When I walked into my last doctor’s appointment, I had to do a double take. The physician who entered the room looked like a teenager.
I don’t mean that in a dismissive way — she was just unmistakably young. Clear skin, easy smile, an iPad, no clipboard. She introduced herself, apologized for running a few minutes behind, and sat down.
I wasn’t worried about her competence. What caught me off-guard was realizing how quietly medicine has changed.
That moment stuck with me not just as a patient, but as a health care executive. For years, I’ve helped recruit and hire clinicians across roles and care settings. I’ve sat in boardrooms staring at vacancy reports, debated retention bonuses, and listened to senior leaders complain that “the new generation just doesn’t want to work like we did.” Too often, we treat turnover as a pipeline problem, not as evidence of something fundamentally misaligned.
The doctor I saw that day belongs to Generation Z, now entering and graduating from medical schools, nursing programs, public health roles, and health-tech startups in real numbers. They’re arriving in a system already under strain. The Association of American Medical Colleges projects a shortage of up to 86,000 physicians by 2036, even before factoring in early retirement or reduced clinical hours. At the same time, clinician burnout remains stubbornly high, with nearly half of U.S. physicians reporting at least one symptom, according to a 2025 national study led by Stanford Medicine.
The problem is particularly acute in some specialties. For instance, family physicians who experience burnout are far more likely to cut back hours or leave practice altogether, changes that ripple directly into patient access and continuity.
The prevailing story says we simply need more clinicians, and that Gen Z will replace the ones we’ve lost. But that idea is at odds with how leaders actually talk about this generation. We can’t simultaneously count on Gen Z to refill the workforce and dismiss them as too soft for it. If the very people we’re counting on to fill these jobs are hesitating, the question worth asking isn’t what’s wrong with them — it’s what do they see in the job that we’re missing.
Gen Z isn’t refusing the work of medicine. They’re refusing the conditions we’ve attached to it. They expect the system to work as hard for clinicians and patients as clinicians are expected to work for it — and they treat that not as a perk, but as a baseline.
During my visit, my doctor didn’t type while I spoke. She listened. When she did turn to the screen, she angled it toward me and explained how parts of her documentation were automated so she could spend more time in the room. Instead of ending with the familiar “any questions?” she asked which part of getting care had been hardest.
Her approach wasn’t radical. It was simply out-of-step with a system that trained clinicians to move fast, document constantly, and take unfinished work home.
Every generation of clinicians reflects the system it trained under. Some practiced before prior authorization consumed visits. Others adapted to managed care and productivity quotas. Millennials trained alongside electronic health records and learned how quickly documentation could crowd out judgment. Gen Z came of age watching a pandemic overwhelm hospitals, saw clinicians speak openly about moral injury, and watched colleagues leave medicine entirely.
They never experienced the version of medicine that leaders keep promising will return. So, they aren’t interested in preserving it.
Instead, Gen Z gets labeled “soft.” It’s a story corporate leadership tells about this entire generation of workers: too sensitive, too focused on mental health, not enough grit. In medicine, where endurance has long been treated as proof of seriousness, the accusation cuts deeper: not willing to sacrifice, not tough enough for the work.
But medicine doesn’t suffer from a grit shortage. It suffers from misplaced grit.
For decades, the system has demanded toughness in exactly the wrong places, tolerating dysfunctional technology, absorbing endless documentation, and compensating for broken workflows. We framed that endurance as professionalism. Burnout happened because caring was buried under work that never should have been theirs to begin with. Physicians now spend more time in electronic health records than with patients, a burden closely tied to burnout and attrition.
Gen Z is less willing to make peace with that reality. In interviews, they ask questions many organizations aren’t prepared to answer. Why does a physician spend hours managing inbox messages and insurance appeals? Why do nurses quietly patch over gaps created by rigid staffing models? Why is exhaustion praised as commitment?
From an executive seat, I understand the reflex to bristle at these questions. Redesigning workflows, confronting misaligned incentives, or undoing bureaucratic creep is far harder than telling people to toughen up. It’s easier to recruit around burnout than to remove its causes.
But Gen Z doesn’t accept those trade-offs quietly.
Their relationship with technology makes that clear. Younger clinicians are neither dazzled by artificial intelligence nor especially afraid of it. They see it as overdue infrastructure, meant to remove busy-work rather than add surveillance. Large multisite studies show that ambient AI documentation tools reduce documentation time and clinician burnout, not through magic but by returning cognitive space to clinicians.
Telemedicine lands the same way. Gen Z clinicians don’t argue much about whether virtual visits count as “real” medicine. They care whether patients can get seen at all. Telehealth has become a critical access point, with roughly 1 in 4 Medicare patients using telemedicine services in 2024, often to bypass long waits.
This generation also brings expectations shaped by proximity to inequity. Medical and nursing schools have slowly opened to a broader range of students — more first-generation trainees and more clinicians from communities medicine has historically underserved — who arrive with firsthand experience of the system’s failures. Many grew up watching family members struggle with insurance gaps, rushed visits, or care that felt transactional. They’re less persuaded by explanations that blame individuals and more willing to point to system design, a perspective that can unsettle leadership cultures accustomed to control rather than critique.
All of this puts Gen Z on a collision course with institutions still built around older assumptions: that suffering proves seriousness, that questioning systems undermines authority, that the job should hurt if it matters.
But trying to toughen clinicians is how we got here.
As my appointment ended, the doctor summarized the plan and told me to message her if questions came up. “You shouldn’t have to chase your care,” she said.
That didn’t sound naive. It sounded like clarity.
Gen Z isn’t here to save medicine by being tougher. They may save it by forcing leadership to confront what it has long avoided. American health care doesn’t need harder clinicians nearly as much as it needs to stop grinding them down. If that insistence makes leaders uncomfortable, it may be because it lands close to the truth.
Frantz M. Berthaud, M.P.H., is the senior vice president of oncology services at University Medical Center of El Paso, an adjunct assistant professor at the UT Health Houston School of Public Health and University of Texas at El Paso, and a frequent commentator on challenges facing cancer care and the U.S. Health Care system writ large.
