I didn’t want to release this stream of consciousness rant, but Tom made me.

He felt it wasn’t fair for me to talk about moral injury and burnout for others, when I was in denial about it for myself. And I think he was right. So here’s how I feel.

For a deeper dive, please check out the below medimoji show Tom & I did.



What’s up Z-Pack? Hey, I just want to talk the real with y’all. Because here I am and they got a camera, and they’re like, “Say what’s on your mind.” Here’s what’s on my mind. I have been struggling with this shit, you guys. I have to be honest. If we’re actually gonna do anything worth doing, and that’s a thing, there’s all kinds of people that say really nice things about the stuff we’re doing. “And oh, your talk was great and you really “inspired me to do this, and this, and this, and this.”

And there’s a real deep part of me that resonates with that but there’s a part of me that’s just like stop lying to me and I feel like an imposter and I feel like nothing is changing no matter how hard we scream and whatever we do. And the question is like, what are we even trying to do with all this shit? Like I could put videos on YouTube, I could put videos on Facebook, I can do social media, I can spin my wheels posting stuff, but what’s the fucking point? The point is we want this to get better for everybody and I put myself in this, right? Like I have suffered through this fucked up system to the point where you know, just severe suffering, and the other day I did this weird path, right?

I left the bay area in 2012 and I went to Las Vegas to do something crazy. It was the scariest thing I ever did. We started this clinic Turn Table Health, we grew the Z-Pac to like two million people across platforms and then we had to close, and then we did our show, and me and Tom and Logan did all this shit. By any stretch of the imagination it was very successful and yet I felt like there’s something else we need to do. So I said let me come back to the Bay area. My wife wants to go back to Stanford, do her radiology it will be her chance to reconnect with her career. My kids will be in schools here. And I’ll be able to connect with really smart, really amazing people, get them on the show and all that. And I get back here and I’m like this shit is just as empty as in Las Vegas. It’s just as bad. And the other day I actually did this weird thing where I went home to Stanford and did the King bioethics lecture. And it was this packed room and I got a standing ovation. I got to connect with all my old colleagues were there, my old professors were there, Steve Coutre, and all these wonderful mentors that were my mentors when I were there were there and I had this incredible experience and then I had dinner with like the dean of the Stanford Medical School and all these people.

And the next morning I woke up and I felt even more empty. And what is going on? Why? Is it because we’re not really connecting? We’re still not, we can do all these things, and is it all just a veneer when we really knew, we need to do is we need to have a deeper connection with everybody in this tribe that’s actually gonna do something, like actually gonna get up and stand up to these fucksticks that are ruining medicine? I have to sit in sometimes in these meetings with the business leaders of big organizations and I want to fucking stab my eyes out. I just really want to jump out of a window because they’re not necessarily bad people, but they are drinking the Kool-Aid of a bad idea which is medicine is a business with cogs that need to be optimized with providers that need to be controlled and managed and with outcomes that need to be quantified and measured in electronic cash register and that’s the model. And I’m sitting there going, okay, so I’ll speak for your organization, tell me what you want to tell– We want to make sure that the providers aren’t experiencing too much burnout.

Fuck that shit, dude. How about this? Fix a system that is causing them the moral distress and the moral injury that’s burning them out. It’s great that you’re having me come speak. That’s a nice sign and all that. That’s a nice gesture. But it feels ultimately empty. I think that’s what I’m feeling is like I don’t want to be a pawn in this shit, right? That, oh look, we’re doing something so ZDoggMD is involved. He’s a maverick that’s gonna say shit and make the providers think that we care. Fuck that shit. Real change needs to happen, right? Like motherfuckers that we have on the show like Marty Makary who’s like out there talking about price gouging and actually fighting these hospitals that are suing their own patients and bringing light on this stuff. Like those are the people we want to connect with.

That’s the movement we want to be a part of. That’s the noise we want to make. Not this other bullshit, man. Like here I am in this fucking nice house. We remodeled it. We saved money by keeping it. I get up everyday and I’m like, I’m not there’s something I’m not doing. I feel like shit. I feel terrible, right? So, on that note. I don’t even know where this is going. This is stream of consciousness. This is how I feel right now and the truth is when I talk to my wife, are you happy being back? She’s like, “I’ve never been happier. “I’m connecting with my colleagues and my purpose.” That’s what I need to reconnect with through you guys, right? So tell me in the comments, man, how can we do this shit? ‘Cause I’m in this space now where it’s like do we need to go to the next level and that involves burning it all down and rebuilding it. Then maybe that’s what we need to do. But I’m not playing this bullshit game anymore. All right, I don’t know what else to say other than, what else should I say? Yeet. Yeet! Fuck everything, burn it down. Together. ‘Cause it’s about connection. All right guys, we out.

– [Logan] Cut! Synergy.

– [ZDogg] Synergy!