Daniel Rosas 🩸🦀

"Younger doctors don't want to work as hard" is the laziest diagnosis in medicine right now. They are responding rationally to a system that has quietly eaten the part of the job worth working hard for. On The Podcast by KevinMD, palliative care physician and physician development coach Christie Mulholland laid out five things health care has to stop doing if it is serious about physician well-being. The one worth bookmarking: Stop blaming the generation. Read the behavior as a signal. When senior faculty describe residents who "just want to finish and leave," they are describing a rational boundary around administrative burden, prior auth, documentation, and corporatized workflows that have narrowed the space to do actual clinical work. Senior physicians sometimes admit the truth in private: their generation had time to sit, teach, and think between patients. That margin got liquidated into throughput. The game changed. The scoreboard did not. The reframe that matters for every chief, every program director, every chair: how the profession responds to the doctors who are setting these boundaries will determine whether there are enough physicians in practice ten years from now. This is not a calling-vs-job debate. It is a retention signal. Christie's second insight is the one most well-being committees will never admit out loud: we keep asking the doctors who care most about burnout to run wellness programs as volunteers, with no budget, while they absorb the distress of every colleague who comes to them. The well-being champion role is itself a burnout vector. The one worth saving for the AI conversation nobody is having honestly yet: Remember the MyChart patient messaging rollout. The promise was better patient care. The delivery was years of uncompensated "pajama time," inbox work spilling into evenings and weekends, and only now a slow retrofit into billable time. Ambient AI scribing and clinical decision support are on the same trajectory right now. Christie's argument: if an AI tool is going to affect patient outcomes and physician workload, it should be vetted like a medical device, by a multidisciplinary committee with physician voices in the room from day one. The EMR rollout is the lesson the industry is about to repeat with higher stakes. Listen to the full conversation on The Podcast by KevinMD. Link in the replies. Program directors and chiefs: what is the single structural change you would make tomorrow if retention of junior physicians were the only metric you were judged on? #ThePodcastbyKevinMD