You are not the only one wondering.
A 2025 Harris poll found that more than half of US healthcare workers planned to switch jobs in 2026. The American Medical Association’s 2025 data shows 31 percent of physicians intend to leave within two years. Reuters projects a shortage of nearly 700,000 healthcare professionals by 2037.
Whatever you are feeling right now, you are part of an entire profession asking the same question.
That does not make the question easier. If anything, the volume of people asking it makes it harder, because the noise drowns out the signal. Every coach, recruiter, and locum agency has an opinion about what you should do. Almost none of them know your life.
I am not going to tell you whether to stay or leave. I am going to walk you through the framework I use with the clinicians I coach, and the one I used on myself.
I should say this up front. I am a working Pulmonary/ ICU physician. I am also a coach for healthcare professionals navigating exactly this decision. I have not left clinical medicine, and I do not plan to. That is a deliberate choice, not a default. If I share my reasoning along the way, it is not because I think your answer should match mine. It is because I want you to see what an examined decision to stay can look like, since most of the content out there only models leaving.
This post is for every healthcare professional asking the question. Nurses considering whether to leave the bedside. NPs wondering whether to go independent. PAs thinking about industry. Respiratory therapists looking at non-clinical pivots. The framework applies to all of you. The pain points are the same. The specifics are yours.
The Guilt Is Real, and It Is Not Your Fault
Before any framework, I want to name what most healthcare workers carry when they ask this question.
Guilt. Guilt for considering it. Guilt because patients still need them. Guilt because their colleagues will pick up the slack. Guilt because they trained for this and should be grateful. Guilt because they used to love it.
I have sat with this guilt myself. I have heard versions of it from almost every clinician I have coached.
The guilt is not a sign that you should stay. The guilt is a sign that you take your work seriously. Those are different things. You are allowed to ask the question. Asking it does not betray your patients, your colleagues, your training, or your past self. Asking it well, with structure, may be the most responsible thing you can do for everyone involved.
The Trap of Binary Thinking
When clinicians come to me asking whether they should leave, the first mistake I see is framing the question as a binary. Stay or leave. All in or all out.
The actual landscape has at least four options.
The first is to stay and change nothing. This is rarely the right answer if you are reading this post.
The second is to stay and change how you practice. Different schedule, different setting, different scope, different boundaries, different relationship to the role or different way of how to approach doing their work.
The third is to expand without leaving. Add a non-clinical income stream alongside clinical work. Coaching. Consulting. Locum. Industry advisory. Education. Writing. A small business.
The fourth is to leave clinical practice fully. Pivot to industry, education, administration, or another field altogether.
In my experience, most clinicians who tell themselves they are considering leaving actually want option two or three. They have just never heard those options modeled by a real human.
The Six Questions I Walk Clients Through
Sit with each of these honestly. There is no scoring. The patterns will reveal themselves.
1. Is the problem this job, this specialty, or this profession?
Imagine waking up tomorrow at a different hospital, in the same role. Would you feel relief? If yes, the problem may be local.
Imagine waking up in a different specialty entirely. Would the relief deepen? If yes, the problem may be specialty fit.
Imagine the same role at the best possible employer in the best possible specialty, and you still feel heavy. If that is your answer, the problem may be the profession itself, or it may be moral injury. Read Moral Injury vs. Burnout before you decide.
2. What did you love when you started, and is any of it still possible?
Most clinicians lose the thing they loved long before they lose the job.
Was it patient relationships? Procedures? Teaching? Diagnostic reasoning? Teamwork? The intellectual work? Whatever it was, can you still find it in your current role for at least a few hours a week?
If your honest answer is yes, with some restructuring, you are looking at option two. If your honest answer is no, not in this system at all, you are looking at option three or four.
3. What are you running from, and what are you running toward?
If you can only describe what you want to leave, you are not ready to leave yet.
Pivots driven by escape almost always replicate the same problems in a new setting. I have watched this happen. I almost did it myself once.
Pivots driven by clarity about what you are building toward tend to land. The Purpose Assessment Quiz at the end of this post is built for exactly this question.
4. What does your nervous system say after a good shift?
Not your worst shift. Not your average shift. Your good ones.
After a shift where things went right, where you helped someone, where the team clicked, do you still feel depleted? If even your good shifts cost more than they give back, that is real data.
If your good shifts still nourish you and your bad ones drain you disproportionately, the issue may be the bad-shift conditions, not the work itself.
5. Whose voice is loudest in this question?
Is it yours? Or is it your spouse, your parents, your colleagues, social media, or the version of yourself from medical school or nursing school?
I have coached clinicians who spent years answering a question someone else was asking. Get clear on whose answer you actually want.
6. What would you regret in 10 years?
This one is uncomfortable but useful.
If you stayed for 10 more years exactly as you are now, what would you grieve? If you left tomorrow, what would you grieve?
The answer to what I would regret losing often matters more than the answer to what I would regret enduring.
The Four Paths in Plain Language
Once you have sat with the six questions, the path becomes clearer. Here is what each one looks like for the real clinicians I have worked with.
Path 1: Stay and Change How You Practice
Real examples. Moving from full-time to 0.7 FTE. Switching from inpatient to outpatient or back. Dropping a poorly-fitting specialty rotation. Joining a different group. Renegotiating call structure. Protecting the first 60 minutes of your days.
Many clinicians never try this path because they have never seen it modeled. I want to model it for you. This is the path I am on right now.
Path 2: Expand Without Leaving
This is the path of the portfolio career. You stay clinical part-time and add coaching, consulting, locum, industry advisory, education, writing, or a small business alongside.
The clinical income protects you while you build. The non-clinical work refills what clinical work depletes. Many of the happiest healthcare professionals I know live on this path.
Path 3: Locum or Hybrid
For physicians, locum tenens has become a legitimate long-term strategy, not just a stopgap. You gain schedule control, geographic flexibility, and an exit ramp from toxic local cultures. The only drawback is a sense of insecurity because the needs and the demands change but they rarely completely go away, (always there are doctors getting sick, having to take a leave, or simply wanting better structured time off to rest, which creates an opening in most specialties).
For NPs, PAs, and nurses, the equivalent is travel work, agency work, or per-diem at multiple sites. The trade-off is benefits and continuity for autonomy.
Path 4: Full Pivot
Industry. Pharma. Medical communications. Education. Administration. Public health. Entrepreneurship. An entirely different field.
This path takes longer to set up than people expect, and it is often best done while you are still employed clinically. The clinicians I have watched pivot most successfully spent 6 to 18 months building skills and networks before they made the jump.
A 30-Day Reflection Plan
If this post has stirred up more questions than answers, that is the point.
Here is the 30-day plan I give clients to move from rumination to clarity.
In week one, track your shifts. Each day, jot down a single sentence about how you felt at the start, middle, and end. No edits. No analysis. Just data.
In week two, sit with the six questions. One per day. Write a paragraph for each. Do not show them to anyone yet.
In week three, talk to three people who have made changes you are considering. One who stayed and changed how they practice. One who expanded. One who left. Ask what they wish they had known.
In week four, make a draft decision. Not a final one. A draft. Sit with it for a week and notice what your body does. If your nervous system softens, that is signal. If it tightens, that is also signal.
You will not finish the work in 30 days. But you will be much further than you are now.
What I Tell Clients at the End of This Process
Most of the clinicians who walk through this framework do not end up leaving medicine.
They end up changing how they practice or they start viewing their work differently in a way that is healthier for their mind or body. They build a portfolio life. They renegotiate call. They drop a rotation that was wrecking them. They take a month and then come back differently.
A smaller number do leave, and they leave well. They leave because they got clear on what they were building toward, not because they ran out of ways to keep going.
Either path can be right. The wrong path is the one you make in panic.
What to Do Next
If you want a structured tool to surface what you actually want, the Purpose Assessment Quiz was built for this question. Ten minutes, four healthcare archetypes, a personalized PDF report. It is not a magic answer. It is a mirror.
If you want to keep doing this work with other healthcare professionals, Rounds Society is the monthly membership I lead: a live coaching session every month, a private community that is open day or night, and short tools for the hardest moments of a shift.
In my experience after many years coaching doctors, most will find more happiness, joy and fulfillment when they have clarity about what they want, view their work and environment in a different way and connect more consistently to why they went to medicine.
If you decide you want one-on-one help mapping the next 12 months, that is what the coaching practice is for.
You do not have to figure this out alone. You do have to figure it out honestly.
Frequently Asked Questions
Is locum tenens a real long-term option, or just a transition?
For many physicians, it has become a permanent strategy. The 2026 healthcare staffing forecasts suggest locum demand will keep growing as physician supply tightens, which gives locums real leverage. The trade is benefits and continuity for autonomy and schedule control.
Can nurses do something similar?
Yes. Travel nursing, per-diem at multiple facilities, and agency work are the closest equivalents. NPs in full-practice-authority states have additional flexibility.
Will I lose my clinical skills if I expand or leave?
If you fully leave, yes, gradually. If you stay clinical even part-time, no. Most expand-without-leaving clinicians keep at least 0.4 to 0.6 FTE clinical work to protect skills and licensure.
What about non-clinical jobs in industry or pharma?
They are real. They pay well. They tend to suit clinicians who like systems thinking, are comfortable in corporate environments, and can articulate their clinical value to non-clinicians. The pivot usually takes 6 to 18 months of intentional networking.
How do I know if I am running from the job or running toward something else?
If you can describe in detail what you want to build, you are running toward. If you can only describe what you want to leave, you are running from. The first is durable. The second often is not.
