The Physician Identity Trap

You’re at a family gathering and before you know it, one of your parents wants to introduce you to someone who’s there that you haven’t met before. You know exactly what they’re going to say before they say it – “This is my son - he’s a doctor.” As they beam with pride, you realize that there’s really no other way that they would have introduced you. And it’s probably the most common way that you would introduce yourself to someone at a dinner party, or when you’re seated next to a stranger on a plane. It’s become such a core part of your identity that you’ve said it a thousand times before without thinking.

As it turns out, your physician identity is the most successful identity that you’ve ever created. It’s also the most expensive.

There are several forces that combine to create the Physician Identity Trap, which is actually one of the more deeply formed identities compared to almost any other profession:

Duration: Over a decade of training and apprenticeship take place before practicing independently. Very few professional identities take this long to forge.

Sacrifice: All the things that you delayed or gave up along your journey. Relationships, opportunities to socialize, years when you could have been earning, sacrificed sleep, and lack of geographic flexibility.

Meaning: What you do is deeply important and meaningful. It is a calling. You help people at their most vulnerable. Identity built on meaning is stronger than identity built on status.

External Validation: Societal rituals enforce the identity. Graduations, white coat ceremonies, the moments your parents introduce you as “the doctor”.

Community: Your collaborators and colleagues, the peers that have been in the trenches with you, and your social network, all of these reinforce the identity that being a physician is who you are.

This identity is truly a gift in many ways. It gives you a clear sense of purpose and meaning. It gives you direction and fortitude during the hard moments of your practice. It gives you a strong sense of respect in society. It gives you a sense of satisfaction for the skills and knowledge that you’ve earned over many years. And it gives you a clear sense of who you are as a person and as a professional. For many of us, it’s the clearest sense of the self that we’ve ever had.

However, the physician identity trap has its costs. You can have difficulty imagining yourself as anything else, or embracing any role that is outside of the predefined concept. You can cling to it tightly because of all of the aforementioned benefits. Ironically, the very same identity that served you and propelled you during your first 15 years of practice can artificially constrain you for the next 15.

Here’s how this identity trap can manifest:

The identity confirming choice:

Every spare moment somehow gets assigned a medically related task to do. There’s always a patient chart that you could be completing, a medical article that you could be reading, or a PowerPoint presentation you could be updating. You even do this on your days off, evenings, or weekends because that’s what a committed physician does. The identity is hungry, ambitious, and competitive, and will consume your choices and free time. This can also manifest in the physician who accumulates titles, institutional roles, and committee memberships not out of genuine interest, but rather because they confirm the physician identity and ascension up an identity ladder.

The “I’m just a doctor” excuse:

If you’re asked about your views on any subjects that are not directly related to what you do, such as policy, business, AI, or finances, you think, or say out loud, ‘I’m just a doctor’. This disclaimer keeps you safely inside the role.

The pre-emptive rejection:

If someone at a conference mentions to you about a new opportunity such as startup advising or consulting for a healthcare company or writing publicly, you instinctively reject that, thinking to yourself, ‘this isn’t what a physician does’. This dismissal can happen in a few seconds before there is even any genuine consideration.

The frozen mid-career physician:

You have this nagging sense that something more could be out there, but you feel scared about how to start, or feel like it could in some ways be a threat to who you are. So there’s this weird middle ground between persisting in what you’re doing and stagnating, versus jumping onto a different path and losing your identity. Neither option feels quite right.

The pre-retirement panic:

Some physicians’ identities are so deeply tied to being a physician, that the thought of retiring is almost tantamount to losing a large sense of one’s identity. If you’re not a practicing doctor anymore, who are you?

We need to think about the costs of maintaining a rigid professional identity. One cost is lost possibilities - avenues that could have been pursued but that didn’t necessarily neatly fit the physician role get rejected without proper evaluation and consideration. 15 to 20 years of foreclosed opportunities create a much narrower and less interesting professional life than what the physician’s capabilities could have actually allowed. Second, there is identity fragility. If your sense of self is built on one role, anything that threatens that role can feel existential. For example, AI changing radiology workflows feels like a large threat rather than a tactical adjustment. Lastly, there’s this nagging thought that there are unlived versions of yourself. Who could you have been as a builder, as a consultant, as a strategist, as an investor, as a writer, as a founder? These versions of you are possible and exist as untapped

potential but they can get no energy put towards them because of the physician identity trap.

The beautiful structure that you have built around yourself was built brick by brick, year by year, but you don’t see how it confines you, you see it as who you are.

We need to understand, however, that there is a path forward that preserves your identity as a physician but expands upon it instead of replacing it. It’s adding layers to your foundation as a physician. It treats your position as a physician - which is a source of purpose, competence, and pride - as the anchor and not the ceiling, and other identities are built alongside it. Understanding that identity can be architected rather than just inherited, we can trace its evolution through four phases.

The Identity Expansion Model:

Phase 1 - Fused Identity: “I’m a doctor.” The physician and the person are strongly fused, and being a physician is inseparable from one’s sense of self. Many physicians can occupy this phase for years if not decades.

Phase 2 - Permission: I’m a doctor who also happens to be curious about other possibilities. The window to explore different avenues has opened and you start to peek through it.

Phase 3 - Integration: I’m a doctor who also happens to be an advisor, a consultant, a writer, a speaker, or an inventor. You become a physician who has embraced multiple identities and roles. You become a multi-hyphenate and the self becomes plural.

Phase 4 - Architecture: I’ve intentionally designed a career and life that complement each other and are bespoke to me, with my clinical work laying the foundation for the other things I do. Identity becomes something you consciously craft and architect rather than something that you passively propagate through time.

Adding identity layers doesn’t diminish the physician identity. It actually expands upon what the physician identity means and what it can hold, rather than replacing it. The radiologist who also serves as an AI advisor is not a lesser radiologist. She is a radiologist whose identity has expanded to include something more. The internist who advises a healthcare startup is not less of a physician - she is a physician whose clinical experience is now shaping products that even reach patients she will never meet in the clinic.

Ultimately, identity is not something you have, it’s something that you intentionally create and architect.

In the next essay, we’ll dive into the Five Forms of Physician Leverage. These are the tools that underpin identity expansion. This is because expansion is by necessity strategic and not just a psychological reframe.

If this essay resonates with you, let me know which of the trap manifestations hit hardest - the “I’m just a doctor” deflection, the pre-emptive rejection, or something else? Let me know. I’m building this conversation with the physicians who recognize themselves in it.

- Scott F. Cameron, MD

Radiologist. AI implementation leader. Angel investor. MRS Past President. Career architect.