Offcall Physician Spotlight: Meet Dr. Christie Mulholland

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1. Christie, what’s one task you’ve fully handed off to AI that you’d never take back?

I have fully handed off the first draft of PowerPoint slides, and I’ll never do one again. I make a lot of presentations for grand rounds, faculty workshops, and leadership meetings. Looking at a blank slide deck is firmly in my past. Now I give AI my topic outline (from my brain) and the template. I still revise and refine, but I never have to start from zero.

I also frequently use AI for editing my writing, although I get the writing far enough along that I can feel solidly that the ideas come from me and that I’m the primary author. I resisted mentioning this in my answer, because it feels taboo. Some academic publications won’t even accept an article where AI has been used in any capacity.

I find it kind of ironic that our profession is embracing AI in clinical settings, but not for expressing our own ideas or advancing ourselves professionally. I wonder about what’s behind that. Are we more accepting of using every advantage when it benefits others (patients and, even more so, our employers) than when it empowers us?

2. Will AI solve the physician shortage or quietly make it worse?

Both are possible. The outcome will depend on how much say physicians have in how AI gets deployed.

Take geographic maldistribution of physicians as an example driver of physician shortages. Telemedicine plus AI could genuinely extend physician reach into rural and underserved areas in ways that matter. But the same technology could also be used to justify never recruiting physicians to those communities in the first place. Whether it becomes access or substitution depends entirely on who’s making the decision.

The burnout piece worries me more. Ambient AI documentation is being touted for its potential to reduce burnout, borne out in early studies. But health systems are already looking for the ROI. How will they pay for the products? The downstream risk is that any physician time saved will be seen as additional patient slots and revenue. We’ve seen this movie before with the rollout of the EHRs. They were supposed to give us more time with patients. Instead, they became a billing engine and created administrative bloat, which is arguably the largest driver of burnout. If AI follows the same pattern, we’ll have reduced documentation burden only to find ourselves expected to see forty patients a day instead of thirty. The fear I hear most from many colleagues is that AI plus expanded midlevel scope will be a deliberate cost-cutting strategy to “reduce the need” for physicians.

The physicians who will shape this outcome are the ones with enough agency to stay at the table and push back.

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3. What’s something you used to judge other physicians for that you now completely understand?

Stepping back. When I saw colleagues taking a leave or going part-time, I didn’t judge them harshly, but I assumed I wouldn’t become one of them. I thought that loving my work and finding deep meaning in it would be enough to sustain me indefinitely.

Then it wasn’t.

I was a role model of well-being for years, with a formal title as a well-being director. Then, it happened all at once. My institution, facing financial pressure, mandated that all clinical faculty increase patient volume, right as I’d been working hard to reduce burden on those same faculty. It felt like a rug pull. Around that same time, I did a peer-to-peer call with an insurance company trying to get a dying patient approved for inpatient hospice. The response of the faceless “peer” insurance company doctor was, “Wow, she didn’t die yet?” Revealing his hand—he’d been waiting her out.

That was the moment. Not burnout exactly — I still cared deeply. It was demoralization. The sense that caring no longer felt worth it inside the system I was in. I applied for a formal sabbatical. When it was denied, I took one anyway. But the sabbatical wasn’t giving up. I still care, and now I’ve repositioned myself just enough that I can stay in the fight.

4. If you had a magic wand for one thing in medicine — not your whole career, just one thing — what would you fix tomorrow?

I’d normalize rest. Actually normalize it, not as a talking point at a well-being conference, but structurally. Sabbaticals. Career breaks. Part-time schedules. Taking 30 minutes per patient instead of 20, even if it means earning a little less.

Right now, the physician who steps back, for any reason, is treated like she’s opting out. She becomes invisible. And most physicians accept this without pushback, because they’ve internalized that any boundary they draw comes at a patient’s expense. That guilt is real. It’s also exploited by institutions that depend on physicians absorbing whatever the system can’t handle.

Here’s what I think gets missed: physicians who have space to breathe are also the ones who can think clearly about what’s wrong and what to do about it. Rest isn’t retreat. It’s how you stay in the fight. The doctors who took a step back and moved forward on their own terms are some of the most clear-eyed advocates I know for fixing this system.

We’re losing physicians not just to burnout but to a creeping sense that there’s no version of this career that’s sustainable for them. More flexibility, real flexibility, not performative, would keep more doctors in the profession. And frankly, we need them here.

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