It is time to move past the pizza party mentality. While burnout has become the ubiquitous buzzword in healthcare leadership circles, the operational reality we are facing is a well-being debt. This debt is not just a personal grievance; it is a systemic deficit that threatens institutional stability, patient safety, and physician retention.
Traditional Employee Assistance Programs (EAPs) are inherently reactive. High-performance medical environments create unique psychological friction — such as imposter syndrome and perfectionism — that standard support models simply fail to address. We must shift our thesis: Professional excellence should not require personal suffering. We are moving from an on-demand model to one of proactive integration, where mental health is treated as a professional standard of practice.
In my work coaching clinicians and consulting with organizations, I have observed why traditional "opt-in" wellness programs often see such low utilization. To access any form of healing, there must be psychological safety. Most physicians feel extremely uncomfortable unpacking work-induced moral injury and mental health concerns with a peer or colleague they might run into in the hospital hallways. As an independently contracted physician, my clients feel safer sharing their concerns, knowing I am not a direct employee and do not have that obvious conflict of interest.
Furthermore, we cannot talk about burnout while ignoring the elephant in the room: moral injury. Too often, wellness interventions are reduced to mandatory modules completed on a physician's own time, rather than addressing how the healthcare system can be optimized to remove the crushing burden on clinicians. This structure makes participants feel gaslit, as if their distress is self-created and isolated from the system around them.
Physicians are extreme high achievers; programs must match their unique needs, addressing self-advocacy, confidence, perfectionism, and leadership — rather than feeling infantilizing. Most of what physicians endure is unwitnessed. When they access traditional resources led by facilitators who are not physicians, they do not feel seen. Having gone through the personal journey of medical education, high performance, and moral injury myself, I know that relatability is the key to creating an environment conducive to growth.
The very traits that get students into medical school often become liabilities for an organization’s patient safety and team cohesion. The Paradox of Perfectionism tells us that while modern society celebrates perfection, research identifies it as a transdiagnostic risk factor for anxiety, depression, burnout, and even suicidality.
I challenge our leaders to adopt a different term: "Excellencism." As an excellencist, you can pursue high standards and be the best while simultaneously leaving room for your humanity. When we expect clinicians to produce perfection 100% of the time, we dehumanize them. Humans are fallible. When we dehumanize our clinicians, we unknowingly dehumanize the patients they care for.
Physicians face socially prescribed perfectionism — a toxic socio-cultural pressure to be perfect from both within the culture of medicine and society at large. I delve deeper into this journey of unmasking these pressures in my TEDx talk, “Perfectionism Has A Solution – It’s Not What You Think.”
It is critical to remember that physicians, too, are human. Denying basic physiologic needs like sleep and rest will eventually catch up. Studies clearly show that physician decision-making is impaired by sleep deprivation and that empathy becomes blunted. Operating under the guise of being "superhuman" is not only inefficient in the long run but irresponsibly dangerous.
To build resilience in environments where "routine" is non-existent, GME leaders must prioritize a return to human physiology. When I was going through my HeartMath Building Personal Resilience program, the obvious was spelled out louder and I learned that when we are tired, we are simply not as resilient. Instead of thrusting meditation on exhausted residents, we must offer opportunities for real rest minus the shame culture. Rest will create the space for resilience.
Looking at physicians as whole human beings is critical. This includes identifying "quiet" levers of attrition like financial dread and relationship strain. Making $16–$20/hour as a PGY1, with six-figure medical school debt and years of delayed gratification, is the current unfortunate reality.
Some of my clients describe debt as a constant source of background stress while they navigate relocating to new cities, getting married, or welcoming children. We must offer whole-person support — including legal, financial, and social wellness — rather than just talk therapy.
The AMA is calling for confidential, low-barrier access, but policies and programs without supportive, visionary leaders will never amount to much. When I was a resident at Cleveland Clinic, I dealt with a serious health diagnosis and pregnancy simultaneously. My program director, Dr. Abby Spencer, created an environment of protected time and gave me the firm knowledge that "it was OK to access these resources." She explicitly and kindly removed the internal shame I felt.
If I could change one systemic norm to ensure career longevity, it would be to normalize physician coaching. We should provide access to coaching for all medical trainees from medical school onwards. Studies have shown how helpful coaching is in increasing self-compassion and managing emotional exhaustion.
We must give this solution the respect it deserves. If you would not expect your star athlete to win without a coach, why are you expecting your physicians to?
My personal belief, after years as a physician coach and well-being consultant, is this: Physician Well-Being = Patient Well-Being = Thriving Communities.
When I witnessed my own primary care physician — the one who saved my life — burn out, become emotionally depleted, distant, and later leave practice, I felt abandoned. Our patients deserve to be cared for by humans who have been cared for. By addressing physician well-being, we can resuscitate and rehumanize medicine and the care we deliver.
Dr. Amna Shabbir is a fractional chief well-being officer, dual board-certified physician, TEDx speaker, and top podcast host, with advanced training in integrative wellness, performance, and leadership development. She speaks and consults on workplace well-being, perfectionism, and curating sustainable success as a high achiever.