'If things get worse, we do what we always do'

Physicians across the US are growing increasingly frustrated with the state of healthcare, and many are questioning whether they can—or should—stay in the profession. A recent discussion on Reddit’s r/medicine revealed a growing sentiment: If things get much worse, doctors may start leaving en masse.

In a thread that has already garnered hundreds of comments from MDs, DOs, and other healthcare professionals, medical student @Tr0gl0dyt3_ asked their healthcare peers, “If it gets much worse… what do we do?”

From government policies that favor private equity and large corporations over physicians and patients, to increased regulatory burdens and reimbursement cuts, the conversation reflects a profession at a breaking point. 

Fears are mounting

Doctors are increasingly concerned about the ethical dilemmas they may face due to restrictive laws impacting patient care. “I’m scared once I become a doctor to have to comply with awful legislation and that people will die because I legally cannot act,” one physician admitted.

These fears aren’t unfounded. With discussions about changes to Medicaid, Tricare, and even restrictions on trans-affirming care, physicians worry they will be put in impossible situations. “People will die if [Medicaid] gets gutted,” @kellaorion said. 

The overwhelming emotional toll

Beyond policy changes, the emotional burden on healthcare workers is evident. Many feel they are screaming into a void, desperate for change but uncertain of how to achieve it. “I feel a bit like a frog in boiling water,” said @question_assumptions.

Burnout is reaching dangerous levels, with some considering taking up another profession altogether. “I now walk dogs for kicks,” shared a former nurse, disillusioned by the system. Others worry about their own well-being. “I NEED help keeping this up—I can barely take care of myself these days.”

Escaping a broken system

Many physicians debated the pros and cons of leaving the US altogether for potentially greener pastures. User @malachite_animus said, “As a doctor, you can emigrate from the US. Canada and Ireland seem to be the easiest places to go to, but I haven't looked in depth. It's a lengthy process, but it's within reason. That's your safeguard,” but this was rebuked by another: “Don’t leave. Resist,” said @kamata-.

Support for unions and labor strikes

“I'm warming up to the idea of a strike where no billing occurs. Still see patients and chart, but just leave out the information necessary to bill and don't submit charges. Patients get seen, but oh boy does that hurt,” said user @antiworkDPT-OCS, with many others supporting the power of strikes and unions. 

“We need professional organizations with teeth. It seems to me like the only physician organizations that are able to get concessions from the powers that be are unions. (Nurse/tech/other healthcare worker unions as well),” said user @mrhorrendous. 

So, what’s next?

While the frustration is palpable, many physicians remain committed to advocating for change. “The very best way you can fight for others AND yourself is to finish med school,” @wumsdoc advised, emphasizing the need for long-term resilience. Others are calling for collective action, with physician and nursing unions emerging as potential solutions. “Striking is the way we get something actually done.”

The path forward is uncertain, but one thing is clear—healthcare professionals are deeply concerned about the future of their field. Whether through activism, advocacy, or simply continuing to provide the best possible care within a broken system, they are determined to fight for the well-being of both their patients and themselves.

This comment from user @o_e_p is especially powerful: “We go into this field to take care of sick people. We might have varying opinions about complex social problems, and we may have a myriad of other goals, but caring for the sick is the job. Whatever politics is happening, sick people are still here. They still need care. Only you can only decide what your goals are… The real answer is, if things get worse, we do what we always do. Our job.”

For now, the question remains: Will policymakers address these concerns before more doctors walk away?