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Surgeon Suhaib J. S. Ahmad discusses his article, “Why even the best employees are silently quitting health care.” Suhaib explores the phenomenon of highly competent and once-passionate health care professionals disengaging and leaving their roles, often without overt complaint. He argues that this “silent quitting” stems not just from issues with the system or individual leaders, but critically from a dysfunctional organizational culture characterized by a lack of clear values, poor communication, and an environment where mediocrity and toxicity can thrive. Suhaib contrasts this with a thriving culture where employees feel empowered and listened to, referencing the Google walkout as an example of employees feeling safe to speak up. He emphasizes that leaders must actively engage with staff, understand their needs, and foster open dialogue to shift the culture from “survival mode” to one of growth and shared vision. For employees feeling stuck, Suhaib suggests that actively choosing to move to a better environment or to stay and strategically work on issues is preferable to silently disengaging. The conversation offers a call to action for leaders to ask their teams: What don’t we talk about around here that we should be talking about?

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Transcript

Kevin Pho: Hi, and welcome to the show. Subscribe at KevinMD.com/podcast. Today we welcome Suhaib J. S. Ahmad. He’s a surgeon in the United Kingdom. Today’s KevinMD article is “Why even the best employees are silently quitting health care.” Suhaib, welcome to the show.

Suhaib J. S. Ahmad: Thank you very much, Kevin. Thank you. Great pleasure. Thank you for the invite. I’m a gastrointestinal surgeon with a focus on cancers of the esophagus and the stomach.

So, the topic that I’m going to speak about today is an important topic that reflects what’s happening around in health care in general. I go to the hospital every day, and you spend around 60 to 70 percent of your time in hospitals every single day, and you wonder, how do you want to spend that time? You want to spend it happily, or do you want to spend it in a sad way, going home after having a stressful day? And how do you want to spend the rest of your life? Do you want to spend the rest of your life doing that also?

The connection in the hospital that I’m working in is not very good, so this is why every time I receive a phone call, I tend to go out of the hospital to look at my phone and pick up the phone call. On the way outside, I once received a couple of phone calls I wanted to respond to. I was walking outside the hospital, and I bumped into a senior nurse. She called my name from the end of the corridor and said, “Hey, Suhaib.” I said, “What have I done again now?” I asked her, “Why are you calling my name?”

And she said, “I want to tell you something. It’s been over 30 years now in the health care system, and I would just like to tell you that today is my last day. And I would like to say thank you for everything.” I said, “Why are you thanking me? I should be thanking you.” She had a look—I can’t describe or explain the look on her face. It wasn’t with bitterness, just a tired smile, and she said that she wasn’t even thanked. She gave her best and didn’t know whether someone noticed.

I told her, “I would like to thank you for everything that you have done for patients. I would like to thank you for everything that you have done for everyone around.” She had a tear in her eyes, and then after that, she walked away.

The thing is that this moment stayed with me. Since then, I started seeing this lady everywhere I go: not the loud ones, not the complainers, but the silent walkouts. On paper, the people are present, but in reality, they are not there. The ones who were once brilliant, kind, and driven are still clocking in, smiling, but their heart is already gone. I mean, the people who were so skilled, they used to operate on things that no one else was able to operate on—such complex cases—and they were so enthusiastic. Where have they gone? I don’t understand what’s happening to them.

They left quietly, not because they are weak, but because they are tired of giving in places where no one listens. I’m not the kind of guy who gives teaching lessons about leadership, Kevin. I’d rather be on the floor with people, working with them and listening to them, listening to their concerns, and working with them shoulder to shoulder, helping them with all the struggles that are faced on a daily basis. That’s what I do every single day.

In theory, you have these workplaces where you have leaders and followers, but the problem in practice is a bit more complex than that. When the communication breaks down, when the values are ignored, when purpose is replaced by politics, people stop believing. Then when they stop believing, they will automatically stop giving—not with a raise or a rebellion, but just with a quiet withdrawal. They are no longer with you. They don’t storm out; they just fade away. My only worry here is that by the time the organization notices, it’s too late.

Chaos has already happened. The waiting times are already getting worse and worse, and patients are waiting longer and longer to be seen by doctors. Yes, we can blame the system, but it depends on what we want to blame in the system. The problem is that the workplaces at the moment are becoming too political, not purposeful; protective, not passionate. They are becoming so political that you can’t even get your job done. We are promoting mediocrity, not excellence. If you work five hours or if you work 20 hours, you will be treated the exact same way, and no one will talk about the good things that you’ve done. People will only mention things when things go wrong.

Kevin Pho: Let me stop you right there. Before you go on, are you seeing this across a spectrum of health care professionals? You told the story about the nurse, so are you seeing this with the MAs, the nurses, the physicians, generalists, and specialists? You’re seeing this across the health care spectrum in the United Kingdom?

Suhaib J. S. Ahmad: Yes, yes, which is very sad. The problem is a simple question. That’s what I do, a simple question. I’m going into the hospital in the morning, and I go into the elevator. I should be using the stairs, but sometimes I’m very lazy, you know; I use the lift to go up instead of using the stairs. I go into the lift and I ask the person going in, “Good morning. How are you?” What’s the response? “Well, I’m here.” Why is the response like that? “Well, I’m here,” or on a Friday, “I can’t wait for the weekend to come.” People are no longer enjoying what they do.

I can tell you one thing. The problem is that people tend to blame the managers. They tend to blame the system. They tend to blame the bigger picture, but it’s more complex than that. In some religions, some people believe that if you want to make a difference, you have to change yourself first. You are a leader in your position regardless of what your level is, regardless of how old you are. Even if you are 20 years old, even if you are 30 years old. I mean, look at Alexander the Great. He was 20 years old; he was the king of Macedonia. Macedonia is one of the most beautiful places, by the way; it’s a very, very nice place to visit.

He didn’t rule from a golden chair where he went and spread the money around and told people what to do. He went and led 10,000 men across deserts and mountains, fought with them, bled with them, shared their rations, and he didn’t shout orders from a place of safety. He was with them shoulder to shoulder, fighting with these soldiers. Why do you think they followed him from Greece to India? Not because he told them, “Hey, I want you to follow me from Greece to India.” Not because he demanded that, but because he demonstrated that.

The problem is that at the moment, everywhere in the world—I’ve got thousands of friends in Europe in the medical field—all of them say there is an issue with the health care system, that there is a shortage of staff. The demands are exceeding the resources that we have. So the last thing I would expect at the moment is for a person to start giving orders to the people on the ground without going to the ground, seeing what’s happening, listening to the people on the ground, and helping them. You need to also be there on the ground, helping them.

This is the thing. Imean, I want to give you just two or three examples from history because I believe if you want to understand the present, you need to go back to history, which is extremely important. It shows how you can make a very big difference in the world that we are living in, in general. And when I say world, this applies to health care; this applies to any single field.

Gandhi. I’ve got many Indian friends. The country of India is a fantastic country with fantastic people, and I can tell you, in a couple of years, India will have a fantastic future. Many people won’t agree with me on this point, but Gandhi was one of the greatest. He was a great man in India. People respected him. He was once in South Africa. He was on a train, and that train was full of people of a white background who were not very elegant. They told him, “Listen, you don’t belong in this train because you are not the same color.” So he could have gone home; he could have kept his head down. Instead, he walked 240 miles in the Salt March. No weapons, no shouting, just a purpose. He didn’t walk out; he walked forward.

People need to remember what we are doing in the health care system. This is not a nine-to-five job. This is not a nine-to-five job. I keep telling people this. The way things are being managed, where people don’t know—we are looking at numbers rather than looking at realities. This is my main concern here. You can keep telling people, “Listen, I want to meet the deadlines. I want the four-hour target in the emergency department to be met. I want every patient who comes through the emergency department to be seen within a four-hour time frame.” You can keep saying these things; however, you can keep pushing, but if you don’t provide the support, you don’t know how things will go. Imagine you’ve got a chain and you push the chain: you don’t know in which direction the chain will go.

Do you remember Rosa Parks? A very famous lady. One seat, one woman, and one “no.” She wasn’t trying to spark a movement or create a big issue in the world; she was just tired of being invisible. People need to have a say. People need to be able to express their thoughts and opinions in the environment that you work in because you matter as a person. You matter. This is what matters.

Something in the U.K. that I always tell people: when I was a medical student, I attended a lecture a very long time ago, and a person came all the way—I think a two or three-hour drive—and he started giving a talk about whistleblowing. I mentioned to him, “Why ‘whistleblow’? Why not highlight concerns and speak about things openly and publicly?” And he said, “Apparently if you whistleblow, you are protected.” So I said, “Why don’t we protect people who highlight issues and concerns in general, rather than having them ‘whistleblow’?” If you provide freedom of speech, if you provide support and a nurturing environment for people working in that environment, I can tell you, people will be working happily.

I always say, don’t blame the system, even if there are long waits, even if there is an issue with cancellations or with bed situations all around the world. Don’t walk out. You need to help.

Look at Mandela. When he was treated badly—I’ll give you an example. Twenty-seven years in prison. He was freed. He didn’t go and seek revenge. He didn’t say, “Why did they do this? Why did they do this?” He went and sought unity. He led a divided country towards forgiveness. Some of the strongest people don’t walk out. They wait, prepare, and then they rebuild. That’s what I keep telling my colleagues. We need to stand together. We need to identify what is going on here in the health care system. We need to see how we can provide the best treatment for patients.

Kevin Pho: So, you’re describing a situation that’s happening both in the U.K. and the U.S. People are “quiet quitting”—that is, showing up but not really being there. Surely the health care leaders must be seeing this. In general, do they acknowledge this? What are they doing in response to this?

Suhaib J. S. Ahmad: I’ll tell you what’s happening. The reality behind that is they know about it. I don’t know whether it’s being acknowledged or not. That’s the reality. I would expect if people are struggling on the floor for the leaders to go on the floor to help the people working on the floor.

Florence Nightingale was a very, very respected lady. She walked around the blood-soaked wards of Crimea with the other nurses, not carrying a flag but carrying a lamp. She cleaned the wounds, tracked statistics, and reformed hospital care forever. She didn’t basically tell people, “Listen, there is an issue. I know about it. I’m not going to address it.” The problem is that the people at the moment—I wouldn’t call them leaders, but I would call them managers—working in the health care sector are not thinking about the future of patient care. They are thinking more about how they can make the organization look better from a numbers point of view or from a statistics point of view.

Kevin Pho: So you’re saying that there’s a definite disconnect? Like you’re not seeing any health care leaders go to the floor and see what’s happening at the patient level?

Suhaib J. S. Ahmad: I’ve experienced that you will find, every now and again, a couple of leaders. It could be a matron. A leader does not need to be a manager, by the way. A leader can be a simple consultant in the department. You don’t need to be a manager because a consultant is still a role model for his juniors.

Imagine a consultant sitting at home, asking the residents in the hospital to do all the work for him, and telling them what to do over the phone. And they are struggling. They are struggling. There is a lot of workload to be done. Instead, he should be going to the hospital and helping those residents with seeing their patients and making sure they are provided with safe, effective care. This is the issue. People just need to be more visible. You can’t put yourself in a locked room on a chair looking at data without seeing what’s happening on the floor. That’s my issue.

Kevin Pho: Now, what about the health care workers who feel trapped, the workers that are silently quitting? What kind of advice do you have for them? Whether to stay in that organization or look for someplace else?

Suhaib J. S. Ahmad: Well, it depends on how strongly you believe in the values that you own. They say we are all rendered fit members of our regularly organized community. Imagine yourself living in a gentleman’s club, for example. If you want to be a member of that club, you either have to abide by the rules or you can’t be part of the club. But sometimes clubs can be flexible, and the same with hospitals.

The thing is that it all comes down to the people in the health care system. Martin Luther King said, “We will remember not the words of our enemies, but the silence of our friends.” He spoke for the voiceless, listened to the unheeded, and that is what made the difference. If people are promoted to express their views and thoughts in the environment that they are working in, I can guarantee you, even if you don’t provide them with what they need, they will still be happy. I promise you, this is the thing. Unity is the key. Whatever you do, unity is the key.

People need to stand together. You can’t separate management. A hierarchy system exists, and you need some hierarchy because otherwise, it will be chaos. I always tell people, 95 percent of people are of average intelligence. This is statistics: 2.5 percent are above average, and 2.5 percent are below average. But most of us are designed to be led. Most of us are not designed to lead. So if there is no leader within the group, it will be chaos. Everybody will be doing their own thing.

Empower that health care assistant. Go to them, ask them, “How can I help you? What can I provide for you? Is there anything…?” And even if I can’t provide anything—I can tell you, I work with many people from refugee camps, many people from war zones. I’ve worked with many people from low-resourced places. They are still happy. Why? Not because they have everything, but because they had each other. That’s the thing that I need to highlight. OK.

Kevin Pho: Is there any hope of turning this around? Have you heard a success story where people or health care workers who have been silently quitting have been reengaged? Have you heard of a successful turnaround story?

Suhaib J. S. Ahmad: Well, there will always be individual success stories, but I can tell you, yes, there is hope. You can make a massive difference. Can I give you a political example, which has nothing to do with that again? After the World War, what happened? Enemies became allies. You know, NATO. Look at the Washington Treaty. NATO was born with 34 countries. They united not to conquer but to protect. Countries that once faced each other across battlefields stood together to protect each other because they knew that unity is not a luxury; it’s the only mode of survival. So I can tell you, yes, I know someone who was zoned out. He didn’t enjoy what he did, and after that, the management or someone spoke to him, and he started enjoying the job again.

But let’s go back to the core values here. The core values say very clearly that regardless of our differences, all it takes is one person to make a difference. All it takes is one person. You can have—I know a department—imagine NATO. So many countries, different religions, different backgrounds, different politics, and that’s what makes our field special. We treat everyone equally, regardless of who they are, whether they are the king, the queen, the managers, the domestics—everybody is equal. No one cares who you are. You get treated exactly the same way, but we need to ensure that someone implements that system, and that is the leadership within the organization. That is the most important thing.

So, purpose, respect, and unity. That’s the thing that I can highlight.

Kevin Pho: We’re talking to Suhaib J. S. Ahmad. He’s a surgeon in the United Kingdom. Today’s KevinMD article is “Why even the best employees are silently quitting health care.” Suhaib, let’s end with some take-home messages you want to leave with the KevinMD audience.

Suhaib J. S. Ahmad: When people feel safe, seen, and heard, they stay, they fight, they care. If I see someone being treated unfairly, whether they are a nurse, a manager, or a doctor, that matters to me, even if they are not my family.

I tell all of my friends who work in management fields or who own businesses, “Go to the grounds and listen to people. Listen to what they have to say, and ask them a question. Ask them a very simple question: ‘What don’t we talk about here, but should?'” And then stop. Don’t defend. Don’t fix. Just listen to what they want to say.

Then they begin to heal. When they heal, they care, and when they care, they stay and will start enjoying the job that they are doing. This is the thing. When they stand together, this is where the biggest difference and the biggest change can happen in the organization.

I have faith that we will stand together despite the limitations and the challenges that we have in the system to make a difference, to change the environment that we are working in, making it more positive. And remember that you can still be happy in a low-resourced place. So you can’t simply say, “Just because I didn’t get approval to get this device—I’m a surgeon, I want this most complex device—and just because I didn’t have it, I’m not going to be happy and I don’t want to work in this place anymore.” No. You can simply say, “OK, if I were the owner of the place, I would say, ‘Listen, I’ve got a limited budget. I can’t do that for you. I can’t provide you with this equipment, but can we work together on something else? I’ll make you lead another project to change the environment. I’ll nurture you. I’ll give you some empowerment in the environment that you are in.'”

So thank you, Kevin, for this great chat that we had together.

Kevin Pho: Suhaib, thank you so much for sharing your perspective and insight. Thanks again for coming on the show.

Suhaib J. S. Ahmad: Thank you very much for that. Thank you.