As I sit in this dark room in an empty house in solitude, I still wonder how I got here.

I have been the subject of quiet firing that resulted in my mental and social health suffering. It soured my work relationships, consumed my day, made me an angry person to everyone, including my family, and gave me anxiety. It culminated in exactly what the system wanted: me leaving. It was not my desire to go, but the environment created around me was toxic.

I know my experience is not isolated. Medicine has become a business now more than ever. COVID-19 showed some of us the dark side of health care that we had not expected. It also sowed some seeds for others to manipulate situations to their advantage. I experienced this situation, and it resulted in the loss of my job. It nearly ended my career as I pondered leaving medicine.

My experience in quiet firing is exactly as it sounds: often subtle but firm pressure, manipulative changes, and general discomfort designed to make you want to leave. It is a cold, calculating, passive-aggressive business approach to help guide a person away from continued employment. At first, you may think it is a small event that you simply overlooked, but those events quickly add up and escalate. Your work is never good enough, your approach is overlooked, you might even be ignored, and over time you wonder how you could even improve. Could this truly be your problem, or is something else at play here? Eventually, time, examples, and intuition tell you something is not right.

I was at this juncture. Early on, I was gaslighted to the issues, then I was blamed, and finally, ultimately, ignored. I spent months cleaning up so many messes and staying relevant when I was already forgotten. It took time to convince myself it was not a problem I could control and that, after seven years, my employment was over. I had lost all trust in my superiors and, eventually, the health system. I asked for help from anyone who would listen, including HR. I tried to get help from people who were much more important and powerful than I was. There was plenty of ghosting, but a few offered advice. They advised it was time to leave. Staying would only invite more mental and academic pain. And in the end, my superiors would find something they could use to officially fire me.

Know that if you are experiencing this, it is hard. It is infuriating and certainly not fair. It makes you ask if medicine is worth the hours, the sacrifice, the mental challenges, the angry patients, the constant legal threats, etc. My advice is to take a step back and look at this situation. Would you let your spouse, child, or best friend struggle through this day after day? Would you tell them to keep enduring, keep taking the punishment, and asking for more? I doubt you would recommend this course of action. Then why should you? Is it your pride in being a physician? Is it the familiarity of a situation that keeps you in that type of environment? Do you think you can rise above pettiness or overcome a challenge? You are enough and are valuable to so many. You must find a place that values you just as much. It is out there. From one quiet-fired doc to another, how long can you afford to keep going in your current situation? As I nearly did, I have not reached that end limit. You are enough.

Shawn McGargill is a physical medicine and rehabilitation physician.