Physician loneliness is driving women out of medicine

We tell burned-out physicians to practice self-care, set boundaries, build resilience. And still, women are leaving medicine earlier and at higher rates than men, taking with them decades of clinical expertise and leaving behind a replacement cost that runs into the hundreds of thousands of dollars per physician. We’ve named burnout as the problem, but haven’t addressed an important driving factor. The missing piece isn’t a wellness app or a mindfulness practice. It’s loneliness.

The moment I realized how lonely I had become happened unexpectedly and at a time when I wanted to walk away from the life I had. In the hours before a women’s community meetup, I was sitting in my car struggling with the decision to leave my marriage, to break apart my family because I was so unhappy and alone. The relationship had eroded slowly because neither of us had the capacity to pour life and energy back into it. As a pediatric intensivist, my work schedule was irregular, unpredictable, and, at times, mentally and emotionally draining. My husband and I were raising a young daughter without a village and ultimately, we had become each other’s only source of everything: partner, co-parent, friend. Over the six years since moving to this city without family or friends, I also hadn’t invested time and energy into building a new community. The final strain was an undiagnosed health condition my husband was struggling with that impacted his vestibular function and led to his own unhappiness. Throughout this time, I bore the weight with the armor of competence, stoicism, and busyness. Until I couldn’t any longer. I felt so alone. And because I had not taken the time to build and nurture friendships, I felt as if I had no one to call for advice or support.

Then I walked into a room of women who had built their own businesses and were meeting to support one another and for belonging. From a single meeting, I gained motivation, renewed capacity, and hope for reconnection. This was the moment I realized the power of community and the necessity of friendship. And I knew that the burnout I was experiencing as a physician, wife, and mother was accelerated by my loneliness. But the conventional advice for making friends as an adult didn’t work for me: Find an activity, group, location to attend consistently, meet the parents at your kid’s school, or schedule regular meetups. I ran into barriers that made this advice feel impossible and further contributed to my loneliness. My work schedule was irregular and included nights and weekends that rotated unpredictably. I couldn’t commit to a Saturday afternoon book club because I might be working or post-call every weekend that month. My energy after a long shift wasn’t just tired, it was the particular depletion of someone who just had to tell the parents that their baby had a stroke. This was why I needed a different solution and knew that I couldn’t be the only physician mom struggling.

Loneliness and social isolation are a population-wide problem and have been declared an epidemic by the surgeon general. When studied in physicians, social isolation scores were higher in women, physicians 35 to 44 years of age, and those with children under 12 years of age. In other words, the physicians most at risk for social isolation look a lot like me and probably like you. And the high social isolation scores were associated with a higher percentage of burnout, lower levels of professional fulfillment, and more suicidal ideation. The prevalence of loneliness in mothers is also well-documented and carries negative mental and physical health impacts. A 2021 Harvard survey found that 51 percent of mothers of young children report serious loneliness. Studies have also shown that increased social connection in women is associated with reduced coronary artery disease, lower blood pressure, reduced mortality, and slower cognitive decline and reduced risk of dementia. But what all the research leaves out is what happens when you are both a physician and a mother. When you carry the depletion of both identities, the risk factors for loneliness compound and create a particularly potent strain on the individual physician mom.

But often loneliness is unrecognizable in ourselves. We normalize it, defer addressing it to a less busy season, and succumb to the glory of the martyrdom of medicine and motherhood. If we can see it, shame and embarrassment prevent us from naming it out loud. How can a high-achieving woman who is self-sufficient, highly competent, and successful have difficulty making friends? Telling a colleague that you feel lonely feels pitiful and like a personal failure. That admission feels risky. But the cost of staying silent is a career cut short, a life that looks full from the outside but feels hollow from within.

Friendship is not a luxury or an unnecessary self-indulgence. It is the infrastructure that is essential to burnout recovery and creating sustainability in your career and in motherhood. I needed a way to build friendships that fit my life and that of other physician moms but couldn’t find it. So I created it, a personalized friendship matchmaking service that overcomes the barriers many physician moms face when building community. This is the place where a physician mom finds someone who understands her season of life so that exhaustion, an unpredictable schedule, and years of putting friendship last are no longer reasons to remain isolated. Medicine is losing its women. Not because we aren’t strong enough, resilient enough, or grateful enough. Because we are exhausted and isolated and nobody built the infrastructure to keep us connected. That is what I am building now.

This article is discussed on The Podcast by KevinMD: Loneliness, not weakness, is driving women out of medicine.

This essay is cited in the KevinMD record on women in medicine.

Cassie Burton Greenbaum is a pediatric critical care physician at Presbyterian Hospital and the founder of Off Service Mom Co., a curated friendship-matching community for physician moms. She writes and speaks on physician mom loneliness as a structural driver of burnout. She shares updates on Instagram and LinkedIn.