A new term surfacing over the past several years is putting a contemporary spin on a long-term problem within the workforce. The problem is essentially tied to a work ethic. Do workers fully engage with their work and sometimes go beyond what is expected, or do they do the minimum to get by to retain their jobs and get paid? If it is the latter, these workers are among the “quiet quitters.”
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January 2025Quiet quitting was popularized in 2022 via social media outlets as a term describing workers who opt out of doing more than their assigned job duties and who are psychologically less invested in their work. It is often described in generational terms, seen more in younger workers who are approaching work with a different mentality than older generations, and it’s centered on achieving a better work-life balance. It is often considered part of the fallout of the COVID-19 pandemic, which rearranged work life across sectors. Since its loud surfacing, the term has been described and analyzed in countless publications, all of which critique its current usage and links to long-established problems within the workforce (Harvard Business Review. https://hbr.org/2022/09/when-quiet-quitting-is-worse-than-the-real-thing; The New Yorker. https://www.newyorker.com/culture/2022-in-review/the-year-in-quiet-quitting; Forbes.https://www.forbes.com/sites/allbusiness/2022/12/19/quiet-quitting-is-a-sign-of-a-deeper-problem-heres-what-it-means/; The Atlantic. https://www.theatlantic.com/newsletters/archive/2022/09/quiet-quitting-trend-employee-disengagement/671436/magazines).
In healthcare, the term is also making its rounds. Editorials and studies discussing its relevance and what it means for the healthcare profession globally are an easy Google search away, as are diagnoses and solutions to the problem offered by industry experts (MGM Journal of Medical Sciences. doi:10.4103/mgmj.mgmj_42_23; Plast Surg. doi: 10.1177/22925503231208495; Healthcare Executive. https://healthcareexecutive.org/archives/january-february-2023/quiet-quitting; iHire. https://www.ihire.com/resourcecenter/employer/pages/how-to-identify-and-overcome-quiet-quitting-in-healthcare; insight training solutions. https://insighttrainingsolutions.io/a-silent-crisis-strategies-to-combat-quiet-quitting-in-healthcare/; and NurseDash. https://nursedash.com/blog/employees-quiet-quitting-the-effects-on-healthcare-industry/).
Read these articles, and the ideas that keep popping up in connection with quiet quitting are burnout, employee dissatisfaction, low morale, different generational expectations regarding work, management problems, and the list goes on. Distilled from this montage is a contemporary phenomenon rooted in and reflecting a cultural shift in work attitudes and expectations.
For the otolaryngologists who weighed in on this, changes to the cultural ethos of the workplace are a general theme cited as causing quiet quitting. This comes in the form of physical changes to the workplace brought on by COVID-19 and workers now expecting the option of working remotely. It also comes in the form of policy changes impacting the ethos of medicine more broadly, sometimes in unexpected ways, such as federal regulatory changes to resident work obligations via resident duty hours that may unintentionally lead to a “shift work” mentality among young physicians. Other changes may come in the form of loss of autonomy as physicians join employee-run organizations. And still, other forces creating a disincentive to work harder or engage more fully may come from lower reimbursements for delivery of healthcare services.
Loss of Autonomy
Autonomy is one theme that emerged from talking to these otolaryngologists, all of whom hold leadership roles in their respective practices. Douglas Backous, MD, past president of the American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS), cited the lack of autonomy increasingly experienced by physicians and staff as they join employer-run organizations, and hospitals in particular.
“As you get into employer environments, physicians are losing autonomy, staff are losing autonomy, and multiple layers of hierarchy are being created to where problems can’t be solved,” he said. “When autonomy is impacted, you get people coming into work and doing just what they need to do, not coming in early, not staying late.”
When autonomy is impacted, you get people coming into work and doing just what they need to do, not coming in early, not staying late. — Douglas Backous, MD