Get over toxic situations by leaving them

“Get Over It” is a 1994 album track that marked the Eagles’ reunion after a 14-year hiatus. The tune reached number 31 on the Billboard Hot 100 chart.

The song was written by band members Don Henley and Glenn Frey (1948-2016). Henley is known for his biting, often cynical lyrics, and “Get Over It” is no exception. The song is a commentary on the ‘victim mentality’ that the songwriters felt was prevalent in society, particularly in the U.S., at the time. It criticizes people who blame others for their problems, refuse to take responsibility for their actions, and constantly complain about their lives.

The song’s message was controversial, and some listeners found it harsh, but it accurately reflected the band’s attitude of tough love towards those who wallow in self-pity instead of striving to improve their situations. At the risk of sounding unsympathetic to my colleagues, I believe the song’s energetic anthem can also serve as a reminder to physicians to stop dwelling on negativity and start taking control of their lives.

It is clear that medical training has inculcated toxic beliefs in physicians and exposed them to toxic work conditions. Regarding the former, physician coach Chelsea Turgeon, MD, wrote, “[D]uring our medical training, we are indoctrinated with a set of harmful beliefs about what it means to be a doctor. These beliefs harm not only us as individual physicians but the profession as a whole.”

Turgeon cited the following myths that are perpetuated by medical training:

1. “Medicine is a ‘calling.’” This mantra resonates with many of us, but it is not an invitation for physicians to be exploited.

2. “You’re either in the hospital or you’re in the hospital.” What, no work-life balance!

3. “It’s going to get better when ____.” Face it, even after we conquer certain milestones (e.g., passing all steps of the USMLE, completing residency and fellowship, obtaining board certification, etc.), there will always be other challenges lurking, imploring us to embrace them.

4. “It’s not about the money.” That’s a true statement for most physicians, but there is no shame in wanting to be adequately compensated for our time, especially when we begin to pay back hundreds of thousands of dollars in student loans.

There are certainly more myths – ones that highlight unrealistic expectations of ourselves, the infallibility of authority figures, and the suppression of our emotions. However, it is precisely when we feel the need to speak out and voice our displeasure that we are told to “get over it.”

Ellen D. Feld, MD, a clinical professor and medical director of the physician assistant program at Drexel University in Philadelphia, Pennsylvania, wrote, “Any traumatic experience can have lasting psychological effects, and medical education is no exception. But these effects can be overcome. It is possible to ‘get over it …’” To put Dr. Feld’s words into proper context, she was talking about overcoming resistance to donating organs to medical science. Still, we can never completely “get over” traumatic experiences, including medical school.

When I said that physicians should take charge of their lives, I really meant walking away from toxic work cultures and starting anew or leaving practice for a non-clinical job. I was not deluded by the thought that physicians—individually or collectively—could change the health care system, which in reality is a sick care system.

A colleague was recently terminated from his 20+-year hospital job. He was crushed. He quickly found work elsewhere and wrote, “Sadly, in hindsight, I finally now realize the toxic and malignant culture I have worked under and dealt with for many years. My firing may have been a blessing in disguise.”

A primary care physician left her job after the hospital administration made unreasonable demands. The email letter she received was posted online and read widely. Here is the list of demands:

  • Work 8 hours per day (or more if you take time off for lunch).
  • Use downtime to complete paperwork and notes.
  • Refer patients to specialists whenever possible
  • Schedule 32 patients per day and see at least 20 to 24
  • Schedule follow-up visits as frequently as possible
  • See patients the same day or the next day
  • Leave a morning slot open to see patients referred from the emergency department

Why would anyone tolerate working under such conditions? Worse yet, how was a “suit” anointed with this much power, and what about the turncoat chief medical officer who sanctioned the email? This letter unmistakeably cites the reasons physicians burn out and leave practice: unreasonable demands, loss of control, time pressure, depersonalization, and others. Yet we stay in toxic situations—mainly at work and in relationships—for all sorts of psychological, emotional, or situational reasons.

Walking away can often be the most effective way to break free from a toxic situation. Although it can be challenging, it’s crucial for personal well-being. This step requires courage and strength because it often means leaving behind a familiar environment, even if it’s harmful. It’s critical to remember that walking away isn’t a sign of weakness or defeat but a powerful choice to prioritize your own mental, emotional, and physical health.

The physician hosting the website where this letter initially appeared had some good suggestions for remedying the situation, such as urging Congress to act to ease physician shortages by expanding training options, providing greater student loan support and forgiveness, and creating alternative pathways to licensure for international medical graduates.

She also suggested that State legislators introduce reforms to reduce administrative burdens. How about outlawing private equity groups from taking over hospitals and medical practices?

I was most in favor of her suggestion to fire the CEO and chief medical officer who concocted this offensive and insulting letter. They simply didn’t have a brain fart. Their intentions were evil and bottom-line oriented – cha-ching, cha-ching.

Many years ago, I was called to the hospital auditorium to meet the new CEO of the health system. At the end of his speech to the medical staff, he said, “Don’t cross me, or you will live to regret it.”

Everyone was stunned. I got over it. I left the organization shortly afterward.

The Eagles never recovered from their internecine war. They tried to make amends through reunion and farewell tours but realized they would only become friends when “hell freezes over.” “Get Over It” was the group’s last top-40 hit in the U.S.

Arthur Lazarus is a former Doximity Fellow, a member of the editorial board of the American Association for Physician Leadership, and an adjunct professor of psychiatry at the Lewis Katz School of Medicine at Temple University in Philadelphia, PA. He is the author of Every Story Counts: Exploring Contemporary Practice Through Narrative Medicine, Medicine on Fire: A Narrative Travelogue, and Narrative Medicine: The Fifth Vital Sign.

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