They Let You Go. Here's What to Do First.

Raise your hand if you've been laid off. Or if a physician you know has. Or if you're watching what's happening in healthcare right now and quietly doing the math on your own situation.

This is not a drill. Women physicians are being laid off at a rate that should be making more noise than it is. Not fired. Not choosing to leave. Laid off, as in: the organization looked at a spreadsheet, decided you were too expensive, and handed you a box. No vote, no negotiation, no warning in many cases.

I recently caught up with a former colleague, a sub-specialist, someone who had been at the same organization for fifteen years, excellent at her work, in a specialty with genuinely high demand. She'd just been laid off. The same organization had let go of roughly 70 women physicians the year before, mostly in primary care roles.

Medicine is going through something right now. The business pressures that came out of the pandemic haven't resolved, and someone has decided that the answer is fewer physicians. I have a lot of thoughts about why that's shortsighted. But what I care about more is what happens to you when it lands in your life.

Because here's the thing nobody really prepares you for: being laid off feels different from choosing to leave. And the difference matters more than most people acknowledge.

When you resign, you hold the pen (er, keyboard). You write the first line of the next chapter. When you're laid off, someone else writes it. And even when you can see the financial logic, even when you know it wasn't about your competence, something in your physician brain starts asking: was it something about me?

It wasn't. But you have to do actual work to believe that, not just tell yourself it intellectually.

The instinct, and I completely understand it, is to jump straight into action. Update the CV. Call the recruiter. Figure out the finances. Start planning. That instinct comes from a real place: we are trained to solve problems, and a layoff is a problem that needs solving.

But if you skip straight to logistics without first doing something with what you're actually feeling, you will make those decisions from that emotional place anyway. You'll just be less aware of it. The anger, the fear, the shame that maybe sneaks in even when you know better, the relief that you might not be letting yourself admit to because it feels like the wrong reaction: all of that will be running the show whether you acknowledge it or not.

There's also something I want to name that I think is undertalked: complicated grief. This comes up especially when the layoff lands on top of a situation you were already half-ready to leave. Maybe you'd been unhappy for a while. Maybe you'd been thinking about making a change. And then the decision got made for you, and now your feelings are a tangle of hurt and relief and anger and maybe even something that looks like excitement, and it's hard to know what to do with all of that at once.

You don't have to sort it out immediately. You do have to let it out before you make big decisions.

The first step isn't finding the next job. It's figuring out what's actually going on inside before you build the next thing on top of it.

If you're in this place right now, or watching it happen to someone you love, or just feeling the low hum of anxiety about what's coming in healthcare, this episode is for you. And if you want support actually working through it, I'd love to connect. You can join my email list at healthierforgood.com for weekly messages made for physicians like you. Because you deserve more than someone handing you a job posting and wishing you luck.