OPINION:
The American Medical Association recently released its annual report on physician burnout, and the headlines wrote themselves: Burnout is down for the fourth straight year, from 43.2% in 2024 to 41.9% in 2025.
The AMA framed it as meaningful progress, but anyone who has practiced medicine in the past decade knows what such surveys actually measure: the number of willing respondents.
I trained as an ear, nose and throat surgeon for a decade. I completed my residency. I built my own practice. A year ago, at the height of my career, I walked out of clinical medicine for good.
I know the burnout rate isn’t dropping; physicians are.
Here is what 41.9% truly measures: the physicians still in the room. It does not count the ones who quit. It does not count the physicians who die by suicide each year.
It cannot count the largest group of all: the doctors who answered “I’m fine” because saying anything else could end their careers.
Seventy-eight percent of physicians say stigma surrounds the seeking of mental health care. When Dr. Lorna Breen, the New York City emergency physician whose name now anchors a federal law, recovered from COVID-19 in the spring of 2020 and returned to her hospital, she was terrified that asking for help would mean losing her medical license, her family says.
She died by suicide weeks later.
In February, Congress reauthorized the Dr. Lorna Breen Health Care Provider Protection Act, extending its mental health programs through 2030. It was a rare bipartisan win, championed by Republicans such as Sen. Todd Young and Rep. Jennifer Kiggans, as well as Democratic colleagues.
The law now awaits appropriations. Lawmakers should fund it. They also should stop pretending that funding alone will fix the problem.
You can build the most generously funded physician wellness program in the country. If the state licensing board still asks invasive mental health questions on every renewal — and many still do — then physicians will not use it.
If the hospital quietly labels the doctor who sought help “a liability,” then she will not use it. If the residency director writes “needs to work on her resilience” in her file, the way mine did when I left an operating room in tears, then she will not use it.
The bureaucratic obstacle here is clear: State medical boards in dozens of jurisdictions still ask physicians to disclose any history of mental health treatment as a condition of license renewal. Hospital credentialing committees follow the same template.
The most consequential reform Congress can advance now is one that costs nothing: Condition federal health-workforce dollars on state and institutional licensing inquiries that ask only about current impairment, not history. Anything less keeps the closet locked.
I know this because I lived it. I made the calculation thousands of doctors make every week: my practice, income and reputation or my honesty. I chose honesty, and I had to leave the profession to keep it.
This should matter to anyone who has ever sat across from a physician. Burnout is associated with a measurable increase in medical errors. Surgeons who cannot ask for help and doctors who cannot acknowledge a mistake are not private mental health concerns; they are public safety concerns.
We do not let pilots fly when they are exhausted. We do not allow air traffic controllers to self-certify their own clearances. We do not allow a paramedic to drive after a 30-hour shift.
Yet a surgeon can, provided she does not document it. We extend medicine a deference that no other safety-critical industry receives, and we are paying for it — patients and physicians both.
The Lorna Breen Act is necessary but not sufficient on its own. The next bill must protect the truth-telling physician from retaliation by her board, hospital and state. Until that protection exists, the AMA’s burnout numbers will keep ticking down, and no, not because medicine is “healing.”
It will be because the people who would have answered honestly are no longer available to ask.
Next year, fewer of us will answer. The number will look even better.
• Frances Mei Hardin, M.D., is an ear, nose and throat surgeon who left clinical medicine in 2025. She is the author of “Surgeon on the Edge” (Hippocratic Press, 2026), creator of Rethinking Residency and a co-founder of the Hippocratic Collective, a physician media company, as well as host of the podcast “Surgeon, Interrupted.”
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