"There's a shortage of psychiatrists in the country so recruitment has always been difficult, not just for us but for the major centres as well."
There were also "really exciting things" happening in Wanganui around mental health, such as the Rising to the Challenge framework, which Dr Rawlinson wasn't keen to step away from.
But the work was starting to get "traction" and "national recognition", which was one of the reasons he felt confident enough to move on from it. He also felt the mental health work in Wanganui might put the health board in a better position to recruit someone.
The new position involved being responsible for everyone from a medical perspective. "The buck stops with me," he said.
It also means being part of the executive management team and strategic decisions, an area Dr Rawlinson believed was "really quite important".
Canterbury and Counties Manakau District Health Boards were seen as "leaders" in the country that had "heavily invested in building their clinical leadership", which Dr Rawlinson wanted to push in Wanganui.
"Clinicians can't stand back, not be involved and then be blaming the system for not giving them the opportunity.
"There's been a drive for some time in the WDHB to grow that clinical leadership ... uptake hasn't been as good."
Dr Rawlinson also wanted to push the idea that healthcare delivery was "increasingly dependent" on information technology, and that it should be seen as a clinical system rather than an IT system. He said it needed to be afforded the "right importance for the right outcomes".
While the role change was exciting, Dr Rawlinson still felt pressure to meet expectations.
"There's a level of trepidation," he said. "Am I able to deliver? Have I got the wherewithal? Ultimately, time will tell."