From the heart of one doctor to another, let’s address the evil spirit haunting our halls: burnout. It has become the unwelcome companion of many physicians, including myself, who frequently lament our moral injuries and the mistreatment that seems to shadow us. We seek refuge as wellness coaches or in the serene embrace of time away, hoping for respite. We call for laws and policies to protect us from the grind, too often pointing fingers at the faceless “system” and the suited “suits.”

But what if I told you, and please, hold the daggers for just a moment, that we physicians have played a role in our own demise? What if we’re partly to blame for the weariness that weighs on our white coats?

What baffles me is our blindness to the giant elephant in the room: our own accountability. Once the captains of the health care ship, we still largely dictate today’s complex health care decisions: from ordering a test or procedure, or perhaps explaining why a test/procedure isn’t necessary, to writing a prescription or administering a vaccination. Physicians are the pulse of health care; we even play executive roles in “the system,” including insurance, hospital management, pharma, politics, the burgeoning tech scene, and even those $25 virtual consults during our morning commute. We embrace and build our own hierarchies, with titles like Chief Medical Officers, Division Heads, and Deans of Medical Schools that adorn our white coats. We are more than just cogs; we are the vital gears of this vast health care machine. We are part of the “system.”

Here’s a splash of reality with ten simple ways we, as doctors, can start making things right within ourselves and our interactions:

Stop the silence. If another doctor reaches out, it’s because they need you. Let’s not leave them hanging with ignored messages. That’s just cold.

Be reachable. Why is it easier to crack a bank vault than to get another doctor on the line? Let’s ditch the phone trees and pagers and get back to good old-fashioned direct lines.

Keep the loop closed. If you encounter a colleague’s patient, a heads-up is more than courtesy—it’s a necessity. Don’t make them play detective with your notes on an urgent or emergent consult.

Clarify referrals. Are you sending a patient my way? Fill me in. What mystery are we solving, and what is your concern? Let’s not turn patient care into a game of hot potato or wonder, “What was she/he thinking?”

Realistic expectations. Specialists swamped with a six-month backlog of consults? Let’s not pretend the ER is the welcome mat. Let’s ensure primary care has the tools to set the stage properly before the wait.

ER isn’t always the answer. Before you reroute your patients to the ER, pause. Could you see them instead? An overcrowded office isn’t a hall pass to overburden the system. If you send them, are you clear on the above?

Stand for something. If you’re a leader handing down policies that make zero sense, let’s challenge them. Don’t just be the messenger—be the leader who fights for what’s best for patients and physicians alike.

Don’t be a bully. Intimidation is a sign of weakness, not strength. Let’s build each other up, not tear down. Mentor, support, and lead with empathy. That’s how respect is truly earned. Don’t abuse your title or influence in our self-made hierarchy.

Check your biases. It’s time for some self-reflection. If someone says you’re treating them differently, don’t deflect—reflect. Bias exists; let’s work on ours together. Race, gender, specialty, or role biases should be called out, and yes, it may be a blind spot. Don’t be afraid to check your blind spot.

Conversation is king. Do you have a question? Are you unsure about something? Seek out a chat. Let’s not leave things unsaid or hide behind notes and guesses. Talk to your colleagues and the staff trying to support your patient’s care.

With some soul-searching and some heartfelt changes to our daily grind, we can steer this health care ship away from the stormy seas of burnout and into the calmer waters of well-being—for us and our patients.

Concrete steps to move the needle in physician culture

Recognizing the issues is one thing; taking action is another. Here are ten concrete steps we can start implementing today to foster a healthier work environment and improve our professional lives:

Dedicated work phones. Issue a work cell phone (or secure app) to every physician, and compile a secure directory—our modern “yellow pages”—with direct lines to the doctor on call for urgent issues. A phone we can turn off when off-duty.

Physician-only lounges. Reestablish private staff lounges as sanctuaries where doctors can converse, collaborate, explore new ideas, and decompress without fear of being misheard or suffering in silence. Doctors lead the siloes, and we need to communicate across these imaginary barriers and learn from each other and get to know each other again.

Inclusive community engagement. Integrate community physicians into the communication loop with specialists through meetings and social events, reinforcing the collaborative spirit of healthcare.

Fair process protocols. Establish a physician-led peer review process for dealing with conflicts, grievances, or clinical concerns, ensuring issues are addressed with due process rather than administrative or hierarchical leverage.

Democratic medical staff meetings and societies. Revive regular medical staff meetings and insist on a democratically elected body, freeing our governance from the grip of administrative appointments and the same voices saying the same things. We should do the same with our siloed societies built on like-mindedness. Dialogue and diversity in every way is needed.

Transparent compensation. Implement transparent salary policies to root out pay disparities. Reward physicians for quality care, patient outcomes, and collaborative practice. Hold physicians accountable for bad behavior and poor outcomes. There is no reason physicians performing the same role should be paid differently based on race, gender, or other biases.

Targeted regulations. Stand against blanket policies that affect all for the misdemeanors of a few. Aim for targeted, constructive solutions rather than broad-brush restrictions. Correct behavior of the few instead of overregulating the many. Professionals should be treated with professionalism, not policy.

Equal care for all settings. My ER bias coming out here. Treat the ER as you would your practice—no shunting patients off due to being too busy. Take responsibility by connecting with ER staff or visiting the patient when possible. No one is ever too busy to at least have a conversation with the ER physician. With better lines of communication the ER could lessen the excuse to reach out to you as well. A 60-second communication could save precious minutes and hours of wasted time for physicians and patients.

Referral due diligence. Develop, use, and uphold consensus referral guidelines. Before passing on a patient, ensure you’ve done the necessary groundwork—being overbooked isn’t justification. Specialists with long waits should communicate clear expectations and what should be prioritized in the queue. Referrals need to be triaged and not just lined up around the building.

Cultivate respect and kindness. Always remember that every physician has earned their place through hard work and running the same marathon. Value the diversity of skills in our fields and respect each colleague’s contribution to our collective mission.

By embracing these steps, we create a ripple effect, generating a wave of positive change that can transform our workplaces, our relationships with colleagues, and, ultimately, the care we provide to our patients. It starts with us—let’s be the change we wish to see in health care. Our work should be more satisfying than just finding ways to unwind after you leave. Meditation, like policy, feels like a distraction rather than a real solution. A solution that starts with us physicians.

Mick Connors is a pediatric emergency physician.