He went that-a-way!

So, I am sitting on the tarmac at London Heathrow and I find myself at another crossroad.  A professional one this time and I am not sure which direction is best for me.  I am about to have my annual performance review and the company is on the verge of transformation -- in very good ways.

I am fairly confident that I will get a great review and hopefully a decent increase.  However, I also know there is going to be a bigger decision to be made about how I fit into the bigger picture of the organization.  Here is the frustrating part -- This conversation is going to be in code because the powers that be (and I don't "be") haven't finalized their planning yet.  So, I am left to surmize what the options are.  Here is what I can figure out:

1. More of the same.  Pro:  I am good at it and it doesn't require a lot of investment now that I know what I am doing.  Con:  It is getting boring.  I am not growing clinically and it is a dead-ender.  I will eventually have to leave.
2. Purely clinical role.  Pro:  I will deepen my clinical skills and be better prepared for the LI exam, although it still won't be as deep as I would like to go.  Con:  I have control needs and need to feel like I am part of the driving force of the organization and decision making process.  Unless this role can grow deeper, I will probably have to leave after my LI.
3. Bigger leadership role.  Pro:  If it can develop over time, I will be able to use both my clinical and business backgrounds and will have some big growth potential.  Con:  I am not sure how this fits into my longer term personal planning.
4. Something I haven't yet considered. 

 I am a bit anxious about this conversation for several reasons, most of which are petty office politics stuff, but this is the big one.  I have been needing a stronger vision for myself for the past several months and this conversation will be key to being able to set some clearer direction for me and the children.