Quiet Quitting, Nike’s Reframe, and the Real Risk in Medicine

Quiet quitting is no longer just a workplace buzzword. A new study in Family Medicine described how residency leaders are seeing disengagement, professionalism concerns, and strategic “time protection” among trainees. The authors traced this disengagement back to multiple causes: generational shifts in work values, mounting systemic pressures, the examples faculty set, and the reality that many residents have less work experience coming into training than in prior eras.

Faculty feel frustrated. Residents feel burned out and disengaged. Both sides have a point, and both sometimes miss each other.

It reminded me of Nike. Since 1988, “Just Do It” has been the rally cry that propelled the brand into iconic status. But almost 40 years later, those words weren’t landing with a generation raised on “cringe culture,” where earnest effort can feel embarrassing and failure is painfully public. (Think "teacher's pet" sentiment on steroids).

So Nike is rebranding: “Why Do It?” Narrated by Tyler, the Creator, their new campaign voices every doubt: "Why risk it, why make it harder, what if you fail?" And then the flip, “But what if you don’t?” As Nike’s chief marketing officer put it: they needed to make sure the message still resonates with each generation. In other words, they’re meeting people where they are, not being frustrated or judging them for a different viewpoint and approach.

Medicine faces a similar challenge.

• From residents: “Why should I go the extra mile? I want a life, No one appreciates it, they still have criticisms, and I’ll still be behind tomorrow.”
• From faculty: “Why won’t they step up like we did? What's wrong with this generation. They have no idea how easy they have it.”
• And let's include the paradox: faculty who get overwhelmed with frustration themselves begin their own version of quiet quitting, pulling back on their efforts and giving up on finding a way forward with certain trainees.

My suggestion is that the real cause is more than generational. It’s what happens when residents stop believing it’s possible to integrate patient care with a life outside medicine, and when faculty give up on residents, writing them off as part of a “new lazy generation.” Both sides stop meeting each other where they are. That loss of belief in a sustainable path forward is what can erode trust, commitment, and growth.

I was reminded of this when a good friend, a former colleague and resident, called recently about a tough clinical situation. In the middle of her packed schedule, she reached out for input, acted on it - including coordinating some remote specialists, and later that night circled back to share what steps she had taken. Her patient is going to be much better off because of the extra effort she poured in.

She doesn’t do that in every situation. She’s selective, knowing when something rises to the level of needing that kind of attention. And that discernment has come through years of refinement and trial-and-error; not through doing everything, all the time.

The real risk is greater still. If faculty begin their own form of quiet quitting, (sometimes loudly with their resignations) then the educational process itself breaks down. Residents, in turn, may be less willing to practice the trial-and-error that teaches discernment about when extra effort is needed, and forges their efficiency, and some may step away from the profession altogether.

The danger isn’t just cultural. It’s structural: fewer physicians learning how to carry the profession forward, fewer willing to give the extra effort when it matters most, and ultimately less access to high-quality care at the very moment the population needs it most.

The path forward isn’t to demand more or to give up on each other. It’s to build systems that make sustainable effort possible, not punishing. It’s to keep believing that meaningful patient care and a life outside medicine can coexist and pursuing it. And it’s for faculty not to give up on residents who seem disengaged; but instead to model (as they themselves figure it out), and invite them into, the discernment of when extra effort truly matters.

Read the full Family Medicine article here

Reflection:

• Where do you feel the pull to disengage — and what might be lost if you do?
• Where do you feel the pull to give in to frustration — and what might open if you didn’t?
• What might it look like to meet each other where we are, for the sake of the future of education, the profession, and primary care?