Nurses Know How to Fix Healthcare, So Why Are They Left Out of the Room?

“Physicians are considered the value drivers—and nurses are considered the costs. What do we do with costs? We try to cut them.”

Shawna Butler is a nurse, an economist, and the creator of the EntrepreNURSE movement. But before all of that, she was a witness. She saw how the healthcare system fails both patients and providers. Not just through policy gaps or staffing shortages, but through design choices that consistently ignore the people who keep it running. Especially nurses.

In this episode of How I Doctor, Dr. Graham Walker talks with Shawna about what happens when nurses are treated like costs instead of collaborators. They unpack the real roots of burnout, why moral injury is often misunderstood, and what it would take to build a healthcare system that values team-based care. It’s a conversation grounded in lived experience, full of data and hard truths, but also rooted in hope for what’s possible if we finally start listening to nurses.

From that conversation, four powerful insights emerged, revealing what’s broken in healthcare today and what needs to change to create a more sustainable future for everyone.

Nurses Aren’t Burnt Out—They’re Being Burned by the System

“Physicians are considered the revenue and the value drivers and the nurses on a balance sheet are considered the costs. And what do we do with costs? We’re always trying to cut them. What are we trying to do with revenues? We’re always trying to expand them.”

Burnout isn’t just about long shifts, it’s a product of misaligned incentives. Shawna explains how nurses, framed in financial models as “costs,” are constantly targeted for cuts, while physicians are seen as revenue generators. This framing undermines teamwork and perpetuates power imbalances that directly impact care quality.

2 Million Years of Expertise at Risk

“By 2030, we’re going to lose two million years of nursing expertise. We can’t afford to lose a single one.”

The numbers are staggering and the consequences, dangerous. Shawna warns of an oncoming brain drain as seasoned nurses leave the profession without successors ready or able to replace them. And yet, little investment is made in retaining, mentoring, or elevating the current workforce. The system keeps training new nurses but fails to keep them.

Innovation Starts at the Bedside

“When nurses are very intentionally part of your innovation agenda… tenure increases when nurses are involved.”

Contrary to popular fear, involving nurses in innovation doesn’t drive them away - it keeps them engaged. Shawna shares stories of how empowering nurses to lead innovation not only improves care but helps retain talent. Nurses don’t need more gratitude weeks. They need real power.

What If Nurse Wellbeing Were a Quality Metric?

“If we really want to improve health outcomes and health experiences, we would focus on making sure that nurses are wherever decisions and budgets about health are being made.”

Imagine a healthcare system where nurse wellbeing isn’t an afterthought but a key performance indicator. Shawna envisions exactly that and shows how prioritizing nurses could unlock better health outcomes, faster innovation cycles, and a more sustainable workforce. It’s not just ethical, it’s economically smart.

Connect further with Shawna on LinkedIn and listen to the See You Now podcast from Johnson & Johnson and the American Nurses Association.

To make sure you don’t miss an episode of How I Doctor, subscribe to the show wherever you listen to podcasts. You can also read the full transcript of the episode below.

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Transcript

Shawna Butler:

Physicians are considered the revenue and the value drivers and the nurses on a balance sheet are considered the costs. And what do we do with costs? We're always trying to cut them. What are we trying to do with revenues? We're always trying to expand them.

So inherently, our financial models, our systems, our hierarchy, our titles, our struggles for power, sometimes it doesn't put us in a place where we're on the same team.

Graham Walker:

Welcome to How I Doctor, where we're bringing joy back to medicine. I'm really excited to be joined by Shawna Butler today. She's someone who is consistently pushed all of us in healthcare to think bigger and lead differently. We talk a lot in medicine about burnout and moral distress, but Shawna names it and unpacks it and challenges it, and I think she's been doing it way before it became headline news.

Shawna is not just a nurse, she's also an economist and a systems thinker, somebody who's worked with hospitals and startups and policy makers and even artists and technologists to redesign healthcare. I had the pleasure of meeting her in person at the NextMed Conference this year, which was outstanding. Shawna is the creator of the EntrepreNURSE Movement and the host of See You Now podcast where she highlights the kind of stories that we just do not hear enough, nurses leading through breakthroughs in policy and technology and human-centered care.

What really drives me to Shawna's work is how she makes the case that we cannot fix healthcare without having nurses in the room and with doctors to have a role as well. Shawna, I'm so excited to have you here. Welcome to How I Doctor.

SB:

I am so excited to finally be having this conversation and I'm so glad that we met in person at NextMed Health. It was really, really good to have you there. And I just want to say thank you for that introduction. I appreciate it. And what I really appreciated is your credentializing my expertise and my authority. And so many times when we are in these conversations where we're talking with our clinical partners and our clinical colleagues, we have this tendency to create the hierarchical stack. And from the standpoint of the problems that we are working on, the phrase I have is that we're taking care of the same people in the same places with the same set of problems. And this is a team sport.

And the economist in me reminds me that one of the reasons why sometimes we don't play very well together as team members is because we're not evaluated and compensated as teams. And the biggest thing is that physicians are considered the revenue and the value drivers and the nurses on a balance sheet are considered the costs. And what do we do with costs? We're always trying to cut them. What are we trying to do with revenues? We're always trying to expand them.

So inherently our financial models, our systems, our hierarchy, our titles, our struggles for power sometimes, it doesn't put us in a place where we're on the same team trying to solve the same types of problems.

GW:

Well, Shawna, I'll just say first thank you back. And you're talking to an ER doctor, and I don't think there is a specialty of medicine that is not more pro-nurse and pro-team sport than emergency medicine.

Let's talk a little bit about the challenges of healthcare. I think physicians and nurses actually have way more in common with the challenges of doing our jobs today in, we'll call it, the post-COVID world. But I think we have way more in common about the challenges that we all face than we have differences for sure.

We talk a lot about distress and burnout on the physician side, but how are you seeing it and hearing from your nursing colleagues? What do you think is similar and maybe even different as well about the way it is showing up for nurses?

SB:

It shows up in the same way, which is exhaustion, fatigue, a sense of hopelessness. A sense of the people who are making decisions don't see me, they don't really care about me, I'm a number. I am highly replaceable.

And I'll just speak on one element of that, which is exhaustion and it comes from a couple of things. Let's talk about the physical exhaustion. Man, taking care of people is just hard. It's hard physically when you think about the lifting, the moving, the up on your feet, the-

GW:

Rolling, wiping, getting weird angles to put in IVs. I know, yeah.

SB:

... There is no part of movement and muscles and skeletal systems that you are not working on and you're absolutely exhausted. Think about the length of time that you have in wherever care setting that you're working. Now, exhaustion on an emotional level. Most of the times we are seeing people in a really bad moment in their life.

GW:

At their worst. Yeah.

SB:

Well, sometimes it's at their worst, but sometimes it's really just in a place where there is pain, there is fear, there is uncertainty, there is worry. Just this layer. Then we are taking on that sense of concern and then taking action. Okay, what is the next right thing to do? What's the next kind thing to do? So there's that constant.

There is the cognitive fatigue of trying to figure out, okay, I got to prioritize. I got to triage, I got to time manage, I got to coordinate, I got to be an ambassador. There's just so many from the cognitive load of trying to manage everything from what is it that I need to explain to you what's going on? And then that whole coordination. Does their family member know? Is there an IV pump? Is a radiology suite? What's going on in the lab? Somebody park their car.

So when I say fatigue, I want people to understand fatigue and exhaustion, there is no dimension of that that people aren't feeling from the standpoint of exhaustion and burnout. Burnout, which is I just am tired. I'm really, really fatigued. I don't think anybody isn't feeling that. So I think from that, those dimensions, it is clearly very similar. I don't think there's actually any dissimilarities.

Just to give some numbers, it's typically around 60, close to 70% of nurses say that they are feeling burned out. It tends to be higher in the younger segment of our workforce. And when you think about the numbers of experienced veteran seasoned nurses who are, they're part of this aging demographic. They've been doing this for 30, 40 years and they are exiting the profession, many of them earlier than they planned, but many of them, for heaven's sakes, it's 40 years. Time to move on.

So when you've got this younger group of nurses who have also left, who is going to support them in helping them to be strong clinically? To manage the complexities that walk through our doors in terms of the social situations? So I think that that's one of the reasons why we see a report of higher burnout rates in our younger population. And I would bet it is the same thing for our physician workforce. So that's the part that's similar. Do you want to talk a little bit about what's different?

GW:

My reaction to your points is mostly agreement. I think the other area that we've seen that, especially with younger healthcare professionals as we'll say, is the lack of... I don't know if it's necessarily mentorship, but it's like showing the younger doctors, nurses, pharmacists, whoever, how to do this as a career for 30 or 40 years. During COVID, many of our nurses burnt out and just decided I think I still want to do nursing, but not emergency nursing. I think emergency nursing is very challenging for lots of reasons.

And so even those people that were continuing to be great nurses, they were nurses in areas that were just different. And so we lost many of the nurses that I'd worked with for a decade. I did a back of the envelope calculation and figured we probably lost, just in my ER, probably 150 or 200 years of nursing experience. And that's nurses who are great at triaging or just putting in IVs or knowing what a sick patient looks like.

That is an incredibly important amount of experience that then can't get then passed down to the younger nurses who want to do emergency medicine nursing as well.

The Nursing Brain Drain: Why We Can’t Afford to Lose Experience

SB:

You're absolutely right on the data. Let me even put a finer point on this.

GW:

Yeah, please.

SB:

So in 2020, the National Academy of Medicine, Engineering Science Medicine, when they're looking at projections of the nursing workforce, pre-pandemic the calculation was that by 2030, we're going to lose two million years of nursing expertise.

GW:

Yeah.

SB:

Just through retirement, through aging, through the process of people exiting careers at a natural, logical period of time. Two million years worth of nursing expertise. When people ask me why should we be really concerned about the health and wellbeing of all of our healthcare workforces? So it's not just in the nursing workforce. This is true for all of our healthcare workforces.

We cannot afford to lose a single set of expertise. And you mentioned several of them, and there are so many. We cannot afford to lose a single one because that is your career progression from the standpoint of who's going to lead, who's going to teach, who's going to mentor, who's going to have the energy to be able to navigate political, technology adoptions, creating new programming, defining new communities that need to be cared for. You have to have a degree of clinical excellence, clinical expertise, institutional expertise, knowledge, wisdom, relationships in order for us to move ahead to just keep the train on the tracks, let alone trying to do anything innovative or transformative.

And just another really interesting data point that people might not have heard. A year ago, the American Nurses Foundation, so this is the philanthropic arm of the American Nurses Association, they did a study and they were looking at philanthropic dollars in healthcare. And there are billions of dollars. Of all of that money that goes to healthcare, only one penny out of every dollar goes to nurses. Specifically to nurses.

GW:

Wow.

SB:

And of that penny, crumbs, that go to nurses, the vast majority, 75% of it goes to scholarships for nurses to become trained to come into the workforce. Very little of it goes to the existing nursing workforce.

GW:

Yeah, the ongoing.

SB:

Or limited into leadership. So this idea of you think about a hamster wheel. If you just keep putting money in, oh, we just need to have more nurses, and this is part of the problem when we don't have a nuanced conversation about the shortage of nursing care and it becomes a nursing workforce shortage, the idea is, well train more, train more.

If they come out and they come into an environment that's like, you're not protecting me. I don't feel safe. I can't do my very best work, they don't stick around. So we keep spending money to train more people to come in and work in a system that's not caring for them. When we talk about the health and well-being of our workforce, currently when you think about delays in care, the number of people who can't get... And this is not technology breakthroughs, can't get their screenings, their mammograms, colonoscopies, the number of surgeries that we have to put on delay, the number of lines of service that get closed down because there's not enough nurses to staff a unit so that babies can be safely delivered in that healthcare system.

And where it is profound and where we see it fast and furious is in our rural settings and in care for the oldest of our population. So, particularly nursing homes.

Patients and Providers Feel the Same Dehumanization

GW:

You mentioned depersonalization as a sign of burnout, and I completely agree with that. I think the interesting thing is that the same feeling that healthcare workers get, that I'm a replaceable number, I'm a butt in a seat, I'm a replaceable widget, is the same thing that patients feel as well.

So we have a system that is meant to help people who are sick, who are patients. And the people that are then delivering that care also feel like they're a number. That seems like a tremendous problem.

SB:

What I want people to do is I want them to understand and know this problem, the magnitude, the severity, and why it matters. Because then when they hear what the solutions are, what approaches actually work, then I think that they all enroll in that same mission on this piece where we have so much similarity with the people that we care for.

One of the things that I think is so powerful is when you look at the hierarchy of who has decision-making power and influence in the care of people. Patients are at the very bottom. They have the least amount of power. And up above them are providers. And within those providers, we've got a hierarchy there. And the group of people who have the most influence, but still not a whole lot, would be the physician workforce. And everybody else is a very distant part behind them.

But if you look at that funnel of influence, it's the people who have the money. So venture capitalists. We take a look at hospital associations. They have some power, but again, they're lower down. But it's really device pharma, payers, and policymakers. And so when you think about where the greatest amount of trust is and where the greatest amount of, when we talk about being person-centered or patient-centered, it's crazy that that's the group of people who we're doing this in service of and they have the least amount of power and influence.

Okay, so where does change and progress and transformation happen? And we have more power than what we think because we have power in numbers. And the provider side, all of the clinicians, the people who are taking care of people, are in that care pathway and care journey. Collectively, we have numbers and that is where our power is and our credibility and expertise. And as providers, we are the amplifiers of the patient, the family, the community voices.

What If Nurse Wellbeing Was a Core Quality Metric?

GW:

Let's play a little imagination game here. What would it look like if we designed a healthcare system around nurse well-being as a quality metric?

SB:

First of all, I think what would change is the longevity, the career tenure, the ability for nurses to... The public really misses out when they don't tap into this enormous pool of expertise and experience and trust-based relationships. We focused on the well-being. If every single one of our nurses are at their top form, they've got systems that are keeping them safe, keeping them cared for, the effectiveness, the efficiency, the innovation, the economic engine that they are on so many different lenses. I really feel, and this is an honest consistent answer, if we really want to improve health outcomes and health experiences, we would focus on making sure that nurses are wherever decisions and budgets about health are being made.

And the reason being is nurses are the fastest license to the patient. They better match our innovation cycles. The feedback mechanisms that nurses have, that is a really fast iteration. And because it is fast and it is trust-based, we actually can move things a lot faster.

The other part is nurses, we do a lot of things. But the thing that we are so good is health promotion and prevention. So much in our healthcare system is very much focused on demand. We have this aging population, we have a mental health crisis, we have huge amounts of diabetes. What if we focused on reducing demand? This really cool part of, wow, fewer people are sick and ill. More people are productive and happy and prosperous. And God knows, in the United States of America, we spend way more than any of our peer nations, or any nation probably for that matter, on our healthcare infrastructure. Not so much on people, but on our infrastructure. And we're living shorter, sicker lives and paying a lot more money for it.

So if we actually focused on the nursing workforce, by default we're actually focusing on wellness, health, readiness to learn, health promotion, management of complex chronic diseases. We would be looking at everything from preconception, how do we make sure that you're in the healthiest possible place for you to decide to become pregnant, being pregnant all the way to the end of life, making sure that people have death with dignity and decency.

So it's this entire cycle. There's a very strong economic and clinical case to be made for why, if you focused on the wellbeing and the performance of the nursing workforce, why it's a benefit for everybody.

Global Perspective: How Systems Shape Health Outcomes

GW:

Shawna, you've done ICU nursing, emergency, transplant. What was it that made you personally decide hey, I want to look upstream of this. Look at it from an economics perspective. That's a different approach than a lot of people take.

SB:

Early on in my career, I had a couple of things that happened simultaneously. And it was really good that they happened at the same time. One of which was I was doing international medical repatriations. So I got to see care delivered all around the world.

GW:

I'm in Nigeria and I break my leg or I have a heart attack and you are helping me get back to the United States to continue my medical care?

SB:

So medical repatriation, what that involves is somebody gets sick somewhere and the level of care that they need is not available to them. And so we need to get them to the place where they can. And oftentimes the best place to do that and to continue on the care is in a place that's home, where you've got family, language, your network of support established. You mentioned Nigeria. That is one place that I have been and picked up people. But Ayers Rock in Australia, Edinburgh, Scotland, all sorts of really interesting places.

And so a lot of people have, when they talk about being involved with global health, they're usually talking about it on a macro level, on a population disease burden. Mine was actually at service line delivery. So while pregnancy metabolically is the same anywhere around the world, it actually unfolds quite differently in Portugal, in Paraguay, in Pennsylvania, in Peru. And so that was a real eye-opening experience to me. It was like, oh, wow, I didn't realize that there was so much variation.

I also started my career at the time when we had another global pandemic. At that point, we didn't know the name of it, but it was HIV and AIDS. And so, started to see this whole movement towards patient-centered care. And that was also a big change when the business models, we didn't have for-profit hospital systems. There was just so much that we really didn't think about, but we had amazing double-digit healthcare inflation.

So seeing things around the world, watching the people that I was caring for, seeing some of the technology and policy and the social changes. And the fact was is that our financial systems were far more willing and ready to pay for a surgical service than they were for an education. Or a primary care service or the number of broken hips that we would see and we'd take care of somebody with whatever other type of clinical diagnosis or condition, and we discharge them home. And we wouldn't spend a hundred dollars for a walker to prevent a fall, but we would certainly spend a million dollars for them to have that hip repaired, replaced, and all of the post-op care.

So I really started asking the questions like, does this make clinical sense? Does this make economic sense? And that was really where I started looking at I want to better understand these systems and I love the sacredness and the intimacy of being with people. And if nothing else, being a witness to their suffering, their fear, their joy. I also love zooming 30,000 feet above and figuring out an algorithm, a technology, or a policy that's going to take care of millions of people across generations.

But that being able to zoom 30,000 feet out is only informed from what it's like for taking care of somebody who's in the community, working three jobs, has three kids, taking care of an elderly mom.

GW:

I think that's the exact reason that you see so many emergency physicians and emergency nurses honestly as well, working in innovation, entrepreneurship, building different things because we see all the ways the system does not work for people. All the people that fell through the cracks because this policy and this policy left a gap for these people or the healthcare system didn't consider this combination of diseases and symptoms and social determinants together.

And they show up on our doorstep and they say, help. And it's our job to make it work and figure it out. So I think... I agree. It's the closeness to the suffering and the ways that the system honestly fails its humans.

When Nurses Lead Innovation, Everyone Wins

SB:

Well, you brought up the word innovation, and that's like sparkly magical dust for me. The interesting part is I've heard so many people who are major employers for nurses in healthcare systems, and there's this little bit of reticence like, oh, we don't really want to introduce nurses to innovation because then they'll leave. And the exact opposite is true.

When nurses are very intentionally part of your innovation agenda, a couple of magical things happen. Number one is problems get identified that nobody ever thought about. Solvable problems. There's no such thing as a simple solution in a complex problem. That is my dear colleague, Diane Baker, who trying to put a toothbrush on a tray so that we could prevent hospital acquired pneumonia from not brushing her teeth after surgery.

But when nurses are involved in helping to iterate and to solve that problem, the interesting thing is that they become far more committed to their clinical practice. Tenure increases when nurses are involved.

GW:

Are engaged.

SB:

Yeah. And it's the engaged, but it's the leading. It is you heard me, you empowered me, you trusted me, you believe me, and we all benefited from it. There's this whole other area of moral injury, and I know a lot of people have been hearing about it. I'm so grateful for the work of Wendy Dean, a psychiatrist. Her early work was with our military soldiers and seeing so much parallel. It's the sense that clinicians have that they know what their patients need and they cannot get it for them because of the constraints outside of their control.

And so it's way more than a state of exhaustion or prolonged workplace stress. It's when your deeply held, ethical beliefs are violated. And they're violated because you just keep witnessing and you're participating in these actions that you know are harmful. This moral injury piece, the best way to address that is to engage people in the problem-solving. And then they can see you're listening, you're hearing, we're solving this together.

I think something that's super important to talk about is you hear the terms about moral injury and burnout and all this workplace distress. And there is this sense of, okay, that's on you, Graham. You're the individual clinician. You need to do more yoga. You need to get more rest. Okay. You cannot solve a system-level problem with an individual solution. And until criteria around the well-being in the workforce is a measurable board-level metric that has clear funding and executive action behind it, we're not going to make a dent in this.

And when we don't do this, the safety of everybody, the people who are taking care of people who are coming in, our community members, safety declines, errors go up, access to care goes down. Nothing good comes out of this. But it's not until we move that up there and then it becomes an organizational enterprise value that we are measuring, that we are putting budget against, that we are actively working on.

And there are a couple of organizations that I just want to make sure that listeners are paying attention to. The Dr. Lorna Breen Heroes Foundation and all the work that they have been doing to normalize the mental health and wellbeing. The legislation and it needs to be reauthorized and re-funded. So the Dr. Lorna Breen Healthcare Provider Protection Act, which provides funding-

GW:

Thank you, yeah.

SB:

... so that we can continue to do this type of research. Another group that I've been working with that I think is doing extraordinary work, and you don't think that it's all that important, but it's amazing how peer-to-peer conversations, there's an organization that Emma Payne put together, it's called Help Texts, T-E-X-T-S. Yeah. So in Case people can hear that correctly. And this is focused on managing our grief. And originally how it was designed was to think about people who are in that period of grief, loss, for any number of reasons. But as Emma and her team started working on this, they recognized that that type of support, caregiver and grief support, needs to happen for healthcare providers. And so it's a really simple approach of sending very well-crafted and timely texts to our workforce.

And then the other one that I think is so powerful is the NeuroArts Blueprint. That is program that's run by Susan Magsamen. She's got a fabulous book out with Ivy Ross, and it's called Your Brain On Art: How the Arts Transform Us. And they really are the repository for all this research that's being done on how the arts change our brains, our bodies, and our behavior. And there's this whole area of how do we take care of the healers.

Going back to your first prompt in your question, I think one of the most important things is that when we talk about wellbeing, the really interesting thing when Judy Davidson started doing this work out at UC San Diego, she had a physician partner and they had been focused on the physician workforce. And it was a couple of years in, and they had three suicides of nurses in a very short period of time. And they had been focused on the physician workforce. And when Judy brought it up, they recognized we had never really even thought about the nurses. Shame on us.

GW:

Yeah. Yeah.

SB:

But it was this catalyst. And so I think one of the most important things is that when we're talking about the wellbeing of the workforce, this is a great place for us to team up.

GW:

You know, Shawna. It's interesting. I'm reflecting now that I probably spend more time with the same set of nurses than I do with the same set of emergency physician colleagues because we typically work different shifts in different hours. And we sit in the same room and we'll maybe bounce ideas off each other, but generally I'm interacting way more with the same five or six nurses every day than I am the same physicians or the same consultants or the same hospitalists or the same cardiologist.

And so I completely agree with you. Some of the nurses that I know really well and know me, and I know them really well, we can check each other or check in with each other and support each other like, "Hey, are you doing okay today?"

Because they just seem like they're maybe in a different head space from the person that I've known for the past 10 years, too. So I love that idea, as well.

Trust, Teamwork, and Why Nurses See It All

SB:

And honestly, that is true with every single specialty. When you think about it, we'll take surgery for an example. Surgeons don't work together. They're off doing the different surgeries. But the surgical teams, they get to work with all of them.

GW:

That's right.

SB:

Obstetrics, all of them. This is just tip to the public. If you are moving to a new place, you're pregnant and you want to find somebody to help you manage your pregnancy, the best group of people to ask would be the nurses who work in labor and delivery.

GW:

Absolutely.

SB:

Because they work with all the midwives. They work with all the obstetricians. And the obstetricians don't work with each other. They don't work in the same ways. But from the standpoint of if you want to know... I mean frequently, we're not looking for a referral for emergency physicians or neurosurgeons. But when you're looking for people, you go to the unit of that specialty and you ask that group of nurses. And you ask them, "Who would you have taken care of you?"

GW:

That's right. Yeah. There's no bigger compliment for me than when one of the nurses I work with checks in as a patient, and then the charge nurse pulls me aside and says, "Hey, so-and-so asked if you would be their doctor. They're having chest pain." Whatever it is.

That is obviously the biggest compliment I can get if somebody wanted me to be their doctor.

SB:

When we get to know people on that human level, oh man. That's again, joy and magic. And I loved how you talk about how you're in this to bring back joy because I think most of the times what we're hearing about in healthcare is that it's really hard. There aren't a whole lot of people right now who are having fun.

But when we do this well-

GW:

That's true.

SB:

... When we do this well, oh my gosh, is it not? It is such a great feeling.

GW:

It's great. It is such an amazing feeling. To feel like you had the opportunity to make a difference in someone's life, and you really connected with that person who is having the worst day of their lives, and you found a way to make it not so terrible. Yeah.

Appreciation Weeks Are Not a Substitute for Compensation

SB:

The last couple of decades, there's been this patient-centered, patient-centered, patient-centered. And to this point of sacrificing. I think so many of us with this Hippocratic Oath, it's been in some ways used against us. When I hear that phrasal for nurses, oh, it's a calling. No, it's a career. We all have mortgages to pay. And when you frame it as a calling for any of those, it gives you license to pay people less.

We just finished National Nurses Week, and one of my colleagues said to me, "The only people who have appreciation weeks are those people who are underpaid. Underpaid and undervalue."

I'm like, oh my God, there's not a venture capitalist day is there?

GW:

That's amazing. I didn't think of that. Oh, my gosh. That's funny.

SB:

Shout out to Andrew Penn out in your neck of the woods, out in San Francisco, who really shared with me that very powerful insight. I'm like, yeah, you don't have appreciation days for people who are well paid and well compensated.

Final Reflections: Bringing Back Joy to Healthcare

GW:

Well, Shawna, it's been an absolute pleasure. Thank you so much for joining me on the podcast today.

SB:

Oh, my gosh. This is such a pleasure and you are such a bright spot. And if there's going to be joy to be had, you're going to be at the center of it, Graham.

GW:

Thanks for joining me today.

For interviews with physicians creating meaningful change, check out offcall.com/podcast. You can find How I Doctor on Apple, Spotify, or wherever you listen to podcasts. We'll have new episodes weekly.

This has been and continues to be Dr. Graham Walker. Stay well, stay inspired, and practice with purpose.