Once again, “The Pitt” has captured something real, pinpointing the chronic problem of stress and burnout in our health system. Toward the end of Season 2, Episode 12, third-year medical student Joy Kwon leaves when her shift is over, even though the ER is busier than usual. Dr. Langdon, a resident who has been battling addiction throughout this season, tells her most people stay when things are in “disaster mode.”
Joy: “You know 62% of ED docs report suffering from burnout?”
Langdon: “Painfully aware.”
Joy: “So maybe all you lunatics need to learn to set some boundaries, like me. See you tomorrow, doc.”
Joy leaves not because she’s burned out, but because she doesn’t want to become like the doctors and nurses she works with. The scene sparked a debate among viewers: Is Joy a boundary-setting hero or a selfish quitter?
It’s telling that so many people were stunned to see a medical professional leave at the end of her shift. Burnout is so commonplace in health that it seems normal.
That expectation — to give more than is sustainable — is not unique to the ER. In my 10 years of practice in state and local health departments, it was an all too familiar feeling. Racing to meet a midnight grant deadline, stepping out of a funeral to answer “urgent” questions about a lead report I wrote (yes, that happened) or grinding through a daily barrage of emails to keep colleagues and community partners aligned.
I’ve missed my fair share of family obligations and personal milestones because duty to the public always came first. In public health and medicine, these aren’t exceptions — they’re part of the culture.
As Joy noted, about 60% of emergency room physicians report symptoms of burnout, due to factors like staffing shortages, long and irregular shifts and exposure to critically ill, dying and traumatized patients and families. ER nurses are in the same boat. And the problem doesn’t stop at the hospital doors.
Less visible than emergency room workers, 71% of another critical group — government public health workers — report at least one burnout symptom, with one in five reporting near-constant symptoms. More than 40% have student loan debt, with an average balance near $50,000. (That’s double the percentage of all U.S. adults who have student loan balances.)
These pressures are well understood, but the flawed design of the system is rarely addressed.
We understand this in other sectors where failure has clear consequences.
For flight attendants and pilots, we mandate rest — with minimum hours between shifts, strict limits on duty time and formal fatigue risk management systems that allow workers to report exhaustion without fear of punishment.
Why? Because when they make a mistake, people die. But in healthcare and public health, fatigue is often treated as dedication. And then we act surprised when the system breaks.
Burnout isn’t a personal weakness; it’s a warning. When public health workers leave — nearly half of all state and local employees left their jobs between 2017 and 2021 — we lose expertise, speed and relationships. Outbreaks fester longer. Disasters hit harder.
The deterioration of the public health workforce didn’t start with COVID, but the pandemic exposed longstanding problems: budget cuts, political pressure and a culture that treats “calling” as compensation.
We ask highly trained professionals to take on debt, accept stagnant wages, absorb political attacks and work through crisis after crisis — and when they show signs of strain, we tell them to be more resilient.
We’ve sold public service as a calling for decades. That’s great, but can’t pay a mortgage with purpose. You can’t pay off student loans with mission. At some point, a cause greater than yourself must be matched with a system that values you.
Instead of debating whether “putting in the extra effort” is a reasonable request, we need to talk about what we do with the system we’ve built where staying feels mandatory, leaving feels immoral and neither option is sustainable.
The system is not just failing professionals, but consuming them. We need a system that doesn’t devour its heroes. But addressing burnout isn’t just about supporting workers; it’s about protecting the systems communities rely on every day.
