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We sit down with Rebecca Arnold, an author and certified executive leadership coach, to explore the emotional challenges faced by physicians experiencing disillusionment in the health care system. Rebecca shares insights on how to reconnect with your values, manage internal stressors like perfectionism and burnout, and find support among colleagues who share your commitment to high-quality, patient-first care.
Rebecca Arnold is an author, certified executive leadership coach, and founder of Root Coaching & Consulting, LLC, a holistic leadership coaching firm for ambitious professionals in high-pressure careers.
She discusses the KevinMD article, “Ways to overcome the grief of disillusionment about medicine.”
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Transcript
Kevin Pho: Hi, and welcome to the show. Subscribe at KevinMD.com/podcast. Today, we welcome Rebecca Arnold. She’s an author, a certified executive leadership coach, and founder of Root Coaching and Consulting. Today’s KevinMD article is “Ways to Overcome the Grief of Disillusionment About Medicine.” Rebecca, welcome to the show.
Rebecca Arnold: Thanks. I’m delighted to be here.
Kevin Pho: So, let’s start by briefly sharing your story and journey.
Rebecca Arnold: Sure. As you mentioned, I’m an executive coach for leaders in high-pressure careers like medicine, law, and academia. I burnt out—I’m trained as an attorney—and I burnt out from a policy job that I was so committed to, completely neglecting my well-being. Things weren’t aligned with my values in terms of how I was operating. After burning out from what I thought was my dream job, I realized I wanted to become a coach to support others, to be the coach I wish I had when I was navigating that experience. That’s what brought me to this work, and I have tremendous respect for physicians. As someone with a chronic illness, I interact with the health care system frequently. I love working with physicians because I see how much support you all need as you go through your day-to-day work. I consider physicians to be like elite athletes, and when we think about elite athletes, they have a whole team of support. That is my dream for what physicians would have.
Kevin Pho: So, you mentioned that you’re an executive leadership coach not just for physicians but for individuals in various high-pressure fields. When physicians come to you, what commonalities do you see between their experiences and those of other professionals in high-pressure fields?
Rebecca Arnold: Yeah, that’s a great question. A lot of folks who come to coaching in high-pressure fields are trying to balance their work with their family and personal life, and they’re also figuring out how to operate within systems that may not align with their ideal vision. For an attorney, it might be the realization that the day-to-day practice of law is different from their initial expectations. For a physician, there’s often a vision they hold through years of training, and when reality doesn’t match that, it leads to pain, frustration, and disappointment.
In my coaching practice, I see clients grappling with overwhelm, trying to make an impact in large systems, and figuring out how to de-stress and process grief. Physicians, in particular, often carry unprocessed grief without space to address it. Many high achievers are perfectionists, and over time, that mindset causes internal stress. Part of our work is finding other ways to maintain motivation without being overly self-critical.
Kevin Pho: Your KevinMD article is titled “Ways to Overcome the Grief of Disillusionment About Medicine.” For those who haven’t read your article, tell us what it’s about.
Rebecca Arnold: The article is about the idea that, during training, physicians develop a vision of how medicine will be. When reality falls short of that vision, it’s almost a shock to the system. My physician clients often talk about the pace of seeing patients, not feeling like they can form meaningful connections, and spending excessive time on administrative tasks like billing and dealing with insurance companies instead of focusing on diagnoses and procedures that energize them.
The article normalizes the experience of disillusionment for those who care deeply about patient care. Physicians often operate in isolation and don’t share their frustrations openly. I outline a simple process for starting to metabolize grief and make small, impactful changes that can build a sense of agency over time. It could be as simple as adjusting a process within their control, like the way lab results are processed or enhancing a questionnaire. Noticing and celebrating daily wins is another strategy I emphasize, as high achievers often overlook their successes and focus only on what went wrong.
Kevin Pho: One of the main points you mentioned is the mismatch between expectations and reality in practicing medicine. Are physicians shielded from these realities during training, such as time pressures, administrative work, and bureaucracy?
Rebecca Arnold: No, I don’t think they’re completely shielded. They do see these realities, but there’s often a mindset of, “When I become X, it will be different.” For example, when I’m fully trained and have my practice, things will be smoother, or I’ll have more autonomy to change how things work. This belief creates a promise that, when unfulfilled, leads to deflation and disappointment once they step into their positions.
Kevin Pho: You mentioned perfectionistic tendencies, which are common among physicians and help them succeed in getting into medical school and residency but can work against them in practice. Talk about shifting away from perfectionism.
Rebecca Arnold: That’s a great question. One of the practices I do with all my clients, not just physicians, is building self-compassion. Perfectionists often resist this because they fear letting up will lead to failure. We explore the actual cost of perfectionism: while it drives high standards, it also creates internal pressure that adds stress. Research shows that stress lowers cognitive function, making it harder to perform procedures or engage in meaningful conversations.
I work with clients to find gentler ways of self-talk, such as “This is hard work, and I’m doing my best,” or “I’m learning, and mistakes are part of that process.” We also emphasize that perfection is an unrealistic standard. Adjusting the mindset to reduce self-inflicted stress while maintaining high standards can be transformative.
Kevin Pho: Can you share a case study of a physician client you’ve coached and how they experienced a shift in mindset?
Rebecca Arnold: Yes, I worked with a physician who performed procedures and also saw patients in the clinic. They struggled with imposter syndrome, which is common early in one’s career or when learning new procedures or technologies. Instead of focusing on the procedure protocol, they were caught up in thoughts like, “I can’t do this,” or “I’ve only done this a few times. Am I the right person for this?”
We worked on reframing those thoughts, focusing on the confidence felt after successful procedures, and practicing deep breathing to settle their system before entering the OR. This allowed them to take command in a balanced way, benefiting their performance and outcomes.
The results were significant. By reducing negative self-talk and building confidence, this physician could focus on the task at hand and command the OR in a confident yet kind way. This shift not only improved their performance but also reduced overall stress. When you multiply that impact across multiple procedures each week, even small improvements can result in a significant drop in stress over time.
Kevin Pho: I want to talk more about the process because I think it’s important for physicians listening to know that shifting your mindset isn’t an overnight change. High achievers, like physicians, often have deeply ingrained habits formed over years. How difficult is the process of changing those mindsets, and how long does it take to see meaningful results?
Rebecca Arnold: That’s a great point, Kevin. The process is gradual, and I typically work with clients for at least six months because that’s the minimum time needed to make a lasting change. We start with small mindset shifts, and clients practice them in their day-to-day work. They then reflect on how it went, what worked, and what didn’t. Change takes time because these thought patterns are often decades old, dating back to middle school or earlier.
During coaching sessions, we identify and challenge limiting beliefs or mindsets causing stress. I point out these patterns, and we explore alternative ways of thinking that might be more helpful. For example, if a client tries a new self-talk practice and it works well for a few days but then they revert to old habits, we examine what triggered that shift and how to address it. Over time, these incremental adjustments add up to substantial progress.
Kevin Pho: So, six months of consistent practice can lead to noticeable changes. That’s not a huge investment when you think about how long these patterns have been in place.
Rebecca Arnold: Exactly. Six months may sound like a lot, but compared to years or even decades of ingrained habits, it’s a small investment. By the end of that period, my clients often say, “The old me would never have thought this way.” It’s rewarding to see that growth. The key is to be patient and consistent with the process.
Kevin Pho: For physicians who may not be ready to commit to formal coaching, what high-yield practices can they start on their own if they’re feeling disillusioned or mismatched with the realities of medicine?
Rebecca Arnold: If someone isn’t ready for formal coaching, the first step I recommend is identifying where they have agency. When you feel disconnected or powerless, it helps to find small areas where you can make a difference. Start by reflecting on your values and noticing where they align or don’t align with your current practice. If there’s a misalignment, look for one small action you can take to regain some control. This might be a conversation with a colleague, making a minor change to a workflow, or finding a way to improve a process that’s within your reach.
The second high-yield practice is to pay attention to your self-talk. You don’t have to change anything at first—just notice it. Many people don’t realize how often their inner dialogue is negative. Becoming aware of these thoughts is the first step toward shifting them. Lastly, my book, The Rooted Renegade, contains over 50 bite-sized practices that can help people start making small shifts on their own.
Kevin Pho: We’re talking to Rebecca Arnold, an author, certified executive leadership coach, and founder of Root Coaching and Consulting. Today’s KevinMD article is “Ways to Overcome the Grief of Disillusionment About Medicine.” Rebecca, what are some take-home messages for the KevinMD audience?
Rebecca Arnold: First, remember that change can feel hard, but small adjustments can make a big impact. You don’t have to overhaul everything at once; incremental shifts add up over time. Second, know that you’re not alone. Many people in health care feel dissatisfied with the direction of the system, but small changes can create a ripple effect. Find your allies—others who are also frustrated or disillusioned—and work together on low-hanging fruit to regain a sense of agency.
Kevin Pho: Rebecca, thank you so much for sharing your insights and perspective. Thanks again for coming on the show.
Rebecca Arnold: Thanks for having me, Kevin.
