Physicians’ Experiences With Life-Threatening Illness and Return to Work

Key Points

Question

What is the experience of physicians who have a life-threatening illness or medical event and attempt to return to work?

Findings

In this qualitative study of 22 physicians with life-threatening illnesses, participants often reported a clash between their professional and patient identities. Leave policies, the supports offered, and the sensitivity of leadership teams were important factors affecting physicians’ ability to return to work and how they felt about themselves during and after their return.

Meaning

This study’s results suggest that shifting from procedurally focused to more relationship-centered return-to-work policies and interactions may help institutions support and retain physicians who have experienced a life-threatening illness or medical event.

This qualitative study explores the perspectives of physicians who had a life-threatening illness or medical event and attempted to return to work.

Abstract

Importance

There is a paucity of research on the experiences of physicians who attempt to transition back to work after a life-threatening illness or medical event. Given ongoing shortages, support of these physicians can impact workforce sustainability. Understanding the experience of physicians during this time of transition and the support that they need is essential.

Objective

To elucidate the individual experiences of physicians who have had life-threatening illnesses or medical events, including their attempts to return to work and the tensions they encountered.

Design, Setting, and Participants

This qualitative study used narrative inquiry to conduct semistructured interviews with physicians who (1) experienced a life-threatening illness or medical event, (2) were in active clinical practice as a board-certified physician at the time of diagnosis of the illness or medical event, and (3) attempted to transition back to work (successfully or unsuccessfully). Participants were solicited through broad-reaching emails across professional networks, advertisement in institutional newsletters, and posting on institutional advertisement boards. Interviews occurred from October 1, 2024, to May 31, 2025, virtually or in-person, according to participant preference. Data were analyzed using narrative analytic approaches.

Results

Twenty-two physicians participated (age range, 43-77 years; 12 [55%] female). Participants described how their professional and patient identities often clashed. Tensions arising from this clash clustered around 5 thematic categories: loss of authority or control, dismantling the illusion of invincibility, identity questioning and reformation, knowledge as a benefit and a burden, and institutional practices as moderators for returning to work. The leave policies, supports offered, and sensitivity of the leadership teams were key in participants’ abilities to return to work and how they felt about themselves during and after their return.

Conclusions and Relevance

This qualitative study found that physicians with life-threatening illness often experienced clashes in their professional and personal identities. This study’s results suggest that health care institutions should consider shifting from procedural to relationship-centered return-to-work policies and interactions during this critical time of transition to better support and retain physicians in the workforce.

Introduction

Physicians adeptly care for and support patients and families through serious illnesses and injuries. However, physicians may be ill-prepared for dealing with their own serious or life-threatening diseases and medical events. This gap is particularly concerning given that more than 80% of physicians have reported personally having or knowing a colleague who has faced a career-threatening illness.¹ In a single-site study,² up to half of surgeons aged 50 years or older have reported experiencing a serious health condition themselves. When physicians become patients, the experience can profoundly impact their identity, role perception, and approach to clinical practice.^3,4,5 Physicians who experience serious illness often struggle with feelings of vulnerability, loss of control, and shifts in their understanding of what it means to be a patient.^3,4 This physician-to-patient transition challenges physicians, who have trained and practiced within medicine’s traditional culture of invincibility, exposing the personal and professional consequences of serious illness among physicians.

Returning to work after a serious illness may pose unique challenges for physicians. Practicing medicine demands high levels of cognitive, emotional, and technical functioning to uphold professional standards, including ensuring patient safety. Some physicians recovering from illness may face residual physical limitations, uncertainty about their clinical competence, and stigma related to health impairment.⁶ These challenges intersect with concerns about maintaining professional identity and balancing personal recovery with workplace expectations.⁶

Understanding the experience of physician-to-patient transition is critical for several reasons. First, health care systems face ongoing workforce shortages^7,8; supporting physicians’ return to practice has direct implications for workforce sustainability. Second, support of physician health and well-being is associated with care quality and system functioning.^6,9 Third, physicians who return after personal illness often report enhanced empathy, improved communication, and deeper appreciation for the patient experience, all of which can improve their physician-patient relationships.³ Given these personal and system-level consequences, this study aimed to explore (1) the perspectives of physicians who experienced a life-threatening illness or medical event and attempted to return to work and (2) the tensions they navigated during their experiences as patients within the context of their professional roles.

Methods

Design

In this qualitative study, we used narrative inquiry¹⁰ because it focuses on participants’ unique experiences and the stories they construct to make meaning of those experiences.^11,12 The research process was structured to ensure data collection and analysis considered 3 common dimensions of narrative inquiry^13,14: temporality (ie, how participants’ experiences evolved over time), sociality (ie, how participants’ experiences evolved across social relationships), and place (ie, how participants’ experiences evolved across physical spaces). This study was deemed exempt by the Children’s Hospital of Philadelphia’s Institutional Review Board because it met the exemption criteria per 45 CFR §46.104(d)2(i) and was conducted in accordance with Standards for Reporting Qualitative Research (SRQR)¹⁵ reporting guideline. Participants provided written and verbal informed consent. Informed consent included permission to record interviews and publish excerpts from interviews (while maintaining participant anonymity and privacy).

Because the narrative inquiry method is founded on interpretivist paradigms,¹² it is important to report how we acknowledged and accounted for our personal experiences and subjective expectations in our study design. Our research team included members with insider, personal experience of the topic (A.E. and S.M.), with experience supporting physicians who negotiate the physician-to-patient transition (J.M.), and with no experience with the topic (K.W., F.J., L.Q., and L.V.). To ensure that the insiders’ experiences did not overly influence the team’s interpretations, we collected their narratives and included them in the dataset, a best practice used to support narrative inquiry.¹⁶ Narratives were transcribed and anonymized before other team members reviewed data, thereby allowing these stories to be treated as equal to other study participants.

Participants

We used broad recruitment strategies and attempted to reach physicians beyond our institution, including sending emails across professional networks. We also advertised the study in our institution’s electronic faculty newsletters and posted on our institution’s digital advertisement boards in common areas, such as elevators and lobbies. Eligible participants were physicians who (1) had experienced a life-threatening illness or medical event, (2) were in active clinical practice as a board-certified physician at the time of diagnosis of the illness or medical event, and (3) had attempted to transition back to work (successfully or unsuccessfully). We purposefully sampled across all eligible participants, aiming for maximum variation¹⁷ to secure participation from physicians who had returned to clinical practice and those who had not, whose illness or medical event had been resolved and those who have ongoing substantial care needs, and those who experienced the serious illness or medical event early in their career and those whose experiences occurred later in their career.

Data Collection

We collected demographic information, including age, sex, race and ethnicity. Race and ethnicity were self-reported by participants; options were defined by the investigator and included American Indian or Alaskan Native, Asian, Black or African American, Native Hawaiian or Other Pacific Islander, White, and other race (any other race as identified by the participant) and Hispanic or non-Hispanic ethnicity. Individual, in-depth interviews were conducted from October 1, 2024, to May 31, 2025, and were held in person or via a videoconferencing platform based on participant preference. Interviews were 60 to 90 minutes long and were audio-recorded with participant permission and transcribed verbatim. The study’s principal investigator (A.E.) conducted 21 interviews using a semistructured interview guide (eMethods in Supplement 1). One of the investigator’s interviews (A.E.) was conducted by another investigator (L.V.) using the same guide. The interview started with the interviewer asking the participant to narrate the story of their experience with a life-threatening illness or medical event, including the nuances and highlights that they deemed important to their story. After the participant narrated their story, the interviewer asked probing questions about specific aspects of their experience (eg, how the institution where they worked affected their experience or how their experience affected their identity as a physician). The interviewers kept field notes and a journal to document contextual details, evolving interpretations, and relational dynamics present during the interviews.

Data Analysis

We followed a holistic narrative analytic approach,¹³ focusing on each participant’s story as a whole to retain its complexity, contextuality, and temporality.^10,13 Each story was synthesized into a small number of interpretations, which were then compared across participant stories.¹³ Each transcript was read to identify the narrative’s storyline, key events, noteworthy challenges, and turning points. This enabled us to restory each narrative (ie, to analyze each narrative to understand the participant’s experiences across time, social relationships, and contexts).¹⁸ We started this process with the first 7 transcripts, with any 2 of the team members analyzing each narrative to ensure agreement of interpretations. During this process, we observed that as participants’ narratives evolved so did their descriptions of professional and patient identity. To further vet this evolution, we created visual story arcs. A story arc is a narrative analysis tool for mapping key events across time within a coherent whole¹⁹ (eFigure in Supplement 1). We followed the Freytag 5-part story arc structure²⁰ for mapping: exposition (ie, prediagnosis descriptions), inciting incident (ie, descriptions relating to diagnosis), rising action (ie, descriptions of experiences after diagnosis to decision moment), climax (ie, description of decision to return to work [or not]), and denouement (ie, description of experiences after that decision). We then conducted restorying and accompanying story arc analyses for the last 15 interviews. In the final phase of analysis, we used the restories and story arcs to examine participant narratives, enabling us to identify similarities and differences between stories as well as identity-related tensions that were narrated in each story. We used NVivo, version 15 (Lumivero) to organize data and support cross-transcript comparisons.

Results

Twenty-two physicians from 8 specialties (pediatrics, internal medicine, family medicine, emergency medicine, physical medicine and rehabilitation, anesthesiology, surgery, and pathology and laboratory medicine) across 16 institutions participated (age range, 43-77 years; 12 [55%] female and 8 [36%] male; 2 [9%] Black or African American, 16 [73%] White, and 2 [9%] other race). Two participants did not provide demographic information. Narrative analysis revealed that experiences of a life-threatening event and decisions to return (or not) to clinical work were framed by shifts in participants’ professional identity. To describe this impact, we first report on how participants described shifts in their identity across the chronologic development of their stories. Second, we report on the tensions these identity shifts created.

Identity Shifts Across Story Chronology

When reporting their stories, participants initially narrated their professional identity. However, as their experiences of a life-threatening illness or medical event evolved, their patient identity emerged.

Exposition: Where Participant Stories Began

When participants began their stories, they universally started by describing their professional identity before the medical event or illness. They shared professional titles, specialty, medical training location, and professional aspirations (Table 1). Some participants described other, nonprofessional identities, including, for example, their status as a parent, athlete, or member of a specific community. However, in their descriptions, their professional identity was always narrated as separate from these other identities.

Table 1. Illustrative Quotations of Professional and Personal Identity Statements at the Beginning of Participant Narratives.

Identity	Illustrative quotation (identifier)
Physician or other professional identity
Professional titles	“I was a partner in a very, very busy private practice.” (Participant 6)
Specialty training	“I’m an emergency physician. As for time frame. I finished residency in [year]. Did a fellowship in [subject matter] at [institution] for 2 years.” (Participant 19)
Training location	“I did my medical school and residency in [city, European country]…then I came to [US hospital] in [year], did 3-year research fellowship in [specialty] and a year clinical fellowship in [specialty] and then joined the faculty in [year].” (Participant 2)
Professional aspirations	“I had risen as far as I was going to rise…I decided it was time to; you know, look elsewhere and see if there were other opportunities.” (Participant 1)
Non–profession-related or personal identity
Parent	“I had 2 children. I had my first before I started [specialty] fellowship. He was 18 months old when I started. And then I had my second about 6 months into my first job as an attending.” (Participant 16)
Athlete	“I am and always was an avid exerciser.” (Participant 11)
Member of a specific community	“I’ve been married for a number of years. My daughter was born in [year]. She was around [age]. My wife’s sister lived nearby. They had kids the same age. We all had built a nice life. Everything was great.” (Participant 19)

Inciting Incident: Diagnosis or Medical Event

The descriptions of receiving a critical diagnosis or of experiencing a major medical event were often narrated with a tone of shock or disbelief. In these descriptions, participants’ patient identities figure in their stories for the first time, weaving into their professional identity descriptions. Participants’ narrations could flip between professional and personal identities in rapid succession, as illustrated by one participant’s recounting of the following:

While I’m at the gym, my doctor called me and said, ‘You’re an [diagnosis] and you’re in [acute crisis]. You have to go immediately to the hospital, and we have a bed for you.’ I was shell shocked…So, I went and got directly admitted. I met my oncologist for the first time who told me that if things went well, I’d be able to go back to work in a year which, like it, was just kind of one shocking thing after another…I thought I was going to work that night. I just grabbed a backpack of stuff and went to the hospital because I thought they would just start me, stabilize me and start me on some chemotherapy and finish up as an outpatient. (Participant 11)

Rising Action: Journey From Diagnosis to Return Decision

These descriptions were often of participants’ experiences as patients; however, participants’ professional identities were frequently voiced, shaping their patient experiences. Participants frequently used their professional identity voice when narrating their patient experience. They listed symptoms, hypothesized diagnoses, described their medical status using medical terms, and reported prognoses with clinical detachment (Table 2). When participants adopted their physician identity to describe their patient status, it frequently echoed case presentations, as if the participant were describing an assigned patient rather than themselves.

Table 2. Illustrative Quotations of How Participants’ Patient Identity Was Shaped by Their Professional Identity as a Physician.

Identity	Illustrative quotation (identifier)
Participant describes their own patient status using their professional voice
Listing their symptoms	“I kept losing weight, so I got really alarmed.” (Participant 2)
Hypothesizing their diagnosis	“I think I’m having a stroke.” (Participant 13)
Describing their status using medical terms	“My [result], which I guess is normally in the sort of 2.4 range, was [value]. Less than 2.2 is cardiogenic shock and less than 2, we worry about whether you can support your organs. I was at [value].” (Participant 10)
Reporting their prognosis with medical detachment	“…and when it happens, it happens and then you know, the point is when it does happen, if disease recurs, there’s not a whole lot of options. So, then I will have to make a conscious decision about how much I want to push, right?” (Participant 2)
Describing themselves as a case presentation	“I hit the [emergency department] as a trauma alert and my hemoglobin, when they put the [intravenous lines] in and I woke up with fluids in me on the ambulance ride, was originally [value]. And in the ensuing hours it’s dropping [value] to [value]. I am in the [surgical intensive care unit], stat pan-scan and labs come back. Bilateral and subdural hematomas. Frontal subdural hematomas. Subarachnoid hemorrhages, heart failure, liver failure, kidney failure. My creatine was [value]. Transaminase is about [value].” (Participant 14)
Social situations call their professional identity forward
Being treated by a learner they recently educated	“It was really awkward for me those days in the hospital. The fellows, the [specialty] fellows that were involved with the attending that ultimately operated on me, were my students. I knew them since they were in medical school.” (Participant 4)
Receiving truncated descriptions of care plan because it was assumed they had the relevant knowledge	“I actually felt more comfortable with some of the physicians’ assistants and the nurse practitioners because I felt like I could be a patient. I didn’t have to be a doctor. I didn’t know the answers because it wasn’t my specialty.” (Participant 5)

Participants’ professional identity was also brought into their patient experiences by the social circumstances surrounding them. One participant-patient described the discomforting experience of being treated by someone who was recently the learner they were teaching. Another lamented being given truncated descriptions of their care plan because their care team assumed, because they were a physician, they had the necessary knowledge. One participant even described their physician identity as problematic and tried to hide their professional training from the care team because “It’s weird to be a patient in the hospital where you are a doctor” (Participant 7).

Climax: Decision About Returning to Work

For several participants, the decision to return to work was determined by clinical outcomes. Some wanted to return to work but could not. These participants often described this situation reluctantly, noting how their professional identity was foundational to them:

I wanted to be productive and being a professional physician is a big part of my identity, and I get a lot of satisfaction from it. I really enjoy teaching and seeing patients. I mean, we had a little fear that I couldn’t do it, but not really. I think I was pretty sure I could do it. It’s hard to articulate, I feel like I had some embarrassment that if I got sick enough that people would ask. (Participant 19)

Several participants articulated returning to work as a need not an option: “They said no one should go back to work for 3 months, some people take 6. I was like, there’s no way I’m staying away” (Participant 10).

Denouement: After the Decision

Once a decision was made to return (or not) to work, some participants adopted a perspective of acceptance. Their illnesses were serious but not identity-shattering (Table 3). For others, their illness experiences and clinical outcomes had them questioning their professional identity. Some even experienced identity crises, often intensified or alleviated by institutional policies and/or communities.

Table 3. Illustrative Quotations of Participants’ Professional Identity After Making a Decision to Return (or Not) to Work.

Identity	Illustrative quotation (identifier)
Illness was serious but did not threaten their professional identity	“If anything, it might have added to who I am. You know, it’s another piece of the puzzle. And again, when someone says describe yourself, I would definitely say that I had [diagnosis]. And again, I wouldn’t hide it. So yes, it’s part of my identity. But again, it doesn’t change who I am. And I still use the same descriptive adjectives at the beginning, and this would be a piece. I don’t think it changed it. Maybe just added to it who I am. I think it’s good sometimes for people to see that you can have a debilitating illness and still go on with your life. I’m not going to say unscathed, as we’re all scathed by what we go through, but it doesn’t limit who you are.” (Participant 6)
Decision not to return to clinical work made them question their professional identity	“I think there is part of me that is like: ‘Am I really a doctor if I am not taking care of patients?’” (Participant 8)
Professional identity crises were moderated by institutional responses	Negative institutional response: “There was even the ask of me to resign from the medical faculty at one point because I wasn’t seeing patients…I’m still completely off put by how much of a burden is put on the individual to figure this out and to be told things like: ‘You’re the only one who’s ever tried to come back from [diagnosis].’ I’m like: ‘That says something about your system.’ I think more physicians would come back and do something if there was a little bit more acceptance.” (Participant 17) Positive institutional response: “My colleagues here were so supportive. They would even do things before I asked them to. Like hey, we thought you might want to rest or something.” (Participant 3)

Overall: Simultaneously Managing Professional and Patient Identities

Participants’ professional and patient identities often clashed. Participants’ physician identity often appeared when diagnosis and treatment decisions were reported, even though they were experiencing those decisions as a patient. For some, becoming patients destabilized their physician identities. These stories revealed that physicians were atypical patients; their experiences as patients were fundamentally shaped by their professional identity.

Tensions Related to Clashing Professional and Patient Identities

Across participant narratives, 5 tensions recurringly emerged as part of their physician-become-patient experiences. Table 4 details these tensions.

Table 4. Illustrative Quotations of Tensions Arising From the Clash of Professional and Personal Identities.

Identity	Illustrative quotations (identifier)
Loss of authority and control	“I think that something that we [physicians] are not—at least I am not—good at asking for help.” (Participant 3) “And maybe it’s worse for us as physicians because we are used to being in control. Knowing what’s going to happen, knowing what we can intervene on, whatever it is. And when it’s you that’s the victim, it is really scary.” (Participant 21)
Dismantling the illusion of invincibility	“...not wanting to be vulnerable…And this was a time where I had to be vulnerable.” (Participant 7) “I was a very good doctor, but I was a very poor patient. I hadn’t seen a doctor in 25 years. And just felt I was bulletproof doing midnights at a level 1 trauma center. That I was cock of the walk as the old expression goes.” (Participant 13)
Identity questioning and reformation	“I mean, my 7-year-old asked me maybe 6 months ago like are you still a doctor if you don’t take care of kids anymore. I was like, oh, that hurts. I think that’s why I clung on to this professor goal of mine, because at least if I achieve that, that’s one of my goals. I had a lot of other goals I had to let go of. At least like this is one, I feel like I can still get to, but yeah, that’s hard. It’s really hard. I love what I do [clinically], and I still do. I almost feel like if there was a change in leadership, there might be an opportunity for me to do something [clinically]. If there’s someone who’s willing to think differently or be creative. But I haven’t had that experience. And so, I had to stop fighting for it.” (Participant 17) “It [illness experience] made me realize that being a doctor is part of my life but it’s not my life. I wish I learned that earlier.” (Participant 18)
Knowledge as a benefit and a burden	“The [type of doctor] said: ‘Have you seen your images?’ And I said: ‘No.’ So, she pulled up the images, and it was just this massive tumor that had eroded down into the [anatomical location]. It was wrapped around my [anatomical location], wrapped around my [anatomical location] and like burrowing into [anatomical location]. It was a pretty large thing. And she said: ‘Well, that’s huge. It’s bled and it’s eroded bone.’ So, then she started rattling off like, I don’t know, 6 or 7 different [diagnoses] that she thought it was. Like there was no alternative to that. And so, I said could this just be a [diagnosis]. She was like: ‘No. Look how aggressive this thing is.’” (Participant 4) “And so my report got released through MyChart the night before she called and it wasn’t supposed to be released. So, I am glad I am a physician as I would have been losing my mind if I didn’t understand what it meant.” (Participant 3)
Institutional policy and support as a moderator of returning to work and identity	“I think the basic human need is to know that you are wanted and valued and that you are contributing. So, I think what the institution can do is to be maximally supportive of finding that place for you.” (Participant 10)

Loss of Authority or Control

Participants were accustomed to being decision-makers who directed care. As patients, they frequently lost that authority, becoming reliant on others to make decisions about their care. They wanted to be the ones taking care of people, not the other way around. This evoked feelings of losing the autonomy they had built their professional identity around.

Dismantling of the Illusion of Invincibility

Participants frequently described that part of their professional identity as a physician involved the perception of being invincible. Experiencing a medical crisis often dismantled or shattered this illusion, leaving participants unmoored from their assumed expectations of normal.

Identity Questioning and Reformation

After a medical crisis and/or serious illness, some participants emerged with greater empathy and insight and reflected on how it allowed them to become an even better physician. Some questioned whether too much of their identity was tied up in being a physician; some realized the need to temper their professional identity with other identities. Some only felt like themselves again once they returned to work.

Knowledge as a Benefit and a Burden

Participants’ medical training and knowledge allowed them to understand their diagnosis, health status, medical care, and prognosis. That same training and knowledge sometimes caused extreme worry or second-guessing of the care being provided to them. For several participants, this made their experiences of severe illness or life-threatening medical event particularly volatile.

Institutional Policy and Support as a Moderator of Returning to Work and Identity

Institutional policy, support, and connections came up often in participants’ stories, especially in their time away from work, decisions to return, and the aftermath, with experiences ranging from very positive to very negative. Leave policies, supports offered, and sensitivity of leadership at the team, division, department, and/or institution level frequently played key roles in participants’ abilities to return to work and how they felt about themselves during and after their return.

Discussion

This qualitative study found the complex, and often invisible, challenges physicians with life-threatening illness face when they become patients. Their narratives highlighted not only the medical and logistical challenges of life-threatening illness but also a deeper identity upheaval that accompanies the erosion of the physician-patient divide. Our findings suggest that when physicians become patients, they inhabit a delicate and unique space in which they are simultaneously positioned as care providers and care seekers, experts and dependents, agentic professionals, and at-risk individuals.

Participants’ stories often contrasted physician and patient identities. Their physician identity—characterized by independence, competence, privacy, ambition, and agency—came into conflict with the patient identity, which was characterized by dependence, public disclosure, relinquishment of control, and a narrowed focus on survival. This dissonance generated psychological discomfort and an existential tension that shaped how participants interpreted their illness, care, and place in the health care system. Being ill destabilized a long-standing professional identity that acted as the foundation and structure of their sense of self and purpose. Participants described a loss of professional distance that had once insulated them from the vulnerability they now experienced as patients. This boundary collapse surfaced the often invisible power differentials embedded in clinical encounters.

Hospital and institutional interactions were central in reinforcing this identity tension. Participants described being called into the patient identity through bureaucratic processes. Simultaneously, they were repeatedly called back into the physician role through assumptions of expertise and competence or being expected to interpret their own test results. These contradictory signals could intensify participants’ state of crisis because some physicians were never allowed to fully occupy either identity. Instead, they were suspended between roles, belonging completely to neither.

This dual positioning created unique feelings of vulnerability. Expectations of medical knowledge sometimes undermined participants’ ability to ask questions, express fear, or seek clarification, whereas institutional accommodations could inadvertently underscore a loss of professional legitimacy. These findings suggest that physician-patients may experience a distinct form of distress rooted not only in illness but also in the fragmentation of identity under competing social expectations.

Our findings carry important implications for health care institutions. When physicians experience life-threatening illness or serious medical events, they are navigating both a health crisis and an identity crisis. Institutional responses that focus solely on logistical or administrative needs (eg, leave policies and scheduling) are necessary but insufficient. Equally critical is recognition of the existential disruption that occurs when a core professional identity is destabilized, even temporarily. Therefore, in facilitating a possible return to work, it is imperative that institutions attend to the emotional, relational, and identity-based dimensions of physician illness.

Institutions can implement evidence-based interventions that address not only clinical reintegration but also the psychosocial challenges associated with illness and returning to practice. Simulation-based return-to-work programs, for example, provide physicians with an opportunity to refresh their clinical knowledge and procedural skills while creating a psychologically safe environment in which they can explore concerns related to professional identity, confidence, vulnerability, and reentry into the clinical workforce.²¹ Equally important is providing education and guidance for department chairs, division chiefs, institutional leaders, and colleagues on how to effectively support physicians throughout their illness and during their transition back to work.

Health care institutions must also recognize the importance of supporting physicians who, because of illness or its sequelae, cannot resume prior clinical responsibilities. For many participants, the possibility of not returning to full clinical practice represented a functional loss and a threat to professional identity, purpose, and belonging. Institutions can mitigate this loss by co-creating alternative pathways for physicians to contribute their skills, knowledge, and expertise in modified or nonclinical roles. These pathways should be framed not as consolation roles or exits from medicine but as legitimate, valued forms of professional contribution.

Our findings suggest that the distress experienced by physician-patients is driven not only by illness but also by a medical culture that equates professional worth with productivity, control, and invincibility. Supporting physicians through serious illness therefore requires a change to the culture to one that acknowledges identity disruption and affirms that needing care or help does not negate professional identity. Similar to findings relating workplace accommodations and retention of physicians with disabilities,^22,23 efforts to support physicians returning to work after life-threatening illness should be complemented by institutional messaging and policies that normalize disclosure, reduce stigma, and foster a culture of psychological safety and inclusion. Although we did not explicitly explore the concept of disability in this study, future studies to examine the role of disability in physicians who experience life-threatening illness and their transition back to work are warranted.

Limitations

This study has several limitations. First, although the sample size is appropriate for qualitative research, it may limit generalizability of the results. However, participants were from several different institutions, specialties, and regions. Second, narratives were retrospective, so results may have been influenced by recall bias. The results do reflect how physicians currently make sense of events, which is central to narrative inquiry. Third, to maintain participant privacy and confidentiality and preserve our focus on shared experiential themes, we did not provide participants’ specific diagnoses. We acknowledge that different illnesses, impairments, or functional limitations may shape return-to-work experiences in distinct ways, representing an important area for future study. Additionally, the study captured only physicians’ perspectives; colleagues or institutional viewpoints were not included and may provide additional insight. This is also an opportunity for future studies.

Conclusions

In this qualitative study, we found that physician illness was not merely a clinical event but also a profound social and identity transition. This study’s results suggest that attending to the practical and existential dimensions is essential for fostering compassionate, sustainable health care systems for those who care for others and, at times, require care themselves.

Supplement 1.

eMethods. Physicians and Severe Illness or Medical Event Interview Guide

eFigure. Application of Freytag’s Five Point Story Arc¹ to Participant Stories

Supplement 2.

Data Sharing Statement