For the first 10 years of my career, I viewed “Administration” as a dirty word. I was committed to taking care of my patients and doing my research. I thought about administrators, or, as we called them, “suits,” mainly to blame them when something went wrong. I cringed every time I was asked to sit on a committee or attend a meeting and thought it was a waste of my time that could be better spent on more important activities. Indeed, I remember one time when I was asked to serve on a committee, I told a colleague in confidence that serving on the committee would be like “gargling dirt.”

My oh my, how times have changed. I now spend more than half my time on administration. My calendar is packed with meetings. I am on a long list of committees at our institution and beyond. I have significantly reduced my patient care efforts because administration takes up so much of my time. Most unexpectedly—I now find most of my administrative responsibilities to be enjoyable and rewarding.

How did I go from viewing administration as “gargling dirt” to being “enjoyable and rewarding”? It happened step by step.

First, I recognized that, as those of us who participate in the Iowa presidential caucuses know, decisions are made by those who show up. Early in my career, I reluctantly agreed to serve on a few committees when I recognized that the committees were dealing with particular issues that were vital to my own career. My participation was self-serving and geared directly toward advancing my own efforts. Much to my surprise, I found that I enjoyed exchanging ideas and alternative solutions with a smart and well-meaning group of people and the mental challenge of trying to come up with creative solutions that balanced disparate perceptions and goals.

Next, I found myself actually volunteering for some administrative duties, not because the decisions to be made would impact directly on my career, but because I thought participation would be interesting and educational, and broaden my perspective. I found it very satisfying when the decisions that were made had a positive impact.

Slowly, and almost imperceptibly, I found myself being asked to serve in administrative leadership roles. At first, these were at the university. Eventually, I assumed such roles in state and national organizations. The broad focus of these efforts, including research, clinical care, policy, and governmental affairs, allowed me to spend time with, and learn from, very interesting, smart and well meaning individuals and groups with backgrounds and interests very different from mine. I got enormous satisfaction from working behind the scenes to help outstanding people do an excellent job, and seeing them succeed.

Yes, there are times when administration requires managing issues that, do indeed, feel like “gargling dirt.” Fortunately, these difficult experiences are more than compensated for by the pleasure of working with many different outstanding individuals and teams to identify creative solutions to challenges.

In many ways, my administrative efforts have come full circle. They have provided me with a better understanding of the issues that are central to clinical cancer care and research. I have seen what works, and what does not work, from different angles. I am better able to the assess short term and longer term impact of decisions, and believe my administrative experience “gargling dirt” has made me a better doctor and researcher.