Imagine yourself being miserable at work and you have been thinking about quitting for a long time now, but you are just really good at what you do. Your colleagues approached you when they needed advice and even your patients praised and thanked you all the time. Imagine leaving all of this and walking away from years’ worth of hard work.

Initially, you might have felt guilty and isolated for feeling so downhearted and wanting to move on and leave. But guess what, you are not alone! Why is it that those who have quit their job were the ones who were once the greatest in their field and were even so passionate about what they did at one time? Just why? I am sorry, but I just cannot stop thinking about this. A nurse approached me before retiring, who served the field for over 30 years, and she told me that she was not even thanked before leaving. I walk down the corridors of many hospitals and look around every day and I see so many sad faces. It took me so long to understand that people are not only quitting the system and the leaders, but also the organizational culture.

The health care environment is supposed to be composed of two sets of people: leaders and the employees. They both are supposed to work under a set of clear rules, where the way people treat each other, the way decisions are made, who gets fired or hired, and which behaviors should be rewarded are clearly defined and promoted. If these values are set, the culture can adapt itself to any changes within the environment.

When you see those great people stressed out and unhappy, this stresses out the whole organization. This leads to the culture operating in survival mode instead of fight or flight mode. That means that you will be walking into work just hoping to make it throughout the day. Over time, this is just draining and exhausting. This lack of leadership has led to the loss of the common vision that employees once had. That is why mediocre performance is very encouraged nowadays. This has led to toxic, unacceptable behavior being accepted in the workplace. People have lost some of their passion! The workplace nowadays is getting too political to get any job done.

Do you remember when 20,000 people walked out of Google in protest of unequal treatment of women at the company, on a single day (1)? The Google employees felt safe enough to do that because if they lost their job, they would be able to find another job easily elsewhere. Not everyone has this luxury. Not everyone speaks up. Walkouts happen every day in the working culture, but it is not done every day with our feet, but in silence. The issue with silence is that it is not noticed by the leaders in the field, and words without action will lead to cynicism and even future walkouts.

In a thriving culture, the line between leaders and employees is blurred to empower employees to take charge and express their opinion. Walk down the corridors and talk to your employees and ask them what they need. Are they asking for empowerment, improvement of certain aspects of the system, new experiences, or obstacles to be removed? It is in your hand as a leader to reinforce a culture either in survival mode or in fight and flight mode.

When employees feel that they are being listened to, they start caring about work and the people around them. Managers should start unblocking communications. At times, managers raise issues that employees do not agree with. At this fragile moment, it will be determined what type of culture we will have. Are we going to engage in debate and stay unified, or will our relationship become diluted? The least that could be done is to try to find common ground, even if it is not ideal.

But sometimes this is not possible. If this is the case, there are two options:

• The first is to accept the fact and move to a different organization with more similar values to ours.
• The second is to accept the fact and stay with the company, keep doing a good job, await the right time to address the issue in the future, and keep working on the issue as you go along.

These two options are still better than a silent walkout.

I would like you, on your next working day, to ask your colleagues after a nice discussion: What don’t we talk about around here that we should be talking about? If the answer was silence, then your organization is probably blocked.

Suhaib J. S. Ahmad is a surgeon in the United Kingdom.