I’d rather be a sex worker than practice medicine in this broken system (and I’m 53, menopausal, and retired from my hot years).

Let me be clear: This is not a whimsical “maybe I will pivot into OnlyFans” moment. I am 53 years old. I am menopausal. My libido is in witness protection. The bloom is not just off the rose, the whole damn bush was yanked out and replaced with a xeriscape of dried sarcasm and silent screams. But I swear to God: If sex work was a viable option for me, I would drop my stethoscope faster than Big Pharma drops accountability.

Let us compare, shall we?

The American health care system:

You train for 12 to 15 years, wrack up $300,000+ in debt, and enter the field with the naïve fire of someone who thinks they are joining the Avengers of Healing.

Then you realize: You are just a glorified data-entry monkey in a Kafkaesque insurance labyrinth, legally obligated to spend more time clicking boxes in Epic than making eye contact with another human.

Every day feels like a hostage negotiation between your soul and your malpractice insurance.

If your patient dies, it is your fault. If they live but post a bad Yelp review, it is also your fault.

You have to beg insurance companies for permission to provide life-saving treatments, as if you are a child asking for an allowance.

Your bathroom breaks are timed. Your sanity is optional.

Sex work (even hypothetically, from my hormonal Hades):

Clients pay you directly. You know, like a sane business model.

You set your own hours. If you are tired, you don’t “just hold your pee for nine hours and code strokes with one hand.”

No one pages you at 2 a.m. because someone’s penis hurts from watching YouTube on the toilet too long.

There is more consent in a single OnlyFans DM than in the average hospital board meeting.

You might fake an orgasm, but you don’t have to fake belief in a “value-based care” model designed by people who have never touched a patient.

A day in the life

Being a doctor used to mean something. Now it means you spend 50 percent of your time documenting symptoms that don’t matter so an algorithm doesn’t flag you as “non-compliant,” and 50 percent explaining to a middle manager why saving someone’s life doesn’t “meet metrics.”

Let us be real: We are not “burned out.” We have been gaslit. Burnout implies we could not hack it. Oh honey, we hacked it. We did residency on three hours of sleep a night while being verbally abused. This is not burnout. This is moral injury. The system has become so ethically bankrupt that staying in it feels like spiritual self-harm.

And no, I am not romanticizing sex work. I know it is hard. I know it comes with exploitation, stigma, risk. But at least it does not gaslight you into thinking you are the problem for being traumatized by the trauma factory you work in.

At least sex work doesn’t require you to kill parts of your soul just to comply with ICD-10 coding.

At least in sex work, when someone screws you, it is consensual.

But you are a doctor

Yes. And I have also been a therapist, a social worker, a tech support agent for malfunctioning e-prescribing systems, a hostage to prior authorizations, and a sacrificial lamb to every budget cut. I got a full-body rash once from the stress of explaining to a Harvard MBA why giving insulin to a diabetic in DKA might be “cost-effective.”

I would rather do sex work.

Final diagnosis

This system isn’t broken. It is working exactly as designed. For profit. Not for people.

And I am done pretending this is noble. I am done being complicit. If I had the knees and the skin of a 24-year-old dominatrix, I would be cracking whips in a leather catsuit rather than charting on a system that crashes every 20 minutes.

Instead, I write.
And I rage.
And maybe, just maybe, I help tear the whole thing down and rebuild something that doesn’t make healers wish they were hookers.

Because, trust me: If you are a doctor in America right now, you know the truth.

Corina Fratila is an endocrinologist.