Here’s what can we create when we question what is possible
I keenly remember the day one of our partners said he was quitting as soon as possible — no new job lined up, no plan. His dad had died just days before, and he said he simply didn’t know how to keep going. He needed a break, and this was his way out.
For those in private practice, this story likely hits a nerve. Life happens. Physicians hurt and struggle, and often that’s exactly when we quit. The system feels so big and the pain so great that quitting seems like the only way out.
I think back to this story now whenever we develop new scheduling systems, structures, and strategies. As a leader, a physician, and a human, one of my core values is recognizing the unique contributions and struggles we each carry. Paradoxically, I also hold the belief that we are all fundamentally human, with the same universal core needs.
“I wanted what everyone wants. To be me, full time.” —Phil Jackson
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As the physician shortage worsens, finding ways to meet people where they are in their messy lives isn’t just nice to have — it’s necessary. We spend so much time thinking about recruitment and so little thinking about retention. I suspect that’s because retention is messy. It runs against our systems, our processes, and our ideas of how things should work. And that’s the crux of leadership: finding space in the paradoxes, and continuously asking what our values are — and whether we’re actually moving toward them.
For years, medicine has asked us to sacrifice individuality on the altar of dedication and professionalism. Now, as you read those two words back, notice how they land for you — as a patient, a physician, a human. We want our physicians to be dedicated and professional, right? Of course we do. But what does that actually mean?
When a physician is struggling because their parent died, because they just had a baby, or because they’re facing a health challenge — does asking for help negate their dedication or professionalism? Too often, our systems lead us to protect the idea that “the system works” rather than ask the harder question: what does sustainable dedication and professionalism actually look like? And sometimes quitting is the best option for the time, and we can only know that when we ask questions first.
As the physician shortage worsens, finding ways to meet people where they are in their messy lives isn’t just nice to have — it’s necessary.
I often ask questions like:
-Do we have a retention strategy and how is it working? How would we know if it was successful?
-Does our leadership have retention as a key tracked and funded metric?
-What reasons or circumstances underlie the reasons people give for quitting and how can we actively ask about them before they quit?
-Is there a way to incentivize pain points like call so that it can be adjusted with equity in mind?
-How do we create solutions for common life challenges and make them accessible and visible?
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As a physician leader, this is the heart of my passion for making medicine work — for physicians, for patients, for humans. My hope is that by asking brave questions, testing real solutions, and pushing for better ways to meet each other as we are, we can build something different. In public health, we have a saying: every system is perfectly designed to get the results it gets.
I want to build systems that make room for physicians, patients, and humans in their messy reality. I want to acknowledge the challenges that come with simply being human. And I want physicians and patients alike to discover that quitting isn’t the only path to feeling better.
Who wants to join me? And what would that look like for you?
