"Toward the end of my clinical career, I didn't feel like I had control over much at all. The patient safety issues loomed large. We used ridiculous workarounds for broken processes. The constant vigilance to provide excellent care in a suboptimal environment was exhausting. I didn't see anything I could change. Based on my work with physicians as a coach, I think that the sense of powerlessness and being a "cog in a wheel" is now at an all-time high.

While on an uninspiring stretch of road on a recent family trip, a realization came to me: There are many, many system issues over which physicians have little control. But physicians do have control over three things:

How they lead in both formal and informal leadership roles
How effectively they advocate for change
Who they show up as every day"

Diane W. Shannon is an internal medicine physician and physician coach and can be reached at her self-titled site, Diane W. Shannon.

She shares her story and discusses her KevinMD article, "The sense of powerlessness and being a cog in a wheel is now at an all-time high." (https://www.kevinmd.com/blog/2021/06/the-sense-of-powerlessness-and-being-a-cog-in-a-wheel-is-now-at-an-all-time-high.html)

Physicians' sense of powerlessness and being a cog in a wheel