Behind the Scenes: Generational Divides, Physician Unions, and What Practice Owners Really Want - A Special Snack Episode, EP 230
What happens when you put Tracy in the interview seat? In this SNACK episode, Miranda Dorta interviews Tracy about her recent speaking tour across California, where she taught burnout prevention for healthcare providers and earned CME credits for the first time. Tracy spoke with the Santa Clara County Medical Association and Fresno Madera Medical Society—and what she learned from those 200+ healthcare providers is shaping how she thinks about systemic challenges, workplace power, and what practice owners really need.
If you've ever wondered why some physicians leave large systems to start their own practices, or why generational divides are creating friction in healthcare workplaces, this episode offers eye-opening insights. Tracy shares what surprised her most, including a discovery about physician unions that raises important questions about workplace protections and power dynamics in healthcare.
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Key Takeaways
Many practice owners started their practices after burning out in large integrated systems—and they're the ones finding the most work-life harmony
Residents in California can unionize (with protections around work-life balance), but attending physicians cannot
A generational divide is emerging: newer physicians are demanding better work conditions, while seasoned physicians feel both supportive and conflicted
Burnout prevention programs often miss the mark by putting responsibility on individual physicians when burnout is fundamentally a workplace issue
Physicians have more collective power than they realize—if systems can't function without their labor, change becomes possible
Q&A: Your Questions Answered
Why do practice owners seem to handle burnout better than employed physicians? According to Tracy's observations, practice owners who left large systems to start their own practices still work hard, but they have the most ease around creating work-life harmony. The key difference? They're working on their own terms, doing medicine the way they want to do it.
What's the biggest systemic challenge Tracy sees in healthcare burnout? The commodification of healthcare. Tracy explains that large healthcare systems are designed to extract physician labor, and burnout prevention programs that focus on individual resilience miss the point—burnout is a workplace problem that requires workplace solutions, not yoga apps and wellness seminars.
Why can't attending physicians unionize like residents can? In California, residents have unionization protections around work-life balance and fair treatment, much like strong nurse unions. But once physicians transition out of residency, those protections disappear. This creates a power imbalance that contributes to burnout and moral injury.
What did Tracy ask that made a room of employed physicians go silent? She asked: "What would happen if 50% of physicians walked out?" The uncomfortable truth is that without physicians providing the labor, healthcare systems can't function—which means physicians have more collective bargaining power than they realize.
Episode Highlights
Why Tracy said yes to speaking at California medical associations (and what made it meaningful)
The pattern Tracy noticed: practice owners who started practices after burning out in large systems
The generational divide in healthcare: residents demanding better conditions vs. seasoned physicians feeling conflicted
The surprising discovery about physician unions in California
Why burnout prevention puts unfair responsibility on individual physicians
The "moral injury" some physicians feel working within broken systems
Tracy's provocative question about what would happen if physicians walked out
How these speaking experiences are shaping the Thriving Practice Community
The universal truth Tracy keeps learning: humans want dignity, meaningful work, and the ability to care for their families
Memorable Quotes
"These were people who took a break, took a beat and decided, you know what? I want to do things on my terms. I don't want to leave medicine. I want to keep doing what I do. I just want to do it on my terms."
"There's this huge push for physician wellness...but it's still putting the onus on the physician to not get burnt out. But burnout, by definition, is a workplace challenge problem."
"Those systems are designed to extract your labor. And without you there providing the means of extraction, they can't function."
"What would happen if everybody walked out? ...You actually have more power than you believe."
"If you strip back everything else, including politics and the way to get there, and we just talk about what it is that people want, it's the same. ...At the end of the day, there are human beings walking around...having the same kind of experience as the rest of us are."
Tracy's speaking tour revealed something important: the challenges healthcare providers face are systemic, but individual practice owners have more agency than they might realize. Whether you're an employed physician considering your options or a practice owner working to create better conditions for yourself and your team, understanding these broader patterns can help you make strategic decisions about your career and your practice.
Ready to explore what's possible when you work on your own terms? Visit thethrivingpracticecommunity.com to schedule a consultation with Tracy and discover how strategic practice management can help you create the work-life harmony you're seeking.
Is your practice growth-ready? See Where Your Practice Stands: Take our Practice Growth Readiness Assessment
Miranda’s Bio:
Miranda Dorta, B.F.A. (she/her/hers) is the Manager of Operations and PR at Tracy Cherpeski International. A graduate of Savannah College of Art and Design with expertise in writing and creative storytelling, Miranda brings her skills in operations, public relations, and communication strategies to the Thriving Practice community. Based in the City of Oaks, she joined the team in 2021 and has been instrumental in streamlining operations while managing the company's public presence since 2022.
Tracy’s Bio:
Tracy Cherpeski, MBA, MA, CPSC (she/her/hers) is the Founder of Tracy Cherpeski International and Thriving Practice Community. As a Business Consultant and Executive Coach, Tracy helps healthcare practice owners scale their businesses without sacrificing wellbeing. Through strategic planning, leadership development, and mindset mastery, she empowers clients to reclaim their time and reach their potential. Tracy designs and delivers CME-accredited wellness retreats and workshops in partnership with medical associations, bringing burnout prevention and sustainable practice management to physicians nationwide. Based in Chapel Hill, NC, Tracy serves clients worldwide and is the Executive Producer and Host of the Thriving Practice podcast. Her guiding philosophy: Survival is not enough; life is meant to be celebrated.
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