I direct a Faculty Well-being Champions Program overseeing 47 physician champions across 33 departments. I also practice palliative care part-time and coach physicians navigating burnout. I liaise with well-being leaders nationwide, some at programs just checking a wellness box, others genuinely trying to get it right. This year taught me that well-being work reveals patterns. The same destructive habits show up across institutions, specialties, and conversations.

As 2025 closes, here are five things health care needs to stop doing if we’re serious about physician well-being.

1. Blaming younger physicians for “not wanting to work as hard”

There’s a pervasive narrative that younger physicians are less dedicated than previous generations. They set boundaries. They decline committee work. They don’t seek mentorship. They prioritize work-life balance. The conclusion: This generation doesn’t have the same work ethic. Often the accusation is couched as concern that these young doctors are missing out on professional development.

This completely misses what’s changed. As a recent Lancet article on the corporatization of medicine noted, “the space for good work in a bad system” has narrowed over time. When physicians spend more time on documentation than patient care, when administrative demands multiply, when metrics prioritize productivity over quality, when the lay public’s trust in experts erodes, the work itself becomes less rewarding.

Younger doctors aren’t lazy. They’re responding rationally to a fundamentally changed system. They set boundaries because the system won’t. They avoid “extra” work because their required work has already expanded beyond what’s sustainable. They cut out water-cooler conversations with colleagues because time with families is scarce (and the water-cooler space was probably repurposed for something revenue-generating).

Instead of dismissing generational differences as a work ethic problem, ask: What has changed about the work that makes younger physicians respond this way? Their behavior is data about our system.

2. Asking physicians to lead well-being initiatives without resources

Well-being champions can create meaningful change when properly supported. The problem is asking them to improve morale without budget, change culture without authority, or advocate for colleagues without institutional backing. Too often, physicians are handed titles, tasked with leading committees, and expected to solve burnout, all in addition to their regular work.

I’ve seen talented physicians burn out from well-being work itself because they lack resources, time, or institutional power to make structural changes. They become discouraged when it feels like all they can do is absorb their colleagues’ distress.

Well-being work isn’t a volunteer hobby. It requires protected time, operational support, and genuine authority to implement recommendations.

3. Requiring well-being initiatives to prove immediate ROI

Health care organizations will implement new clinical technology, expand service lines, or renovate facilities with long-term strategic thinking. But well-being initiatives are held to a different standard: Pay for themselves or they’re cut.

We’ll pay for AI scribes, but only if physicians see extra patients to offset the cost. We’ll fund wellness programs, but they need to demonstrate reduced turnover within six months. The implicit message is that physician well-being matters only insofar as it serves the bottom line. This thinking is short-sighted. Shanafelt and others have established the business case: investing in well-being reduces turnover, absenteeism, and medical errors. Yet too many executives seem to forget this during budget season.

We need to stop treating physician wellness as a luxury expense rather than infrastructure investment.

4. The all-or-nothing employment model

Health care treats part-time clinical work as a failure of commitment. Physicians who reduce hours face professional penalties: loss of benefits, fewer leadership opportunities, less respect from colleagues, concern about “keeping up their skills.” The implicit message is that serious physicians work full-time, and anything less means you’re on your way out.

This rigidity is unsustainable. Physicians have caregiving responsibilities, health issues, and the simple human need for balance. Some want to combine clinical work with research, education, advocacy, or other meaningful work. Our health care system faces impending physician shortages. Making space for those who want to stay in the work, but on different terms, could be crucial for patient access.

And while we’re reforming employment models, let’s actually make sabbaticals accessible. Since 1880, universities have offered sabbaticals as a cornerstone of academic life. Medical schools include sabbatical policies in handbooks, but a 2021 survey found only 53 percent of U.S. medical schools reported any faculty taking sabbaticals in the past three years, with a median of just three per school. The benefit exists on paper but is functionally unavailable until full professor (15 to 20 years into your career, if ever).

5. Rolling out every shiny new technology without planning for downstream effects

Institutions implement new EHR modules, AI scribes, patient portal features, telehealth platforms, and documentation tools at breakneck pace. Physicians are promised these innovations will empower us. Instead, historically, each creates new workflows, new problems, and new tasks that become the physician’s responsibility.

Years ago, no one mapped out how patient portal messaging would increase physician workload. Only now, after alarming data on “pajama time,” have health systems begun exploring billing for portal care. Giving patients open access to radiology results opened Pandora’s box: patients reading their cancer diagnosis Friday night, unable to speak to their doctor until Monday. So what will happen with AI scribing and clinical decision support? We’ve seen the movie before. The technology gets rolled out; physicians absorb the fallout, the good and the inevitable bad.

Before implementing any new system, ask: What will this actually require of physicians? Who will handle the problems it creates? What are we removing to make room for this?

What should replace these patterns

Health care needs to recognize that younger physicians’ behavior reflects system changes, not character flaws. We need to resource well-being work properly and evaluate it with the same long-term thinking we apply to other investments. We need employment models that accommodate physicians’ lives and evaluate technology by actual workflow impact, not theoretical promise.

Most importantly, we need to recognize, really believe, that sustainable physician careers require institutional commitment, not just individual resilience.

What’s on your list to leave behind?

Christie Mulholland is a palliative care physician and certified physician development coach who helps physicians reclaim their sense of purpose and connection in medicine. Through her work at Reclaim Physician Coaching, she guides colleagues in rediscovering fulfillment in their professional lives.

At the Icahn School of Medicine, Dr. Mulholland serves as associate professor of palliative medicine and director of the Faculty Well-being Champions Program. Affiliated with Mount Sinai Hospital, she leads initiatives that advance physician well-being by reducing administrative burden and improving access to mental health resources.

Her recent scholarship includes a chapter in Empowering Wellness: Generalizable Approaches for Designing and Implementing Well-Being Initiatives Within Health Systems  and the article, “How to Support Your Organization’s Emotional PPE Needs during COVID-19.” Her peer-reviewed publications have appeared in Cancers and the Journal of Science and Innovation in Medicine.

She shares reflections on professional growth and physician well-being through Instagram, Facebook, and LinkedIn. Dr. Mulholland lives in New York City with her husband, James, and their dog, Brindi.