Telling them to ‘be more resilient’ won’t keep physicians in rural Kansas | Opinion
Kansas leads the nation in rural hospitals at immediate risk of closing — 30 of them, more than any other state, according to a recent national analysis. Sixty-one of Kansas’ 105 counties are designated underserved for primary care by the state’s own standard. Rural Kansas needs roughly 83 new primary care physicians every year just to keep pace.
We keep calling this a physician shortage. The more accurate word is exodus. And the language the medical establishment reaches for every time a doctor says she is struggling, the word it uses as both diagnosis and prescription, is making the problem worse.
That word is “resilience.”
I am an ear, nose and throat surgeon. I left clinical medicine in 2025 after five years of residency and three years in my own practice. I heard “resilience” throughout my training, from attendings, program directors and the culture of every hospital I worked in.
We doctors train our bodies to operate for 12 hours without water or bathroom breaks, and it’s called competence. We learn to ignore all bodily cues: suppressing pain, hunger, doubt, exhaustion. Evenings are filled with catching up on patient and medical record documentation, whether at the hospital or in the comfort of our own homes. When we can’t remember why we wanted this job, we’re told any number of versions of the same thing:
“Be more resilient.”
What I know now is that “resilience” in American medicine has quietly become a mechanism for silence. It asks doctors to absorb institutional failures without complaint. It treats suffering as a personal deficit instead of a systemic signal. Two physicians named the real diagnosis in a 2018 STAT essay that has circulated inside hospitals ever since: moral injury. The distress that arises when physicians cannot deliver the care patients deserve because time, documentation and financial pressure won’t let them. Burnout is the symptom. Moral injury is the cause.
The data bears this out locally. Missouri’s primary care physicians report some of the highest rates of burnout in the country, driven not by the patient care they signed up for, but by the documentation and administrative load that has crowded it out. Family medicine, the backbone of rural communities across the nation, sees a burnout rate of 42%.
And the institutional response almost everywhere? Wellness programming and mindfulness apps. Resilience workshops and free water bottles with the hospital logo on them. A 2025 systematic review in BMC Health Services Research found that most physician wellness programs focus on individual-level strategies — meditation, stress management, resilience training — while organizational changes that would actually reduce workload remain rare.
These programs have value. Without structural reform alongside them, they can also make things worse. A physician attends a noon resilience workshop, returns to an inbox of 200 messages, and walks away with the institution’s real message: Her inability to cope is the problem.
Maternity care deserts in nearly half of counties
Kansas’ situation is a case study in what misdirected solutions look like. The state funds the Kansas Bridging Plan, a loan-forgiveness program designed to retain new primary care, OB-GYN and psychiatry physicians in rural counties after residency. KU School of Medicine runs an assured-admissions rural-track pipeline. The training infrastructure exists. And yet Kansas lost obstetric care at 17 rural facilities between 2014 and 2023, and nearly half of Kansas counties now qualify as maternity care deserts — counties without a hospital, birthing center, or any obstetric clinician, per the March of Dimes’ 2024 assessment. The Robert Graham Center projects Kansas will need 247 additional primary care physicians by 2030 just to maintain the status quo.
Kansas can recruit them. Kansas cannot keep them. What awaits them in rural practice is what is unsustainable.
Real accountability looks different. It means examining the documentation requirements that routinely extend physician work into evenings and weekends — time stolen from patients, families and basic recovery. It means asking why primary care remains so undervalued relative to procedural specialties that medical students with six-figure debt rationally opt out of it. It means treating physician retention as a patient access emergency, because that’s what it has become.
When a Kansas county loses its last obstetrician and the local hospital closes its labor and delivery ward, pregnant women in that county begin driving 60-90 minutes to give birth. That is a policy failure that will not be fixed by another wellness app.
I left surgery. I wrote a memoir about what training cost me, and I built a platform because medicine needed voices willing to say the uncomfortable thing — that the system is breaking its own people, and then calling the breakage their failure. The physicians still driving rural Kansas roads to cover shifts at understaffed critical access hospitals are there for one reason only: Their patients have no one else.
That is not resilience. That is something we should be ashamed to rely on.
Frances Mei Hardin is an ear, nose and throat surgeon who left clinical medicine in 2025. She is the author of “Surgeon on the Edge,” creator of Rethinking Residency and the co-founder of the Hippocratic Collective, a physician media company. She is the host of the podcast, “Surgeon, Interrupted.”
This story was originally published May 7, 2026 at 5:06 AM with the headline "Telling them to ‘be more resilient’ won’t keep physicians in rural Kansas | Opinion."