefit of being right. These factors, according to Sunstein, are easier to estimate without the need for forecasting outcomes.
Applying this very logical argument to using high-quality AI tools for diagnostic medicine, we come to a straightforward problem as fleshy, fallible humans: the logical course of action is to agree with any plausible AI answer and only contradict the machine in cases of undebatable error. This is true for potential liability, but it’s also true just for saving face generally.
If the goal is to maximize accuracy or quality, one can imagine a world where a human radiologist interprets a scan independently and an algorithm interprets a scan independently. If both agree, then we’re done. If those two evaluations are in disagreement, then a third party—either another human or a different algorithm with different parameters—steps in to adjudicate the disagreement. (We could, of course, have that initial AI product itself be the result of a debate between multiple algorithms, but you get the idea.)
There is no guarantee that such a combination would be an improvement, but it’s a plausible outcome that will, of course, be studied. However, the effectiveness of such an approach remains uncertain. How much would such a system genuinely enhance diagnostic accuracy? Surely, it would be a moving target, but would such human-AI collaboration genuinely enhance accuracy or would it be awkward source of complexity and hamstring the needed efficiency gains. It certainly wouldn’t look very good if the third party nearly always sided with one source.
There are several possible outcomes:
That will be studied. Yet, reality could be complex—we may find that AI’s strengths and weaknesses differ across imaging modalities, patient populations, or specific pathologies. AI may be great at breast screening but terrible at most MRI. Or the opposite. The optimal balance between AI independence and human oversight may depend on more or different variables than we’d suspect. Or not. Why pretend to know?
The commercial reality is that the sort of AI utilization I just described is unlikely to be the primary solution for handling the radiologist shortage or maximizing profitability for stakeholders unless it’s a rule. The more likely scenario is that AIs will churn out preliminary reports of increasingly high quality, which a human radiologist will review, make changes to, and ultimately be liable for.
This shifts the radiologist’s role from a thoughtful creator and analyst to more of a quality inspector—checking for plausibility rather than deeply analyzing every case. When the AI is reasonable, the human will likely agree. When the AI makes an obvious mistake, correcting it won’t require much effort from the human. Obvious contrast mixing in a pulmonary artery is not a thrombus. Calcified lymph nodes are often chronic findings, etc. A clearly benign breast lesion misclassified as a potentially malignant tumor may be easy for an experienced mammographer to catch, especially if that mammographer has access to priors and context that the AI does not.
It’s easy for many observers with a vested interest to believe that their magical subset of skills will be particularly thorny to emulate, and some may even be right.
Even the quality inspector assumption presumes a relatively stable and predictable level of AI performance. How confident should a human be in their assessment when there is disagreement if the AI is improving while the human is mostly stagnant? What if AI-generated reports vary significantly in quality for different use cases? Scrutiny may be hard to employ judiciously in a piecemeal fashion.
Regulatory agencies could impose strict requirements for human oversight that make the process more labor-intensive than expected, and those requirements could be either reasonable or stupid over the short, intermediate, and long term. AI adoption will depend not only on technical feasibility but also on evolving legal, ethical, and financial pressures.
But what will radiologists do when the AI calls a focal asymmetry that the radiologist would not have called? We’re getting there already. If the AI is usually right, the human being will almost certainly just agree with whatever it says as long as it’s plausible—because the risks of agreeing are negligible, but the risks of incorrectly disagreeing are high.
How foolish will you feel calling a mammogram normal when the AI suspects a mass—with its black-box, pixel-based approach that detects patterns beyond and different from your human understanding? No one wants to get in the way, so no one will disagree and take on the liability of calling a case negative when the AI has flagged it as positive in an otherwise usually accurate system.
That’s the reality we need to live in. That’s what we’re going to see unless we specifically craft one to prevent it.
That’s going to be a big problem—because all the commercial and workforce pressure will push us toward utilizing AI tools in ways that practically ensure automation bias becomes the single biggest challenge facing radiologists in the near future.
From Face it: you’re a crazy person, about the importance of “unpacking” a job to understand your relationship to a potential career:
High-status professions are the hardest ones to unpack because the upsides are obvious and appealing, while the downsides are often deliberately hidden and tolerable only to a tiny minority.
[…]
Making matters worse, people are happy to talk about themselves and their jobs, but they do it at this unhelpful, abstract level where they say things like, “oh, I’m the liaison between development and sales”. So when you’re unpacking someone’s job, you really gotta push: what did you do this morning? What will you do after talking to me? Is that what you usually do? If you’re sitting at your computer all day, what’s on your computer? What programs are you using? Wow, that sounds really boring, do you like doing that, or do you endure it?
How important and yet almost impossible does that sound?There are wide chasms between expectation, perception, and reality. I’m not sure most people are truly psychologically willing to confront unpacking themselves, let alone comprehensively do it for others.
If you have ever dabbled in personal productivity or internet software, you may have heard of—or already be using—Notion.
Notion is an incredibly powerful and sometimes complicated web software that allows you to create, essentially, a digital brain/personal database for just about anything.
Many companies use Notion for literally everything, and there are certainly many powerful features (some you can pay to unlock), but the personal version of Notion is free and incredibly powerful (and is what I use).
One of its key features is that it allows you to easily create and update databases—think flexible, easy-to-use Excel spreadsheets on the fly—including all different kinds of complicated fields like file attachments and tags that can then be searched and filtered accordingly.
I have multiple workspaces in my Notion for multiple reasons, including everything I keep track of to run Independent Radiology, but one use case I was also able to get my wife (who smartly does not share my obsession with digital tools) to implement was Notion to organize her CME.
This is the very simple way I have my CME tracking set up:
A simple table that allows me to easily enter the name, hours, and tag (opiates, ethics, etc) for every CME item I complete—and then attach or upload the corresponding certificate so the proof is never lost. Adding more columns like date done or granting organization would be just a simple click. I make a new table every year.
Because Notion is on the web and is a well-funded, stable platform, this means I can add or find any element at any time whenever I need it—and retrieve it easily if I ever get audited by the Texas Medical Board, the American Board of Radiology, the hospital, or anybody else.
I have everything I need in one place to prove my compliance—and the pics to prove it.
If you’re keeping your CME in a physical folder, or in a folder on your desktop, or just letting them accumulate in your email inbox and hoping you’ll be able to find them in the event of an audit, I would consider trying Notion as an easy way to organize this—and potentially other parts of your life. I find it to be an easier way to stay organized than a thousand Google docs & sheets.
(Alternatively, the easiest thing you could do is just use OrbitCME (reviewed here back in the day, $20 discount affiliate link thingie here). It’s a webservice with a browser plugin that will give you credit for using sites like Radiopaedia, PubMed, or UptoDate, which means you can easily get all your CME hours taken care of passively just by doing what you’re already doing. You can upload your external CME events to it and keep everything in one place. Pricier but undeniably super convenient.)
In The Thing (1929), G.K. Chesterton argued:
In the matter of reforming things, as distinct from deforming them, there is one plain and simple principle; a principle which will probably be called a paradox. There exists in such a case a certain institution or law; let us say, for the sake of simplicity, a fence or gate erected across a road. The more modern type of reformer goes gaily up to it and says, “I don’t see the use of this; let us clear it away.” To which the more intelligent type of reformer will do well to answer: “If you don’t see the use of it, I certainly won’t let you clear it away. Go away and think. Then, when you can come back and tell me that you do see the use of it, I may allow you to destroy it.”
I will admit when I was a medical student and resident, I had a lot of opinions about how things should be different and should be done. Some of those were right and some where wrong. Some had the benefit of fresh eyes and some were the result of naivety and a narrow perspective. It’s often not possible to know which are which prospectively.
In The Lessons of History, Will Durant suggests:
Out of every hundred new ideas, ninety-nine or more will probably be inferior to the traditional responses which they propose to replace. No one man, however brilliant or well-informed, can come in one lifetime to such fullness of understanding as to safely judge and dismiss the customs or institutions of his society, for those are the wisdom of generations after centuries of experiment in the laboratory of history.
Cultural evolution is less often people changing their minds through enlightenment and more often just the replacement of old people and their old ideas with younger people and their new ideas. This isn’t always going to move in the right direction. Pendulum swings are hard to control. It’s also challenging, if not impossible, to understand which failed old attempts signify a bad idea that should be discarded versus reflect bad timing/context and should be retried.
I, too, roll my eyes when older people complain about young people. Generational politics are so incredibly tedious. But, sometimes, there is something there. Time marches on. I am not quite 40, but I can feel the aging. The gap between the youngs and the olds is impossible to ignore (or prevent). The trends discussed by Jonathan Haidt and others like in his excellent books The Anxious Generation and The Coddling of the American Mind are absolutely real.
There are so many problems in the house of medicine, but so many changes are just rearranging deck chairs and attempts to more fully embody the law of unintended consequences.
Healthcare is not insulated from broader cultural trends of quiet quitting, the desire for remote work, and the general American focus on individualism. But we’re always changing.
It’s not always possible to ensure we make things better and not just different, but more nimbleness and experimentation would help. More toe-dipping. We could be a little less precious with many of our core assumptions and be willing to try big changes instead of just marginal differences with big ripple effects (i.e. the same test, but not graded).
We need relentless iteration and experimentation, because it’s admittedly hard to know which parts of what we take to be the problem are Chesterton’s fence.
In Give and Take, Adam Grant divides people into three types: givers, takers, and matchers.
Grant argues that givers are both the most and the least successful (because people like givers, but they are also the easiest to take advantage of):
“Givers are overrepresented at the bottom and the top of the success ladder.”
Radiology practice is no exception. The culture is the people, and it arises organically from the people in the organization working within the constraints of the clinical work.
Consider cherry-picking in radiology:
The reality is that people’s behavior is both variable and domain-specific. Someone may run amok on the list but be willing to do tedious extra administrative work that no one wants to do. Someone may be a huge team player at the hospital when they’re part of a small group where they feel seen, but a bad actor when part of a massive shared list.
We need to acknowledge that 1) hiring matters, 2) culture matters, and 3) we should try to build better systems that make it easier for people to behave nicely and win.
It’s impossible, even in easy times, to hire right all the time. The solution, in the old days, was to make partnership contingent on good behavior (and, sometimes, high productivity). The problem of course is that, like tenure, that doesn’t fix sloth or selfishness among partners. And certainly in the current market, dropping people when staffing is tenuous isn’t trivial when the work has to get done. Rug pulling too often would seriously harm a group’s reputation, and warm bodies don’t grow on trees.
Workflow-wise, too many metrics and too much surveillance are extremely toxic. No one wants to have their movements tracked like an Amazon warehouse worker to make sure their bathroom breaks are industry-conforming. But the reality is that an open list where you select your next case is a big temptation for takers, and it only takes a tiny sliver of takers in an organization to spur the suboptimal behavior of matchers. That leaves everyone feeling like a distrusting victim.
Not all giving is equal. And not all of it scales.
“Being a giver doesn’t require extraordinary acts of sacrifice. It just involves a focus on acting in the interests of others.”
Matching is about dividing the work pie fairly, but giving often involves other gifts of time, energy, knowledge, skill, and emotional support. Teaching is a gift. Administrative duties like committee work, medical directorship, and practice leadership often disproportionately fall on givers. The “reward” for doing these tasks well (or even just being willing to do them) is often being given more responsibilities.
We can’t let giving be a suckers game:
“If you don’t protect yourself, giving can be dangerous.”
Give to matchers, and you build reciprocity.
Give to givers, and you build culture.
Give to takers, and you burn out.
Takers exploit. Matchers track. Givers build.
We need systems with guardrails to ensure that opportunities for exploitation are rare and that bad behavior can be policed effectively. If your group is using independent contractors for list support, that might mean giving them access to only a specific list or specific cases instead of letting them graze freely.
The problem is that if takers dominate, everyone becomes a matcher. Generosity becomes naïve. Trust becomes weakness. And the whole system corrodes.
“The more often people give without strings attached, the more others start to match their generosity.”
Practices thrive when givers can lead with open eyes and no remorse.
Niko McCarty, writing about writing in the age of AI:
“This is so boring. Why do you write like this?”
The truth is that my past slew of academic and corporate jobs had neutered my ability to write evocatively and creatively. Up until that point, I had never really stood up for anything in public. Perhaps I was afraid that people would attack me, or that my former mentors would be disappointed in my decision to publish argumentative or opinionated pieces. But that single sentence, uttered by my boss, shook me up. I started writing with fewer self-imposed restrictions. I stopped fearing the reactions of others. I decided to just be myself—to be uniquely human, and not give a damn.
Be a write, and not a write-not.