“Frequency illusion” or “frequency bias” is the cognitive effect of noticing something once, seeing it again soon after, and believing those occurrences are increasing. You experience this effect when you buy a new car and suddenly it seems like that exact make and model is all around you on the road. Or someone uses a phrase you have never heard before and you hear it used again in conversation the next day only to then see it in print. The belief that something in the world around you shifted is—as its name makes clear—an illusion, entirely dependent on your perception. I mention this because there may be a bit of frequency bias taking root in the department and perhaps even within University of Iowa Health Care. There have been a couple of high-profile departures recently and a few others in our department who are less visible but still critical to our operations. But does that mean “everyone” at Iowa is heading for the exits? Or is that our perception?

It is probably the latter. Yes, we have watched beloved and respected leaders leave or announce their departure. Yes, we have seen more than a few colleagues retire or pursue other opportunities elsewhere in recent months. Good-byes are hard, and their absences can temporarily place new burdens on us at a time when we already feel at capacity. Each new announcement reminds us of all the others that we have bid farewell. But are these departures doom for the Department of Internal Medicine? Of course not. Many of us who have been in academic medicine more than a handful of years know well that turnover is part of the culture. What has changed in the last couple years is that the pandemic slowed that turnover. Our frequency bias may be noticing the release of a bottleneck, perhaps even a sign that some parts of our old world are returning.

Here is what I also know. Since 2006, when I arrived at Iowa, I have worked alongside multiple Chairs and Interim Chairs, multiple Department Administrators, and more than a couple Deans, VPMAs, and hospital CEOs. I have watched scores of faculty and staff join our department, thrive, and then leave Iowa better than when they arrived. These cycles are a part of academic medicine, this is academia in general. But I have never seen, with all these comings and goings, things get worse. Instead, quite the opposite. Every departure means that there will be an arrival of someone new, with fresh ideas and new energy to inspire us all. Our size allows their new voice to be heard, our collegiality encourages their participation, and our curiosity is satisfied by their input. Some of the “new arrivals” grow over time to become leaders here at Iowa. In fact, the department has made it a rule to promote our own faculty wherever we can. Some individuals do move on to take on challenges elsewhere, a sign that while they were here at Iowa not only were they doing good work for us, but they were doing good work for themselves too. We celebrate their success and their growth because we care about them. Two of the most visible and recent departures from UI Health Care were recruited by two of the largest and most prestigious academic medical centers in the country. Other former Chairs have gone on to be Deans and Chairs at very reputable schools. Also, our trainees continue to excel. Ask someone, for example, in Pulmonary about how many of their fellowship graduates are now Division Chiefs or Chairs or other prominent leaders in the field. What do all those departures say? It says to me that at Iowa we have the space to dream big things and the encouragement to try them out. That will never change. That is the one constant that has always made us great, the continuity we may be looking for.

If you will allow a suggestion, a way to shift all of our perspectives in this moment, let me encourage you to look at the colleagues standing beside you. How long have you known them, how long have they been here? What is something you have learned from them, and what is something you have taught them? I want to hear your answers and I will bet that your co-workers would love to hear it too. Wouldn’t it be wonderful to read those? You can tell them directly, but you can also use our Feedback Form right now or this weekend. Choose either “Comments” or “Kudos for someone in the department” and tell us all about them. We can share them with all of you very soon.