Physicians Taking Back Medicine: ‘Suck it Up, Buttercup’: Why these doctors left medicine — and what they’re doing to fix it

Editor’s Note: Welcome to Physicians Taking Back Medicine, a podcast from Medical Economics. Hosted by Dr. Rebekah Bernard, each episode dives into the real-world challenges facing today’s doctors. The show will explore how doctors can reclaim their autonomy and shape the future of health care with candid interviews and actionable insights. Join Dr. Bernard and her guests each month as she guides you toward an empowered and sustainable medical career. The views expressed in the episode do not necessarily reflect the views of Medical Economics or MJH Life Sciences. Scroll to the bottom for show notes, including topics and timestamps, music credits and more.

MaryAnn Wilbur, M.D., M.P.H., M.H.S., racked up $650,000 in student loans and spent decades training to become a gynecologic oncologist. But not long into her career, she became so disillusioned with the health care system that she walked away from clinical medicine to fight for reform.

Rebekah Bernard, M.D.

Host, Physicians Taking Back Medicine

“I was struggling with getting what I needed to provide good patient care — in terms of support at the hospital and at home,” said Wilbur. “I was essentially powerless to decide what my patients received, and I didn’t feel comfortable with that anymore.”

The Doctor is No Longer In

Wilbur soon realized she wasn’t alone. One in five physicians reported wanting to leave clinical medicine. “I knew what had pushed me and my colleagues out of practice, but these stories weren’t being told,” she said. “Patients know their doctors are distracted and overwhelmed — but they don’t understand just how handcuffed we are when trying to get them the care they need.”

With two master’s degrees in public health and training in qualitative research, Wilbur began interviewing physicians who had either left or were planning to leave clinical practice. “You keep going until you reach thematic saturation — until you’ve heard it all,” she explained. “Then you code it, put it back together, and add quotes back in.”

Her findings culminated in the book The Doctor is No Longer In, which outlines systemic problems in health care. By the time the book was published, the number of physicians planning to leave medicine had doubled. “Not only are more physicians leaving,” Wilbur said, “but physician suicide is also doubling.”

The Phrase That Sparked a Movement

The research led to something even bigger: a documentary titled Suck it Up, Buttercup: Trust and Betrayal in American Medicine. “Physicians aren’t the only ones in this story,” said Wilbur. “We talk to nurses, patients, administrators, even insurance companies. The documentary is about giving voice to everyone impacted by the broken system — and asking, how the hell did we get here, and what are we going to do about it?”

Todd R. Otten, M.D., a former full-time family physician and now one of the documentary’s executive producers, echoed the urgency. “I went through burnout in 2019,” Otten said. “I remember hating the job I had always loved, and that was so painful.”

After leaving what he described as a toxic work environment, Otten turned to advocacy, co-authoring the book Ripple of Change and building community through social media. That’s where he met Wilbur. “She ran the idea of the documentary by me,” he said. “From there, it’s been like a thousand miles an hour.”

A System on the Brink

The title of the film comes partly from the toxic mantra physicians internalize during training — but it also came directly from interviews. “We asked an insurance executive, ‘Why are you chewing up your best assets — physicians?’” Otten recalled. “And they said, ‘Well, they just need to suck it up, buttercup.’”

The problem, Otten said, isn’t a lack of grit. “Resiliency and effort are not the problem here. There are many upstream causes. And patients are being told to suck it up too. Trying to navigate the system is nearly impossible. People are being buried — and at times killed — for the sake of profits.”

The film is being funded through a grassroots effort led by physicians and change agents. “We’re at about 70% of our funding, which is incredible for just six months in,” Otten said. “The support from funders shows how frustrated the public is with our health care system.”

Completion is expected by November 2025, with plans to stream on a major platform. “The second half of the film is about hope, courage, and action,” said Otten. “There are great organizations out there doing incredible work. But they’re often siloed. If we can create an impact network of health care change agents — people over profits — we can’t be ignored.”

The documentary features voices from across the health care spectrum: Don Berwick, former head of CMS; Wendy Dean, who champions the concept of moral injury; physician wellness advocate Dike Drummond; managed care whistleblower Linda Peeno; U.S. Surgeon General advisor Tina Shah; entrepreneur Mark Cuban; insurance critic Wendell Potter; nursing leader Camille Burnett; and cancer patient advocate Matthew Zachary — along with many others.

A Warning — and a Call to Action

Both Wilbur and Otten believe the physician exodus signals a looming collapse.

“Any system that sacrifices its core resources is going to collapse,” Wilbur warned. “And I’d argue that it’s already happening. Maternal mortality is up across all demographics — and Black maternal mortality has tripled in the past decade. When a system isn’t designed for you, you don’t get the right service. We built our system around money. It’s a business.”

She added that physicians leaving clinical care are often the ones who care the most. “It’s not the weak ones who burn out or die by suicide — it’s the ones who care so much that they can’t bear the moral injury. I want patients to understand: we’re suffering right alongside you.”

The struggle to access care, the denials, the medical bankruptcies — it’s not the fault of physicians, Wilbur said. “There’s institutional greed. Private equity. Corporate buyouts. We had chances to stop this 20 or 30 years ago, but now physicians are largely powerless. And we’re hurting too.”

Finding Strength in Connection

Despite it all, Wilbur and Otten want people to know they are not alone — and change is possible.

“One of the biggest reasons doctors feel trapped is debt,” said Wilbur. “They’re wearing golden handcuffs. Their families are scared. That pressure can become overwhelming.”

She encourages those struggling to seek out like-minded support. “If you don’t feel the support and understanding from family or friends, find us,” she said, referring to the grassroots group Medicine Forward. “It’s for anyone who cares about the physician-patient relationship. You will find your people.”

Wilbur said Medicine Forward helped her through the guilt and shame of leaving clinical medicine. “That’s where I found my community. That’s where I found the strength to keep fighting — just in a different way.”

Otten agreed: “Connection is everything. We are meant to work together. But physicians were taught to ‘suck it up, buttercup,’ tough it out, never ask for help. We have to look out for each other better.”

“Sometimes asking a colleague if they’re okay could literally save their life. And sometimes, standing up for yourself — or for them — can change everything.”

“It’s the power of one-plus-one,” said Otten. “We see this as a way to connect all these amazing individuals so that there can be call to action after call to action, because there is so much work to do to unwind the legacy institutions that that are well funded, well lobbied, powerful, and very happy making a lot of money and keeping the status quo.”

Rebekah Bernard, M.D. is a Family physician in Fort Myers, Florida and the author of three books, including Physician Wellness: The Rock Star Doctor’s Guide.

Music Credits
Medical Education by Art Media - stock.adobe.com

Editor's note: Episode timestamps and transcript produced using AI tools.

Introduction and Dr. Wilbur’s Background (00:00:15) Dr. Wilbur shares her journey leaving clinical care due to systemic barriers in healthcare and her motivation to seek change.

Systemic Problems and Physician Powerlessness (00:01:20) Discussion of systemic issues, lack of autonomy, and the inability of physicians to provide optimal care within current structures.

Qualitative Research and Book Genesis (00:02:32) Dr. Wilbur explains her qualitative research interviewing physicians leaving medicine, leading to her book "The Doctor Is No Longer In."

Physician Debt and Misconceptions (00:04:27) Addressing the misconception that society pays for physician training and the reality of massive medical school debt.

Collapse of the Health care System (00:06:14) Rising physician attrition, suicide, and predictions of health care system collapse due to neglecting core resources.

Patient and Physician Suffering; Greed in Health care (00:08:04) Exploring shared suffering of patients and physicians, and the impact of greed at multiple levels in health care.

Physician Employment and Loss of Autonomy (00:09:12) Shift from independent practice to physician employment, and the resulting loss of decision-making power for doctors.

Anecdote: Dr. Guy Clifton and Patient Safety (00:09:43) Story of a neurosurgeon advocating for patient safety, resistance from administration, and the power of physician integrity.

Moral Injury and Physician Suicide (00:12:14) Defining moral injury, the existential crisis for physicians, and factors distinguishing those who leave from those lost to suicide.

Messages of Hope and Community (00:14:37) Encouragement for physicians facing moral injury, the importance of community, and resources for support.

Making Noise and the Documentary (00:16:16) The need for advocacy, public awareness, and the transition from book to documentary to amplify all stakeholder voices.

Dr. Todd Otton's Story and Documentary Origins (00:17:21) Dr. Otton’s experience with burnout, meeting Dr. Wilbur, and the inception of the documentary project.

Meaning Behind “Suck It Up, Buttercup” (00:18:42) Origin of the documentary’s title from both physician training and insurance executive attitudes.

Documentary Goals: Impact and Network (00:19:33) Aims to combat learned helplessness, inspire hope, and create a network of health care change agents.

Diverse Voices in the Documentary (00:21:12) Highlighting the inclusion of physicians, nurses, patients, and advocates in the documentary.

Funding, Timeline, and Distribution Plans (00:21:49) Progress on funding, expected completion, and plans to reach a wide audience via streaming platforms.

Ongoing Call to Action and Systemic Barriers (00:22:56) Vision for continuous calls to action, the entrenched status quo, and the urgent need for systemic change.

Personal Impact of Systemic Decisions (00:23:53) Dr. Otton’s personal story of burnout, the ripple effect of administrative decisions, and the cost of short-term thinking.

Connection, Support, and the Power of One (00:25:06) Emphasizing the importance of connection, mutual support among physicians, and the exponential impact of collaboration.

Podcast Conclusion (00:26:01) Host wraps up, highlighting the mission to share stories of physicians working to improve health care.