The white coat isn't just a uniform. For many, it's a cage. Lately, there’s been this massive groundswell—a sort of quiet rebellion—called the 23 former doctor truths. You’ve probably seen snippets of it on TikTok or buried in long-form Substack posts from physicians who just… quit. They didn’t leave because they hated medicine. They left because they loved it too much to watch what was happening to it from the inside.
Healthcare is messy. Honestly, it’s more than messy; it’s a bureaucratic nightmare that treats patients like line items and doctors like data entry clerks. When these 23 truths started circulating, they weren’t just complaints. They were a diagnostic report on a dying system.
It’s about the "moral injury." That’s a term you’ll hear a lot from people like Dr. Wendy Dean, who co-founded Moral Injury Healthcare. It’s not "burnout." Burnout implies the doctor isn't resilient enough. Moral injury means the system is forcing them to act against their own ethics. Imagine knowing exactly how to help someone but being told by an insurance adjuster with a high school diploma that the life-saving test isn't "medically necessary." That’s the reality.
The 23 Former Doctor Truths and the Myth of the "Difficult" Patient
One of the biggest takeaways from the 23 former doctor truths is how the system labels you. If you ask too many questions or bring in a printed stack of research, you're often flagged as "non-compliant" or "difficult." Former doctors are now admitting that these patients are actually the ones they liked most. Why? Because they care.
But the system isn't built for care. It's built for throughput.
The average primary care visit is now clocked at about 12.1 to 17.4 minutes. Think about that. In less time than it takes to get a Starbucks order during a rush, a doctor is supposed to review your history, perform an exam, diagnose a complex issue, and bill it correctly. It’s impossible. So, truth number one is simple: Your doctor isn't ignoring you; they are being hunted by a clock.
Dr. Danielle Ofri has written extensively about the emotional life of rounds. She points out that the "clinical gaze" often strips the humanity away from the person in the bed. When doctors leave the profession, they often cite this loss of connection as the primary reason. They went into the field to hold hands and solve puzzles. Instead, they’re clicking boxes in an Electronic Health Record (EHR) system that was designed for billing, not for healing.
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The Insurance Shadow
Let’s talk about the "Prior Authorization" nightmare. This is a core pillar of the 23 former doctor truths.
It’s a shell game. Insurance companies know that if they make the paperwork tedious enough, a certain percentage of doctors will just give up. They call it "utilization management." Doctors call it "practicing medicine without a license" by the insurance company.
I talked to a former cardiologist who told me he spent four hours on the phone one Friday trying to get a stress test approved for a man with clear chest pains. The person on the other end of the line was reading from a script. They hadn't seen the patient. They didn't care about the patient. They cared about the "criteria." This cardiologist quit three months later. He realized he was spending 60% of his day fighting people who weren't even in the room.
Why We Should Listen to Physicians Who Quit
When someone spends eleven years and $300,000 to become something, and then walks away at age 40, we should probably pay attention. This isn't a mid-life crisis. It's a whistleblow.
The 23 former doctor truths highlight that the "Doctor-Patient Relationship" is now a "Provider-Consumer Transaction."
- The Pharmaceutical Influence: It’s not always about bags of cash. It’s about the subtle ways data is presented.
- The Mid-Level Creep: Hospitals are replacing experienced MDs with less-trained staff to save a buck, then charging you the same price.
- The Suicidality Secret: Physicians have one of the highest suicide rates of any profession. We are literally killing the people who are supposed to keep us alive.
There's a specific truth that resonates deeply: "The most expensive piece of medical equipment is the doctor’s pen." This was a common saying in the 90s. Today, it’s the "algorithm." We’ve outsourced clinical judgment to software. If the software says a patient is low-risk, they get sent home. Even if the doctor’s gut—that intangible, 20-years-of-experience gut—says something is wrong.
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The Wellness Industrial Complex
Many of these former doctors end up in "Functional Medicine" or "Direct Primary Care." Critics call this "concierge medicine for the rich," but the doctors see it as the only way to actually practice safely.
If you have 3,000 patients on your roster, you can't be a good doctor. If you have 400, you can. The 23 former doctor truths reveal that the "standard of care" is often just the "minimum viable product." It’s the lowest level of care that won't result in a successful lawsuit. That’s a terrifying thought when you’re the one on the operating table.
What You Can Actually Do With This Information
Knowing the 23 former doctor truths shouldn't make you cynical. It should make you tactical. You have to navigate this system differently now. You can't just be a passive recipient of "healthcare."
First, stop apologizing for being "annoying." If your doctor seems rushed, call it out. Politely. Say, "I know you’re on a tight schedule, but I have three things we must cover today." It resets the room. It forces them to look up from the iPad.
Second, ask about the "Why." If a doctor suggests a drug, ask what the Absolute Risk Reduction (ARR) is, not just the Relative Risk Reduction. Big difference. One sounds like a miracle; the other shows it might only help 1 in 100 people. Former doctors admit they often didn't have time to explain this distinction unless asked.
Third, look into Direct Primary Care (DPC). This is a model where you pay a monthly fee (like a gym membership) directly to the doctor. No insurance involved for the visits. Because they don't have to hire three people just to handle insurance billing, they can spend an hour with you. It’s a return to the "old way" of doing things, and it’s growing fast because doctors are desperate to escape the corporate machine.
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The Reality of the "Exit Interview"
If you read the resignation letters of the doctors who contributed to these truths, a pattern emerges. They aren't angry at the patients. They are heartbroken.
They talk about the "Ghost Patients"—the ones they couldn't save because of a delay in authorization. They talk about the "Payer-Provider" war where the patient is just the battlefield.
One former ER doc wrote that he felt like a "glorified triage officer for a sinking ship." He wasn't practicing medicine; he was just deciding who got the last lifeboats. When we talk about the 23 former doctor truths, we are talking about a plea for help.
The system is currently designed to maximize billing codes. If a doctor spends "too much" time talking to a grieving widow about her husband's passing, that's "unproductive time." In the eyes of a hospital administrator with an MBA, that doctor is a low performer.
Actionable Steps for the Modern Patient
Don't wait for the system to fix itself. It won't. The incentives are too skewed toward profit. Instead:
- Request your full notes: Use the 21st Century Cures Act. You have a legal right to see your clinical notes immediately. Read them. See if what the doctor wrote matches what they told you.
- Verify the "Standard": If a treatment is denied, ask for the "Clinical Peer Review" report. Demand to know the name and credentials of the person who denied it.
- Find a "Leaver": Look for doctors who have left large hospital systems to start independent practices. They are usually the ones who cared enough to take the financial risk of going solo.
- Prepare a "One-Sheet": Doctors love data, but they hate digging for it. Create a one-page summary of your meds, past surgeries, and your top three goals for the visit. It cuts through the noise.
The 23 former doctor truths aren't just a list. They are a map. They show us where the bodies are buried in the modern healthcare landscape. By understanding the pressures your doctor is under, you can better advocate for yourself. You aren't just a patient; you're a person trying to survive a corporate structure. Act accordingly.