A System That Devours Its Own: Why Providers Are Set Up to Fail
Part II: What Providers Already Know
“Experience declares that man is the only animal which devours his own kind…”
— Thomas Jefferson
Note: This one’s for my fellow providers. It’s a long read—maybe because I’m carrying some of my own burnout. But I feel deeply called to speak up. I still believe we can build a system that’s good for patients and for the people who care for them.
If you’ve ever felt like the system is working against you as a provider – it’s not just your imagination. You’re working inside a structure that wasn’t built with your well-being or autonomy in mind. Instead, healthcare has become a layered machine where each part – insurance, hospitals, tech, administrators – chases its own metrics. And when those layers misalign, it’s the provider who gets crushed. You’ve likely seen it firsthand: the 12-hour shifts that still leave piles of unfinished notes, the impossible choice between squeezing in another consult or giving the last patient the extra five minutes they desperately need. So you stretch yourself to fill the gaps – coming in early to tackle charts, staying late to squeeze in emergencies, fighting with insurers to get patients the care they need. And still, you end most days feeling like it wasn’t enough. Healthcare today tends to reward those who can endure these pressures – not because they’re better clinicians, but because they’ve contorted themselves to meet the system’s unspoken expectations. They’ve learned which boxes to click and which battles to pick. They discharge patients on time and answer every portal message and never complain at staff meetings. In short, they’ve figured out how to survive in the system. But that doesn’t mean the system is healthy.
A Bad System
“A bad system will beat a good person every time.”
— W. Edwards Deming
We tell burned-out clinicians to “build resilience” or “practice self-care,” as if yoga or mindfulness apps could paper over structural insanity. Hospital leadership rolls out wellness webinars and free pizza, implying that if you just manage your stress better, you’d be able to handle an impossible workload. Too often, it becomes another way to offload responsibility: if you’re drowning in paperwork, struggling with double-booked schedules, or dreading another weekend on call – well, maybe you just need better work-life balance. Maybe you aren’t efficient or organized enough. But many providers who have “held it together” in recent years did so by sheer personal sacrifice. They’ve finished charting well past midnight, worked through supposed days off, skipped meals and family events, and accepted chronic exhaustion as normal. They didn’t maintain high-quality care because they were inherently stronger or more virtuous – they did it because they became system-fluent under duress, often at great personal cost. And this isn’t about individual weakness or strength at all. It’s about a system design that leaves even the best-intentioned clinician beaten down (mgma.com).
Consider the data: even before COVID-19, about 40% of nurses and 38% of physicians reported symptoms of burnout (commonwealthfund.org). By 2022, those numbers had skyrocketed – roughly 50% of nurses and 63% of physicians were experiencing burnout (commonwealthfund.org). That is nearly two in three doctors. These aren’t people who suddenly forgot how to cope; these are professionals being ground down by having too much work and not enough time or resources – the textbook recipe for burnout. Increased patient acuity, heavier caseloads, and “administrative harms” like endless documentation and prior authorizations pile on to leave clinicians exhausted and, in many cases, unwilling to continue. Little wonder some are rejecting the word “burnout” altogether – “I’m not burned out; I’m being abused,” one might say. They argue the issue isn’t that they lack resilience, but that they’re demoralized by a system that too often puts profit ahead of patients. In fact, physicians Wendy Dean and Simon Talbot have reframed burnout as moral injury, and the concept is striking a chord. Every day, clinicians face scenarios that chip away at the ideals that brought them into medicine. Maybe it’s an insurer’s denial that forces you to watch a patient go without a treatment you know would help. Maybe it’s being told to “work faster” through clinic visits that feel dangerously inadequate. As one physician wrote, many are finding it hard to shake the feeling that our healthcare institutions “primarily serve a moneymaking machine” rather than the Hippocratic mission. That nagging sense – that you’ve become a cog in something that betrays the very care you want to provide – cuts deeper than mere fatigue. It’s soul-crushing. It’s moral injury. And it has real consequences: moral injury has been linked to guilt, shame, and even PTSD in healthcare workers. In other words, it’s not just your body and mind that are tired – it’s your conscience.
Success is A very hideous Thing
“Be it said in passing, that success is a very hideous thing. Its false resemblance to merit deceives men… Everything lies in that [silver spoon].”
— Victor Hugo
We also have to talk about how we define a “good” provider. In healthcare, we often conflate a clinician’s output with their worth. If Dr. X manages to see 28 patients a day, chart perfectly, answer every 2 a.m. call, and never beg for mercy, we hail them as exemplary. We assume they have superhuman efficiency or dedication. But as Hugo notes, success can falsely resemble merit. Often, what “successful” providers have is a hidden silver spoon of support or circumstance. Perhaps they have a spouse or stay-at-home partner handling all the life-tasks they don’t have time for. Or they’re in a specialty with no weekend call. Or they’re simply newer to the field, not yet burned out, doing insane hours at the expense of their personal life. Their apparent invincibility might just mean they haven’t hit their breaking point yet. Meanwhile, another provider struggles to keep up and blames themselves. We must not mistake sheer endurance (or luck) for virtue. In fact, many clinicians privately recognize this: they see how the colleague who skips every lunch is praised, how the ones who never push back get labeled “team players.” It creates a warped moral hierarchy. But high personal sacrifice in a broken system is not the same as excellence – and treating it as such only perpetuates the cycle (mgma.com). It turns a calling into a commodity, a sacred duty into a numbers game.
The Real Robbers And the Shadow
“Let us never fear robbers nor murderers. Those are dangers from without, petty dangers. Let us fear ourselves. Prejudices are the real robbers; vices are the real murderers.”
— Victor Hugo
The most insidious threats to a clinician’s career aren’t an isolated bad outcome or a difficult patient. The real danger is the quiet, accumulating weight of a dysfunctional system that wears down even the best providers. We often brace ourselves for dramatic external threats – a lawsuit, a tragic clinical mistake – but the everyday vices of the system are what truly kill our spirit. The prejudice that our time with patients isn’t valuable if it’s not billable. The vice of valuing throughput over thoughtful care. These are the “murderers” Hugo warns of. A rude administrator or one chaotic shift is survivable; it’s the inertia of the whole structure – a structure that works just well enough to limp along, while quietly draining the life out of its people – that we should truly fear. The inertia keeps everyone going through the motions even as joy and meaning are siphoned away. In this system, good providers don’t immediately drop out en masse; they slowly fade, one compromise and cynicism at a time. One day you realize you haven’t felt excited about your work in months, or that you automatically numb yourself to each new guideline or mandate because caring too much would hurt. The danger isn’t you or your patients – it’s a system that normalizes this grind as “just how it is.” And it is dangerous: not only for providers’ mental health, but for patient care, because a system that devours its healers will inevitably harm those they serve.
“The guilty one is not the person who has committed the sin, but the person who has created the shadow.”
— Victor Hugo
Amid all of this, it’s important to say: if you are a provider feeling disengaged, burnt out, or thinking of leaving, you are not the guilty one. The shadow over your practice was cast by systemic failures, not personal weakness. We hear so many clinicians say, “I don’t know if I can do this anymore,” often with a deep sense of shame – as if they’re letting down their patients or their younger self who dreamed of being a healer. But the guilt lies not with you, the individual who is struggling, but with the conditions that made you struggle. When yet another nurse gives her notice, or another physician quietly opts for early retirement, it’s not a moral failing on their part. It’s the predictable outcome of a work environment that has become unlivable. The sin is in the system that created the shadow – the impossible schedules, the moral quandaries, the relentless pace – under which good people are forced to operate. No amount of personal commitment can completely overcome a fundamentally flawed design. And acknowledging that is liberating: it replaces self-blame with a call to action for change.
The Cost of Carrying On (and the Breaking Point)
All of this has led to a grim reality: people are leaving. Good, experienced clinicians are cutting their careers short, and many promising newcomers are hesitating to enter at all. In a recent 2024 poll, 27% of medical groups reported that they’d had a physician leave or retire early that year due to burnout (mgma.com). Nurses are leaving too – in one survey, 29% of RNs said they planned to exit their current direct-care role, and about 15% intended to leave the profession entirely (oracle.com). These aren’t isolated anecdotes; they reflect a nationwide trend. We’re staring down a serious workforce crisis. More than one-third of active physicians in the U.S. will reach retirement age within the next decade (beckershospitalreview.com), and many are accelerating their exits. One projection warned that if current trends hold, over 6.5 million healthcare workers will permanently leave their positions by 2026, while only about 1.9 million will step in to replace them – leaving a shortfall of over 4 million workers (oracle.com). That figure should stop anyone in their tracks. This isn’t just a staffing issue; it’s a patient care issue, a public health issue, a full-blown system integrity issue.
For those who remain, the strain only increases. When a colleague leaves, guess who picks up the pieces? The patients still need care, so their appointment slots get dispersed among the already overbooked. A recent report noted physicians having to absorb extra patients for months (or more) because replacing a departed doctor can easily take a year (mgma.com). That means even busier schedules, even less margin for error or empathy. It’s a vicious cycle: burnout leads to departures, departures lead to more overload on those left behind, which leads to more burnout. Front-line stories echo the data – the senior nurse who left after 20 years because she couldn’t safely care for twice the patients with half the support staff, or the young physician who quits residency because she can’t envision a future that isn’t consumed by work and devoid of family time. Each loss represents incalculable expertise and compassion walking out the door, perhaps never to return.
One especially troubling aspect of this exodus is who the system is driving away. We are losing many of our most empathetic and community-minded providers – often women, often those with young families or other caregiving roles. Healthcare has never been particularly friendly to work-life balance, but in the past there were at least some paths (however limited) for carving out a slightly saner schedule. Those paths are disappearing. Today, more than 77% of U.S. physicians are employees of large hospitals or corporate entities (beckershospitalreview.com). The era of the small independent practice – where a doctor-mom might arrange to work three days a week, or a seasoned nurse practitioner could job-share to spend time with an ailing parent – is fading. Big systems value consistency and scale; a shift is a shift, a quota is a quota. If you can’t fit the standard mold, you’re often out of luck. If you’re a provider with children or elder care duties, you’ve probably felt this acutely. School pickups, daycare closing times, grandma’s chemo appointments – none of these seem to interest the clinic schedule or the OR block time. Many clinicians (disproportionately women) find themselves in a cruel bind between being the provider they want to be and the parent or caregiver their family needs. Often, something has to give – and it’s usually the personal life. Before the pandemic, physician mothers were already far more likely than physician fathers to reduce their work hours; only 73% of physician moms worked full-time vs 91% of dads (pmc.ncbi.nlm.nih.gov). During the pandemic, 19% of women physicians (vs 9% of men) further reduced their hours to cope with childcare and remote schooling demands (pmc.ncbi.nlm.nih.gov). Some even felt they had no choice but to leave medicine altogether when no flexible options could be found (pmc.ncbi.nlm.nih.gov). These numbers lay bare a heartbreaking truth: the system is often incompatible with the realities of caregiving, and we are forcing dedicated healers to choose between their calling and their loved ones. When faced with that choice, many rightly choose their families – but it shouldn’t have to be a choice at all.
What We Believe at Storyline
We created Storyline because we’ve seen too many good clinicians – smart, compassionate, called people – fall through the cracks of a system that demands too much and gives too little. We believe caring for patients shouldn’t require sacrificing your own health, family, or values. In our view, helping patients and supporting providers must go hand in hand; you simply can’t fix one side of the equation and not the other. Our mission is not just to help patients navigate healthcare, but to give providers a way to practice medicine in the way they once felt called to. We want to help build a world where being a great doctor, nurse, or NP is sustainable – where you can do the work you love and have a life outside of it, where you can uphold your oath and sleep at night. We help providers:
Cut through the chaos: By equipping patients to be more engaged and organized, we reduce the bureaucratic back-and-forth that lands on providers’ shoulders (fewer missing records, fewer “Did you ever get that test?” mysteries). Less time chasing paperwork means more time for actual care.
Focus on the story: We develop tools and workflows that center the patient’s narrative and context, so clinical encounters become more about listening and problem-solving, less about battling the EMR. When patients come prepared with their Storyline summaries, providers can immediately see what the key issues are without digging through dozens of siloed records.
Reclaim autonomy and flexibility: We are exploring care delivery models that give clinicians more control over their schedules and practice styles. Whether it’s virtual follow-up options, more sane panel sizes, or leveraging team-based support, we’re committed to carving out breathing room. You shouldn’t have to choose between being a good provider and being a good parent or person.
Rediscover meaning in medicine: By alleviating some of the system-driven frustrations, we aim to reconnect providers with the reason they went into healthcare in the first place. We want you to end more days feeling fulfilled rather than defeated. We champion initiatives (like improved practice workflows and smarter tech integrations) that let you focus on healing and teaching – the parts of the job that do feed the soul, not just drain it.
Because your calling matters. Your story as a healer matters. And it deserves a system that lets it flourish. Autonomy and balance aren’t luxuries – they’re forms of safety for both you and your patients. A healthcare system that nurtures its providers’ well-being is not indulgent; it’s the only way to ensure high-quality, compassionate care for patients in the long run. We’re here to help you reclaim that sense of purpose, control, and yes, joy in practicing medicine. Clarity, autonomy, flexibility – these are not unattainable ideals. They are the pillars of a better system, one that doesn’t devour its own.
At Storyline, we refuse to accept that burnout and disillusionment are “just the way it is now.” We believe the system can change because it must change – for patients and providers alike. We’re working every day to shine light into that shadow, to give good people the tools to not only survive in healthcare but to truly thrive. It’s a long road, but we know why we’re on it: a system that devours its healers cannot heal its devoured. It’s time to build something better, together.
References
Hostetter, M., & Klein, S. (2023, Aug 17). Responding to Burnout and Moral Injury Among Clinicians. Commonwealth Fund. Retrieved from: commonwealthfund.orgcommonwealthfund.orgcommonwealthfund.org.
Rushton, C. (2023). Burnout and Moral Distress in Health Care. Commonwealth Fund – Transforming Care. Statistics on pre- and post-COVID burnout rates: commonwealthfund.org.
Reinhart, E. (2023, Feb 5). Doctors Aren’t Burned Out From Overwork. We’re Demoralized by Our Health System. The New York Times. Quoted in commonwealthfund.org.
Mayo Clinic Proceedings (2022). Findings on physician burnout rates reaching 62.8% in 2021: commonwealthfund.org.
American Nurses Association (2022). Survey reported ~50% of nurses experiencing burnout: commonwealthfund.org.
Harrop, C. (2024, Sept 4). Physician burnout still a major factor even as unexpected turnover eases. MGMA. Insights on documentation burden and burnout causes: mgma.com and the “calling vs commodity” perspective: mgma.com.
Condon, A. (2024, Apr 11). Nearly 80% of physicians now employed by hospitals, corporations. Becker’s Hospital Review. Statistic on physician employment: beckershospitalreview.com and commentary on corporate vs patient care: beckershospitalreview.com.
Twenter, P. (2025, Feb 28). The other physician pipeline problem. Becker’s Hospital Review. Data on physician age and retirements: beckershospitalreview.com.
Preston, R. (2023, Jan). The Shortage of US Healthcare Workers in 2023. Oracle. Projection of workforce shortfall by 2026: oracle.com; nursing survey data: oracle.com.
Omoscharka, E., & Hamdan, H. (2023). Physician Moms: Too Many Hats to Wear. Missouri Medicine, 120(3). Statistics on physician mothers’ work hours and impact of pandemic: pmc.ncbi.nlm.nih.govpmc.ncbi.nlm.nih.gov.
