
The hidden epidemic: Physicians who stay but mentally quit
Many physicians stay in their roles but have quietly “quit” in spirit—going through the motions while their passion and engagement vanish.

Many physicians stay in their roles but have quietly “quit” in spirit—going through the motions while their passion and engagement vanish.

Let me confess something that might sound ridiculous coming from a doctor: for most of my career, I treated rest like a threat. A sign of weakness. A guilty pleasure to be earned only after I’d answered every email, seen every patient, signed off every note, and probably rotated the tires on someone else’s car just to be safe.

Is the motive behind resilience training to retain staff so that the system can continue to stay revenue-positive, or is it an investment in the ultimate resource of medicine, the human one?

I am just a physician who has spent 20+ years in the ER, had a few leadership roles along the way (which makes for a mildly robust LinkedIn profile), and nurtured some wisdom too. I think that is enough.

After burning out, I learned that chasing a perfect 50/50 work-life balance is unrealistic—especially in medicine. Instead, I now embrace asymmetric balance, where some days work wins, and others, life does.

Psychological safety, defined as a shared belief that the team is safe for interpersonal risk-taking, is a critical component of effective healthcare delivery. Yet, numerous reports and studies indicate that a lack of psychological safety persists in many healthcare settings, leading to adverse outcomes for both patients and providers.

In this article, Part 2, I concede that there are some excellent principles differentiating ineffective from effective physician resilience programs. We hope that colleagues and medical leaders designing such programs will find the guidance useful, and further grasp the nettle of addressing the root causes of physician burnout.

Resilience programs, springing up like mushrooms, are a sticking plaster to avoid dealing with the fungating tumor underneath. We have to talk openly about the demands of modern medicine and how these are hurting the healers we need the most.

Practicing medicine is making us physicians sick. Physicians in the US have some of the highest burnout, mental illness, addiction, and suicide rates in the world. Medical student and physician burnout and suicide are a “silent epidemic”.

Modern medicine is no stranger to the toxic trio of burnout, stress, and dissatisfaction, and perfectionism plays the role of the puppet master. It’s time to swap the scalpel for a mirror and reflect. Bowlby’s framework challenges physicians to redefine excellence, shifting from unattainable perfection to a sustainable “good enough” approach.

My biggest fear in medicine is messing up. Inevitably, it happens. And while we rightly are trained to reflect, detect and learn from errors, improve practice, and ultimately save lives, the flip side – the cost of excessive perfectionism – can be very high, especially on physician well-being.

Behind the crisp white coats and stethoscopes, there lies a silent majority—physicians who are silently suffering from the immense pressures of their profession — and barriers to help.

In Part 2, guest writer Dr Bryce Bowers has to move from losing a young patient under tragic circumstances onto another young patient without a moment to breathe.

“Trauma 1!” I heard them yell. “Let’s go! Let’s go!”
I stood. Frozen. Trying to process all that was going on.
Then I felt a large palm on the upper part of my back.
“Come on, kid. It’s your time to shine”.

The demanding nature of modern medicine places physicians under significant stress and strain, prompting a growing interest in the benefits of therapy to help them navigate the complexities of their profession. Engaging in proactive therapy can offer physicians a unique opportunity to enhance their insight, manage stress, and foster emotional well-being. However, like any intervention, it comes with its own set of advantages and disadvantages.

“Physician heal thyself,” says the aphorism. By extension, we could also say, “Physician know thyself”. Understanding one’s priorities is a crucial aspect of personal development. Here are five self-help exercises, including the obituary/eulogy exercise, to help individuals gain clarity on their priorities:

So the new year is near, and physicians everywhere are planning to make 2024 an even better one. Our intentions may be to engage in more self-care, develop a better LIFE-work-balance, and learn about ourselves in an “examined life”. In this context, the debate between therapy and coaching for physicians takes center stage, raising important questions about the most suitable approach for addressing the unique challenges faced by medical professionals.

As a trained psychiatrist, workaholic, depressive, and (formerly) excellent clinician, I’ve come to the following maxim with apologies to REM: “Everybody needs a little therapy (sometimes)”. As the year winds down and the nights draw in, we are taking time to reflect on 2023. Over the next weeks over the Holidays and after we ring in the new year, Physicians Anonymous will be publishing a series on self-examination.

We’ve achieved a TON in 2023, especially as we are self-funded and run by volunteers. So from 2024- HOW do we reach the suffering physician? How do we let our colleagues know that there is a safe place where they can be human first, healer second? Where they will not be judged, but they will be heard and loved. Where we can laugh and cry together bonded by the commonality of being wounded healers.

Unlike overt resignations, quiet quitting manifests as a subtle withdrawal, marked by disengagement and diminished job satisfaction. To effectively address this issue, it is imperative to delve into the scale of the problem, understand the causes behind this quiet exodus, and propose actionable solutions tailored to mitigate its impact.

As I sit down to reflect on my decision to quit a toxic hospital workplace, I’m overwhelmed by a mix of emotions – relief, anger, and sadness. Leaving a career I had worked so hard for, after just three years as an attending physician, was not an easy choice.