During my MBA, I read countless articles highlighting the fact that younger generations now shape work around life, as opposed to shaping life around their work. In medicine, that shift feels nearly impossible. We don’t have the luxury of logging in remotely to perform a a colectomy or to fuse someone’s spine. Our patients demand presence—often at the expense of family, hobbies, health, and sanity. Smartphones, secure chats, EMR in-baskets, and endless meetings have erased the boundary between work and home.
Recent data paint a sobering picture. According to Johnson & Johnson MedTech’s 2026 “Behind the Mask” report, more than 50% of surgeons feel burned out and over 40% have contemplated leaving surgery — rising to 65% among those already experiencing burnout. Top contributors include administrative burden (47%), family time conflicts (48%), and unrelenting hours (44%). While national physician burnout has eased to ~45%–47%, surgeons remain at higher risk. Orthopedic attendings, in particular, have seen burnout rates double in recent years at some institutions. We cannot continue training surgeons for a decade only to watch them exit early due to preventable systemic strain.
The financial stakes are equally sobering for health systems. Replacing a single physician costs organizations between $500,000 and more than $1 million — often two to three times the departing surgeon’s salary — when factoring in recruitment, lost productivity, and onboarding. Including foregone revenue, the total can reach $1.2 million or higher. Orthopedic surgeons, for instance, generate an average of $3.3 million in annual hospital revenue; an open position can therefore drain $1.8 – $2.8 million in billings while straining remaining staff. Nationally, physician burnout-driven turnover costs the healthcare system $4.6 billion each year. In an era of razor-thin margins and projected physician shortages, early attrition is not just a wellness issue — it is a direct threat to clinical capacity, service line viability, and the bottom line. Supporting early-career surgeons in setting sustainable boundaries is one of the highest-ROI investments a department or health system can make.
In academic medicine, I watch partners accumulate titles and responsibilities until their calendars defy the concept of time. As a resident and fellow, I assumed the path to success required the same approach: say “yes” to everything. During my fellowship a wise mentor—now retired—challenged that assumption. He deliberately protected time for family and personal passions. Listening to him describe the life he built, I realized I wanted the same. He reminded me of the “eulogy test”: pointing out that no one at your funeral will praise how many committees you chaired or how early you arrived for 6 a.m. meetings.
COVID intensified an already demanding culture. Virtual meetings proliferated and never receded. I found myself rounding at one hospital before dawn meetings, racing across town to the next campus, operating all day, and clearing in-baskets between cases. Evenings became a sprint—dinner standing up, shuttling kids to sports, collapsing exhausted beside my wife. I knew what I signed up for in medical school, and I still thrive on purposeful busyness. But I had quietly surrendered my own health: rising cholesterol, twenty-five extra pounds, poor sleep, and low energy. My mentor reminded me that while we all think we manage stress like it’s nothing, our body’s physiology does not lie. Surgeons already face higher mortality rates than our non-surgical colleagues. That statistic, combined with my mentor’s blunt warning about unmanaged stress, forced a reckoning.
A few years ago, I drew a hard line. I stopped attending meetings where I held no active role or genuine interest. I kept only the non-clinical work I was passionate about—primarily political advocacy through the Colorado Orthopedic Society and serving as my department’s co-director of well-being and working on managing compensation plans. The reclaimed early mornings now go to case preparation, inbox management, or exercise. Between cases, I can walk hospital stairs or enjoy an uninterrupted cup of coffee. Most evenings I leave the hospital with essential tasks complete and my mind fully available for my children and wife. Weekends are no longer dominated by catch-up work. The result: greater efficiency during clinical hours and deeper presence at home. As Jack Black aptly put it, family is about “presence, not presents.”
The shift initially triggered anxiety. Would partners view me as disengaged? Would I forfeit advancement? None of those fears materialized. Instead of FOMO, I discovered JOMO—the joy of missing out. The ability to gracefully say ‘no’ is a skill that all of us should learn to use. By concentrating on what truly matters, I contribute more meaningfully where it counts.
Early-career surgeons can replicate this approach with a straightforward exercise:
- List every essential clinical task your job requires
- Write down the non-negotiable tasks that define your job: clinic, OR, inpatient rounding, trauma call, case preparation, and documentation. These are the activities that directly serve patients and fulfill your contract.
- List the non-essential activities currently on your plate
- List committee work, task forces, journal clubs, quality improvement projects, optional meetings, research that isn’t funded, and any “other duties as assigned” that have quietly accumulated. Be brutally honest—most of us are carrying far more than we realize.
- Define your personal priorities
- Beyond medicine, what truly matters? Time with spouse and children, physical health and exercise, hobbies (golf, fishing, coaching youth sports), faith, community involvement.
- Articulate your core career goals
- What does long-term success look like to you? Building a high-volume joint replacement practice, earning national speaking invitations, achieving partner status in three years, maintaining excellent patient satisfaction scores, publishing in top journals, or becoming a leader in health policy? Rank these goals by importance.
- Score each of your essential and non-essential tasks
- Assign each item on your combined list a simple 1–5 score (or use a basic spreadsheet rubric) based on how well it advances your ranked personal priorities and career goals. A 5 perfectly aligns; a 1 consumes time with little return.
- Begin to protect your time by setting hard boundaries
- Block recurring personal time first and defend it as fiercely as you would an OR block. Communicate these boundaries clearly and early to your partners and administrators.
- Re-evaluate your circumstances at least once a year
- Life changes—kids get older, practice volumes shift, new leadership opportunities arise. Regular re-calibration prevents drift back into over commitment.
Include your spouse or partner in this process. Their priorities matter as much as yours. Use the same rubric when evaluating new job offers. Use your assigned point values for each of your goals or priorities and then score each job opportunity against your ranked list. The clarity can be incredibly insightful.
The message from my department chair during residency, Dr. Ted Parsons III, was ‘the reputation you set in your first 6–12 months of practice will likely follow you throughout your career.’ For those who know Dr. Parsons, you are likely to appreciate the wisdom that he imparted on countless young orthopedic surgeons. If Tuesday nights are family taco night, protect them from the beginning. You will not regret establishing priorities that allow you to remain a skilled surgeon and a healthy, present human being.
References
- AMN Healthcare. 2019 Physician Inpatient/Outpatient Revenue Survey. Merritt Hawkins; 2019. https://www.amnhealthcare.com/siteassets/candidate-blog/physician/merritthawkins_revenuesurvey_2019.pdf
- Shanafelt TD, Balch CM, Bechamps GJ, et al. Burnout and career satisfaction among American surgeons. Ann Surg. 2009;250(3):463-471. doi:10.1097/SLA.0b013e3181ac4dfd
- Han S, Shanafelt TD, Sinsky CA, et al. Estimating the attributable cost of physician burnout in the United States. Ann Intern Med. 2019;170(11):784-790. doi:10.7326/M18-1422
- Johnson & Johnson MedTech. Behind the Mask: The Hidden Toll of Surgeon Burnout. Johnson & Johnson MedTech; February 2026.
- Merritt Hawkins. 2022 Review of Physician and Advanced Practitioner Recruiting Incentives. AMN Healthcare; 2022.
Patel VR, Stearns SA, Liu M, Tsai TC, Jena AB. Mortality among surgeons in the United States. JAMA Surg. 2025;160(9):1032-1034. doi:10.1001/jamasurg.2025.2482
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