Understanding the Crisis, Reclaiming Your Options, and Aligning Wealth with Wellness
TL;DR — Key Takeaways
Physician burnout isn't about weak resilience—ours or yours. It's a structural crisis driven by EHR overload, insurance bureaucracy, and corporate medicine. But burnout is also a money problem: financial stress and "golden handcuffs" trap us in unsustainable jobs. Aligning your money, work design, and wellness creates real options.
Key takeaways:
- What burnout is: A triad of emotional exhaustion, depersonalization, and reduced sense of accomplishment—affecting nearly half of all U.S. physicians.
- The systemic drivers: "Pajama time" (after-hours EHR work), inbox overload from patient portals, prior authorization battles, AI denial bots, and private equity's erosion of autonomy.
- The Wealth & Wellness connection: For many of us, money is a major stressor—right up there with admin overload. High debt and lifestyle creep create "golden handcuffs" that prevent career changes and trap us in toxic environments.
- The 0.8 FTE solution: Working 80% time with a 20% pay cut can extend career longevity by years—and may actually yield more lifetime wealth than burning out at full-time in a decade.
- Exit ramps are wellness tools: Locums, nonclinical pivots, financial independence (FI) buffers, and having a "Plan B" reduce the feeling of being trapped and lower cortisol even if you never use them.
- Next steps by severity: This article ends with a practical roadmap—whether you're in early burnout (focus on schedule boundaries and FI foundations) or severe burnout (prioritize mental health support and exit planning first, optimization later).
I didn't set out to reinvent my career. I trained as an OB/GYN, delivered babies, worked long shifts, and—like so many of us—found myself caught in a system that felt increasingly at odds with why I went into medicine in the first place.
The breaking point wasn't a single event. It was the accumulation: the 24-hour call schedule that fractured my sleep—the night before call when I couldn't settle, the sleepless night on call, and the wired, restless night after when my body refused to come down. Add an inbox that never reached zero and the feeling that I was practicing defensive medicine rather than compassionate care, and something had to give.
"For years, I told myself I just needed to be tougher and sleep more. It wasn't until I looked honestly at my money and my schedule that I realized the system—not my resilience—was the problem."
When I finally stepped back, I realized the exhaustion wasn't just physical—it was moral. And the financial golden handcuffs made leaving feel impossible. Eventually, I found a different path: a redesigned schedule, deliberate financial planning that gave me breathing room, and the realization that career redesign wasn't failure—it was survival.
My story isn't unique. It's the story playing out in hospitals, clinics, and EDs across the country. If you're reading this, chances are some part of it feels familiar.
This article is my attempt to explore physician burnout not as a personal failing, but as a systemic crisis—and to offer a roadmap for those of you who want to reclaim both your practice and your life.
Physician Burnout at a Glance
If you feel like burnout has become the norm rather than the exception, you're not imagining it. Recent national data released in 2025 show that burnout has improved but remains pervasive. In AMA organizational surveys, 43.2% of U.S. physicians reported at least one symptom of burnout in 2024, down from 48.2% in 2023 and 53% in 2022. Medscape's 2025 Physician Mental Health & Well-Being report similarly found that 47% of doctors describe themselves as burned out, and about one in four report depression—still worse than the pre-pandemic baseline.
This isn't just a personal wellness issue. In an AMA comparison study released in 2025, about 40% of physicians met criteria for burnout on a brief screen, compared with about 25% of other U.S. workers, even after adjusting for age and work hours. And modeling published in Annals of Internal Medicine estimates that burnout costs the U.S. healthcare system roughly $4.6 billion each year, with an individual replacement cost of $500,000–$1 million per physician when turnover and lost clinical capacity are included.
But behind the statistics are real physicians—people like you and me: residents finishing notes at 11 PM, attendings who dread opening their patient portal on days off, and experienced clinicians who've started researching real estate investing because they can't imagine doing this for 20 more years.
When you look at the data, it's pretty sobering. Burnout isn't a phase or a personal failing. It's a predictable response to a broken system.
Burnout isn't a phase or a personal failing. It's a predictable response to a broken system.
What Is Physician Burnout—and What It's Not
Physician burnout is classically defined as a syndrome with three core dimensions:
- Emotional exhaustion: Feeling drained, depleted, and unable to recover between shifts.
- Depersonalization (or cynicism): Treating patients as cases rather than people, losing empathy, feeling emotionally detached from your work.
- Reduced sense of personal accomplishment: Doubting your competence, feeling ineffective, questioning whether you're making a difference.
This definition comes from the Maslach Burnout Inventory (MBI), the most widely used assessment tool in burnout research. I remember when I first saw these criteria and thought, "Well, that's just... Tuesday."
Burnout vs. Normal Fatigue
It's important to distinguish burnout from ordinary tiredness. Fatigue improves with rest. Burnout doesn't. You can take a week off, sleep well, and still wake up Monday morning with that same hollow dread. Burnout is chronic, pervasive, and structural—it's woven into the conditions of your work, not just your energy levels.
I know because I tried the "just rest more" approach for years. It didn't work.
Burnout vs. Moral Injury
There's a growing movement to reframe physician burnout as moral injury—the psychological distress that results from actions (or lack of action) that violate your core values and ethics.
Here's the difference: Burnout suggests your battery is empty. Moral injury recognizes that the system is forcing you to act in ways that conflict with your conscience.
If burnout is exhaustion, moral injury is betrayal—of yourself, your training, and your patients.
If burnout is exhaustion, moral injury is betrayal—of yourself, your training, and your patients. And for many of us, moral injury is a more accurate description of what we're experiencing.
Large national datasets also show that burnout isn't distributed equally. A 2025 analysis in JAMA Network Open found that physicians had 63% higher odds of burnout than other U.S. workers, even after accounting for age, relationship status, and work hours. Female physicians were more likely to be burned out than their male peers and had about one-third lower odds of being satisfied with their work–life integration. As a woman in medicine, that finding didn't surprise me—but it did validate what so many of my colleagues have been saying for years.
Burnout Isn't Distributed Equally
How Physician Burnout Shows Up in Your Daily Life
Burnout doesn't announce itself with a diagnosis. It accumulates quietly, until one day you realize the job you loved has become the thing you dread most.
Signs and Symptoms of Physician Burnout
Burnout manifests in multiple domains. You might notice:
Emotional and cognitive signs:
- Chronic exhaustion that doesn't improve with sleep or time off
- Irritability, short temper, or feeling emotionally numb
- Difficulty concentrating or making decisions
- Persistent sense of dread about going to work
- Loss of satisfaction or meaning in patient care
Behavioral signs:
- Avoiding patient interactions or cutting them short
- Increased reliance on alcohol, substances, or other coping mechanisms
- Social withdrawal from colleagues, friends, or family
- Procrastination on documentation or administrative tasks, leading to a growing backlog
Physical signs:
- Headaches, GI disturbances, muscle tension
- Sleep disturbances (insomnia or hypersomnia)
- Increased susceptibility to illness
For me, it wasn't so much charting—it was call. I almost never slept well the night before a 24-hour shift, barely slept on call, and then I'd lie awake the night after, too wired to come down. It felt like I lost three nights for every one call shift.
Recent national wellbeing data underscore how intense this can feel. In a 2025 Physicians Foundation survey, 54% of physicians said they often feel burned out, 55% reported debilitating stress, and 34% said they had felt hopeless or without purpose in the past year. Nearly half reported withdrawing from family, friends, or coworkers because of how they were feeling.
If those numbers sound uncomfortably familiar, you're not broken—and you're definitely not alone.
The Invisible Workload: "Pajama Time" and Inbox Overload
One of the most insidious aspects of modern physician burnout is the invisible workload—the hours spent outside of scheduled clinical time.
Primary care physicians, for example, now spend an average of 6.2 minutes per patient encounter on after-hours EHR work, often referred to as "pajama time." That's time spent charting at home, in bed, on weekends—time that used to belong to you and your family.
For many physicians, the laptop lives on the kitchen table. They tell themselves they'll just finish "a few notes" after dinner, and suddenly it's 11 PM. Their families get the tired, depleted version of them—if they get them at all.
The patient portal, designed to improve access and communication, has created a 24/7 on-call reality. Messages have increased by 157% since 2020 in some systems, and unlike a phone call, portal messages feel obligatory, never-ending, and often uncompensated.
This is the "chart at home" trap. As one physician put it: "I refuse to bring my laptop home. My co-residents are shocked I don't have remote access. If I did, I'd never stop working."
Vacation Guilt and the Myth of Recovery
Even when we take time off, burnout follows. Many of us report spending the first morning of vacation clearing our inbox so we won't drown when we return.
A recent study of more than 3,000 U.S. physicians found that most took three weeks of vacation or less per year, and about 70% worked while on vacation. Physicians who took fewer days off and did more patient-related work on vacation had higher burnout scores, while those with more time off and true inbox coverage had lower burnout. In other words, if your "vacation" is just working from a different zip code, it doesn't help.
If you've ever taken PTO and felt guilty, anxious, or spent hours catching up remotely, you've experienced this paradox: time off doesn't feel like time off when the system is designed to make absence punishing.
Systemic Drivers: Why Your Burnout Is Not Just About "Resilience"
For years, the healthcare industry's answer to burnout has been resilience training: yoga classes, mindfulness apps, wellness retreats. The implication? If you're burned out, you need to try harder to cope.
But here's what I've come to believe: resilience training is gaslighting when the coal mine is toxic. If the structural conditions are breaking physicians, teaching us deep breathing is not the solution.
Let me walk you through the real systemic drivers of physician burnout—the forces outside your control that are creating this crisis.
EHRs and Administrative Burden
Electronic health records were supposed to make documentation easier. Instead, they've turned us into data entry clerks.
The average physician spends nearly as much time on EHR tasks as they do with patients. And much of that time is uncompensated—the "pajama time" that happens after clinic hours.
This isn't just annoying; it's a fundamental reordering of what it means to practice medicine. One resident described it this way: "The number of people managing me has tripled, but I can't get a single medical assistant to help room patients. I am a $300/hour data entry clerk."
I've felt that frustration. And I've watched it break colleagues who had so much more to give.
Prior Authorization: The Modern Sisyphean Task
Recent AMA survey data show that more than nine in ten physicians say prior authorization delays access to necessary care (94%), 93% say it has a negative impact on patient outcomes, and 89% report that it somewhat or significantly increases their burnout.
Prior auth isn't just bureaucratic inconvenience—it's a daily moral injury. You know what your patient needs. The insurance company disagrees. You spend hours on peer-to-peer calls, filling out forms, appealing denials. And even when you win, you've lost hours you could have spent with patients.
The Rise of "Bad AI": Denial Bots and Algorithmic Denials
On the positive side, a multicenter study published in 2025 found that after just 30 days with an ambient AI scribe, the proportion of clinicians reporting burnout fell from 51.9% to 38.8%, corresponding to roughly 74% lower odds of burnout for those using the tool. That's genuinely encouraging.
But there's a darker side to AI in healthcare. Sixty-one percent of physicians now fear that insurers are using unregulated AI in ways that increase prior authorization denials. These denial algorithms don't consider clinical nuance—they follow rules designed to minimize payout.
The result? More administrative combat, more appeals, more moral injury.
So while some AI helps, other AI hurts. The technology isn't neutral—it depends on who's deploying it and why.
Patient Portal Overload and the "Always On" Problem
Patient portals were designed to improve access and empower patients. And in many ways, they do. But they've also created an expectation of 24/7 availability—and a tidal wave of uncompensated work for physicians.
Messages that used to be phone calls (often triaged by staff) are now direct-to-physician portal messages. And because they're written, they feel obligatory. The result is a never-ending stream of requests, questions, and concerns that follow you home, into weekends, into vacation.
This is the "patient paradox": patient-centered care, taken to its extreme, is destroying the provider. We've normalized physician availability without corresponding boundaries or compensation.
Private Equity, Corporate Medicine, and Loss of Autonomy
Private equity (PE) firms have increasingly acquired medical practices, particularly in emergency medicine, anesthesiology, dermatology, and other high-margin specialties. The promise? Better management, economies of scale, financial stability.
The reality? Studies show PE-owned practices have higher physician turnover, lower autonomy, and more aggressive productivity metrics. When you lose control over your schedule, your patient panel, and your clinical decision-making, burnout follows.
One physician summarized it: "It's not just being tired. It's the feeling that I am violating my oath because the system forces me to discharge patients who aren't ready or deny care due to insurance."
That's not burnout. That's moral injury. And it's structural.
Structural Fixes Matter
A 2025 JAMA Network Open study of more than 6,000 physicians in seven countries found that hospitals with better nurse staffing and work environments had about a 10% lower odds of high physician burnout and roughly 20–25% lower odds of physicians planning to leave their hospital for every modest improvement in nurse work environment scores. Investing in nurses turns out to be a physician-burnout intervention, too. This is one of those findings that gives me hope—because it means systemic solutions actually work.
The Money Side of Burnout: The "Golden Handcuffs" of Medicine
Here's what most burnout articles won't tell you: for many of us, money is a major stressor—right up there with admin overload, even for high earners.
You might make $250,000 or $400,000 a year. But if you're carrying $300,000 in student loans, a $700,000 mortgage, two car payments, private school tuition, and a lifestyle that requires every dollar you earn, you're not financially free. You're trapped.
This is the "golden handcuffs" phenomenon: high income combined with high debt and high lifestyle creates a prison. You want to leave your toxic job, cut back to part-time, or take a sabbatical—but you can't. The money won't allow it.
For a long time, our mortgage and loans were the main reason I stayed in a job that no longer felt sustainable. I suspect I'm not alone in that.
That tension between wanting change and feeling financially trapped is one reason why, in Medscape's 2025 report, nearly two-thirds of physicians said they would accept a pay cut for better work–life balance. The desire is there. The financial runway often isn't.
How Financial Stress Amplifies Burnout
Financial stress and burnout reinforce each other in a vicious cycle. Here's what I see in my peers:
- You're burned out, so you cope with "retail therapy"—luxury cars, expensive vacations, material comforts that numb the pain.
- You increase your fixed expenses (bigger house, private schools, lifestyle creep), which locks you into high-income work.
- You can't afford to reduce hours, change jobs, or negotiate boundaries—because your financial obligations demand full-time (or more) income.
- The lack of optionality increases stress, which deepens burnout, which leads to more reactive spending.
That's the golden handcuffs in stark terms. And it's why I believe we can't talk about burnout without talking about money.
Why Financial Independence (FI) Is a Burnout Intervention
Financial independence doesn't mean you have to retire at 40. It means you have options.
In my conversations with colleagues, I've noticed that physicians who have even 2–3 years of living expenses saved feel more autonomous and less burned out—not because they quit, but because they know they could. That psychological buffer matters. It's the difference between "I have to stay" and "I'm choosing to stay."
In the context of burnout, FI isn't just wealth-building. It's a clinical intervention.
This is sometimes called "F-U Money"—the financial cushion that allows you to walk away from a bad contract, push back on unethical policies, or redesign your career without catastrophic financial consequences.
In the context of burnout, FI isn't just wealth-building. It's a clinical intervention. It reduces moral injury by restoring agency.
The Physician Living Wealth & Wellness Journey
At Physician Living, we talk about the Wealth & Wellness Journey in five stages:
- Foundations: Build an emergency fund, eliminate high-interest debt, establish basic financial infrastructure.
- Growth: Pay down student loans strategically, invest for the long term, increase income and savings rate.
- Balance: Align spending with values, protect wealth through insurance and estate planning, maintain equilibrium between earning and living.
- Lifestyle: Optimize work schedule, pursue geographic or career flexibility, design a life that doesn't require burnout.
- Legacy: Transition toward part-time work, wealth transfer, or nonclinical pursuits; define what you want to leave behind.
The key insight? You can't skip Foundations and Growth if you want Lifestyle and Legacy. Financial stress will sabotage every wellness intervention until you address it. I learned this the hard way.
From Crisis to Choice: Designing a More Sustainable Schedule
One of the most powerful—and underutilized—burnout interventions is schedule redesign.
Most of us assume the options are binary: full-time (burned out) or quit (financially catastrophic). But there's a middle path that's increasingly common: the 0.8 FTE solution.
The 0.8 FTE Solution: Is Part-Time the New Full-Time?
Working 0.8 FTE (four days a week instead of five) typically means a 20% pay cut. But it can result in a 100% increase in career longevity.
Here's the math: If you burn out at 1.0 FTE in 10 years, you've worked 10 years. If you work 0.8 FTE for 30 years, you've worked 24 full-time-equivalent years—and you're still practicing. You're happier, healthier, and you've actually worked more over your career.
This aligns with what physicians say they want. In Medscape's 2025 Physician Mental Health & Well-Being report, nearly two-thirds of doctors said they would accept a pay cut in exchange for better work–life balance.
Part of why I eventually changed my schedule was admitting how much those 24-hour calls were costing me. I could pretend I was "fine," but my body and my family were telling a different story. Redesigning my work felt terrifying on paper. In reality, it's one of the reasons I'm still in medicine—and still able to write articles like this one.
And when you factor in the replacement cost of burnout ($500,000–$1 million per physician), the long-term wealth calculation often favors sustainability over maximizing short-term income.
In the UK, where physician burnout has also reached crisis levels, a recent trend has emerged: just 1 in 13 early-career GPs now work full-time. The "new full-time" is becoming 0.8 FTE, simply to preserve longevity in the profession.
Negotiating Schedule Flexibility
If you're considering a schedule redesign, here are some practical steps that might help:
- Know your worth. In a physician shortage, you have more leverage than you think.
- Frame it as retention. Employers save money by keeping you at 0.8 FTE rather than losing you entirely (and paying $500K+ to replace you).
- Start the conversation early. Don't wait until you're on the edge of quitting. Proactive schedule redesign is easier to negotiate than crisis intervention.
- Consider locums. Locum tenens work offers schedule control, geographic flexibility, and often higher hourly rates. Schedule control is a top reason physicians choose locums, cited by about half or more of respondents in industry surveys.
Protecting Boundaries in the Age of EHR and Patient Portals
Schedule redesign isn't just about days worked—it's also about protecting your time within those days.
Some boundaries you might find helpful:
- No remote EHR access at home. If you don't have it, you can't use it. Many residents and attendings report this as a game-changer.
- Designated inbox time. Rather than responding to portal messages throughout the day (and evening), set specific windows for message management.
- Paid portal time. Some practices are beginning to compensate physicians for after-hours portal work. If yours doesn't, advocate for it.
- "Pajama time" limits. If you're regularly charting after hours, that's a workflow problem, not a personal failing. Work with your EHR team or practice manager to streamline documentation during clinical time.
The goal isn't perfection. It's sustainable.
Getting Help: Treatment, Support, and Community
A NOTE ON THIS SECTION
This article is for educational purposes only and is not a substitute for personal medical or mental health advice. If you're struggling, please seek care from a qualified professional who can evaluate your specific situation.
Burnout is not something you can simply "push through." It requires intervention—and often, support. I wish I'd learned that earlier.
When to Seek Professional Help
If you're experiencing any of the following, it's time to talk to a mental health professional:
- Persistent thoughts of self-harm or suicide
- Substance use as a primary coping mechanism
- Inability to function at work or home
- Panic attacks, severe anxiety, or depressive symptoms that don't improve with rest
- Feeling emotionally numb or detached most of the time
Crisis resources: If you're in crisis, call or text 988 (Suicide and Crisis Lifeline) in the U.S. You can also reach the Physician Support Line at 1-888-409-0141 (confidential peer support for physicians and medical students).
Therapy, Coaching, and Peer Support
Many burned-out physicians benefit from:
- Psychotherapy (CBT, ACT): Cognitive-behavioral therapy and acceptance and commitment therapy have strong evidence for burnout and moral injury.
- Physician-specific coaching: Coaches who specialize in physician wellness understand the unique pressures of medicine and can help you navigate career transitions.
- Peer support groups: Talking to other physicians who've experienced burnout reduces isolation and provides practical strategies.
Stigma is still a major barrier—and that frustrates me. In the Physicians Foundation's 2025 wellbeing survey, 73% of physicians said stigma around seeking mental health care persists, and 38% said they or a colleague had avoided getting help because they were worried about how it might affect their license or credentialing.
We take care of everyone else. We deserve to take care of ourselves too.
Institutional vs. Individual Interventions
Here's a hard truth: wellness programs offered by hospitals—yoga, mindfulness apps, resilience training—are often viewed by physicians as "corporate gaslighting." They put the burden of change on the individual rather than addressing the structural problems.
That doesn't mean mindfulness isn't helpful. It means it's not sufficient.
Real solutions require systemic change: reasonable workloads, administrative support, fair compensation for after-hours work, and leadership that prioritizes physician well-being over productivity metrics.
If your institution offers wellness resources, by all means, use them. But don't mistake them for a cure. They're a band-aid on a structural wound.
Exit Ramps and Career Pivots: Why an Exit Strategy Is a Wellness Tool
Here's something counterintuitive I've learned: having an exit strategy reduces burnout, even if you never use it.
Knowing you have options—whether it's a nonclinical career, a side income stream, or FI that allows you to walk away—lowers the psychological stakes. You stop feeling trapped. And when you stop feeling trapped, staying becomes a choice rather than a sentence.
Nonclinical Careers and Pivots
Many of us assume that leaving clinical medicine means leaving medicine entirely. Not true. There are dozens of nonclinical and hybrid roles that leverage your training without the patient-care grind:
- Hospital administration and leadership
- Medical writing, editing, consulting
- Pharmaceutical or medical device companies (clinical development, medical affairs, regulatory)
- Healthcare technology and AI companies (clinical advisor roles)
- Telemedicine (often more flexible, lower administrative burden)
- Locum tenens (clinical work with schedule control and geographic flexibility)
- Teaching, research, public health
- Legal consulting, expert witness work
The point isn't that everyone should leave clinical practice. The point is that knowing you could changes how you feel about staying.
Geographic Arbitrage and Locums
Locums work offers a unique combination: clinical medicine with schedule autonomy. Many locums physicians report higher satisfaction because they can control when and where they work, avoid hospital politics, and often earn higher hourly rates.
Geographic arbitrage—living in a lower cost-of-living area and working periodic high-paying locums contracts—is a strategy some physicians use to achieve FI faster while maintaining flexibility.
When It's Time to Leave: Dr. Shola Ezeokoli's Red Flags
"Remember, burnout is not your fault. However, it’s up to you to protect your physical and mental health from its ravages. In larger organizations, as an employed physician, you may not always be able to push for the systemic changes needed to alleviate your burnout. Still, try, document your efforts, and avoid complacency. Sometimes, it’s necessary to leave an organization for greener pastures. Here are some signs that it may be time to move on:
- You experience panic attacks, depression, or anxiety.
- Your supervisors or managers are unresponsive to your concerns.
- Instead of addressing your issues, they suggest ‘doing yoga’ or attending ‘resilience trainings.’
- Patient safety or your ethics are being compromised.
- You feel you’re being 'managed out'—subtly encouraged to leave rather than being formally terminated."
– Dr. Shola Ezeokoli, MD, Founder of Balance with Dr. Shola LLC
These aren't signs of personal failure. They're signs that the system is failing you.
The FI Buffer: Why "Enough" Is the Goal
You don't need $5 million to have options. You need enough.
For many physicians, "enough" looks like:
- 6–12 months of living expenses (emergency fund)
- Student loans under control or eliminated
- A reasonable savings rate (15–25% of gross income)
- No consumer debt
Once you have that foundation, you can start building toward 2–3 years of expenses saved (early FI buffer) or full financial independence (25x annual expenses, per the 4% rule).
The goal isn't to retire. The goal is to not be trapped.
Practical Next Steps: Your Wealth & Wellness Roadmap Out of Burnout
Burnout recovery isn't linear, and it's not one-size-fits-all. Where you start depends on where you are.
If You're in Early Burnout (Tired, Cynical, but Still Functioning)
Focus on prevention and boundaries:
- Establish schedule boundaries. Start with small wins: no charting after 8 PM, one admin-free day per week, designated inbox time. One of my first honest questions to myself was: "How many 24-hour calls a month can I actually tolerate and still be okay?" That answer was lower than what I was doing.
- Build your FI foundation. Open a high-yield savings account, automate savings, track spending for one month to see where your money is going.
- Invest in relationships. Burnout thrives in isolation. Reconnect with friends, family, colleagues outside of work.
- Explore schedule flexibility. If 0.8 FTE or a different work model is feasible, start the conversation with your employer or contract negotiation.
- Use PTO intentionally. Take real time off. Leave the laptop at home. If you can't, that's data—your system is unsustainable.
If You're in Moderate Burnout (Struggling, Considering Leaving, Losing Motivation)
Focus on triage and options-building:
- Get support. Talk to a therapist, coach, or peer group. Burnout is not something you fix alone.
- Audit your finances. Calculate your "F-U number"—how much you'd need saved to take a 6-month sabbatical or switch to part-time. You might be closer than you think.
- Research career pivots. Even if you're not ready to leave, knowing what else you could do reduces the feeling of being trapped.
- Negotiate or exit. If you've raised concerns with leadership and nothing has changed, it may be time to consider a new job or organization.
- Protect your health. Sleep, exercise, nutrition aren't luxuries. They're minimum requirements for surviving burnout.
If You're in Severe Burnout (Crisis Mode, Can't Continue, Suicidal Ideation)
Focus on safety and stabilization:
- Get immediate help. Call 988 (Suicide and Crisis Lifeline) or the Physician Support Line (1-888-409-0141). This is not optional.
- Take medical leave if needed. Many of us resist this because of stigma or fear. But you can't recover while drowning.
- Simplify everything. This is not the time to optimize your investment portfolio or negotiate contracts. Stabilize first.
- Lean on your support network. Family, friends, colleagues—let people help you.
- Plan your exit. If the job is actively harming you, leaving is not failure. It's survival. Work with a financial planner or career coach to create a 3-month, 6-month, and 12-month exit plan.
The key principle: Triage first. Optimize later.
Conclusion: Burnout Is Not Your Fault, But Recovery Is Your Responsibility
Physician burnout is a systemic crisis. It's the result of EHR overload, insurance bureaucracy, corporate consolidation, and a healthcare system that prioritizes revenue over people—patients and physicians alike.
But here's what I've come to believe: while burnout isn't your fault, recovery is your responsibility.
I wish I could say the system is going to fix this for us, but so far it hasn't. What finally helped me was realizing I had to start designing a more sustainable career for myself—and that I had more options than I thought.
That might mean:
- Building FI so you have options
- Redesigning your schedule to 0.8 FTE
- Setting boundaries around EHR and inbox time
- Leaving a toxic organization
- Pivoting to nonclinical work or locums
- Taking a sabbatical to recover
The good news? You're not alone. Thousands of physicians are navigating this same path. And while the system is broken, you don't have to be.
