“Why don’t they see?” “Why can’t they understand?” “Why are they doing this to us?”

These questions echo in exam rooms, in meetings, in the hallways of hospitals and clinics across the country. They are often sparked by policy changes, institutional decisions, or administrative mandates that feel disconnected from the physicians providing the care. Underneath the questions is the hope that the reality in front of us isn’t actually true. That things should be different.

The idea that things should be different seems innocuous. It’s true; they should be different. And this thought is costing us greatly. It shows up as tight shoulders, clenched jaws, sleepless nights, and exhaustion that no vacation can fix. It shows up in conversations with colleagues that leave us bitter and resentful, and as a quiet drain on our energy, our relationships, and our capacity to care.

I used to live in this space all the time. I also saw it everywhere around me, among my patients and my colleagues. We think of resistance as a kind of vigilance, even virtue. But it doesn’t change what’s happening. In fact, it erodes our ability to respond to it effectively.

Acceptance of reality is not approval. It’s not agreement. It’s the courageous act that allows us to pause and see clearly. This is happening. Now what?

Sometimes the pause looks like allowing ourselves to feel the full weight of disappointment, anger, or sadness before moving to action. Other times, it’s finding humor or perspective: “Of course that policy passed.” “Of course the EMR updated again with no input from clinicians.” Not as resignation, but as recognition.

In the practice of medicine, this kind of mindfulness matters. We can’t always change the EHR, the RVU system, or the latest top-down decision. We can notice how our bodies respond, how our thoughts spin, and whether we’re reacting from frustration, or responding from clarity.

When we stop resisting reality, we reclaim agency. We begin to ask better questions. We can shift from “Why are they doing this to us?” to “What do I want to do next, knowing this is the case?” We show up more grounded, with patients, with teams, and with ourselves.

The truth is, we can’t control other people, just as we wouldn’t want them to control us. What we can control is the stories we tell ourselves, the energy we bring, and the space we create to feel before we act. This is where our real power begins. Not in pushing reality away, but in choosing how we meet it.

Jessie Mahoney is a board-certified pediatrician, certified coach, mindfulness and yoga teacher, and the founder of Pause & Presence Coaching & Retreats. After nearly two decades as a physician leader at the Permanente Medical Group/Kaiser, she stepped outside the traditional medical model to reimagine what sustainable well-being in health care could look like. She can also be reached on Facebook and Instagram.

Dr. Mahoney’s work challenges the culture of overwork and self-sacrifice in medicine. She helps physicians and leaders cultivate clarity, intention, and balance—leveraging mindfulness, coaching, yoga, and lifestyle medicine to create deep and lasting change. Her CME retreats offer a transformative space for healing, self-discovery, and renewal.

As co-host of the podcast, Healing Medicine, she brings self-compassion and presence into the conversation around modern medical practice. A sought-after speaker and consultant, she partners with organizations to build more human-centered, sustainable, and inspired medical cultures.

Dr. Mahoney is a graduate of Dartmouth College and the University of California, San Francisco, School of Medicine.