By now, most of us are familiar with the term the "Great Resignation" -- the tidal wave of people quitting their jobs, in the U.S. and around the world, primarily in response to the coronavirus pandemic. Nearly one in five healthcare workers in the U.S. have left their jobs since February 2020.
The term "Great Resignation" was coined by organizational psychologist Anthony Klotz, PhD, MBA, an associate professor of management at May Business School at Texas A&M University. Klotz explained, "From organizational research, we know that when human beings come into contact with death and illness in their lives, it causes them to take a step back and ask existential questions like what gives me purpose and happiness in life, and does that match up with how I'm spending my [time] right now? So, in many cases, those reflections will lead to life pivots."
Healthcare is the second largest sector hit by the Great Resignation (food services is number one). As a result of the pandemic, approximately one-third of physicians, advanced practice providers, and nurses in the U.S. intend to reduce work hours in the next 12 months. One in five physicians and two in five nurses intend to leave their practice within 2 years. We used to say that healthcare costs are no longer sustainable. We can now drop the word "costs" and still be correct.
Perhaps the most disturbing trend of the Great Resignation is the long-term implications. In order for resignations to be filled -- especially doctors' jobs -- we should be encouraging our children to consider a career in medicine, along with other, more immediate measures aimed at boosting staffing levels.
Stimulating an interest in the field of medicine is a good long-term strategy to replenish healthcare workers who have quit their jobs -- an estimated 500,000+ since early 2020. Not uncommonly, one or both parents who are -- or were -- physicians plant the seed to become a doctor early in their children's lives. The seedlings are cultivated with loving care until they germinate into premedical students, accepted into medical school on their own merit or as "legacy" students. In either case, some individuals would not have become doctors if it weren't for encouragement from their parents and high praise lavished upon the medical profession.
However, in a time where burnout and exhaustion are widespread, many physicians debate whether or not they would advise their children to follow in their footsteps. Even Hippocrates was uncertain about the rewards of a career in medicine. "The life so short, the craft so long to learn," he famously said. The crux of the matter is often viewed in terms of a tradeoff between the time invested to become a doctor and the return on investment -- not only the financial return, but especially the personal gratification of practicing medicine.
A recent poll conducted by Doximity is quite revealing. Of approximately 12,000 physicians who responded to an online survey in January 2022, 60% said they would probably or definitely not want their children to work in medicine.
The most common reasons were those we've been reading about for the past decade: heavy caseloads, long hours, loss of autonomy, third party intrusions, and toxic workplace cultures. One family medicine physician even asked: "Why make them [our children] suffer what we are suffering in this horrible situation created by EHRs, insurers, burocrats (sic), and so on and so forth?"
To be sure, a vocal minority did advocate for the profession. "I would be so proud to see my children continuing in this noble profession," a telemedicine physician commented. A neurosurgeon incredulously asked, "What can be more satisfying than saving lives?" A geriatrician said, "It's a great joy for me to see the likes of [my daughter] and her friends entering our still sacred profession and I hold out hope that they can smooth the rough edges."
That sentiment was echoed by many physicians who said that medicine was a worthwhile profession, calling it a "privilege," but only if their children have the "passion" and "desire" to enter practice. That makes me wonder, how much influence do we actually have over our children's career choices? While we cannot decide their future, we can encourage an interest in science and the humanities, and introduce them to the field of medicine through career fairs and job shadowing. But at the end of the day, most children will follow their hearts and not our wishes or dreams.
Only one of my four adult children became a doctor; another is a physician assistant and another is a mental health counselor. The fourth is a poet and university instructor in creative writing -- far afield from medicine. I didn't try to steer any of them into medicine, although I've always believed it was a great profession and told them so. I still feel that way today.
I'm afraid, however, that not enough physicians share my conviction. The moniker the "Great Resignation" can also be applied to those among us who hesitate to speak proudly of our profession and promote medicine as an honorable career -- one worthy to serve the suffering -- and who fail to inspire promising students to choose medicine as a career. I'm heartened by surveys that disagree with Doximity -- surveys that have found that most physicians would still choose to go into medicine if they could do it over again.
The story I've repeatedly told my children (and others) comes from the "Field of Dreams," the scene where Ray Kinsella tries to persuade Dr. Archibald ("Moonlight") Graham to travel back in time to experience a once in a lifetime opportunity: a chance to bat in the major leagues. Dr. Graham refuses to go with Ray, and Ray exclaims in amazement: "It would kill some men to get so close to their dream and not touch it. God, they'd consider it a tragedy." To which Dr. Graham replies, "Son, if I'd only gotten to be a doctor for 5 minutes...now that would have been a tragedy."
Arthur Lazarus, MD, MBA, is a member of the Physician Leadership Journal editorial board, a 2021-2022 Doximity Luminary Fellow, and an adjunct professor of psychiatry at the Lewis Katz School of Medicine at Temple University in Philadelphia.