If you ask a five-year-old what doctors do, they’ll say something adorable like,
“They help people feel better.” If you ask many doctors the same question at 2 a.m.
during their seventh admission and third EMR crash of the night, the answer is more
like, “I click boxes and apologize for the wait.”

The pain of doctoring today isn’t just about long hours or tough cases. It’s about a
profession built on compassion that’s trapped in a system obsessed with metrics,
volume, and documentation. Physician burnout, moral injury, and mental health
struggles are no longer background noisethey’re the soundtrack of modern medicine.
And while some trends are finally moving in the right direction, the crisis is far
from over.

Burnout is not a buzzword. It’s the new normal.

Before the pandemic, physician burnout was already high. Then COVID-19 poured gasoline
on a slow-burning fire. Surveys from major medical organizations in the United States
show that at the peak in 2021, roughly six in ten physicians reported at least one
symptom of burnoutemotional exhaustion, depersonalization, or a sense of reduced
accomplishment.

The good news: recent national data suggest burnout rates have started to fall,
dropping from that peak of around 60–63% down into the mid-40% range in 2023–2024.
That’s progress. The bad news: when nearly half of an entire profession feels
burned out, that’s not a success storythat’s a code orange.

Burnout isn’t just “being tired.” It’s a deep mismatch between values and reality.
Doctors went into medicine to listen, connect, diagnose, and heal. Instead, they
often find themselves battling:

• Relentless workload: Overbooked clinics, full waiting rooms, and endless call schedules.
• Staffing shortages: Fewer nurses, techs, and support staff mean doctors pick up the slack.
• Production pressure: RVUs, throughput, and “encounters per hour” instead of meaningful care.
• Administrative overload: Prior authorizations, quality dashboards, and forms that never end.

When half of your workforce is running on fumes, it’s not a “resilience problem.”
It’s a systems problem.

From burnout to moral injury: When good people feel forced to do bad work

Increasingly, doctors are arguing that what they’re experiencing isn’t simply
burnoutit’s moral injury. That term, borrowed from combat medicine,
describes the emotional and spiritual harm that happens when people are forced to act
in ways that violate their core values.

For physicians, moral injury can look like:

• Rushing through a complex visit in 10–15 minutes because the schedule is double-booked.
• Watching a patient bounce between pharmacies or insurers because of coverage rules.
• Being unable to admit someone who clearly needs a bed because the hospital is full.
• Spending more time documenting care than providing it.

The pain of doctoring is not just physical exhaustion. It’s what happens when the
story in your head“I’m here to help people”collides daily with a system that
treats healthcare more like a factory assembly line than a healing profession.

The EMR: Tool, tormentor, or both?

No modern discussion of doctor pain would be complete without mentioning the
electronic medical record (EMR) or electronic health record (EHR). On paper, EMRs
sound great: one place for all patient information, legible notes, integrated lab
results, decision support, and e-prescribing.

In reality, poorly designed systems can feel like a digital escape room where every
click takes you farther from the exit. Studies have shown strong links between EHR
burden and physician burnout. Common issues include:

• Click overload: Dozens of required boxes, checklists, and templates for each visit.
• Inbox chaos: Lab results, patient messages, refill requests, and alerts piling up like digital laundry.
• After-hours charting: The infamous “pajama time,” when doctors finish notes at home instead of sleeping or seeing their families.
• Poor usability: Clunky interfaces, nested menus, and workflows clearly designed by people who have never actually seen a patient.

One study of primary care clinicians found that more time spent on the EHR after
clinic hours was strongly associated with higher burnout and worse work-life
balance. Large reviews have identified common themes: documentation burden, poor
design, and constantly changing regulatory requirements all amplify stress for
clinicians and staff.

The technology itself isn’t inherently evil. Research has also shown that when EHRs
are usable and physicians are satisfied with them, burnout is significantly lower.
In other words: it’s not that doctors hate computersit’s that they hate badly
designed computers that eat their evenings and weekends.

The mental health toll: When the healers are hurting

Behind the statistics are painful truths about physician mental health. Meta-analyses
have found that nearly 30% of medical residents screen positive for depression,
compared with under 10% in the general population. Other studies show that
physicians die by suicide at rates significantly higher than the public, with
hundreds of doctors lost each year in the United States alone.

During training, residents and fellows juggle:

• Long shifts and rotating schedules that disrupt sleep.
• Exposure to death, trauma, and difficult conversations on a regular basis.
• High stakes and constant evaluation, with little room for error.
• Cultural norms that still whisper, “Don’t be weak. Don’t ask for help.”

One large study of U.S. residents found that among those who died during training,
suicide was one of the leading causes of death. Other data show that female
physicians, in particular, face suicide rates much higher than women in the general
population. Those numbers are not abstractthey’re colleagues, mentors, classmates,
and friends.

The stigma around mental health in medicine is slowly starting to crack. More
physicians are sharing their stories openly, and organizations are beginning to
address the damage caused by intrusive licensing questions and credentialing forms
that discourage people from seeking care. But the fear of being labeled “unfit” or
“impaired” still keeps many doctors suffering in silence.

Why “just be more resilient” is not the answer

For years, the standard approach to physician wellness sounded suspiciously like
telling a drowning person to “try swimming better.” Workshops on mindfulness,
yoga, and gratitude are not bad things. But when the core problems are structural
understaffing, excessive documentation, unsafe workloads, and misaligned incentives
telling doctors to meditate more can come across as insulting.

Imagine a clinic where physicians routinely see 25–30 patients a day, stay late to
finish charts, cover for vacant positions, and still juggle multiple inboxes. Now
add a wellness email suggesting they download a mindfulness app on their lunch
break. That contrast is the definition of moral whiplash.

Real change requires shifting from individual blame to systemic responsibility.
Physicians are not broken. The system they work in is.

Green shoots: What’s actually helping

Amid the gloom, there are encouraging signs that the tide can turn. Several
strategies have shown genuine promise in reducing the pain of doctoring:

1. Redesigning workflows and cutting “stupid stuff”

Some health systems have launched campaigns specifically aimed at eliminating
low-value documentation and pointless clicks. By involving physicians, nurses, and
staff in redesigning workflows, they’ve been able to remove duplicative forms,
simplify order sets, and reduce unnecessary alerts.

These efforts may not sound glamorous, but shaving just a few minutes off each
patient encounter and trimming after-hours charting time can have a huge impact
on stress, especially across large clinics or hospitals.

2. Team-based care and task redistribution

In many practices, doctors are gradually shifting away from the “do everything
yourself” model. Using scribes, care coordinators, pharmacists, and advanced
practice clinicians, teams can share the load:

• Pharmacists handle complex medication reconciliation and refills.
• Nurses and MAs manage protocol-driven follow-up and patient education.
• Behavioral health specialists support patients with anxiety, depression, and chronic conditions.
• Care coordinators help with referrals, transportation, and social needs.

When doctors stop being default data-entry clerks and return to practicing at the
top of their license, both physician satisfaction and patient care tend to improve.

3. Smarter technology, including AI (used wisely)

Ironically, the same tech revolution that helped create this mess might now be part
of the solution. “Ambient” AI tools that listen to the visit (with patient consent)
and generate draft notes are beginning to reduce documentation burden. Early
research and pilot programs show that these tools can cut after-hours charting and
decrease burnout scores for many physicians.

AI scribes and workflow assistants are not magic wands, and they raise important
questions about privacy, accuracy, and cost. But when implemented thoughtfully and
paired with good governance, they may finally let doctors focus more on the human
being in front of them and less on the glowing rectangle behind them.

4. Leadership that treats wellness as a safety issue

The most effective organizations treat physician well-being the way they treat
medication errors or falls: as a safety issue with measurable metrics and
accountability. That means:

• Regularly measuring burnout and engagement.
• Making changes based on survey results, not just filing them away.
• Creating confidential reporting channels for unsafe workloads or toxic cultures.
• Ensuring that wellness leaders have real authority, not just a decorative title.

When executives openly acknowledge the pain of doctoring and invest in real fixes,
it sends a powerful signal: “You’re not the problem. We’re in this together.”

A call for change: What needs to happen next

The pain of doctoring isn’t inevitable. It’s the result of policy choices, payment
models, tech designs, and cultural norms that can be changed. To truly protect the
people who care for us, we need a multi-level response:

At the system and policy level

• Reform documentation requirements: Regulators and payers should simplify charting rules so notes serve patients and clinicians, not just billing audits.
• Align payment with value, not volume: Move away from pure fee-for-service models that reward doing more instead of doing what matters.
• Support mental health without punishment: Licensing boards and hospitals must remove or revise invasive questions that deter physicians from seeking care.
• Fund workforce and infrastructure: Investments in staffing, technology, and training reduce pressure on individual clinicians.

At the organization and clinic level

• Include frontline clinicians in every major workflow or technology decision.
• Use data to monitor burnout and act quickly when red flags appear.
• Offer protected time for documentation, learning, and recovery.
• Normalize taking vacation and stepping away after difficult events.

At the individual and cultural level

• Encourage physicians to see help-seeking as strength, not weakness.
• Build peer support and mentorship networks, especially for trainees and early-career doctors.
• Talk openly about moral injury, grief, and trauma in clinical practice.
• Retire the myth of the invincible doctor who never gets tired, sad, or scared.

Patients can be part of this call for change too. When you see your doctor, you’re
meeting a human being who may be carrying an invisible load. Offering patience,
kindness, and realistic expectations doesn’t fix the systembut it does make the
day a little less heavy.

Even doctors deserve to heal

At its best, medicine is a breathtakingly beautiful profession. Doctors are invited
into the most intimate moments of human lifebirths, diagnoses, recoveries, final
goodbyes. The privilege of that access is enormous. But so is the emotional cost.

The pain of doctoring today is a warning sign, not a verdict. Burnout, moral
injury, and mental health struggles are telling us something important about the
way our systems are built. If we ignore those signals, we risk losing not only
individual clinicians, but the heart of medicine itself.

Doctors are trained to run toward suffering, not away from it. But they can’t do
that forever with empty tanks and frayed hearts. Honoring the profession means
building a healthcare system that allows physicians to be fully humansupported,
heard, and healedso they can keep showing up for the rest of us.

Stories from the trenches: Lived experiences of the pain of doctoring

To really understand the pain of doctoring, you have to hear what it feels like
from the inside. The following composite experiences are drawn from common themes in
physicians’ stories, essays, and conversations. The details are blended, but the
emotions are very real.

The intern who cried in the stairwell

It’s 3:30 a.m. on a general surgery service. An intern has just finished her third
emergency consult of the night. She’s been awake for nearly 24 hours. Her pager
hasn’t been quiet for more than six minutes at a time. She still hasn’t written all
her notes from the day shift.

On the way back from the ICU, she ducks into a stairwell for “just a second” and
finds herself suddenly in tearssilent, exhausted, and unsure whether she’s crying
because a patient died, because she made a small mistake, or because she hasn’t had
time to eat anything but a granola bar since yesterday.

She wipes her face, straightens her white coat, and steps back onto the unit.
Morning rounds begin in two hours. She is 27 years old and responsible for dozens
of sick patients. On paper, she’s “doing fine.” Inside, she’s wondering how long
she can keep this up.

The primary care doctor with a full inbox and an empty tank

In an outpatient clinic, a family physician starts the day with a schedule of 24
patients. Before the first visit, her electronic inbox already holds 75 unread
messages: refill requests, lab results, insurance questions, and a long thread
about a prior authorization that keeps bouncing between the clinic, the pharmacy,
and the insurer like a very unfun game of ping-pong.

She moves quickly but not carelessly, trying to make eye contact and listen to
each patient’s story while also completing all the required checkboxes. Every
time she falls behind, the system auto-generates warnings about productivity
targets. She jokes with her staff about needing three clones or a time machine.
The joke stops being funny when she realizes she’s serious.

After clinic, she stays an extra two hours to finish notes and clear her inbox.
At home, she opens her laptop “just for 10 minutes” to catch up on one more
message. An hour later, she’s still typing. The next morning, she wakes up feeling
like she never really left work.

The specialist torn between metrics and meaning

A hospital-based specialist loves the intellectual challenge of her field. She
enjoys teaching residents, solving diagnostic puzzles, and talking with families.
But her days are now punctuated by dashboards: length-of-stay metrics, throughput
targets, relative value units (RVUs), and utilization reports.

She’s told she needs to “optimize” her workflow, which usually means seeing more
patients in the same amount of time. She notices herself cutting short
conversations and avoiding complex topics because there simply isn’t enough time.
When a patient’s family wants to ask questions about prognosis, she finds herself
watching the clock.

At home, she feels guilty. This is not the doctor she wanted to be. Yet she also
knows that if her numbers drop too low, she’ll be called into a meeting and asked
to justify her “productivity.” Her moral distress isn’t about not caring; it’s
about caring deeply in a system that treats compassion as a nice-to-have bonus
rather than a core part of the job.

The attending who finally asks for help

After years of pushing through, a mid-career attending physician realizes he’s not
okay. He’s irritable at home, numb at work, and waking up at 3 a.m. every night
replaying difficult cases in his head. He starts making small mistakesnot harming
anyone, but enough to scare him.

For months, he tells himself to “tough it out.” One day, a younger colleague
casually mentions seeing a therapist and how much it helped. That conversation
lands harder than he expects. Later that week, he quietly schedules his own
appointment.

In therapy, he finally says out loud: “I’m burned out. I’m angry. I’m scared I
don’t recognize myself anymore.” Instead of being judged, he’s met with empathy,
tools, and validation. It doesn’t fix everything, but it gives him something he
hasn’t felt in a while: a sense of possibility.

He starts setting boundaries, delegating more, and speaking up in meetings about
unrealistic workloads. To his surprise, other physicians nod along. He wasn’t the
only one suffering; he was just the first to admit it that week.

These stories are not rare. They’re the quiet background hum of modern medicine.
The pain of doctoring should not be a badge of honor or a test of worthiness. It
is a signal that something precious is at riskand a call for all of us, from
policymakers to patients, to help build a system where doctors can thrive, not
just survive.

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