A New Term ?

The term "quiet quitting" has gained significant traction in recent years. While the phrase has been around for at least four years, its application to professional spheres beyond the corporate world has not been widely explored. After learning its meaning—performing the bare minimum required by a job description, without going above and beyond—one might reflect on whether this behavior manifests in the practice of medicine. At first, the idea seems nonsensical; a healthcare provider's job is so fundamentally tied to a patient's well-being that performing with minimal effort seems antithetical to our core values. Yet, upon deeper consideration, this subtle disengagement, while not as dramatic as walking off the job, might be more common than we think. Consider the following four case studies:

A physician is completing their notes after a long day in the hospital. The patient is stable, with no major changes from the day before. The physician opens the previous day's note and simply copies the entire assessment and plan, pasting it into the new note. The doctor has no new thoughts to add. Is this quiet quitting?

A patient is admitted to the hospital with a complex set of problems: multiple chronic diseases, new side effects from a recent medication change, and an ambiguous symptom that has yet to be diagnosed. The provider writes a one-sentence assessment and plan, with no detailed thought process, no differential diagnosis, and no clear next steps. The note is a formality, not a reflection of the patient's intricate clinical picture. Is this quiet quitting?

A provider is faced with a challenging clinical case. The patient's symptoms do not align with a clear diagnosis, and a quick search on a popular medical information tool like UpToDate doesn't provide a clear answer. Instead of taking the time to search research databases like PubMed, the provider defers to a general, non-specific treatment plan. The provider does not take the time to conduct independent research. Is this quiet quitting?

A provider is constantly frustrated by a flawed or outdated order set within their hospital's electronic health record (EHR) system. They know it can lead to confusion and errors, but they never report the problem. Instead, they find a personal workaround—a series of extra clicks and steps they have memorized to get the orders right. When asked about it by a colleague, they shrug and say, "That's just how we do it here." They never provide feedback to the order set committee to improve the system for everyone. Is this quiet quitting?

At first glance, these behaviors could easily be dismissed as quiet quitting. They are, after all, examples of doing the bare minimum and avoiding the more difficult or time-consuming work. But in the demanding world of medicine, can we truly use that term? Or is there something more profound at play?

Is it burnout—the emotional, physical, and mental exhaustion caused by prolonged stress? Or is it moral injury, where a provider is forced to act in a way that goes against their deeply held ethical beliefs, such as a patient's best interest? Could it be disillusionment, a loss of faith in a healthcare system that prioritizes metrics and efficiency over patient well-being? Or is it simply a survival reaction—a provider's unconscious way of coping with a relentless workload and a lack of institutional support?

So, what do you think? And how will the increasing use of artificial intelligence in medicine impact these behaviors?